HomeMy WebLinkAbout11-08-05 (2)
REV-l500 EX + (6-00)
'*
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
2 1 -0 5 0 0 8 34
COuN'rYCOiiE --vEA~ - - NUMsER- -
I-
Z
W
C
W
o
W
C
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
PROSSER MARSHALL
DATE OF DEATH (MM-DD-Year)
SOCIAL SECURITY NUMBER
L.
DATE OF BIRTH (MM.DD-Year)
1 74- 0 5 - 3 605
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
09/06/2005 03/28/1917
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
lli] 1. Original Return
o 4. Limited Estate
lli] 6. Decedent Died Testate (Attach copy of Will)
o 9. Litigation Proceeds Received
I-
Z
W
C
Z
o
l1.
U)
w
0:
0:
o
CJ
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
SOCIAL SECURITY NUMBER
o 2. Supplemental Retum
o 4a. Future Interest Compromise (date of death after 12-12.82)
o 7. Decedent Maintained a Living Trust (Attach copy of Trust)
o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1.95)
o 3. Remainder Return (date of death prior to 12-13-82)
o 5. Federal Estate Tax Return Required
_ 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
W
I-
~ :$U)
CJ a:~
w l1.CJ
:rOO
CJ 0:....1
l1.lD
l1.
<
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
ROGER B. IRWIN ESQUIRE 60 WEST POMFRET STREET
FIRM NAME (If Applicable)
IRWIN & McKNIGHT
TELEPHONE NUMBER
717 249-2353 CARLISLE PA 17013
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
z
o
i=
<C
...J
::>>
l-
ii:
<C
o
w
a:
OFFlc:lM- USE ONLY
)
60,505.85
2,938.70
(",)
0.00
(8)
63,444.55
11,910.97
7,054.60
(11)
(12)
(13)
18,965.57
44,478.98
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
z
o
i=
<C
I-
::>>
a.
:E
o
o
><
~
(14)
44,478.98
22,239.49 X _(15)
22,239.49 X .045 (16)
0.00 X .12 (17)
0.00 X .15 (18)
(19)
0.00
1,000.78
0.00
0.00
1,000.78
~
20. 0
CHECK HERE IF YOU ARE REOUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
'UO!ldope JO poolq Aq Ja41a4M 'luapa:)ap a4141lM uowwo:) uI1UaJed auo lsealle se4 04M lenp!^IPuI
ue se 'GO ~6 uo!pas Japun 'pau!!ap sl BUllqls V '[(8' ~)(e)9 ~ ~6~ 'S'd U] %G ~ sl sBullqls s,luapa:)ap a41 10 asn a41 JOI JO 01 sJalsueJl 10 anle^ lau a41 uo pasodwI aleJ xel a41
,[( ~)(e)9 ~ ~6~ 'S'd U] (G' ~)9~ ~6~ 'S'd U U! palou se lda:)xa '%91' Sl sa!Jepllauaq \eaulI s,luapa:)ap a41 10 asn a41 JOI JO 01 sJalsueJllo anle^ lau a41 uo pasodw! aleJ xel a41
'[(G' ~)(e)9~ ~6~ 'S'd U] %0 S! PI!4:) a41 10 luamddals e JO
'IUaJed a^!ldope ue 'IUaJed leJnleu e 10 asn a41 JOI JO 01 41eap Ie JaBunoA JO aBe 10 sJeaA auo-AluaMl PI!4:) pasea:)ap e WOJI SJalsueJl 10 anle^ lau a41 uo pasodw! aleJ xel a41
:OOOG '~ Alnr Jalle JO uo 41eap 10 salep JO:l
'AJep!!auaq AIUO a41 sl as nods BUI^!AJnS a41
II ua^a alqe:)lldde 1I!IS aJe uJnlaJ xel e BUll!! pue slasse 10 aJnsopslP JOI SIUaWaJ!nbaJ AJolnlels a41 pue 'xel WOJI asnods BU!^!AJns e 01 JalsueJl e lowaxa IOU saop alnlelS a41
