The URL can be used to link to this page

Home My WebLink About07-27-06 (2) REV-1500 EX (6-00) OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBEFl ~L COlMY CODE .....QL 0086 ___ YEAR NUMBER I- Z W C W (.) W C DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Serbieff John DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 1/24/2006 3/11/1916 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) C SOCIAL SECURITY NUMBER 207-07-6301 THIS RETUAII MUST BE FILED IN DUPLICATE WITH THE iREGISTEiR OF WILLS SOCIAL SECURITY NUMBER ~ [i] 1. Original Return :ll::~cn D o a::ll:: 4. Limited Estate wl1.0 J: 00 I.;l o a:..1 LAJ 6. Decedent Died Testate (Attach copy of Will) l1.lD ~ D 9. Litigation Proceeds Received D 2. Supplemental Return D 3. Remainder Return (date of death prior to 12-13-82) D 4a. Future Interest Compromise (date of death aner 12-12-82) D 5. Federal Estate Tax Return Required D 7. Decedent Maintained a Living Trust (Attach copy of Trust) _ 8. Total Number of Safe Deposit Boxes D 10. Spousal Poverty Credit Idate 01 dealh belween 12-31.91 and 1-1-95) D 11. Election to tax under Sec. 9113(A) (Attach Sch 0) THIS SECTION MUST BE COMPlETED. All CORRESPONDENCE AND CONFIDENTIAl TAX INFORMATION SHOUlD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS I- Z W o Z o Q. en W II: II: o () Craig A. Hatch, Esquire FIRM NAME (If Applicable) Gates, Halbruner & Hatch, P.C. TELEPHONE NUMBER 1013 Mumma Road, Suite 100 Lemoyne, PA 17043 717-731-9600 z o ~ j :::) l- e: <( (.) w a: 6. J~ Owned Property (Schedule F) U Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) (6) 144,937.02 0.00 0.00 0.00 157,244.74 0.00 OFFICIAL USE ONLY 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) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (4) (5) 0.00 8. Total Gross Assets (total Lines 1-7) (8) 20,594.50 1,902.22 302,181. 76 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) (13) 22,496.72 279,685.04 0.00 11. Total Deductions (total Lines 9 & 10) (11) 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) (12) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) 279,685.04 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 10.000.00 269,685.04 x .12 (17) 0.00 0.00 1,200.00 16. Amount of Line 14 taxable at lineal rate 0.00 0.00 x.O L(15) x.O 45 (16) z o i= <C I- ::) l1. :!E o o X <C I- 17. Amount of Line 14 taxable at sibling rate 19. Tax Due 20.0 (19) 40,452.76 41,652.76 18. Amount of Line 14 taxable at collateral rate x .15 (18) CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 3W4645 1.000 Decedent's Complete Address: SiREET ADDRESS 113 June Drive Cumberland CI1Y Came Hill Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount I STATE PA (1) 0.00 39.500.00 2.078.94 3. Interest/Penalty if applicable 0, Interest E. Penalty Total Credits (A + 8 + C) (2) 0.00 0.00 Total Interest/Penalty (0 + E) (3) 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) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WIL~ AG~NT (58) 73.82 Yes D D D D without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0 CiI IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and \0 the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which pre parer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred;. . . . . . . . . . . . . . . b. retain the right to designate who shall use the property transferred or its income; . c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . d. receive the promise for life of either payments, benefits or care? . . . . . . . . . 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death Carter B. polm & Carol A. Polm ADDRESS 3525 Apollo Avenue SIGNATURE OF PREPARER On-iER n-iAN REPRESENTATIVE Craig A. Hatch, Esquire ADDRESS &#:4 / ,n . '") Il, -it 'f !1-^9 CJ{, . v Harr1sburg, PA 17110 Road. Suite 100 Lemoyne, PA 17043 1~01l- 41.652.76 41.578.94 0.00 0.00 73.82 0.00 No D!l D!l D!l Lid [JQ []j DATE 'JI, I," ") ,.' I"- /._ r, ... '. 'J. 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. 9 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 slPouse is 0% [72 P.S. 99116 (a) (1.1) (ii)] 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. 89116(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. 8 9116(1 ,2) [72 P.S. 99116(a)(1 )]. The tax rate imposed on the net value of translers to or for the use of the decedent's siblings is 12% (72 P.S. 9 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption, 31'14646 1.000 REV-1502 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER John c. Serbieff 21 06 0086 All real property owned solely or as a tenant In common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller. neither being compelled to buy or sell. both having reasonable knowledge of the relevant facts. Real property which Is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION NUMBER 1. One-story, single-family dwelling, located at 113 June Drive, Camp Hill, CUmberland County, Pennsylvania; being Tax Parcel No. 1-22-0531-036; transferred to decedent by deed dated December 3, 1971, and recorded on December 9, 1971, in the Recorder of Deeds Office in and for Cumberland County, Pennsylvania, at Book K-24, Page 366. Value is net sales price. VALUE AT DATE OF DEATH 144,937.02 3W4695 1.000 TOTAL (Also enter on line 1. Recapitulation) (If more space is needed. insert additional sheets of the same size) $ 144,937.02 AEV-1S03 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE 8 STOCKS & BONDS FILE NUMBER John C. Serbieff 21 06 0086 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. None DESCRIPTION VALUE AT DATE OF DEATH 3W4696 1.000 TOTAL (Also enter on line 2. Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 0.00 REV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF John C. Serbieff Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolntly-owned with the right of survivorship must be disclosed on Schedule F. FILE NUMBER 21 06 0086 ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 1999 Oldsmobile Cutlass GL value is sales price 5,995.00 2 AARP refund 12.50 3 Blue Cross/Blue Shield refund 93.60 4 Boscov' s refund 23.36 5 Caremark Rx, Inc. refund 15.00 6 Comcast Cable refund 45.25 7 Erie Insurance Group homeowner's insurance refund 26.00 8 M&:T Bank Account No. 487953 828.93 9 Miscellaneous Personal Property - value is gross proceeds from auction of property 1,914.00 10 Peerless Insurance Company return of unused premium 160.00 11 Sovereign Bank Acct. No. 2331030898 148,102.60 12 The Patriot-News Co. refund 28.50 3W46AD 1.000 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 157,244.74 REV-1509 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF John C. Serbieff SCHEDULE F JOINTL V-OWNED PROPERTY FILE NUMBER 21 06 0086 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. B. c. JOINTL V-OWNED PROPERTY: lETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BAtoI< ACCOUNT DATE OF DEATH DECD'S VALUE OF NUMBER JOINT f'.U..1BEA OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR VALUE OF ASSET INTEREST DECEDENTS INTEREST TENANT JOINTLY-fED REAL ESTATE 1. A. Non4 TOTAL (Also enter on line 6 RecaDitulation\ $ 0.00 3W46AE 1.000 (If more space is needed, insert additional sheets of the same size) REV-1510 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF John C. Serbieff SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21 06 0086 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of thEl REV-1500 COVER SHEET is yes. DESCRIPTlON OF PROPERTY ITEM ItO.l.DE TH:: NAME OF ll-E TRANSFEREE, THEIR RHA TIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBEF Tl-E DATE OF TRANSFER. ATTACH A OOPf OF THE DEED FOR REAl ESTATE. VALUE OF ASSET INTEREST 'IF APPUCABLE' VALUE 1. None TOTAL (Also enter on line 7, Recapitulation) $ 0.00 3W46AF 1.000 (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 ESTATE OF John C. Serbieff ITEM NUMBER A. B. FUNERAL EXPENSES: 1. Costco Wholesale funeral luncheon SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Debts of decedent must be reported on Schedule I. DESCRIPTION Total from continuation schedules . . . . . . . . . Claimant Street Address City Relationship of Claimant to Decedent 4. Probate Fees 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Street Address Social Security Number(s) / EIN Number of Personal Representative(s) 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Borough of Camp Hill sewer bill Name of Personal Representative(s) City Year(s) Commission Paid: 2. Attorney Fees State Zip 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3W 46AG 1.000 State Zip Total from continuation schedules . . . . . . . . . FILE NUMBER 21 016 0086 TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) AMOUNT 29.98 10,709.39 5,000.00 348.00 85.00 4,422.13 $ 20,594.50 207-07-6301 Estate of: John C. Serbieff Item No. 2 3 Schedule H Part 1 (Page 2) Description Amount Neill Funeral Home, Inc. funeral goods & services 10,381.40 Red Lobster funeral luncheon 327.99 Total (Carry forward to main schedule) 10,709.39 207-07-6301 Estate of: John C. Serbieff Schedule H Part 7 (Page 2) 2 Brickers Auction auctioneer's fees and costs for auction of personal property and real estate 2,175.00 3 Cumberland Law Journal publication of estate notice 75.00 4 Don Ezbianski lawn service 120.00 5 Freeman Real Estate real estate appraisal 300.00 6 Janet L. Miller, Tax Collector real estate taxes 467.32 7 Miscellaneous repairs to house and car to prepare for sale. 541.63 8 Patriot-News ads for sale of personal and real property 103.04 9 Patriot-News publication of estate notice 251. 67 10 Peerless Insurance Company insurance premium 204.00 11 Penn Waste, Inc. trash removal 42.63 12 Pennsylvania American Water utility bill 66.70 13 PPL Electric Utilities Corp. utility service 39.26 14 Register of Wills short certificates 16.00 15 UPS Store photocopies 1.53 16 US Postal Service postage 18.35 Total (Carry forward to main schedule) 4,422.13 REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF John C. Serbieff SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21 06 0086 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH American Water Co. utility bill 18.05 2 Highmark Blue Shield insurance premium 93.60 3 Janet L. Miller, Tax Collector personal tax 4.90 4 PA Department of Revenue 2005 income tax liability 228.00 5 Pennsylvania American Water utility bill 34.92 6 PPL Electric Utilities Corp. utility service 36.94 7 Pulmonary & Critical Care Medicine Assoc., P.C. medical bill 9.22 8 Sears Credit Cards credit balance 13.12 9 United States Treasury 2005 federal income tax liability 1,457.00 10 Verizon phone service 6.47 3W46AH 2.000 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,902.22 REV-1513 EX+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF John c. Serbieff NUMBER I 1 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERlY TAXABLE DISTRIBUTIONS [include outright spousal distributions. and transfers under Sec. 9116 (a) (1.2)] Myrle B. Cooper 702 North Front Street Liverpool, PA 17045 General Bequests: 10,000.00 2 Carol A. polm 3525 Apollo Avenue Harrisburg, PA 17110 100% Residue: 259,685.04 3 Phillip S. Weber 5002 E. Mesquite Wood Court Phoenix, AZ 85044 General Bequests: 5,000.00 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Sister Niece None FILE NUMBER 21 06 0086 AMOUNT OR SHARE OF ESTATE 10,000.00 259,685.04 5,000.00 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 3W46A11.000 TOTAL OF PART 11- 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) $ 0.00 Estate of: John C. Serbieff Item No. Description 4 Susan L. Weber P.O. Box 354 Edwards, CO 81632 Schedule J Part 1 (Page 2) General Bequests: 5,000.00 None 207-07-6301 Relation Amount 5,000.00 J j(,-c..J... /,J.' '.t. " /, " < ...'._ i..... (',/ i... (: :~i./ / ! .J jl ,.... 1 ~ "J ') r- 1 " ~ ~...- (.... 1:::- .' " 'if' -(I ~ fili< /i '! I L) 'C:;)/CU IJ b.. , K'f/f,j ~ I., " ,,~ is i/ I' -\. " I ....)/~'- /~ - I'. f<' II< r1Hb I.n H~v (J1Db TYPE/PfllNT IN P:I".::A,",~t~r CERTIFICATE OF DEATH STAIEFllE NIIMUEcA l-jQtri~r G:::SC ~ 6\ SEF -=~~~~=--_-~~=---'---]'fY\]~ot:N01._~ ~ .3ill~' :;;;~~t;''i:idJ~ - " ^", (l~bq"lt'",I~~",,*:,~ I~='li tI"~~lii;,",,;:g-=~~"~I"'I"'lth dal'q~l" =--jl'-r~'Rhp.'''(Uy!''!!'''~'''''''''~--f~'~'''''U''C1'''''~L_!<i;;;- --.~ - c:... ,-:.~ _~_~~_.L_~~___ __l ..L!'-~----------L.:-_'fo'_Jt1-tLJ?:\~~~. rn ~~!![1 lk.'flC--.-SJIX)A~NI '!orne DI~elll:e_.!:!Uhet_~ __ · ,-,,,,,., "l"'I~"..- :IT: ,-~..~- ~._--, · ~'~:::::-'=:-~r:::. -- - - " _Df\\)PH! N - Hl\RR\';,e!2r-m +\f\R:r1<.lS~j(<C1J~lTAl-- ___ ""....:-':'"""'~ lDlilTE.._ l~UsllilIQCUJlJhOrl~2!workdof1eduIMlgrroSI()I~~~tkJoolslilterellr00) 12 WasOocedcnle\ltl/lIllheUS ~ Dec~s[dlJ(;allln ~_~h~{J'adeCQ01lleted) 14 Ma/u,I5Lalus Mamed Ne'fOlrRlf11OO I~ SuMmg~{If" UNe~-;-~1 _'i.,~ffi;~f\~k.~~illi'~'fi"F~ ;":o,,;?~ __ ~:~:"""'::'((}~~_L L~'~"'5'1 _. \,lJI"QoW'E1Q" _~_ _____ __,_______ Ib [)"ceJ~lllsMdllllltJArklre55(;lfeCI (rty-1own sL11e lip code) Doclldcnls p~. (^I(,,:'UlIJA"'11\ ""Doc...... tl3 0t)NE Dl2-tVE Aclualll<!sUtHlCC I/dSlale ~NI'I--?....... ~=~I I/eU'l't:s!JoclllIeIIlIIl{MIJI Iwp eF\tY\p HILL PA l~otl 1/b CoW'Y e.vM~t::lUJ\j\..)O "" U( ~::'~N"''''''' QAfY\P t\\LL L"€i~ .____. _ _._1._____________ _ _______ _ _ _ ____~__~__ _ .__ '" 'pe/;"p-li~'~\"~~ ScP- e, IE F 19iP:~';~""~AN St)SEl~K t _________._,_____.__E___ __ _____.~___,_ ___________., .._______'__________________,____ 20,. lnkmmni's Name (I ,pe.iprull) ~ Inbmanl's Uaiktg Address (Sbeel. tAy/1oMJ, slald,l" code) _ C hK: \ ell. ~,~~ ______ ____u_ _~ -2~2~ &~OLL() f\VEI'~OE;J-\t\f2-R_l~fill(L(y-. Vf\ l1ll D n ~la MelhodoIOI.<.posg.m -~ltluID~sll.llnlaAonlh day year) Ie l'Ialfl~nlSpOSUlfl{NolOleolcamwwy C18rT1aloryorolhcrpQcc) l21tJ locaIDl(CItyAuwn ~ l~~l ~ _~ ~'~","~ ~:~l:'~ . 0 "'~::".'I'~_--"..:=--~f\i.J .,2L_,~,lQ. _ - 1'K:l5~.H~~\1\tl1WI/\liBlL~__ ~ArY\P HILL PillJ,9Jl ~ ~ ~ 22, rur"""'N"lm 7Y~~ =rFDl~ a<?!'4L.Jtr~T'iT'f~~((L kffi~ "Tl~~1f~Effi~~~ I L()~lllele liEn]:) ,jJ l. only When !;t!!llfylllg {\l~ Ihe lIe:;l ullllY kllo.lwled\}tl uealh occurr;;' al Ule lime dale and place :;1.1100 (~9l<Ilure and Iao) iJtl llCOOS8 NOObf~ 23c 0aIs SqMld (\blIb day rear) . ;J~;I~~~;u~e~11 ~;~II~l1Ie allllne Dr dedth 1 .._.._.__ H ~_J . 11"m.s2":l26~1_;.;:;tJec~;~~lcledLV-p~-;-s~ <'4--r.ma1fealh-~---125 Dale PfOflOu-------rlead(MtMJ\h-d.ly-yea') ---- - - --- 26-Was~Bei;nooloa-~~~--~-- --- ~ ."o,,"",""'''"e,,th i1,:Sd If ___" . .. __ ___ l1L~ Ai; ,g tJl &, _ ___ _ _ 0 y~ ~~. _.___, . u __ _____~ .~____ CAUSE OF OEA HI t~ ifl$lroclions ;lIld eu""*sl' : /lwluulldltll!tel\lal Pari b tRIer ~ 2Iill!!d!!l ~!H!~!l!~ ~ ~ 28 0I:l I utJaao Use Cool'tlWl n tltl.a1il1 ddl,21 PJnl LnhHlhelJlill!:!!J!~::!1!!h-{Jlwa:;e:;,lnJUr~S,Ul(;\lIl.)llidl~J(lo.-lh..Llli~~I/)'LdW>tlulIleulldlh lJONll tlfllerltl,nlllldlevenls:;LlL ascarUldLalltlsl. : on:>cl10 dt:dlh bu!,Q'e:.uln,JlllheuntJelly..",cauwgivaJinParII ~:: ~ ~= !e:;plriilury JIIl!:iI, (.r "tlllUl..uku ItJlllLllion ....Ilhoul ShOWIllllht;ll!IIOUgy 00 NUl abble\llJle [nl,,( only une WlC>8 on 1ll1e COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS ~ ~. -Cl ~ ~ J> IMMEDIATE CAUSE (Ful..ll (jI::jI;lJ:;C ur LUrll;JlllUllll~SUnlnYlndeil1h1 -:> il ~L{4(k6-L !ol.Lv\.-l~e,e rv\e0~<fV1 i('-.. UU{l [(, (()/ <IS d (~on.<.cqllcn(;u 01) COrn UUtllu(oIJSacorI::iUl.jut.lllCeol) : toct",'!', : L;' () yi:."ll;2. S ')cquenlul!yustconulllOliS.11anv leJ(jlnY!tlll1tltJlIsell:>looonlinIlJ - llllllr lilt! UNOERl VlNG CAUSE . l,jI~.:JSIl ullnlur~ 1Iid.IIIlIIlJlcd thll I, ~Vbllb re:'lIl1lllillll ull<llh) LAST 2'J Uoo" U NoIJHe1j,IrIa'llwltW:Ipas!Yeaf DI"~II.;lI'-nl!oldtwtJ Ll No4ptO\JOilIIl.btaJllec;.ww.Ill.w&t"142dd~ "'....