HomeMy WebLinkAbout07-06-15 J 15�561�105
REV-1500 E"`°"°"°'L`�
PH Departmenl of Revenue PennsylvaMa oFFlCinL uSe oH�v
°,'•^",^°••'•• Cow Gode Year FileNumber
BureauoflntlividualTaxes '" ty
ao BOx zeo6oi INHERITANCE TAX RETURN I�J �I/y �
Harrisburo an v�ue-osoa RESIDENT DECEDENT L.� / � ��'
ENTER DECEDENT INFORMATION BELOW
Social Secunly Numbar Date o!Death MM��YYn Date o/Bitlh MMppYYrv
200-36-
SuRix oecetlenPs Fust Name MI
Romito Jr Guy q
QtApplicabla)Enter Suniving Spouse's Informatien Below
Spouse's Lasl Name Sufflx Spouse's First Name M�
Spouse's Social Securiry Number
THIS RE7URN MUST BE FILED IN DUPLICA7E WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� 1.Onginal Retum O 2.Supplemental ReWm O 9. Remaintler ReNm(Dale o�Death
Prlor ro 12-t&82)
O G. Llmltetl Estate O Qa-FUWra Intarest Compromise(tlate ot O S Fetleral Estate Ta�RaWrn Raqwretl
tleatM1 atter 1242�82)
O fi.OeceEent�led Teslate O Z Deceaent Maintained a Llving Tmst 8. Total Number of Sate�eVosit Boxes
(Nl�ach Copy of Wil1J (Atlech Copy otTm51J
O 9.Litigalion Proceetls Recervetl O 10.Spousal PoreM Cretli�(Oa�e oi Death O 1 t Election ro Tax un0er Sec.9113(A�
Between 12-31-91 antl 1-0-95) (AttacM1 SCM1etlule 0)
CORRESPONDENT- TNIS SECiION MOSi BE COMPLETED.ALL LORRESPONUENCE AND CONfIDENiIAL TAX MFORMAiION SHOULO BE OI�E�i0:
Name Dayllme Te�, M1one Numb� � A
m
PeterJ. Russo (717) 59�'1�5 � � o
'' r rn �
REGIBTEgOFWILLSUSEON �
� ��
First Llne of Address ' � ' "� �
� ri
5006 E. Tnndle Road � - �i 3 �
w __
Second Line ofAatlress ' � � .
Suite 203 - 'L �'
c.�
Clty Or POSf OffICB S�at¢ ZIP COtlB DATE FIIED
Mechanicsburg PA 17050
CorraspontlenPa e-mail addnss:prU55o@plflaW.Com
UnUe�penallies ot pepury,I tleclare l�a�I M1ave examinetl t�is reW m,mtluding accompanying uM1etlules antl sla�emenls,and�o t�e�est ol my knowletlge and peliel.
tlsWa.con0cla Oacla�aLonolpreparero��erNanl�epersonalrepre5enteLveisbasetlonelllnlorme�lonofwM1lcM1prepererhasanykiwMetlge.
�SIGNATU O PER RESPONSIB�E FOR FlLING RETORN nOHTE
\ /- �_ �
�'�(o t l nv�d�2 �.t1 $IF �� 11� rN'6Y` '1 YSbC�� F�I� 1'�O �27
SIGNqTURE OF PREPHRER OTHER THAN REPRESENTATIVE OATE
AD�RESS
PLEASE USE ORIGINAL FORM ONLV
Sid¢ 1
L 15�56101�5 15�561�1�5 J
�
J 1505610205
aev-�soo ex�Fp
Dacetlenfs Social Securiry Number
oeceaenrsHame� GuyA. Romtio, Jr.
RECAPITULATION
1. Real Es�ale(Schetlule A). . . . . . . . . . . .. . . . . .... ...... . . . . . .. ....... . . . . 1.
2 Stocksantl Bontls(Schedule B) . ... ........ . . . . . . .. ....... . . . ......... 2.
3. Closely Heltl Gorporatlon,Partnership or Sole-Proprielorship(Schetlule C) . . . . . 3.
6. Mortgaqes antl Notes Receivable(ScM1etlule D).... . . . . . ........ .. . . . .. . . . 4.
5. Cash,8ank Deposits antl Miscellaneous Personal Property(Schetlule E). . . . . . . S 4,197.68
6. Jointty Ownetl Property(Schedule F) O Sapaate Billing Requestetl . .. . ... 6. 55,572.50
Z InterVivos Trenslers 8 Miscellaneous NomPmbate Pmpeny
(Schetlule G) O Separete Billing Requeste0........ �.
e. Total Gross Asaets(total Lines 1 �hrougn]�. ....... .. . . . . . . ....... . .. . . . e. 59,770.18
9. Poneral ExOenses and Atlministralive Cos�s(Schetlule H). ....... . . . . . . ..... 9. 12,810.00
10. Debls of�ecetlent, Mortgage Oabllities antl Llens(Schetlule I). .. ....... ... . . 10. 171,012.02
n. iotai Detluctions potal Gnes 9 and io�. . . . ............ . . . ....... ... . .. . 11. 183,822.02
12. Net Valua oi Esta�e(Gne e miws�ine ii) . . . . . . . .. . . ...... . . . . . . . ...... 12. -124,051.84
13. Charitable and Gevemmental BequastslSec 9113 Tmsls tor which
an election lo[ax M1as not been matle(Sche�ule J) ....... . . . . . . .... ... . . . . 13.
16. Net Value Subjact to Taz(Line 12 minus Line 13) . . . .. ....... . . . ........ 14. -124,051.84
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14�axable
al iha spousal tax rele,or
Vansfers untle�Sea 9116
(a)112)X_0_ 15.
16. Amount of Llne 14 taxable
atlineaira�e x.o� -124,051.84 �g 0.00
1]. Amounto(Linetataxable
a�siblingrata X.12 ��
iB. AmounlotLineM�axable
� atwllateralrale X.15 �g
19. TA%DUE . . ..... . . . . . . . . . . . ....... . . .. . . . . . . . . 19. 0.00
20. FILL IN THE OVAL IF YOU ARE REOUESTING A REFUND OF AN OVERPAVMENT p
Side 2
L 15�5610205 15056Y0205 J
ftEV-0500 E%�Fl) Page 9 File NumOai
DecedenYs Complete Address:
DECEOENT'S NAME
Guy A. Romita, Jr.
STREETAODRESS .. .. . — .... .._. . . .——.. —.—. . ..
625 Woodlantl Ave
�CIN -. —.. STATE !, ZIP
Mout Hilly Springs PA � 17065
Tax Payments and Credits:
1. Tex�ue(Page2,One19) (1) 0.00
2 GreditslPaymenls
A.PriarPaymenls _ __
B.�iscount
� Ta�elCretlits�A+BJ (2)
3. In�eres�
4. If Line 2 is grealerthan Line 1 �Line 3,enler ihe diHerence. This is ihe OVERPAYMENT. (3)
Fill in oval on Page 2,Line 2010 reques�a refuntl. (q�
5. If Line 1 .line 31s greaterihan Llne 2,enter�he dlRerence-Thls Is ihe TAX DUE. (5) 0-00
Make check payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROVRIATE BLOCKS
1. Did dece0ant make a transler and: Ves No
a. re�aintheuseorincomeo(�hepropertytransferreG.......... ........... ....._. ....._. � �
b. relain ihe rght lo designate who shall use the property transferred or its incnme ......_..._..............._..._...... ❑ �
c. relain a reversionary interest ............. .......__ __..._ .......... ._...... ❑ �
d. receive ihe promise for life ot ei�her paymenis,6enefils or care� _...... ._......... _......... ❑ �
2. If death occurred after Dec.12,1982,did decedent irensfer propeM1y within one yearof tlealh
wi�hoNreceivingadequa�econsiderationl .,_..... ............. .. � �
........ .............
3. �iddece0entownan"inWsi(or"orpayable-upondea�hbankacwuntorsecurityalhisorherdeath?_...._._. ❑ �
4. �id decetlen�own an intlividual retirement account,annui�y or o�her nonqmba�e pmpetly,which
contains a bereficiary tlesignahon? _...... _ . ,,, � �
......... ....._.. _..._... ....,...
IF THE ANSWER TO ANY OF THE ABOVE pUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994,and before Jan. 1, 1995,ihe tax rale imposed on�he net value of iransfers to or forihe use o�the surviving spouse
�s a percem��2 Ps§s�is�e)(t�)1�➢�
For dates o(death on or after Jan. 1, 1995, the tax rate imposed on the ne� value of iransfers to or for the use ot the surviving spouse is 0 percenl
[72 flS.§9118(a)(1.1)(ii)].The slaWte does nol exempt a Irenster�o a surviving spouse Gom tax,and ihe staWtory requirements tor dlsclosure of assets and
Flling a tax retum are still applicable even if the surviving spouse is the only beneficiary
For dates of death on or afler July 1,2000:
• The�ax ra�e imposed on ihe ne�value of transfers from a tleceased child 21 years of age or younger at dea�h to or for the use of a naturel parent, an
atlopfive parenl or a stepparen:of Ihe child is 0 percen�[72 PS.§9116�a)(12�J.
• The tax 21e imposed on�he net value of Vansfers lo or for the use of�he tlecetlenCs Ilneal benefclades Is 45 percent,except as notad In p2 P.S.§9116(a)f�)]�
• The kx rate imposed on ihe ne�value of transfers to or(or ihe use of Ihe decatlenfs siblings is 12 percent[72 P5.§9116(e)(1.3)�-A sibling Is ae(ned,
under Seclion 9102,as an individual who has at least one parent in common wiN ihe decedent whether by 61ood or adoption.
� ew-�soeex+coa-.��
� pennsylvania SCNEDULE E
��� oevna�wervrorAeveHUE CASH� BANK DEPOSITS & MISC.
�xnea�rnrvce*aeanuan pERSONALPROPERTV
aesmexr oEceo[rvr
ESTATE OF: FILE NUMBER:
Guy A. Romtio, Jr. 2012-00949
Indutle Ihe proceeds of li[igation anC the da[e[he proceetls were received by Me ertate.
All property jointly owned with tlght ol survivarship muR be tlisclosetl on Schetlule F
ITEM VALUE AT pATE
NUMBER DESCRIPi70N
OF�EaTH
1, Corners�one Federal Credit Union 33.66
y_ 2005CheryCobalt 2,164.00
3, Personal Belongings 2,000.00
TOTAL(Also enter on Line 5, Recapitulation) ¢ 4.197.68
If more space is nee0ed,use additional sheets of paper o(the same siie.
2005 Chevrolet Cobalt Scdan 4D Tradc In VaLues - Kelleq Blue Rook � Page 1 of 2
4" �',zircooe�.nou I s�g�'��io�s�g�uor
Home I Car Values � Cars for Sale I Car Reviews I Awards b Top lOs I Research Tools
� .: POPularatNBB.com
Mltlshe SNen 9uyers GulOe
� « �
„ome>ca,vawg>cne.wee>com¢> zoos��eyorv>nNe>oouo�:,seoanno eneVroiet [� eoee¢ �J zoos � co
YourBlueBoolc�Value s�ow�ua�a.A«„o �e.��.�e.��a,
2005 Chevrolet Cobalt
���` sy�.�. xaan so
�
Em[optlpns IGecxspe;5 Mil¢aga: I95000 Cnange Llb �
TnE¢In Getanlnitant Sellroa � �
toa Dealer Cas�Otler Priwh Gany �Pnn[rep>rt �+
� . � i.;�'..� krunoei
�
�at'��. . . zouHw�ae�
Price a New Car s°""'
me�erow.e re.�ewz vnorov °°"ms`�m wnr,�. '."".' .'
52.164 s�.sa�amore.
�.. ..�.r.ew
�^`°°^" � ��"°^�` � I FAULKNERMASERATI (
$PP Whdf yOp SM1OOId pdy
� SellYourCurrentCar
a�m mmio�or nrrms�
\S rcaa�omaroa�ronneer.mm
t � �__..__ viacea�ao (
,� amopona zauma.a,ancn�en
' 393 95
GooEConOition � vmwnuivvervioAv I
�
PNaR�aMValu6vali4brryuramvtM1mupnJ/9/IDIS .bvertiurmt v�MaE9
T26 N�s mh ni luu
FAULNNER MiISEPpTI
TeIIUsAboutThisCar ..u�+NeAu.sE�.� ,oeEs�aE
ow�e�s r�ke yo�aem me zoos coonu vs om or w,¢e yom own re�iew
�o.
Next Steps to Selling Your Car <
�e���vona amsma:arnnemon
n Get an Instant Cash s sea ns
'�� Offer sarcyouroaer �
AurotmEa� fineeeaiersreaoyroe�v virwaweveNrcav
�eaee m ro�r�nr.�way' -
Benchmark Local P'daes seersn�gs
. . r��,a,eaaren:u�am,w�,��. � � a�.�nyv�e.m�a I wr°v'�awrs s:.e<a, •,^•'�n I3
http://www.kbb.com/chevroledc obalU2005-chevro let-cobalt/sedan-4d/?condition=good&ve... 7/2/2015
FEv-i5o9 Exa(o�-vo)
fij?r pennsylvania SCNEDULE F
ey� oFo.a,ME�.o.aE����,
�rvxea�raNcernxarruarv JOINTLY-OWNEDPROPERTY
aesmervr oec[oercr
ESTATE OF: FILE NUMBER:
Guy A. Romito,Jr. 2012-00949
I(an asseF became jointly awnetl within one year of the EecedenPs date o(death,it must be repartetl on Schedule G.
SURVIVING]OINT TENANT(5)NAME(5) ADDRE55 REtATI0N5HIP TO DECEDENT
A� Mary Romito 625 Wootlland Ave, Mount Holty Springs, PA Mother
a.
c.