'[(!!) (~.~) (e) 9 ~ ~6~ 'S'd U] %0 S! asnods BUI^!AJnS a41 10 asn a41 JOI JO 01 SJalsueJllo anle^ lau a41 uo pasodw! aleJ xel a41 '966 ~ '~ AJenuer Jalle JO uo 41eap 10 salep JO:l
'[(I) (~.~) (e) 9~~6~ 'S'd U]
%8 Sl asnods BUI^!AJns a41 10 asn a41 JOI JO 01 sJalsueJl 10 anle^ lau a41 uo pasodWI aleJ xel a41 '966 ~ '~ AJenuer aJolaq pue P66 ~ '~ Alnr Jalle JO uo 41eap 10 salep JO:l
8~OH 'v'd
'Nl::In13l::1 3H1.:lO ll::l~d S~ 11 311.:1 ON~ ~ 31n03H:>S 3131dWO:> lSnW nOA 'S3A SI SNOI1S3nO 3^08~ 3H1.:lO AN~ Oll::l3MSN~ 3H1.:lI
j 3l81ltN8
1.33tU J.,it8.:lV\lOd 1.83M 09 SS31:100'v'
'--rJP. . C 1Vj/1 /
t_ 3A11'v'lN3S31:1d31:1 N'v'~3H10 1:I31:1\fd31:1d:lO 31:1n1\fN9IS
3l81lH'v'8
1.33H1.8 H3^ON'v'H H1.HON 9GB
c;! J ::> -II -c-~v:n>~-::'7~Y fit.. ~-}
_,~ 31VO N~n13~ 9NIlI:J ~O:l318ISNOdS3tt NOSH3d :10 3ctnlVN91S
'a6pa1MOU~ ~UB SB4 JaJBdaJd 40!4M )0 UO!IBWJO)UII\B uo pasBq S! a^!lBluaSaJdaJ IBUOSJad a4l UB4l Ja410 JaJBdaJd )0 UOllBJBloaa
'alaldwoo pUB lOaJJOO 'anJl S! II 'ja!laq pUB a6palMou~ ~W)O lsaq a41 01 pUB 'slUaWajBlS pUB salnpa40s 6U!~UBdwOOOB 6u!pn\ou! 'wnjaJ S!41 paU!WBXa a^B411B4l aJBpap I '.lJn~ad)o sa!IIBUad JapUn
37; .
SS31:100\f
00 0 ....................................................................................................... i.uO!leuBISap AJepllauaq e sUleluO:J
4:)14M AlJadoJd aleqoJd-uou Ja410 JO 'Allnuue 'IUnO:J:)V lUaWaJllal:llenp!^IPUI ue UMO luapa:Jap Pia 'p
00 0 ................. i.41eap Ja4 JO Sl4 Ie A1IJn:Jas JO luno:J:Je ~ueq 41eap uodn alqeAed JO "JOI ISnJl U!" ue UMO luapa:Jap P!O '8
00 0 .............................................................................................. 'i.uO!leJap!Suo:J alenbape Bu!^!a:JaJ ln041!M
41eap 10 maA auo U!41!M AlJadoJd JalsueJllUapa:Jap PIP 'GB6~ 'G~ Jaqwa:Jao Jalle paJJn:J:Jo 41eap II 'G
00 0 ............................................................. i.aJe:J JO sl!lauaq 'sluawAed Ja41!a 10 alii JOI aSIWoJd a41 a^la:JaJ 'p
00 0 ...................................................................................................... JO ~ISaJalul AJeuo!sJa^aJ e U!elaJ ':J
00 0 ........................................ :awo:)u! Sl! JO paJJalSueJl AlJadoJd a41 asn lIe4s 04M aleuB!sap 0114B!J a41 ulelaJ 'q
00 0 ........................................................................... ~paJJalsueJl AlJadOJd a41 10 awo:JuI JO asn a41 u!elaJ 'e
ON saA :pue JalsueJl e a~ew luapa:Jap P!O '~
S)I~OlS 3!Ylt::IdOt::lddY 3H! NI "X" NY ~NI~Yld AS SNOI!S3nO ~NIMOll0:l3H! t::I3MSNY 3SY31d
00'0
lN3Dtf :/0 l:I31SID3l:1 :OJ >t~e4:J e>tf3W
(89) '3na 3~NV1V8 a41 S! Sl41 'V9 + 9 aU!l 10 lelol a41 Jalu3 '8
(V9) 'anp xel a41 uo ISaJalUI a41 Jalu3 'V
(9) '3na XV 1 a41 sl S!41 'a:)uaJall!p a41 JalUa 'G aU!l ue41 JaleaJB sl 8 aU!l + ~ aU!l II '9
(p) pun,aJ e ISanbaJ 01 OC; aU!1 ~ a6ed uo xoq ,,:>a4~