~ U NtA ~tylol.lll., W (lI!Vlol.nl4J dd~ II" , yt;Oll DUll !U(Uf as a wu:;equ{lllce ul) blIbedealb d n lJ~'pllt","taI"'W.hlllnkl ~slyu.u iOdwas.lrl~~psy-- 3Ub WefeAutopsyFnlmQs IT-Mdn/1eIOI~ J32iiUiiiO~'lnjlHytl.toodl daY~I)- ~ IJ2b O';;,Ibt:~~yCiCOO--;;d----~-~~- ~ PW;aot~:HomB,farm.SlIIlOJII,fildofy..i.ikc- Pllrlol1l)f:l!) ::~~u~~~:~e~~t~Ullllll;lhun I'J..N.JlufJI 0 ttofoclde BuIbng.<<*: t~ Dill:; B No 0 Yes UNo n ACCldenl 0 Pell\,linyhl\ltl-SlltJ<l.lll.lll -i2dT;"OIInM-~J""'._' -- ...C............,.... --- 1~ ,....,...~----- o SWJ.:Iue 0 CuukJNolOcUctcmwl1oo (] Ye:. 0 No (l o..Nef~aIur 0 I'~~ JJJ Cerlifier (check untyOfleJ ~-----~ -~------~- --- -- 3Jb-~~61ot~ ~-- Ccrhl)'ing physicllin (f'tlysiCliln cefll/'o;llI'J caust! ot lIcalll....hcn anulhl;!r pllYSIC1an has plOllOUl~ed doalh alld compltlltld Itlllll;!3) /" (')( JZ-t 1/ ( . < _ __ ;\. J( I) . __ _ _ ___ _ ____ __ To lhe besl 01 my kllOw!ed9t!,dealhocclJfredduetolheC3USe(sI300 nlJinnerasslillcd . .tJ :ii:-I-K:enseN~--~- -- ~-- 3Jd Ualll~(tr.blIb day year) Pronouncing and ~ertilyil1g physif;L;lll (f'lly~lI.;l.Illl)Ulh prU/lUUIl;;IIIQ dCoIUI dud ~er'dYNlY 10 CoIU:>o 01 death) To UM!b"lil 01 lilY knowk!dge, lie.lthoccufledallheUnle,date,and p!.ace,;lndduelothecause(5);loom;r,nnet;llslilh:d .u _ 3~L/'--;c../_ ~ _ _ _ ~ ,~/ 2..:-i j c 6 _ 6::~~:~~7:~:'%~~n andJo( Investigation, In my opinion, tte.lh occurred..1 Ole Ume, daole,;lnd pbce.,)OO dl..lo I~ (~uS<<!J ~I!d frull!ftef.u suted ______0 :" Name and AddI__..nI PH~11Il Whll c..)I'.*"f<I! r ."IUS"-' of (~Ih!ktm 2'llypwf't,,, l'."~"V.'.-;';5"'"i"",,;jG'"<l"~''''' ..-=.l.. I .~'I-J:' j .IJ:l6:l6--llbi;"....(~""~~=-. J l-)LJE,tsA M, SIAN I":'GV lC /'.1,.[) __~.u 'J~'-d >--" . ~~" J!ltu.i-;} L~,l-Ll~~~~n~lr::IiOnS~~~e~o~--;;;~;se) -----~-- .------.-,-----~--.. ~ -::, "./ ,. tE 8 ~ o " o 'u '"> ~ LAST WILL AND TESTAMENT OF JOHN C. SERBIEFF 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 27th day of January, Two Thousand and Six, Letters TESTAMENTARY es ta te of JOHN C SERBIEFF in common form were granted by the Register of said County, on the , la te of CAMP HILL BOROUGH IFi,st, Middle, Last! in said county, deceased, to CARTER B POLM lFi,st, Middle, Last! and CAROL A POLM 'First, Middle, Last) and that same has not since been revoked. IN TESTIMONY rvHEREOF, I have hereunto set my hand and affixed the seal of said office at CARLISLE, PENNSYLVANIA, this 9th day of February Two Thousand and Six. File No. 2006-00086 PA File No. 21-06-0086 Oa te of Dea th 1/24/2006 S. s. # 207-07-6301 (,,1 ' T . ," '.' I -';''''-~>[-i/7i ~'t ( ,~-J---~,L,1 /); ( ,~(,/J',. 4 ~ ,J .~ Register Of Wills - ,J~)_}/"'l ,.;. , /f , . C- le.-,/. :' ~Lr';'L_, ,-,/.1)-_; --J ) Z, . / Deputy NOT VALID WITHOUT ORIGINAL SIGNATURE AND D'vlPRESSED SEAL ..-, ~..)) G- , -." (' .... ,-," , f (~',~~, \ ( ).-i ~=J LAST WILL AND TESTAMENT OF JOHN C. SERBIEFF L JOHN C. SERBIEFF, now of 113 June Drive, Camp Hill, Cumberland County, Pennsylvania, 17011, do publish and declare this to be my Last Will and Testament, hereby revoking all other prior wills and codicils made by me. FIRST: Familv Background and Appointment of Executor. (A) Familv and Background Information. I am not currently married. I have no children. (8) Appointment of Executor. I appoint as my Co-Executors (all hereinafter referred to as Executor) under this Will, the following named persons to serve without bond and without being required to account to any Court: Co-Executors: My niece, CAROL ANN POLM and her husband, CARTER B. POLM, to act jointly or individually. SECOND: Funeral and Last Illness Expenses~ Taxes. (A) Expenses~of Funeral and Last Illness. I direct my Executor to pay my funeral expenses and the expenses of my last illness from my estate. (8) Taxes. I direct my Executor to pay any and all estate. inheritance. succession. legacy. transfer and other death taxes or duties, by whatever name called, including any and all interest and penalties thereon, imposed under the laws of any jurisdiction by reason of my death, upon or with respect to any and all property included in my gross estate for the purpose of such taxes. whether such property passes under or outside of this Will, out of my residuary estate, without being prorated or apportioned among or charged against the respective devises, legatees, heneficiaries, transferees, or other recipients of any such property or charged against any property passing or which may have passed to any of them. The Executor shall not be entitled to reimhursement for any portion of any such taxes from any such person. II ',) /;' - , I '/ ,'. c.. "<,r. ~' LAST WILL AND TESTAMENT OF JOHN C. SERBIEFF PAGE 2 THIRD: Tangible Personal Property. Except for those items excluded below and those items enumerated in the Letter of Instruction, I bequeath to my niece, CAROL ANN POLM and her husband, CARTER B. POLM, all tangible personal property, including but not limited to clothing, jewelry, heirlooms, furniture, personal effects, motor vehicles, and all other similar articles, which I own, and the insurance thereon. Notwithstanding any other provisions in this Article THIRD, I may leave a separate, dated and unsigned Letter of Instruction, which I shall place with my Will, containing directions as to the ultimate disposition of certain of the property bequeathed under this Article THIRD, and such Letter of Instruction shall determine the distribution of such items. FOURTH: Residuary Gifts. (A) I give. devise and bequeath all the rest, residue and remainder of my estate, of every kind and character, real, personal and mixed, tangible and intangible, and wherever situated, including any lapsed or renounced legacies or devises (and including any property over which I may have a power of appointment), in the following amounts to the respective named and designated benetlciaries: /1 \ r:'T1:Tr:' 'T'TTr\T TC1'\ 1It.TT""\ T"\r\T T A nCt /(tl~ "AA ()f\\ L_ nTTTT T T..... C1 ",...-:"....~...-- Tf'" \ 1 J 11 V L I11VU urtl ~ U UVLLrtl'\.u \JlJ,VVV.VV) LV r ll.lLL.lr ..:). "" J!..DJ!..n.. 11 PHILLIP S. WEBER should predecease me, then his share shall be added to the residue of my estate. (2) FiVE THOUSAND DOLLARS ($5,000.00) to SUSAN L. WEBER. If SUSAN L. WEBER should predecease me, then her share shall be added to the residue of my estate. (3) TEN THOUSAND DOLLARS ($10,000.00) to my wife's sister, MYRLE B. COOPER. If MYRLE B. COOPER predeceases me then her share shall be added to the residue of my estate. (4) The remainder of my estate, to my niece, CAROL ANN POLM and her husband, CARTER B. POLM, per stirpes. 'J~/f I (J C' t/ /#~ LAST WILL AND TEST AMENT OF JOHN C. SERBIEFF PAGE 3 (B) Distributions Durin2 Administration. Prior to final distribution of my estate, the Executor, in his discretion, may make partial distributions to one or more beneficiaries or Trusts. As a consequence, the Executorship and any Trusts created under this Will may exist contemporaneously. A distribution may be made subject to any indebtedness or liability of my estate. FIFTH: Spendthrift Provision. No beneficiary shall have the power to anticipate, encumber or transfer his or her interest in the estate in any manner other than by the valid exercise of a power of appointment. No part of the estate shall be liable for or charged with any debts. contracts, liabilities or torts of a beneficiary or subject to seizure or other process by any creditor of a beneficiary. SIXTH: Powers of Executor. In addition to the powers and duties as may have been !:,'Tanted elsewhere in this Will, but subject to any limitations stated elsewhere in this Will, the Executor shall have and exercise exclusive management and control of the Estate and shall be vested with the following specific powers and discretion, in addition to the powers as may be generally confen'ed from time to time upon him by law: '.r\ \ T....,. f-............ ..-ro_............,..,,__......_-4- ..........,,_.... ~_..J .-J;~._~~;""; _~_ _.LJ..L _ -r _,.... _J, _ 11." , 1 11 1 ., \".., H. LH'- .uauao'-Hl'-l1L, '-an.. aHU Ul~1-'V~ll1VU VI LHC C~LdLC, LH\; CXl;:l:ULUr SHall nave lne power to do all things amI to execute such deeds and instruments as may be deemed necessary or proper, including the following powers, all of which may be exercised without order of or report to any Court: (1) To sell, exchange or otherwise dispose of any property, real, personal or mixed, at any time held or acquired hereunder, at public or private sale, for cash or on terms, without advertisement, including the right to lease for any term notwithstanding the period of the Estate, and to grant options, including any option for a period beyond the duration of the Estate. (2) To invest all monies in such stocks, bonds, securities., mortgages, notes, choses in action, real estate or improvements thereon, and any other property as the Executor may deem best, without regard to any law now or 1 1) I I . ~.>) l' '''"l~ \._ ("i ,) ! .r'~ " ."" -' / ~ ':'''/'~~ t/ / LAST WILL AND TESTAMENT OF JOHN C. SERBIEFF PAGE 4 hereafter enforced limiting investments of fiduciaries. (3) To retain for investment any property deposited with the Executor hereunder. (4) To vote in person or by proxy any corporate stock or other security and to agree to or take any other action in regard to any reorganization, merger, consolidation, liquidation, bankruptcy or other procedure or proceedings affecting any stock, bond, note or other security. (5) To use attorneys, real estate brokers, accountants and other agents, if such employment is deemed necessary or desirable, and to pay reasonable compensation for their services. (6) To compromise, settle or adjust any claim or demand by or against the Estate and to agree to any rescission or modification of any contract or agreement affecting the Estate. (7) To renew any indebtedness, as well as to ounuw IIlum;:y, ami LU st;:l;un.: the same by mortgaging, pledging or conveying any property of the Estate, including the power to borrow at a reasonable rate of interest. (8) To retain and carry on any business in which the Estate may acquire an interest, to acquire additional interest in any such business, to agree to the liquidation in kind of any corporation in which the Estate may have an interest. (9) To register any stock, bond or other security in the name of a nominee, without the addition of words indicating that such security is held in a fiduciary capacity, but accurate records shall be maintained showing that such security is a Estate asset and the Executor shall be responsible for the acts of such nominee. (B) In making distributions from the Estate to or for the benefit of any minor or other (}IJ ,7 J cij ~#:4 LAST WILL AND TESTAMENT OF JOHN C. SERBIEFF PAGE 5 person under a legal disability, the Executor need not require the appointment of a guardian, but shall be authorized to payor deliver the same to the custodian of such person, to payor deliver the same to such person without the intervention of a guardian, to payor deliver the same to a legal guardian of such person if one has already been appointed, or to use the same for the benefit of such person. (C) In the disbursement of the Estate and any division into separate trusts or shares, the Executor shall be authorized to make the distribution and division in money or in kind, or both. regardless of the basis for income tax purposes of any property distributed or divided in kind, and the distribution and division made and the values established by the Executor shall be binding and conclusive on all persons taking hereunder. The Executor may in making such distribution or division allot undivided interests in the same property to several trusts or shares. (D) The Executor shall have discretion to detennine whether items should be charged or credited to income or principal or allocated between income and principal as the Executor may deem equitable and fair under all circumstances, including the power to amortize or fail to amortize any part or all of any premium or discount, to treat any part or all of the profit resulting from the maturity or sale of any asset, whether purchased at a premium or at a discount, as income or principal or apportion the same between income and principal, to apportion the sales __~,-....-.. ,......s...............w.~~~~.l_~.L_____~_ :.___.____ ___..3 ____:._-,:.__1 .L_ L____L _______ JO . 1 1 ,1 10 101 ," ("I !-Ill'-''-' Vi allY a.:'>.:'>I;;L UI;;LWl;;l;;l1 111'-'U1111;; allU 111111'-'I[Jd1, LU Ul;;dl dllY UI V 1UellU VI Vlller Ur:SlHUUllVll VI any investment as income or principal, or apportion the same between income and principal, to charge any expense against income or principal or apportion the same, and to provide or fail to provide a reasonable reserve against depreciation or obsolescence on any assets subject to depreciation vr ubsulescence, all as the Executor may reasonably deem equitable and just under all the circumstances. SEVENTH: Rights and Liabilities of Executor. (A) No bond or other security shall be required of any Executor. (B) This instrument always shall be construed in favor of the validity of any act or omission by any Executor, and any Executor shall not be liable for any act or omission except in the case of gross negligence, bad faith or fraud. Specifically, in assessing the propriety of any /') . f ,'~-,.j t 1,</ _ .j '::'Y/, /;f. ,,/. /('#.// - ;(// LAST WILL AND TESTAMENT OF JOHN C. SERBIEFF PAGE 6 investment of the estate, the overall performance of the entire estate shall be taken into account. (C) Each Executor shall be entitled to receive reasonable compensation for services actually rendered to my estate, in an amount the Executor normally and customarily charges for performing similar services during the time which he/she performs the services. EIGHTH: Tax Elections. In determining the estate, inheritance and income tax liability relating to my Estate, the Executor's decision as to all available tax elections shall be conclusive on all concerned. In accordance with IRC Section 2632(a) and without regard to whether a Federal estate tax return is actually filed, my Executor shall allocate so much of the Federal Generation Skipping Transfer (GST) exemption amount as will fully exempt any generation skipping transfer which may occur under this Will. NINTH: Definitions and General Provisions. (A) Survival. Any beneficiary who dies within sixty (60) days after my death shall be considered not to have survived me. (B) Trust Estate. "Trust Estate" means all assets, however and wherever acquired, incl uding income, which Iuay belong to a T 1 u::st at au y gi Vt:H tirnt:. (C) Children. Except for discretionary distributions which may be made unequally among a group of persons and distributions pursuant to a valid exercise of a Power of Appointment, in making a disttibution to the children of any person, the property to be distributed shall be divided into as many shares as there are living children of the person and deceased children of the person who left children who are then-living. Each living child shall take one share and the share of each deceased child shall be divided among his then-living descendants in the same manner. A posthumous child shall be considered as living at the death of his parent. (D) Code. Unless otherwise stated, all references in my Will to section and chapter numbers are to those of the Internal Revenue Code of 1986, as amended, or the corresponding provisions of any subsequent federal tax laws applicable to my estate. /)' ~K?4 (/ c;2/ 4# LAST WILL AND TESTAMENT OF JOHN C. SERBIEFF PAGE 7 (E) Other terms. The use of any gender includes the other genders, and the use of either the singular or the plural includes the other. (F) Captions. The captions set forth in this Will at the beginning of the various divisions hereof are for convenience of reference only and shall not be deemed to define or limit the provisions hereof or to affect in any way their construction and application. (G) Powers of Appointment are Exercised. By this Will I exercise any Power of Appointment which I may possess at my death. IN WITNESS WHEREOF, I, JOHN C. SERBIEFF, the Testator, have to this my Last Will and Testament, typewritten on eight (8) pages, including the Acknowledgment and Affidavit, set my hand and seal this~? /A day of May, 2003. Ot-~ e jl> {i~ J<)HN C. SERBIEFF Signed, seuled, published and declared by the above-named Testator, d:S dUll 1'ur hi:s Ld:si Will and Testament, in the presence of us, who have hereunto subscribed our names at his request, as witnesses hereto, in the presence of the said Testator, and in the presence of each other. Each of us further declares that he or she believes the Testator to be of sound mind and memory. The preceding instmment consists ufthis and seven (7) other consecutively numbered typewritten pages including the Acknowledgment and Affidavit. "' '7"-" '1. ' ' C.. ,'~ \. ,- c/ '7\ . '- T \J- ,~iLi,_ {_ k'-'__ residing at c: f\ f \~ \ ~) I-I I LL \ . I P~\ ',,- r~ ,,~ ~ FI( ,..