]OINTLY OWNED PROVERTY:
�a onr. DESCRIPTI�NOFPROPERtt ^,eaF oAi[oFofniH
IRM FO0.101M MA�E IN6UOENNIEOLFINMCITlIN511AR10NPNpBqNNPCC00MNpMBE0.0d5IM11FP DAiEOF�GiX pECE0ENi5 VPWEOF
NUMdER iEAANi ]OIM I�EMIWINGNVMgEd.4IIACN�EE0fOP10INRYMELD0.EALE4FTE VPWEOFASSR NiEPESi pfCE�ENi51MERE5i
1' A' 10130108 E25Wootllan7Ave,Moun�HOltySprings,PA 111,OWA0 50 55,500-00
2. A 10I04/83 SavingsAccoun�25004920036107 fi5.00 50 3250
3. A Ofi/05198 SavingsAccouN25004920107fi19 15.00 50 7.50
4. A 10/04183 SavingsAccoun125004920716602 55.00 50 32.50
TOTAL(Also enter on Line 6, Recapitulation) ; 55,572.50
If more space is needed, use aOGltional shee[s of paper of[he same size.
� ��S�P'b: ���!NoUo�h�l�i���a�
Law Otfices of Peter J. Russo, P.C.
5006 E.Triodle Road,Suitc ]00
Mechanicsburg, PA 17050
Parcel No. 40-30-2fi46-046
DEED
THIS INDEHI'URE,made ihe�day of���(x'�� , 2008.
BETWEE� GUY A. ROMITO aod �fARY E. ROYIITO, his wife, as tenants by the
entirety, where the aforementioned Guy A. Romito having died on June 24, 1998, there6y
vesting full title unto Mary E. Aomito, as CRANTOR, Party of thc First Pan,
A
N
D
MARY F,. ROM17'O and GUY A. ROMITO, JR., }oint tenan�s with nght of
survivorship, as GILANTF.FS, Party of lhe Sccond Part,
WITNESSF:PH that the said Party of the First Part, for and in wnsideration of lhe sum
of ONE DOLLAR AND ZERO CENT9 ($L00) lawful money of the United States of Ameiica,
well and huly paid by lhe said Party of the Second Part ro the said Party of the First Put, at and
before the sealiog and delivery of these presen[s, the receipt whereof is hereby aeknowledged,
have granted, bazgained, sold, alienated, enfeoffed, released, conveyed and confirmed and by
these presen� does granl, bargain, sell, alicn, enfeoff, release, convey and confirm unto �he tiaid
Party of lhe Second Part, Iheir 6cirs and assigns.
ALI.the following described real property si[ua[e in South Middleton I'ownship,
Cumberland County,Pennsylvania, 6ounded a�d descnbed as fbllows:
BEGlt\'NING a[a poin[on thc Sou[hcrn side of Woodland Avenue, said point being at
�he dividing line between I.ols Nos. 74 and 37 in lhe hcrcinafter Plan of Lols, and said poim
being 1581 Cee[ in an Eastedy direction from the Easiem side of Highland Avenue; lhence
South 71 degrees 42 minules Eas[ along Ihc Southem side of said Woodland Avenuc, a dislance
of 76.3 feet to an iron pin a[[he cenler linc of Lot No. 73; thcnce South 00 dcgroes 19 minutes
Wes[along suid cen[er line of Lot No. 73, a dis[ance of 140 feet to an iron pin o�the Northem
line of Lo[No. 67; thence North 70 degrees 37 feet West along the Northem line of Lots Nos. 67
and 68, a distance of 75 feet to an iron pin at the Eastcrn line of Lot To. 36; thence\orih 1
degree West along the Weslem line oC Lots ros. 36, 35, 34 and 33, a distance of 140 feet to a
point on the Southern side of Woodland Arenue, the p'.ace otBEGlT'MNG.
BEING Iats Vos. 74 and the Westem half of Lot No. 73 in the Ptan of Lots known as
"Moun[ain View Addition"; said plan being rccorded vt thc Offce of the Rccorder o£lleeds for
Cumberland Count}'in Plan Book No. 3,page G8. Having thereon erected a bnck dwelling
house.
BEL�`G THE SAMF, PREMISES wYuch Fredenck E. Smith and Ianice L. Smith, his
wife, by deed dated March 75, 1966, and recorded in the Cumberland County Recorder of
Deed's Office in Deed Book X Volume 21 Page 747 on Marc:h 3Q 1966, granted and conveyed
unto Guy A. Romi�o and Mary E. Romitq his wife, where the aForementioncd Guy A. Romito
having dicd on June 24, 1998,thereby vesting full ti[Ic unro Mary F,. Romito.
UNDER AND SUBJECT to conditioi�s, restrictions and easements of prior record
penaining to the premises.
AND TIIE SAID Pariy of the Firs[ Part, for their selves, thein c�irs, executors and
adminis[rators, do by these presents, covenanl, grant and ao ec to and with the said Pariy of the
Second Part, lheir heirs and assigns, that lhey, the said Parly of �he First Part, thein c�irs all
singulaz the hereditaments and premises hereinabove described and granted or mentioned and
intended so [o be, wilh appurtances, unto the said Pariy of �he Second Part, their heirs and
assigns, against [he said Party of[he First Part and their heirs and against all and every other
person or persons whomsoeveq lawfully daiming or to claim the same or any part thcreof, by,
from ur under ihc-�n, then or any of them, shall and will, by these presents, SPECIALLY
N'ARRANT AND DEFEVll.
TIIIS IS A CONVF.YANCE FRONI MOTHER TO SON AND IS
TFTEREFORE EXEMP'C FRO�I TRANSFER TAX.
'fHF. RF.M1IAINDER OF TH15 PACE IS INTERTIONALLY LEHT BLANK
IN WLTNESS WIIEREOF,the said Party of the First Part, have hereunto sct thcir hands
and seals Ihe day and year£rs[above writ[en.
Signed, Sealed and
Delivered in thc Prescncc of
.�t?2(�-P! �7C a0���'lt�t�(7 (SEAL) "�ct�� �, j�a,y�,,�b (SHAL)
WITNESS MARY E. OMITO
STATE OC PEN?iSYLVANIA )
: SS
COUNTY OF CUMBERLAND )
On this, ihe I�c day of �C r���UC�'; 2008 before me, a Notary Public, the
undersigned officer, pe�onatly appeazed MARY E. ROMI'IO, the Grantor, known to me (or
satisfactorily proven) to be the person whose name is subscribed to Ihc within instrument, and
acknowledged that shc cxecuted the same for thc purpose therein contained.
IN WITNESS WHEREOF, I hereunto set my ha��d and Notonal seal
(�. ,.� [ � i � =��k
no[ary Public
My Commissian Cxpires �
��
COMMONN�_ALCY OF pENNSYLVANIh
Notane!Seal
ASNty 3ip�,Nnt�ry PUUIk
HampCen tw�.,Cem)cilarq G unry
M1�Y�m�n�en F:vp:rt�s(k:t 12.2011
Membe�,C6nnsVlvaninqcgp 31 no'NotBrla
CERTIFICATION OF ADDRESS
I hereby certify thc precise residence of the Grantees in the within Deed is:
625 WoodlundAvenue
Mount Holly Springs, PA 17065 _-----_
---�/" >
i / -
\`_ ��
Agent for Granrees
COMMONWF,ALTH OF PENNSYI,VANIA )
; SS
COUNTY OF CUMBERI,AND )
RECORDF.D in [he Ofliw for Recording of Deeds in and for lhe County nf Cumberland
in Inslrument No.
WITNESS my hand and seal of office this day of_ , 2008.
Recurder
I Ceetify This Document To Be
Rewrded in Cumbedand CounTy, PA
PROPERTY ADDRESS:
625 WoodlandAvenuc
Mount Ilolly Springs, PA 17065
ROBERT P. ZIEGLER
RECORDER OF DEEDS ' �
CUMBERLAND COUNTY -- �`.�
� 1 COURTHOUSE SQUARF: �-= � A `-'
i CARLISLE, PA 17013 ;
717-240-6370 7 �I
— � � "_.1, ° €� .�. ; i .
Instrument Number-200835621
Hecorded On 1D/31/200A A[8:48:13 AM "To�al Peges- $
'Insirumcn�Typc-UF;ED
InvoiceNumber-31519 CscrID-MSW
*Grantor- ROMITO,GUY A JR
`Grenlee-ROMITQ MARY E
*Cus[omer-PF,TF,R ROSSO
'FEES
STATE 97RIT xwc go.so CertificationPage
STATE JCS/ACCESS TO $10.00
JUSTICE DO NOT DETACH
RECORDING FEES — $11.50
RECOROER OF DEEDS
PARCEL CERTIFICATION gio.oo This page is now part
eess of this Icgal document.
AFFOf2DABLE NOUSING 511.50
COUNTY ARCHIVES FEE 52.00
ROD ARCNIVES FEE $3.00
SOUTH MIDDLETON SCHOOL $0 .00
DISTRICT
SOVTH MIDDLETON TOWNSHIP 90 .00
TOTAL PAID $48.50
i Certify t6is to be recorded
in Cumberland County PA
. v �7�� ��
J•� �� �a..T� y�^.y't-
� � �. o i ir
�r � . � ReWRDEROF'DL�'EDS
t��
*-Informnlion denoted by nn asterisk may change durinp
the verifiaalion pro<ess end mny nol be retlected un�his page.
���������������������������
p n�s�
C99 Ni¢M1ell Road.Millsbom,DE 199b6 RccorAs Mwageman
Phonc 888-502i349
Pex (3027934-2955
Moy I1.2015
Law OFtices of Peter J Russo
5006 East Trindle Road
Suite 203
Mechanicsburg, PA 17050
Re: Esta[e oE Guy A Romito,Jr
Social Security: 200-36-6823
Date of Death:July 1 l,2012
Dear Sir or Madam:
Per your inquiry oo April 29, 2015,please be advised Ihat at the time of death, Ihe above-named decedent
had on deposit this bank the following:
I. TypeofAccount ��N�
AccounWumber 2500492003670'7
Ownership(Names ofl Guy A Romiro,Jr
Mary E Ramito
OpeningDate 10/04A983
BalanceonDateofDeath $65.00
Acc�ved Incerest $ .pp
Totel $65.00
2. TypeofAcwwt gy�j��
AccountNwnber 25004920107619
Ownership(IJames o� Guy A Romiro,Ir
Mary E Romim
OpeningDate 06/OS/1998
Balance on Da[e ofDea�h $15.00
Accruedlnlerest $ .W
Total $I5.00
3. TypeofAccowt Savings
AccowtNumber 25004920116602
Ownership(Nemes a� Guy A Romim,!r
Mary E Romi[o
Opening Wte 70/0.1/1983
8alance on Dace of Death $55.00
Accruedlnterest a .pp
Total $55.00
For any addi[ional information on the above accounts, including ownership and any changes,closures
and/or reimbursement of Ponds,please call Moun[Holty Springs at 717-486-3038.
We were unable to locare any safe deposit box for[he above mentioned decedent.
This letter dces not include any accou�rts in which the deceased may have been listed as Power of Attomey,
Custodian of Unifortn Transfers,Representative Payee,or Trus[ee under a Written Agcement.
Sincerely,
Tomara Williams
Rewrds Management
REV4511 EXi (OB-l3)
�pennsylvania SCHEDULE H
oeraalmervroFaeveHue FUNERAL EXPENSES AND
1NHER1iANCET"%RE10RN ADMINISTRATIVE COSTS
RESIDEM DECE�ENT
ESTATE OF FILE NUMBER
Guy A. Romito, Jr. 2012-00949
UeceEenPs Eebts mus[be reported on Schedule I.
ITEM
NlIM6ER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1� Hollinger Funeral Home 8 Crematory 12,424.54
B. ADMINISTRATNE COSTS:
1. Personal Representative Commissions:
Name(s)oF Peaonal Representative(s)
SGeet Address
Ci[V _'___. State 21P
Year(s)Commission PaiE:
2. AI[omey Fees
3. Family Exemption�. (If decedenPs aAdress is not(he same as daimant's,at[ach explanation.)
Claimant
Street Address
ciry State_z�v
Rela[ianship of Claimant to Decedent
4. Proba[e Fees: 385.46
5. Acmuntant Fees:
6. Tax Retum Preparer Fees:
].
TOTAL(Also enter on Line 9, Recapitulation) ;
IF more space is neeGeG,use a�ditional shee[s of paper of[he same size.
pl
m ��'.fi'.n .
Hollinger Funeral Home&Crematory, Inc.
Eric L.HoII1nCe�.Supervisor
July 11,2012
Estate of Guy A.Romito
625 Woodland Ave.
Mt.Holly Springs,PA 17065
The Funerel Servlce fir GN�A.Romlto: -
We sincerely appreciate the mnfidence you have placed in us and will continue to assis[you in every way we can,please
feel free to contact us ff you have any questlons in regard to this statement.
THE FOLLOWING IS AN ITEMIZEU SfATEMENTOF THE SERVICES,FACILRIES,AUTOMOTIVE EQUIPMENT,ANO
MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS.
Profeulonal Service
Troditional Services S 5350.00
Merchandlse �
Batesville Newpo(nf Blue 1750.00
Guardlan Concrete� 1250.00
Memorial Package�Register Book,Memorial Folders,
AcknowledgementLards,9ookmarks NoCharge
AT THE TIME FUNERAL ARRANGEMENTS WERE MADE,WE ADVANCED LERTAIN PAYMENTS TO OTHERS AS AN
ACCOMMODATION. THE FOLLOWING IS AN ACCOUNTING FOR THOSE CHARGES.
