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HomeMy WebLinkAbout10-25-07 .....I 15056051058 REV.1500 EX (06-05) PA Department of Revenue *' Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT 611 01 oor(' Date of Birth 180-22-8275 01/20/2007 09/03/1926 Decedent's Last Name Suffix Decedent's First Name MI Wolfe Mrs Betty L (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI 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 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 Living 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 Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes Sandra A. Olley (717) 232-1831 Firm Name (If Applicable) REGISTER OF WILLS u:s1. ONLY J . First line of address r"'-:) I.... . 6 Louis Lane Second line of address C,) '.J -4 City or Post Office State ZIP Code DATE FILED -J Enola Pa 17025 Correspondent's e-mail address:solley@comcast.net Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to 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 preparer has any knowledge. RESPONSIBLE FOR FILING RETURN DATE 10/19/07 L..o VA.! L7't .A.I@/ SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ~ nor-J DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 .....J L 15056051058 . ~ 15056052059 REV-1500 EX Decedent's Name: Betty L Wolfe RECAPITULATION 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. Jointly 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 18. Amount of Line 14 taxable at collateral rate X .15 15. 16. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 L 180-22-8275 Decedent's Social Security Number 17. 18. 0.00 0.00 0.00 0.00 9,053.09 0.00 0.00 9,053.09 8,926.00 11,837.53 20,763.53 11,710.44 0.00 0.00 15056052059 ~ REV-;SOO EX Pt!ge 3 Decedent's Complete Address' File Numbllr . , DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER Betty L Wolfe 180-22-8275 STREET ADDRESS 6 Louis Lane CITY I STATE I ZIP Enola Pa 17025 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 0.00 Total Credits ( A + B + C ) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( 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. (5) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (5B) A. Enter the interest on the tax due. 0.00 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 [i] b. retain the right to designate who shall use the property transferred or its income; ............................................ D [i] c. retain a reversionary interest; or.......................................................................................................................... D [i] d. receive the promise for life of either payments, benefits or care? ...................................................................... D [i] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. D [i] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D [i] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ............... ..... .... ................................... .......................... ......................... ..... ..... D [i] 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 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 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)]. 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. oREV-1508 ~X+ (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Betty L Wolfe FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH Belco Credit Union Checking (S4 Acct # 754-240) 535.01 Harrisburg, Pa 17108 Savings (S1 Acct #754-240) Christmas Club (S2 Acct # 754-240) Joint Checking (S4 Acct # 754-250) 50% of 837.62 6,935.34 400.89 403 N 2nd Street PO Box 82 418.81 Joint Savings (S1 Acct # 754-250) 50% of 134.08 67.04 2 Clothing 500.00 3 Jewelry 150.00 4 Cash on Hand 46.00 Note 1 Property in Question (in the Will) was sold to Daughter Sandra Olley in August of 1984. All house hold Furniture and appliances have since been replaced by Sandra. Note 2 Auomobile in Question (in the Will) was disposed of 2 years prior to the demis of Betty. Since she could no Longer drive. TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 9,053.09 REGISTER OF WILLS CUMBERLAND County, Pennsylvania CERTIFICATE OF GRANT OF LETTERS No. 2007-00088 Esta te Of: BETTY L WOLFE PA No. 21-07-0088 (First, Middle, Last) Late Of: EAST PENNSBORO TOWNSHIP CUMBERLAND COUNTY Deceased Social Securi ty No: 180-22-8275 WHEREAS, on the 26th day of January 2007 an instrument dated August 2nd 1984 was admitted to probate as the last will of BETTY L WOLFE (First, Middle, Last) late of EAST PENNSBORO TOWNSHIP, CUMBERLAND County, who died on the 20th day of January 2007 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, GLENDA FARNER STRASBAUGH Register of wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: SANDRA A OLLEY who has duly qualified as EXECU TOR (RIX) and has agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYL VANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 26th day of January 2007. ..,. **NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) o ;i ~ ) j: Ii Ii I' II I LAST WILL AND TESTAMENT OF BETTY L. WOLFE I, BETTY L. WOLFE, widow woman, of Enola, East Pennsboro Town- ship, Cumberland