HomeMy WebLinkAbout07-31-07 (2)
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15056051058
REV-1500 EX (06-05)
PA Department of Revenue *'
Bureau of IndMdual Taxes
PO BOX 280601
Harrisburg, PA 17128-0601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
11 Code ;Jft1
Date of Birth
159-24-8641
11/09/2006
01/12/1928
Decedent's Last Name Suffix
Decedent's First Name
Heffelfinger Jr.
Lloyd
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WillS
FILL IN APPROPRIATE OVALS BELOW
... 1. Original Return
File Number
/ {);2 7
2. Supplemental Return
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
4a. Future Interest Compromise (date of
death after 12-12-82)
7. Decedent Maintained a Uving Trust
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
4. limited Estate
....
6. Decedent Died Testate
(Attach Copy of WHI)
9. Utigation Proceeds Received
8. Total Number of Safe Deposit Boxes
Robert L. Keuch, Esq.
Firm Name (If Applicable)
(717) 249-8433
REGISTER OF WILLS USE ONLY
First line of address
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615 Devonshire Drive
Second line of address
City or Post Office
Carlisle
State
ZIP Code
PA
17013-3605
Correspondent's e-mail address:boblacey@aol.com
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DATE
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ADDRESS
615 Devonshire Drive, Car isle, PA 17013-3605
PLEASE USE ORIGINAL FORM ONLY
Side 1
L
15056051058
15056051058
.....I
Wt)
-1
15056052059
REV-1500 EX
Decedenfs Name:
RECAPITULATION
Lloyd
J Heffelfinger
1. Real estate (Schedule A). .. . . . . . .. .. .. . . . .. . .. .. . . . .. .. .. .. . .. .. .. . .. 1.
2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. . .. 3.
4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5.
6. JoinUy Owned Property (Schedule F) Separate Billing Requested . . . . . .. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) Separate Billing Requested.. . . . . .. 7.
8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8.
9. Funeral Expenses & Administrative Costs (Schedule H). . . .. . . . . . . . . . . . . . . .. 9.
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . . . . . 10.
11. Total Deductions (total Lines 9 & 10). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.
12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . .. . . . . . . . .. . . . . . . . 12.
13. Charitable and Governmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) .... . . . . . . . . . . . . . . . . . . . . 14.
TAX COMPUTATION. SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2)X .0_
16. Amount of line 14 taxable
at lineal rate X.O_
17. Amount of line 14 taxable
at sibling rate X .12 93,436.95
18. Amount of line 14 taxable
at collateral rate X .15 267,216.58
19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
L
15056052059
Side 2
159-24-8641
Deeedent's Social Security Number
15.
16.
17.
18.
127,000.00
331,083.13
81,129.25
22,074.49
561,286.87
52,839.16
3,185.88
56,025.04
505,261.83
144,608.29
360,653.54
11,212.43
40,082.49
51,294.92
15056052059
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REV-1500 EX Page 3
Decedent's Complete Address:
File Number
DECEDENTS NAME DECEDENTS SOCIAL SECURITY NUMBER
LLoyd J Heffelfinger 159-24-8641
STREET ADDRESS
90 East Ridge Street
CITY I STATE I ZIP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due (page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
6. Prior Payments
C. Discount
(1)
51,294.92
38,000.00
1,999.94
Total Credits (A + 6 + C ) (2)
39,999.94
3. Interest/Penalty if applicable
D. Interest
E. Penally
TotallnteresUPenalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, 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.
11,294.98
6. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5)
(5A)
(56)
A. Enter the interest on the tax due.
11,294.98
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; .......................................................................................... D !Xl
b. retain the right to designate who shall use the property transferred or its income; ............................................ D ~
c. retain a reversionary interest; or.......................................................................................................................... D ~
d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 ~
2. If death occurred after December 12, 1982, did decedentlransfer property within one year of death
without receiving adequate consideration? .............................................................................................................. D ~
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D !Xl
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ ~ 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994 and before January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is three (3) percent [72 P.S. ~9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent
[72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax retum 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 zero (0) percent [72 P.S. ~9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in
72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)J.
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent (72 P.S. ~9116(a)(1.3)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1 502 EX+ (6-98)
*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF R.EtI.NBER
Lloyd J. Heffelfinger, Jr. 2006-01207
AU real property owned solely or as a I8nant In convnon must be reportsd at fair rnarit6t value. Fair market value is defined as the price at which property would be
exchanged between a WIlling buyer and a wiling seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant fads.
Real property which is jolntIy-owned with right ofsurvivOlShlp must be disclosed on Schedule F.
ITEM
IIUvBR ~
1. Decedenfs residence at 90 East Ridge Street, Carlisle, Penna.
VALUE AT DATE
OF DEAThl
$127,000
(See settlement sheet for sale of real estate in documentation)
TOTAL (Also enter on line 1, Recapitulation) $
$127,000
REV-1 503 EX+ (6-98)
~
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Lloyd J. Heffelfinger, Jr.
All property jolntly-owned with right of survivorship must be disclosed on Schedule F.
FILE NUMBER
2006-01207
ITEM
NUMBER DESCRIPTION
1. Citibank Account 73H-01628-13-SLP
-(Please see listing of individual stocks and securities on Schedule provided
'oy Citigroup, Smith, Barney, 419 Village Dr., Carlisle, Pa 17015, Phone Number:
~00-348-1776. Schedule in documentation.)
VALUE AT DATE
OF DEATH
$325,369.63
2.