Cash Advanre -
Grave Opening 700.00
Certifled Copies of[)eath Certiflwte(30@ 56) fip,pp
F�owers 280.90
Sentinel Newspaper 111.64
Minister 125.00
Vaulc Ext2 Charge Cror Sunday 200.00
Cemetery Equipment 350.00
Cemetery Lot � 400.00
Cemetery Marker&Installatlon 2��Q� ��, t
. . . /1 'u-d`
BALANCE S 12424.54
501 NORTH BALTIMORE A��ENUB•MOUNT HOLLY SPRINGS.PENNSYLVANIA �7p55•(]19)48fi-3033• FAX(717)486-3215
wmw.ho111ngeAunerelhome.com
RECEIPT FOR PAYMENT * DUPLICATE *
GLENDA FARNER STRASBAUGH Receipt Date : 8/30/2012
Cumberland County - Register Of Wi11s Receipt Time : 15 : 28 : 46
One Courthouse Square Receipt No . : 1071213
Cariisle, PA 17613
ROMITO GL'Y A JR
Estate File No. : 2012-00949
Paid By Remarks : LAW OFFICES OF PETER S RUSSO
DMB
---- - - -- - ---- - -- - ----— - Receipt Distribution
Fee/Tax Description Payment Amount Payee Name
PSTITION LTRS TEST 45 . 00 CUMBERLAND COUNTY GEVERAL FU
WILL 15 . 00 CUMBERLAND COUNTY GENERAL FJ
SHORT CERTIFICATE 20 . 00 CUMBERLAND COUNTY GENERAL FU
JCS FE6 23 . 50 BUREAU OF RECEIPTS & CNTR M.
AUTOMATION FEE 5 . 00 CUMBERLAND COUNTY GENERAL FU
_ _ _ _ _ _ _
Check# 4572 $108 . 50
Total Received. . . . . . . . . $108 . 50
The Sentinel P�R J.RUSSO,ESQUIRE AD NI/MBER PAGE NO.
na�li�k..om SOO6EASTTRINDLEROAU 440478 10}1
�n�eV m �. � SUITE 203 BILL DATE SALESPERSON
(/!prt/A�'✓� MEGHANICSBURG,PA17050d32] 05115N3 wol(c
�� y�� rt��mm 77�581-7755
START DATE STOP DAiE
05/07N3 OSH5/1J
PDNUM1�ER �1DDESCH ION LUSS lINE3
420618 E%ECUTRI%'S NOTCE LETTERS OF ADMI 10 PIIBLIC NOTCES 30 • 2 cob
PubliwHon Insertlon6 Rate NetAmount GrosaAmaunt
3TMESENTINEL-LEGRL ] LGL 5159.30
TOThL AO CMRRGE 5159.30
�PROOFOFPUBLICATION 01PRF 3].00
3 MOBILE SITE MOB2 52.00
vu.a�a+eaaer Est GuyRomito PAY 7HI3 AMOUN7 $768.30 $201.96•
•AFTER OfJ09H3
7HE SENTINEL
Thank you for ativertising with The Sentinell Deadline for Uo LEE NEWSPAPERS
in-column lagal ads is 4:00 p.m.Rvo business days prior to PO BOX 540
da[e of insertion. For questions,call(717)240-7130. �NNTEftL00IA 5070C-05C0
newmmaw�.nnrW.wm�ene Le9ai
THE SENTINEL
❑ Check# ❑CretlRCerd AENumber <P0/78
rJo LEE NEWSPAPERS ❑ � ❑ �I � � � � Bllling Date OSHSH3
PO BOX 500
WATERLOOIA 507040540 A«�� m AmountDue $ 788.30
�'�'W m
rvemeooa.au�.m $
5ierewre
aieaamWemenmpa,eweio�. T1IESENTINEL .
�yt �a TNE SEMINEL
GF PETER J.RUS50,ES�UIRE do LEE NEWSVAVERS
5008 EAST TRINDLE ROAO PO BO%16I548
SUITE203 CINCINNATOH 45Y7425dB
MECw,rrlcseURG,PA 17050A327 I,I��I�I�I���I�II���I�I��I��I�I�I�I��I��II��I��I��II��I�I���II
215402000000042�478000000000000��02019600000168302
PROOF OF POBLICATION OF NOTICE
IN CUMBERLAND LAW dOURNAL
(Under Act No. 587, approved May 16, 1929), P. L.1784
COdIMONWEALTROFPENNSYLVANIA :
. ss.
COUNTY OF CUMBERLAND .
Lisa Marie Coyne, Esquirc,Editor of the Cumberland Law 7oumal, of the Coun[y and
State aforesaid, being duly sworn, according to law,deposes and says that the Cumberland Law
Iow�nal, a legaf periodical published in the Borough of Cazlisle in the CounTy and State aforesaid,
was eslabtished January 2, 1952, and designa[ed by the local cour[s as the official legal
peiiodical for the publica[ion of all legal notices,and has,since January 2, 1952, been regularly
issued weekly in the said County, and that the printed notice or publication attached hereto is
exacUy Ibe same as was printed in the regular edi[ions and issues of the said Cumbedand Law
7ournal on the following dates,
viz:
Mav 10 Mav 17 and May 24,2013
ACfiant further depose.s that he is au[hocized to veriTy[his sqtemcnt 6y the Cumbecland
Law Journal, a legal periodical of genoral ciroulation, end tk�at he is not interes[ed in the subjcct
matter of[he aforesaid notice or advertisement, and Ihat all allegations in the foregoing
staCements as to Time, plaee and chuacter of publication aze [me.
�- J
�
s MaricCoyne,�Edito
SWORN TO AND SUBSCRIBED before me Ihis
24 dav of Mav 2013
� Notary C��
Ramlto,Ouy A.,Jr.�dec d.
Late of3outh Middlemn To�mship.
Executov Petcr J.Russo,Esqutre,
Imv O(Has of Perer J.Ruaso,P.C.,
5006 L Tcindle Road, Sai[e 203, -�-_^-�
Mechan[ceburg,PA 14050. �'OTARIAL 3EAL
A[mmeys:PctQJ.Russo,Esquue, �ECuP.,iH A COLLNS
Law Odres of Ptta J.Russo,P.C., P!91ary Public
5006 E.T�tllc Road, Suite 2�3, CAfiLISLE GOqCUGH,CUM6ERLANp COOMTY
Mechevtcabvrg,FA 1906D. My Commission EeGlr:s Apr 28,2014
REV�t512 E%t (L242)
,�i pennsylvania SCHEDULE I
TiT oecnarnervroFaevenue DEBTS OF DECEDENT�
wxeuraeiceruanuax MORTGAGE LIABILITIES & LIENS
aesmervr oecEoexr
ESTATE OF PILE NUMBER
Report Eebb IncurreE by[he EeceEen[prior ta Eeath that remained unpaid at the date ot death�InchEing unreimbursed meEical expenxc.
REM VAWE AT DATE
NUMBER DESCRIPTION �F DEATH
�� FIACardServices 6,564.68
2. Bank of America 124,629.82
3 DCMServices-Acct2185 76324
4. DCM Services�Aat 4491 3,237.66
5. Cornerstone FCU Visa Acct 3737 5.001.58
6. Monrae Mufller 92826
7. BureuaofAccouniManagementAatNo.28415795 1,5�252
e. BureauafAccouniManagmentAcctNo.28364027 1,527.32
9. BureauofAccouniManagemen�AwlNo,28374879 1,544.12
10. eureau of Account Managment Acct no. 28287564 60624
1 t Bureau of Aaounl Managment Acd No.28253129 563.30
12. BureauofAccountMangemen�ofAccWo.28203518 3,87078
i3. Penn State Hershey Aat 17337651 57575
14. Penn State Hershey Acct 17338616 42.94
15. Penn Sta�e Hershey Acct 17498678 28.40
16 Penn 5tate Hershey Acct 1180054 362.13
11. Walgreens 30.00
18. VellowBreechsEMS 1,131.00
19. Springlea�Financial Services 6,145.19
20. AIIyBank 148.85
21. CapitalOneAccI6720 2,092.00
22. CapitalOneAct3142 1,466.95
23. Capital One Acct 2089 38275
24. Bureau of Accowt ManagemenL Accl No.28434321 7,796.52
TOTAL(Alsoen[eronLinelO, RecapiNlation) 5 ���.012A2
If more space is neeAeC, Insert aOCiYlonal sheets of the same size.
Capita� ��I Penn Ave South,Suite A650
Minneapolis,MN 55423-5007
_
Toll-Fme 855-2341142 7:00 am-7:00 pm CT([vI-Th) Accowt Numbei *»xx........3142
Fax 877-32G-SG89 7:00 am-5:00 pm CT(� Remw»ng Balance $146G.95
Refeance Numbec 20061259
Fov Ihe Estate of.
GUY
PETER RUSSO ROMITO
500G E TRINDLE RD STE 2 203
MECHe1NIC5BURG PA 17050
Mazch 26, 2014
Deac PETER RUSSO:
The documentation foc the acmunt of GUY ROMITO is eodosed,as you requested. Please mntact us roll-hee at
855-234-1142 if you have any questions.
Thank you foi youc hclp.
Coidially,
Caf�ilalOne E.rtater Care Team
NOTICE: PLEASE SEE NEXT PAGE FOR IMPORTANT INFORMATION—PAGE 1 OF 2-
CI�/-�,,,�, 7601 Penn Ave Sossth,Suire A650
ap• �VI[G MInneapolis,MN 55423-5007
_
Toll-Free 855-2341142 7:00 am-7:00 pm CT(IVI-Th) Account Number +*Rx******<*G720
I^ax 877-32G5689 7:00 am-5:00 pm CT(� Remaining Balance $2092.00
Refe¢nce Numbee 200G1253
Foi the Estare of:
G[lY
ROMITO
PETER RUSSO
SOOG E TRINDLE RD STE 2 203
MECHANICSBURG PA 17050
Mazch 26,2014
Deaz PE1'ER RUSSO:
The documentarioa Eo�the account of GIIY ROMITO is endosed,as you requesred.Please covtact us toll-&ee at
855-2341142 if you have any quesdons.
Thaak you Eor youx help.
Cocdially,
CapilalOne Ertater Care Team
NOTICE: PLEASE SEE NEXT PAGE FOR IMPORTANT INFORMATION—PAGE 1 OF 2-
Capita�- �601 Penn Ave South,Suite A650
Minneapolis,MN 55423-5007
_
ToR-Free 855-234-1142 7:00 am—�:00 pm CT(M-Th) dccount Nwnbet ******��{'**2089
Fax 877-32G5689 7:00 am-5:00 pm CT(f) Remaining Balance $382.75
Refeience Number 20061212
For[he Estare oL
GUY
ROMITO
PETER RUSSO
SOOG E TRINDLE RD STE 2 203
MECFGINICSBURG PA 17050
Mamh 26,2014
Deaz PETER RUSSO:
'f'he documentauon foi the account of GUY ROMITO is endosed,as you iequested.Please mvtact us roll-frcc a[
855-234-1142 if you have any questions.
Thaak you foc your help.
Cocdially,
Capita!One Erlater Care Team
NOTICE: PLEASE SEE NEXT PAGE FOR IMPORTANT INFORMATION—PAGE 1 OF 2-
BBnkofAmerica c°'�""s`^"` s�ao.me�maeanrorzmz
, YO bar 51"IO 1 0l0
� s'�mv�ey,cnsaocrz.s�m AttountNumhe�17967152fl
PmoeMaatlre:s
Home Loans szswooaiananve.
Nome laan overview
PrincipalBalance $124,629.82
002 5886 m aroari^aura narves na�imi Escmw balance -$]2,27
MSfl I]AG 0101-0.3—COWULJ IN 1 PE911
GUY A HOMITO
fi25 Woodland Ave
Maunt Holly Springs PA 17065-1937
III�����lil����hldldh��llr���h�����uilull411�1��l�llhh
. . . . . . . . . . . . . . . . . . . . .
: IMPOPTANTNOTICE
6aok olAmence,NA urvices your heme laen an bahelf al@e holtler oi your no�e�Nadhalder�.This is m ativise you Ihalyour accauntremains zariously
delinquent
H wa do mt hearfrom you immetliatety,we will have no apemative bu[ta take apprapriate acuon to pm[ec��he imerest of Ne Noteholder in Vour properry.ihls
actian may inclutle reWming paymen(s�hat are less fian ihe Total paymen¢due�o bring loan current
Pleese pive Ihis melleryaur mosl urBentavemien.Please send fie amount aue wnh�he coupon below immetliately.Addnionel amoun4 may become past due.
Bank oi America,NA.will pmceed wi�h callecfion action until yaur accoun�is bmuqMfully curren�,and yau will be responsible for a�l cos�incurrea in Nis
pmcess�o ihe full ex�en�permitteE by law.
Please remember Nat fie au[oma0c payment oi your home loan cannot occurif your paymen6 are delinquent If yaur loan is no�bmugM current priorta your next
schetlWetl Dayment debit date,Bank o�America,N.A.will not amome�ically debdyour bank accounno make Vour home loan payment In such ceses,you will
needto send your payment direclNlo Bank of Ame�ice,NA..
Nme�o Oelaware Besiden6:�elaware resitlen6 who are struA9ling wiN iheir morigage paymenta will fintl intormafion on s�a�e-supponed assistance byvisiYng
www.tletaredasurehelD�org.
If you are unable m bring your accoun[curren�,please cantact us at i.&pb69.6654.
Sincaraly,
LOAN SENVICING
Loan Caunselor
.
