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LAW OFFICES OF
GATES, HALBRUNER &-HATCH, P.C.
1013 MUMMA ROAD. SUITE 100' LEMOYNE, PENNSYLVANIA 17043
(717) 731-9600' FAX: (717) 731-9627
BRANCH OFFICE:
'3 WEST MONUMENT SQUARE, SUITE 304
LEWISTOWN, PA 17044
(717) 248-6909
LOWELL A. GATES, LL M.
LL. M.inTa)(ation
A~so Admitted to Massachusetts Bar
MARK E. HALBRUNER
Also Admitted to New Jersey Bar
CRAIG A. HATCH, CELA
Certified as an Elder Law Attorney by
the National Elder Law Foundation
CORY J. SNOOK
ALBERT N. PETERLlN
Also Admitted 10 Maryland Bar
CLIFTON R. GUISE
Also Admined 10 practice before the
U.S. Patent & Trademark Office
WEB SITE:
WWW.Ga\eslawFirm.com
April 28, 2005
CORRESPONDENCE ADDRESS:
Lemoyne Office
STACEY L NACE
ParalegaVOtficeManager
TRACI L SEPKOVIC
Paralegal
VALERIE LONG
Paralegal
Certified Mail - Return Receipt
Cumberland County Courthouse
ATT: Glenda Famer-Strasbaugh, Register of Wills
One Courthouse Square
Carlisle, PA 17013-3387
Re: Estate of Rachel J. Brosius - Date of Death: 01105/2005
PA Inheritance Tax Return
Dear Ms. Famer-Strasbaugh:
I am writing with further reference to the above-captioned estate. Enclosed please find
the following:
I. Two originals of the P A Inheritance Tax Return Form REV -1500 with attachments "A"
through "F", together with one photocopy of the tax return alone which I ask you to
date-stamp and return to my office in the envelope provided;
2. Two originals of the Inventory of Assets, together with a photocopy to be date-stamped
and returned as above;
3. Estate Check in the amount of $98.00 in payment of the balance of inheritance tax due at
this time; and
4. My firm's check in the amount of $30.00 in payment for the filing fees herein.
5. Pre-paid envelope for the return of the copies.
If anything further is required, please give my office a call. Thank you for Y~\P,'
consideration.
CAH:vl
EncI.
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REV-l500 EX (6-00)
() APD
OFFClf4L USE ON\. Y
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG. PA 17128-0601
REV-1500
INHERIT ANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
05
0050
21
COlMY C.ODE
YEAR
NUMBER
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DECEDENl'S NAME (LAST. FIRST, AND MIDDLE INITIAL)
BROS~US RACHEL
DATE0FDEATH (MM-OD-YEAR) DAlE DFBIRTH (MM-DD-YEAR)
01/05/2005 02/04/1925
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
201-16-5621
TltS RETURN MUS,. BE FILED 1M DUPLICA."E WITH THE
J
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
00,
D4.
D6
D9.
D 2. Supplemental Return 0 3. Remainder Return (d~le 01 dAAlh prior In 12-1.1-92)
D Aa. Future Interest Compromise (dale of death after 12-12-82) 0 5. Fel;Ieral Estate Tax Return Required
D 7. Decedenl MaintaIned a Living Trust (Allach copy 01 Trust) L a. Teital Number 01 Sale DeposIt Boxe!'.
o 10. Spousal PovertyCredl! (dolo (II dllalhbDlwoon 12.31.91 III'dH95} 0 11. Election to tax under Sec. 9113(AhAllachSchOl
Original Return
l-im\\ed Estate
Decedent Died Testata (Allach copy of Will)
Litigation Proceeds Received
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THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONADENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
Craig A. Hatch, Esquire 1013 Mumma Road, Suite 100
FlAM NAME (If Applicable)
Gates, Ha1bruner ~ Hatch, PC Lemoyne, PA 17043
TELEPHONE NUMBER
717-731-9600
1. Real Estate {Schedule A}
(1)
(2)
109,000
o
OFFIOAl USE,6~L Y
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
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4. Mortgages & Noles Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
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(4)
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56,552
6. J~ O'Mled Property (Schedule F)
U Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non.Probate Property (7)
(Schedule G or L)
(6)
72,044
237,596
(B)
23,497
1,913
(11)
(12)
(13)
(14)
6. Total Gross Assets (Iolallines 1-7)
9. Funeral Expenses 80 Adminislrative Costs (Schedule H) (9)
10. Debts 01 Decedent, Mortgage liabilities, & Liens (Sctladulel} {10l
11. Total Deductions (total Lines 9 & 10)
25,410
212,186
o
12. Net Value of Estate (Line B minus line 11)
13. Charitable and Governmental 6equesls/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
212,lB6
14. Net Value SUbJeetto Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
, 5. Amounl of line 14 laxable allhe spousal tax
Z rale. or transfers under Sec. 9116 (a)(1.2)
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!;i 1 6. Amounl 01 Une 14 taxable atlineaJ rata
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Cl. 17. Amount of Une 14 taxable al slbl"ing rale
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~ 19. Tax Due
20. [!]
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,.0 ~(16)
x .12 (17)
x .15 (18)
(19)
9,54B
212,186
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9,548
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
3W46451.000
V-
Estate of
Name
Address
Tax ID
201-16-5621
Executors (Page 1)
Donald L. Brosius
P.O. Box 173
Raynham Center, MA 02768-
173-38-7187
Decedent's omolete Address:
STREET ADDRESS
27 N. 9th Street
CUmberland
CI1Y I STATE I ZIP
Lemoyne PA 17043-
C
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C, Discount
(1)
9,548
o
9,000
450
3. Interest/Penalty if applicable
D. Interest
E. Penaily
Total Credits (A + 8 + C) (2)
9,450
o
o
Total Interest/Penalty (0 + E) (3)
o
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
o
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
98
A. Enter the interest on the tax due. (SA)
o
8. Enter the total of Line S + SA. (58)
AGENT
98
PLEASE ANSWER THE FOLLOWtNG QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes
a, retain the use or income of the property transferred;. . . . . . . . . . . . . . . D
b. retain the right to designate who shall use the property transferred or its income; . D
C. retain a reversionary interest; or .. . . . . . . . . . . . . . . . . . . . . . . D
d. receive the promise for life of either payments, benefits or care? . . . . . . . . . D
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . .. D
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ~ []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEOULE G ANO FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, including a;companying schedules and statements, and to the best of my knowledge and belief, it is true, correct
and complete
Oeclaratlofl 01 preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATIJRE OF PERSON RESPONSIBLE F9R FIL~ETUAN
'-p c?2?&/ / A:...5/.l ?~
AOOAES
P.O. Box 173
SIGNATIJRE OF PREP ER om
.-1
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Raynham Center, MA
DATE
(P f~S-
02768
OAT
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1
Lemoyne, PA 17043
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. ~ 9916 (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 for the use of the surviving spouse is 0% [72 P.S. 9 9116 (a) (1.1) Iii)]
The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
Or a stepparent of the child Is 0% [72 P.S. 99116(a)(1.2)].
The tax rate Imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9 9116(1.2) [72 P.S. 9 9116(a)(1)]
The tax rate Imposed on the net value of transfers to or for the use of the decedent's siblings is 12% (72 P.S. S 91 1 6(a)(1.3)1. 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.
3W46461.000
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL EST ATE
REV-1502 EX + (609B)
ESTATE OF
FILE NUMBER
RACHEL J. BROSIUS
21 D5 0050
All real property owned solely or as a tenantln common must be reported at falr market value. Fair market value is de1ined as the plica at wh~h property would be
exchanged between a willing buyer and a willing seller, neither being compelled 10 buy or sell, both having reasonable knowledge of the relevant facts.
Real property which Is lolntly-owned wIth right of survivorship must be dIsclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
One Fam11y Res1dence at 27
North 9th Street, Lemoyne, PA
17043 (Sold)
109,000
3W46951.000
TOTAL (Also enter on line 1, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$
109,000
REV-1503 EX + (6.98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
RACHEL J. BROSIUS
21 05 0050
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRlPTlON
VALUE AT DATE
OF DEATH
1.
3W46961.000
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
o
REV-1504 EX+ (6-9B)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
SCHEDULE C
ClOSEl V-HELD CORPORATION,
PARTNERSHIP OR SOLE-PROPRIETORSHIP
ESTATE OF
FILE NUMBER
RACHEL J. BROSIUS
21 050050
Schedule C-1 or C-2 (including all supporting Information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a
sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships.
ITEM
NUMBER
DESCRIPTION
VALUE AT
DATE OF DEATH
1.
3W46871.000
TOTAL (Also enter on line 3, Recapitulation)
(If more space IS needed, Insert additional sheets of the same size)
$
o
REV-1507 EX+ (6-9S)
COMMONWEALTH OF PENNSYLVANIA
INHERIT.A.NCETAX RETURN
RESIDENT DECEDENT
ESTATE OF
RACHEL J. BROS~US
SCHEDULE D
MORTGAGES & NOTES
RECEIVABLE
FILE NUMBER
21 05 0050
All property JoIntly-owned with right of survIvorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTlON
VALUE AT DATE
OF DEATH
TOTAL (Also enter on line 4, Recapitulation) $
D
3W46AC1.000
(If more space is needed, insert additional sheets of same size)
REV-1506 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITI>.NCETAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
RACHEL J. BROSIUS
FILE NUMBER
21050050
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property JolnUy.owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
3W46AD 1_000
TOTAl{A!so enter on line 5 Recanitulalion\ $
(If more space is needed, Insert additional sheets of the same size)
o
REV-1509 EX -+ (6-98)
COMMONlNEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
RACHEL J. BROSIUS
SCHEDULE F
JOINTLY-OWNED PROPERTY
FILE NUMBER
21 05 0050
If an asset was made Joint within one year of the decedent's date of death, It must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
A. Brosius, Donald L
ADDRESS
P.O. Box 173, Raynham Center,
IdA 02768
RELA1l0NSHIP TO DECEDENT
Son
8.
c.
JOINTLY-OWNED PROPERTY:
<mER DATE DESCRIPTION OF PROPERlY %OF DATE OF DEATH
ITEM FORJOINT MADE INCLUDE NAME OF FINAN:::IAL INSTITUTION Ar-D BAN< ACCOLWr DATE OF DEATH DECO'S VALUE OF
N..MEERORSlMILAR IDENTIFYINi3 ~MaER AnACH DEED FOR
NUMBER ''''''"' JOINT JQINTLY+€LDFEALESTATE VALUE OF ASSET INTEREST DECEDENrSINTEREST
1. A.
1 A 8/1/2000 Fulton Bank Account
#2219-01420 26,937 49.000 13,192
2 A 8/1/2000 Fulton Bank Savings/Checkin
MM Account #9903-10813 3,547 50.000 1,773
3 A 10/1/2001 PSECU 24-Month CD ID#50 8,578 50.000 4,289
4 A 10/1/2001 PSECU Checking Account ID#O 47,630 50.000 23,815
5 A 10/1/2001 PSECU Savings Account ID#Ol 25,250 50.000 12,625
6 A 12/4/1998 Waypoint Bank Account
#1000008971 CD 1,073 50.000 537
7 A 6/17/1993 Waypoint Bank Savings Accou t
#1002127212 642 50.000 321
TOTAL (Also enter on line 6 Aecanitulation\ $ 56,552
3W46AE 1.000
(1I more space is needed, Insert additional sheets of the same size)
REV.1510 EX+ (6-98)
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX AETUAN
RESIDENT DECEDENT
ESTATE OF
RACHEL J. BROS~US
FILE NUMBER
05 21 0050
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVEA SHEET is yes.
DESCRIP1l0N OF PROPERlY
ITEM 1r>a.U:E TrE No'ME OF TrE TRA.NSFEREE. THEIR RELATIONSHIP TO DECEDENT MO DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE
NUMBEF n-e OATEOF1'FlIIN3F8'I. AITACHACOPV OF n-e DEED FOR REAL ESTATE VALUE OF ASSET INTEREST IF APPLICABLE' VALUE
1. FuI ton Bank ~RA Account
#390-1921452 49,769 100.000 0 49,769
2 MetLife Investors Annuity
Contract #A205300I - DOD
Statement Value: $21,188.95 -
Annuitized value over 5 years
@ $371.15 per month. 22,275 100.000 0 22,275
TOTAL (Also enter on line 7, Recapitulation) $ 72,044
(If more space is needed, insert additional sheets of the same size)
3W46AF 1.000
REV.1511 EX + (12-99)
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
RACHEL J. BROSIUS
Debts of decedent must be reported on Schedule I.