\ ",,: /::.... "-Ii ;,,,,' I) (print name) / ;;:/ ~ //'7 '_' ~~", ',"",__#'/7 ',....". .~/ ;:;,. residing at - // -"7/7 0;, "'<',!- rs.oo/"'~, rr ",,/ ./~ - '" // , ,'-,- (print name) ACKNOWLEDGMENT AND AFFIDA vn: COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND The Testator and the witnesses whose names are signed and subscribed to the attached or foregoing instrument, being first duly sworn and qualified according to law, do hereby acknowledge, depose and say to the undersigned authority, that the Testator signed and executed the instrument as his Last Will in the presence of the witnesses; that he signed it willingly or willingly directed another to sign it for him; that he executed it as his free and voluntary act for the purposes therein expressed; that each of the witnesses were present and saw the Testator sign and execute the instrument as his Last Will; that each subscribing witness in the hearing and sight of the Testator signed the will as witnesses; 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 int1uence. . Jtdt ( ~/, vI! V e~<~ Testator ~I- \_J-0c7'\1 ~Y-;'-.c;LLl'I._A~~ '''1T~L_~ ___ vv 1LUt;::;::; ~ ~t~/~ ~ Witness Sworn to or affirmed, su~ribed to, and acknowledged, before me by the above-named Testator and witnesses, this~{!ay of May, 2003. $clmau Notary Public My Commission Expires: \'r. NotarlaJ Seal T eri L Walker, Notary PWlic Lemoyne Bore, ClI1lberland ColI1ty My CcmnIssion Expires Ja1. 20, 2007 Member. Pemsylvanla Assodatfon or Notaries 2-0265 ,r A. B. T '": OF LOAN: U.S. DEPARTMENT OF HOUSING & URBAN DE'vt:LOPMENT 1.0 FHA 2.OFmHA 3.~L . V. UNINS. 4. OVA 5. OCONV. INS. c F'LE~" "nDeD. I 7. LO/\N NU~v~8ER: SETTLEMENT STATEMENT v. r.AD062n2u~'AP 5700519430 8. MORTGAGE INS CASE NUMBER: C. NOTE: This form is fu~rishe~.to give you a statement of actual settlement costs. Amounts pa~d to and by the settlement agent are shown. Items marked '[POC] were pard outside the closmg; they are shown here for mformatlonal purposes and are not included in the totals. 1.0 3/98 (CAD06202 SAPPFD/CAD06202 SAP/15) D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER. PAUL J. GINGRICH ESTATE OF JOHN C. SERBIEFF FULTON BANK ONE PENN SQUARE LANCASTER, PA 17602 G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 25-1638737 I. SETTLEMENT DATE: 113 JUNE DRIVE CRAIG A. DIEHL, ESQUIRE CAMP HILL, PA 17011 June 2, 2006 CUMBERLAND County, Pennsylvania PLACE OF SETTLEMENT 3464 TRINDLE ROAD CAMP HILL, PA 17011 J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 1 00. r.:I:~nc::c:: 400. ",onee ^Mni l11F 0 SELLER: 101. Contract Sales Price 146,000.00 401. Contract Sales Price I 146,000.00 102. Personal Property I 402. Personal Property 103. Settlement Charqes to Borrower (Line 1400) , 5,658.06 403. 104. Payoff 1 st Mortoaqe 404. I 105. 405. Ilrllll~tmen s ~or tems Pain Bv -"e er m anWlf1ce ilrl1us ments For tems Paid Bv Seller m advance 106. City Taxes to 406. City Taxes to I 107. County/Boro Taxes 06/02/06 to 12/31/06 I 278.27 407. County/Boro Taxes 06/02/06 to 12/31/06 278.27 108. School Taxes 06/02/06 to 06/30/06 I 107.04 408. School Taxes 06/02/06 to 06/30/06 107.04 109. Sewer 06/02/06 to 07/01/06 ! 13.62 409. Sewer 06/02/06 to 07/01/06 I 13.62 I 110. Refuse 06/02/06 to 07/01/06 13.59 410. Refuse 06/02/06 to 07/01/06 I 13.59 111. 411. I I 112. 412. I 120. GRn.C;.C; AMOUNT 0/ IE FROM BORROWER , 152,070.58 420. GROSS AMOUNT DUE TO SELLER I 146,412.52 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Deposit or earnest money 10,000.00 501. Excess Deoosit (See Instructions) , 202. Principal Amount of New Loan(s) I 116,800.00 502. Settlement Charges to Seller (Line 1400) 1,475.50 203. Existina loan Is) taken subject to I 503. Existina loanis) taken subject to 204. Gift Money 22,000.00 504. Payoff of first Mortgage ! 205. 505. Pavoff of second Mortoaoe i 206. 506. I 207. 507./Deposit disb. as proceeds) 208. 508. I 209. Closina Costs Paid By Seller 509. Closino Costs Paid By Seller Adiustments For Items Uno81r1 Bv::ieller Ailiustments For Items Unpaid BV Seller 210. CitvTaxes to 510. City Taxes to I 211. Countv/Bora Taxes to 511. Countv/Boro Taxes to ! 212. School Taxes to 512. School Taxes to 213. 513. I 214. 514. 215. 515. I I 216. 516. I 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER 148,800.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 1,475.50 300. CASH AT SETTLEMENT FROMITO BORROWER: 600. CASH AT SETTLEMENT TO/FROM SELLER: 301. Gross Amount Due From Borrower (Line 120) 152,070.58 601. Gross Amount Due To Seller (Line 420) \ 146,412.52 302. Less Amount Paid By/For Borrower (Line 220) ( 148,800.00) 602. Less Reductions Due Seller (Line 520) ( 1,475.50) 303. CASH ( X FROM) ( TO) BORROWER ----- 3,270.58 603. CASH ( X TO) ( FROM) SELLER 144,937.02 The undersigned herebV'C~d~6;fe~~a~d copy of pages 1 &2 of this statement & any a~~ChlT~ent~_~ef~rr,ed to h~-=in. /; '-;. -t- Borrower ,/ h /A'. ~ <,,'II i Seller / ct/.;.4!j;/ V'/"" //( 1th-- /;:.. ,F!4. h,~ .,);!/ LpAUL J. GINGRICH / ESTATE OF JOHN C SERBIEFF OMS NO 250 ...:-. I" ~ I i. /. /' I r I' .t'/' "-.__._ {i.'l [,-- 'cJ _ C ( . 'if) I Ii <- _,.c (G'~ ( I1UD-1 (3-86) RESf'A, 1184305.2 PaDe L. SETTLEMENT CHARGES 700. TOTAL COMMISSION Based on Price $ @ % I PAID FROM I PAID FROM ~ivision of Commission (line 700) as FolluWS: BORROWER'S SELLER'S fUi, :Ii to ----~ FUNDS AT FUNDS AT 702, $ to SETTLEMENT SETTLEMENT 703. Commission Paid at Settlement 704. to BOO. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Oriaination Fee % to 802. Loan Discount % to 803. Appraisal Fee to FULTON BANK $300.00POC by Lender 300,00 804. Credit Report to CBC $11.45POC by Lender 11.45 805. Delivery Fee to FULTON BANK 15,00 806, Administration Fee to FULTON BANK 325.00 807. Flood Determination Fee to FIRST AMERICAN FLOOD $12.50POC by Lender 12,50 808. Automated Underwriting Fee to FANNIE MAE POC $29.00b 809. 810. 811. 900. ITEMS REnUIRED BY LENDER TO BE PAID IN ADVANCE 901, Interest From 06/02/06 to 07/01/06 @ $ 19.600000/day ( 29 days %) 568.40 902, Mortgage Insurance Premium for months to 903. Hazard Insurance Premium for 1.0 years to ERIE INSURANCE POC $389.00b -- 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance 2.000 months $ 32.42 per month 64.84 1002, Mortgage Insurance months $ per month 1003. City Taxes months $ per month 1004. County/Bora Taxes 3.000 months $ 39.74 per month 119.22 1005. School Taxes months @ $ 112.27 per month 1006. months (cj) $ per month 1007, months (cj) $ oer month 1008. Aaareaate Adiustment months ((j) $ oer month -184,06 1100. TITLE CHARGES 1101, Closinq Protection Letter to FIRST AMERICAN TITLE INSURANCE COMPANY 35.00 1102. Abstract or Title Search to 1103, Wire Fee to 1104, Courier Fee to CRAIG A. DIEHL, ESQUIRE 1550 1105. Document Preparation to 1106, Notarv Fees to LACY A. JAY 15,00 10.0! 1107. Attorney's Fees to (includes above item numbers: ) 1108. Title Insurance to CRAIG A. DIEHL ESQUIRE 1 088.75 (includes above item numbers: I 1109. Lender's Coverage $ 116,800.00 103104092PAL -- 1110. Uwne(s Goverage $ 146,000,00 1 04222248P AO -- 1111, Endorsements 100, 300, 8.1 to CRAIG A. DIEHL, ESQUIRE 150.00 1112. 1113, 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201, Recording Fees: Deed $ 40.00; Mortgage $ 60.50; Releases $ 100.50 1202. City/Countv Tax/Stamps: Deed ' Mortqaqe 1,4600{ 1203. State Tax/Stamos: Revenue Stamps 1,460.00: Martaaae 1,460.00 1204, 1205, Recording Fees to RECORDER OF DEEDS Assignment of Mort. 29,00 1300. ADDITIONAL SETTLEMENT CHARGES 1301, Survey to 1302. Pest Inspection to 1303. Tax Certification Fee to CASH - --- 5.5! 1304. 2006 County/Municipal Taxes to JANET MILLER, TAX COLLECTOR POC $1 ,320,30s 1305. 2006 School Taxes to JANET MILLER, TAX COLLECTOR 1,531,96 1400. TOTAL SETTLEMENT CHARGES (Enter on Lines 103, Section J and 502, Section K) 5,658.06 1,475.5C .- By signing page 1 of this statement, the signatories acknowledge receipt of a completed co~ge 2 of this Ilwo page statement ~ / . SHELLY J. K E~QUIRE Settlement Agent Certified to be a true copy ( G.AD06202_S.li,P! C/\D06202_SAP ! 15 ) WAItltANTY DEED Primed on Plankeohorn's 100% Linen Record Paper C, r', ~~is 'ttb,~ ~ ." n::n~ '=171::;::' . '"""':l~("7j.~ , ~~-~~~ -c , -, ~-, "':"'l - ,.:. ,.~~"'''' 'h ~-.,c :...,.; - ~.0')_1 Sabr the In the year nineteen hundred and Ill. day 01 \,1 -: --- , ~III lYrtmrrn ,I '" ~ ! I" 'In , f ~ IiI T' 1-"1 ,I I. ; I '11 : n 1- I' ~l "l") I i tJ 1,-111' 11.:: r 1t111 In 1:" , '''1I1i 'I 'i' 'l ,11.,l ~ )' t j \: ':; n r i " " 1;'1'1 ': II - il,'l; ( . I'll T ;1 :1d ~, ny I'. '<.11); 1'1"1" , ' 1 i ~~ I r t,)" ~~ .'! "t 1..' ,] IC: i-i tl' I 11 '1 r 1 i;'.":; (I j 1 ~ l <:1.'1_'(11].1 .,:11..... .ttllrJ1.!irt~. That in consideration 01 1\ -; i J. ' )!) L 1 :1 r "Ill,] It le r 11,11 "111 1,r~'1111'1]' ~ ':! en!).; i i l' ,.-, t i (1 c. . _ _ _ _ _ _ _ _D01l~, in hand paid, the receipt whereof is "'"reby acknowledged, the said grantor" do hereby grant and convey to the said grantee 1-;\.:-lr lei 1"': ~n\\I. \::::i.,'\\'.;. .\\11 ,',i"T I" \[ "I"':'.' "J' ""IT'.'] c.l' ],1'1'! ~it";Itc l'l ',"";\""" ,',I' ::-lll;~ i,ill, I Ii) )'-I;I!ld l>,')ll!lt :-:,t:ltC l-,F !'\-']!lls\'l\Z\fJi;l. 'Cill','T LnL .1'. ;J()L"- \'. "';',:'l:rll',n l. fl(" !'1'\\\ \'If '\1':ill,llt' \'i 1 1..]11, "':;JtL~il Pl'lll )'i",',-'ri ,I iil ill~l_11 l:c"I',]-, 1'1 :,1, il:ld ill:>lJi"t ('ull, iti:1,",1 '1111 ,J~>~-;l..:r l.J ;\Clnr,ll\\." t,"l ""':'\ tll',--:r!:~nf, !1:l'L" !J\' Il,l', -']f(Pll'~"(-r'lc'r. 1'1 t:.:'rl' ~ll!-\'(: ,l' )')1- :'1 l,~IS,~. 1.:-; lIIJ_"', L 1 1 r: ,j i~ I '.. I ..', :, 1 lilt ('11 ,1':: C;l~-;t,-~t'n :; jll\"' !\\11(\ 111'1 -\",: r 1 I" t :" I.l)) I' ~'<', t \':\ i I:: ',1 1, 1 ) '1 '\ t 1'-~ :, 1 .\ i s t ;111 t,:l' (') I" Illlf' lllii ll',,, ,1 ell 11] ) I rt:1 I) r till' -;'7' ~: '...,:1 1 ii 1 ~" '.... t I I III (') i " I r ~l ',; 'r 1 '," :11 " I ! ' "1 1'" . ~ -, r i 11 ',) Il_'1 !1 t, ,i i ",!1 i Ii"~ i 11 F' I, (' t' 'CC' I) l.l) L Ill" .:-1(1 II1J 1,1<: '111 i\,_ j ',.' 1"~ 1 i i I '-11', illi 1'1 ,it ,d' I" L S: !'j It 11 ill': i ~ t 1";1 (1 ( ,Ill IIi' : \1' i_ ',"l' r+ il,' 1",-1[11 ( ~.l \ k I', ~ \', \ \ II' , l 'I,)) '-'I '111 "\ L,' 'lj'i 'I i r r .. I' II tll ,'[ rL' ,11 't li i i i_Jr. I jill' t\, I i III III i ,I, C' 'il 'I ill (I ---,ltl;1 I" 1"'.1 l' ; l I r t 11]' ilL It f,. ;-,C lljjl _J l' l il l I ] i I) j' ~ ' (' ;.:(\ 1 ~r;]J~, It t,il. c.l L\ j It 1 t" 't :i'\ 1 i L Ii ,:1 -11', t II It t l', :[1 \)'1 , 1 ,~ )Ii t \ . \ I ~ ~ , ,[,,'tl i1 i i't,:: - f. i ,,:, '1, i' r ' i t :-r ];1 i j' I, , , !' i I: i'l ,-11,1\,' l i 1,,-11 i, , ! ') 'l ~ , : I ~ '.1' ..l"t, ii, , ) r t j"illl ,I: 11il. ,\\ 11 t;) n ]11; :--1 ~ r, y' 24fAGf ~H)~; t ! 1 (: ! I 1 :\ C (~ n f~ f ~ t: I" r! " iT' : {" . 1 Tfr; I Dt I l'Cl:n rill' :n. :=ill, i tile! i ~1 1'1 ;111 L (\ n L rL;{' r1rivc, TdL; j ": lrindlc "-J!-:CTI I:, Vil1n\lc. , , ()n I"'] 1:) () r I.lyL ~ ( l')" i Ii, II P.1fTC ':)], Cll,dH~rl :111l\ ('!)il'it" i' i I I 'I " rc;c'\rll~; . I (' \ ~ l 1 ;; j n {l I e lLr(; 11 i n ,.,r ~ 1 () 11 S ,; \.:1 <:l1.L'11 :~ ~ '!o. ! 1.1 . 11111 ~ "LI;!I; IIIL 'iMn' 1"!F:'i';]'S l!iliCh hl,,;] V. '!cCnnkcy, 1'!i,jOh', 1.>\' ,Iced ,I,aled LIl Du,:_:~1 r~CJn!, ',,1, "i:1'," IS, 1~)("1;\ 111,1 reen] de,l in t:l(~ {~llnllC'rlillll Cnllllt "1 il,\ l" n , , l' (J ('. _ "( -1 -1 t T r:~:l t '.=' PeLI)'-'] rl~-; 1(7ri~' 'Itcn,;,lrl'il~ll -i Ll. 11"'-' ::~criJiefr :\nd -':lry ,1. l\t:~l1snll: tile S:lj,l ,In:lll r. (It':,rbieff 1:.1<:: ..ilH':C \':': ll:ltl-' .li1'1 l !',ellS on. eccKf :2.jPAGE 367 .I\IIU the said grantor WH. 1:1 :r I' ',LL ';" hereby cont."eyed. Uilarrunt UUll ]1unUl'r l!Iefcnll the property d.u.y and year first ah01.'e-illritten. 111 lUihlCliJl W[/Cfl'uf. said grmtor s ha 1'(' hereunto set t ," i r han,j; and seal.~ ,the _:Scald'! ,mo i'u~li.il1'rd'l ill tile prl'I,Wme llf , / .._:Iiv!.h~_'~_.J~~,.t n.L .....-__.~:.{..._~;/s.r.l....,..._... ) \ ",..'~.:...:,.~.:;{.J..~:....,;.::......~,~,L;,J;(~.~..;.f/...... ~ /I~'J'lJl I,. '11<1'1\ Il:J r -:','. i. " /' ..(....,..I.{;~:~..!cH.,,<;;..;:.ij.r~.h,.).~L..;..{.........~ .-----..,!:<.'.::'(L::~.~:.~/.~../~,;?:.~~~..;~~:--'...n................ ~ ':1J",'(.-'T.,"' 'l~-;(Jll ~ ....hh......_......_........._.hn.h...._.h. u...._._.............. _"h___'__'_'~ un_n.____....... __.___,__.____.__~ ......_..........h..m...hh..~ 113 O!crtlflrntl' uf ill,CJiihcuU I hereby certify, t/lat the precise June ')}'1 Fe' II i 11, Pel. t::11'1 ;, J.7!111 <.ll;:;lnutllHlUCi\!lJlllf :tlcmli!yhmniu '} 1l.9: C!lmmiiJ of ...._.._....... ...........U.:\LIJ.:.!.!..!.;L.............. On this, the ::; r' day of lCc{_~I:I1)er , reSidenr of tI,e grantee ., herem IS as follows: "'~ \~ I -- .\,-- ,!. f "''' ...11:...... . ....h.l..- .......::-,,_. ..:.~~.. .~............. .............. ......____ ~ Attortley or Agent lor GrantM 19 7 I ,before me 'l ;:n t ;11 \" I"'tl11 lie. tile undersigned officer, personally appeared ,JOil;< C. (" c.,'; ":.. l~ 1 ". t .\ 1', '" :i [ ~ ~.; (~. I. .: - - _.: ,- known to IllC (or satisfactorily proven) t~ "be \~h~' ~~son:~ instwment, and acknowledged that contained. ,;J:"UIl].T 'I,\!(Y ,. ,;r",', llTr, are whose name <;! subscribed to the within t lIt"',. executed the same for the pU~lIo.e tIu;rein . . 1 I . , '. -- I) . IN WITNESS WHEREOF, I have Ilereunto set my hand and : I () t" 1'; 'j 1. !ieaJ. :'.::._~~ ' ....:i;I,LLL~--'L~:Ld::~~:I:~:~~}~:{~~~;;~.~.;;;--r;;~ue M y Co::::r~~~;~~---~~k1}~~=~:1~~~~;i:.~-:.~~;.E;:~~i~~-5.- O~'I~b~.~-i8-,.'191i wom~:I::I:l.::l.:::~~~!...:.~..~~.l:~::~.I::.l:.i.:.__..,..... } S5: On this, the day of tIle undersigned officer, per!OnaI1)' appeared 19 } before me .known to me (or satisfa.ctorily proven) to be the person instrument, and acknonr/edged that executed the same for tile purpose therein whose naI11e subscribed to the within .(...., ,~''''; e.tatr of QlDuut!) of On this, tIle -, -'-". '''-.. ',,-, ..,J.""',,- 'Ir"'c~""""""~",,,,;,"~~_ the undersigned officer, personalty appeared dol' of ) \ 55: known to me (or satisfactorily proven) to be t11e person instrument, and acknowledged that contained. 