'lN3I/11AVdl::l3^O a41 sl S!41'a:JuaJallIP a41 JalUa '8 aU!l + ~ aU!l ue41 JaleaJB sl G aU!l II 'p
(8) (3 + 0) AlIeuad/lSaJalUllel01
AlIeuad '3
ISaJalUI 'a
alqe:Jlldde I! Alleuad/lSaJalUI '8
VL' 096
VL'096
00'0
170'09
(G)
(:) + 8 + V) SI!paJ:)lel01
170'09
lunO:JslO ':)
sluawAed JO!Jd '8
llpaJ:) AlJa^Od lesnods 'V
sluawAed/sllpaJ::l 'G
(6~aU!l ~aBed)anoxe1 .~
:SI!paJ:) pUB sluaWABd XB.l
BL'OOO' ~
( ~)
8~OH I 'v'd I 3l81lH'v'8
dlZ 31lf1S All:)
1.33H1.8 H3^ON'v'H H1.HON 9GB
SS3l:laalf 133l:l1S
:ssaJ a aldwo s ua aoa
pp" I I
:) ,I P
o
REV-15G8 EX + (6-98)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
PROSSER
ITEM
NUMBER
1.
FILE NUMBER
MARSHALL L. 21 05
Include the proceeds 01 litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
00834
DESCRIPTION
M& T BANK - Checking Account - 9838896307
VALUE AT DATE
OF DEATH
60,505.85
TOTAL (Also enter on line 5, Recapitulation) $
(II more space is needed, insert additional sheets 01 the same size)
60 505.85
REV-1509 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
PROSSER
MARSHALL
L.
FILE NUMBER
21 05
00834
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
ADDRESS
RELATIONSHIP TO DECEDENT
A. Ethem M. Richwine Prosser
825 North Hanover Street
Carlisle, PA 17013
Spouse
B
c
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTL V-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. M& T Bank - Savings Account - #021000000992158 5,476.83 50. 2,738.42
2. A. M&T Bank - Savings Account - #025004920106281 400.55 50. 200.28
TOTAL (Also enter on line 6, Recapitulation) $ 2938.70
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX + (12-99)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
PROSSER
FILE NUMBER
MARSHALL
L.
21
05
00834
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
2.
FUNERAL EXPENSES:
Hoffman-Roth Funeral Home
Luncheon
4,007.20
150.00
B.
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City
State
Zip
Year(s) Commission Paid:
2.
3.
Attorney Fees Irwin & McKnight
Family Exemption: (If decedent's address is not the same as claimants, attach explanation)
Claimant Ethel M. Richwine Prosser
Street Address 825 North Hanover Street
City Carlisle State PA
Relationship of Claimant to Decedent Spouse
3,500.00
3,500.00
Zip 17013
4.
Probate Fees
169.00
5.
Accountants Fees
6.
Tax Return Preparer's Fees Patricia A. Rosendale, CPA
350.00
7.
8.
9.
Cumberland Law Journal - Estate Notice
The Sentinel - Estate Notice
Register of Wills - Filing Fee
75.00
129.77
30.00
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
11.910.97
REV-1512 EX + (6-98)
'*
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
PROSSER
FILE NUMBER
MARSHALL
L.
21
05
00834
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1.
Continuing Care, RX
438.58
2.
Stoken Ophthalmology, Medical
59.74
3.
Mobile X-Ray, Medical
85.80
4.