PaVments and amounts due summary
Currempaymemdueont3�➢120Rxo1fl?92012 _ Toulpeymen�sduetobrinploancurrenK
Principaland/orimerestpayment 5909.96 PrincipalandinterestpaymenRduelpastandcurrent� 53,639.84
Escrowpaymentamount $143.17 Escmwpaymentsdue�pastandcurrenq 5593.08
Paymen�duean17p17/2072 $1,053.13 To�al $q,byyp
LatechargeofS45.50'rfpaymen[receivedaRerl2/172012 7ateloeymentsandamounlsdue
Paymenttpas[due�incl.optprod.asepPlies� $3,119]9
�Pormore'mformauon,DleaseseememnerlmpamMlnlermeronsecoonofmisscahmene Currantpaymenidueonll/OIROIP $7,053.73
Outstandinglate charges $136.50
Fees Due y3p.pp
Tetal 54,399.42
Youcanm�keyourpeyment Iloanrvumber� 179671528 (0� Paymentdue0¢C1,2012 *$1,053.13
GuyAflomiro Ifpaymen[receivedakerDec17,2012 f�,098.63
• Byau[amadcdrahpaymen[usingPayPlan fi15WootllandAve. •y�meuewenai.auee .�aue
• OnlineatWwua.bankotemerica.com Mouncxolry5o���qs,PAV065 "�'V oM�.uimainiW�+.�eatmNe
• Byphone-Cd111800.669.6fi07 " Atlenianal
• AtanyBankofAmericeBankingCemer � �I P�����oal
• BymailusingNeenclosedenvelope BenkofAmerica,N.A.
-Makeyourcheckpayablem PDBOX15R2 Aaainonal
Benka�America,NA. WILMINGTON,�E19886-5PPP Escrmv
�Pleese wrue yaur loan number on ihe
check or monay order Toval amount
-Include�hispeymentcauponwnhyaur '���'�'I�I����'�"1��'I�II����"III�'��I��'I�'�I'�I"�I"'�I����� enciosea
check Ido notstaple your check m ihe '
coupanl 179671528000000105313000109863
-Please Ea notsend cesh or include
mrrespondence
�:58 6 9900 58�: i7967 � 528ii'
����a
BankofAmeriea s�aeeme�ocaeeninrzorz ��q
� A�count Number 179671528
v�ooertvaaere::
NomeLoans siswoomananve.
"— _--_... ..__ _. _—
Payment processing infarmation
PaymennarecansideradrobereceivedbyBank Any�ullperiodicpayment@a[isreceivedand PaAelpeymentpoliry-NPartielpaymen[isa
ofAmarica,NA.whenrecaivedlhroughfie accepteEwillbeapPliedro�helongest paymentlessihanyour/ullperiodicpayment
maansoratNelowtionsdesigna�edintheTou ou6�antlingperiodicpaVmentdue,unless dua. 0epentlingoniherequiremenisafyaurloan
canmakeyourpaymenYsectiononihe(ron[at o�heiwiseexpresslypmhibi[edorlimi[edbyyour documents,Naownedmsureypueren�oro�your
yourremittancecouponoratsuchoNer IoanJocumen6,Neowne�/insurer/guaran�orot IoanorapPlicablelaw,and,depenJinganthe
iocationsasmaybetlesigna[adbyBenkof yourloanorapplicablelaw.Paymen6willbe stawsofVouraccount,paeialpaymentsmaybe
Ameriw,NA. Oyourloanisnoteurrent,basetl appliedasdesenbedinyaurloandacumen4, promO�YreNmedtoyou,apPliedtayouraccaunt
oncenaincontli0ons,suchasbankmptcyor inclutlinganymod"Aicafians�ofieariginal orheldinanominterestbearinqaccoumtora
foredasura,youmeybeunabletomakea documents.lfyourloaniscurrent,pleasespecity perioJaflimeunfilyausentlusatlJitianalPonds
paymantusingoneormoreotthameansor howyouwan�anyeddi�ianelamoun6youpayto suflicien��oeyualehllperiodicpeymen[duaJf
IocationslistedintheNoucanmakayour beappliedmyaureccountlfyouEonotspecily. yourloaniscurrentantlyaurloandacumen�s
paymenYsec�iortFormailedpaymen6,ifyoutlo subleclmyourloanaocumanLs,aEditianal permi�ustoapplypahialpaymenBtoyour
notmailyaurremitlancecouponwiNyom amounlswiilfirs[beappliadtofeesorother account,partialpaymen6willbeapplietlasyau
paymentardono�mailyourpaymen�[othe amounbowedonyouraccoumandfie spectlied,and,ifmlSpacHied,sublactroyour
designatetlpaymen�loca4on,i�maycause remaintlerappliedeseprincipalreduc4onl�we IoandocumenLs,thaywillfrstheappliedmfees
aelaysinMepmcessingofyourpayment areunabletoepplyedtliuonalamoun6toyaur ornNeramaun6owedanyauraccountanethe
PaymentsmaileAwithfieremitlancecouponto accomtasyauspecity,wemayreWmNe�unds remeinderepP�iedeseprincipalreduc�iaal�we
@etlesignatedlocaLonwhicharereceiveEby toyouPos�datedcheckswillbe0mcessetlon araunabletnaOVWPartialpaymen6royourloan
SOOp.m.in�hefimexaneatNedesignated Neaaterecervedunlessanauthorized asyouspecity,wemayream[hapaymentm
paymentloca�ionwillbecredned�oyoureccount re0resenta�iveagrees�ohonorNedatewrmen yaulfyourloenisno�currentandyaurloen
ettectiveonNa�businessday,unlessmherxise onfiecheckasacanditiono�arepaymentplan. documenapermi�usmholdapaNalpaymemin
specifietl on ihe remittence coupon prwidetl.All a nomimerest bearinA accoum,we will do sa
payman4meiledmBankofAmarica,N.N.mus[ Wemeychargeyouafee�afuptaSC0.00�farany untilyousendusadamonaHundssuificienno
bein�heformofecheckormonayarder�drawn paymen�reWmedorrelecteEbyyour(nanciai aQualefullpariodicpaymentdue. l�youdont
inUniteaStatesdallarsandpayablebyaUnireJ ins�iWtion,sublactrofierequiremen6ofyour sendusadtlifianalWntls,sublectmyourloan
Sta�es�inancialinstiwtiononheUnitedS�ates Iaendocumenxandapplicablelaw. InaJtlifioq Dacumen6,wemayapplysomearallafthe
PostalService�madepayableroBankoi iheremaybe�eesforcertainservicesrelatetlm paNalpaymentmamountsowedonyour
America,NA.Certi�etloratherfarmso�paymen[ Neservicingofyourloan,whichsuch�eesare accaun[andreNrnlhebalanceaf�hapayment
mayberequiredi�previouslyadvised. eiNerlis[edonourwebsi�eorwillbequoted �oyou.liyourloanisintlefaultanddeclareddue
upomaquestAlHeesaresubjacuochanga antlpayableoryourloenisin7areNosure,we
Therearebothno-costan0lowws�opfions wiNoutpriornolice. maybeunable�aacceptorapplyOaNal
available ta you 10 make your payment To leam paymen¢and wi0 reWm�hem to you.
moreaetailspleasecallcus�omerservicea� Forellfullmonihpaymentperiads,interes�is
I.BOO.6fi9.660]. calcule�ed on a monthlV hasis.Accordingly,
interesttor all full months,including Febmary,is
calcula�eA as 30/J60 ot annual interest,
irrespective ot�he acWel numbar af days in @e
mamR Por perfiel monNs,interast is calculated
aeily on Ne basis o�a 365 dayyear.
TOtherimpartantinformation
Cmdit paporting Notice:We may repor[information abautyaur accountto credi[hureaus La[e paymen[s,missed paymen[5 or mher defaults on
your account may be reflecred in your creditreporc
Total paymems due to hring loen currenl—The mtal amount in ihis sec9an represemsthe rotal af(i�all periodic principal,interest and escrow�if
applicable�payments now due under your loan documents,inciuding past due payments and�ii�ihe periodic principal,in[erest and escmw(if
applicable�paymen[of the current Paymen[tlue under your loan documems es indica[ed on[his staremenc If you suhmit funds suHicien[ro cover
�his rotal amounL Your loan will be considered curren[wi�h respectro[he periodic principal,in[eres[and escmw(i�applicebiel Vaymems due
underyourloan. Pleasenare.i�youonlysubmitMismtalamounCYoumaysnlloweadditionalamauntsonyouraccount,suchaslatepayment
tees and other fees as well as amounts for any apfional pmductsyou may have elected m receive.H you wan[ro pay those amounts as well,
please include additional�unds. In additian,[he calculation af lhis mtal amaun[daes not include any unapplied funds rela�ed ro your accaunt,i}
applicahle.
Statemem Intarmetion-The information contained in ihis s[atement is accurate as o}the date of this statement hut may not contain all informaVon
relatedroymrloaa Porfiemos[uptodateandcompleteinforma5onregardingyourloan,pleasecontact1.B04.fi69.fifi07.
WSW6UA141
FIA Card Services NA 3/17/2014 L 25 : 13 PM PAGE 2/003 888-294-5658
Previous accountendin :
FIA CARD SERVICES^ 2es3
Newaccountentlln :
ESTATE OF GUV A ROMITO JR asas
C/O ASHLEY MALCOLM
5006 E DRINDLE RD STE 100
MECHANICSBURG PA17050
March 17, 2074
Dear Sir or Madam:
Please accept our condolences on the loss of Guy A Romito Jr.
The previous account listed above has been charged off. As a resul[, for internal processing
purposes onty,a new account number was established. Both oi the above referenced accounts
are closed.
We're writing to inquire about the updated status�or the Estate of Guy A Romito Jr and whether
Wnds are available to pay our claim ot$6,564.68. Please contact us at your earliest opportunity.
Please be advised that we are not attempting to collect this debt from you individual ly.We
are seeking payment from ihe assets of the decedenl's Estate.
If funds are available to pay the claim, please use one o�these convenient payment options
available to you:
- Overnight a payment by express delivery to FIA Card Services, Retail Payment
Services, MS: DE5-023-03-02, 900 Samoset Drive, Newark, DE 79713. Please write
the full new account number on the front of the paymen[
- Mail a paymen[[o RA Card Services, PO Box 15019, Wilmington, DE 19850-5019.
Please wrde ihe full new account number listed above on the front ot the payment
- Make a payment over the phone by calling us toll-free at 1.888.339.6262, 24 hours a
day, seven days a week. Please have a checkbook available when you call
� � JGOl PENN AVE S� fJUtTf/��100
MINNEApOlIS� MINNESOTA SS423-SOOM1
services
Oc[ober 17, 2012
Re: [he Esta[e of Dear Si�or Madam:
GUY ROMITO
On behalf of our client Chase Bank USA N.A., we offer condolences for[he loss of GUY
Our Client: ROMITO, who was a valuetl customer.
Chase eank USA N.A. We are attempting to collect a balance remaining on a cretlit account from [he asse[s of the
estate of GUY ROMITO. This company is a tlebt collector and any informa[ion obtained will be
Account #: used Por that purpose. We are contacting you only in your capaaty as Personal
************2185 Represen[ative or a[torney for the es[ate. We are not holding you personally responsible for
the balance. We are seeking payment from the asse[s of[he decetlent's es[a[e. Please
Reference #: accept this le[ter as a Notice of Claim on behalf of our client.
8488895 You have the right to dispute [he valltlity of this tlebt or any portion of it. We will assume this
debt to be valitl unless you do so within 30 days aRer receipt of this le[ter. If you do so in
Unpaid Balance: wri[ing within tha[time frame, we will obtain verification antl mail It to you. If you send a
$763.24 writ[en request within the same[ime frame, we will provide you with the name antl adtlress
of the origlnal creditor, if different from the current creditor.
Please contact us. You may:
1. Comple[e the paymen[slip below and mail it antl a check made payable to DCM
Services LLC in [he envelope provided. DO NOT SEND CASH.
2. Call us toll-Free at 1-877-326-6766. We have a number of paymen[options available.
3. If you are not the one handling decisions about the outstanding bills of[he estate, fll in
the form at[he bo[tom of the reverse side of[his letter and return it to us in the
envelope provided.
4. Call us with a probate case number antl/or trust information, if applicable.
Respec[fully,
OCM Services, LLC
lam- 9pmCTM-TH
7am - SpmQF
8am- 12pmCT5a
Telephane: 612-243-8620
Tol I-Free: 877-326-6]66
Fax: 87]-326-e]84
NOTICE: SEE REVERSE SIDE FOR IMPOR7ANT INFORMATION -Sitle 1 of 2-
"'Delech Lower Potlion enE Relum wil�VeymenP"
DCM SERVICES, LLC
7601 PENN AVE 5, SUI7E A600 Reference #: 8488895 Qient ID: JPMC11
• MINNEAPOLIS, MN 55423-5004 Unpaid Balance: $763.24
ADDRE55 SERVICE REQUESTED Checks Payable to: DCM Services LLC
�����h���������h�������������������M���u����������������������������������������������������d���������� Amount Endosetl: ��
October 17, 2012
seess.,ne
#BWNJGZF o
� #1651729027079029# DCM Services/Chase
' � The Estate of GIIY ROMITO PO Box 1473
' PETER RIISSo 1linneapolis MN 55440-L473
Sa06 E TRINnLE RD STE 100 STE 2203 I,I�I��I�I��I��I�I��III������II�I��II���I��II�I���I��II�I���II
MECHANICSBURG PA 1705�-3647
8488895 2185 86855-]001d96
�� 7601 PeHn Ave S, Sune A600
MINNEAPOL[S� MINNESOTA SSM1�I3'SOOM1
services
October 17, 2012
Re: the Es[ate of Dear Sir or Madam:
GUY ROMITO
On behalf of our clien[ Chase Bank USA N.A., we offer contlolen<es for the loss oF GUY
Our Client: ROMITO, who was a valued ws[omer.