19 , before me wflose name executed the Bame for the purpose tl1erein subscribed to the lv'ithin IN WITNESS WHEREOF, I have hereunto set my {land and ~ttltr of (!lOl1l1!!J of On this, the the undersigned ol/icer, personally appeared day of r SS: known to me (or satisfactorily proven) to be the person instnllnent, and acknowledged that I.:untained. My Conul.'iss;on ET.pire~ 19 , before me seal. whose name executed the s<:me for the purpose tl1crein subscribed ro the within My Conunission Expires ." " 'is Cl .. .~j ~j ~~j :::1 f-.j lr~ r-< r~ IN WITNESS WHEREOF, I have hereunto set my hand and seal. ~ t...J t..I ~ ~ .. . ii L J ~ ~~ ~J w ~ " .0 H ~ ... H (J ,,) t...-I ,::' -...-I r;j ~ r. t:. (I, L.. I-i I..: c~ ~ CJ-:" :-.J o ,"":j'r-I ;0-' -.:- If:; .rl , ;:"':i ~L ,. ;; ... (!llllllmOI1U1rilltl, uf tJ~I1Il!l!Jltllllliil C!fllllll!!J uf .... . ...... }Iln: vi II I' J 8!1 ~ I' ii , !I In II . II II II 1\ '>l. LJ er, er' w~ o~ < .~ LJW z f-" ero w~ m< o er ...; ~ ~ f-< "- .------ --- ~ 8 & 5 .9 '0 ] Pl ." " "2 a 'J ~ " ii -: b u " " o Cl ~ ] " '" ilh;iOtl1l'l'i in the Otfice for Recordin!~ of Deeds, etc., in Hod for said County, in Deed Bool.;: No. J Page Ulitnr55 m)' Hand and Official Seal this .dayof ,,).9 "'t. ,',", /) L~"'~-~"-!-.J,.v'.' -/ Recorder vi Deeds PA REV-1500 SCHEDULE E CASH, BANK DEPOSITS & MISCELLANEOUS PERSONAL PROPERTY T)m to! Curhlicil!f, "I rill., !(J 11,., vHhid", dtlM;ribetJ :;nl!or1hhuCl SiGNATURE Of APPi.I,:ANT OR AUTi-iC,RiZEfJ SiC,NER AUTHOI-lIZED SIGNER I /Ytll~1' i~ft~nt wn'trln., ..t~:'l't~ft n~f'I1'ff''N +'I1tl~~ffi~<-~tLl ~"'r:1fr~~~.'!..!'.~.:.:...,;,.,n.r...-,..'I"&D"_'WI;..~~fll'!:~~~~.:mmn1l1'1:r.';'iYIP."Grnm:~~":~l~.lWmI;~~~~'''j\:tIt.~.~:~mii~~~~~~f~~~~~ _ .g . '" '~.I<"JI ! -,4 - - - " ~ 31 ..1.. '8 ttt- "~, ~. I'-.,~ .~ en Jj.g III . e 51.'..... o,g 1-.""""" ..so . .' ,..... '" (J ~~, E" >.............. - -*~ d 1- <>>'0 ""'.1.0 - ..~.,..... B .:;> ....., ""- '1i!O /f.-i ~-'~ ~~ o ':."~ 1ii1l\. ,'""" . - ""w ,.' "'<II S / "'s:: _~_ <~ ~o ~., ~ ~.f.i '1'" ..t::.'" E'. -Gt:(D-,O, .,' iij::; " .~ ;.-- UJ ~ o eEl -,0.0 <0 0.0 "'M ',. <II,., li':l"">" .....,0.,...., . ........0..,..... 1"1"" ,.... .0- .... _. III I c ..re *% i *- . u.. "0 u..1ll . 1oLI!:- I .... "0 I +:l s:: "::s w:x: 0 I <II UI ~ . l:: ~ C,J:.... n:; '1 n.J ::Z::.-' C'- %....... %"00 cr Oc.:l I ..,t1/o tJ] Ift.O r....;:So I cr :0 J! ~ C'- WI- X I Ln l- . X <C Gl. t..O I- >~ , en ....-.c I 0 w r... IG I I n'\, I d I 0 I ct3 I tJ] I I .... \J.. - 0 rr Ula: C'- ::t:W 1 l1" >-1-0 i 0 <t:Oa: I 0-1-0 0 I 0 n.J 0 ffil ... >1 .. O. - !i_.il ~ ~l l"\J .., rn il Ln ~ ~l nJ ~ ~l J (!l" rn C;:;UJ ~ O"'! w'5 NO _ LIJ ~ ~I :r LIJ ....!]; ::> ~ <~ ~l ril N ~l ~l '0 ~\ \ I I ;>. c '" 0- s: 1l'00lsb 2522111 a:Ob... 2 '(aaa: ~ 2qqa .qbqOIlI - MRP 601 E. Street, NW. Washington, D.C. 20049 DATE 02109/06 CHECK NO. 462522 DATE 02/03106 INVOICE I CREDIT MEMO TYPE 120465758702/03106 I DESCRIPTION 1.201 - Member Refu d Vendor No.: 1451125 GROSS DISCOUNT 12.50 NET 12.50 ~, THE ATTACHEO CHECK IS IN PAYMENT FOR ITEMS OESCRIBED ABOVE. 12.50 12.50 . . - -". -,:'" .. .;:..... _,' .' .BI~. : . : ... .....~'-~ Jfe,,,,,":"jic,:,,:,;,';::;,.'1!~r:._;\1:! ~i~"~"'~6: ~.' " '~~~~~~~c~~'7t!';'~~i~e:.:;.U:..m;:!~;; .' "Ii,;;. ...... ." '. ;.i,ee'...,e ,d,. """'.!,if[!!~;;;I!~!I*!il:i~l! 'AYj;T~~f,;~,,'~~j:::::'fL~.;...:"J~~l~i~t~_';ic"!';'F;II ,.!!!~.'~'~?;je,I;;~'i.;-llilil~~~If~~.'~e,;~i~l;_~,:",",~:~.!i':,i;,;"'~: .' .f, ::.';:'." . ';':. : 'i...::,:>"':.., . .:,-.... ....... 'i. :..~;.......~..t(..:.,.::............',....................:N,'.:::,.,'..;::~~Jif,.',...,.>.,: '.::':...:;.,".,;!_."'..1f!f,-,. ""'Ii:'~')ti:/l~"'~"~.il:"~":"~iuc'\"'~" '~-.8':'-"-lJ':;'" ..'_..:,'.... _,:.:..,....:...;.::;~:-...: ,;,.~..iiii.i..~~~ ...,', ..., C'. . .., 'e . _ _ __ ..:...-;;.~,if;,li:..... .',' _,..p~~~f'Kt..;~~:.COf.,:_ . '.:_.:_.;;,....;.~~.i\(~~:J~~.~f"~i:-.f.:.:' "".'.' . ",. , __"'" ;,-", .' , ~ : ; ; l' .. .~. II' 52. 388bbll' 1:0 :1.0000 531: Bb. .,,1. 350"11' ..... -- <t --......-..-. tt P:i~~i lJilio. 8..o:..:o( o.tl.,..". Wi1milllloo, UE 19803 :'i"..' ....Otd&;JOI#f~~ '. Of ; IJ$ ,JUII&J)IF c:AMPmtL . PA 1'1Dll..... 003095c5 GROt Cie4il B~.il.. R.tutjd . ' ~CounINllJli!>er ; 003107590 . . . . ...'.'.......,..'....- ,- '.. . .' ~ cimDtr DEPAR'I1iI8MT P.Q.Box 411~ Read~g..PA ....~~ '.-, >:--,.. ..c:._: Date; 01124/06 ~~~Uid3WIOODOThus .">,, . ..'t2~.'er.~L . Authod...d.. Sigaature, 1110030 q 51; Sill 1:03. .00 2 251: 20 7qq 500 5 5 51; .11' ..., No Interest, No Payments For One Year" On your Bo.coV. Charge, for Order. placed before 2/4/06, Free Installation On all Window TrtIOImenl> 1T0m Kon.mgton and OxIord Hoose. PIu,. ~d 1 ~ Off Sh_ Radiance . .' 'iF" 10% Off Kensington Cellular Shades O' V'::;;'---- 50% Off OxIord Hoose Vertical Blind. ~. . Not available in all Jocotions, Call 1-888.S1002660 . . terlOrs E-mail CIlIIr>IllCIoco..llOboocon.com . -~~ 'F' C""",,r!oIw1oI;.It,,!hePOricdSDO<i&din"'_, IbcIan<o i""" id' Mt by 'f:" ~.a".nod, ....... wiN be coIcUIaMd &om lIIOI ri0 forWorrJ '" m AP/l. ,t;'?..fJ on ~ui .,...doo... . FinM<ong i, ..hio<t "."../it."",...,]..JIIt Ilofo:w'. q.,..g. C""j, Oi/;';, It" Wwlivid...., no' ""........ A> of I iJ/lM, !he -"", a.o.g. Carel Annual """- _ (APIlI is 11 t<< <<)wer'. LOV8at GkJN lm ~I lotroduc:iog the neweslfragraoce from Jenoifer Lopez l.7-oz. Eou de Ttliletle Spray.....$42 3.4-oz. Eau de Toilette Sproy.....$56 6.7-oz, Body latioo.................27.50 6.7-oz. Shower' Ge!............... , 22.50 1...111...111......11...11.1.1.11....11..1.1",..11..11.111..1 / -"J6-- t) 6 ~ ~ f?A-f.;f'~ ~' 003107590 01/03/06 -23.36 5,000 01/31/06 .00 JOHN C SERBIEFF 113 JUNE DR CAMP HILL PA 17011-5069 1:::;h!h1!hm~~1:!~~~hi~!i!:j~:::!:~j:~:t~~::m!;'j;::I',~ii!iE~i:::mj:iililL\t:i~~li:J:i~f:~:i:8:!i.!!;:~~:;:i:::F.~~:'~!(!m:j"::!:3[[t!'!7;'jJ:';:!:;i'F.f:;j~:::tc.;H:!i:f:::1(;:f;ij\ij_~J;:;F.hj~ REGULAR CREDIT PLAN (10) -----------~~--- fl') ---) .."" '--.-V !? I ( / /'r-I cJ,/ / t.._ " ,YO - J-' , . fJ({f'-;J f?XL/J-J 3/ e/lI , .. - ---- /f'. DETACH CHECK AT PERFORATION /f'. CAREMARK RX INC P.O. 80x 52115 Phoenix, AZ 8!i072-2115 ,..,:.~~t1:ri;;l:t~:ij)8j:~~j:;H~~I:j;;:tjf;:;'j;J~\ii~:2:$;j::~~;d::::i!::;::]~:~~.;:H:'3]'~:;!': ::;:Pl$p,~j'!fr' :.:;;:::.!'I.';;',; ,,' :,:~:t;~"'T;"::U,:i"t:;;'1 1900008286 01/24/06 062112476 15.00 15.00 t') '- COMCAST CABLE COMMUNICA TrONS 04OCBDT-OOOOO2467697 4008 N. DUPONT HIGHWAY ATTN: SUPPORT SERVICES NEW CASTLE, DE 19720 @omcast 03763 JC SERBIEFF 113 JUNE DR CAMP HILL, PA 17011-5069 1'11111".11111 t11111'1I11.I.J.II'IIIII..I,1 t111111..III1I1..1 Dear Jc Serbieff, -, ,.-- The attached check represents a subscriber refund for account number 09547-184777 in the amount of $45.25. If you have any questions or concerns regarding the refund check you can write us at the address above or call Com cast's toll free customer service number at 1-888-GOMCAST. ~~. k;",.J . J ()witIt.f{1-) Check Dale: 02117/2006 r f V. '" tJlV" Check Number: 157445675 ~ ~ 1-,,?:?-Ob tr fjPft DETACH AND RETAIN THIS STATEMENT THE A IT A~D CHECK IS r, PAYMENT OF ITEMS DESCRffiED ABOVE IF NOT CORRECT. PLEASE NOTIfY us rROMPn Y. NO RECEIPT DESIRED . . .. . ";",:,-, '-' --", '- -'-,.,",':-,;'" ...,'....._-... ....... ... ,... .' ",.: COMCAST FINANCfA,Vt\Gjj:NCY COR~QRATION. '. ................ A'COMCAST CABLECOMMUNICA TlONS.GRQUPCOMPt\r'{Y.<..... ,.., 7.3-97 1\}2P PAY EXACTLY: TO THE ORDER OF:JC SER8IEFF' SUBSCRIBER ACCOUNT NUMBER: $ .7't~~"45.25 ."'.-., . ..:.--.', "'."." .. '.' .."--,,,., -...... --.... .'.:":':',:'", . .' .,; , ,.,..... '.'" ," '."C ,:,,',' ".': ';";':"":'C':,' .- ;i .. . .,..,...~... ." dL' ....:,..: . ~ .!",.:. :':'. .: .. .... AllTlIDRmDSTOllA'R11tE . l....edbyl..<!!fal..U't)'mem Syst....loc, Englewood. Colnr>do JPMor!!>l'Ch,o;e Bank. NA.. DenyOf. Colonuto ?ll EXPLANATION OF ADDITIONAL SECURITY FEATURES INDICATED ON REVERSE SIDE 0 NDSFD 120040510) II' L. j B ] 0 Ii 1I' I: ~ 0 2000 g ? g I: b 800 ~ 5 ? l.l. 5 b ? 5 L III ~ !iiiiII = liE ~ iiiiIii!: ---- ~ && ~ ~ . ~ 5 ~ ~ ~ r 14~U J ~" / j 1.", ~ .., L, .J-"~rl-~Z1... j-_ ~,,,I r1",[ ,L.---j;>J,L-;J V J ~" i:..-<... (/"-- ~'/I, L-"'-<:- r-A--v /)' . . ! 1"",-",' I'" L (7 '~/>- ~ 1- ,/..-'.t..- l. /1 tf. tL c-_C- , )~ ",/U ~ Li vL-L'Vcr '/' frt,i ;} Pl:1M&rBank 2600 Linglestown Road. Harrisburg, PA 17110 7176520885 "",,7176526512 DATE: February 9,2006 TO: To Whom It May Concern FROM: Ryan P. St John, Select Banker, M&T Bank SUBJECT: John C. Serbieff As of January 24, 2006, there was no interest earned on account # 487953 as it was a non-interest bearing checking account. There was a total of $828.93 in this account at the time of John's death. The title of the account was John C. Serbieff He was listed as the sole account owner and Carter and Carol Polm were listed as Power of Attorney. Please feel free to contact me with any further questions. Sincerely, /~ ~~hn Select Banker M&T Bank (717) 652-0885 ft~ IV Blll/E IJ-cC'T h'/( fi'IN {;, SEl(d(E"/:r- /3'/1\( #7/-{,'J-7-S--3g~ M '-1-7- 13 4~^.l K Ikrr fJ tjJ Lf''}.. /:} I Ci I Y- ell ~{'K / /v'6:'- f}-e'eT V tk AiE V .2 ~:3 -t' fe~ !I-t { [lr:(Jc'J s. f 7-:> f- Tl<7/1 tV ~S Ft:.-;f( 5 Fr.~>>l IYI Ai 11 pC'~c;- PLSPW 33PM6ll4962 PEERLESS INSURANCE COMPANY CHECK NO. 2100556397 DATE: 03-31-2006 ~ {1~ /tw;/J'LLC(' ;:;;LCf, j, L; L t.t-1-h 61 '~1l t' \ / {j;xtc/p~-1:"-~ J- MAll.. TO: JOHN C SERBIEFF c/o EXEC OF ESTATE CARTER POLM 3525 APOLLO AVENUE HARRISBURG PA 17110 III 2 .00 5 5 b 3 q ? III I: 0 b . 20 q ? 5 b I: 20 ? q q DOlt * 5 ? ? q III W Sovereign BanksM TO: To Whom It May Concern 7-- I Cj I Ob FROM: John Cappawana, Assistant Manager, Sovereign Bank SUBJECT: John C. Serbieff As of January 24, 2006, the interest earned for 2006 is $236.96. The date of death value is $148,102.60. The title of his account was John C. Serbieff. If you have any further questions, please contact me at 7P909-6640. ~~ ..._~ -> -r_______ ~ John Cappawana Sovereign Bank Paxton Square-Assistant Manager . '. ---- ---- - -~ II. I. 2 q :38 ~II. ':O:J ~ :J008 :3 I.': 05.a baa qll. r DA1E 1 1127120061 CHECK NUMBER I 429381 INVOICE NUMBER INVOICE DA 1E DESCRIPTION GROSS AMOUNT DISCOUNT NET AMOUNT 008190227012606 112612006 Vchr: VC341142 $28.50 $28.50 Refund V. VE: 01/26/2006 , -----------~- --. --.-...--------. PA REV-1500 SCHEDULE H FUNERAL EXPENSES and ADMINISTRATIVE COSTS ,/~ fl- ~/J'J<.t~ 'Ytf/ It. 'EJifw Sai?lfZFP r(/~~~ i/ N c.H -~!J j.tJBs-1lC~ #327 Harrisburg PA MEMBER .839483003000 52507 WHITE CAKE 14.99 52507 WHITE CAKE 14,99 TOTAL 29, 9ll VF Cash Card 29.98 XXXXXXXXXXXXXXX8338 SWIPED Seq': 007238 Ref': 01 Cash Card Resp: AA / AHO,UNT: '29.98 REMAINING lALANCE: S'~1.65 , 0327 007 0000000033 0010 CHANGE ,00 TOTAL NUMBER OF ITEMS SOLD. 2 CASHIER: MICHEL E G. REG' 7 ,. 1/301.20-0.6 ~2,: 1 o-~7 ,,07iHrtiJ'!3" Online Shoppin9: WWW,COSTCO.COH Me~ber ServIce: 1-600-774-2678 *****Thank You***** ***Please COMe Asainl*** NEILL Funeral Home Inc. Mr. Carter Polm 3525 Apollo Ave Harrisburg, PA 17110 Services For: John C. Serbieff Services of Funeral Director and Staff. . . . . . . . . . . . . . . . .. $ Embalming .. . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . , Dressing Casketing and Cosmetology . . . . . . . . . . . . . . . . . . Visitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Funeral Service .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Transfer of Remains. . . . . . . . . . . . . . . . . . . . . . . . . . . " . . . Hearse/Coach and Driver . . . . . . . . . . . . . . . . . . . . . . . , . . . Safety/Lead Vehicle and Driver . . . . . . . . . . . . . . . . . . . . . . . Flower Van and Driver . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Rolling Green Memorial Park ....... . . . . . . . . . . . . . . . . . . Pastor Norman Evans .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Patriot News Obituary .............................. Death Certificates 20 @15.00~a~h . . . . . . . . . . . . . . .. . . . . J30 625 0 ROMAN ..... . . . . . . . . . . . . . . . . . . . . . . . . . . . Sentinel Protective Burial Vault . . . . . . . . . . . . . . . . . . . . . . . Package Savings ... . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . Inscription Plate I Romberger Memorial ................ " ~ .3' ~ l~ of.., ":J / '~. U " . ". 'CJf')- C~ b\}4.tc / Total Funeral Charges Adjustments (Payments) Balance Due on Account (Due date: 01/31/2006) 340 I Market Street Camp Hill, PA - 170 11-4428 tel71? 737.8726 fax 717 737-1859 Rebecca J. Donahue. Supervisor 3501 Derry Street Harrisburg, PA - 17111-1817 tel 717 564-2633 I fax 717 56/-9918 I I Stephen J. Wilsbach, Supervisor February 7,2006 Ref No.: 1003176/ C06 012 1,935.00 515.00 205.00 315.00 515.00 415.00 315.00 205.00 100.00 1,195.00 125.00 176.40 120.00 3,195.00 1,295.00 ' (370.00) 125.00 $ $ $10,381.40 0.00 $ $10,381.40 Member of ALDER\VOODS ,"ROUP fi Jf-I\J SbJe Bt t:FF t:vN~ ?p/l/C~IU ~ j'/El)jP/F h'-7/.rNIAGJ:;> RED LOBSTER 4711 CARLISLE .~KE MECHANICSBURG~' PA' 11055 717-763-1760 JAN 31, 2006 0195 NAME Me AUTH conE SERVER CHECK POlM/CARTER B ************5269 057464 JUSTINE B 1503 :~~.A AMOUNT $287.33 CHARGE TIP $40.66 TOTAL CHARGE $327.99 ADD'L TIP ------- $------- FINAL TOTAL $-~2-J.!ff L~C~__~ I Agree to ~bove total ~~ount as per card issuer asreelllent j~~~37-----------r7-T6-----------275~-;M Please leate a slsned cop~ for ~~ur server. flJHJ SPi(Btt:7=F FV~ t..vJ1/C/lBJIU 3:J j?EO/?/F A>-rrrNt:IG(;) RED LOBSTER 4711 CARLISLE PIKE HECHAHICSIlURG, PI! 17055 111-763-1760 JAN 31, 2006 0195 NAIlE : POLH/CARTER II HC : ..............115269 RUTH CODE ; 051464 SERVER ; JUSTINE 8 CHECK : 1503 AMOUNT S287.33 CHAR~E TIP S,,",0.66 TOTAL CHARGE $327.99 ADO'L TIP ----- $_______ FINAL TOTAL s-~2-J!..'lf -'" L_~~__~ ~ I Asr.. 10 .tIOI/' total alO(lun t as pe" card issu.r a"...~.n! JAIl 31 Ll T6 2 :50 PH Pleas. luve a l1",.d coP~ for !/Our s,rv.r, --~~----------- :MIIN k~BIcr:F Fv,A/5Yl/H.. 1-V I\.t:/IEC^, 3.3f'EtPj?ts;- H7T€N~ RED LOBSTER JAN 31, 2006 2:150 PH 0195 615 20050 Serv.r : JUSTINE II ,Coshier: JUSTINE II a..ck , t 503 T,blll : 41 Guest No. 1 ICED TEA '1.99 l/ATER WI LEMON HOT TEA 1.79 COFFEE '1.79 SOFT DR!( I. 99 ICED T~A '1.99 ICED TEA '1.99 SOFT ~R!( I. '9 SOFT DRK '1.99 ANGUS BUllGER-LR 6.50 ENDlSS SOUP ISAL 625 [iuNbo-b ENOLSS SOUP ISIll.. 6,25 GI>>Ibo-b L -CHK&FR SHRHP-LR S.99 L -CHKlFR SHRHP-LR !i.'9 ENDLSS SOUP ISAL 1;.25 Cho",d!!r-b l-CliKIFR SHRHP-LR lU9 L -CHKIFR SHRMP-LR !;.99 L-CHK & SCAMPI-lR 5.": IMTER 5 .'9" L -CHl(aFR SHRMP-LR ICED' TEA Ii ,99 SOFT DRK Ii , 99 SOFT DRK Ii. 99 COFFEE 11 , 79 ICED TEA Ii , 99 \lATER ICED TEA I: .99 ICED TEA Ii ,99 COfFEE II ,79 COFFEE Ii .79 SOFT DRK Ii ,99 SOFT ORk Ii , 99 SOFT lJIll( Ii ,99 - -t:g:~ ~~:L~ - - - -1J}-. ---- L -IU( CRTFISH-SR 6,99 ENDLSS SOUP ISAL 6 , 25, ____ Cho~-b L -tHK&F SHR"p-Ur--- 5. " L -CHK&FR SHRI1P-lR 5, 99- ANGUS BURGER -LR 6.50 L -CHI(&F1l SIlIlHP-LIl 5,99 L -CHI( .. SCAHP! -LR !;, 99 L - CHI( a SCIIPlP I -LR 5 , 99' L -CllK&FR SHRIlP-LR !>. 9l1' L-B FLO-SR li,99 COFFEE :i ,79 COFFEE 'I ,79 SOFT DRk 11 . 99 ICED TEA 'I ,99 COFFEE :1 . 19 COFFEE 'I .79 SOFT l)RI( 11 , 99 !lATER WI LEMON SOFT DRK 'I ,99 COFFEE 'I _ 79 COFFEE I ,79 COfFEE 'I , 79 SOFT DRK 'I ,99 SOFT DRK 'I ," L -FR FLO-SR 41,99 ANGUS BURGER -LII ~ - 50 ANGUS IWRGEIHR 1>.50 i. -CHK&FR SHRIIP-LR 5 99 L -CH1(&FR SlIRHP-LR 5.99 l-CHi( " ~"PI-LII 5,99 i.