FILE NUMBER
2105 0050
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Funeral Flowers 339
2 Funeral Reception 450
Total fram continuation pages 7,816
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s) Donald L. Brosius
Social Security Number(s) I EIN Number of Personal Representalive(s)
Street Address P.O. Box 173
City Raynham Center State MA Zip 02768
Year(s) Commission Paid: Waived
2. Attorney Fees 4,500
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees 302
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
1 Attorney Darrell C. Dethlefs -
Tax Certification Fee 4
2 Borough of Lemoyne - 4th
Quarter Sewer paid at closing 60
Total from continuation pages 10,026
TOTAL (Also enter on line 9. Recapitulation) $ 23,497
3W46AG 1.000
(If more space is needed, insert additional sheets of the same size)
Schedule H part 1 (Pag~ ~)
Estate of: RACHEL J. BROSIUS
Item
No. Description
Amount
3 Grave Opening 300
4 Myers-Harner Funeral Home
Camp Hill PA 17011 7,366
5 Pastor 'l'ed HW1II1le 1 - Church
Donation 150
Total (Carry forward to main schedule)
7,816
Schedule H part 2 (pag.
Estate of: RACHEL J. BROSIUS
Item
No.
Description
Amount
3
CUmberland Co. Law Journal -
Publication
75
4
CUmberland County Reorder of
Deeds - Recording Fee on
closing
39
5
Deed Transfer Tax
1,090
6
Donald L. Brosius -
Reimbursement for gas, tolls,
postage, cleaning and
maintenance of real property
596
7
Family travel (air) expenses
for funeral attendance
446
8
Lewis B. Buchanan, Plumbing <<
Heating - Furnace Repair
352
9
RSR Realtors - Commission on
sale of real property
6,540
10
RSR Realtors - Transaction Fee
on sale of real property
125
11
Safe Deposit Box Opening Fee
97
12
The Patriot News - Publication
269
13
Town & County Property Tax -
Borough of Lemoyne &
CUmberland County
397
Total (Carry forward to main schedule)
10,026
REV.1512 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
RACHEL J. BROSIUS
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
05 21 0050
Include unrelmbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. AT&T
VALUE AT DATE
OF DEATH
29
2 Byerly Inc. - Homeowners'
Insurance - back premiums
802
3 Comeast
84
4 Pennsylvania American Water
Co.
70
5 PP&L (Electric Utility)
108
6 Refuse<< Sewer
190
7 UGI (Gas Utility)
511
8 Verizon
119
3W46AH 1.000
TOTAL (Also enter on line 10, Recaoitulation\ $
(If more space is needed, insert additional sheets of the same size)
1,913
REV-1513 EX+ (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
RACHEL J. BROSIUS
SCHEDULE J
BENEFICIARIES
FILE NUMBER
21 05 0050
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers
under Sec. 9116 (a) (1.2)]
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
1
Donald L. Brosius
P.O. Box 173
Raynham Center, MA 02768
Son
212,186
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
11 NON-TAXABLIE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO T AA IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
3W46A11.000
TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
(If more space IS needed, Insert additional sheets of the same size)
$
o
Estate of Rachel J. Brosius
Pennsylvania Inheritance Tax Return
Form REV -1500
EXHIBIT A
Copy of the Receipt for Prepayment of Inheritance Tax
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128.0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BROSIUS DONALD l
POBOX 173
RA YNHAM CENTER, MA 02768
--- told
ESTATE INFORMATION: SSN: 201-16-5621
FILE NUMBER: 2105-0050
DECEDENT NAME: BROSIUS RACHEL J
DATE OF PAYMENT: 04/05/2005
POSTMARK DATE: 04/02/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 01/05/2005
NO. CD 005161
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $9,000.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 1
SEAL
INITIALS: JA
RECEIVED BY:
TAXPAYER
$9,000.00
GLENDA FARNER STRASBAUGH
REGISTER OF WillS
Estate of Rachel J. Brosius
Pennsylvania Inheritance Tax Return
Form REV -1500
EXHIBIT B
Certified Copy of the Death Certificate of the Decedent
This is to certify that the information I~"'l~ givt:n is corrt:ctly l'oflicd from an origin~d
Local Registrar. The original certifiG' ill he forwarded t" the Slate Vilal Reco
certificate of death duly filed with me as
')ffice for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
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13Rev2187
NAME:: OF DECEDENT If,'... MoOOIS, c~"l
..
AGE(la..SortM.ayl
UN[)f:R 1 YEAR
Monlll. D.V-
79
,,,
.
COUNTY OF DEAl"l-i
Cumberland
...
Loca\ Registrar
JAN 11 2005
No.
Date
COMMONWEALTH OF PENNSYLVANIA" DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
"Alii ~'I.E ~U"Bf:R
-Rache~-~~~rosius~~~--~==--~~--~ Female t2oiCUR'TYN1"'6EA
UNOt:A I DAY_ -8lRTHPLACfICd~"M PLJoCEOFDEATl-i(C~""k""'1o)('1l-.. _.,"I<""I......""O<N"......1
..... ": MI/lUl... '3Ia'~"'fe,e'9"C"'-'n"11 IiQsP.TAL --
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7 Lave Ie, PA ..:~...n "'OJ".....----'
FACILIT'l' NAME (II """"....Iu"on, gwe.!r....land"uon""'"
k.
5 2005
~,O
Lemoyne Bora
27 North 9th Street
KIND OF BUS'NESS/INDUSTRV
W'oSoeCEOEN.TEliERlt>l
US ARMEO~ORCESl
v..O Null(]
1ol"".l1ALSTA,TUS......'oH
N....MlWToH,Wiclooo<ed,
DIVOI'*'(Spec4'vl
Widowea
SlJIMVlNQ sPOUSE
(1I_,~"__1
DECEDENT'S USUAl. OCCUPRION
(~:,.~~~:i.,~u~':'J~::f
11.. Secretar I1I1.Corrm.
OEOOOEW"i'SWAlt.lMG}.DOfIESS lSI>..... C.ofy(iQwrJ,~, ZopCodel
27 N. 9th Street
..Lemoyne, PA 17043
fATlifR'S NAME lf~s'- MiOOI.., la$l)
".
INifClflMAlllT'S NA"'E (T ypM"inq
of PA
DECEDENT'S
ACTUAL
RESlOIONCE
lSee"'\$lIlICllOnI
ooOlll..,;i<le)
..
Pennsylvania
l1c:.Ov..,,*_lMf<lin
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-
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...OHIER'S NA"'E i~"'1. """<lle, M~iden S<J,,,amel
...
Lemovne
--
1711.Coun
Ra mond T. Walters
Donald L. Brosius
"'.
IHfOAMANT'S """lUNG AOGRESS (SIr..... C,IyITown, SlaIe. ZIP COde)
'k. PO Box 173 Ma nham Center MA 02768
PLACE OFDISPQSITlQt,I. "'''''I olC.mlll.ry, C'..m..ory LOCAtION. CiIy/TOwn. S~.r'PCodI
OfOl""'P~
Hepler's Ch. of God Cern.
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IIlET~OF DISPOSITION
&un.lK): Cr.maIiO"O R___SI.I..O
OU-(Specoly'
.lCTING A$ SUCH
lICENSE NUMBER
....
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''''.
WIl.S CASE REFERRED TO /,lEOICAL EXAl.IlNEFlICOROOEAT
v..fiU "",0
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!ME OF DEATH A DATE PRONOUNCED 01:,0.0 1""""It>. D..y, Yea,!
pprox.
24. 7: 00 Mas. Januar 7 2005
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WERE AUlOPSV fiNDINGS
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cow.P\.EllOKCFCA\)Si:
OFDE.AJ"H7
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""
INJURVATW{)RKl
OESCRI8E HOW INJURV OCCURRE:D.
OATEOf INJURV
(MO",",Da.~. Year)
TIME OF INJUIW
MANNER OF DfATl-i
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"PRONOUNCING AND CERTlFVING PHVSICIAN IPhVSO;:Q(llXJ'h ~'""O"'':<>g dea'h ..nd ~",,,ly"IIJ '0 Gause 01 d~~'hl
lothe boN! of my k""...te",;!". d...lh occurr'" .1_1Imoo. ".1... ~ncl plle..,'nod du..lo Ill. .~u..(.I'n<l .....'ne'.. 11~lood
.1ft;DleAI.. EXAMINER/CORONER
Orllh.....i.ol....min&lio".nd/ori..w..lig"lion.inm'opiniOn.d...lho(;curr.d"llhellm'.d..!...andpla.*.~nddu..lott,,,c:'u...(.J.nd
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-----
Estate of Rachel J. Brosius
Pennsylvania Inheritance Tax Return
Form REV-1500
EXHIBIT C
Copy of the Last Will and Testament of Rachel J. Brosius
Dated August 19, 1999
,
OJ-
I
?'F'
WILL
OF
RACHEL J. BROSIUS
I, RACHEL J. BROSIUS, of the Borough of Lemoyne, Cumberland County,
Pennsylvania, declare this to be my last will and revoke any will previously made by me.
ITEM I. I direct that all my just debts and funeral expenses, including my
gravemarker and all expenses of my last illness, and any and all taxes and assessments
imposed by any governmental body as a result of my death, whether on property passing
under this will or otherwise, shall be paid from my residuary estate as soon as practicable
after my decease as ? part of the expense of the administration of my estate.
ITEM II. I give, devise, and bequeath all of my possessions and estate of every
nature and wherever situate to my son, DONALD L. BROSIUS, provided he survives my
death by sixty (60) days. Should my said son predecease me or be deceased on the
sixty-first day after my death, I give, devise, and bequeath all of my possessions and estate
of every nature and wherever situate to such of my issue, per stirpes, as survive my death
by sixty (60) days.
ITEM III. I appoint my son, DONALD L. BROSIUS, executor of this my last will.
ITEM IV. In addition to the other powers and authorities granted to my personal
representative by Pennsylvania Law and by the other terms and provisions of this will, I
hereby give to my personal representative the following powers and authorities effective
without court approval and until actual distribution of all property: to compromise any claim
,or controversy; to make distribution in cash or in kind, or partly in cash and partly in kind,
and in such manner as my personal representative may determine and at valuations finally
to be fixed by them; to invest in all forms of property, including any stock or other
securities in any corporate fiduciary or its successor without restriction to investments
authorized for Pennsylvania fiduciaries, as my personal representative deems proper,
without regard to any principle of risk or diversification; to retain any or all assets of my
estate, real or personal, without regard to any principle of risk or diversification; to sell at
page 1 of 3
Estate of Rachel J. Brosius
Pennsylvania Inheritance Tax Return
Form REV-1500
EXHIBIT D
Copy of the Short Certificate Letters Testamentary
issued on 01118/2005
STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SHORT CERTIFICATE
I, GLENDA FARNER STRASBAUGH
Register for the Probate of wills and Granting
Letters of Administration in and for
CUMBERLAND County, do hereby certify that on
the 18th day of January, Two Thousand and Five,
Letters TESTAMENTARY
estate of RACHEL J BROSIUS
in common form were granted by the Register of
said County, on the
, late of LEMOYNE BOROUGH
(First, Middle, Last!
in said county, deceased, to DONALD L BROSIUS
(First, Middle, Last)
and that same has not since been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the
seal of said office at CARLISLE, PENNSYLVANIA, this 18th day of January
Two Thousand and Five.
File No.
PA File No.
Date of Death
S.S. #
2005-00050
21- 05- 0050
1/05/2005
201-16-5621
b~J&- ~~j,
r?~ c e'1 L-.
NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL
Estate of Rachel J. Brosius
Pennsylvania Inheritance Tax Return
Form REV -1500
EXHIBIT E
Documentation of Assets
1. Letter from Waypoint Bank
2. Letter from Fulton Bank
3. Letter from PSECU
4. Settlement Statement on sale of real property
5. Letter from MetLife Investors
1/31/2005
GATES HALBRUNER& HATCH
lOB MUMMA RD STE 100
LEMOYNE PA 17043
", Way~qi!lt
The information which you requested on the account(s) of RACHEL J BROSIUS
(Social Security Number 201-16-5621) is/are as follows:
1002127212
SAVINGS
061793
642.13
.01
642.14
Account Number
Class of Account
Date Opened
Principal Balance
Accrued Interest
Balance at Date of
Death
Account Ownership JTO
Name of Joint DONALD L
Owner, if any BROSIUS
1000008971
CERTIFICATE
120498
1073.08
.20
1073.28
Date Ownership 120498
Was Established
Account Number
Class of Account
Date Opened
Principal Balance
Accrued Interest
Balance at Date of
Death
Account Ownership
Name of Joint
Owner, if any
Date Ownership
Was Established
Additional
Information
Requested
JTO
DONALD L
BROSIUS
061793
~11f\r ~ ru-
ER1N~V'\
SENIOR SERVICES REP.
P.O. Box 1711. HARRISBURG. PeNNSYllIANIA 17105-1711
Toll FrEe I-B66-WAYPOINT (I-B66-929-7646) 'IN YORK AREA 717/815-4500 . www.waypointbank.com
PSE(~
the finaneia/link TM
January 25, 2005
Account # 0201165621
CRAIG A HATCH
GATES HALBRUNER & HATCH PC
1013 MUMMA RD SUITE 100
LEMOYNE, PA 17043
Dear MR HATCH:
The fol1owing is the status of RACHEL J BROSIUS's account with PSECU as of the date of death.