Chase eank USA N.A. yye are attempting to collect a balance remaining on a cretlit account from the assets of the
estate oF GUY ROMITO. This company is a tlebt collector and any information obtainetl will be
Account #: used for tha[ purpose. We are mntacting you only in your capacity as Personal
************4491 Representative or attorney for the estate. We are no[ holding you personally responsible for
the 6alance. We are seekin9 payment from the assets of the tlecedenPs estare. Please
Reference #: accept this letter as a Notite of Claim on behalf of our client.
8489677 You have the right to dispu[e the valitlity of this debt or any portion of it. We will assume this
debt to be valid unless you tlo so within 30 days after receipt of this le[ter. If you do so in
Unpaitl Balance: writing within tha[[ime frame, we will o6tain verification and mail it to you. If you sentl a
$3237.68 written request within the same time frame, we will provitle you with the name and address
of the original cretli[or, if tlifferent from the current creditor.
Please contact us. You may:
1. Complete the payment slip below and mail it and a check matle payable to DCM
Services LLC in the envelope provided. DO NOT SEND CASH.
2. Call us toll-free at 1-855-234-1135. We have a number of payment op[ions availa6le.
3. If you are not[he one handling decisions about the outstanding bills of the esta[e, fll in
the form at the 6ottom of the reverse sitle of this let[er and re[um it to us in the
envelope provitled.
4. Call us with a probate case number and/or trus[ information, if applicable.
Respectfully,
DCM Services, LLC
] am- 9pmCTM-TH
7am - SpmCTF
eam - 12pmCT5a
Telephone: 612-243-8620
Toll-Free: 855-234-1135
Fax: 877-326-8784
NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION -Sitle 1 of 2-
—oamon�w,m aonion ena aewm w�m aevmam—
DCM SERVICES, LLC
7601 PENN AVE 5, SUI7E A600 Reference #: 8489677 Client ID: JPMC11
a MINNEAPOLiS, MN 55423-5004 Unpaid ealance: $3237.68
ADDRESS SERVICE REQUESTED Chetks Payable to: DCM Services LLC
�0��������������������������d������������������������������������������W��������������������������u������ Amount Endosed: �
Oc[ober ll, 2012
esess-,sn
#BWNJGZF
s < #1651729027079037# DCM Services/Chase
$ � The Es[ate of GUY ROtlITO PO Box 1473
� PETER RIlSSO Minneapolis MN 55440-1473
5006 E TRINDLE RD STE 10� STE 2203 I I I I I I ' I �II II I I' I II I I II I 'I
tlECHANICSBIIRG PA 17050-3647
8499677 4491 BB856]001-12]]
CORNERSiONEFCU . . . �'SA
GUY A ROMITO JR . . � .::. . �.
Account Number:irJflFp-W.F#pCRWk 3737 Statemenl Closing Date:
Movember Ot, 20�2
� Sumlrary oPAceouniflctivity_ � ��Payment Intormat�on
_._ ,.. .::_ ._,. :...� , �:.�.�. .::: _._L ...._:
RFviousBalence � $4,91672� NewBaianre f5,001.SB
Qnclude.iastDueNmountotS739.00p -
Paymen� � � � - . ppp �otal Minimum Paymen�Due E881.58
OIhe�Cretl�ls - 000 (InciutlesPaslDueAmoun�of$129.00)
O�heroebns + �� paymeniDueDate 11136HY
Purchases 0 00
Cash Ndiances ♦ � 000 Late Payment Warning: IF WE�O NOT RECEIVE YOUR
Fees Chaiged . - 15 W MINIMUM PAVMENT BV THE DATE LISTED ABOVE,YOU MAY
Inleres�Char ztl 3?.i36 HAVE TO PAYA LATE FEE UP TO 515.
NEW BALANCE S 5,OU7`.e
Credi;Limu g5,000.00 NinimumAaymentWarning:lfyoumakeonlytheminimumpayment
Cash Limil q 5 ppp op P�=h periotl,you will pay more in inleresl antl it will take you Icnger�o
AvailableGedit p� payotlyourbalance.Forexample:
nvailable Gash 000 � ]f you meke no�. �� 'Vou vnll pay off the � Antl yrou will end up �
Amount Diapuied 000 atlCilwnal chaiges �� balance shwvn on Nis .� paying an estlmatetl �
Statemem Closing Dale I110i1�12 �using Nis cerd and � .sta@menGin aboul tatal o( � .
Oays in BNinq Cysla 37 ¢ach rtwnih you pay._ .�
— � . Onlyiheminimum Iiyear(s) $6,953.00
� � � CoMact InFormalion � � payment
_"'_..: _.--_ _'_,.. :- _____- -_—. :.
l Cuslorner Service:(800�433-0505 163 00 3 years $5,8�1 00
y Reporl Losi or Stoim Car1(]1])249-8]11 � (Savings=§1,082.00)
After Hau.s:(800)931-4961 ———-—--—J.--...- ---'—
If yrou woultl like information aEouf cretltl rounseling services,
,�� P:casn sancf Billing Inquiries and Cmrespondence ro: call(877)277-4932 .
�,r CGST01�!ER£ERVICF_P060�(30495 TAMPA,PL33fi30 ,
� PleasaMaiiYourPaymen[sto:
CORWERS i CNG FF�ERAL CREDIT UNION PO BOX 4519
CAROL STP.Eqh1I160197-Aii9
—'— __ �
� � � � �-Important�News ��� . �
VOUR/.CCOUHT REMAli�15 FNc MONTHS PAST Ol1E PLEASE REMIT THE TOTAI PAYMENT DUE.� � - -
� Transactions
.__ _ �.._ � ...: �-..:_ ::--_ __-_— .�..:_ ._ _
Tran50ate � ac;�oa�e � fdCCCede � Re(erenceNumbef �� Desaiphon Amount
� .Fees���. . . � . . . . . .
�1G116 :O1;6 � W00 : ....7AIIf9922:00W2900f20C9 �IATEfEE � S IS.W .
NOTICE�,COMINUFD ON PAGF.3
Naee t oi ?
PLEAaE0L1ACHL0'J40NANUFEiURNVAYMENI'USINGTHEENCLOSEOENVELOPLALLOWSOqYS(-0HqNlOELNERY VI-'
CORNEF<STONEFCO � A�countNumbe� �
P o eox i t Gt #�M#NNHIF�3737
CARIISLE PA i]013-WG� cnmu mvm'�ne�oa
o�meranaraszcnanye �
eaa onn�:�o���
Tatal MinimUm � AMOUNT OF PAVMENT EMCLOSEO
'ClosingUate� kewBalanre.� PaymentDurDale�
. �.. . . . Paymenl➢ue
� t?!09/t2 .. $5.001.58 . . .$88t58 . . .....�1126/�2 ... �
GUY 4 HO�dITO JR
REGISTER OF WII.LS
#1COURTHOUSESQUARE
CARLISLE, PA 17613
IN RE: ESTATE OF
a0000�
GUY A. ROMITO JR
625 WOODLAND AVE
MOLJNT HOLLY S, PA 17065-1937
File Number.
Division;
DECEASED DATE: 07/11/12
STATEMENT OF CLAIM
The undersigned hereby presents for filing against the above estate this statement of claim and alleges:
1. The basis of the claim is goods and services provided GUY A. ROM1T0 JR and chazged on
account#625431859.
2. The name and address of the claimant is:
Credit First Nafional Associauon
Revolving Charge Account for MONRO MUFF[.ER Customers
BK13/Credi[Operations
PO Box 818011
Cleveland, Ohio 44181-8011
3. The amount of the claim is $928.26 which amount is now due and owing.
4. The claim is not contingent.
5. The claim is not secured.
6. A statement of the accoun[is attached.
Under penal[ies of perjury,I declaze that I have read the foregoing and the facts alleged are true, ro the
bes[of my knowledge and belief.
Exewted this 14th day of Augus[, 2012.
CREDIT FIRST NATIONAL ASSOCIATION REVOLVING CHARGE ACCOUNL FOR
MONRO MUFFLER CUSTOMERS
Claimant
sY: C�o,.,,�./�, D,.�:
�Credit Re esentative
Copy mailed to personal representative
on_i��✓�n„c[a.� {�,�01 .
�—
ma
, > ; , , ,_ .-
� :.; , � � ._.
� ��,,u_ � � .__
i , -�:;� <, _ --
;�.F����.�_. , _ . _
, _-F n "A '_ .`.. r ";E. .��� . .,��� ���u-.i'.:�t i i � � � :: , ., �.. ;,. ;. .
t �,:
,-i'i: 6 _. F 3� . , � . .._ , -. .. ..
..Pi- .i� i. , � : . _ ..� : , � . . .,. �-��;5 _ r �� . ..
. '. i'1-� Uh .l 1 �..:'. � A -• J. _. , .:. t. . �.. . ._ .
�
.... /� i _. _ _ .,._._ . .�.
. 'I' Vt _. -. _,tL.. - i. -.. 1 Yaq . :_
. _ , , . �„ ,� _.,
� . ,. .,,., ..,... �._
. i°i"i p i, � ii:� , . , �... c.... . ._�. _ .
.. ._ _ ._ ._._ .. :.1. � ( i'3pi�i ' . . ..
.l'F U � ...z (�1 :._ . . . _ ..
-M', c / � �_� _,. ' _ _ �. OJ . . . 07 ' - „_
.. . �. , -= i ,._ ., 'ft � � i �.,-
�: ; . '_ ' _ , .� , . 7(} _ . �.�. ._
1._hl i� ' '_ . - _ ' . ..- , iEi_
t _. . . .. - _ ., . .,.. u. . . -.
,_ _ .. , .., . :-.. . . .
_. .
r-.;i ' i� L � ", : , , , _,._ :..
, , �
.. _ . � _-,+-
. f� '� '. - ir . , . , _._ .. � _ i ' ,:. . :.�
,. , ,.: : .. . .� � �. .. ;.
' ?H C�1 i ' � 1�_ � ,3 . ..,. . ,...- -
, : hi'" le, �:, ' i. i , ::.:_ ' '�'. .i�:J v.. .:�- _ _.:
iLF� ' �'.' j. '� .o � . :�� . . -l� . �-i= �. I �� f ;�;' . a'i=. . �-� . . c „_
:n:3�'�. l. / . .. '.- _ , il .`1 . llv-� _
�1�1�1 i , ... _ . . .. .. . ,.. . . . . . �_ ..:
� i . ,,.. � . � .:. . , ., .
�..�1-� �L1/ 1 .1��. l `._ _ , . .�? �l.l—
. i-}'Y 4 C �;' � 1 ,.. _ � . . . . i - n. .. 'lr�
BUREAU OF ACCOUNT MANAGEMENT
� 3607 Rosemont Avenue,Suite 502
PO Box 8875
Camp Hill, PA 17001-SS75
Telephone: 1-717-214-3017 Toll free: 1-800-599-0423
Monday-Thursday 5:30- 8.30 (EST)
Friday 8:30-5:00 (ES'1�
December 19, 2012
— In Re: Your Creditors
— Amount Due : $7796.52
— Guy A Romito Jr Account# :28434321
— 5006 E Trindle Rd Ste 203 Client Ref.# : 17706540-1
— Mechanicsburg,PA 17050-3651 • Please see reverse side for importaut account
information.
Guy A Romito Jr:
Your account has been placed with this office for collectioa This notice has been sent to you by a debt wllection
agency.
Payment in full is being requested to resolve this�ast-due aceount. If payment in full is not received, this
account may be reported as"placed for wllec[ion'wi[h[he credit bureaus.
If you have any quesUons call our office using[he accoun[# as a reference to your file.
Unless you notify this office within 30 days after receiving this notice that you dis ute the validity of this debt or
any portwn[hereof, this office will assume this debt is valid. If you notify this o�ce in writing within 30 days
from receivmg this notice,this office will: obtain verificaUon of the debt or obtain a copy of a judgment and mail
you a copy of such 7udgment or verification. If you request this office in writing wi[hin 30 days after receivmg this
not�ce,th�s off�ce will prov�de you with the name and address of the original creditor,if different from the current
creditor. This is an attempt to collec[a debt by a deb[collector and any information obtained will be used for
that purpose.
Your paymen[should be made direcNy ro this office for prompt credit ro your account A twenry-dollar service
charge will be added to all checks retumed to us by our bank. Should you des�re a receip[, a self addressed,
stamped envelope is required.
Bureau OfAccount Management
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ " _ _ _ _ _ _ _ _ _ _ DetachandRetumwithPaymeub _ _ _ _ " " " _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
� To pay by credit card,please complete the information below:
PO Box 8875 Check one: ❑ Visa ❑ MasterCard
Camp Hill, PA 17001-8875
Card Number.
Return Service Requested
Eacpira[ion Date: / / Paymen[Amount
Signature:
Amount Due : $7796.52 Account# :28434321
Clien[Ref. # : 17706540-1
Amount Enclosed : $
PERSONAL& CONFIDENTIAL
Guy A Romito Jr 28434321
5006 E Trindle Rd Ste 203
Mechanicsburg,PA 170503651 Bureau of Account Management
I���IIL�dIL��JJdI����JI��II���IJ����ILLI��JI��LdI PO Box 8875
Camp Hill, PA 17001-SS75
L�dIL��III��JI������IILdJ��I�L��I�I�I�I��d�Ll���dll
PKTCB01 000715P 1 550 000206 356 076808 Z-CRE
BUREAU OF ACCOUNT MANAGEMENT
� 3607 Rosemon[Avenue, Suite 502
PO Box 8875
Camp Hill, PA 17001-8875
Telephone: l-717-214-3017 Tollfree: 1-800-599-0423
Monday-Thursday 8:30 -8:30(EST)
Friday 830-5:00(EST)
December 6,2012
— [n Re: Your Creditors
— Amount Due : $1572.52
— Guy A Romito Jr Account# : 28415795
5006 E Trindle Rd Ste 203 Client Ref. # : 17498678
— Mechanicsburg, PA 17050-3651 •Please see reverse side For important account
information.