-CHI< & SCFlHPI-LR '5.99 ENDlSS SOUI'/SAL 6 , 2S GUNbo~b L -CHK&FR SHRHP-LR '5,99 L -8 FlO-SR '6.99 L-II FLO-SR 6.99 COHEE 1 ,79 SALES TAX 16/26 1~ ~ ~r~+ul+Y ~O.66 RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17~13 SERBIEFF JOHN C Estate File No. : Paid By Remarks: 2006-00086 CARTER POLM RSK Fee/Tax Description PETITION LTRS TEST WILL SHORT CERTIFICATE JCP FEE AUTOMATION FEE Check# 744 Total Received......... Receipt:: Date: Rece~pt Time: Recelpt:: No.: 1/27/2006 15:41:41 1043203 Receipt Distribution ---------------------___ Payment Amount Payee Name 310.00 15.00 8.00 10.00 5.00 ---------------- $348.00 $348.00 CUMBERLAND COu~TY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN BUREAU OF RECEIPTS & CNTR J.'v1. D CUMBERLAND COUNTY GENERAL FUN - BRICKERSAUCTION Buy & Sell on Commission - Complete Sale Service 93 Texaco Rd., Mechanicsburg, PA 17055 766-5785 J ?o5V Personal Property of 11 /J C. Address / (,3 :JV)/ c- Sold At Public Sale ' L-. A l' 20 () ro I Outstanding Total Sale / t) D ~/ SD ;LtJ d J Total Checks Total Cash Cash After Payout Expenses Auctioneer & Clerks \ Of) 00 33'S 0 l I ItfbOoo __ Jro,- I 75: ttJ Adv. Cost Property Fee _~ale Set~ ~!~e!p Total Expenses (pPd ~~ ~ b. JO$ if c, A J f)v.J.. U-U" ,/9,.0 ~ P?7~ ptnJ ~MV.~ DWG-~ 3~, CJl. Thank You For Selecting Chuck Bricker, Auctioneer & Staff ..... ._. ,.... .,.~",....., u u.. .'u' u. .-";~...."..~_. ,............... .....~~..... .,...~~.,.,..' ':h."" u'.. ....... .'. ..........~V.....,.. u h..... .'u'.~' ~~'.~...,"..U' ',' .... .'.., .......,..~..'" "';:::':;:-:.,.:.:::.:.;::>-:>.;<::;<:.: ..... '.L.':"-::;kiI~~l.i~li~;:_'''j:;;;~~......!:~-"';~H .. .[:~b~;:..\.'.' . ......,........ .. . ::>{<{><:>><::;::>~)<> T.<>~~;1~~:.)..: .......>1034:. iJlllfi .,.........._4{.: ':::::::;::;:)::::>::::::::::::::::::::::~~:~:.::': :::;::~{<{:>~{{:::):;> ::;:::,::::::;::>::;:;:::::::::"'. :::..;::-:/.:-:.:...,:-:;':.....: ..,"'..............' :::::~:.::::::::. .;.:::::::.::::'::;: ......'.......:.'.:'...;.:.:-.:::::::::::::::::::;:: .:::.:::-:.:-:.:.::::.<..'-:< . .........."...... ~. CUMBERLAND LA W JOURNAL 32 SOUTH BEDFORD STREET CARLISLE, P A 17013 March 24, 2006 Cumberland Law Journal is published every Friday by the Cumberland County Bar Association and is designated by the Court of Common Pleas as the official legal publication for Cumberland County and the legal newspaper for publication of legal notices. TO: Craig A. Hatch, ESQUIRE RE: John C. Serbieff, ESTATE Legal advertisements must be received by Friday Noon. All legal advertising must be paid in advance. Make all checks payable to: Cumberland Law Journal. ---------------------------------------------------------------------- ---------------------------------------------------------------------- Advertisement inserted on following dates: March 10,17,24,2006 Advertising Cost Second Proof Request $ 75.00 $ 0.00 $ 0.00 $ 75.00 ------------- Proof of Publication Payment Received Total Amount Due $ .00 --------- --------- Payment received March 6, 2006 by Becky H. MorgenthallExecutive Director ~'1'.. -";'J'- ..".... ..,........,.....- ,........... ..>~-'_, + '>-. ~.. ....".r ...... l}O/'-" e'c[3//-f1't'5JL/ _{" /:/l--(.(,( III 5c?c...L'1 CE: 1/3 JtJ AlZ {/llfL.,:r:: Fee 'III 3- Jf /.?-C ) ~ ..~,....J>~ ~ .......;;",.- -.....::.,....' . ----------......-------- ',-..--' . . ' - ....~<'"' '. ,~~.'...._.... - .,"'....... .- .''-''r- '_ ,. ) PON Ec8/f)tJ SKI . . /1 -2. "If) to E. till/V c\l SDLU lC E -" >t ! [J,Lt{ c rctZ ~f {Zr 7 CV\I'-&. q r 8 I I / --------~-~~-~'~~- r-:" ......:..:::~~;:;:::;::.......::.. ::;:;:;:::;::::;::::::;:;:::::::;: . . ~ :.:...:.;.;:,:-;;;;;::.':::::::::::;;: .-...-............-.... ::;:':1:::':'::0:::,:;"e;:;'::':7:':-'- ".-_.: ... ','-" .;.>:-..:-....:-.;.;..-: .. . .. ... .. .. ... .... FROM: Freeman Real Estate Terry Freeman 4076 Market Street Camp Hill, PA 17011-4200 INVOICE TeIIpIlonINumbIr: 717-763-n12 FuNumbIr. 717-731-9612 ESTATE OF JOHN SERBIEFF C/O MR. CARTER POW 3525 APOUO DR HARRISBURG PA 17110 TtIIphone Number: AItiIrIlIliI Number: Fu Number: E-IhII: tnIImII 0rdIr #: 0001226 LIndIr Cae (I: CIlIIII FIll #: IIIIn FIlII on form: au. FlIt Ion form: FtdnI TulD: Employer 10: TO: Lender. ~/BOnOWt(. Property AcIdrMI: 113 June Dr. CIty: Camp Hili County: Cumberland lAgII DeIcription: See Site Area Below ClIent Estate of John Serbleff SlatI: Pa. ZIp: 17011.5006 . ... . . . , ~ ~ .... - - , , -... ... - - , ." . APPRAISAl.. SERVICES 300.00 I 1 ~ . j t r . I' \. ... . _._ " . .h. .. . .. ""- (]. ~/ f./ I/t~ " () ,.1. :) L.., i 'f if--. .1- " 0 t, 3./17 SUBTOTAL 300.00 CbIck II: ctleck /I: Check II: 011I: 011I: Dati: DtacrlptJon: DHcrIptJon: DncripIIon: SUBTOTAL 0.00 TOTALDUE $ 300.00 Freeman Real Estate Fonn NN3 - 'TOTAl for Wllldows. appraisal software by a Ia mode, inc. -1-800-Al.AMODE :AbH ON!. Y AFTER 12J06.lll8 t~ ~ f r~ It i I F~ f' I I i i JANET L MILLER. TAX COlLECTOR 1939 WAlNUT STREET CAMP HILL. PA 17011 ASSESS.NO -01002359 MAPNO; 01-22..Q531-Q36 113 JUNE DRIVE ACRES .170 DEED 0024W 00366 TRINOLE VILLAGE LOT 56-A ResldentlalBuiIQin~ RESIDENTIAl,. . I SERBtEFF;'JOHN C t 13 JUNE DRIVE .CAMP HILL PA 17011 MAR-0cT31 WEDS 10-2 & 4-6 SPEC HRS: THURS-4I2O & 4/27 4-6 FRI- 4121 & 4/28 10-2 PHONE (717) 763-01 n 10H ONLY AFTER 1~ i ~'INU! rQ, JANET L. MILLER, TAX COlLECTOR 1939 WALNUT STREET CAMP HIlL. PA 17011 ~, Assess.NO -010<l235Q MAP NO: 01-22-053H)36 J. 113 JUNE DRIVE ACRES .170 DEED 0024K'00066 TRINDLE VILLAGE LOT 56-A Residential BUilding RESIOENTlAL , T-ix \t ~E -: I SERBIEFF. JOHN C 113 JUNE DRIVE CAMP HILL PA 17011 MAR-0cT31 WEDS 10-2 & 4-6 SPEC HRS: THURS-4flO & 4/27 4-6 FRI- 4121 & 4128 10-2 PHONE (717) 763-01n TA: 'ERCOPY _No: Bill Date: Total 111 990 ... '2OMf 310112006 10 t 231. 7:l ..... Zf '.u,s Oa 0:1: U~ Zf >>del Oa o:r "f~ ~ BYt et.MIltUREAUFOR COlLEC11ON AND FIUNQ OF It. UBI AGAlN8T YOUR r-raOrD.l t. 1f11312DOt - SEE REVERSE SIDE OF BILL FOR A BREAKDOWN OF YOUR COUNTY TAX DOL1.ARS- ~ ~etum B!I!~eaym~Fo~l1 Receipt-, Enc~~SeIf Addressed~tamped Envelope. TAX COllECTOR Copy sa No: 24t7 310112006 10 t 270.66 10 t 22.17 10 t: 23 .'/2 ... J:t! .U4 Oa,ozUt,w %f .aid CIa 01': ..fore 111I_ - SEE REVERSE SIDE OF BILL'FOR A BREAKDOWN OI!F YOUR COUN1'YTAX DOUARS- Control No: 001 - 002359 Assessed Land Values 22 520 2G08 .~of'''' EatIIIIa T_ IlIIprovement M neral 89 470 0 Rates COtlNTY R E Rates COOllTY 1>18 210.65 :H 2oll.13 2 , 19.75 .00219700 196.57 .00018000 16.10 246.05 20.15 2' 206.44 .00188100 168.29 Rates IlUNIC. R E TAX AMOUNT DUE-> $417.32 $41U5 ~.-' Control No: 001 .002359 Auened Land Values 22 520 2G08 ..........01 ....e...T_ IIIIprO'llellent M1.neral 89 470 0 BIR Date: Total 111 990 Rates .00219700 .00219700 2 , CXIUJITY 11. E 49.48 U6.S7 241.13 Rates .00018000 .00018000 2' COUli'l'! LIB 4.05 111.10 19.75 Rates .00188100 .00188100 2' MUNIe. R 42.36 168.29 2~~44 TAX AMOUNT DUE-> MS7.32 :146.05 20.15 210.65 $478" CLMI8URI!AU FOR COLLECTICIH AND.....OF A LEN AGAINST YOUR PROfS" t. \ Retum Billwittl Payment. For a Re<;eipt . Enclose ~1Idc:IreSSed stamped. Envelope. / .-.......-->'* '"~............_. .,....-- -~.. -'-.-~ .......... -_ -...- ..... .~.- ~~ .rK_ - ."'...... o . ,< " ftJ--'-J /-,) -, lr-??<,lLINLI/!3 ,g F S G ) , () J.- )p-"l'- 7 - f~e4!M; JW11<'Ji/3/;Z5f- .. / /1 " 'fC;' , i L'1 I:: /) --.' /1 ~1-~~; v vvL--v) (/f' ~y I' V / .I ----------------- ~ !'3fY,S' j -l>>fr-l / /' THE HOME DEPOT 4120 6000 CARLISLE PIKE, MECH PA 17055 STORE MANAGER MARK ULRICH (117)795-9602 4120 00056 04111 03/16/OS ___ SAtE --14 SC0156 02; 35' PM -- --. asss .. ~ ~~~ ~., 16 ~~ @ 078477144107 15A GFCI IV - 3 --1--11:-75---- 018477211625 18 WP, AL 3 ~ 0.69 046462000172 MAILBOX SUBTOTAL SALES TAX TOTAL XXXXXXXXXXXX5269 MASTERCARD AUTH CODE 981416/6561256 --35.75 --- 2.01 9.97 47.29 2.84 $50.13 50.13 ....- TA t~~II".lIJJ ...... NOW HIRING SPRING SEASON ASSOCIATES PT/FT APPLY TODAY IN-STORE OR ON-LINE AT: STORECAREERS.HOMEDEPOT.COM/HOURlY .~*.~~~W~~KX.~*~.~~*~~.~~~~~*xw~..~~~*~ THE HOME DEPOT 4120 6000 CARLISLE PIKE, MECH PA 17055 STORE MANAGER MARK ULRICH (117)795-9602 4120 00059 63707 03/18/06 SALE 14 5COT59 07:09 PM 11307 .. .4- -----_.~~,~ -- _d _.,~~~ .....~l.O ~*. @ 051411160104 GRND CLAMP 4 i 1. 09 781789718101 CLIPS 320528 WIRE 2 t 0.66 079407992164 WIRE SUBTOTAL SALES TAX TOTAL XXXXXXXXXXXX5269 MASTERCARD AUTH CODE 407784/4592280 4.36 . 1.49 1.32 2.49 9.66 0.58 $10.24 10.24 ....- TI~ 111 ~11~Jllllllltl /' NOW HIRING SPRING SEASON ASSOCIATES PT/FT APPLY TOOAV IN-STORE OR ON-LINE. AT: STORECAREERS.HOMEDEPOT.COMlHOURlY ~~~~~~.......~~~~..~....~..~.~**..~xx.~ -. -_.. -------- EXPENSES TO PREPARE HOUSE FOR PUBLIC SALE ON APRIL 29,2006 AT 12:00 NOON -lflft:(~ \->f) 1l1>t ~ 1/3 J5~ -5- (; -ill "" THE HOME DEPOT 4120 6000 CARLISLE PIKE. MEGH PA 17055 STORE MANAGER MARK UlRICH (717)795-9602 4120 0002009Zl3 03/18/06 22 AH658H 06:32 PM ~ THE HOME DEPOT. 4138 5101 JONESTOWN RD LOWER PAxr';f~ PA, 17112 WE INSTALL. ROOfS,SIOING,IW(:iW5. fENCES " . 4136 00007 87242 03/18/06 II ECSON7 02:17 PM r';;~. ~ I~~ B.*' ~ SALE SALE ~'O?~. S) ~~~ ~~, l~ I .." lRl 078477086902 1G SW IVORY 6 i 0.22 1.32 078477099865 1GDUP IV tOP 1.99 I SUBTOTAL 3,31 . SALES TAX 0.20 l TOTAL $3.51 XXXXXXXXXXXX5269 MASTERCARD' 3.51 AUTH CODE 338871/4201925 TA 078477966129 1G SW AL 5 @ 0.22 078477772713 15A SP SW IV 078477829090 1G OUP AL 6 @ 0.22 078477151365 2G SW OUP IV 2 @ 0.82 078477151235 2G SW IV 725916814120 EXTERIOR LAN 078477141496 15A GFCI AL 078477099865 1GOUP IV lOP 2 @ 1. 99 032886263026 WIRE SUBTOTAL SALES TAX TOTAL XXXXXXXXXXXX5269 M~STERCARO AUTH CODE 585111/4071912 JjW~I~~Jjlll~l~I~1111 NOW HIRING SPRING SEASON ASSOCIATES PTln APPL V TODAV IN-STORE OR ON-LINE . AT: STORECAREERS.HOMEOEPOT.COH/HOURLY ~:.r,* :r:t."N ~ ~.xU1r~.X ...x-a........ .,.~~..~ )f..l(~~X~1.-_ 1.10 0.54 1.32 1..64 0.72 9.97 11. 75 3.98 8.33 39.35 2.37 $41.72 41.72 TA ,. 1Illllllllllllllllllllllllllllllmlllllllllllllllll 4138 07 87242 03/18/2006 J69S NOW HIRTNGSPRING SEASON ASSOCIATES PT/fT APPLY TODAV IN-STORE OR ON-LINE AT: STORECAREERS.HOMEOEPOT.COM/HOURLV *..'*''''***'''''....................1t.,......I.. """''''' ~....-..c.t........""......",............. tAio,.,,,,. --~-_..~-------------~+-------- EXPENSES TO PREPARE HOUSE FOR PUBLIC SALE ON APRIL 29,2006 AT 12:00 NOON dry , THE HOME DEPOT 4~20 6000 CARLISLE PIKE. MECH PA 17055 STORE MANAGER MARK ULRICH (717)795-9602 4120 00001 75083 03/19/06 SALE 61 JA01ZM 04:56 PM . THE HOME DEPOT #4~~3 4200 DERRY 5T HARRISBURG. PA 17111 WE INSTALLl!1 CALL 1-80Q-79-DEPOT " 4113 00010-61035 03/20/06 SALE 11 MK25AL 05;56 PM r::-:- ~.. 170~~~ ~) I ...~~ ~*'@ 596019 0-21 CULL 051411205119 ROMEX CONN. 050169006603 1-7/8"HDY BX 032076651756 STAPLES 078477151235 2G SW IV 725916814120 EXTERIOR LAN 866318 14THHN GRN 50 (j 0.13 SUBTOTAL SALES TAX TOTAL XXXXXXXXXXXX5269 MASTERCARD AUTH CODE 463634/3014819 0.51 1.24 0,79 1.87 0.72 9.97 6.50 21.60 1.30 $22.90 22.90 TA . 00141-1160104 . ~ND CLAMP 2 II 1.09 078477086902 1GSW IVORY 078477772713 15A SP.SW IV 4 II 0.54 076477144107 15A GFCI IV SUBTOTAL SALES TAX TOTAL XXXXXXXXXXXX5269 MASTERCARD AUTH CODE 053644/2101758 2.18 0.22 2,16 11 . 7.'5 16.31 0.98 $17.29 17.29 TA J)~I~IIIJlllmlml~~~ J)llll~ll~lll~]J~1111 NOW HIRING SPRING SEASON ASSOCIATES PT/FT APPLY TODAY IN-STORE OR ON-LINE AT: STORECAREERS.HOMEDEPOT.COM/HOURLY ~.%.~~XX.~*.W~**.~~W~y~...~.~~.*~x*%WW~ NOW. HIRING SPRING SEASON ASSOCIATES PT 1FT APPLY TODAY IN-STORE OR ON-LINt-u- AT: STORECAREERS.HOMEDEPOr.COM/HOURLY '-~~..w~..~~y~.~w..w.......~~.;y.~~~~w. EXPENSES TO PREPARE HOUSE FOR PUBLIC SALE ON APRIL 29, 2006 AT 12:00 NOON /;l3 THE HOME DEPOT 4~20 6000 CARLISLE PIKE. MECH PA 17055 STORE MANAGER MARK ULRICH (717)795-9602 4120 00056 11876 03/22/06 SALE 14 SCOT 56 05:28 PM ~ '~ a*~~ @ l_ 079941275150 LTXWTPRF5GWH 2 (j 87.98 175.96 175,96 10.56 $186.52 186.52 TA SUBTOTAL SALES TAX TOTAL XXXXXXXXXXXX5269 MASTERCARD AUTH CODE 521291/0561573 lljlll~I((I~JI~llllll'ml NOW HIRING SPRING SEASON ASSOCIATES PT/FT APPLY TODAY IN-STORE OR ON-LINE AT: STORECAREERS,HOMEDEPOT.COM/HOURLY .wx*~~~~~~x~**x~*w~*~..*~ww~~*~~*w~x*~~ r / EXPENSES TO PREPARE HOUSE FOR PUBLIC SALE ON APRIL 29, 2006 AT 12:00 NOON fie; ---------- -- ------------- EXPENSES TO PREPARE HOUSE FOR PUBLIC SALE ON APRIL 29,2006 AT 12:00 NOON "'---- - ~--- ---- THE HOME DEPOT 4138 5101 JONESTOWN RD LOWER PAXTON PA, 17112 WE INSTALL ROOFS,SIDING,WINDOWS,FENCES 4138 00008 53507 04/02/06 SALE 11 ECSON7 11:24 AM THE HOME DEPOT 4138 5101 JONESTOWN RD lO'Wi R I'AXTOl'4 P", 17112 WE INSTALL ROOfS,SIt'NG,WINDOWS,FENCES 4138 000'0 97369 04/03/06 n KWV4Ql 12:13 PM SALE "~) ~~ ~~ ~il~_~ 082474905043 PPEXSENUPWOT 032628355156 CEMENT OB2474270011 STUCCO PAINT SUBTOTAL . SALES TAX TOTAL XXXXXXXX2903 STORE CREDIT CARD BALANCE XXXXXXXXXXXX5269 MASTERCARD AUTH CODE 097964/9083188 11.48 8.97 16.98 37.43 2.25 $39.68 0.74 0.00 TA 38.94 TA 082474505011\ m:XS{U~WHGA Si.l.E5 TAX Tiff"\. X)(XXXXXX9016 S" )RE CREon CARD BALANCE XXXXXXXXXXXX5269 I~I\STERC."RD AUTH CODE 650470/6104997 24.98 1.50 $26.48 12.17 0.00 TA 14.31 TA I \\II\I~\ll'\IIIIIW~IIIIIIIIIII\ ,~ 4138 10 9136: J4/[I~/2006 7324 !'lOW HIRING spRInG SEASON ~SSOCIATES PT/FT APPLY TOD~" IN-STORE;' OR ON-LINE AT: STO~~~~~ER~ ,HOMEOEPOT.COM/~OURLV 11111111111111111111111111111111111111111111111111111 4139 08 53597 04/02/2006 2161 NOW HIRING SPRING SEASON ASSOCIATES PT/FT APPLY TODAY IN-STORE OR ON-LINE AT: STORECAREERS.HOMEQEPOT.COM/HOURLV ~ww.***._***~.*_.~~~**.~~...*w**<<~*~* " --~-~--_._~'-;:_-.~;.~~~~- ll~-/ .;? AdvallCe/~' Auto PartslX We're ready in Advance. ...................,... . S-tor-e # 06848 (717) 764"T'3065 1406 KENNETH RD. YORK PA , 7401 3/09/2006 15:09:,g REG 05 Cashier: JORGE M, TRIANGLE CAR WASH HARRIS 3620 WALNUT ST HARRISBURG, PA 17109 717-545-1234 27020039733804 COP Y 03/08/2006 18:42:19 Sa.le: ITEK QTY , 7'1'077 1 ARTIe WHITE Sub Total Tax @ 6,00% Total . Cash P a!:ll'len t CHANGE DUE PRICE $5.77 NGGM153 TOTAL $5.77 Transaction ;t 47 Card Type: MasterCard Ace: ___****_**_*5269 Entry: Swiped Invoice ~ 3353 Total: 7.04 $5.77 $0.35 $6.12 $6.20 -0 08 Reference No.: 00255290 Auth.Code: 447504 Response: CAPTURE 447504 " CUSTOMER COPlt Scen to RETURN It.~. 11~IIIRIIII~lIllmlll~~~~I~ *X749460056826* Transaction #6826 RECEIPT REQUIRED FOR RETURNS WARRANTY INFORMATION AVAILABLE Visit us at www.advanceautoparts.col.l CUSTOMER ,COpy --- -~--~- )7. ',' iz; -," /,. ' /i" . " " i/l-Lj/ll2JWr/1i .(,) ,A-t---t/ L /" V / f C; f 421~tj f'{,i/lIq.y(-.6-L /-7 ~ V- I! (p,ZC jj -:-. :i"~ i./- '7;,-liil I .'l" I I .(- - / I /ir-?,7'<-- 0 ---._----_.~---......... USPS HARRISBURG PA HARRISBURG. Pennsylvania 171069714 4134870106-0096 03/07/2006 (BOO) 275-8777 02:27:21 PM Sales Receipt Product Sale Unit Final Description Cty Price Price .-. HARRISBURG PA 17129 $0.63 First-Class 1.30 02. CuSlOft8r Postage -$0,58 -------- ...------- .--H---H-----I$$Ue-PVI.:____ ---$0.05 - PHILADELPHIA PA 19255 $0.63 First-Class 1.60 02. Customer Postage -$0,58 / ======== Issue PVI: $0.05 t~r trJ~tJ ;<OOJ~ ~ Total: P(ilq by: Cash $0.10 !Zt.fd<1tc-:'u/Jn.t? <.->]d';L.[L-..d . 'fi1;L/ 0 II, c' .f- c/ $0 ~ 10 Bl11*: 1000401852487 Clerk: 06 r - All sales final on stamps and postage. - Refunds for guaranteed services only. Thank you for your business. Customer Copy /1 ~ tJ~1 f7'C 7 - f '\-'... /' )-, \ \ i -."-.---------------- .-----~-~-_.._- -----.~ ------- ....----------- It} fdlJ'c f)~woy r[J1l. ) VtFwAf I.~t<;; THE HOME DEPOT 4138 5101 JONESTOWN RD LOWER PAXTON PA, 17112 WE INSTALL ROOFS.SIDING,WINDOWS,fENCES 4138 00002 21267 04/07/06 61 ACT717 06:48 PM SALE 1JRt VIE? W!k/ ;f 6fJiJ-/R.5 THE HOME OePOT 4~20 6000 CARLISLE PIKE, MECH PA 17055 STORE MANAGER MARK ULRICH <717l795-9602 4120 00002 71320 04/09/06 61 JG729Q 04:09 PM SALE ;--~-- I~~~ ....~ ~ 07 I~~"" ~ ~~..) ....