Joint Owner's Name
Date of Death
Date of Birth
DONALD L BROSIUS, ADDED 10.01.2001 AS JOINT OWNER W/ROS
01.05.2005
02.04.1925
Share Description Open date Balance Accrued Dividend
SOl Regular Savings 10.15.1991 $25,297.67 $2.08
S 04 Checking 10.15.1991 47,630.31 1.30
S 50 24 Month Certificate-l 07.21.1997 8,578.26 1.96
S 51 36 Month Certificate-2 07.21.1996 8,778.00 3.64
The dividend earned from January 1, 2005 through the date of death was $8.98. The decedent had no loans with us.
We do not have safe deposit boxes for OUf members.
If you have any questions, please ca11234-8484 in Harrisburg or our toll-free number, (800) 237-7328. At the menu
prompt, enter 6 and then extension 2227.
Sincerely, ?
:t1f
Member Service Representative
Finance Support Unit
PENNSYLVANIA STATE EMPLOYEES CREDIT UNION
Main Address: 1 Credit Union Place. Harrisburg, PA 17110-2990. (717) 234-8484. (800) 237-7328
Mailing Address: P.O. Box 67013, Harrisburg, PA 17106-7013. (717) 777-2100 (TDO) . (800) 472-1967 (TOO)
Web Address: wwW.psecu.com
Savings federally insured up to $100,000 by the National Credit Union Administration.
January 26, 2005
Gates, Halbruner & Hatch, P.C.
1013 Mumma Road, Suite 100
Lemoyne, Pa 17043
Attn: Craig A Hatch
Dear Mr. Hatch,
I have received your letter regarding Rachel Brosius and enclosed is the
information that you requested.
Mrs. Brosius has a checking account, money market account and an IRA
with Fulton Bank.
On checking accoWlt 2219-01402:
Opened 10/22/1992
Balance as of 1/5/05 $26,937.02
Titled: Rachel Brosius or
Donald Brosius
On Money Market account # 9903-10813
Opened 10/22/1992
Balance as of 1/5/05 $3,546.66
Titled: Rachel Brosius or
Donald Brosius
On IRA accoWlt #390-1921452
Opened 08/21/1996
Balance as of 1/5/05 $49,768.85
Titled: Rachel Brosius
Beneficiaries: Christopher D Brosius
Michaell L Brosius
Donald L Brosius
,>2:d
L2961U6 :01
~968 1~L L1L OH5 153M ~N~8 N01rn~:WO~~ 21:01 S002-S1-~d~
Fulton Bank
LISTENING.
SANDRA L. LEE 099 N. IHH 5TREET
llMOVNE. PA 110,3
CUSTOMk:l~ SERVICI::i I<EPRESENrAfI\JE 7172550-/614
WESHHOHo OFFICE 111 BI-e9ijHAX
C 1J~e<}j:uI'ff:b~nkCD,"
rLJllonbank.c(Jll"I 01Ut!..l1"7 ~
001\(l..\d lAJOS'~ 0 f\
IJ.1l-C! ~ dd- \q - 0\ l\;@
0...1\6 9Q03 -I ogl3 .
1\,,,,.c..1- \ 7....000
Oil ~~V-=l \ ~
~ +o71{)~JI^1 f~
--tv v~(,-ht.
JalAIIS\1 J .rl."'J__~__I..,~,,,,--,~_.,,~~~Ii~~J'"'ilI""~~ilif;~:'l:.lri;I.f"";4~~.-'
TO: "ULTON BANK, LANCASTF" PENNSYLVANIA
- "'IOo"""'l"',"",v:.~t- J ~-':tl r... ...1.\.
TAANSFEIt-cm;;CKING, CEKTIFICA'm OF J)E~OSrr, ItEGlJLAR SAVINGS, ~-rA'r!':Mt;l'fr SAVINGS
CIRCLe ONe:
(17,/. a"it;ru""fllllromje:r IIlllid only if ,"corded 0" tile
s of tl,e bo"k.)
,C', 1 J.CCD
~J Q. Ol~ro 001.
l(tQhet~l1~ign/traJ1,rO' CortJl1cat<lAccoul1t No, ~ Issued by tho Fulton B.l1k with a pr.IiOn! bal.lICe of
$~} and <ill nlonlt!Y du~ anll to becollle' due thel'~on. including lllter~st.
T:~'~j ~:~~ .
N31 \J, ~
Str'riN"': l~ +l
Ct
UJI . It." ,902.\
SOl::ldl S<;curlty NumDar
~J;.:2~;,11<i,7
'7bl\j
OLD
TITLE:
stilre
~ Zlo
j, .2.a...,:. -4.
o ."..",0\...",. Q~ .
7~~.~r{&~
a..po:lllQt'S. 514 t"''\1
'11.1
l~tilJ
00 Q;lltor'~ Name
(SllIall
I
I
.1
.
;
I
st.uu
ZI.
l,l'''.(IT)
0/ll.ga.(J o-MoJ.. BIG'
__""".;...__......-:--~___~.--.__.........,'_",'_-.:-o:;.
..............~
.L
oj"~
.,
"
-
f>>::d
2,296 .>:2,5:01
>:958 ,>:2, 2,.2, OH5 153M ~N~8 NOlln~:WOM~ 2.:0, S002-Sl-~d~
HUD-1 (~~ev_ 3/86)
.. . .<<~I;:"fTl!;N1I:;~Tc:t1AR:G.I;:S
OMB No. 2502-0265
L
700. TOTAL SALES/BROKER'S COMMISSION
BASEDONPRICE $109,000.00
@
6 %= $6,540.00
PAID FROM
BORROWER'S
FUNDS
AT
SETTLEMENT
PAID FROM
SELLER'S
FUNDS
AT
SETTLEMENT
DIVISION OF COMMISSION (LINE 700) AS FOLLOWS:
1-0:1: "::$~~::S:~i,J::.::OO
702
703 '
704
7.05: :cb~iS:S;6n:pa:id:;U- 8~tll~~~~f
706 Transaction Fee to RSR Realtors, LLC
)0:::- :)~$~:::~"'~i~o~~;:)~.:tic
to
to
$<ri::540::.:O(
$125.0(
800. ITEMS PAYABLE IN CONNECTION WITH LOAN:
80-1 '~Q:an :~riginali9n fee:
B02_ Loandiscounl
:%: :IQ :Ame:ti:c~ri :-Honie Mci:rtgage
% 10 American Home Mortgage
eo3::Apprais,:alh)~:t9:, A;merlccin:: :1Ior.n~: :~()rt;gag:e:
B04, Credit report to' American Home Mortgage
8Q5:Le:nder'smspeciron:f~e AAE!~:..fC',iu~_ RQin~ :HQ.i_t_ga~
B06, Mortgage insurance application fee 10 American Home Mortgage
807: 'AssumpliorrfliEi:: Aineri:can -: :Home: :Mort:~ti.ge,
808 DU/LP Fee
gO!~: :P,tin(;f;i,ri:g/$e:v:felt-::F~e: :~9:)~i!'i~i:li;:-.;iri:::J1~ffl~ :~c:.t~g~:-
810
811
812
813
$3~S.OO
$8.25
$21. 70
::$4:nL:QQ
: :Tax: :Sejy:i~tiI:: :l?e(ft:'
MERS Registration
Piooei <H~:Zard 'Pee
Fee
:$7:4:.::00'
$3.95
$is-;:oo'
8"
8-15 :Bori"9we~: :Plii:CL9!l: :A~C9Urit :-(:C~e~~~)
816
ff17
818
819
820
($295.00)
900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE:
9OUnterest(ram 03(~1/2:0:a5 to 04/01/2005
@
:$:13~?3:(.da:t:
$13.93
902, Mortgage insurance premium for
9'03:. Hazardinsurari~. premiUm for
904. Flood insurance premium for
mos_to
':yis:.:10
yrs_lo
months@
..-.',- ~24:::17~r.ri'!~lt]:'
per month
90S:
1000. RESERVES DEPOSITED WITH LENDER:
1001:Hazard fnsurance :3:;:OP::mo!ithS:@.
1002. Mortgage insurance months@
1003;:City:p~i?et!y:ta:~es.::
1004. County property taxes
:'005,::Arintiat a~~es.s~lits.
1006, Flood insurance
1'007: sdioCii :ta-xes'
1008
3.00months@
$33.77 per month
months@
permonlh
,. '::$~8'~5~:~~i!i?iitti:'
per month
. ,- i:o<o~::ilw~t~~:@r' ,.
A. Settlement Statement
U.S. Department of Housinq
and Urban Development ~
,r
OMB No. 2502-0265
B. Type of Loan
1. D FHA 2. D FmHA
4. D VA 5. D Conv. Ins.
C. NOTE:This form is furnished to give you a statement of actual settlement costs. A~ounts ~aid to and by the settleme~t agent ~re shown.
Items marked "p.D.C" were paid outside of closing; they are shown here for Informational purposes and are not Included In the totals.
D. .N.A.M.E. ANO....A. O.'.O.R.'. E$$O. F. iB. O. R. R. O....iN..E.R. :.....Alfi"iit;:~. ......c~.ii...... SillijlC:~filiic~i"'>
.. .... .... ........................... .... ...... ....... ... 2$~.SQl1!hY.Qik$treet;Ettersi-P)L1t31~.... . ...~$~S<>u'hY"rkSlteet,.Etters'/~A.1731~
3. ~ Cony. Unins File Number
B19779-LAW (GF)
Loan Number
0000757359
Mortgage Insurance Case Number
N/A
E. NAME AND ADDRESS OF SELLER:
Estate of Rachel J. Brosius
27 North Ninth Street, Lemoyne, PA 17043
FNAMEANDADDRESS.OF.[ENDER' .........~%tt~~~g~~~otftteivi,je'%,tl~t4t...................
G. PROPERTY
LOCATION:
27 North Ninth Street
Lemoyne, PA 17043
H..~~16~E6:~[ri~~~~~T,..."...'...~f~~Z:fsV~f~~~~%~~~WD.........
TIN:.. ....:..:...:::...:.~$"t1~1~~C:....... .. ....................................
L SETTLEMENT DATE: 03/31/2005 I RESCISSION DATE:
J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION
100GROSSAMOUNTDUE~ROMB()RROVIIER: ... .... ... ................4~O,~()S!lANIQlJNTl)U!rT().SEq:!1I't:
:.' '.-'.C' '.... '"1:ag ::~o:aoUo:o: \: ::/$109: /(j:cf(j:/o:o;
102. Personal Property 402. Personal property
ADJUSTMENTS FOR ITEMS PAID BY SELLER IN ADVANCE: ADJUSTMENTS FOR ITEMS PAID BY SELLER IN ADVANCE:
104. 404.
l()6:: C;ilyftown:.tf!xes
107_ County Taxes 03/31/2005 t6 12/31/2005
1oa.A.'""'rJJ.nt,>djjjihi1osido~jid/ii1ds
109. Municipal, 03/31/2005 -03/31/2005
111.
$300.51 407. County Taxes 03/31/2005 to 12/31/2005
..4.oi"'a""..m.';\.' .' ..' .'ojjiiiiolls.,.'".., ..' o~iii1j~i1i1s.'.
409. Municipal, 03/31/2005 -03/31/2005
$300.51
$1.04
120. GROSS AMOUNT DUE FROM BORROWER:
20\)......MOllNT$..P...IOl>yQR..IN$108A~F.QFOORRQiNIOR'...
$113,150.65 420. GROSS AMOUNT DUE TO SELLER:
......................................... .$\)O;RIODi.!OTION$.IN.AMO(,JNt.QVIOTO$IO~kER;.....
$109,504.78
""" I""\~~~~;I ~~ "'''''''''''''' mnnF!V
$1,000.00 501. Excess deposit (see instructions)
...... ;';':';-:':':-o:~':'7:::-~:n
04/18/2005 12:36 FAX 515 457 4219
COVA
I4J 002
MetLifelnvestors~
April 18. 2005
GATES, HABRUNER, & HATCH
ATTN: CRAIG HATCH ESQUIRE
1013 MUMMA RD STE 100
LEMOYNE PA 17043
RE: Contract Number: A2053001
Owner: Rachel Brosius
Dear Mr Hatch:
Thank you for your recent request regarding the above referenced contract. Our
records indicate the account value on the date of death as follows:
Date of Death: January 5, 2005
Account Value: $21,188.95
The primary beneficiary is Donald Brosius. There is no earned income from the
date of death, rather a loss of $555.13_ The policy issue date is December 4,
199B.
If you have any questions regarding the above please contact an Annuity Service
Representative at 1-800-284-4536. Our staff will gladly help you between the
hours of 7:30 a.m. and 5:30 p.m., Central Time, Monday through Thursday and
7:30 a.m. to 5:00 p.m. on Friday.