Church of God Home, Nursing
6,470.48
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
7 054.60
REV-1513 EX + (8-om
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
MARQU^I I I ?1 OF; OOR~4
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS [include outritt spousal distributions, and transfers under
Sec. 9116 (a (1.2)]
1. Ethel M. Richwine Prosser Spousal
825 North Hanover Street 112 Remainder
Carlisle, PA 17013
2. Arlene Y. Bartholomew Lineal
40 Garden Parkway 1/8 of Remainder
Carlisle, PA 17013
3. Karen E. Eby Lineal
1495 Simpson Ferry Road 1/8 Remainder
New Cumberland, PA 17070
4. Bonita M. Forsythe Lineal
867 Giblerville Road 1/8 Remainder
Gettysburg, PA 17325
5. Shirley A. Lamp Lineal
512 Barnstable Road 118 Remainder
Carlisle, PA 17013
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
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)
'r,
.'
LAST rVILL AND TESTAMENT
I, l\IARSHALL L. PROSSER, of the Borough of Carlisle, Cumberland County,
Pennsylvania, declare this instrument to be my Last Will and Testament, hereby expressly
revoking all Wills and Codicils heretofore made by me.
1. I direct my executrix to pay all of my debts, funeral and administrative expenses as
soon as may be done conveniently after my decease.
2. I authorize and empower my executrix to sell any realty owned by me at my death,
and not specifically devised herein, at either public or private sale, and to give good and
sufficient deeds therefor, in fee simple, as I could do if living.
3. I devise and bequeath all of my estate of every nature and wherever situate as follows:
(a) My Grandfather's clock to Arlene Y. Barthomew,
(b) The remainder of my furniture and appliances to EthelM. Richwine,
(c) 1/2 of the residue to Ethel M. Richwine, and
(d) 1/2 of the residue to be divided between Arlene Y. Bartnomew, Karen E.
Eby, Bonita M. Olson and Shirley A. Lamp, share and share alike.
4. I nominate and appoint Ethel M. Richwine to be the executrix of this my Last \Vill and
Testament; she is to serve as such without bond. Should she die before my death, renounce or
refuse to serve tcw any reason, or die leaving any of my estate unadministered, I nominate Karen
E. Eby, as substitute executrix, also to serve as such without bond, with the same powers as are
given herein to my executrix.
5. I hereby suggest that my personal representative retain the servlces of Irwin,
McKnight & Hughes, as attorneys in the settlement of my estate.
IN \VITNESS WHEREOF, I have hereunto set my hand and seal this 21 ST day of May,
1998.
JYlat.-;J!,.d{~: {~~~t/" (SEAL)
MARSHALL L.PROSSER
Signed, sealed, published and declared by MARSHALL L. PROSSER, the above
named testator, as and for his Last Will and Testament, in the presence of us, \vho at his request,
in his presence and in the presence of each other have subscribed our names as witnesses hereto.
~:d(~
2
,
ACKi~O'VLEDGME~T AND AFFIDAVIT
\VE, lVlARSHALL L. PROSSER, CHERYL L. CLELAND and MARTHA L.
NOEL, the testator and witnesses respectively, whose names are signed to the foregoing
instrument, being tirst duly sworn, do hereby declare to the undersigned authority that the
testator signed and executed the instrument as his Last Will, and that he had signed willingly,
and that he executed it as his free and voluntary act for the purpose herein expressed, and that
each of the witnesses, in the presence and hearing of the testator, signed the Will as a witness and
that to the best of their knowledge the testator was, at that time, eighteen years of age or older, of
sound mind and under no constraint or undue influence.
1lLa.v~,..{{ ~i, 1Y;'Zt/rrl'......
MARSHALL L. PROSSER
~(rd:~
~~~
COMMON\VEAL TH OF PENNSYL VANIA
SS:
COUNTY OF CUMBERLAND
Subscribed, sworn to and acknowledged before me by MARSHALL L. PROSSER, the
testator herein, and subscribed and sworn to before me by CHERYL L. CLELAND and
MARTHA L. NOEL, witnesses, this 21 ST day of May, 1998.
/'J/Lo, <~ c:>(..