~~, "' ~~ @ , i 039645110348 SAND MIX 40# 3.24 039645170144 BLKTP PTCH50 2 @ 7.47 14.94 SU8TOTAL 18.18 SALES TAX 1.10 TOTAL $19.28 XXXXXXXXXXXX5269 MASTERCARD 19.28 AUTH CODE 281752/4022705 TA 4oo02000214G 50ff FLAVS^ND 0.27 SALES TAX 0 . 20 TOTAL ~3.47 XXXXXXXXXXXX5269 MASTERCARD ~.47 AUTH CODE 26e032/Z0Z2629 TA 11111111~IIIIIIIIIIIII~WIIIIIIII1111111111111111111 4138 02'21267 04/07/2006 8680 NOW HIR1NG SPRING SEASON ASSOCIATES PT/fT APPLY TODAY IN-STORE OR ON-LINE AT: STORECAREERS.HOMEDEPOT.COM/HOURLY ww******w**~**..~***w*w**w~~w******.*ww JJlIIUI!llIIWlllt~11 NOW HIRING SPRING SEASON ASSOCIATES PT/FT APPLY TODAY IN-STORE OR ON-LINE AT: STORECAREERS.HOMEDEPOT.COM/HOURLV ~~~.w.**.*.w~ww~~..~ww*_~w~w*.....~~w_ . dtl~ (\ ae L-), J. C ("l M~a~' :; ~7 - ~ U" JJ! 0 '3)'/ J-. fJ I t.f 1-.1 rr C,vl,~ ----------- FINAL EXPENSES TO PREPARE 113 JUNE DRIVE FOR, PUBLIC SALE ON APRil 29, 2006 AT 12:00 NOON ft:fi//-7--3 -;:::I/J},()f it if -~ 1t:2 /f" ~ ~ ;I 7( l-- 7 III ~- /} ;':---:~ ---... . 1'lh.~"'1"! 111//{. 71 / (ffe/ ! O~~. ~ I....~ I ~j.-, @ ~ - T u~.s r XJf~.s.-f ~7Lj /!ill FrP,J..J{ (lokV ~JJ Cr-- 4-II:J .r d /VIE: J}IL ~"f! HJ THE HOME DEPOT 4138 5101 JaMESTOWN RD LO'-NEI I'AXTON PAt 17112 WE INSTALL ROOfS.5IfJIlJG,I,HNDOWS,fENCES 4138 OO( 02 40713 04/13/06 SALE 51 Tw950W 05:33 PM 11<0#1 fr;RefI C/Jf.PG7 tfo/L( THE HOME DEPOT q~20 6000 CARLISLE PIKE, HECH PA 17055 STORE MANAGER MARK ULRICH (717)795-9602 4120 00009 00274 04/11/06 SALE 11 JEU6kI 03:47 PM ~~ QBla3366J402 CARPET AOH 12.B~ 925837 CARPET 8 i 2.97 23.76 SUBTOTAL G6,61 SALES TAX 2 , 20 TOTAL $JB.Bl XXXXXXXXXXXX5269 MASTERCARD ~8.81 AUTH CODE 871743/0091814 TA - 030699198214 PLASH.AI: 'JflS 030699087662 1/4WiSI J1D, 2. 1.22 ARL 1/4X11/2LSCG 6 @ 0.36 . JJIII~II~'~Jlll'lll SUfi TO'iAL S.A.I.E~ TP.X TOIAI. XXXXXXXXXXXX5269 MAiiTERC.'RD AUTH COOE 909666fOO:~31)42 0.98 2.44 2.16 5.58 0.34 $5.92 5.92 TA ,/ - < 111111' 111111I11111111111 i Illllljlllllllll" 111\ "'1111 4138 02 40713 011/13/2006 7617 NOW HIRING SPRH:.:i 5E,I,SJN ASSOCIATES pT/n APPLY TOD,,\' IN-STi.IRE ~R Q~H.INE - --AT; STORECAREEl(SHUME.lEI'OT .COM/HOURLY 'lll."'.;w.....*Yf1tw:1It.W"'*l(O*~.:: IIt)J "'<#1"""'''''''' . ""w..."""". I NOW HIRING SPRINt, SEASON ASSOCIATES PT IFTAPPL Y TODAY IN-STORE OR ON-LINE AT: -STORECAREERS.HOMEDEPOT.COM/HOURLY ~XXK~KX~X~~KKK~K~K~K~~~K~~KXWX~X~~K~~~~ ~........_-~._~------- FINAL EXPENSES TO PREPARE 113 JUNE DRIVE FOR PUBLIC SALE ON APRIL 29, 2006 AT 12:00 NOON LJ-- W~~ -"---- ".. :3~~~ pll?r~wl &~ ~e LOW E . S I'//Ib If/'-5 P~fJ)gW~ !9jJht1.J ~L€u- !13JVN'G ()A/Vrr: THE HOME DEPOT 4138 5101 JONESTOWN RD LOWER PAXTON PAt 17112 WE INSTALL ROOFS.SIDING.WINDOWS.FENCES 4138 00002 73813 04/24/06 SALE 61 MMC2PB 12:48 PM HARRISBURB. PA (717)540 -0660 -SALE - : SALES.: S0522TP2 994960 11~. ~~') , ~6J." ~.~, ca, 04-14-06 33235 6X24 CORRUGATED ' 11.94 3 @ 3.98 SUBTOTAL: TAX 38550: INVOICE 51050 TOTAL: 11.94 0.12 12.66 090932320161 LATEXITE SALES TAX TOTAL XXXXXXXXXXXX5269 MASTERCARD AUTH CODE 571791/7025149 7.99 0.48 $8.47 8.47 TA \-', / .'\ 11111111111111I1 1111111 ~IIIIIIIIIIIIIIIIIIIIIIIIIIIIII 4138 02 73813 04/24/2006 1704 NOW HIRING SPRING SEASON ASSOCIATES PT/fT APPLY TODAV IN-STORE OR ON-LINE AT: STORECAREERS.HOMEDEPOT.CON/HOURLY *~w~.wwwwww...**ww~..*w~w~~~***.w*~~w.w B~LllHCE DUE: 12 . 66 M/C: 12.66 Hie xxxxxxxmX~269 653820 AMOUNT: ' 12.66 0522 TERMINAL: 51 04/14/0613:21:10 I11111111111111111111111111 THIllIK YOU FOR SHOPPING LOWE'S FINAL EXPENSES TO PREPARE 113 JUNE DRIVE FOR PUBLIC SALE ON APRIL 29, 2006 AT 12:00 NOON It.- II~-r' I".j'r -, --r' ../' --.- -----.-- fl1'1!1ff ~t< fC/t'tJR P{(II/M tj. '., C~~rcl!.. . ~~, '~- ,/ .5 ~~ LAtJ { kIN 6- ,co R.. P/)i~J'li J.JG- THE HOME DEPOT 4138 5101 JONESTOWN RD LOWER PAXTON PA._l?~!2 WE INSTALL ROOfS.SIDING.WINDOWS.ftNCt~ 4138 00006 19262 04/12/06 SALE 11 TW9SDW 01 :27 PM . , Olliel Borsatn Outlet 717-766-636" ~"0S .. &~ ~L, ~ I~~~~ ~*' t!> I ; I ===:~=~=~==~~=;=====z=:~:=~~;~~~=~==:; ITEM Description QTY Ite~ Total 566168 BROWN KRYLON K 1 $0,99T 070798180659 ALXPNTCAULK SALES TAX TOT AL CASH CHANGE DUE: 1.29 0.08 $1.37. 1.50 0.13' Sub Total Tlx Total Ca~h Sales Associate: Debra Jean Cllles ArM~ # " 00000000 '0,99 10,06 $1,05 $1,05 Illllllllllllllllllltllllllllllllllllllllllllll~ II till 4138 06 19262 04/12/2006 7705 NOW HIRING SPRING SEASON ASSOCIATES PTifT APPlv TODAV IN-STORE OR ON-LINE . AT: STORECARmS.HO~IEDEPOl.COM/HOURtY.-- . ft.*~*w~.~..***w.w*~*w**~~w.ww**ww~*~w.* ;=;~~===~~~=~==:=======_=~=:==~~~z=~~~~c~: Thank '~ou f or ~oPP i ngi \ Ollles Bar9a~n Outlet Miss a day,'""MiSs" deal!! r . .__~=:~;_= ~.:;..;;;.;;;;;:_;:.:;;::;:, =-:r.o;a:::t-==~~=',:~-=:-::,:=;:r;~:; Trn 2653 Str 3' Re904-15 4/08/06 17:09 11~11'1 ~1111~ 1~1I111111111~~ 1111111mllllllllll~11111 *EGXSAEDVBAAAD* FINAL EXPENSES TO PREPARE 113 JUNE DRIVE FOR PUBLIC SALE ON APRIL 29, 2006 AT 12:00 NOON II c;; fA I Jtc? . YALE ELECTRIC SUPPLY CO. ;:< k it- Ctf-~10 tJ'1Ji;f fJ LIf~ ' 1/3 :J{I~ ~Il. CUMBEL BILL TO: CUMBERLAND ELECTRONICS 642 SOUTH 20TH STREET POBOX 8003 HARRISBURG PA 17105 CUSTOMERP.O_NO. 03/21/06 14:18:05 :"~OOMamFF;;} . , . . . . . . . . . . . . . . . , . . .. . . . . ':::;:;:;:.:~:;~;;:::;;: 9IWE~Eri ? ~rjl~6{ijsf ?~: .r~~rEim;ftoii: . . SHIP TO: REMIT TO: COUNTER SALES YALE ELECTRIC SUPPLY P.O. BOX 647 LEBANON, PA, 17042-0647 ';~:::::':;;::::::::::;;:;:::g~I,:~i:;:::::):;:!:::::,:,:1 4186708-0001-04 CUMBERLAND ELECTRONICS 642 SOUTH 20TH STREET HARRISBURG PA 17105 CUSTOMERP.O.NO. 03/21/06 14: 18: 05 > ' Any claim of_error or damage must be filed within 72 hours 2 2 P&S TP226-I * ~ ~' lOlI-I~'Z V" <C 00 ~ ~::5 ~. ~ ~ \ u :i:.:l>-: ~ ~1 C\. z:: i2)" I Of ~~ - ::"'::I.l.J:go ... 1"-- It U I lO ....- . .... ~ 11 HI. . ~ 11\ ,..." IX I ....0 .~ ~" 0.. t ~~ "" II I '" c:: /I i ~ 111 =:: ,.. : ........-4 ~ ~ ~.'f~ f:dl ~ ~ l~. ~ ::: l<- .s:::: ~ ~ c=:::; _~ ~ JS_____J: 7 : ~'$" -0 ~::~:U)1.l.J ~ 'oJ Q II a.. I 20 ~ allHIOH <llltlX'OX ~nUi-10 OI1(1)I-1CC ......uUJt<W CJ)41ClICCa.. -.....$ ~~' 00 .... an ~O ..~ ~ ... 0 0 Ol .~ C"I ~ ~ I {,/:J- 0.. H IX -ux m (1)< ......,.wt- ~g:(I)~ . I I.I.J m,C .g5q;!~~ (I) Z (I) >- (J II " II II III II L It lU 1\ " III /I 3< It " :: ~ .. .- n L U) 'I a.."U " C nG)-~ 1\ ::J~ 1\ ~ at n to L " > ^ .. ..c 1\ II III u> " tt_fIJ II u..QO II \. JI ___ ~a1~ II L- U (J > It CO ::-a " L :: 5~ " t, 0 ~ H~_ " ..Cl tl Q) (Q " ::J C 1I0.:J ~ z < U :!:,j::':,:.;:'I.i;:ili:::i:!~:, C /310.4229 6.21 <ll .c:. ... .c:. .... "i E III .... n If jl II (.) Q) u n ;....,~ tl___ U - <J) +-- It n U II .:. 0 II n c...... II U W C'P II It 0 i ~:: ::. ~ O~_;I It..... .-L II On, ..- a'- II OS 0 II -q- to "c . II ':C-O 11-<<>>.......11 III II g<<t-w-u .. OJ II L JI ~ i ::~S_(J):: ~...c:: U(I)cnQII (/) 0 II C,n ~ ~ :: a::C:: 11'1-'-+-'11 .. iD II ..... .">0 II u...c. 11:3 Ln ~- ::~1J~:: ..... _ 11 _ LLl I' (/)_ II ~~ n ,:'~ ~ ::,_.a8-fJL ..c 4]) . It.r:. Q) II ("",)(/)"0111-- .J:::.tt -- C 11 3: II ~-- "'0 Q) It II me II H ClOCU II o..cou II {/) U if) II H t'D L '(0 II II Q)Q,)4)n u r.n E f/) II II 10 an ....... ..... >. C lIJ III 01 C <U .c:. (,) x w.... ~ :>.- ~1Il nn aJlIl -L OJ ~ltJ -I:: 301 IIlL ~ 0 an -M en .... an.., ... II) R:i o u ... III 10 ... om ----;;o---~- NO r-u> 01/1 < ..... NI/I Mill M- Oltl o (I) FINAL EXPENSES TO t'Kt:.f'lAKt:. 11~ ~UNt:. utUVE: r-VI'( t"UDLI\,o O:)"'LI:. ON APRIL 29, 2006 AT 12:00 NOON Jt,{ ,$~~7 --------- - _." .....-~ --- ~..." .,' .::..-.............. ~..~ ---..",-- .A MER RY '98 TRACER $4,000. Reb . engine with 3,000 miles 6 CD enger, remote keyless enfry. ii~: -'i68~~1 p~es. Call before '""Ii 2004 COOPER "5" #~60.~I~~~.I~..t~~'.~?2l~~,~i S6N MOTOR CARS BMW 697-2300 MINI 2004 COOPER "S" #~~~t~~_a_~~.~~..:~~r:,,3.~~~,~ SUN MOTOR CARS BMW 697-2300 MINI OF TOWSON 700 Kenil~fJ:~9~~7~~~son, MD. MITSUBISHI 2001 SPIDER ECLIPSE, 49 nnn m Hp,,_ glossv silver, black rag-top, leather. New fires, spoii- er, Inlinlty soundij V6. garage kept. Mmt condo $12,9 0./17-386-0482 --------------------------_______________ .___MITSUBISHI '99 ECLIPSE Good condition. 87,800 miles. Air, auto, moon roof, spOiler, side detailing. $6200.938-4638 after 5. MIT5UBISHI '99 ECLIPSE 5pyder Convertible,S spd, 81,000 miles. Air. Power steering and brakes, AM/FM/ CO, new brakes, Ins~~~leo~f~~tiHgoMi~g8 or MITSUBISHI '97 MIRAGE Teal, I auto, all power. 14511100 miles. ~~~;,'j\~1: c~~Wi!jllifft MI~I'SUB1SHI '95 Edipse G5T, t Ilbo, exhaust, sunroofknew tlm- Inlbelt, inspected Feb u7, many ~1 :2~~rtf8t~~0?1~~t6e~-~~~~r. MIT UBISHI '94 ECLIPSE GS: dg~1nfnuJ~.p~~~e~~.'~r~Pe~l.a~r;h performance exhiJust. 16" alum1. num wheels. Aiternator. Battery. Inspected until 11/06. Very clean. $2500. or best offer. CaiI652-1184 or 943-8406. OlDS 2000 AlERO 95,000 miles, GOOD lOOKING CAR $5I~0~R~5ISoro'ilJ~gNlI~MD OlDS '99 Cutlass Gl: estate car. 28,200 miles. White with neu- tr~~r\;'I~J}:S~d"~~~I~~~s t~~~., rattery and tires $5,995. 2'3'2-3782 I I} 0 I en con t~~~r ~;~~~~e;SJuR~~:;~~t~J: very dean. $4,200/or best offer. Call Dave 731-1866. OlDS '98 CUTLASS 78,000 miles, 4 door, automatic transmissIOn, great condItion, Tan metallic exterior, ran leather M~i~t?~\~~~r' cyl~nders, 2WD~n cr . OlDS '97 AURORA Heated leather seats, sunroof, VB, fUily equipped, chrome rims. looks and runs great. $2,700. 717-232-6026. OlDS '95 CUTLASS SUPREME Very good condition, 126,000 miles,2 door, leather Interior, well ~~~if.Pi1di-Wf~:fJ38'-~~~~f;~ist OlDS '89 ~ORONADO: 118,000 mi es, runs great, $900/ est offer. Call 717-385-7749 PLYMOUTH '85 Reliant 78,000 miles, 4 door,excellent con ~~~~Mib~~~ri-7t~b~i8ust PONTIAC 2006 TORRENT Metallic blue, brand new, must t~::' ti~~~~"~6~5k~~~~~~i~~~: PONTIAC 2001 Grand Prix SE Must sell. 53,000 miles. Newly ~,s~~~1~1ie~e'y7t~e-~"43~S~S~ ONTIAC 2000 Grand Am SE: ~ 128,000 ~lles..inspected, silver ; with grey interior, 2 doord power ~~dJ1'}~5~~?5m.1)1~-51~~~~~6 'PONTIAC '99 GRAND AM SE: 6 cyUn- , der. 72,000 miies. Black. Very aood condition. Air, auto, aSKLn_g_ !, SA2~~2 9- 3 SE CONVERTIBLE Black/Tan T urb~ Auto, leather 17" $ri,~~6.lfooiler 99-3 SE CONVERTIBLE Green/Tan .leather, Turb03 5 5~eed, CD PlaYYii,~8.bo iles BobbyRahaL:t Car1I~I; 'Pik~, M~~~;'~Sburg 691-5600 SATURN 20D6 Saturns from $12,490. If you buy a Saturn anywhere else, you are making a big mistake! Always over IOO certified used Salurns tram $2,995. Our service dept. otfer3 a 3iJfcty in~pection of the other guys' car with written results for only $75. Saturn of ~g;~~~'\i~~~~.g-~~~15aturn of SEE THEM All AT www.sutliffauto.com _! .~;.,<:,,,.,,r', People first SATURN 2004 ION III COUPE Blackl fUl1 egUiPjed, 38,000 mi fill 71~~~2~~~0, SATURN 2001 SCl COUPE 74,000 miles, 5 speed, white. New In~~fo~~7~:i5B~~rk~~3~ft%'J . SATURN 2001 SC COU8"' 4 CY~~~;~x~:i~:~t~' 70'0~65~ges, Budget Auto 303-0558 SATURN '98 Sl2 auto, beige, 106,000 miles, air, power locks, new brakes, rotors, tires. New Insp~ction/emissions. Very clean U,700. Call 554-1825. SATURN '97 5C2: Air. Power windows. Cruise, sunroof. 8lack. !1j'~80 miles. Needs inspection. SATURN '95 SCl I 126,000 miles,.2 dO'\(} a.utoil. ark ~r~e~~ t~I~~'~~~~o~p~n~~n~/i~~ j c-'~ e ~t Jlatriot-Ntws CLASSIFIED ADV. RECEIPT 812 MARKET ST. P.O. BOX 2265 HARRISBURG. PA 17105 PHONE 255.8121 3-1- ~b YEAR AIT CLASS 16 TF ~-~., Whf!8."'"":' Offtce Copy Pink - Counter Copy Y"Iow';"';~ Copy .. ..,- ~;__~~ ;,,:~~~~ ,;;;'J;' .;,..._~~j:' .. - . . ., . ,,' '. .. ,. '. "",,,,,,jrJS~d",,,.;:,:,;,.~""'L;";;;': : . ?f~~"",';J."i;':.";:,,,,o ..;.:.:j;..;;..h";'.,":c",,j;,'~ili~..\;;;;.;;;..'ii.... ;,., >i,""'~-,-,i;,',,,,,,;<,::~, '~;dl..~''';';'.0~.hIi;"'~~'";",,,,.,;j~. l' . Nlnole Jill.. Classified Sales Rep""",ntatWe ,- PflTRIfJT NEhlS ([be patriot-News Now you know lViTF. 03Ji7 '06 TU[ P.O. Box 2265, Hanisburg, PA 17105 Ph"ne 717.255.8126' i'Ou Free: 1.800-692.7207. Fax: 717.257-4726 EmaiI: njames@pnco.com ----FJ~ \-~) r I. ~)?~' ~?iJ . -_._~----.......;.....-__.._ n.'_~__ ~l $?9~?n f'! 4 r~ (' I< 1;?'~ .. ~"H{)H~;r (!(, C! I.ln, 'j Tt~r 1 ~-i ~ 11) !"l(~{\{i - ./ ~t.\ ,. ---------,-------------------------- ._-_._~--_...~~-_..._.- tbt patriot-Ntws -y.C CLASSIFIED ADV. RECEIPT 812 MARKET ST. p.o. BOX 2265 HARRISBURG. PA 17105 PHO 255-8121 L/ -/3-" fJ1J ,,~ AIT JAN. CUSTOMER NAME YEAR ClASS .-4,~\.",",.-~........~""t~....._-~. '\..,,1"" ....,.r-.,....."_.^-.A,./'_..........,............-.., Hl ;;.7I f NEW; 17 Mon. KEYWORD 10 11 26 27 Fri. I DrlfF D'Ll,? ~ '06 '. ' r- Otftce Copy l~IED ; Pink - Counter Copy Yellow ....,Customer Copy ...- RFTAll $?3.B4 TfJHit. $73.84 CHECK $7:184 i r:HANG E $1)..00 CI.EHV 1 NfLOIi'i5J] n m: 1]:;'? 0000 (;J-"TK1Cr 1L;e:~'.J Oja--J He,'SE Ros- Icutv' If!~> fy.1( '-1/1 b 7JAA.( Ift'-L/j-(:,- ?l-I-~ Ij i /?-.)- ftlC if I ~3 k C( ~be patriot-News Now you know Order Confirmation Paver Payer Account Number 41052 Sales Order Taker Order Source 0001468024 rholton rhelten Fax Customer GATES, HALBRUNER & HATCH, P.C. Orderer Account Number 41052 Ad Order ." Special Pricing None GATES, HALBRUNER & HATCH. P.C. ATTN: TRACI L. SEPKOVIC,1013 MUMMA ROAD,SUITE 100 Lemoyne PA 17043 USA PO Number Ordered By Customer Fax ETATE OF SERBIEFF TRACI \ Customer EMail Customer Phone 717-731-9600 Paver Phone. 717-731-9600 Tear Sheets o Proofs o Affidavits 1 Blind Box Promo Type Invoice Text CLIENT COpy Ad Order Notes Made change in address from Apolla to Apollo Materials Total Ad Cost $251.67 $0.00 Payment Method Payment Amount Amount Due $251.67 Ad Number Ad Type 0001468024-0' Legal Liners Ad Size :1.0X19U Color <NONE> Production Method Production Notes Ad Booker Product Information # Inserts Run Dates Classification PNCO: :Full Run 80G-Estate Notices 3 3/8/2006, 3/15/2006, 3/22/2006 Run Schedule Invoice Text LETTERS TESTAMENTARY for the Estate of John Serbieff, deceased, 3/22/2006 8:22:49AM PREMIUM NOTICE ACCOUNT NUMBER: 33PM684962 ~ Peerless \PI Insurance. ~.~JIhoc..r..... Agent: TELEPHONE (717)-591-8280 AMERICAN INS ADMINISTRATORS -R 4550 LENA DRIVE MECHANICSBURG PA 17055 Account of: JOHN C SERBIEFF 113 JUNE DRIVE CAMP HILL PA 17011 Notice issued to: JOHN C SERBIEFF 113 JUNE DRIVE CAMP HIll PA 17011 Insurer: PEERLESS INSURANCE COMPANY 62 MAPLE AVENUE KEENE NH 03431 SEE REVERSE SIDE FOR INFORMATION ON: F~URE PAYMENT SCHEDULE, SERVICE FEES, 24-HOUR STATUS HOTLINE, ADDRESS CHANGE REQUESTS AND OTHER IMPORTANT NOTICES. -----G~ lean Numbef;------ --------~~~04-3$J - .- --Payment Plan' QlIA.RIERlY.mvoice Oate'O:U06l2006 -~ I Policy Number Trans. Description of Transadions Charges! Policy Minimum Date Credits Balance Due 33P M684962 INSTALLMENT AMOUNT 199.00 199.00 199.00 SERVICE CHARGE 5.00 5.00 -" - < . Payment Due Date: 02127/2006 Policy Type: AUTOMOBILE Account Balance: $ 204.00 Minimum Amount Due: $ Future Payment Schedule: Please See Reverse 204.00 --ft,---..c - '.1' i, ~ r~... M:. H..... L...,.. r-....L_.,/\,. ~vtll ~."t)fd:~ A..J r...h..'1I U,,,, b....Uv.., rn-'.t;...." ..;::f.J......... ....1,.......1, VI "........} wId..... Account of: JOHN C SERBIEFF Co: 10 Invoice Date: 02/06/2006 Payment Due Date 02/27/2006 Account Number 33PM684962 You may pay the minimum amount due or the total account balance. Account Balance S 204.00 I Minimum Due S 204.00 - Please make your check or money order payable to: PEERLESS INSURANCE COMPANY -'MPORTANT: Please write your account number on your check or money order - never send cash! -If your address has changed. please notify your agent, place an X on the black line below and fill out the reverse side. 33P Mb849b201109 000020400 000020400 6 6 C/O PEERLESS INSURANCE COMPANY PO BOX 703 KEENE NH 03431-0703 "'.....1'..'..'..""..""...',1."'