Sincerely
Marilyn Hall
Annuity Policy Service Department
~:
MefliFa InnSlOrs USA Insut'ance Company
..- Send All c........".,...... ""
1'.0. &;ur.1i1.5C?3 OesMclf1e~.1A .;0306-'3593
for fJCpr856 Mail Only:
4700 We:.k.,....' ?orb..-ClY, $uHe 200 W.dl i:::~!~ Moin6~, J^ 50266-671 a
Ph, 800 28~ ~53~
Estate of Rachel J. Brosius
Pennsylvania Inheritance Tax Return
Form REV -1500
EXHIBIT F
Documentation of Paid Administration Expenses
and Creditors of the Estate
.
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MYERS-HARNER FUNERAL HOME, ING.
1903 MARKET STREET
Mr. Donald L. Brosius
POBox 173
Raynham Center MA 02768
Services for Rachel J. Brosius
January 13, 2005
Charges for Services Selected
Professional Services
Use of Facilities
Automotive Equipment
Charges for Merchandise Selected
Casket
Vault
Cash Advanced
Newspaper Notice/Local
Newspaper Notice/Out-of-To\<n
Clergy
Organist
Certified Copies
Milage
ROBERT H. HARNER
SUPERVISOR
CAMP HILL. PENNSYLVANIA 17011
LOCALLY OWNED AND
OPERATED
TELEPHONE
717-737-9961
January 27, 2005
$ 3,775.00
$ 3,775.00
$ 1,950.00
980.00
$ 2,930.00
$
196.00
90.00
100.00
75.00
20.00
180.00
$ 661. 00
Total due within thirty days, please:
$ 7,366.00
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RECEIPT FOR PAYMENT
GLENDA FARNER STRASBAUGH
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17U13
BROSIUS RACHEL J
Estate File No.:
Paid By Remarks:
2005-00050
BROSIUS
CCP
Receipt Date:
Recetpt Time:
Recelpt No.:
1/18/2005
16:07:49
1039155
------------------------ Receipt Distribution ------------------------
Fee/Tax Description
PETITION LTRS TEST
JCP FEE
SHORT CERTIFICATE
AUTOMATION FEE
WILL
Check# 2178
Total Received.........
Payment Amount
260.00
10.00
12.00
5.00
15.00
----------------
$302.00
$302.00
Payee Name
CUMBERLAND COUNTY GENERAL FUN
BUREAU OF RECEIPTS & CNTR M.D
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND COUNTY GENERAL FUN
([be patriot-1~ew5
Now you know
Order Confirmation
0001261244
kkline
kkline
Phone
Customer
GATES, HALBRUNER & HATCH, PC
Orderer Account Number
11885
Ad Order
Paver
Paver Account Number
11885
Sales
Order Taker
Order Source
GATES, HALBRUNER & HATCH, P.C
ATTN: VALERIE LONG@13 MUMMA ROAD, SUITE
1~
LEMOYNE PA 17043 USA
Special Pricinq None
PO Number
Ordered By
Valerie
Customer Fax
Customer EMail
Customer Phone 717-731-9600
Payer Phone 717-731-9600
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MEMO # /$7.s-
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RACHEL BROSIUS
27 N. 9TH ST.
LEMOYNE, PA 17043
Invoice la'xl
Ad Order Notes
Materials
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Ad Number Ad Type
0001261244-0' Legal Liners
Ad Size
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Color
<NONE>
Production Method Production Notes
Ad Booker
Product Information
Classification
# Inserts
Run Dates
PNCO: :Full Run
806-Estate Notices
3
2/12/2005, 2/19/2005, 2126/2005
Run Schedule Invoice Text
ESTATE NOTICELETTERS TESTAMENTARY for the Estate of RACHEl J. BRD'5/u5
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_DI-;IDEND MILES
JNALD L BROSIUS
,NICE D BROSIUS
:count Number:
4356 0077 0611 0498
our US Airways@ Visa@ Classic Card
lew Balance $1,695.11
otal Credit Line
$12,000.00 Available Credit
$10,304.89
$10,304.00
ash Limit
$12,000.00 Available Cash
$0.00 Billing Date
01/26/05
.verlimit Amount
linimum Payment Due
$10.00 Payment Due Date 02115/05
.Hour Customer Service
. Lost or Stolen Cards
1.800.441.0130 Payontinel Visit
1.800.848.6090 www.bankofamerica.com
') Airways@ Dividend Miles Summary
';dend Miles 1,695
'idend Miles Account Number 116B6C6
"ansactions View recent transactions and pay your bill online at www.bankofamerica.com.
>ST.
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102
107
107
108
110
TRANS.
DATE
Dee 29
Dec 30
Jan 05
Jan 04
Jan 08
Jan 08
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$217.90
110
110
$10.00
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113
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Jan 09
Jan 11
$21.00
$217.20
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REF. DESCRIPTION AMOUNT
NO. CR=CREDlT
344 HESS 21332 RA YNHAM MA $20.00
436 CUMBERLAND 91801944 BRIDGEWATER MA $20.00
_._._-~------
945 HILLTOP CITGO RA YNHAM MA $21.50
. -
462 CHIANTIS ITALIAN GRILLE MIDDLEBORO MA $40.00
243 Payment - Thank you CR $2,782.53
945 US AIRWAYS 0372175786156PHONE SALE NC '"$217mi-.
BROSIUS/CHRISTOPHER
MDT MDT BOS MDT BOS
# 0372175
Jan 08 952 US AIRWAYS 0372175786157PHONE SALE NC
BROSIUS/MICHAEL
MDT MDT BOS MDT BOS
# 0372175
Jan 08 823 US AIRWAYS 0370612535170PHONE SALE NC
BROSIUS/CHRISTOP
===
# 0370612
379 CUMBERLAND 91801738 REHOBOTH MA
318 RED LION INN STOCKBRIDGE MA
-~---
Jan 11 326 RED LION INN STOCKBRIDGE MA $217.50
Jan 12 365 .EJe<ONMo-BiLi8 09720467 'CAMP HIL PA...$1.6'''!h
Jan 13 840tlOYl1RS/STEPHENSNS FLWR LEBANON PA / $212.00
Jan 13857ROvERS/STEPHENSNSFLWR-LEBANON-PA--r--'$s4:ilo Ji (
Jan 13 133 STEPHENSON'S FLOWE-nD 717.273.2683 PA \~4.~.~~~)
Please return remit coupon
withyourpayment~
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INVOICE#
46258
ACCOUNT :NO~.'
CSR:>'-' . ,", ::::DATE::::-'"
BYERLY
INCORPORATED
m
HOV40323603
Zurich North America
Rachel J Brosius
27 N 9th Street
Lemoyne, P A 17043
Susan D Koellner
:-EFFECTIVE :-:-:-'::EX:P:IRATI6N:" .. ':-:-:-::::BALANCEt)ui:6N:::-'-
02/27/02 02/27/03 01/19/05
AMOt.i~ipAID::::':
. :.:<.:,'::::::::: ::::-kMOON;r:DlJE'-'-'
..".......,
.............
.............
.........-..,.
'"15D. CD
$
750.00
..._--,.......
...."....---.."
Itm# 'EH I)~te 'Ttii>'rypepEosdr:i.pt:ion<'
INVOICE # 46258
.. ..-............-.-........_--...
, '<<<<>>AInbunt.<
............-.....
179728 02/27/02 MEM HOME Homeowner Premium
for period 2003c04, 2004-05 and 2005-06
$
750.00
Invoice Balance:
$
759.90
-0-
1f&~]
A Com1nehemive Imumnce, RiIk Management and Financia.l Services Company.
525 NORTH 12TH STREET' PO, BOX 525 . LEMOYNE. PA 17043-0525 . (717) 761-401 0 . 1-800-872-1127 . FAX (717) 761-4320
www.yerYlne.com
Received By:
Byerly Insurance Agents
pO Box 525, 525 N. 12th SI.
Lemoyne, PA 17043
717-761-4010
RECEIP I FOR PAYMENT
Received From:
H043615849
111_IIII11IU11lI11I11IlllIl1lIIllll!ll8IIII11II11II111I1!lIIlllllIll__IIllIII1II1111_1III1
02/27/2005 02/27/2006
IIII11l11W_IIIIIIII.IIII11III111I11I11.l1IIIIlIIlIIllIImlllllllm_IIIIIIllIII1_III1II_11111111111
Farmers Insurance Group
IIIIlWIIIlIIIIIIIlIIIIIIIIIIIII!II8ll11lll11l111ll11ll111111111l111ll11lmlllilll1llllll_I___
Susan 0 Koellner
ACCOUNT NO.
Rachel J Brosius
%Oon Brosius
PO Box 173
Raynham Center, MA 02768
This is to certify that we received payment, in the amount of $52.00, from the above listed customer.
Susan Koellner
Control No: 012 ~ 000810
TAXPAYER COPY
LOGS Statement of Real Estate Taxes
Bill No:
Bill Date.
IF TAXES ARE ESCROWED, FORWARD
MORTGAGE COMPANY **$2.00 COpy I
PAY~
TO
~ BILL TO YOUR
FAITH A. NICOLA, TAX COLLECTOR
665 MARKET STREET
LEMOYNE, PA 17043
Assessed Land Improvement Mineral Total
Values 22 000 75 110 0 97 110
COUNTY OF CUMBERLAND Discount Face
Rates .00200600 ,00200600 2.
COUNTY R/E 44.13 150.67 190.90 194.80
Rates .00018000 .00018000 2 .
COUNTY LIB 3.96 13.52 17.13 17.48
BOROUGH OF LEMOYNE : I
Rates .00199000 .00199000 2 .
MUNIC. R/E 43.78 149.47 189.38 193.25
TAX AMOUNT DUE-> $397.41 $405.53
Xf Paid On or After :j~:~2005 ~j~~j~OO5
Xl Paid on or Before 4 30/2005 6 30 2005
IF NOT PAID BY 1213112005 THIS BIll. WIll. BE RE1URNED TO TAX
CLAIM BUREAU FOR COLLECTION AND RUNG OF A UEN AGAINST
YOUR PROPERTY.
OESC:
MAP NO: 12.21.0267.219
27 N NINTH STREET
ACRES .090 DEED 0036000399
LAND LESS THAN 1 ACRE
Residential Building
RESIDENTIAL
TAX B .
PAYER rOSIUS
PO BOX ]73
Raynham Center, MA 02768
- SEE REVERSE SIDE OF BIll. FOR A BREAKDOWN OF YOUR COUNTY TAX [
OFFICE IVIVI"UMI u..,.-,.." no .~~___.__
HOU'S, MAY, SEPT, DEC, JAN, FEB TUESDAY
ONLY 9.11AM 'CLOSED ALL HOliDAYS
PHONE: (717) 761.7785
TAXES ARE ESCROWED, FORWAHD H11S BILL TU YUUH
)RTGAGE COMPANY U$2.oo COPY FEE"
Return Bill with Payment. For a Receipt, Enclose Self Addressed Stamped Envelope
I AX LULLt:L I UH LiU....Y 6111 NO:
Control No. 012 ~ 000810
2005 Statement of Real Estate Taxes
Bill Date-
MAP NO: 12.21~0267.219
27 N NINTH STREET
ACRES .090 DEED 00360 00399
LAND L~'ss..rHAN 1 ACRE
Residential Building
RESIDfNTIAL
Assessed Land Improvement Mineral Total
Values 22 000 75 110 0 97 110
COUNTY OF CUMBERLAND Discount Face
Rates .00200600 .00200600 2%
COUNTY RIB i 44.13 150.67 190.90 194.80
Rates .00018000 .00018000 2'
COUNTY LIB 3.96 13.52 17.13 17.48
BOROUGH OF LEMOYNE : I
Rates .00199000 .00199000 2 .
MaNIC. R/E 43.78 149.47 189.38 193.25
TAX AMOUNT DUE-> $397.41 $405.53
if Paid On or After ;~?~~;OO5 ~~~1~2005
if Paid On or Before 4 30 2005 6 30/2005
IF NOT PAID BY 1zr.n12OO5 lHlS BILL WILL BE RElURNED TO TAX
"ABLE
"
FAITH A. NICOLA, TAX COLLECTOR
665 MARKET STREET
LEMOYNE, PA 17043
;c,
'"
."
BROSIUS, RACHEL J
2..NORTH NINTH STREET
LEIlIOYNE PA 17043
II'
CLAIM BUREAU FOR COLLECTlON AND flUNG OF A UEN AGAINST
YOUR PROPERTY.
,;,.
- SEE REVERSE SIDE OF BIll. FOR A BREAKDOWN OF YOUR COUNTY TAX I
,c, MONDAYS 4.6PM TUES&WED 9~ 11 :30AM
,"s MAY, SEPT, DEC, JAN, FEBTUESDAY
ONLY 9~11AM 'CLOSED ALL HOliDAYS
PHONE: (717) 761.7785
Return Bill with Payment. For a Receipt I Enclose Self Addressed Stamped Envelop!
[--
i
RACHEL BROSIUS
27 N. 9TH ST.
LEMOYNE, PA 17043
2197
$ :se17, 00
DOLLARS fi'I iE-::':'-
FbltonBank:
~ Capital Division . Drovers Bank Division.