23 certified shares, MetLife.
(Please see documentation.)
1,340.28
3.
AIM Treasury Fund Account # 1000096487, Financial Network Invest Corp. 5
<acey Court, Suite 101, Mechanicsburg, Pa 17055-9220, Phone Number: 717-
766-4551. See documentation.
4,373.22
TOTAL (Also enter on line 2, Recapitulation) $
331,083.13
REV-1 508 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Lloyd J. Heffelfinger, Jr.
Include the prooeecIs of litigation and the date the proceeds were received by the estate.
All property jolnlly-ownedwilh rlghtaf survlvonIhIp must be discIo8ed on Schedule F.
ITEM
fIlMER
~
1.
Cash on hand
2.
Checking Account # 146000749
Orrstown Bank, 22 South Hanover St., Carlisle, Pa 17013, Phone Number: 888-
677-7869. (See documentation.)
Bank Deposit Program Account # 734-01628-13-SLP. Citibank, Smith, Barney, 419
Village Dr., Carlisle, Pa 17015, Phone Number 800-348-1776. (See documentation.)
3.
4.
Personal vehicle 2005 Ford Firestar SE van.
5.
Model train collection.
6.
7 hunting rifles
7.
Miscellaneous personal property including home furnishings, tools, clocks, gun
cases, a safe and other personalty sold at auction by Rowe's Auction Service, 2505
Ritner Hwy, Carlisle, Pa 17013, Phone Number: 717-249-1978. (See receipt dated
12/5/06 in documentation.)
(Prior to his death, decedent had sold a greater variety and number of personal
items through an auction by Rowe's. The amount realized was $20811.00, and the
funds were deposited to his checking account in Orrstown Bank described above on
10/19/2006. No single item was valued at more than $3000.00, and no category of items
was valued at more than $10,000.00.)
8.
Accounts Receivables as follows:
Social Security check
Federal income tax refund
State income tax refund
Home insurance refund
Auto insurance refund
Medical insurance refund
Prescription drug plan refund
Phone bill refund
Oil payment plan refund
Magazine subscription cancelled
Discover credit card cash back bonus
IRA distribution, Western Southern Life Assurance Co.
IRA distribution, AIG
9.
(See page 2, attached.)
TOTAL (Also erter on line 5, Recapitulation) $
FLEtuIEER
2006-01207
VALUE AT DATE
CFl:EAlH
$588.00
21,208.24
9,426.02
17,500.00
2,700.00
1,130.00
3,057.25
743.00
1,230.00
265.00
351.00
471.00
95.79
57.23
22.71
988.80
28.72
140.00
323.42
781.60
20,021.40
81,129.25
Schedule E - Page 2
Estate of Lloyd, J. Heffelfinger, Jr., Number: 206-01207
9.
IRAs payable to the estate. The only named beneficiary on each of
the following IRA accounts is decedent's late wife
Martha Ann Heffelfinger who died September 21
2005.
IRA Account # 00000238197185
Sovereign Bank, 17 West High St., Carlisle, Pa 17013, Phone
Number: 717-258-4680.
$4,215.42
3 IRAs under Account # 818667211 Edward Jones Investments, 21
West High St., Carlisle, Pa 17013, Phone Number: 717-254-4680,
invested in separate American Funds. Date of death value obtained
from the American Funds website: www.americanfunds.com.
b. New Economy Fund - A
5,252.52
5,062.37
5,491.16
a. EuroPacific Growth Fund - A
c. American Mutual Fund - A
REV-1510 EX+ (6-98)
~
SCHEDULE G
INTER.VIVOS TRANSFERS &
MISC. NON.PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Lloyd J. Heffelfinger, Jr. 2006-01207
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1 500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECD'S EXCLUSION TAXABlE
ITEM INClWE lHENAME OFTHE lRANSFEREE, '!HER R8.AllONSHP TO DECEDENTANJ
NUMBER nE DATEOFTRANSFER. AlTACHA COPY OFlHEDEEO FOR REi\J.. ESTATE. VALUE OF ASSET INTEREST VALUE
1. RA contract # W 0020627789, Western - Southern Life $6,849.93 100 $6,849.93
Assurance Co., Annuity Operations, P.O. Box 2918, Cincinnati,
OH 45201-2918, Phone Number: 800-926-1702
Beneficiary: Samuel J. Heffelfinger, 610 Keller St.,
Mechanicsburg, Pa 17055
Relationship to decedent: Brother.
2. RA contract # BX205483 AIG Annuity Insurance Company, 15,224.56 100 15,224.56
p.O. Box 871, Amarillo, TX 79105-0871, Phone Number: 800-
~24-4990.
Beneficiary: E.K. Weitzel, 445 West Penn St., Carlisle, PA
17013
Relationship to decedent: Niece.
TOTAL IAI!'lo AI ItAr on IinA 7 RAca itulation) $ 22,074.49
REV-1511 EX+ (1Q.OO) _
_~i~.
cc::M/KJIII\EALlH<FPENIISYlVANA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
Lloyd J. Heffelfinger, Jr.
2006-01207
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
Hoffman Roth Funeral Home
Cleaning expenses, decedent's clothes
9,064.60
1,000.00
11.55
Addition to grave markers, Rice Memorial Works
Pallbearers' honorariums
200.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
E.K. Weitzel (
15,600.00
Street Address
445 West Penn St.
City
Carlisle
State
PSZip
17013
Year(s) Commission Paid: 2006
2.