..11.1'."",.",,,".., BL-Oi (07/96) Thank you for selecting us to service your Insurance needs! '*- Peerless ~ Insurance. ""..~_...r....... 33PM684962 011 PPICPBN 00003966 Page 2 Penn Waste, Inc POBox 3066 York, PA 17402 www.pennwaste.com Phone (717) 767-4456 Fax (717) 767-4285 01753900005045850000004263 Invoice Number: Page Number: Date: Customer Number: Site Number: 504585 1 03--01-06 RS 017539 0000 Please Do Not Enclose Any Written Communication With Your Bill Please Contact Customer Service At (717) 767-4456 1111111111111'111111111111.111.111111111111111I111111111111111 ESTATE OF JOHN C SERBIEFF 113 June Dr Camp Hill PA 17011-5069 14 Remittance Amount: $42.63 Check Number: -------.....--....--. Make Checks Payable To:Penn Waste, Inc. -~-- --~._. I PLEASE DETACH AND RETURN TOP PORTION WITH PAYMENT Code Description Date Reference Quantity Amount (0001) JOHN C SERBIEFF 113 JUNE DR, CAMP HILL, PA 170 15 32.00 Curbside Trash & Recycling 06-30 1.00 42.6 01 Apr06-30Jun06 C I} 1/<< I vi ~ I: 111,/ I '.t/ /. ~';) it Lr f( l? l yl' ,C . '._ _. m. .. _____ PAYMENT IS DUE BY 03/31/2006 AFTER THIS DATE A LATE CHARGE WILL BE ASSESSED 42.63 30 - 60 Days 0.00 60 - 90 Days 0.00 Over 90 Days 0.00 Invoice Total: Total Due: $42.63 $42.63 Current Note: PLEASE VISIT OUR WEBSITE @www.pennwaste.com FOR SERVICE & COLLECTION INFORMATION. Invoice Number: 504585 Date: 03-01-06 Customer Number: 017539 Site Number: 0000 ~ Penn Waste, Inc. POBox 3066 York, PA 17402 PhOD~ (717} 767-4456 Fax (717) 767-4285 EIN# 23-3030774 ~ ] 000240b38338b0000000000001807012 For Service To: 113 June Dr AMOUNT PAID Jl. % 'It) "~,~,",,,pe.nn/.)y.evani.a. Ame.JUC!..a.n Wa.:t.e./f. PO BOX 578 ALTON, IL 62002-0578 00000643 01 AV 0.293 B 00004 04 FAOOR 1m I t111111111111111...IIIIIIIIIIIIIIlI,t,fumtlllllulll.1 John C Serbief'f 113 JUNE DR CAMP HILL PA 17011-5069 Pleasa return tillS ponio:1 W:t1 cheek ". Payable to the address below ". .. .:c..:.:.::. ."'::"":"':. ..:/:::?::::{:!:':I'fI:::::::t{:{,::::,~.::,:::::/<:."..:::::.:::.::::::~~~~ .:.:.,,:~_.......tS~""I!J$:. '. H.. : . :*,r:',' "".: Riiibd.&/MfitiJi/fiildtmatltiif::::: ..:':.: .'::':smWbi.fbtiWJ:.' H?.:'C'c '.:".:::'C:<::' ..: . iH;!; -, l,~gL... H F:~...... .M,. c .' ,= ..' ........ '.:.'J.' ...:.:.... :..~@::::~::tf;:f:E.. '. ..' 11.50 . . . SlUI~:~;:~y:j5.'r20Q~.':'.: ".' :.'.':'.:>?j:j:}(.::..:~..... :. :::W'~~X~~:($'C~?$5.X:~l: ...... 1.15 ;.::H '::, SilJlmJ.:PeJ'loa~:~::n::w MliI:t::,:(r(~j;J~~tc: .:-:. ... '.. $.fI;1S)?Awq'Witeii "i<<ii?W~ .':'. '. .. . . '. - . 04~. <. Ne~t:r~fmi:orii~tlt; )JUtrn9,2006 '.. ... ........: ::' :-.. pst:;.#Awd%m~~:S;q$%. :'c:'..... ..... ..: .<.46 :..::.: .U: RaI~:~t:ReSlderitw . .. .. .......:.:..:..:.:.. .: :.<:.:tatii_tijr~i1~.a#vtay::)~r~.:::c:-:.., . . . 13 07 · ~G~~JI~~~ : .... .. . ~, : . w". .... ..... ~ '[:'[! ,,':.':'" ~ :" :..:.:."..." '.. ~::;'t~ Wi'::!" . '''R: .. '..i.....I'::i~\li;::}:.: ..w '.r: f:;~~ . .~. .~ . .U:~. ~ ~}tc..~..o ~ * a.. # a . .. .... ..:" . . ... . . . J!<> . . . ~ Y:..YAJ cog .p. .:t.~ ~ .n 1:1:. Ei+. ~::...,:. .' .'.:- . : . . ..... .'. H ..... ........................................................... . ... ;:I;!;lil;;!iiill~JII!:II:lt"llllllllllii!illlfliiil;1 .:1; . .i'iiiiii;: i/: . ........ .......... ...... ............::.:: .......... ....... .......... . .... ..................... ....... ......... tn. ....:. 000240b3~33&boor-~OOOOOOOl~&501b - ACCOUNT NUMBEFl 24- 0638338-6 AMOUNT DUE $ 1 9 . 8 5 DUE DATE .Mi~,,!. AMOUNT PAID Please I ell! '11 tlli~ po i II ()" 1:1' c 1';;( k ,. ... Pay <10 Ie to tlle ;]clrl ! ess belol'! ... ~~ ,.p~n~ytvan.i.a _<<can Wate/r. PO BOX 578 ALTON, IL 62002-0578 For Service To: 113 June Dr . - iiiili!! . III III!l! !Ii am Ii . .. Ii IiiI iiiiiiI 00020880 01 AV 0.293 B 00081 83.1'11.088 1.11111.11111111...11...11.,.1."....11..,.1...111,..11..1111' .John C Serb!"'" 113 JUNE DR CAMP HILL P A 17011-5069 Pennsylvania American Water PO Box 371412 Pittsburgh, Pa. 15250-7412 1.1111.1.111.1.1.1.1.11.11111.1.1. .1. 1111..'.1..11.' I O PlflaSfiI chfilCk htlrfllo add H2o-HGIp to OIhsrs C()fItribution to your monltlly bIlt or 10 ch8llgfil your adlt'fls$ or If1If1phonfiI numbfilr, and print information on ffWl1fSfI sfdfiI. " I .... , " 11.50 2.87 -.04 .52 14.85 5.00 5.00 $19.851 ~"-,,,--Pvtn~!I...van.ia. AmVL-<.C4I'l Wa.teIL PO BOX 578 ALTON, IL 62002-0578 For Service To: 113 June Dr ill - 5!il II - ii - .... IiI!l!l l!!!i - ~ !ili!i =: 000240b3833860000000000001745014 24- 0638338-6 AMOUNT DUE $17,45 DUE DATE~pt'~~f~ AMOUNT PAID 00023028 01 AV 0.293 B 00107 19 PAOCH 1."11I".111"....11,,,11.1.1.11....11..1.1.....11.,11,,11..I John C 5erbi..,., 113 JUNE DR CAMP HILL PA 17011-5069 O PI6a.Q chllcl< hlN9lo add H2O-Help to 0t1uIrs conlr1but/On.to YOU( monthly big _ -<J<~-" orltilQp/l<>DQ~cipttn~1JIlUWXICD.,qa CU$ti1mtiiAi:Countln~ii'. For serVice To: John.C .~ieff . . 113 JtineDJ: Account NlII1l/)lln2+063&33iA3 P......i.eNumber:..24;0377353 ", ,"','. ,; """. ' . . ... ." .. ", ...' .' .' '.. . '. .' . .' - . ~.- . BilllngPetkl!J& Af8tw1n~*ri . Billing. Dat&; ~r14,~OO6 ...... .... ", . .8iIl1n9PefiQd~Feb081ot,4aJ-ln(30d~l>l ~t~~: APr12,2006 .... . . "."TYpe: ~ . : ..c,' "-"'.._,' ....,..'..: . . " " - . ,'... . '.' . .,' ',... ., ,'. Meter~~.in~Urtelltbillili9~:"'. MeterNumberN044Hi~j$.~~8f, . -P!"e.lt.lld1r.ll '20/+7tl1l .- .' Ql&t'~ .2.0,4600 . ~t9ns~ P'ease leiUln tillS por;lon "ltl1check . Pa'l3ble to tl'8 addless oelo' I . Pennsylvania American Water 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 - ----'"-:..- .'.. " "'. :');j'\';':+'iit~,~~;\,;";'0:";:;1.;,: ____PriC)l".~. ....... ." Balance.",,1!' u<<;(blfl." ....... .........i ...... .. PaYff!fJn~ptipr(()Mar 14. 2(}()6.T1l~k$1..' 'TOlalJlri.orbliJal1c'; Mat 14. 2006i ........ · --CIHr~'W.terCbarge.'-~ . $eryic.eO~ ...... . . .\lYster Voi~('X)057351C lQ()) SrASPAWC.Walec.'()~% 'DSFPA~c;hafQe3.4s'" . 1o"lwa.OJulr~iMar14._ .. ~,c;utr4tlJt..ctJii,.gea~ QUS(Prrt(if~tlJtectronW'l9t Litle T~l o~r Ciuar.... ~'14.,2006' 11. 50 .57 -.04 ~ 12.45 --2.J1Q 5.00 $17.451 Messages to you from Pennsylvania American Water Any portion of the water charges which is not paid as of 4/10/06 will be subject to a 1.50% penalty. . Customers may use their credit card, debit card or pay by electronic check only by calling toll free: 1-866-271-552 . Customers may also pay on-tine at www.water.paymybill.com. A service fee will apply. . Approximately 4.72 percent or $.58, of State taxes are included in your current bill. . fffective January 1,2006, the Distribution System Improvement Charge (DSIC) increases from 2.39% /r) 3.45%. This charge funds the replacement of water distribution facilities. . Effective January 1,2006, the State Tax AdjuslmentSurcharge (STAS) decreased from -_14% /r) -.29%. /.l ' "'.. -VC-(.../vC>- (/tL,.t~:lL- "7 _ 2/,- {; f-: . ~/- <. j ,: 'p. z- I . . (. Cuslomer$efv~&..l:merYl)nci-es'1,.aOO-565.729~.(24 Hoors) FiJi- Httaftn~.lfilpairffd'CtJ,:jtQrflQfs::TQD:1,_~c;op~309..~202(24 :Hoy,iS):,., . VIsit us on.~ INTEFlNET;www.pawc.com . . . -.. -. -,.. . - '--'" .-',., . -, - . '- '-." " .. .... ",''', "" . --- - -. .. ,. - - " .. . . - -,.. ".".. ...,. .'" .. .. - . . .-, '-',- ' . . . .. ....", ". ...." . " . .... --...., ,,,,,.., .... - , ... --." ,-,.,. . "-,.,,,.....,.. .-.. -- "-'", . ,. .. - - - . - ......-." "" - ....... ....... ..".' " . --" , "". .. " "'.' - . - . - .' - - - -- - -" ....- .".. . .. - , .....,...-."., ,..". - -,',' .-'. '. - ,- ".. . ,.", -'." ','- ......,'-',..:',. ,.- -. -. - ,-. , ,., , ....-.. -"-' "- .. , - .., ,.. ,,- ..-"......... ., ' . ",- -'.' ','" ..' '.. -.'" -.." ..." ... .", "....",.. . - ., " . - . .... - - ,"- ".. ."... - " .. -- - -- .... .. -"..." .... ." -- -. . . - .'- , . """"'."" . '" . -- - .. . -"-"-"-- -"', "--' . -.. -'-"-,'-" ,-.,' "-' .- -, , " . ",'.' --. .-- -.,- --..' -,'-"-'- .' "','-',". ,'-'-','-' .',' - . '.. -'..-".'" - .......",'- ,'..'.. .' -..- -."..'. .. '.PPLElec:tric ..... · . . . .UtiUtie, ..." ...... -- ... '.Ele~tr~c .'. .... Servicen . ,,--.-'"'' .., . . '" . "........ . .-..... . ....",. ....." ,,,,. ..- -.- ..,.......... ".. .. .. -..- - -.." .... ...".. .....,..".... - ., ,..... --... .'.. ..' ,'-. -....".. ..- ," ., ,.. .., ". ,.." ."."" ,.. .- ,'- - . --. ...., .,.., ., .-. ," ... -......., "....,..... ". . ",',,'-,- '-' -,.'....','. '-"-"-',',',,'--"-:-'-:,'-:--'-',-'-:-': ,-, , ,-" ... - ,- '-"-',., ,- - -------- . .. -".... - ,,-. . ....... .. . . .... . '. .. , .,., ' -.-. ." ... .... ..,,, .... -- --.. - . -.. . .'FOr:,..> '.. ..,.,,", ....... .1QHNC$flR~iEW'E$iwtE ..',," ilS JUNE DR < .'. " .' . . 'i ." . cA,MP;ffitLMJ19H> .. .....,. . Fln3.1 BUt . ..., ... "......... .. -.. . - -. . - ---.. -.. ".., .. ." , .. .---,..".. . -.- "" - .... . . ' , - -. - -. , . . . -., - . .. ,-_. ... ,.. . -.. ..'" ~~.~'J~ ......... .'. d.'. . .......~..~~~~~)1'~~9u:........,.. .4.84~344900 .... ....... . '" ...... ...., -. -..... p-.."....., ...... .. ........ ........ ...... ,-.. ".., -.. .'6rw.rite:th~< 'n ..... " CuStom&Sem~ ....... ,. 821EaullmanR~1 . . AII~ntown. PA .... 18Hl4-9JI)'2 .' . . . www.pplelectric;com .' . - ...... - '.. ... ". --... '.' .".. .. - .. Electric Use Tbi$gJapU.iih()w$. Youtelectl"i~tlSe ......, . <)vertheJast.13 montbs. . . Types of ..' 'M~ter Readtug~~ . Actual Estimat~d Customer " -... ~ ~ "~~"'\.~:l~/~v:> ' ppl:~~: "',,-;>.' Page 1 ';<"";:?',YQw;l:UU:~~; .... 72080-74003 .:~~~}:::::~:i~:::::~:t" ....~ ',' ','r ";{""" ...",<;",,::: -...,.~" Summary Page Balance as {)f May 26, 2006 Tg:fP~L ELECTRIC UTILITIES Charges . 'Total Cbarge~ f?(L elk::t;f I tl &/:if . ,- . .....~6-"'"~&" AC~l1J .. Actual Anrage - Muy Temperature KWHPel" Day Yearly Use: . Ju~ ;2~I04 - May 200$ Jun2{}05 - May 2006 Total Use 3744 2610 2006 59F o Average . MuntMy 312 218 JIASOND J FMAMJ 2005 Months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ther importaflti~ftlrmati~l1(}n batk'" .. PPL Electric Utilities , ' , \ ~ I I ' "....,,'.....::...l.~'. '" ppl ~:~~~: " no Page 1 i:!\lI"I;l'Uh,\~c(lilnr 72080-74003 ';';;i';;.';::'USti..W . Electric Service Summary Page Balance as of Apr 10, 2006 Char~s: TotafrPL ELECTRIC UTILITIES Charges Total Charges $ 0.00 For: JOHN C SERBIEFF.ESTATE 113 JUNE DR CAMPHILLPA 17011 $12.32 $ 12.32 Account Balance $12.32 Questions about this hilI? Please contact us by May 1 at 1-800-34]-5775 or 484-634-4900 or write to: Cllstomer Service 827 Hausman Rd. Allentown, P A } 8104-9392 www.pplelectric.com J1..JJ IOrlf f~~ b ~~ (q-O .z.~ Y/'/ 1''''<''' ~A Electric Use KWH - Average Per Day Meter Reading InforJ,.ation . " 24 f\1eter 20 ~rlO Actual 10005 ar 10 Actual 9961 16 31 Davs KWH Billed ~ 12 Average - Apr 200S 2006 Tem~rature 45F 47F KW Per Day 9 1 8 Yearly Use: Total Avera~e 4 Use Month ~ May 2004 - Apr 2005 3780 31 0 May 2005 - Apr 2006 3074 256 AMJ JASONDJ FMA 2005 Months 2006 This graph shows your electric use OVer the last 13 months. 'Types of Meter Readings: Actual . Estimated rn:i8'{;:~ Customer 0 Other important information on back .. Return this part to address below with a check payable to PPL Electric Utilities Corporation tB'i:lO tN l'~yTl1i$Ainf,ililF .. .1 $ 12.32 . Amount Enclosed DDD,rJ[Zl~.~~ M~Y 1, 2006 ....1 72080-74003 AV 01 017718 723438115 A**SDGT JOHN C SERBIEFF-ESTATE 113 JUNE DR CAMP HILL PA 17011-5069 PPL ELECTRIC UTILITIES 2 NORTH 9TH STREET RPC-GENNI ALLENTOWN PA 18101-1175 I III ii i 11111111111111 111111 1.1.1111111111111111111111111111111 1 1700000123270000012328 7208074003 I I 1 PPL Electric Utilities , , , \ , . J I .. ... . J. ., i '.:......~..:...." ppl.?~~: " m Page 1 '::::;':::,,{;QUi':Bill'~unt:Numbei:':::::C ... 72080-74003 w.."'wrlhil..::: Elec~ric Service Summary Page Balance as of Mar 10, 2006 Char~s: TotafPPL ELECTRIC UTILITIES Charges Total Charges $0.00 For: JOHN C S~RBIEFF-EST ATE 113 JUNE DR CAMP HIItL PA 17011 $ 11. 73 $ 11. 73 Account Balance $ 11. 73 Questions about Uiis bill?: Please contact Us by Apr 3 at 1..8001-342-5775 or 484-634i4900 or writeJto: Customer Service 827 Hausman Rd. Allentown, P A 18104-9392 www.ppJe1ectric.com i1JJJl ~~1~0 (f' J(orf 11" Electric Use' 24 KWH - Average Per Day Meter Reading Information eler 20 Mar 10 Actual 9961 Feb 8 Actual 9923 16 30 Da s K WB BlUed ~ 12 Average - Mar 2005 2006 TemRerature 33F 33F KW Per Day 10 1 8 Yearly Use: Total A vera~e 4 Use Month y II. Apr 2004 - Mar 2005 3728 311 0 Apr 2005 - Mar 2006 3332 278 I I I MAMJ J ASOND J FM 2005 Months 2006 This graph shows your electric use over the last 13 months. Types of Meter Readings: Actual . Estimated mil Customer 0 Other important information 011 back ... ~~..;;.~.....=__..__..r.J-_______~..._~_______~'iI'Z"_.~IJlJNi~____ ~_~~-x.. ___-___...____...__.......__._T~__..._.._ _...:;:;X. -~::';:-=-~ AV 01 017654 614628118 A"5DGT JOHN C SERBIEFF-EST ATE 113 JUNE DR CAMP HILL PA not 1-5069 Return this part to address below with a check payable to PPL Electric Utilities Corporation r' ''''~~~~::~~ 'I r':;"'~~~~;'l r"W$~~o"1 ocIoo 0 D DO PPL ELECTRIC UTILITIES 2 NORTH 9TH STREET RPC-GENNI ALLENTOWN PA 18101-1175 1'1.111.,.1111"'1.11"111.1,1,11....11..1.1.....11..11..11..1 1 3600000117360000011738 7208074003 RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17G13 Receipt Date: Receipt Time: Receipt No.: 2/09/2006 11:45:49 1043333 SERBIEFF JOHN C Estate File No. : Paid By Remarks: 2006-00086 C POLM VZ ------------------------ Receipt Distribution -----.----------_________ Fee/Tax Description Payment Amount Payee Name SHORT CERTIFICATE Check# 1001 Total Received......... 16.00 ---------------- $16.00 $16.00 CUMBERLAND COUNTY GENERAL FUN The UPS Store - #2204 . 2033 Li ng 1 estown Rd HarnsbLlrg, PA 17110 (717) 541-5484 02/06/06 12:08 PM We are the one stop for all your shipping, postal and business needs. We offer digital prmting - email files to ups5tore220~omca5t . net 111111111I1111111 ~IIIIIII 111111111111111111111111 ~ 1111111111111I111 00 1 000001 ( 003 )! Copies Reg Unit Price It $ 0.60 Ory 5 $ 0.12 .._~~.---- ----:-;~-----_._- SUBTOTAL $ 0.60 6.0% SALES TAX (T1) $ 0.04 TOTAL $ 0.64 Cash $ 1.00 Change $ 0.36- f ~"'" RECEIP1 10 88322801894715988837 DOS HEMS CSH: Donna TRAN:5693 REG: 001 Track ymlr-'rrackageSat~jIf:~o'--'''' ~ or call lIPS at 1-800-742-5877 Whatever YOII!' bus i "less and personal needs. we are here to serve you. ___--......______...............-,.....,.......,,-,_....-rr-~-- The UPS Store - #2204 2033 Linglestown Rd Harrisburg, PA 17110 (717) 541-5484 02/10j06 04;58 PM USPS HARRISBURG PA HARRISBURG. Pennsylvania 171069714 4134870106-0092 02/10/2006 (BOO}275-8777 01:02:04 PM Product Sales Receipt Sale Unlt Final Description Qty Price Price 7.80 Ndn -:1 $7.80 $7.80 11 b/Fl ag PS Ble Total: $7.80 Paid by: Cash $10.00 Change Due: -$2.20 We are the-one stop-toroHyouruh-- shipping, postal and business needs. We offer dlgita'! printing ,- email files to upsstore2204jcomcast.net 1111111111111111111111111111111111111111111111111111111111111111111111 ., -- Order stamps at USPS.com/shop or call 1-800-Stamp24. Go to USPS.com/cllcknshlp to print shipping labels with postage. For other information call 1-800-ASK-USPS. Bl11#: 1000800348475 Clerk: 13 001 000001 (003) Copies ~eg UriH Price T1 $ 0 .84 QTY 7 $ -ll; lZ-- . __n -- h______ -- All sales final on stamps and postage. -- Refunds for guaranteed services only. Thank you for your business. Customer Copy SUBTOTAL $ 0~84 6.0%~ALES TAX (Tl) $ 0.05 TOTAL $ 0.89 Cash $ 1. 00 Change $ 0.11- ,/ - ~-......... -.......................~.....__v<:-:......~ -..,....,..._. _........-c;_, ........_....'~___...""'~r....