Guy A Romi[o Jr:
Your account has been placed with this office for collecfion. This notice has been sent to you by a debt collection
agency.
Payment in full is being requested to resolve this Qast-due aceounL If paymen[in full is not received, this
account may be reported as "placed for collection'with the credit bureaus.
If you have any questions call our office using the account#as a reference to your&le.
Unless you notify[his of5ce within 30 days after receiving[his notice that you dis�pute the validity of this debt or
any port�on thereof, this office will assume this debt is valid. Ify ou notify th�s otitice in writing within 30 days
from recervmg this notice, [his office will: obtain verification of the debt or obtain a copp of a judgment and mail
you a copy of such judgment or verification. If you reqcest this office in writing within 3U days after receimng this
not�ce,this office wil]prw�de you with the name and address of the original crediror,if different from the current
creditor. This is an attempt to collect a debt by a debt wllector and any informa[ion obtained will be used for
that purpose.
Your paymen[should be made directly ro this office for prompt credit to your account. A twenty-dollar service
charge will be added to all checks returned to us by our bank. Should you desue a receipt,a self-addressed,
stamped envelope is requued.
Bureau Of Account Management
' - - - ' - - - - - - - - - - ' - - - - " " ' " " De[achandReNrnwithPayment' - - - " - - - " " ' - - ' - - - - - - ' - " - -
To pay by credit card,please complete the informa[ion below:
PO Box 8875 Check one: ❑ Visa ❑ Mas[erCard
Camp Hill,PA 17001-8875
Card Number:
Re[urn Service Requested -- ----
Expira[ion Da[e: / / Paymen[Amoun[:
Signature:
Amount Due : $1572.52 Account# :28415795
Client Ref. # : 17498678
Amount EnClosed : $
PERSONAL&CONFIDENTIAL
Guy A Romito 7r 28415795
5006 E Trindle Rd Ste 203
Mechanicsburg,PA 17050-3651 Bureau of Account Management
L�dII��dII����LIdI���idli�Il��J�L��JIdJ��Jl�ilidl PO Boz 8875
Camp Hill, PA 17001-8875
I���III���III���IL�����IILJ�L�I�L�JJ�LL�J�Id����lll
PKTCBO7 002621 P 1 522 000226 341 076808 Z-CRE
BUREAU OF ACCOUNT MANAGEMENT
3607 Rosemont Avenue, Suite 502
PO Box 8875
Camp Hill, PA 17001-8875
Telephone: 1-717-2143017 Toll free: 1-500-599-0423
Monday-Thursday 5:30- 8:30 (EST)
Friday 830 -5:00 (EST)
November 9,2012
— In Re: Your Credi[ors
— Amount Due :$1527.32
Guy A Romito Jr Account# :28364027
— 5006 E Trindle Rd Ste 203 Client Ref. # : 16958746-1
Mechanicsburg,PA 17050-3651 •Please see reverse side For important account
information.
Guy A Romito Jr:
Your account has been placed with this office for collection. This notice has been sent to you by a debt collection
agency.
Payment in full is being requested to resolve this�ast-due account If payme�[in full is not received,this
account may be reported as"placed for collec[ion'with the credit bureaus.
If you have any questions call our office using the account# as a reference to your file.
Unless you notify this office wi[hin 30 days after receiving this notice[ha[you disPute the validity of this debt or
any portwn thereof, this office will assume this debt is valid. If you no[ify this of£ce in writing wrthin 30 days
from recervmg this notice, this office will: obtain verification ot"the debt or obtain a copy of a judgment and mail
you a copy of such judgnen[or verificaaon. If you request[his office in wri[ing within 30 days after receiving this
not�ce, this office will provide you with the name and address of the origi�al crediroy if different from the current
creditoc This is an attemp[ro collect a debt by a debt collector and any information obtained will be used for
that pu�pose.
Your payment should be made direcUy to this office for prompt credit to your.account. A hventy-dollar service
charge will be added ro all checks retumed to us by our bank. Should you desae a receip[, a self addressed,
stamped envelope is required.
Bureau Of Account Management
_ _ _ " _ _ _ _ _ _ _ _ _ _ _ _ _ _ ' _ _ _ _ _ _ _ DetachandRelumwithPayment_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
To pay by credi[card, please complete the information below:
PO Box 8875 Check one: ❑ Visa ❑ Mas[erCard
Camp Hill� PA 17001-8875
Card Number.
Re[um Service Reques[ed Ezpiration Date: / / Payment Amomt:
Signature:
Amount Duc :$1527.32 Account# :25364027
Client Ref. # : 16958746-1
Amount Enclosed : $
PERSOIYAL&CONFIDENTIAL
Guy A Romito Jr 2s364a27
5006 E Trindle Rd S[e 203
Mechanicsburg,PA 17050-3651 Bureau of Acwunt Managemenl
L�iIII�iJIL��iIdJI�����IIiJI��JiL��dLId��JLd�dl PO Box 8875
Camp Hill,PA 17001-8875
I���IIL�dIL��II������III�Jd�Jd���IdJJ���LLL���lll
PKTCB01 000250P 7 4]2 00�272 314 0�6808 Z-CRE
BUREAU OF ACCOUNT MANAGEMENT
� 3607 Rosemont Avenue,Sui[e 502
PO Box 8875
Camp Hill, PA 17001-8875
Telephone: l-717-214-3017 Tollfree: 1-500-599-0423
Monday-Thursday 830- 8:30(EST)
Friday 830- 5:00 (EST)
November 20,2012
— In Re: Your Creditors
— Amount Due : $1544.12
Guy A Romito Jr Account# : 28374879
5006 E Trindle Rd Ste 203 Client Ref. # : 17502180-2
— Mechanicsburg,PA 17050-3651 • Please see reverse side for importan[ account
information.
Guy A Romito Jr:
Your account has been placed wi[h this office for collection. This notice has been sent to you by a debt collection
agency.
Payment in full is being reques[ed to resolve this�ast-due accounL If payment in full is not received,this
account may be reported as"placed for collec[ion'with[he credit bureaus.
If you have any questions call our office using the accoun[# as a reference to your file.
Unless you notify this office within 30 days af[er receiving[his notice that you dispute the validitp of this debt or
any porhon thereof, this ofEce will assume th�s debt is valid. Ify ou notity this ofrlce in writing wrthin 30 days
from recervmg this no[ice,this office will: ob[ain verifica[io�oT Ihe debt or obtain a copy of a judgment and mail
you,a copy of such jud�ent or verification. If you request[his office in writing within 30 days after receivmg this
nohce, this office will provide you with the name and address of the origina]creditoy if different from the curzent
credi[oc This is an attempt ro collect a deb[by a deb[collec[or and any information obtained will be used for
tha[pu�ose.
Your payment should be made direcfly to this office for promp[credit ro your accounL A hvenry-dollar service
charge will be added ro all checks returned to us by our bank. Should you desire a receipt, a self addressed,
stamped emelope is required.
Bureau Of Account Management
" ' _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ " _ _ _ _ DetachandRetwnwithPayment_ _ _ _ _ _ _ _ _ " " " " _ _ _ _ _ _ _ _ _ _
To pay by credit card,please comple[e[he information below:
PO Box 8875 Check one: ❑ Visa ❑ MasterCard
Camp Hill�PA 17001-5875
Card Number:
Return Secvice Requested Expua[ion Da[e: / / Payment AmounC
Signature•
Amount Due :$1544.12 Account# :28374879
Client Ref. # : 17502180-2
Amount Enclosed : $
PERSONAL& CONFIDENTIAL
Guy A Romito Jr 28374879
5006 E Trindle Rd Ste 203
Mechanicsburg,PA 17050-3651 Bureau of Account Management
I���III��JIL��dJJI�����ILJI���LL���IIJJ��JI��I��II PO BoX 8875
Camp Hill,PA 17001-8875
L��III���III���II�����JII��I�I��LI���LIdJ���I�IJ����lll
PKTCBOt 000180P 1 491 000161 324 076808 Z-CRE
BUREAU OF ACCOUNT MANAGEMENT
� . 3607 Rosemont Avenue, Suite 502
PO Box 8875
� Camp Hill, PA 17001-8875
Telephone: 1-717-214-3017 Toll free: 1-800-599-0423
Monday-Thursday 8:30 - 8:30 (FST)
Friday 8:30 -5:00 (EST)
September 6,2012
— In Re: Penn State Hershey Medical Cent
— Amount Due :$606.24
— Guy A Romito 7r Account# :28287564
625 Woodland Ave Client Ref.# : 17335616
— Moun[Holly Springs,PA 17065-1937 •Please see reverse side for important account
information.
Guy A Romito 7r :
Your account has been placed with this office for collection. This notice has been sent to you by a debt collection
agency.
Payment in full is being requested to resolve this Qast-due account. If payment in full is no[received,[his
account may be reported as "placed for collection'with[he credi[bureaus.
If you have any questions call our oHice using the account# as a refere�ce ro your file.
Unless you notify this office within 30 days afrer receiving this notice tha[you dispute the validity of this deb[or
any portwn thereoF, this office will assume this debt is valid. If you notify th�s office in writing wrthm 30 days
fmm receivmg this notice, this office will: obtain verification of the debt or obtain a wpy of a judgment and mail
you a copy of such�udgment or verification. If you request[his office in writing within 3U days after receiving this
❑ohce,this office w�ll provide you with the name and address of[he original crediroy if differen[from the current
creditor. This is an at[emp[to collect a debt by a debt collecror and any information obtained will be used for
[hat purpose.
Your payment should 6e made direcHy to this office for prompt credit to your account A twenty-dollar service
charge will be added to all checks retumed to us by our bank. Should you desue a receipt,a self-addressed,
stamped envelope is required.
Bureau OFAccount Management
' - - - " " - ' - - ' - - - - ' - - - " " ' " ' - DetachandRetumwilhPayment' - - - - " " " " ' - - - - - " " " " -
To pay by credit card,please complete the informatian below:
PO Box 8875 Check one: ❑Visa ❑ Mas[erCard
Camp Hill,PA 17001-SS75
Card Number:
Remrn Secvice Requested
Expiration Date: / / Payment Amomt:
Signature:
Amouut Due :$606.24 Account# : 28287564
Client Ref. # : 17338616
Amount EncloSed : $
PERSONAL&CONFIDENTTAT.
Guy A Romito Jr 2828756a
625 Woodland Ave
Moun[Holly Springs,PA 17065-1937 Bureau of Account Management
Ii�iIII��dIL��JIi��LI���JILI���JLL�d�JddJ��hdl PO Box SS75
Camp Hill, PA 17001-SS75
I���III��JIL�JI������III��LI��LI���LLIJ���IJJ����III
PKTCBOt 002947P 1 352 000395 250 076808 Z-CRE
BUREAU OFACCOUNT MANAGEMENT
� 3607 Rosemont Avenue, Suite 502
PO Box 8875
� Camp Hill, PA 17001-5875
Telephone: 1-717-214-3017 Toll free: 1-800-599-0423
. Monday-Thursday 8:30-830 (EST)
Friday 5:30 -5:00 (EST)
August 13,2012 �
— In Re: Penn Slate Hershey Medical Cent
— Amount Due :$56330
— Guy A Romito Jr Account# :25253129
62S Woodland Ave Client Ref. # : 17197126
Moun[Holly Springs,PA 17065-1937 •Please see reverse side for important account
informa[ion.
Guy A Romito Jr:
Your account has been placed with this office for collec[ion. This no[ice has been sent to you by a debt collection
agency.
Payment in full is being reques[ed[o resolve this�as[-due account If payment in full is not received,this
account may be reported as "placed for collection'with [he credit bureaus.
If you have any questions call our office using the account#as a reference [o your f le.
Unless you notify this office within 30 days after receiviug this notice that you dispute the validity of this debt or
any port�on thereof, this office will assume this debt is valid. If you notify ttus office in writing wrthin 30 days
from recervmg[his aotice, this office will: obtain verifica[ion of the debt or obtain a copy of a judgment and mail
you a copy of such�udgment or verification. If you request this office in writing within 30 days af[er receivmg this
nohce,th�s office w�ll provide you with the name and address of the original creditor,if different from the cunent
creditor. This is an attempt to collect a debt by a debt collector and any information obtained will be used for
that purpose. .
Your payment should be made directty to this office for prompt credit ro your accounL A lwenN-dollar service
charge will be added to all checks returned to us by our bank. Should you desire a receipt,a se1Y addressed,
stamped envelope is required.
Bureau Of Account Management
_ _ _ _ ' _ _ _ _ _ _ _ " _ " " " " _ _ " _ _ _ Detach and ReNrn wi[h Payment_ _ _ ' " " _ _ _ ' _ ' _ _ _ ' _ _ _ _ ' " _ _ ' _
To pay by credit card, please comple[e the information below:
PO Box 8875 Check one: ❑ Visa ❑ MasterCard
Camp Hill,PA 17001-8875
Card Number:
Re[urn Service Requested
Expiration Date: / / Payment Amount:
Signa[ure:
Amount Due : $563.30 Account# : 28253129
Client Ref. # : 17197126
Amount Enclosed : $
PERSONAL& CONFIDENTIAT.