Attorney Fees
15,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
State
Zip
Relationship of Claimant to Decedent
4.
Probate Fees
480.00
5. Accountant's Fees
6.
Tax Retum Preparer's Fees
Included in Attorney
r-ees)
7.
Mise fees:
Advertising
Checking account fees
Copy of van title
Settlement costs, sale of personal residence
197.51
72.80
22.50
6,485.83
8.
(See page 2, attached.)
4,704.37
TOTAL (Also enter on line 9, Recapitulation) $
52,839.16
Schedule H - Page 2
Estate of Lloyd, J. Heffelfinger, Jr., Number: 206-01207
8.
Expenses for maintenance of real estate listed on Schedule A:
a. Borough of Carlisle Water and Sewer
b. Embarq Phone
c. PP & L
d. Littiz Mutual Home Insurance
e. Stitzel's All Mechanical (turn off stove and water)
f. Old Town Homes (plywood patch on door)
g. Dirty Dog Hauling (trash removal)
(At time of decedent's death, there was an outstanding
Notice of Violation from the Borough mandating removal
of an accumulation of trash, rubbish, and junk. Such
removal was necessary in any case for safety and
sanitary reasons.)
$66.18
56.46
42.54
59.29
45.00
35.00
4,400.00
REV-1512 EX+ (12-03)
~
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FilE NUMBER
Lloyd J. Heffelfinger, Jr. 2006-01207
Report debts Incurred by the decedent prior to death which remained unpaid as of the date of death, Including unrelmbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
orough of Carlisle, Water and Sewer $266.09
2.
he Thornwald Home, 442 Walnut Bottom Road, Carlisle, Pa 17013, Account # 990 2,125.04
3.
harAmerica, 41A Blue Eagle Ave., Harrisburg, Pa 17112, Account # 5702-01-232521 265.75
(Items 2 and 3 not covered by medical insurance.)
4.
nnual fees due on real estate owned in District of San Felibe, Baja California,
epublic of Mexico. (Decedent did not have a contract to sell this property.)
529.00
TOTAL (Also enter on line 10, Recapitulation) $
3,185.88
REV-1513 EX+ (9-00)
~
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Lloyd J. Heffelfinger, Jr.
FILE NUMBER
2006-01027
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not list Trustee(s) OF ESTATE
I . ,.nelude outright Spousal OiStrlbutions, ana transfers unaer
Sec. 9116 (a) (1.2)]
1. George H. Heffelfinger, 16 Beechwood Drive, Brother $46,718.48
Dillsburg, PA 17019
2. Samual J. Heffelfinger, 60 Keller St., Brother 46,718.48
Mechanicsburg, PA 17055
3. Nancy Wentzel Cornman, 2199 Princeton Place, Niece 133,608.29
Broomall, PA 19008
4. E.K. Weitzel, 445 West Penn St., Carlisle, PA Niece 133,608.29
17013
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1. Lycoming College, 700 College Place, Williamsport, PA 17701 $10,000.00
2. Carlisle Musical Arts Club, in care of Lorrie Elliott, 921 Thornton Dr., 1,000.00
Mechanicsburg, PA 17055
3. The First United Church of Christ, 30 North Pitt St., Carlisle, PA 17013 133,608.29
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 144,608.29
LJ COpy
LAST WILL AND TESTAMENT
OF
LLOYD J. HEFFELFINGER
I, LLOYD J. HEFFELFINGER, now domiciled in Cumberland County, Pennsylvania,
declare this to be my Last Will and Testament. I revoke all other wills and codicils that I may have
previously made.
Article I
My just debts and expenses of my last illness, funeral, and administration of my estate shall
be paid by my Executor from the principal of my residuary estate as soon as practicable after my
death.
Article II
All inheritance, estate, and succession taxes (including interest and penalties thereon, but not
including any generation skipping tax) payable by reason of my death shall be paid out of and be
charged generally against the principal of my residuary estate without reimbursement from any
person. This provision is not a waiver of any right which my Executor has to claim reimbursement
for any such taxes which become payable as the result of any property over which I have the power
of appointment.
Article III
I give, devise and bequeath in accordance with any memorandum which I have either
handwritten or signed, located with my will or with my valuable papers and found within 30 days of
the probate of my will. Gifts may only be to persons who survive me or to organizations which exist
at my death, and if there is a conflict, the memorandum having the latest date shall govern.
Article IV
I gIve and bequeath the sum of TEN THOUSAND DOLLARS ($10,000.00) to
LYCOMING COLLEGE, or its successor(s), of Lycoming, Pennsylvania, to be used at its
discretion.
Article V
I give and bequeath the sum of ONE THOUSAND DOLLARS ($1,000.00) to
CARLISLE MUSICAL ARTS SCHOLARSHIP FUND, or its successor(s), to be used at its
discretion.
Article VI
I give and devise my real property located at 90 East Ridge Street, Carlisle, Pennsylvania, IN
EQUAL SHARES to the FIRST UNITED CHURCH OF CHRIST, or its successor(s), of 30
North Pitt Street, Carlisle, Pennsylvania, and to my niece, NANCY WENTZEL CORNMAN, of
Broomall, Pennsylvania, and to my niece, E. K. WEITZEL, of Cumberland County, Pennsylvania.
Article VII
All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever
situate, I give, devise and bequeath according to the following schedule:
- 2 -
D.
TWENTY-FIVE PERCENT (25%) to the FIRST UNITED CHURCH
OF CHRIST, or its successor(s), of 30 North Pitt Street, Carlisle,
Pennsylvania, to be used at its discretion.