// v /i . " ....-
( ry>tary Public
Notarial Seal
Roger B. irNin. Notary Public
Carlisle Bora, Cumberland County
My Commission Expires Oel. 3. 2000
Memb:1r Pennsyl'}al1ld A:J:,o,~i:]tion of Notaries
r ~
figM&TBank
499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12
Phone (888) 502-4349
Fax (302) 934-2955
September 19,2005
Irwin & McKnight Law Offices
West Pomfret Professional Building
60 West Pomfret Street
Carlisle, Pennsylvania 17013-3222
~~~~uw~~
JcP 22 2005
Re: Estate of Marshall L Prosser
Social Security: 174-05-3605
Date of Death: September 06, 2005
IR\':,'
\
.lc;H.T
Dear Sir or Madam:
Per your inquiry dated September 13,2005, please be advised that at the time of death, the above-named decedent had on
deposit with this bank the following:
1.
Type of Account
Checking Account
Account Number
9838896307
Ownership (Names oj)
Marshall L Prosser *
Opening Date
07/08/05
Balance on Date of Death
$60,501.05
Accrued Interest
$
4.80
Total
$60,505.85
Interest Paid YTD
4. 78(Accrued interest is not included)
2. Type of Account Savings Account
Account Number 021000000992158
Ownership (Names oj) Marshall L Prosser *
Ethel M Richwine *
Opening Date 01/17/89
Balance on Date of Death $5,475.14
Accrued Interest $ 1.69
Total $5,476.83
Interest Paid YTD $ 4.09(Accrued interest is not
" ,
3. Type of Account Savings Account
Account Number 025004920106281
Ownership (Names of) Marshall L Prosser *
Ethel M Richwine *
Opening Date 01117/89
Balance on Date of Death $400.36
Accrued Interest $ 0.19
Total
Interest Paid YTD $ 0.33(Accrued interest is not
Please be advised, there was no safe deposit box found for the above decedent.
*For further account information, regarding ownership and any changes, closures and/or reimbursement of funds,
etc., please call the North Middleton Office # 717-240-4521.
Sincerely,
~~cy[/(JAo
Nancy Clagett
Records Management
Medicare A Co-Insl Ok
Days Coinsurance
June
July
August
Owes
Private Nursing
Days
August
September 5
Insurance covers day 21-100 (Not guaranteed)
Paid Owes
15
31
2
2,964.00
228.00
2,964.00
3,192.00
29
Private Charges Paid Owes
Beginning Bal
Room 5,394.00 5,394.00
Pullups 32.80 5,426.80
Laundry 20.30 5,447.10
Supplements 7.28 5,454.38
Room 930.00 6,384.38
Laundry 3.50 6,387.88
Briefs 24.25 6,412.13
Pullups 44.10 6,456.23
Beauty/Barber 9.00 6,465.23
Name Labels 5.25 6,470.48
!}tjq" ~3?d-
M Prosser_1 031 05Prosser10/24/20052:15 PM
September 21,2005
Ethel M. Prosser
825 North Hanover St. , Apt. 306
Carlisle, PA 17013-
Hoffman-Roth Funeral Home, Inc.
219 North Hanover Street
Carlisle, P A 17013
(717)243-4511
The Funeral Service for Marshall Lee Prosser
14598-150
We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please
feel free to contact us if you have any questions in regard to this statement.
THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT,
AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS.
OUR SERVICE:
Traditional Funeral Service Package . . . . . .
FUNERAL HOME SERVICE CHARGES
THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE
THAT YOU HAVE SELECTED . . . . . . . . . . . . .
Cash Advances
Newspaper Obituary Notice-Sentinel .
Clergy Offering . . . . . . .
Certified Copies of Death Certificates.
Flowers. . . . . . . . . .
TOTAL CASH ADVANCES AND SPECIAL CHARGES .
Total
Total Cost .
. . . . . . . .
~
To be credited when receive from Cumberland County VA
This statement is net and payable in full within 30 days of receipt.
TOrAL AMOUNT DUE
$3690.00
$3690.00
$3690.00
$119.70
$75.00
$90.00
$132.50
$417.20
$4107.20
$4107.20
100.00
$4007.20
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ---. - -. - -. - - - - - - - - - - - - - - - - - - - - - --
Please return this portion with your Remittance
$
Amount Enclosed
Service 10 # 14598-150
Marshall Lee Prosser