. Great Valley Division. lancaster/Chesler Division.
,_~et_~~___~
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MEMOf'un-,M,f.~ OItl..~()ooS'lc)
I:OH:lO~"'22I: 2n'i
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3i11ing Summary for Service to:
"CHE!. BROSIUS
27 N 9TH ST
.EMOYNE PA 17043
iate Classification: '
~esidential Heating
~il/ing Period:
12/17/2005 to 03/1812005 (29 days)
Final Read
Juestions?
;all 717-232-1 Bll or write to UGI at
'0 80X 13009
leading, PA 19612-3009
{our current UGI charges include
itate taxes totaling $ 4.42.
;PT 216 546 5242 04 1
"
Past Bil/lnlormation - UGI Utili\y
The account balance on your last bill was ................
Thank you for your payment of .....................................
Your balance as of 03/22/2005 ...................................
$ 80.00
-80.00
0.00
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"'o;;w '"'" ," ....""."..M
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216546524204
Current Bil/lnformation - UGI Utility
Customer Charge .............................................................. 8.55
Commodity Charge ( 104 CCF at $0.B9212)............ 92.7B
Distribution Charges (First 50 CCF at $0.3BOOO) ... 19.00
Distribution Charges (Next 54 CCF at $0.31537) .... 17.03
PA State Tax Surcharge .................................................. -0.21
Total Current Charges - UGI Utility ............................... 137.15
Budget Billing Close Out Amount ................................. 214.03
UGI Utility charges owed this bil/ ..................................................................................
Total Amount Due, Please Pay by Due Date (04/13/2005) .....................................
$ 351.18
$ 351.18
7.10
6.39
5.68
4.97
4.26
3.55
2.84
2.13
1.42
0.71
0.00
Average
\\
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~ PAYTOTHE
., ORDER OF
~ ~~ _~ Vke- oW/kt~
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Average CCF Per Day
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2004 : i
. = I -
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Meter Reading Information
Meter Number Previous Reading
1089248 9054J>ViQ<!0_wL .
Present Reading
9J5R_lfinill_____
CCF Used
---<-^--
2203
RACHEL BROSIUS
27 N. 9TH ST.
LEMOYNE, PA 17043
60-14222
313
221901420 / /,
DATE 3, "'I (f J-
I $ 3-2/1 /ff"
~f5 A _,_
DOLLARS l.!J =-,"",,..,.
I !P
u {z z:-
. Capital Division . Drovers Bank Divisio.n.".
. Great Valley Division. Lancaster/CheSter DIvISion.
MEMO .2/6 -.:;-/jt; ~-,pI2.. of
I:O:lUo~...nl: 2nq 0~"'201l'
/<' I
<:" ~~fM_(d~---'!!
220 :I
:CF/day
Qaily temperature 40ClF
310F
P1U~
l.~ GAS SERVICE
" you pay at a payment agent please take your entire bill. Make check payable to UGI.
Keep this part lor yourrecords. Important Inlormation Is on the back 01 this bil/.
UGI Utilities, Inc.
Post Office Box 13009
Reading, PA 19612-3009
Please pay by the due date
to avoid the lale charge.
Please return this portion
with your paymenl
CPT 216 546 5242 04 1
~
~
..
RH
/11...,.1.11...1.11..1..1.11,.....111...1..11.1,..1..11..11..1
*********AUTO** MIXED AADC 195
RACHEL BROSIUS
POBX173
RAYNHAM CENTE MA 02768
270
216546524204041301000351180004390000000000000000000002
~~
I~ 6AS HHICE
Billing Summary for Service to:
RACHEL BROSIUS
27 N 9TH ST
lEMOYNf fA 17D43
Rate Classification:
Residential Heating
Billing Period:
12/17/2004 to 01119/2005 (33 days)
Estimated Read
Questions?
Call 717-232-1 Bl1 or write to UGI at
PO BOX 13009
Reading, PA 19612-3009
. Your current UGI charges include
State taxes totaling $ 5.93.
CPT 216 546 5242 04 1
Past Bill Information - UGI Utility
The account balance on your last bill was ..............
Thank you for your payment of ...................................
Vour balance as of 01/21/2005.................................
$ BO.OO
-BO.OO
0.00
.~li..:if~
rm- 546 5242 04
Curr.nt Bill Information - UGI Ulllity
Customer Charge ............................................................ B.55
Commodity Charge ( 143 CCF at $0.B9217) .......... 127.5B
Distribution Charges (First 50 CCF at $0.3BOOO).. 19.00
Distribution Charges (Next 93 CCF at $0.31527) .. 29.32
PA State Tax Surcharge ................................................. -0.2B
Tolal Current Charges - UGJ Utility............................. 1 B4.17
BUdget Billing Amount .................................................. BO.OO
UGI Utility charg.s owed this bill ..................................................................................
Total Amount Du., Pl.... Pay by Du. Date (02/11/2005) .....................................
$ 80.00
$ 80.00
7.20
6.4B
5.76
5.04
4.32
3.60
2.BB
2.16
1.44
0.72
0.00
A..rag. CCF P.r Day
.
II
.
.11.. .1
.
.
J FMAMJJASONDJ
2004 Months 2005
= Estimated Usage
Last This
Average Year Year
CCF/day 4.64 4.33
Daily temperature 310F 320F
t'-.::!.m.
M.ter Information - N.xt R.ad Date F.bruary 17, 2005
Meter Number Previous Reading Present Reading
10B9248 B747 (window) B890 (estimated)
CCF Us.d
143
M.ssag.s Irom UGI
.Vour current price to comp.re is $ 0.89216/CCF.
.Vour total annual usage is 845 CCF. Vour average monthly usage is 70 CCF.
.Vour annual budget year began with September 2004.
To date you have been billed $ 400.00
To d.te you h.ve used $ 484.53
. Help prevent pipeline damage, accidents and selVice disruptions. If you see someone
digging near your home please call UGI.
'Z-l~~L
D~
\.
,
:J ,(~
If you pay at a payment agent please lake your enlire bill. Make check payable to UGl
Keep this part for your records. Important information Is on the back 01 this bill,
II yuu PdY a( a payment agent plea t k ..
Keep this part for your records. Imspeo:t::.o~~,enl"e blli/. Make Check payable (0 UGI.
ormat on Is on the back o( this bill,
UGI Utilities, Inc.
Post Of lice Box 13009
Reading, PA 19612-3009
Ple.se p.y by the due date
to aVDid the late charge.
Please return this portion
with your payment
CPT 216 546 5242 04 1
RH
l~
~
~
1.,.111.,.111,...1..1..11....11.1..1..1".1,1,..1.11..,1..11.1
************** AUTOCR ** C-OD2
RACHEL BROSIUS
27 N 9TH ST
lEMOYNE PA 17043
280
21654 65?4?n li n;:q,l,nl.nnnnAnnnnnnl nnnnnnn~~___ _ _
80.00
80.00
~
I
Billing Summary for Service to:
RACHEl. BROSIUS
27 N 9TH ST
LEMOYNE PA 17043
Rate Classification:
Residential Heating
Billing Period:
0111912005 to 0211712005 (29 days)
Window Read
Questions?
Call 717-232-1811 Dr write to UGI at
PO BOX 13009
Reading, PA 19612-3009
. Your current UGI charges include
State taxes totaling $ 6.75.
CPT 216;;:42;~,- A) 7 ~
-
~-~.
Past BiIIlnlormation - UGI Utility
The account balance on your last bill was ................
Thank you for your payment 01 .....................................
Your balance as 01 02/22/2005 ...................................
~
$-:~:~~ ~
Current BiIIlnlormatlon - UGI Utility
Customer Charge .............................................................. 8.55
Commodity Charge ( 164 CCF at $0.89213) ............ 146.31
Distribution Charges (First 5D CCF at $0.38000) ... 19.00
Distribution Charges (Next 114 CCF at $D.31535) . 35.95
PA State Tax Surcharge .................................................. -0.31
Total Current Charges - UGI Utility............................... 209.50
8ud~t BiUing Amount .................................................... 80.00
UGI tlllty c arges owed this bill ..................................................................................
Total Amount Due, Please Pay by Due Date (03/15/2005) .....................................
$ 80_00
$ 80.00
7.20
6.48
5.76
5.04
4.32
3.60
2.88
2.16
1.44
0.72
0.00
Average CCF Per Day
.
.11 .
FMAMJJASDNDJF
2004 Months 2D05
. = Estimated Usage
Average
Last
Year
This
Year
CCF/day 5.70
Oaily temperature 260F
5.66
280F
':~ f-#
l-t- GAS $1111'/&1
Meter Information - Next Read Date April 20, 2005
Meter Number Previous Reading Present Reading
1089248 889D (estimated) 9D54 (window)
CCF Used
164
Messages from UGI
. Your current price to compare is $ D.89216/CCF.
.Your total annua' usage is 856 CCF. Your average monthly usage is 71 CCF.
.Your annual budget year began with September 2004.
To date you have been billed $ 480.0D
To date you have used $ 694.03
. Help prevent pipeline damage. accidents and service disruptions. If you see someone
digging near your home please call UGI. :
II you pay at a payment agent please take your entire bill. Make check payable to UGI.
Keep this part for YOur!".!'~r~~ _'mportant Information is on the back 01 this bill.
-
UGI Utilities, Ino.
Post Office Box 13009
Reading, PA 19612-3009
Please pay by the due date
to avoid the late cbarge.
Please return this portion
with your payment
CPT 216 546 5242 04 1
~
~
~
RH
1...111...111....1..1..11....11.1..1..11..1.1...1.11...1..11.1
************** AUTOCR ** C-002
RACHEL BROSIUS
27 N 9TH ST
LEMOYNE PA 17043
280
216546524204031501000080000001000000000000000000000007
@omcast.
ACCOUNT
NUMBER
DATE
DUE
TOTAL
AMOUNT DUE
7f.
Visit us on the web at www.comcast.com
09547 178942.01.2
02f28/05
$42.24
RACHEL J, BROSIUS
How to reach us...
How to reach us:
4830 Carlisle Pike, Suite 0-14
Mechanicsburg, Pa 17055
(717)540.8900
Telephone Customer Service
24 hours a day. seven days a week
For service at:
27 N 9TH ST
LEMOYNE PA 17043-1435
Summary of Charges
Billed from 02/18/0510 03/17/05
Previous Balanc~ ._____
Paym,,-nlu!~c1udes payments r.."ceived by 02/93./Qil
M.'!..n.!l1.!Y_ServicHs
T-"x-"~n~u,,:;harg~~,~_fee~_____ ._. _ .. _____._.___ ____
42.24
42.24 cr
39.95..__
2.29
Total Due
$42.24
Detail of Charg,"' on back
News from Com cast
The Federal Communications Commission public inspection file for this system.-is
maintained at 4601 Smith S1reet, Harrisburg, Pa 17109.
Thank you for your prompt payment. For your convenience, we now proV!5jeNoU with
more quick and easy payment options, including one-time payments, reCufrj~g-Gredit
card payments or direct debit payments. Please call your Comcast Custoiner
Account Executive and find out how you can sign up for Corncast PayDired today.
......._---~
@mcast.
ACCOUNT DATE TOTAL J
NUMBER DUE AMOUNT DUE
09547178942-01-2 01130/05 $42.24
Visit us on the web at WWW.comcast.com
RACHEL J. BROSIUS
How to reach us...
How to reach us:
3800 Trtndle Rd, Suite B
Camp Hill, PA 17011
(717)540-8900
Telephone Customer Service
24 hours a day, seven days a week
For service at
27 N 9TH ST
lEMOYNE PA 17043-1435
Summary of Charges
Billed from 01/18/05 to 02/17/05
Previous Balance
Payments (includes payments received by 01/06/05)
Momhly Services
Tax.es, SurcharlJE'S., & Fees
42_24
42.24 cr
39_95
2_29
Total Due
$42.24
oJ-
J
,)(~ loj
d)~ J-' sl
Oetail of Charges on back
News from Comeast
Thank you for your prompt payment. For your convenience, we now provide you with
more quick and easy payment options, including one-time payments, recurring credit
card payments or direct debit payments_ Please call your:Comcast Customer
Account Executive and find out how you can sign up for Comcast Pay Direct today.
@C?omsgv~!@
4008 N DUPONT HWY
NEW CASTLE OE 19121).6328
Please derach and enclose this coupon with your payment.