TWENTY-FIVE PERCENT (25%) to my niece, NANCY WENTZEL
CORNMAN, of Broomall, Pennsylvania, Per Stirpes.
TWENTY-FIVE PERCENT (25%) to my niece, E.K. WEITZEL, of
Cumberland County, Pennsylvania, NOT Per Stirpes.
TWENTY-FIVE PERCENT (25%) IN EQUAL SHARES to my brothers,
GEORGE H. HEFFELFINGER and SAMUEL J. HEFFELFINGER, or
the survivor, of Dillsburg, Pennsylvania, NOT Per Stirpes.
If NANCY WENTZEL CORNMAN predeceases me or fails to survive me by thirty (30)
A.
B.
C.
days, I give, devise and bequeath her share to her issue who survive me, per stirpes, or if she has no
issue, the share(s) are to be added equally to the other shares.
IfE.K. WEITZEL and/or GEORGE H. HEFFELFINGER and SAMUEL J.
HEFFELFINGER predecease me or fail to survive me by thirty (30) days, I give, devise and
bequeath the share he/she would have received to my remaining beneficiary who survives me by
thirty (30) days, PER CAPITA, NOT PER STIRPES.
Article VIII
I nominate, constitute, and appoint my niece, E.K. WEITZEL, as Executrix of my Last Will
and Testament. In the event ofthe renunciation, death, or inability to act, for any reason whatsoever
of my Executrix, I nominate, constitute and appoint my brother, SAMUEL J. HEFFELFINGER, as
- 3 -
successor Executor of my Last Will and Testament. In the event of the renunciation, death, or
inability to act, for any reason whatsoever of SAMUEL J. HEFFELFINGER, I nominate,
constitute and appoint my niece, NANCY WENTZEL CORNMAN successor Executrix of my Last
Will and Testament. I direct that my Executrix or successor Executors be permitted to serve without
bond and in addition to those powers granted by law, I grant them power to distribute in cash or in
kind in like or in unlike shares and to file any qualified disclaimer I could have filed if living. My
Executrix and successor Executors shall receive reasonable compensation for services rendered to
my estate.
Article IX
In addition to the powers conferred by law, I authorize my Executrix and successor
Executors, in his/her absolute discretion:
(a) to retain in the form received and to sell either at public or private sale, any real estate or
personal property except that which I specifically bequeath herein,
(b) to manage real estate,
( c) to invest and reinvest in all forms of property without being confined to legal
investments, and without regard to the principal of diversification,
(d) to exercise any option or right arising from the ownership of investments,
(e) to compromise claims without court approval and without consent of any beneficiary,
(f) to file any federal income tax return for any year for which I have not filed such return
prior to my death,
(g) to make distributions in cash or in kind, or in both, and to determine the value of any
- 4 -
such property,
(h) to employ any attorney, investment advisor, or other agent deemed necessary by my
Executor; and to pay from my estate reasonable compensation for all their services,
(i) to conduct alone or with others, any business in which I am engaged in, or have an
interest in at time of my death, and
U) to receive reasonable compensation in accordance with their standard schedule offees in
effect while their services are performed.
IN WITNESS WHEREOF, I, LLOYD J. HEFFELFINGER, hereby set my hand to this my
Last Will and Testament, on
t:1A~ ~~
,2005.
7ft I~ ~ ~
"~i'r e' ! ~~P'"
LLO D EFF N ER
In our presence, the above-named LLOYD J. HEFFELFINGER signed this and declared
this to be his Last Will and Testament and now at his request, in his presence, and in the presence of
each other, we sign as witnesses.
Name
CL.) ob-k (). E IJPA ~~;;~
!/yJj/iM of ~ad;
Address
~~5 S;'r /JW'YYLtJ.S Uj S+e {d; {+bit P4 /7/~j
~5 SI'r~M\ cJ) Sit /;)., ffh; ,Pd7Lcl9
- 5 -
I, LLOYD J. HEFFELFINGER, Testator, who signed the foregoing instrument, having
been duly qualified according to law, acknowledge that I signed and executed this instrument as my
Will, and that I signed it willingly as my free and voluntary act for the purposes therein expressed.
Sworn to or affirmed and
acknowledged before me by
LLOYD J. HEFFELFINGER, the Testator,
on S ,~ 1 , 2005.
-J~d~
C otal)j ublic
~ II ~IiItfL
LLOYD WEFFE R 1f7
COMMONWEALTH Of PENNSYlVANIA
NOTARIAL SEAL
JACQUELINE A. KELLY, NOTARY PUBLIC
LOWER PAXTON TWP., DAUPHIN COUNlY
MY COMMISSION EXPIRES DEC. 17,2007
We, the undersigned witnesses who signed the foregoing instrument, being duly qualified
according to law, depose and say that we were present and saw the Testator sign and execute this
instrument as his Will; that he signed and executed it willingly as his free and voluntary act for the
purposes therein expressed; that each of us in his sight and hearing signed the Will as witnesses, and
that to the best of our knowledge, that he was at that time eighteen (18) years or more of age, of
sound mind, and under no constraint or undue influence.
Sworn to or affirmed and
subscribed to before me
by J vet \ IfA F1-t:h" ~(j Ie
and ''Eo /Jda, F J{c,}-ylft ,
witnesses, on [;', d t.j
,2005.