Guy A Romiro Jr 2au312v
625 Woodland Ave
Mount Holly Springs,PA 17065-1937 Bureau of Account Management
I��iIII��iIlli�iJl�iJJ���JIIiI���JI�I�.�I��IJild�iliJl PO Box 8875
Camp Hill�PA 17001-8875
I���IIIuJIL��II�����JII��LLJJ���IJJJ���IJJ���dll
PKTCB01 003225P 7 300 000375 226 0�6808 Z-CRE
• BUREAU OF ACCOUNT MANAGEMENT
� 3607 Rosemont Avenue, Suite 502
PO Box 8875
Camp Hill,PA 17001-8875
Telephone: 1-717-214-3017 Tallfree: l-800-599-0423
Monday-Thursday 5:30- 8:30 (EST)
Friday 830-5:00 (EST)
July 3,2012
— In Re: Penu State Hershey Medical Cent
— Amount Due :$387098
— Guy A Romito Jr Account# :28203518
625 Woodland Ave Client Ref. # : 15472231
— Mount Holly Springs,PA 17065-1937 • Please see reverse side for important account
informa[ion.
Guy A Romito Jr:
Your accoun[has been placed with this office for collectioa This notice has been sent to you by a debt collection
agency.
Payment in full is being requested to resolve this Qast-due account If payment in full is not received,[his
account may be reported as"placed for wllection'with the credit bureaus.
If you have any questions call our office using the account# as a reference to your file.
Unless you no[ify this office within 30 days after receiving[his notice that you dispu[e the validity of this deb[or
any por[�on thereof, [his office will assume this debt is valid. If you no[ify this ofr�ce in wri[ing w�thin 30 days
from recervmg this notice, this office will: obtain verification of the debt or obtain a copy of a judgmen[and mail
you a wpy of such�udgment or verificatioa If you request[his office in writing within 30 days after receivmg this
nohce, th�s office will provide you with the name and address of the original creditor, if different£rom the current
creditor. This is an a[tempt to collec[a debt by a debt collector and any information ob[ained will be used for
[ha[purpose.
Your payment should be made directly to this office for prompt credit to your account. A hvenry-dollar service
charge will be added [o all checks returned to us by our bank. Should you desue a receipt, a self-addressed,
stamped envelope is required.
Bureau Of Account Management
' _ _ _ _ _ " ' _ _ _ _ _ _ _ _ _ _ _ ' _ _ _ _ _ _ DetachandReturnwithPayment_ _ _ _ " _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ' _ _
To pay by credit card,please complete the information below:
PO Box 8875 Check one: ❑ Visa ❑ MasterCard
Camp Hill, PA 17001-8875
Card Number.
Re[urn Service Requested
Expiration Da[e: / / Payment Amoun[:
Signature:
Amount Due : $3870.78 Accounl# :25203518
Client Ref. # : 15472231
Amount Encbsed : $
PERSONAL& CONFIDENTIAL
Guy A Romito 7r 2s2o751s
625 WoodlandAve
Mount Holly Springs,PA 17065-1937 Bureau of Acwunt Management
I�iJlli�dlli��ilL��LI����IILL��JIJ��iLJJ�LLJi�II POBox8875
Camp Hill,PA 17001-8875
I���IIL��IIL��IL����dILJJ��Id���Id�Ll���l�id����lll
PKTCBO7 001227P 1 23200036�16fi 0]6808 Z-CRE
PENNSTarE HERSHe)' " ' ' ' 3rd Statement
Paelof2
�^��lillnn S Henliey
�iNletli��I C'enk:.r � � ' =
vo eo.sa3xei You agreed [o pay on your balance monthly but payments
vi�omyn.aniszsaazsi have been missed. If ywr account is not brought up to
date, your accountwill be tumetl over to an outside
agency.
GUY ROMITO rvomaa
625 WOODLAND AVE
MOUNT HOLLY SPRINGS PA 17065-1937
I���III���III����IL�J�L���III�L��JLI���I��hhI�I��LJI
Patient Name 120MIT0 GUY A �ATE DESCRIPTION AMOUN7
Statement�ale O6/05/12
VSi�NUmber �5q�2Z3� 05/OB/12 PRIORBAtANCE 3870�8
AccouniNumber R1140364 TOTAL 3870.78
New Charges/Adj $0.00
New Payments/Adj $0.00
Acwunt Balance $3,870.78
Amount Pending Insurance $0.00
Agreed Monthly Paymen� $ 125.00
1
This new statement has been specially desi9ned For billing ques[ions or insurance chanees:
wi�h you in mind. Let us knOW W hal olher Para preguntas arerca de su fectura o cambios de seguro con[amos con
improvemenis we ShOuld make. representantes disponibles para asis[ir a la comunidad hispana.
Phona (71l)53L5069ar(800)254-2619
Please e-mail you�ideas to: Availnble Hours:Mondag Tuesday&Wednesday 8:00 am m 530 pm
Statementideas(alhmaosu.edu Thursday&Friday 8:00 am to 4:30 pm
or write to us a�: Written Correspondence:
Penn Sla�e Milton S. Hershey Medical Cen�er Penn State Milwn S.Hershey Medical Center
Statement Ideas, PO Box 854, MC A410 Pa�ient Financiel Smices Department
Hershey, PA 17033 PO Box 854,MC A410
HersM1ey,PA 17033-0854
Please Nole: Ymu•p6��siciaies ivi!!bil/sepnrntely for Uieir professianrd services. „EqsxE.s,-,o
. . _ _....... ._..._. __..... ......... ............ ..._.... ..___.
PENNS7ATE HERSHEY Statemenl Date: O6/OS/12 Patient Name Visrt Numbe� � Da�e Due
�1iYl.ill0[IS.Henbey ROMITOGUV�A 15472231 UponReceipt
�Vleiiic il Center ' � � � . � . . :: � �
A reed Monthl Pa ment Amount Paid
PO Bw643281
PitlsEurgM1,PA152643291 $ �2$.0� � $
� Ii Check he2 iiyour atltlress o�insurenre in/ormeGon has charrgetl.
CHECKSSHOULDBEMADEPAYABLEANO `••� P�easeintlicakchan9esonthebackofMispage.
SENT TO: To pay by cretlit ca�tl: Por your mnvenienca,you may pay by Vsa,
MaslerCartlor�iscoverCard. Pleaseindicateyouroretlitrartl
prekrence,provMe lhe account information,and sign below
MSHERSHEYMEDICALCENTER IJ I�� � f'��J'I 'J �
PO Box 853 Account No.
Hershey,PA 17033-0853
I���III���III�����IL��II�IL��L�L�I�L�JLII���I ExpirationDate CWCode
Signature X
PEi\NSTATE HERSHEY ' ' ' 2nd Statem�nf
L�YGt�nn S. He�l�ey Pa a� o��
� �:fedical Center '
vo so.s<azsi Thank you for your recent payment toward the balance on
v�nsc��yn,vniszsaazsi youraccount. Weappreciateyourcontinuing
commitment lo clear the remaining balance as quickly as
possible. You are responsibie for any amounts not
covered by your insurence carrier. Do not delay taking
care of this matter any longer. Please send your payment
GUY ROMITO JR rvoass� for Ihe full amounL If ycu are interested in a montnly
625 WOODLAND AVE budget olan olease con[act our office.
MOUNT HOLLY SPRINGS PA 17065-1937
L�JII��JII����II���I�I����III�I����IIJ���I��I�Lld��l��ll
PatienlName ROMITOGUYAJR DATE DESCRIPTION AMOUNT
Statement Date 08/25/12
Service Date(s) 04/16/12 0]29H2 "BALANCE FORWARD" 28.40
TypeofService OUTPP.iIENT TOTAL 28.40
Account Number 17498678
New Charges/Adj $0.00
New Payments/Adj $0.00
Accounl Balance $28.40
Amount Pending Insurance $0.00
Amoun�You Oeve $28.40
I
This new statement has been speciatly designed For billinc ques[iuns or insurance changes:
with you in mind. Let us know what o�her Para pregumas acerca de w facara o cambios de seguro contamos con
improvemenis we should make. re0resentanres disponibles para asistir a la comunidad hispana.
Phone: (71"n53L5069oc(800)254-26I9
Please e-mall yoUr itleas lo: Available Hours:Monday,Tuesday&.Wednesday 5:00 am ro 530 pm
S�atemenfdeas a'�hmc.osu.etlu Thursday&Friday 8:00 am to 4:30 pm
ar wrile to us aC Writhn Correspondence:
Penn Stale Milton S. Hershey Medical Center Penn Stam Milton S.Hershey Medical Cenrer
S�atement Ideas, PO Box 854,MC A410 Patient Financial Services Departmrnt
Hershey,PA 17033 PO Box 854,MC A410
Hershey,PA 17033-0854
Plensei�"oir. Yoiu�pl+psicim�sivi!!Gi!lsepmrrtelvfarUeerr�n�ofessiaunlservices. „Eas�E.sr-0,
......... .......... ._......_ __._.. __.__. ._.._. ......... .......... ...___ ...__...
PENNSTATE HERSHEY Slatement Date� OB/25/12 � Patienl Name � � Acwunt Number� Date Due
i�'9MiltonS.}�us�12V ROMITOGUYAJR � 17498678 UponReceipt
�Mzclical Center . .. . . .
. AmountDue � Amount Paid �
PO Box 6J3291 � �
PitlsEurgM1,PN 15264-3281 $ 2$.40 $
Check here Ayour atltl2ss orinsurence inPortnafion has changetl.
CHECKSSHOULDBEMADEPAVABLEAND �� Pleaseindicetechangeson(hebackoffhispage.
SENT TO: To pay by credit ca�d: For your convenience,you may pay by Usa,
MasterCartlorDismverCartl. Pkaseintlirateyourcretli�cartl
preference,pmvitle lhe acwunt infarmation,and sign below.
MS HERSHEY MEDICAL CENTER �� �� � L'�1�'�� � �
PO Box 643291 Account No.
Pi��sburgh,PA 15264-3291
I ��ILLL�dJ�II���I��L�11���61LI�����IIL��II Ezpirationoate cwcode
Signature X
00000�0174986780416120825120000002840
PENNSTATE HERSHEY 1 st Statement
Paetof2
F�Milton S.Hershey
�Medical Center ' -
voeo.saazsi If you have any questions regarding this bill please
Pitlsburg�,PA 152643291 contact our offce. If not,we look forward to receiving your
payment in full.
GUY ROMITO JR iwnse
625 WOODLAND AVE
MOUNT HOLLY SPRINGS PA 17065-1937
I���IIL��III����II���I�h��JII�I����ILI���I��l�l�l�l��l��ll
Pa�ientName ROMITOGUYAJR DATE DESCRIPTION AMOUNT
Statement Date 07/17/12
Service Da�e(s) 04/02/12 062�112 "BALANCE FORWARD" 5]5.]5
TypeofService OUTPRTIENT T�TAL 515.15
Accounl Number 17337651
New Charges/Adj $0.00
New Payments/Adj $0.00
Account Balance $575.75
Amount Pending Insurance $0.00
Amounl You Owe $57575
I
This new statement has 6een specially designed For billing questions or insurance chan�es:
wi�h you in mintl. Let us know what other Paa preguntas acerca de su facNra o cambios de seguro rontamos con
improvemenls we should make. representanres disponibles parn azistir a la comunided hispana.
Phone: (717)531-5069 or(800)254-2619
Please e-mail your ideas[o: Available Hours:Monday,Tuesday&Wednesday 8:00 am to 530 pm
Statemenfdeas(a�hmc psu edu TM1ursday&Friday 8:00 am to 4:30 pm
or wrile to us at: Written Correspondence:
Penn Sta�e Millon S.Hershey Medical Center Penn Stare Milmn S.HersM1ey Medical Crnter
Slatemenl Ideas, PO Box 854,MC A410 Patirnt Pinancial Serviws Department
Hershey, PA 17033 PO l3ox 854,MC A410
Hershey,PA 17033-0854
PlenseNote: Yourpl�ysicimasivil(bi!(sepm•nlelyjorNreirprofessionalservires. �Eqsnevs,-��
....... .. _._._. .___._ __._.. ._._._ .___.. _..__. .._.._. .._.__ __.._..
PENNSTATE HERSHEY Statement Date� 07/17/12 Patient Name Account Number Date Due
R�MiltOn S.Hetshey ROMITO GUV A JR 17337651 Upon Receipl
�MedicalCen[er � �� � � � � � .
Amount Due � Amount Paid
PO Box643291
Pitlsburgh,PA 152fi<3291 � $ S�S.�S $
I:J Check here iI your atld2ss or insurance in/ormafion hes changed
CHECKSSHOULDBEMADEPAVABLEAN� Pleaseintlicafechangesonfhebacko/thispage.
SENT TO: To pay by credit card: Por yourconvenience,you may pay by Visa,
MasterCaMorDismverCartl. PleaseindirateyourcreGitwM
preference,provitle lhe acwunt information,antl sign below
MS HERSHEY MEDICAL CENTER -'� I�, IJ I�li �J �
PO Bax 643291 Account No.
Pittsburgh,PA 15264-3291
L�JLId���I�I�IL��L�l��ll���l�ll�l�����lll���ll ExpiretionDate CWCode
Signature X
0000000173376510402120717120000057575
STATEMEM�DF PHYSICIAN SERVICES . i i ,�
� �� �.i.� .�.€' .� ` _' _ _ - _PfGE t 9 i.
����!7�,��"��"j� U��,Ji-¢�e'..- �� GUYAJRROMITO 3or 3
625 WOODLAND AVENUE STATEMENT
MT HOLLY SPRINGS PA 7 70 6 51 93 7
�� I�/"itltor,_ �. ��eruhey _ oA�E: o9�osi�z
T /[�v.�{ (' tr LAST STATEMEMT
� +��/d'.^��C�� i.��nl�er ACCOUNT# 718005A — DATE: OBIOB/'IZ
ic nxv puEsnons, a�ase coxrncr: MSHMC PATIENf FINANCIAL SERVICES FED TAX ID # 251857035
pA� .. PROC�OURE '�, DIAG QTM ' •DESGRIRTIOM INS CHARGE�� � PAYMEt(II. GUARANTOR
� ' C06E: �s � CODE� '., .:, : �ADJUSTMENT.�..BALpNCE�
OTNER CHAR6ES BILLE0�T0 YOUR IlSURANCE CdNpNY. 671U.OU ����� � � � � � � � � �
NE H0.VE WT RECEIVEU YWR PAYMFM. TO AVOID FURTNER
COLLECTION EFFORiS� PYlNi IN NLl MST BE IIELEIVED IMIEDIATELY.