Do not send cash. Make checks payable to:
COMCAST CABLEV/S/ON
ADDRESS SERVICE REQUESTED
01130/05
$42.24
AMOUNT
ENCLOSED
$
Date Due
Total Amounl DUG
OOQ-01-0S-C-C
Account Number 09547178942-01-2
AC 01 009623 509868 30 8"C002
RACHEL J. BROSIUS ? 0 ""ClX /'7.3 1...111.1....11.1.1..1..1...11.11...11....1.1...1.11
-27 fl !HII"Sf- DC
Iol'Mf>Yf4[ fA 178'3 113&- /51/'j,iJkf11( ChI' /11.1-
D,}. 7G, Y
1..,111...111.,..1..1..11...,11.1..1..11..1,1".1,11...1,,11.1
COMCAST CABLE
POBOX 3005
SOUTHEASTERN PA
19398-3005
09547 178942 01 2
2
004224
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AT&T Stateml t
#BWNCJFM
00901143215201300 0095025MB I 0.3098457 A81616
111"",1,11,.,1,11,.1,.1,11"""111",1,,11,1,,,1,,11,,11,,1
MR LEE P BROSI\-JS
PO BOX 173
RA YNHAM eTA MA 02768.0173
1,.111111....111.1.11..111111..111.,1.11.11..111.1.111..1.1,111.1.111.,1
Summary of charges
:)revious balance mm',,,,'m'" ..m.',,,,,,,, .................. ..............26.27
'ayment received Feb 14 . Thank you ..................... ....... .26.27
H& T direct dialed calls ........................................p 3 .......0.42
)ther charges and credits.. . ...... ...........p 3 ............ 1.95
faxes and surcharges.. .................. ....................p 3 ......... 0.34
rotal amount due
[late due
$2.71
March 27, 2005
.=..
r
RACHEL BROSIUS
27 N. 9TH ST.
LEMOYNE, PA 17043
. .
~ '\ .----
PAYTOTilE /1- 'f R' /
ORDER OF - -. /'
! '~O /hd/dAS r L- .
l Fulton Bank
~ ,-,.. :.. Capital Division . Drovers Bank Divisi~n..
. Great Valley Division. Lancaster/Chesler DIVision.
. 17 2 77 """<0:: .J) \
MEMO 71, <, !'J(J', ....-
I:OH30~1,221: 2nl:J O~1,201l'
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Customer 10: 717 737-8066 1432152
Page 1 of 4
Customer Service: 1 800222-0300
Text Phone (TTY): 1 800833-3232
Internet Address: www.att.com
I
4Y-" Extra! Extra!
Subscribe to USA TODAY and
enjoy the convenience of home or
office delivery tor only $12.95
per month. Continued...
-'--'=;;<...-
,-~-
1
2196
60-14222
313
221901420? / I" ,___
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~ $';<.. 7/
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DOLLARS "-'
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=..~-
0.-..0-,0.
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JJ
Detach and return with paymcnt
Please write your customer ID on your check or money order
made payable to AT&T. Do not send cash. Do not staple this
::>ortion to your payment. Thank you.
Total amount due
Date due
$2.71
March 27, 2005
Amount enclosed: $1 .2, '7 (
111..,1".1.,.1111."."11,.,11"1,111,,.11,,.11,.,11.,,1.,1,1
AT&T
PO BOX 1200
NEWARK NJ 07101.1200
11.1.111.1.,.111,1.11..111111..111..1.11.11..111.1.111..1.1.111.1.1.1.11
Continues on back ~
AT&T
-
-
MR LEE P BROSIUS
Feb 3-Mar 2.2005
Customer 10: 717 737-80660
D
Moving? It's hassle-free with
A T& T. Check the box, print your
new address on back.
Save your check! Visit
www.att.com/remitdoc
n90114~?152010000100000000271000000027100000002713
it
,8WNCJFM
.090114321520130 D 0077861 MBl 0.309B405A 79149
111"",1,11",/,/1"1"1,11"",,111,,,1.,/1,1,,,1,,1',,11,,1
MR LEE P BROSIUS
PO BOX 173
RA YNHAM eTR MA 02768.0173
1.,111111,.,,1/1,1,11,,111111,,111..1.11.11..111,1.111..1.1.111,1.111.,/
Summary of charges
lrevious balance ._... h. .." .......... no......... __................... ".. ........ ...25.48
'ayment received Nov 16 - Thank you ............................. -25.48
\T&T direct diated calls.................... .....p 3 ............0.70
lther charges and cledits.. .....p3 ..........22:26
'axes and surcharges ..........................................p 3 ............3.31
AT&T
CuslomerlO: 717 737-8066 1432152
Page 1 ot4
Customer Service: 1 800222-0300
T exl Phone (TTY): 1 800 833-3232
Internel Address: www.attcom
~ Extra! Extra!
Plans change at the last minute?
Diat 1-BOO-CALL -A TT tor collect
calls & stay in touch when
someone is counting on you,
anywhere ill the USA
.otal amount due
late due
$26.27
February 27, 2~~__________
---.-- . -- -.,,"
73 r? . Qa6C; D
. ( - (/ ~22
313
22\%1420 ~ ~
DATE ~ I) d. ")
F
----
if . '7/'1
~ RACHEL BROSIUS
i~ 27 N. 9TH ST.
17043
! ;1 'j( dd~ + /d'O
'; ~
i~ . capital Division . Orove(sBankDivisil::~n... ~
~,. 0 MEMO. Gleat Va;Jt'J o~terlChester DIVIsIon. .... ,P
/7'"Z1-....- ../~d. 0---_____ -""
1:03UOI,I.,22I: 221.9 01.1.,2011" 21.85
2185
$o<,d' ,cf2 7
A --
DOLLARS l!.l =--
Dctach and return with paymcnt
Continues on back ~
----- - -. _.--- --- ~ - ---- .
)Iease write your customer 10 on your check or money order
nade payable to A T& T. Do not send cash. Do not staple this
)ol1;on to your payment. Thank you.
r otal amount due $26.27
)ale due
February 27, 2005
Amount enclosed: $1 ;2 /, .).. 7
11I...1"'1...1111......11...11.,\.11I",""."","".1,.1.1
AT&T
PO BOX 1200
NEWARK NJ 07101.1200
11,1,111.1",11I.1.11.,11I111,.111..1,11,11,,11I.).111..1,1,111,1,1,1,II
-
-
-- AT&T
-
-
MR LEE P BROSIUS
Nov 3-Feb 2,2005
Customer 10: 717737-8066 0
D
Moving? It's hassle-free with
AT&T. Check Ihebox, print your
new address on back.
Save your check! Visit
www.atl.com/remitdoc
09011432152010000100000002627000000262700000026272
~
iferl70q
Page 1 of 17
717 737-8..066-352 81Y
ease make pavment to Verizon March 28, 2..0..05
ld return this Rage with y-our Rayment
Due Immediately
$16.34
Fi II in Amount Paid
MR P BROSIUS LEE
PO BOX 173
RAYNHAM CTR MA ..02768-..0173
111.....1.11...1.11..1..1.1111....111...1..11.111.1..11..11..1
$ [Z] [(J.[J G
~...
ver,ZRD
iunmarv of vour account
PO Box 28..0..0..0
.....LehigtJYly PA 18D()2-80DQ
Page 5 of 17
717 737-8..066-352 81Y
March 28, 2005
:harges from last month
Amount you pa i d through Mar 28 ...... -. ..0..0
Amount you s till owe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$...0..0
:harges for this month.
Our charges.......................... $...0..0
C<;lll 1 800-640-2032 if you have a question
MeI charges.......................... $16.34
Call 1 800-444-3333 if you have a question
Total- for this month...... .,. ... ...... .............
$16.34
$16.34
Total amount you owe - Please pay Inmediately
For Spanish speaking customers:
Si ~~ed no entiende 0 tiene alguna\pregunta sobre esta
factura Ilame al 1 8..0..0-479-..03..05. Preguntas sobre pagos 0
arreglos de pago lIame al 1 8OQ-834-D7D9.
RACHEL BROSIUS
27 N. 9TH ST.
LEMOYNE, PA 17043
60-14222
313
221901420 / /.
DATE ~. j tflS-
2205
-)
:;~~~~ cl"~E ~.-V'i.t "1 C'''L
<;"X i~t:; .cCpd4A.-S .A--",e-
FultonBank
. Capital Division . Drovers Bank Division .
. Great Valley Division. Lancaster/Chester Division . "~ '
MEMO 7/77378'0/,.{-352 ~~~~M'
1:0:1 LIOIoI, 221: 22loq 0101,2011. 2205
$ 1(,. 3(
A _.._
DOLLARS W =".;,__
~
...,;#"" ,
veriZl1n
We never stop working for you.
MR LEE P BROSIUS
~
Account Sum':!1ary
Previous Charges
Payments Received thru Mar 3
$45.11
-45.11
Past Due Charges
$.00
New Charges
Verizon (page 3)
Other Providers (page 5)
Total New Charges due Mar 28
$15.97
14.54
$30.51
Total Due (Past Due -+ New)
$30.51
Billing Date 03/01/0t 'age 1 of 7
Telephone Number: 71 { 737 8066
Account 717737806635281 Y
How to Reach Us: See page 2
rn
Manage Your Verizon Account On/Ine!
View & pay bif/s, request repairs, place orders.
It's quick and easy:
Go to verizon.com
Click "Sign in" under "Manage My Account".
First time user? Get starled with.
User/D:7177378066$
Password: 7K1 DQD
... and customize your 10 as you register.
Then follow the step-by-step instructions.
:"-OSL
-~'"'-~
---_._~---------------------~-_._-
rAnOTHE '\ J h, n / ..,
ORDER OF V Vi rj'/V(
? ....'"
,,~~~v1 (
,~ ,-. Capjlal Division . Drovers Bank Division. \ \ \
MEMO. G'j;;:;;7i;;~'{~;;r \ < P""-/2.fl~L~_~_ 07___ rN
1:0 H ~'b ~l, 221: 2 n~ ~L, 2011' n"lS
RACHEL BROSIUS
27 N. 9TH ST.
LEMOYNE. PA 17043
/f-zr' /'
Go to verizon.com/billingaddress or see page 2.
~~.,;....:
2195
60"'4222
313
221901420. /
DATE ~/ ///{~ ~-
$ 30,S-(
s/
DOLLARS lD
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_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ "!: D.!I~h2 ~Iu!..n e.aYEle!.l1 ~ip .!"i!!:! y~ur:....ch!c~ P2.y~t~lo "ye.!!z~. _ _ _
~
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Yes! I want to be a Literacy Champion.
Sign me up for a $1 monthly donation
to Verlzon Reads.
MR LEE P BROSIUS
CoO DONALD BROSIUS
PO BOX 173
RA YNHAM CENTE MA 02768-0173
111..."1,11",1,11"1"1,11,,,,,,111...1,,11,1,,,1,,11,,11,,1
Account: 717 737 8066 352 81 Y
New Charges Due: 03/28/05
Total Due
$30.51
Amount Paid:
$ 0~.00
VERIZON
PO BOX 28000
LEHIGH VL Y PA 18002-8000
1,,,111,,1,11,,,11.,,,,1.11,,1,11,"11,..11,,,".111
1D9717D7378Dbb3523D28D2189DDDDDbDDDDDDDDDDDDDDDDD3D51D00000
~~
ver;7on
Account: 717737806635281 Y
New Charges Due: 02128/05
D
Yes! J want to be a Liferacy C/Jamp;o11.
Sign me up for a $1 monthly donation
to Verizon Reads.
Total Due $45.11
Amount Paid:
$ ~0IJ[]
MR LEE P BROSIUS
CoO DONALD BROSIUS
PO BOX 173
RAYNHAM CENTE MA 02768-0173
111.....1.11...1.11..1..1.11......111...1..11.1...\..11..11..I
VERIZON
PO BOX 28000
LEHIGH VL Y PA 18002-8000
/...111..1.11...11",,,1.11,,1.11,,,11...11,,..,,111
10971707378066352302802109000006000000000000000004511200000
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..~.1...... DONALD L. BROSIUr~ ?>;'" ~;Y5/'" file? .J" 5:.:>- !l> y -1~
JANICE BROSIUS ' /. . 5945 ii,
.~~.:.' 82 AUCE ROAD i~i
. P.O. BOX 173 ,Ifil!
It,! RAYNHAM CENTER, MA 02768 -=-.--'). //. c/ -{"-- ~::~~13 I,'~i
i~: DATI?
]: 8~'h~~b~~-~)~~ ~' !~
rl,; ~.. i> . ~ $ 5/...r- // I,'
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Account 717737806635281 Y
How to Reach Us: See page 2
We never stop working for Yo~ , <6 d--
MR LEE P BROSIUS Lr~\ ~
Account Summary
:'-OSL
Verizon Online DSL: $29.95/Monthl
The Best Value In Broadband/
With a one-year commitment get our
lowest price ever, a free modem, & free
wireless router, plus a 30.day money
back guarantee. Call 1-877.668.5375
or visit verizon.com/orderDSL.
Service not available on all lines.
Subject to final verification by Verizon.
Other terms and restrictions apply.
Previous Charges
Payments Received thru Jan 5
Past Due Charges
$35.91
-35.91
$.00
New Charges
Verizon (page 3)
Other Providers (page 5)
Total New Charges due Jan 31
$17.39
9.45
$26.84
rn
Total Due (Past Due + New)
$26.84
Manage Your Verizon Account Online!
View & pay bills, request repairs, place orders,
It's quick and easy:
Go to verizon.com
Click .Sign in" under "Manage My Account",
First time user? Get started with
UserID:7177378066$
"~':H::wnrrl. AAAI!JTD
.....