~"~ (( [k~
tness
cfJil4ida/ r ~(lh~
WItness
COMMONWEALTH OF PENNSYLVANIA
NOTARIAL SEAL
JACQUELINE A. KELLY, NOTARY PUBLIC
LOWER PAXTON TWP., DAUPHIN COUNTY
MY COMMISSION EXPIRES DEC. 17.2007
- 6 -
HUD - I UNIFORM SETTLEMENT STATEMENT
OMB Approval No. 2502-0265
A. U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT
B. TYPE OF LOAN 6. File Number: 7. Loan Number:
1. FHA 2. FmHA
3. Conv. Unins. 4. VA 5. Conv. Ins. 8. Mortgage Insurance Case Number
C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.c.)"
were paid outside the closing; they are shown here for informational purposes and are not included in the totals.
NOTE: TIN = Taxnaver's Identification Number
D. NAME AND ADDRESS OF BORROWER: E. NAME, ADDRESS AND TIN OF SELLER: F. NAME AND ADDRESS OF LENDER:
Scott Hench E.K. Weitzel, n/a
Executrix for Heffelfinger Es
251 Sheaffer Road 445 W. Penn Street '.
Carlisle, Pa 17013 Carlisle, Pa 17013
G. PROPERTY LOCATION: H. SETTLEMENT AGENT NAME, ADDRESS AND TIN
90 E. Ridge Street Jacqueline M. Verney, Esquire
Carlisle, Pa 17013 44 South Hanover Street. Carlisle PA 17013
PLACE OF SETTLEMENT I. SETTLEMENT DATE
44 South Hanover Street 12/15/2006
Carlisle. Pa. 17013
J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION
100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER:
101. Contract sales nrice 127 .000.00 40 I. Contract sales nrice 127 000.00
102. Personal nronertV 402. Personal nronertv
103. Settlement charlles to borrower (Line 1400) 1 670.00 403.
104. 404.
105. 405.
Adjustments for items naid bv seller in advance Adjustments for items naid bv seller in advance
106.C[hJtowntaxes 406. Citv/town taxes
107. County taxes 12/15/2006-12/31/2006 43.23 407. County taxes 12/15/2006-12/31/2006 43.23
108. Assessments 408. Assessments
109. 409.
110. School Tax 12/15/06-06/30/07 1.290.94 410. School Tax 12/15/06-06/30/07 1 290.94
111. 411.
112. 412.
120. GROSS AMOUNT DUE FROM BORROWER 130.004.17 420. GROSS AMOUNT DUE TO SELLER 128 334.17
200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER:
201. Denosit or earnest monev 127 000.00 501. Excess denosit
202. Princinal amount of new loan(s) 502. Settlement char!!es to seller (Line 1400) 7.820.00
203. Existinl! loan(s) taken subiect to 503. ExistinlJ loan{ s) taken subiect to
204. 504. Pavoff of first mortl!al!e loan
205. 505. Pavo IT of second mort!!a!!e loan
206. 506.
207. 507.
208. 508.
209. 509.
Adiustments for items unnaid bv seller Adiustments for items unoaid bv seller
210. CiN/town taxes 510. City/town taxes
211. Countv taxes 511. Countv taxes
212. Assessments 512. Assessments
2\3. 5\3.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
220. TOTAL PAID BY /FOR BORROWER 127 000.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 7 820.00
300. CASH AT SETTLEMENT FROM/TO BORROWER 600. CASH AT SETTLEMENT FROM/TO SELLER
30 I. Gross amount due from borrower (Line 120) I 130.004.17 60 I. Gross amount due to seller (Line 420) T 128 3'\4.17
302. Less amount naid bv/for borrower (Line 220) I 127 000.00 602. Less reduction in amount due seller (Line 520) . I 7.820.00
303. CASH FROM BORROWER I 3.004.17 603. CASH TO SELLER T 120 514.17
SELLER'S STATEMENT
The information contained in Blocks E, G, H, and I and on line 401 (or, ifline 401 is asterisked, line 403 and 404) is important tax information and is being furnished to the
Internal Revenue Service (see Seller Certification). If you are required to filc a return, a negligence penalty or other sanction will be imposed on you if this item is required
to be reported and the IRS determines that it has not been reported. You are required to provide the Settlement Agent with your correct taxpayer identification number. If you
do not provide the Settlement Agent with your correct taxpayer identification number, you may be subject to civil or criminal penalties imposed by law. Under penalties of
perjury, I certifY that the number shown on this statement is my correct taxpayer identification number.
E.K. Weitzel,
(Seller's Signature)
Executrix for Heffelfinger Es
(Seller's Signature)
iD EASY SOFT, Inc. 2001 Previous editions are obsolete
Page I
form HUD-I (3/86) ref Handbook 4305.2
L. SETTLEMENT CHARGES
r '700. TOTAL SALESlBROKER's COMMISSION based on nriee ~ 127 000.00 (cl 5.000%
Division of Commission {(ine 700) as follows:
701.1: 6 350.00 to Hooke Hooke & Eckman Realtors
702.$
703. Commission naid at Settlement
704.
SOO.ITEMS PAYABLE IN CONNECTION WITH LOAN
80 I. Loan Ori..ination Fee S
802. Loan Discount S
803. Annraisal Fee to
804. Credit renort to
805. Lender's Insnection Fee
806.
807.
808.
809.
810.
811.
812.
813.
900. ITEMS REOUIRED BY LENDER TO BE PAID IN ADVANCE
901. Interest from
902. Mortoaoe Insurance Premium for
903. Hazard insurance Premium for
904.