~ RECEIPT 10 88322801803183288833 007 ITEMS CSH: Colin TRAN: 6012 REG: 001 USPS HARR!SBURG PA HARRISBURG, Pennsylvania 171069714 4134870106-0092 02/10/2006 (800)275-8777 01:01:32 PM Track your packages at IJIWW.upS.COI1I or call UPS at 1-800-742-5877 Whatever your business and personal needs J \~e a re he re to 5e rve you. Product Description 2c Navajo Jewelry PSA Total: sates Recetpt. Sale Unit Qty Pri ce 20 $0.02 Final Price $0.40 $OAO 6~~~ by: $0.50 Change Due: -$0.10 Order stamps at USPS.com/shop or call l-aOQ-Stamp24. Go to USPS.com/cllcknshlp to print shipping labels with postage. For other 1nformation call 1-800-ASK-USPS. 8111#: 1000800348467 Clerk: 13 -- All sales final on stamps and postage. -- Refunds for guaranteed services only. Thank you for your business. Customer Copy jog-Are USPS HARRISBURG PA HARRISBURG. Pennsylvania 171069714 4134670106-0094 02/07/2006 (800) 275-8777 12:45;30 PM Sales ReceIpt Sale Unit Qty Price Product Description Final Price WARWICK RI 02887 J~a~t~~!8n . $0.87 - ..-....---- -----...""'.. Issue PVI: $0.87 Total: Paid by: Cash Change Due: $0.87 $1.00 -$0.13 .~..., 8111*: 1000601952772 Clerk: 18 -- All sales final on stamps and postage. -- Refunds for guaranteed servlces only. Thank you for your business. Customer Copy r-'l m l:J ~ ~1 ~l~1aij1~~~::.J fl1 , , Cl f'{..,?~~,) p: g "M:!'<1~"<Wl.. . .f~, J :)1l)~ \ o ;~"d,~;~;~~m1i~~ir""""ii.") 100r 6~ I ~~>' o R("st~~~~~{~ ~)>>;.:~:~;~.;s::"'~:~~..... ".:,~~w..,..~. .. . "." 0" : '7J:7i::1:EJr~~:ti~;f~~$ ~~$~,~!~~~~~'~\:i+~-~-,J r;';'~~f;:,~~;~f/;~tJ..1t~~Lf;SV~~"-~~'~-""f _fml;~'W~~; :JJ!!.i~~~~ Cl Cl Q Cl Cl I"- U1 ru U1 [:::V. o :t'- '": . "-S: 0"" US~SHAflRr~MRGPA HARRIsaURG, pennsylvania 171069714 4134870106-0096 05/19/2006 :.{SOQ)27S--S777 04;$2;OS.PM ~.~.~._~.~ Sales Recaipt PN:lduct. . . Sa)eUMlt Oeser j pHon . <.It II Pi 1 eEl ~----- .. LIVERPOOL PA 17045 Fir$t~Cla$S 0.40 Ol. Return Rcpt (Green Card) CertifIed Label *: ~ I$sU$PVI: PI1QfNIXAf$5044 Fi rst~Class .. 0.3002. ~turn RaPt (Green Canj) Certified Label If: ISSU$ PVI: Total Paid by: Cash.... Change Due: . ....... ..:F-ifl$l Price $0.39 $'1~'85 $2.40 70D52570QQ003665e{)4~ ;;:;=:Z::::l::~::==::;::::: $4,64 $0.39 $1.$5 $ZAP 700525700000S66~60~t :' :=;:~::P:1:*::;::':.1iI:C;:; $4.$4 $~.2g :.:.:.:.:.:..:.:::::::....:.:..:$2Q..,..OO "'$t(L72 Bl 11 It : 1000401910664 Clerk; 14 - All sal&sfinalon stamps and postage. R<:efundsfor 9uatanteeds(;lrviCQ$only. Thank you. for your b1..l$1ns$S. Custo\'\\et' COpy PA REV-1500 SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES and LIENS - D00240b3!33!br 0000000003492011 ~pe.nn~Ylvan,{a ~ Ame.4ican Wate,1t PO BOX 578 ALTON, IL 62002-0578 ACCOUNT NUMBER 24- 0638338-6 For Service To: 113 June Dr AMOUNT DUE $34.92 DUE DATE,~Cfe,'i'~' ":-:. ::.: "., ,; .. ~ ,'", -""', . .., . - IiIi . II ...... II = E = Ill!!!!! - = - - AMOUNT PAID /%,{)S' 00021853 01 AV 0.293 B 00100 07 PA08M 1."111."111,'111,11",11,1,1.11",,11,,1,1,,,,,11,,11..11,,1 .John C Serbieff 113 JUNE DR CAMP HILL PA 17011-5069 Please return thiS por;:on ,'Jlth check ... PavalJle to Ule adclmss tJelo\j ... Pennsylvania American Water PO Box 371412 Pittsburgh, Pa, 15250-7412 111111.1.11111.1.1.1.11...1...1.1111. ..11111.1..11.1 I O Please chBCk hflrs to add H2O-H9Ip to Othsrs contribution to your f1lOnth/y bill or to change your ada'9ss or tBlBphOnB numbBr, and print inlormaJidn on ,.VBfSB side. e'" ---":--~~"",-"_-"""""^,,,,,----,,",,:,,,".-"'-.~:---:.?, ,-,', ;-'--.:,', '''---''~''- ", '. -,- '~' - ", '.; ,- -, - ,'. ,." ',- ",,'.':0 -, -:' ., __ '. ':.:ZZ~=fto~"";.".',.~/,',;~~~:.,.:.,:... ':k~;~t:~.". ':';~~~~::'.i3~2ci06~ThabksI' · Pt_",~::24-03n353'. . -.. . '. ...'. .; r'Otid......~ f-tb. 13;'2006 . .~~~:;t=/ .../~~ .=~=W='0m',~~': . ...... '" . . .. ...~~~~:~ $34921~ --- I' M A ~ r 0002~Ob3~33~bOOOOOOOOOOOOlb!701! '-~ ,PUln~!IlVan-i.a .' , Ame.1U.c.an Wa.tvt: PO BOX 578 ALTON, IL 62002-0578 . - iliii !l! !!I - II - . Ill!! II! - iilii III 00021949 01 AY 0.293 B 00105 05 FA052 1".111.. .111. 1111111,11 11.1.1.11. 11.11111.1.. II .11..1111 11..1 John C SerbiArH 113 JUNE DR CAMP HILL PA 17011-5069 ACCOUNT fvUivlBER 24- 0638338-6 AMOUNT DUE $16.87 DUE DATE I=eb"QI,alo& AMOUNT PAID ELECTRONIC PAYMENT ',1 . I Please retutl' tillS portlUfl "JIHI check ... Payaale tu U"p, ;,cfrirp.ss :)\::10\'; ... For Service To: 113 June Dr Pennsylvania American Water PO Box 371412 Pittsburgh, Pa. 15250-7412 1,"11.1.1.. .1.1.1. 1.11...1...1.1. .1,"11..1.1..11.' I O P~iI check h9r9 /0 add H2Q-HtIIp /0 OthflfS contribution /0 your monlhly bill or /0 chan(Jfl your aQ:hss or ~on. oombtlr, BlId ptIflt information on ,.""'. side. -".-,;;' _,CT,"":',"-:'-' ~ , "';':~: :-':':::::;;;~<;;~:;:~ ";, ,','.~; :..::.r;:~;;(~T~1:'!;';>~:']~j!J::/,... >.,.;;' <':; :~J~::-'j~:.;;)~J~,:;;-/,: ~'J~~~ :.;:~l;_;,~,{t: \:~f~~,t:":,~~~:~;\'i\:.~~,,:":: ---;__~~::2~, ,'-,,': '~;,';"-;,,,~~..,. ---~-- -,; A' BlueCross .. . ~!~~~~~!e~l'rugrall1 Camp Hill, PA 17089 February 23, 2006 Mr. John C. Serbieff C/O Carter B. Polm 3525 Apollo Ave. Harrisburg, PA 17110 Patient Name: Contract Number: Date of Service: Cl..ihl Numbei~: Inquiry Number: Provider Number: John Serbieff 01 R007817620 December 17, 2005 06526632859 116053304425 442257 Dear Mr. Serbieff: We recently discovered that a payment was issued to you 1n error for John Serbieff for services provided on December 17, 2005. Check Number 0052138866, in the amount of $93.60, was issued to you on February 02, 2006. No payment should have been made because claim was processed with incorrect provider information. Please refund our payment of $93.60 within 30 days along with the enclosed Refund Notice to the following address: Cashier P.O. Box 890150 Camp Hill, PA 17001-9774 Please contact our Customer Service Department if you have any questions regarding this matter. We apologize for any inconvenience this may have caused you. Sincerely, Junnita Nelson Federal Employee Program 1-800-779-6945 1-800-345-3848 (TTY) Enclosures: Return Envelope Refund Notice OESC TAXES DUE AND PAYA9\.E FRO'''' , TAX COLL. OFFICE HOURS ;.; ,,- ~,.~~ BILL DATE 3/01/2006 BILL NO 4220 JANET L MILLER. TAX COLLECTOR 1939 WALNUT STREET CAMP HILL. PA 17011 2006 PERSONAL TAX NOTICE COUNTY OF CUMBERLAND BOROUGH OF CAMP HIll CASH ONLY AFTER 12/05/06 UNPAID TAXES SUBMITTED TO DELINQUENT COlL 12/13/06 ~~, ASSESSED 1';;\ VALUATION ~h 'OEscRiPnm.roi' .. . eTl 1 1885 5.00000 4.90 5.00 . a ': 4.90 5.00 DISCOUNT FACE 3/~llb2 O.~~__~~U 20061 4/30/2006j 6/30/200~ 2.0% 10.0% MAR-OCT WEDNESDAYS 10-2 & 4-6 SPEC HRS: THURS-4/20 & 4/27 4-6 fRI- 4/21 & 4/28 10-2 ~~"".>: 5.50 5.50 PENALTY AFTER 6/30/2006 ------- ~-~--~-~------- ....------..--......----~-.~...........-~---~.-.- -~~-_.- .-.--.~~- -- .----. -, ------- ---.-- - ~---_.. - --------- -~-~--,---------------- " PPLEleCtric Utilities . . , \ \ I , F ........'.....::./.,' .- .. . +.,,' ppl J~~: ", m Page 1 .put.BiIl.i\c'c(j!ilit.Ni:Uttbet....::... 72080-74003 w Electric Service Summary Page Balance as of Feb 8, 2006 CharMs: TotafPPL ELECTRIC UTILITIES Charges Total Charges S 19.91 For. JOHN C SERBIBFF-I'lSTATE 113 JUNEDR CAM!> HILL !>A rrol1 $ 17.03 $ 36.94 Account Balance $ 36.94 OnestioBs about tfiisbil1? . Please contact us by Mar 1 at l..so0~342~5775 or 484-634-4900 p~~ti:J7 I ;2_jt,_d-b or write to: Customer Servke 827 Hausman Rd. Allentown, P A 18104-9392 www.pplelectric.c(lm .,......---...-'l Electric Use KWH - Average Per Day Meter Reading Information Meter Feb 8 Jan 11 28 Davs Actual Actual KWH Billed This graph shows your electric use overthe last 13 months. 24 20 TvPes oC Meter ReadiBgs: 8 Average ~ Feb T emjlerature KWH Per Day Yearly Use: Mar 2004 - Feb 2005 Mar 2(J05 - Feb 2006 2005 30F 11 9923 9831 ~ 2006 39F 3 16 12 Actus! _ Estimated _ Customer D 4 II I I I T~~~~ i\~~~.~~ 3664 lUV1l30~ 3608 301 o FMAMJJASONDJF 2005 Months 2006 Other important information 011 back .. ----------.......----..----...--------...---..-------------------------------...-.....----...----------------------------------......-----------...-------------------. Retum this part to address below with a check payable to PPL Electric Utilities Corporation r ....~~~8':~0~ Mar 1, 2006 r""'$~:^:'1 trDDDDDDD AV 01 017938 514288117 A.'5DGT JOHN C SERBIEFF-ESTATE 113 JUNE DR CAMP HILL PA 17011-5069 PPL ELECTRIC UTILITIES 2 NORTH 9TH STREET RPC-GENNI ALLENTO\Vl'~ FA 18101-1175 111111111.111,1111I1111I11.11111111111111111111,,11,,111111,,1 1 1200000369420000036948 7208074003 Pulmonary and Critir · Care Medicine Associates, P.C. BILLING FOR C~ . rAL REGION SLEEP CENTER 1631 N. FRONT STREET HARRISBURG, PA 17102 PHONE: (717) 234-2561 ROBERT C. GILROY. M.D. WILLIAM M. ANDERSON. M.D. FRANKLIN J. MYERS. III, M.D. RICHARD G EVANS. D.O. SAFA P. FARZIN. M.D. STATEMENT DATE 02/17/06 JOHN C(ESTATE) SERBIEFF 113 JUNE DRIVE CAMP HILL PA 17011 ACCOUNT NUMBER 46847 (1) SEND PAYMENT TO Pulmonary and Critical Care Medicine Associate., P.C. BlLUNG FOR CAPITAL REGION SLEEP CENTER 1631 N. FRONT STREET HARRISBURG, PA 17102 PHONE: (717) 234-2561 STATEMENT DATE 02/17/06 ACCOUNT NUMBER 46847 Detach this stub and return with payment. 46847.0) ~ 9.22 12/25/05 9.22 Lj.. . Please /l-, pay this ~ amount! . ber: 5121-070 -5779-059911 U lilt 1111 11111111 IIIIUI 1 $ I REVIEWED THE ENCLOSED SEARS CHOICE REWARDS PROGRAM SUMMARY & AGREE TO THE TERMS. MY SIGNATURE BELOW ENROLLS ME. Change 01 Add,...? SlgnatlMe 1'1.111...111'111..11...11.1.1.11"1111111.1,,".11..11..11111 JOHN C SERBIEFF ~ 113 JUNE DR CAMP HILL PA 17011-5069 1.1111'1111111.1...111..1...1.1...11.1.1..11111..1.1 PO BOX 182156 COLUMBUS OH 43218-2156 5012 5121070157790599 0000b5b 0000b5b 000065b t ..tears Gold MasterCard Account Number 5121-0701.5779-0599 Customer Service 1-800-669-8488 10F1 Billing Cycle Closing Date Account Balance 02102106 $6.56 .' ~ Amount Over Credit Line Amount Past Due $0.00 + $0.00 + Total Credit Line Available Credit Line Cash Access Line Available Cash $9,100.00 $9,093.44 $1,820.00 $1,820.00 Current Minimum Due Total Minimum Due Payment Due Date f ~ 02/26106 $6.56 $6.56 = ~ . Show Someone They're S~ial on Valentine's Day. Get great designs at ~ .~~~.~~~. c;,~~~~, II"" 11',v Jv'9"v"1 y\. '""n..;u.tJ. A2fJlVOU06 Previous Balance Payments & Credits Purchases & Debits Other Charges FINANCE CHARGES $6.56 $6.56 $0.06 $6.50 $0.00 .cCt:: .u,oJO.,I .. . M. I. __~ I I'\tAJUUI It coldr I\A;J -- !Ill!!!!!!! == ~ Current Activity ;r;;;;;;;; Trans Post Description Charges! Date Date . m Credits n< 1 < n<.' , - TI-lA"lK vnll ._. ___._,..$6.5fL ---.--"- 01.27 01-28 ALLSTATE CERT. .5484103394682, ALLSTATE LIFE lCAD&D, CALL . ----...- ~---._- _ TQl.J.:.EBe...I;HQQ- 736. 2242 $6.50 02-02 02-02 SEARS MC ACCOONTCARFHB8::J05~4409-m.__. __n_ "H --..- -------- _.-._~.- --_.- .- .-W06 ~ '--'~-~ -- - .--.-----.""' - __ I ==== ;r;;;;;;;; - - - - - - - Finance Charaes Davs In Billino Period: 31 Corresponding ANNUAL Periodic Rate Transaction Balance Average Daily PERCENTAGE D-Day Periodic Tvpe Balance RATE M.Month FINANCE CHARGE - - Sears Regular $6.56 $0.00 18.83 "lb' 0.0461 % (D)' $0.00 External Regular $0.00 $0.00 16.83 "lb. 0.0461 % (D)' $0_00 Cash ACCflss Regular $0.00 $0.00 18.05 'lb' 0.0495 % (D)' $0.00 so.OO - - - - - == - - == 'The Rate Varies. NOTICE: See reverse side for important information and billing rights summary. Call 1-800-669-8488 lor customer service or 10 report your card lost or stolen. Mail Billing Error Notices to PO BOX 6922 THE LAKES NV 88901.6922 SEARS Gold Ma~terCard Account Number: 5121-0701-5779-0599111 WIIIIIIIIIIIIIII~IIIIIIIIIIIIIII iA::m . '::::' . :~:~ ,,' $/ ,~;~sedl Make Checks Payable to Sears Credit Cards MANAGE YOUR ACCOUNT ONLINE 24 HOURS A DAY AT SEARSCARD.COM. REGISTER TODAYI Change of Address' IT'S FAST, CONVENIENT & FREE! .1111111...111..,.111111111.1.1.11.. 1111..1.1.....11..11..11..1 ,JOHN C SERBIEFF 0005589 113 JUN~ DR CAMP HIll PA 17011-5069 i 5128 5~21070157?90599 0000656 0000656 0000656 i 1.1. .1..1111 .1.1...111111...1.1...11.1.1..11..1111.1 PO BOX 182156 COLUMBUS OH 43218-2156 i .. Sears Gold MasterCard Account Number 5121-0701-5779-0599 Customer Service 1-800-669-8488 1 OF 1 Bi ing Cycle Closing Dale Account Balance Total Credit Line Available Credit Line Cash Access Line Available Cash 03102106 $6.56 $9,100.00 $9,093.44 $1,820.00 $1,820.00 aunt Over Credit Line Amount Past Due Current Minimum Due Total Minimum Due Payment Due Date $0.00 + $0.00 + $6.56 = $6.56 03/26106 iiiili5 === ~ E!l!! ~ I!!!!!!I!!I from your front yard to your backyard, Sears has all your lawn & garden needs A2lG03I06 $6.56 $6.56 $0.06 $6.50 $0.00 .56 /~, ... F'\ , 1//" ~r{, _~ _/,r:._ {!'! t, !/ f. "-".- - -t' -- ,l~ (Il~~-r:~lc / D ;L.(.) urrent Activity PQst Date Description Charges! Credits .. -.$&~' $6.50 $0.06 v ~ ~ !!!!!!!! ~ ;;;;;;;;;;0 ~ - ~ - === fi!!i!i1il = ~ Iii! - === ~ E!ii!5 === - ;;;;;;;;;;;; - - = === ~ : 02-24 02-25 i cl3.02 03-02 ALLSTATE CERT. # 5484103394582, ALLSTATE liFE iCAD&D, CALL' TOLL-FREE 1-800.736-2242 SEARS MC ACCOUNTCARE 888.365.4409 : ! . I !If h I inane. C IIrges Dalls In BillinQ Period: 28 , Corresponding I ANNUAL Periodic Rate Transacti~n Balance Average Daily PERCENTAGE D-Day Periodic I Tvne : Balance RATE M-Month FINANCE CHARGE Sears Regular $6.56 $0.00 17.08 %. 0.0468 % (D)" $0.00 External Regular $0.00 $0.00 17.08 .... 0.0468 % (D)" $0.00 Cash Acces$ Regular $0.00 $0.00 18.30 %" 0.0502 % (D)" $0.00 , Hannum : en.oo "1rhe Rate Va~s. NOTICE: See reverse side lor important information and billing rights summary. C~1I1.800.66$.8488 for customer service or to report your card lost or stolen. Mail Billing Erfor Notices to PO BOX 6922 THE LAKES NV 88901-6922 . " -----------~==- Form 1040.V PaymentVouqher oepanment of the TreaSury 2005 Internal ReVenue Service .. Use \I1l$ """"'* ~ ~ e ~t wiltt Form 1(lAG. .. 00 not '$UlPle \Ilis wuci"" or y<>>J' payrMll\ \G For'" 1040 .. .,... your d1IlCl< or (l1OMllI QAIrof peyel>le to the ~ SI1l\eS Tr-"'Y.' .. Writ.. YOU' ~ ...,.,nty number (SS~ on your C~flCk or - order, = 1 1,4.5'1J 1030 JOHN C SERBIEff 1'13 JUNE l>RIVE CAMP HILL PA }7011 INTERNAL ~EVENUE SERVICE PHILA~ELPHIA~ PA 1~2SS-0102 \ 207076301 R~ SERB 30 0 200512 b10 ~~- ..",' .', " ' . ' .. . . .. .. ~----_.__._-~--_.~-- ~", -_....------~ -- .....-----------.... ~. -- ' ,'" \ ---- ~ WN idlt .. ,.., *P1IlllftiIg lor ,.ou. Biiiing Date: 02/15/06 Page 1 of 5 Telephone Number: 717 761 t638 Account: 717761 163824247 Y How to Reach Us: See page 2 MR JOHN C SERBIEFF Previous Charges Payments Received thru Feb 15 patt Due Charges (Please Pay Now) $18.50 .00 $18;50 rn Account Summary New Charges Verizon (page 3) Total New Charges $ -12.03 $ -12.03 Convenlencel Menage Your Verlzon Account Onnne AnytIme Day & Night Order services, view & pay your bill, request repairs, anytime day or night! At verizon.com click "Sign In" under "My Account. " New user? Start with: User ID: Password: and customize your 10 as you register, Total Due (Past Due + New) $5.47 .,.--" ~~ ~ .P-/Z-3~" ~/{)01 # 10, Cf 7 Mall payments to: venzon, I-'U MOX 2t1UUU, Lenig" vly PA l&uu~-ilu(j(j Change of billing address? Go to verizon.com~illlngaddress or see page 2. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ !:~~..!<l!tu.!.n~a~Et~lp.!'il!!Y.2O'".:h!C~p!yl!!:>k!..!O'ye.!!z~._ _ _ ~ Account: 717.761 163824247 Y Total Due $6.47 Amount Paid: $ r71 Q r.:;-, ~"L!J I1J MR JOHN C SERBIEFF 113JUNE OR CAMP HILL PA 17011-5069 11111111111111111111111111111111111111111111111111111111111111 Verizon PO BOX 28000 LEHIGH VL Y PA 18002-8000 1111111111111'1111111111.11..1.111111111111'11111111 11771707611638242902802196999991000000185070000000647800000