~
ter.
ns,
, __ ~ RACHEL BROSIUS
I ~ _ J 27 N. 9TH ST.
--=--- LEMOYNE, PA 17043
60-14222 2182
313
221901420, J
DATE /// ~L!:'U-
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!
~
'i PAYTOTHE {).,^ J' 2c::wL
ORDER OF ~ _
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ton Bank
I $ .;2c J f/7
ff"y, 0. _,,_
DOLLARS W t::'..__
fa?
.. Capital Division . Drovers Bank Division'
. Great Valley Division. Lancaster/Chester Division.
MEMO 717 737 g-otC 3,:,-:< 81 y
I:O:l~:I0~1,221: 22~9 O~I,20II'
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I
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,
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ver,ZSlIJ
New Charges Due: 01/31/05
o
Yesll want to be a Literacy Champion.
Sign me up for a $1 monthly donation
to Verlzon Reads.
Total Due $26.84
Amount Paid:
$ 0[~J.~[f]
MR LEE P BROSIUS
27 N 9TH ST
LEMOYNE PA /7043-1435
1,"111",111""1"1,,11,",11,1.,1,,11,,1,1",1,11,,,1.,11,1
VERIZON
PO BOX 28000
LEHIGH VL Y PA 18002-8000
1,.,111"1,11".11,111.1.11,,1.11,,,1111,11111111111
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. .
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16070-80009
Page I
'.'-:-':::::;:::j:;:::::You{Bitt:A-ccil.urii.Ni;iiTIfui':::':-: "
'-'''-'---':--::-::;::-:U''e,vJici;j::c-aniri~:rit:Wfffitiv':-:':
Electric
Service
Summary Page
Balance as of Mar 18, 2005
Char~s:
TotarPPL ELECTRIC UTILITIES Charges
Total Charges
$ 4.09
$ 26.85
$ 22.76
For:
LEE BROSIUS
:!.7N 9TH ST
LEMOYNE PA 17043
Filial Bill
Account Balance
$ 26.85
-::=----=
:,;;-.-=--
rr-
QllestiOl ~'
this bill?
contact u
at 1-800. .
484-634'1 !
or write ;
Custom4 ~ PAY roTHE ? r!{ L
827 Hau. !; ORDER OF
Allento\\ I ~7~("'" /../.P/. / I A /.?
18104-9., ._~6 ~tv{.....> .~
www.ppl ~
< Bank
. Capital Division . Drovers Bank Division'
. Great Valley Division. Lancaster/Chester Division.
. ~.EMO fin {)7tJ - <;Jcn>O'1'
I:D:lUO~I.22I: 22*"l 0~1.201l. 2202
RACHEL BROSIUS
27 N. 9TH 8T.
LEMOYNE, PA 17043
60-14222
313
221901420 I h
OATE 3' 27" ".:,-
I ~
2202
I $ c:ld, , 3'6-
6'1 =::::.:-1
.
8""6-:-
DOLLARS
/&"ZJ
Elecl o.
Use
~ ~~--_'!!
This gral
your ele( I
over the
months.
.. Average - Mar 2004 2005
6 T emlIerature 42F 32F
,It KW Per Day 8 3
4
Yearly Use: Total Avera~e
2 Use MOllthy
Apr 2003 - Mar 2004 3019 25:!
0 Apr 2004 - Mar 2005 2573 214
AMJ JASONDJFMA
2004 Months 2005
Tvpes M,
Meter Readings:
Actual _
Estimated r,rrl
Customer 0
Other importaJJtill!().-mat~()J~()1I bl)~_k. ~
Return this part to address below with a check payable to PPL Elecl1ic Utilities Corporation
:-:;:-'Y-our:B'Il::' -..'cf:.-....-f F"il
......'.....:.:::;::Please:P.a\{Bv_!;:";::::-:-:"'-. :<'>':::Pa~(T"]"< - . fi:,::-
16070-80009
Apr 11,2005
$ 26,85
MB 01 059174 71328 B 367 A
LEE BROSIUS
C/O DON BROSIUS
PO BOX m
RA YNHAM CENTER MA 02768-0173
Amount Enclosed
DDD.D~~]00
PPL ELECTRIC UTILITIES
2 NORTH 9TH STREET RPC-GENNI
ALLENTOWN PA 18101-1175
111","1,11."1,11"1.,1,11,",,,1110,,1,,11,1,,,1,.11,.11,.1
1 4500000268550000026859 1607080009
]
PPL Electric
Utilities
~ . ,..
Electric
Service
For:
LEE BROSIUS
27 N 9TH ST
LEMOYNE PA 17043
Queslions a
this bill? PI,
contact us b
at 1-800-34'
484-634-491
or write to:
Customer ~
827 Hausm, .
Allentown, J
18104-9392
www.pplwe
Electr
Use
This graph ~l
your electri(
over the last J.)
months.
Types of
Meter Readings:
Actual
Estimated
Customer
. ,.
P'p":"I':~:~--
. ..... ~
.~"",
" '"
Page I
::'::':::::::':'::':::YQUi:;:BiltAcc-QJmJ:'Nllm~-::::;::::'-
16070-80009
: se\vh&d.::hl' ,-..:",{",.,.., iil~F>::' ..
Summary Page
Balance as of Mar 10, 2005
Char1@s:
TotafPPL ELECTRIC UTILITIES Charges
$ 0.00
:I> 22.76
:I> 22.76
:I> 22.76
,r=
---~---
~~,;;-
~-~"::-~~,.,-~~~......=<~
I'
I
RACHEL BROSIUS
27 N. 9TH ST.
LEMOYNE, PA 17043
60-14222
313
221901420 _.j, ~_ '_
DATE -) /7- 00
I ,
2200
rfPI t:
Yhe<,~ton~l'd tU..f /1-J!
PAYTOTHE
ORDER OF
I
7?
/tZ'
$ ~c:1, ?6
DOLLARS ID =::~
. Capital Division . Drovers Bank Division.
.. Great Valley Division. Lanca.sler/Chester Division. '-n _ ,,1 # --r /? '
MEMO /60Ft? - f5CW 7' ~Y/.-<..~ 7'-- (~~ ..
. . ._--"-_._----~---._------._--_._--~-_._-----_._-_._-- ----._--
'l:o:n:ID~I,22I: 2n"l 0~1,201I' 2200
6
4
Average
Monthly
253
233
Average - Mar
T em..Qerature
KWH Per Day
Yearly Use:
Apr 2003 - Mar 2004
Apr 2004 - Mar 2005
2004
36F
8
2005
34F
5
Total
Use
3036
2795
-
""""".HM
~
D
2
o
MAMJ JASONDJFM
2004 Months 2005
Other important informatioll 011 back -+
----- ..."."-..... . -
-----------------------------------------------------------------------------------------------------------------------------------------------
-- .--- - -
Return this part to address below with a check payable to PPL Electric Utilities Corporation
I'W~;~~A;:~~;~I
Mar 31, 2005 I ,::,:"jP.~1';;~unc:::: '1
Amount Enclosed
DDD,D~00@]
AC 01 002016 69619B 15 A""C002
LEE BROSIUS
27 N 9TH ST
LEMOYNE PA 17043-1435
PPL ELECTRIC UTILITIES
2 NORTH 9TH STREET RPC-GENN I
ALLENTOWN PA 18101-1175
1."111,.,111""1,,1.,11,,,,11,1,,1,,11,,1,1,,,1,11.,.1,,11,1
1 2400000227640000022769 1607080009
PPL Electric
Utilities
ppl
Page I
YQur:BiUAC~QlilitNi:iirtbei:<
16070-80009
':.Use:,vhe-n:'callme:p-r:wntirili:::::::::"-" .
Electric
Service
Summary Page
Balance as of Feb 8,2005
$ 0.00
For:
LEE BROSIUS
27 N 9TH ST
LEMOYNE PA 17043
Char~s:
TotarPPL ELECTRIC UTILITIES Charges $ 27.21
Total Charges $ 27.21
ffm'($!iflP~r~f~~;,;~i;.\tt(l(~ItM~rt:C1;:~00~;;~i~<0\;2;;i:;\{~~' $;~7;# I
Account Balance $ 27.21
r-
Questions a- I j
this bill? PI<
contact us b,
at 1-800-34~
484-634491 .
~--"'~~~:,"--",---~",,;,,"="--=-----'~,~~~,
or write to:
Customer S
827 Hausm,
Allentown, J
18104-9392
www.pplwe .
RACHEL BROSIUS 603-,;"22
27 N. 9TH ST. 221901~20
1 LEMOYNE. PA 17043 DATE c2. /';:f/'() :,-
'j ~~~~? 1- /' ~ elf) c it) ,/'/e \ G ~I/ I $ c2 7. ~ I
, '7 ~Z::::~4.'.1.( r?e /~ DOLLARS ID == I
. Capital Division . Drovers Bank Division.
. Great Valley Division. lancaster/Chesler Division.
MEMO / ~tJ 7.1 - rr ('J?JC1 f'
':O:U:iOIol,UI: Ulo"l
2188
Electr
Use
This graph: 'm
your electri "----
over the last] 3
months.
6
'--~"::L~'?/!~~~
o lol, 2011' 2loBB
M'
Types of
Meter Readings:
Actual _
Estimated t"'01
Customer D
4
.t:L--~:....
Average - Feb ZUU4 LUU:)
TemlIerature 2lF 30F
KW Per Day 8 7
Vearly Use: Total A vera~e
Use Month b
Mar 2003 - Feb 2004 2999 25
Mar 2004 - Feb 2005 2893 241
2
o
FMAMJ JASONDJF
2004 Months 2005
_ Other important informatioll m~ back ...
------------------------------------------------------------------------------------------------------------------------------------------------
Return this part to address below with a check payable to PPL Electric Utilities Corporation
....;', 11' .,-~-'--.,.--'-:t: W:.
16070-80009
:;;a: -1:.~005 I :~.V$T;;~:iffii' :::::1
Amount Enclosed
DDD,D0[1J.~0
AC 01 002005 629048 15 A"C002
LEE BROSIUS
27 N 9TH ST
LEMOYNE ~A 17043-t435
PPL ELECTRIC UTILITIES
2 NORTH 9TH STREET RPC-GENNI
ALLENTOWN PA 1810t-1175
1...111.,.111.,..1.,1.,11,..,11.1..1,,11..1,1..,1,11,.,1,,11,1
1 8500000272150000027219 1607080009
PPL Electric
Utilities
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" '"
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'-;;:YiJut Bill Acc:citintNum
.
16070-80009
u \VI~lcaniri2nr:vi'
Electric
Service
Summary Page
Balance as of Jan 10,2005
$ 0.00
For:
LEE BROSIUS
27 N 9TH ST
LEMOYNE PA 17043
Charges:
TotafPPL ELECTRIC UTILITIES Charges $ 31.40
Total Charges $ 31.40
1:r~~~;rlils':;\;tn()lili(NALltiertllan 'Jan 31; 2005l'1tl~~';;;: j~(>;;;)f"tfJ$:3 1:;;1'0 I
Account Balance $ 31.40
~-----~
---Liii.~---
~-~.~~.= - ....:..;..;....=.~;...:.;.,.~~..,-,...__~__._..~....._';c;,;;;.o:;:,;,~:;;.... .":..:_.';,;.~-.;,;_.; '~"""";-:"'~~.Ti
60~14222
313
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ORDER OF
I 7h~.~ c7k.-{ ~vtl4L( /,<h-7:t 9c nnLLARS !TI ~:::.- I
~ ~, d~
1 tonBank
. Capital Division. Drovers Bank Divisi~n.", ' ~ f
~ Great Valley Division _lancasterfChester DIvIsion. ,,- /) ~ / / J~
MEMO I (, 0 '10 - f5 art) 9' -kJ?!:t ~C ----~ - ------ --
I:O:H30~1,221: 22~"l O~1,201l' nao
2180
I
RACHEL BROSIUS
27 N. 9TH ST.
LEMOYNE, PA 17043
3' /. 'YO
,
M'
........""u~.... 6 Average - Jan 2004
- Te~erature 36F
~pes of KW Per Day 9
eter Readings: 4 -
Yearly Use: Total
Actual - 2 Use
Feb 2003 - Jan 2004 2994
Estimated - 0 Feb 2004 - Jan 2005 2912
Customer D J FMAMJ J ASONDJ
2004 Months 2005
5053
4769
~
2005
36F
9
Average
Munthly
250
243
Other important information on back -+
Return this part to address below with a check payable to PPL Electric Utilities Corporation
r "":"'W~;~~A~:~~:~ iil
AC 01 002123 57220B 16 A"C002
LEe BROsIUS
Z11HTII8T . Po Box /73
LIiMeynC PA 178H-14'l5
n f} y A1 )1/17lL C fr, 1/\ 11
0cJ. U ))'
1".111",111""1"1.,11",,11,',,'.,11,,',',,,',",,,',,11.1
Jan 31, 2005 rp'~T;~~~""ti:l
Amount Enclosed
DDD.D[Z]~][1J[g
PPL ELECTRIC UTILITIES
2 NORTH 9TH STREET RPC-GENNI
ALLENTOWN PA 18101-1175
1 6300000314030000031409 1607080009
000240b30805200000P-100000544012
-...,
~~-
~~ Penn~ylvania
Amell.ie-an Wa.tM
PO BOX 578
ALTON, IL 62002-0578
ACCOUNT NUMBER
24- 0630805-2
AMOUNT DUE $5.44
DUE DATE Apr 11 , 2005
For Service To: 27 N 91h SI
AMOUNT PAID
.s; 'I f
00002844701 FP 0.352
111.,,,.1.11,,.1.11..1,,1.11.,,11...11...11...11..,11,..1,..11
L P Brosius
PO BOX 173
RAYNHAM CENTER MA 02768
Please return this portion with check
T Payable to the address below T
Pennsylvania American Waler
PO Box 371412
Pittsburgh, Pa. 15250-7412
1."11,1.1.,,1.1.1,1,11...1,,.1.1..1.,,11..1.1.,11,1
Closing Bill
D Please check here to add H20~Help to Others contribution to your monthly bill
or to change your address Of telephone number. and print information on reverse side.