905.
1000. RESERVES DEPOSITED WITH LENDER
1001. Hazard insurance
1002. Mortllalle insurance
1003. CitvPronertv Taxes
1004. Counlv Prooertv Taxes
1005. Annual assessments
1006.
1007.
1008. Aoorellate Accountinll Adiustment
1100. TITLE CHARGES
1101. Settlement or closinll fee to Jacaueline M. Vernev.Esauire
1102. Abstract or title search to Karen Coon
1103. Title Examination to
1104. Title insurance binder to
1105. Document nrenaration to
1106. Notarv fees to
1107. Attornev's fees to Georae Dourrlas Esauire
(includes line numbers: Deed Dren
1108. Title Insurance to
(includes line numbers:
1109. Lender's coveraoe $
1110. Owner'scoveralle $ 127000.00
1111.
1112.
1113.
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Recordinll fees: Deed $ 38 . 50 Mortllalle $
1202. Ci~fc~ tax/stamns: Deed $ 1 270. 00 Mortl!al!e $
1203. State tax/stamos: Deed $ 1 270.00 Mortllalle $
1204.
1205.
1300. ADDITIONAL SETTLEMENT CHARGES
1301. Survey to
1302. Pest insnection to
1303.
1304.
1305.
1306. Carlisle Bora: Final water/sewer (POC) ,
1400. TOTAL SETTLEMENT CHARGES tenter on lines 103 Section J and 502 Section J(\ 1 670. 00 7 82n. 00
CERTIFICATION: I have carefully reviewed the HUD-I Settlement Statement and to the best of my knowledge and~lief' it is a a accurate:7tatement of receipts and
disbu,,~ment~ mfde on my account or by me in this transaction. I further certifY that I received a copy of the HUD-I Settlem t menl.
L ~ W.u:Q,J fit etum X ~ -,-~ ~
Seller [) J. K. Wei t zel Borrower - 7 Scott Hench ~ V ...., --
PAID FROM
BORROWER'S
FUNDS AT
SETTLEMENT
PAID FROM
SELLER'S
FUNDS AT
SETTLEMENT
6 350.00
250.00
111.50
200.00
I
Release $
38.50
1 270.00
1 270.00
Seller Executrix for Heffelfinger Es Borrower
The HUD-I Settlement Statement which I have prepared is a true and accurate account of the funds disbursed or to be disbursed by the undersigned as part of the settlement of
th' transaction.
~~_~ ~~ 12/15/2006
Agent Jacqueline M. Ve ey, Esquire Date
WARNI G: It is a crime to knowingly make false statements to the United States on this or any other similar form. Penalties upon conviction can include a fine and
imprisonment. For details see: Title 18 U.S. Code Section 1001 and Section 1010.
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What could be _ore convenient?
1.877.SQV.BANK (768.2265) sovereignbank.com
Sovereign Bank~
CUSTOMER RECEIPT
"*
?-1;; t)'A~
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S-tO~
Date 12/14/06 10:52 Teller 003
Deposit
AN: ~U****7938
Transaction A~ount:
Ledger Italance=
Seq: 044
0167
$1,340.213
$33,534.52
Member FDIC
BROODS 5/06
~
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==
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!!!!!!!!!!!!!!
AIM2R 03/05
II
PERIODIC 8T A TEMENT
January 01, 2006 - December 31,2006
INVESTMENTS
>02248 4738306 001 008116
LLOYD HEFFELFINGER
445 W PENN ST
CARLISLE PA 17013-2235
Your Financial Advisor:
JOSEPH BOWDEN
FINANCIAL NETWORK INVEST CORP
5 KACEY CT STE 101
MECHANICSBURG PA 17055-9220
PHONE: 717-766-4551
For More Information on Your AIM Account:
. Contact Your Financial Advisor
. Visit us online at www.aiminvestments.com
. Call our 24-hour automated information line
at 800-AIM-L1NE
. Talk to a Client Services Representative at
800-959-4246 from 7:30 a.m. to 7:00 p.m. CT
Value on 12130/05
Additions
Withdrawals
Exchange In
Exchange Out
Transfer of Shares
Change in Market Value
Value on 12/31106
$4,244.33
$0.00
$4,363.02
$0.00
$0.00
$0.00
$118.69
$0.00
Tax time is coming...most of the TAX FORMS you receive from AIM can be expected to arrive in LATE JANUARY, such as Forms 1099-B, 1099-DIV, 1099-R
and 1099-Q, as well as the new Form 1099-INT, which is replacing the Statement ofTax-Exempt Dividends.
Tired of juggling armloads of mail? You can opt to receive your AIM statements, tax forms, prospectuses, and annual and semiannual reports online. When you
sign up for eDelivery, we will e-mail youalink.andyouwillnolongerreceivepapercopiesbymail.Toenroll.logintoyourAIMaccountatAIMinvestments.com.
click on the Service Center tab and select "Register for eDelivery." You may cancel the service at any time at the same location.