IF PpYHENf XAS BEQ! MAIIE� TNANC YQI AND DISRE6ARD TXIS BILL.
PLEiLSE lDTE: TO KEEP YOUR ALCallf WMENf� OUR POLICY IS TD
APPLY YUUR PAYMENf iD THE OlDEST p1fSTANDIN6 BALANCE.
TXMlC YW FOR USIN6 151lIC Pth'SICI015 6NUUP FON YOUR PHYSICIAN
SERYICES. IF YOU NAVE AN1' flUESTIQG RE6ARDIN6 TIQS BILL� PLE0.SE
CWrACT US RT 717-531-5069 OR BOD-2Yr2619, BETYIEEN 8:DOAM AND
5:30PM H1N�pY TN�U6N NEOt�SDqY OR BETNEFN B:OOAM pN0 4:30PM
THIIAS�AY AND FRIOAY.
BqLANCE SUMARY RESPOl157BLE PARtt POLICY i MAL
�eeE 6UARAMDR RESPa15I6ILIN S 362.13
i
0
_ IMGOFTANT:GLEASE OETACM�RE�RN BOTTOM PORTION OF STATEMENT NTTH YO(lR G�YMENT _
STATEMENTDATL GUA0.ANTORRESPoN5181LITY: MINIMIIMPAVNENT
BF6 09/OS/12 5 362.73 5 362.73
MSHMC PHYSICIANS GROUP
BILLING SERVICES
P O BO7C 854
HERSHEYPA 170910854 00001380054 UP oonn000noaoa621ao9osaa
I,,.II,LL..I.LII.,,I.,L,II.,,Ii..,.11„II.,,,II„11,1,.1.1 000a1451 oa
Mai/ MSHMC PHYSICIANS GROUP GUY A JR ROMITO
ra MSHMC PHYSICIANS GRDUP 625 WOODLAND AVENUE
PO BOX 643313 MT HOLLY SPRINGS PA 17065-1937
PITTSBURGH PA 15264-3313
�iFlCEYSFONLY WNCPmITCRPUPAYMEXT.PlFM1SEFlLL�XIXiOPM0.TION8EIDW -_
� RemitTa:Walgreens Specialty Pharmacy
15358 Collect Ctr Dr Page 1
Chicago, IL 60693
ACCOUNTNO. DATE
GUY ROMITO 10997248256 07-05-13
625 WOODLAND AVE
MOUNT HOLLY SPRINGS,PA 17065
BIILING�EPRRTMENT HOURS OF OPERATION:Manday-FnOay,BAM-5PM EST AMOUNT REMITTED
Billiig�uestlons please rallldfi6]5GB05'/
PLEASE DETACH AND REfURN WITH YOUR PAYMENT
_-_-___________________-_______..____.____-_________._____._____._.___________.____________
DATE RAt �ESCRIPTION CHARGES PAYMENTS BAIANCE
O6-Ot-13 Beginning Balance 30.00 30.00
Payme t Due On Receipt.
Name: GUYROMITO
Aedress: 6PS WOODLAN�AVE MOUNT HOLLY SPRIN6S,PA 1]065
THANKYOU FORYOUR BUSINESS
CURRENT 30 DAYS 60�AYS 90�AYS 124�AYS AMOUNT DUE
0.00 0.00 0.00 0.00 30.00 30.00
Dispensing Locations
Carnegie,PA Ann Arbor,MI Morristown,NJ Beaverton,OR Fnsco,TX Wilmington,MA
PleaseRemi[PaymentTo: - - �, -
Yellow Breeches EMS Inc.
Billing Office 12-133631 9/76/2012 $7,131.00
PO Bax 726
New Cumberland, PA 77070-0726
QUESTIONS P60UT THIS BILL? PM1one: 8»-214-6018 espanol: e66-029-4114 Fax: J1J-214-6020 Email: info@ambulancebillingoffice.mm
Date of Service: 3/18/2012 2028 Please visit our website to provitle insurance or make payment, and
Patient Name: ROMITO,GUY A. for adtlitional payment ovtions and frequently asked questions:
From: RESIOENCE www.ambulancebillingoffice.com
To: HERSHEYMEDICALCENTER
. � . .
*'THlS ISAN UNRESOLVED BILC* Your account has now been transjerred!o onr Co7lection&Credit Depar[ment.
**IMMEDIATEACTlONISNECESSARY`*
3/18112 BLS Emergency TranspoK A0429 1.0 650.00 650.00
3/18/12 Mileage A0425 37.0 13.00 481.00
Total 1,131.00 0.00 0.00
OETACH AND RETURN BOTTOM PORTION WITH YOUR PFVMENT.
We accep[payment in PoII by cFeck,*credi[cartl or elecVOM[ Glease Make Check Paya61 To:
check deauc[ion. Flease intlicate your payment chaice below Yellow Breeehes EMS Ina � �
and flll in requiretl Info�maUon. If oNer arrangemen[s are
necessary, Olease call us at 8l]419-6038.
12-133631 $ 1,131.00
oV- o o��o��
CretlitCarE: ❑MPSTERCFRD ❑VISA ❑AMERICANEXVRESS ❑DISCOVER Art1011fl[ Pdld:
� Please make any mrrections fo aEdress below.
_ __ ._._ _ . .
Electronic Check oetluctian � GUY A. ROMITO
Please sentl a wlpe0 cl'e[k OR proNtle Information�elow: � 625 WOODLAND AVE
MOUNT HOLLY SPRINGS, PA 17065
'ReNrnea cM1ecks—You will�e rezponslble for all Incurretl bank lees Oe�missible un0er sta[e law.
Ashley Malcolm
From: Brenda.Bishop@springleaf.com
Sent: Tuesday, March 18, 2014 4:13 PM
To: amalcolm@pjrlaw.com
Subject: RE: Guy A romito Jr.
This email is in response to the letter I received from you today, March 18, 2014.
Mc Romito had an account with Springleaf Financial Services, which was paid oH in full upon his death on July 11, 2012.
The DOD payoff was
$6,145.19.
If you need any additional information from us, please call me at 717-243-6055.
Thank you,
Brenda Bishop
Sc CustomerAccount Specialist
Email Disclaimer
This E-mai] contains confidential information belonging to the sender, which may be legally privileged
information. This information is intended only for the use of the individual or entity addressed above. If you are
not the intended recipient, or an employee or agent responsible for delivering it to [he intended recipient,you
are hereby no[ified[hat any disclosure, copying, dis[ribution, or the taking of any action in reliance on the
contents of ihe E-mail or attached files is strictly prohibited.
No virus found in this message.
Checked by AVG- www.av .g com
Version: 2014.0.4336 /Virus Database: 3722/7210 - Release Date: 03/18/14
i
Account Number: 020 91 2 87 3 81 0
A I'� STATEMENT TOTAL: $148 85
TOTALAMOUNTPAID: $
PO BOX 3803D2
BLOOMINGTONMN 554380902 �
PAVMENTPROCESSING CENTER
. PO BOX 9001951 �
EST/GUYA ROMITO JR LOUISVILLE KV 40290-1851 �
625 WOODLAND AVE �
MOUNTHOLLYSPRINGSPA 17065 I�I��III�����I�II�I��II������III�I���I�I����II�I�I����II��II�I =
I���III���III����II���I�I����III�I�„�II�I���I��I�I�I�I��I��II =
02 01 D20 9128 73810 9 0�014885 8 7 0
- - - -_._ — _ _ _._ _ _ _._ ___. .- -�—�'�- - -�—�—�—�— �—�- --�- - - -�—�- - --�----�—�—�—�- -- " "
=a�oaienFHeqE� ponotsenEcasM1 pc¢I-0alMchecla AIIMeckswillbetl posttetluponrecepl. MakechecNsOayableloALLY. �Fo�oai[aqHen
ftNum Ne aEove poNon MtN your payment lo Il�e Payment Rocessln8 Cenler atltlr¢ss a�mie.
Questions?Visit allyauto.com or call 888-925-2559 (ALLY) � � �'I�
AccountNumber. 0209128738'10 Make/ModeI: OSCHEVCOBALT VIN: IG1AK52F557610223
Account Summary
_., : . ._ :. . ., .
..., .. � .._ . .P ,: ..::. . -. , _ ..
, . . , .: . ., :
MeM PaymeRt, g , � ,� Past Dqe Payments, _ , '�, - `Other Uopaid l�mdunts � �
- ' . � .,..,:
queDate .', ,�-:. -70%17H2 Due_Da,t; ' " -'= ' AMount lale;Chafge
pmounlDue ' §14885 Ins'�raraePremium� '
.
__
.,.. .. ... ... . .. , _ _�—_. .... _-- _.
Miscellaneous. �
� Ertenslon Fee:
�� TotaL•_ E148.85 � '. Total: _ ., _ __ _ _ . Total: __ J
STATEMENT TOTAL: ` §148.85�� Statement reflects payment(s}receivedthrough. 08/25/12
Last Payment Applied As Follows
+ u � e - n a F nahc ,?�; � - eY x�'� o -
� r=Daie '��:payment � ` `Patd ' '��. ' Balan¢e'` `" 'Char�e `•` ' Charge '" 'Charge" ' Paid�`
09/'17/12 748.85 09/22/12 282.63 5.07 5.94 303.64
Addilional Paymen[Options:
AuamaliePavmems-qllowsyourprymenitobeconvenien11y1amferteElmmyawcM1eckin8orsavin8saccounlbNl0. PleaxeWsflay� �.�mformareinloemalian.
Online Pavmenls-Regisler for Ally Online Servicee al-����� m,add you�eccounl.lhen whedule one-�ime paymen�s al your convenience.
Olna�ea�a• oy����=-To M1ee�ewileEle op�ions ce11808-9252559. AtM1irtl perly urnce P�vitler lee mry apPly.
Important Account Messages
REMP�ININGUNPAID'B)1L9'NCE� $1�f§7.58.THI9AMOUNT.DDESNOT;1[JCCUDE°FlNA�{CECHPRGESqNDRTHEkUN��IpAMdUNTS. ;�-� �`
PCEA$ECALLUSFORVOURPAVOFF` - -
� �
� , _.
�..� �, , :. _ _.. ".T
.� 1 ,� � � : . ,
. ..a= " . ._. ,- ,. . :_.. ,s , , . . � , , , _
_ � �
Maxi%nize youf sevfn§s SafheriAlfy}ligh Vield CD,7,Ily CDs offer-Fa[es tfiaLare cunsisfently ama`n,g tfie
mnsL;compe4hve,ihYbe cn�otry Y,cu cart choose CDs wRh 5zed termshnm,H mnnt6s uR�a 5 qesrs Io -
. . , ; .�. `� _
learn:more,visiC us'r`lnhne et�wyw;a`1lybank.coin:T�Aetri6er FDIC. ' �
i
�- i
� J
ainaiusrAai osnz ��e1
��
LAW OFFICES OF
PETER J.RUSSO �.c.
Yete�l.2�syo,Esyulre ATTORNEYSATLAW AshleyR_Ma1wlm,Pnrelegnl
Kathleen Minurak-Gingrich,Bsquire�' Derck M. Svouphaueq Paralegal
Lindsny Gingrich Maclay,Es'quire^ Laurie L. Wa�son.Pomlegal
len�ik�Spea�s Brenize.Esqoire Melissa M_MehetPeY. Pernlegnl
David C. Dagle,Esquire Tara E.Bullen,Legal Su�craq�
Thomas D.Gould,Fsyuire
"Atlmived in PA&M
Fridav, Julv 03, 2015
Office of the Register of Wills
Cumbedand Coonty Courthouse
One Courthouse Square
Carlisle, PA ]7013
RE: Estate of Guy A. Romito, Jr.
Dear Mr. Buell,
Enclosed herewith, please find one Q) o�iginal and th�ee 3) copies of the Revenue 1500 in
regazds to the above mentioned mat[er. Kindly file the ociginal, time-stamp the cemaining copies,
and remm same �o our office in the self-addressed, postage pre-paid envelope I have provided for
you�convenience. �
Thank you for your attention to the enclosed. If you should have any questions or concems,
please feel free to contact our o�ce.
ery tmly yours,
V t � �
Ash ey R. Mal olm, Paralegal
/arm
Enclosures
� � � �
� o ^ m
m
m � c � o
I' � G) �
S r— r —i �
r-- v r„ � rn m
�o 0
u y '� o
, o `�i 3 T -�*�
= �
� a w � m
_ -� i-
� s � o
" CJ �t
5006 EAST T0.INDLE ROAD, SUITE 203. MECHANICSBURG, PA 17050
PHONE: (777)597-1955 FnX: (717J 591-1756
'm o £
3 � O
�. -i n
Q 7 O
C d
� A �
9 O �
D a �
v _
J N A
� � H
O
N p
� 9
W ^
d O � Q
� � y �
N O � �
b �j �i �
�
o a �?
o ri o A
wti � �
a � �
d n �
� o 0
c -n
s F
o _
c ;,
� � o a
�
; o ` m �rnj
Q � � � O '
rn v � r' r,� s+
rl � r- -4 �
_ - � rnrn
- o 0
� o
� � �
F n
W � rn
r
t V� �
� j T
.Y�
➢I Inl �