Customer Account Information
Billing Summary
For Service To: L P Brosius
27 N 9th SI
Accounl Number: 24-0630805-2
Premise Number: 24-0372776
------~---Prior Balance-----------------------
Balance from fast bill
Payments prior to Mar 22, 2005. Thanks!
T DIal prior balance, Mar 22, 2005
.-....-..Currenl Waler Charges.........-
Service Charge
Water Volume ($.005735 x 200)
STASPAWC Water-0.14%
DSI. PAWC Charge 1.42%
Tolal waler charges, Mar 22, 2005
Billing Per.iod & Meter Information
Billing Dale: 'Mar 22,2005
Billing Period: Mar 07 10 Mar 18 (11 days)
Nexl reading on/aboul: Apr 07, 2005
Rale Type: Residential
Meter readings in current billing period:
Meter Number N000509586 is a 5/8-inch meler.,
m......-AMOUNT DUE m.m._.__.....__
----.......
r ..
I! ~~b;~ 6~E
~!,,! F"'- FulOOn~
. . v . Capital Division . Drovers Bank Division.
. Great Valley Division. lancaster/Chesler Division' ..,,/ "
I M:;~~ ~t~-~ ::':O8'::~~2-0 ~~~~~:~h~/~
,I'
_';;'~c;;.-:'<=-';='""='"'----'~'--~'~-
-~.~~--
RACHEL BROSIUS
27 N. 9TH ST.
LEMOYNE, PA 17043
A
J...
$~ $I
DOLLARS {D
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2
o
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4
2
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5
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~19.20
-19.20
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4.22
1.15
-.01
.08
5.44
I $5.441
~
I'
01 I
i
f II
~
~:'~::'.,
!
~,
22
Messages to you from Pennsylvania American Water
Thi.~ i.c: vnllr F;n::fl Rill fnr .c:p.rvir.p. 7, hR.~ been B n/easure servina VDU and we hone we may aaain have the
00024063080S20000l ,000001920013
~~ Pe.nnJ.>ytvania
Ame.JUcan Wate.J1.
PO BOX 578
ALTON, IL 62002-0578
ACCOUNT NUMBER
24-0630805-2
For Service To: 27 N 9th St
AMOUNT DUE $19.20
DUE DATE Mar 29, 2005
AMOUNT PAID
000023972 01 FP 0.352
111,,,.,1,11,,.1.11..1,,1.11...11,.,11...11...11...11,..1."II
L P Brosius
PO BOX 173
RAYNHAM CENTER MA 02768
Please return this portion with check
~ Payable to the address below ~
Pennsylvania American Waler
PO Box 371412
Pittsburgh, Pa. 15250-7412
1."11,1,1",1.1.1,1.11."1,,.1.1..1,,,11.,1,1,,11.1
O Please check here to add H20-Help to Others contribution to your monthly bill
or to change your address or telephone number. and print infom1stion on reverse side.
Customer Account Information
Billing Summary
For Service To.
L P Brosius
Prior Balance-----------
27 N 9th St
Account Number: 24-0630805-2
Premise Number: 24-0372776
Billing PeriQd & Meter Information
Billing Date: Mat 09,2005
Billing Period: Feb 07 to Mar 07 (28 days)
Next reading on/about: Apr 07,2005
Rate Type: Residential
"-
Meter readlngsin current billing period:
Meter Number N000509586 is a 5/8-inch meter. \
Present-actual 237600
Last-actual 236300
Gallons used 1300
Balance lrom last bill
Payments prior to Mar 09,2005. Thanks!
Total prior balance, Mar 09, 2005
--------Current Water Charges------
Service Charge
Water Volume ($.005735 x 1,300)
STASPAWC Water-0.14%
OSI - PAWC Charge 1.42%
Total waler charges, Mar 09, 2005
\\1,
----------AMOUNT DUE m_________________ I
$22.10
-22.10
.00
11.50
7.46
-.03
.27
19.20
$19.201
Wal
Ij"--='" Bbt2 ,"D2'1~O bt22 :122'1~O~HO:1
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- - "'va 8vOH Vd '3NAOV'J31 !
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0002406308052000000001 02210018
~ Penn-6ytVQn.ta
~ Amel1..tC'.Wl Watel1.
PO BOX 578
ALTON. IL 62002-0578
ACCOUNT NUMBER
24-0630805-2
For Service To: 27 N 9th 51
AMOUNT DUE $22,10
DUE DATE Mar 02, 2005
AMOUNT PAID
00002862401 FP 0.352
111.....1.11...1.11..1..1.11...11...11...11...11",11,,,1.,,11
L P Brosius
PO BOX 173
RAYNHAM CENTER MA 02768
Please return this portion with check
... Payable to the address below ...
Pennsylvania American Water
PO Box 371412
Pittsburgh, Pa. 15250-7412
1.../1,1.1..,1.1,/./,//.,,1...1.1.,/...11../.1..11.1
] Please check here to add H2O-Help to Others contribution to your monthly bill
or to change your address or telephone number, and print information on reverse side.
lIstomer Account Information
Bif1ing Summary
Ir Service To: l P Brosius
27 N 91h SI
:counl Number: 24-0630805-2
emise Number: 24-0372776
----------Prior Balance--------..-------------...
Balance from last bill
Payments prior to Feb 10.2005. ?hanks!
T alai prior balance, Feb 10, 2005
--------Currenl Waler Charges---------
Service Charge
Water Vofume ($.005735 x l,aOO)
STAS PAWC Water -0.14%
05/- PAWC Charge 1.42%
Tolal waler charges, Feb 10, 2005
$23.27
-23.27
.00
Wing Period & Meter Information
lIing Dale: Feb 10. 2005
lIing Period: Jan 1010 Feb 07 (28 days)
'xl reading onfaboul: Mar 08, 2005
.Ie Type: Residential
11.50
10.32
-.03
.31
22.10
eter readings in current billing period:
eler Number N000509586 is a 5/8-inch meter.
Present-actual 236300
Lasi-actual 234500
Gal,
, '
i RACHEL BROSIUS ~22
~. 27 N 9TH ST 313
I lEM 221901420
',." DYNE, PA 17043 -'1/ . /
, DATE ~ <=,/0. 5-
l' PAYTOTHE 'J /1'. J
-;~ ORDEROF /-0?v')1'f::?t:t~4 /}'77w)IC'd....- i/t>!-t I $.2-R, /6
Wall t,.! ~ ,/00 d~~ d-- ~ ~ /Q..
"l ,.F6ItonBank: // '" /~DOLLARS I'D 1a?::::;- I'
I ; . Capital DivisiOn . Drovers Bank Divisio .
;1 . Great Vall Division. lancaster/Chester Dj~iSion . ....
i ME:O 02 ~3C) ?4?-z. ~~L 4~ ..
,~ 1.0 :1 ~:10 ~.. 2 21: 2 2 ~ ~ 0 U. 2011' 2loB q ------
----------AMOUNT DUE -----------------
$22. 101
2189
0IL-D' '.nn ~,
2 F M A M J J A S 0 N D J F
0 e a r a u u u . c 0 . a g
0 b I Y n I 9 P t v c n
4
2
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Messages to vou from Pennsylvania American
j-.. ~~rl"",,,, ....nJ...... .....1.........1, '2,......<3~ ...,hi...h ;c n....f n~irl ~~ nf :Vn7/n.li wi/J hP. ,t:;uhiBCI 10 a 1.50% DenaJtv.
c--
-..
OUU24U6.:lUIlU52
IUUUUUUOU02327010
~ Penn~ytvan~a
~~^mek~ean Watek
PO BOX 578
ALTON, IL 62002-0578
ACCOUNT NUMBER
24-0630805-2
AMOUNT DUE $23.27
00004004801 AC 0.275
1,..111..,111....1"1,,11,,,,11.1,,1..11,,1.1.,,1.11.,,1,,11.1
L P Brosius
DUE DATE Feb 01, 2005
AMOUNT PAID J3. 2- 7
For Service To: 27 N 91h SI
Please return this portion with check
'" Payable to the address below '"
27 N 9th 51
Lemoyne PA 17043-1435
Pennsylvania American Waler
PO Box 371412
Pittsburgh, Pa. 15250-7412
1..,11,1,1."1.1,1.1,11...1,,.1,1,,1...11,,1.1..11,1
D Pfe-:Jse check here to add H20-Help to Others contribution to your monthly bifl
or to change your address or telephone number, and print information on reverse side.
Customer Account Information
Billing Summary
For Service To: L P Brosius
27 N 9th St
Account Number: 24-0630805-2
Premise Number: 24-0372776
~u_------Prior Balance-n--------------_n____
Balance lrom last bill
Payments prior to Jan 12,2005. Thanks!
Total prior balance, Jan 12, 2005
---..m..Current Water Charges-------m
Service Charge
Water Volume ($.005735 x 2.000)
STAS PAWC Water-0.14%
OSI- PAWC Charge 1.42%
Total water charges, Jan 12, 2005
PAY TO THE
ORDER OF
RACHEL BROSIUS
27 N. 9TH ST.
LEMOYNE, PA 17043
2179
$19.70
-19.70
.00
11.50
11.47
-.03
.33
23.27
$23.271
"- I
- I
Billing Period & Meter Information
Billing Date: Jan 12,2005
Billing Period: Dee 07 to Jan 10 (34 days)
Next reading onlaboul: Feb 07, 2005
Rate Type: Residential
r
d
ton Bank
. Capital Division . Drovers Bank Division.
. Great Valley Division. lancaster/Chester Division. /:? .
, ME,MO 4et!-- ~f -O(,,?O~ ~~J;d'L&~_____..
I,O:lHO~1,221: 22Fl O~1,201l' 2*?'1
,
I
,
I
$ 0<3 , ,;2 7
/O~
DOLLARS ~ =.
,
J F M A M J J
~g~r;~~~
ASONDJ
II e c 0 e a
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2
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Register of Wills
Cumberland County, Pennsylvania
INVENTORY
Estate of Rachel J. Brosius
No.
2005-00050
also known as
Date of Death 001/05/2005
Deceased
Social Security No. 201-16-5621
DONALD L. BROSIUS. of P.O. Box 173. Ravnham Center. MA 02768
Personal Representative(s) of the above Estate. deceased, verify that the items appearing in the following inventory include all of the personal
assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite
each item of said Inventory represents its fair value as of the date of the decedent's death, and that Decedent owned no real estate outside of
the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. INJe verify that the statements
made in this Inventory are true and correct. IN/e understand that false statements herein are made subject to the penalties of 18 Pa. C.8.
Section 4904 relating to unsworn falisification to authorities.
Name of
Attorney:
Gates, Halbruner & Hatch, PC
Craia A. Hatch. Esa.
Personal Representative
7?cndJ/ /..;S/)~'2U~/J f X eJz,r
Donald L. Brosius, Executor J
I.D. No:
#76361
Address:
1013 Mumma Road. Suite 100
Lemovne. PA 17043
Dated: April J t <
I
2005
Telephone:
(717) 731-9600
Description
Value
1. One-Family residence at 27 North 9th Street, Lemoyne, PA 17043
109,000.00
Total
$109,000.00
---------
"---:-------...,...-
";"1
",::;
(Attach Additional Sheets if necessary)
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-' '62 EXn 1-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
HATCH CRAIG A
1013 MUMMA ROAD SUTIE 100
lEMOYNE, PA 17043
-- fold
ESTATE INFORMATION: SSN, 201-16-5621
FILE NUMBER: 2105-0050
DECEDENT NAME: BROSIUS RACHEL J
DATE OF PAYMENT: 05/06/2005
POSTMARK DATE: 05/05/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 01/05/2005
NO. CD 005299
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $98.00
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TOTAL AMOUNT PAID:
$98.00
REMARKS:
CHECK# 2
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WillS