Fund Name
Fund Symbol
Value on Additions Withdrawals Net Transfer Change in Value on
12130105 Exchanges of Shares Market Value 12/31106
Non-Retirement Accounts
AIM LIMITED MA TURITY TREASURY FUND - CLASS A
SHTIX
$4,244.33 $0.00 -$4,363.02 $0.00 $0.00 $118.69 $0.00
Total Non-Retirement Accounts
$0.00 -$4,363.02 $0.00 $0.00 $118.69 $0.00
Totals:
$4,244.33 $0.00 -$4,363.02 $0.00 $0.00 $118.69 $0.00
Important: This account statement reflects financial transactions for the period indicated. Carefully review all of the information to verify the
accuracy of the transactions. Please notify us immediately if there is an error. If you fail to notify us of an error within 30 days of this statement,
you will be deemed to have ratified each transaction.
n').,AQ ....7..:u:t':ln~ nnAAQ~ nnQA-::t'l nnnn11nnnn"
..
INVESTMENTS
PERIODIC 8T A TEMENT
January 01, 2006 - December 31, 2006
Page 2 of 2
Non-Retirement Accounts
-
AIM UMITED MATURITY TREASURY FUND - CLASS A Fundi Account: 1523/1000096487
LLOYD HEFFELFINGER
Post Trade Transaction Dollar Share Transaction Ending
Date Date Description Amount Price Shares Shares
Value on 12130105 $4,244.33 $10.06 421.902
01/31/06 01/31/06 DIVIDEND REINVEST @ NAV $11.70 $10.04 1.165 423.067
02128/06 02128/06 DIVIDEND REINVEST @ NAV $10.98 $10.03 1.095 424.162
03131/06 03131/06 DIVIDEND REINVEST @ NAV $12.75 $10.01 1.274 425.436
04/28/06 04/28/06 DIVIDEND REINVEST @ NA V $12.39 $10.01 1.238 426.674
05/31/06 05/31/06 DIVIDEND REINVEST @ NAV $13.06 $9.99 1.307 427.981
06/30/06 06/30/06 DIVIDEND REINVEST @ NAV $13.18 $9.97 1.322 429.303
07/31/06 07/31/06 DIVIDEND REINVEST @ NAV $14.03 $10.00 1 .403 430.706
08/31/06 08/31/06 DIVIDEND REINVEST @ NAV $14.25 $10.03 I 1.421 432.127
09/29/06 09/29/06 DIVIDEND REINVEST @ NAV $13.93 $10.04 1.387 433.514
~ _10/~1/06 DIVIDEND REINVEST@ NAV $14.87 $1Q,Jlli 1.483 ~
11/21/06 11/21/06 REDEMPTION .111~~ $1J.lJl3 -~ .000
11/21/06 11/21/06 DIVIDEND CASH $10.~0 .000 .000
Value on 12/31106 $10.01 .000
iiiiiiiiiiiiiii
~
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-
~
iiiiiiiiiiiiiii
~
==
iiiiiiiiiiiiiii
Fund Name
Dividends and
ST Capital Gains
$141.34
Long Term
Capital Gains
$0.00
AIM LIMITED MATURITY TREASURY FUND - CLASS A
Year-to-Date Total
$141.34
$0.00
Fund Name Telephone Redemption
Telephone Exchange
AIM LIMITED MATURITY TREASURY FUND - CLASS A Yes
Yes
Dividends
Capital Gains
Reinvest
Reinvest
Systematic
Withdrawal
No
Automatic
Investments
No
Automatic
Exchange
No
Be sure to place your order if you would like to receive the AIM Tax Guide again this year. The 2006 AIM Tax Guide remains entirely free of charge, but
shipment is now upon request, rather than automatic. Just print your name and address on the reply card panel of the enclosed flier and mail the card to
AIM to have your free Tax Guide mailed to you in early 2007. If you prefer to view or print the Tax Guide from our Web site, AIM investments. com,
directions are provided on the reply card.
Beginning January 1, 2007, AIM Investments will charge a fee for copies of statements that are not available online. You can access your AIM account
statements by logging in to your AIM account at AIMinvestments.com.
\IM2R 03/05
02248 4738306 004497 008435 00002/00002
ORRSTOWNBANK
A Tradition of Excellence
Date 12/05/06
primary Account
Enclosures
1'11111'1111111....111111.1..1.1
Lloyd J Heffelfinger Jr
90 East Ridge Street
Carlisle PA 17013
WE PUT THE LOW IN LOANS!
ASK ABOUT OUR SPECIAL LOW RATE HOME EQUITY LINE TODAY!
CALL 1-888-0RRSTOWN ABOUT THIS LIMITED TIME OFFER!
C H E C KIN G A C C 0 U N T S
Account Title
50+ Interest Checking
Account Number
Previous Balance
Deposits/Credits
2 Checks/Debits
Service Fee
Interest Paid
Current Balance
Lloyd J Heffelfinger Jr
Check Safekeeping
Statement Dates 11/06/06 thru
Days In The Statement Period
Average Ledger
Average Collected
Interest Earned
Annual Percentage Yield Earned
2006 Interest Paid
146000479
21,216.62
.00
21,216.62
.00
1.62
.00
Page 1
146000479
12/05/06
30
9,897.42
9,897.42
1.62
0.20%
7.74
Activity In Date Order
Date Description
11/09 Check 1193
11/20 Interest Deposit
11/20 Close Account
Trace No
002090130
006066070
006066070
Amount
10.00-
1. 62
21,208.24-
Balance
21,206.62
21,208.24
.00
--- CHECK SUMMARY ---
Date Check No Amount Reference
11/09 1193 10.00 002090130
* Denotes missing check numbers
ORRSTOWNBANK
A Tradition of Excellence
111111111111111111111111111111, I
Lloyd J Heffelfinger Jr
90 East Ridge Street
Carlisle PA 17013
Date 11/03/06
Primary Account
Enclosures
Page 1
146000479
~o\O\P
WE PUT THE LOW IN LOANS!
ASK ABOUT OUR SPECIAL LOW RATE HOME EQUITY LINE TODAY!
CALL 1-888-0RRSTOWN ABOUT THIS LIMITED TIME OFFER!
Account Title
50+ Interest Checking
Account Number
Previous Balance
2 Deposits/Credits
5 Checks/Debits
Service Fee
Interest Paid
Current Balance
C H E C KIN G A C C 0 U N T S
Lloyd J Heffelfinger Jr
Check Safekeeping
Statement Dates 10/06/06 thru 11/05/06
Days In The Statement Period 31
Average Ledger 12,928.89
Average Collected 12,816.16
Interest Earned 2.13
Annual Percentage Yield Earned 0.20%
2006 Interest Paid 6.12
146000479
477.24
21,809.90
1,072.65
.00
2.13
21,216.62
Activity In Date Order
Date Description
10/11 Deposit
X 10/19 Deposit
10/20 Check
10/23 Check
10/23 Check
10/24 Check
11/01 Check
11/05 Interest
Trace No
005015620
003019820
002060610
002061230
002053830
002056880
001014480
1250
1249
1191
1251
1192
Deposit
Amount
998.90-
2 0 , 811. 00 -f\.we t>
54.00-
473.97-
13.68-
521. 00-
10.00-
2.13
Balance
1,476.14
22,287.14
22,233.14
21,759.17
21,745.49
21,224.49
21,214.49
21,216.62
Check No
1191
1192
1249*
missing
--- CHECK SUMMARY ---
Amount Reference Date
. 13.68 002053830 10/20
10.00 001014480 10/24
473.97 002061230
check numbers
Date
10/23
11/01
10/23
* Denotes
Check No
1250
1251
Amount Reference
54.00 002060610
521.00 002056880
/....,
11/20/06
Lioyd J Heffelfinger Jr
90 East Ridge Street
Carlisle PA 17013
Available Balance:
Collected balance:
Current balance:
Yesterday's bal:
Last stmt balance:
Avg collected bal:
Avg ledger balance:
Interest rate:
Stmt/Service chg/lnt cycle:
Automatic NSF fee:
Statement/Passbook code:
Deposit
21,206.62
21,206.62
21,206.62
21,206.62
21,216.62
21,208.76
21,208.76
.200000%
5
Yes
Statement
Waive ATM Foreign Fee (Y,N) ....... N
F1=Addl functions F2=Image
F5=History F6=Messages
Inquiry Page 01 of 11 12:22:50
CIF number: ROMACK H025748
Phone: (H) (717) 249-4024 Birth date:
(B) (999) 999-9999 1/12/1928
Tax ID number: 159-24-8641 Br#: 046
Account type: 50+ Interest Check
Account number: 146000479
Date last active:
Last Dep: 10/19/06
Date last overdrawn:
Date opened:
Date last statement:
Date last contact:
Closing balance:
Accrued interest:
Service charge:
SC Waive expiration:
Service charge code:
F3=Exit
F8=Maintenance
11/09/06
20,811. 00
0/00/00
7/08/05
11/05/06
7/08/05.
~>
1. 62
Yes
0/00/00
11
More. . .
F4=Sweep Inquiry
F24=More Keys
. Sovereign Bank
10-41l-IRl
P.O. Box 12646
Reading PA 19612-2646
For Inquiries Please Call: (877) 768-2265
INDIVIDUAL RETIREMENT ACCOUNT
Bank FIN 23-1237295
~umber
**********
[0, **********
12-31-06
Be in Statement Perl,Q~, 01-01-06
EndStatement Period 12-31-06
LLOYD JAMES HEFFELFINGER JR
445 W PENN ST
CARLISLE PA 17013-2235
1...111.,,111111...11,,11"1111..1.11.11..1.1..1'1111.1.1,1.11
3891-30.3
Page 1 of 1
Description
INTEREST
INTEREST
INTEREST
INTEREST
INTEREST
INTEREST
INTEREST
INTEREST
INTEREST
INTEREST
INTEREST
PAYOUT DISTRIBUTION
INTEREST
Date
01-31-06
02-28-06
03-31-06
04-30-06
05-31-06
06-30-06
07-31-06
08-31-06
09-30-06
10-31-06
11-30-06
12-27-06
12-31-06
Amount
8.81
7.97
8.85
8.58
8.88
8.61
8.92
8.94
8.67
8.98
8.70
-2,078.51
8.44
........11'7181
2.510
Balance
4,137.02
4,144.99
4,153.84
4,162.42
4,171.30
4,179.91
4,188.83
4,197.77
4,206.44
~ 412,b,15.42
4,224.12
2,145.61
2,154.05
Prior Cash Balance
Plus Credits
Plus Interest
Less Debits
New Cash Balance
Total Plan Value
2,154.05
2,154.05
0.00
0.00
0.00
FAIR MARKET VALUE OF PLAN AT THE END OF 2006 2,154.05
THE FAIR MARKET VALUE INFORMATION IS BEING FURNISHED TO THE
INTERNAL REVENUE SERVICE.
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Values as of the date of death for the IRA's listed on schedule G were obtained orally from the
respective companies.
Item 1 information was requested by fax from the Annuity Operations Department and the value was
obtained from a phone call to the Department at 1- 800926-17202.
Item 2 information was obtained from the Annuity Claims Department by phone call to 1-800-424-4990
Extension 311.