County, Pennsylvania, being of sound and disposing Imind, memory and understanding, do hereby make, publish and declare this to be my, Last Will and Testament, hereby revo~ing any and all Wills and Codicils previously made by me at any time heretofore. FIRST: I hereby direct that my personal representative, hereinafter named, to pay all my just debts, funeral and testamenta y expenses as soon after my demise as maybe practicable. i SECOND: I hereby specifically bequeath ONE THOUSAND ($1,000.00) DOLLARS to my church, the Zion Lutheran Church of Enola. THIRD: BE IT KNOWN, that as of this same date, I have conveyed my residence known 'as 6 Louis Lane, Enola, Pennsylvania, o,.,~ my daughter, SANDRA A. OLLEY, reserving for myself a:~fe-E~ate y? 15 ~ ::1,'-; ;-:-:~ THEREFORE, upon my demi:~~~ si; c i t%6--- 1;) /:~$ ,.:; E')?; bequeath whatever household goods , furniture and appl-::b.@cesO'th~t-;1":'1 :'3 ~~ 'r{ ~ ..J 2'~ might own that are in said residence, to my daught~J;~SAND1{,A A;.,:;::U "'::~ --. ~-~ -'.- -. Ownership Interest therein. OLLEY. u'l o I ~', I. i -; .0-'..1 ~;;~ "l. FOURTH: BE IT KNOWN that on Dr about July 1983, I loaned money to my son, WA~NE, and his wife, MARY, to help them purchase a mobile home. Sould'I die before this debt has been paid in full, I hereby direct that the debt be cancelled as if payment had already been made ~n full. FURTHERMORE, I hereby bequeath to my son, WAYNEI L, demise. ! ! j I i lOLLEY, I I I ji 1\ Ii and his wife, MARY, whatever car(s) I own upon my I' ~ I ii Ii J! II I I FIFTH: All the rest, residue and remainder of my estate,l I hereby give, devise and be~ueath among my four (4) children, e~Ua~lY I j I and I per capita. A. B. C. D. BONNIE L. HOSTETtER~ DONALD R. OLLEY SANDRA A. OLLEY WAYNE L. OLLEY SIXTH: I hereby nominate, constitute and appoint my daughter, SANDRA A. OLLEY, as Executrix of this my, Last Will and Testament. In the event that SANDRA A. OLLEY should predecease me, fail to ~ualify, cease to act or for some reason is incapable of performing such task, I then nominate, constitute and appoint my daughter, BONNIE L. (nee: OLLEY) HOSTET~, as Executrix of this my, Last Will and Testament. ~ SEVENTH: None of the abovenamed persons shall be re~uire to post bond or surety in this or any other jurisdiction for faith- ful compliance of the office of Executrix. IN WITNESS WHEREOF, I hereunto set my hand and seal to this Last Will and Testament, the L day of 1.?7UA:I:. , 19 If my, ~/tJ~_ BETTY . WOLF]t/ (SEAL) The preceding instrument, consisting of this and one (1) other typewritten page, identified by the signature of the Testatrix, BETTY L. WOLFE, in the presence of us, who at her re~uest, who in of each other, have hereunto hereto. Iher presence, and in the presence subscribed our names as witnesses #-- '"' ~ RESIDING AT I" 1.Lu-",-~ RESIDING AT i ~ ):~~ ~ flv BELeo Community Credit Union L getting you tlwre (I STATEMENT OF ACCOUNT Page 1 MAIN OFFICE: 403 N. 2nd Street P.O. Box B2 Harrisburg, PA 1 71 0 B 3251 1 AT 0.308 1...111...111.....1.1.1.1...1.1...11..1.1.1.1.11....11..1.1..1 BETTY L WOLFE 6 LOUIS LN ENOLA PA 17025-2125 JOINT OWNERS STATEMENT PERIOD From To lOI PREVIOUS BALANCE ~ ~ SAVINGS 683534 ";103 * PREAUTHORIZED AUTO TRANSF 693534 0126 TRANSFER WITHIN SAME ACCO 480121 0126 TRANSFER/OTHER PRIME ACCT 461860 78803 0126 ET FINANCIAL TRANSACTION 461860 480121 0126 TRANSFER/OTHER PRIME ACCT 754250 212072 0131 DIVIDEND 2125 1 THE ANNUAL PERCENTAGE RATE IS 1. 00 THE ANNUAL PERCENTAGE YIELD IS 1. 00 THE ANNUAL PERCENTAGE YIELD EARNED IS 1. 00 1.00 070101 070131 1.00 D 5997.02 0131 NEW BALANCE 212581 0101 PREVIOUS BALANCE S2 ~ HOLIDAY ~ 30049 0103 * PREAUTHORIZED AUTO TRANSF 10000 40049 0131 DIVIDEND 33 40082 THE ANNUAL PERCENTAGE RATE IS 1. 00 THE ANNUAL PERCENTAGE YIELD IS 1. 00 THE ANNUAL PERCENTAGE YIELD EARNED IS 0.99 0.99 070101 070131 1. 00 D 394.03 0131 NEW BALANCE 40082 0101 PREVIOUS BALANCE S4 ~ CHECKING 113501 0103 * PREAUTHORIZED AUTO TRANSF 754250 -80000 33501 0108 PAYMENT VIA OFFICE/MAIL 20000 53501 0202 * DIRECT DEPOSIT 3031036030 86 00 139901 us TREASURY 303 SOC SEC 0131 NEW BALANCE 139901 **CONTINUED** TOTAL DIVIDEND YEAR- TO-DATE for all savings except IRA. Dividends shown, if $1 0 or over, wUl be ~orted to the Internal Revenue Service for this calendar year. . TOTAL FINANCE CHARGE YEAR- TO-DATE for all loans . NOTICE: See reverse side for important information. 0619183 BELCO . rI STATEMENT OF ACCOUNT Page 2 Community Credit Union L getting you there MAIN OFFICE: 403 N. 2nd Street P.O. Box 82 Harrisburg, PA 1 71 08 JOINT OWNERS BETTY L WOLFE STATEMENT PERIOD From To 0101 0126 0131 VISA LOAN BEGINNING BALANCE TRANSFER WITHIN SAME ACCO NEW BALANCE-PERIODIC RATE.030109% (RATE >> ANNUAL PERCENTAGE RATE 10.990% << ******* CREDIT LINE SUMMARY ******** ** CREDIT LINE 0.00 CREDIT 213413 00 00 0.00 TOTAL DIVIDEND YEAR- TO-DATE for all savings except IRA. Dividends shown, if $1 0 Dr over, will be reported to the Internal Revenue Service for this calendar year. 5.42 TOTAL FINANCE CHARGE YEAR- TO-DATE for all loans . 0.00 NOTICE: See reverse side for inportant infonnation. 0619184 BELeo Community Credft Union L getting you there II STATEMENT OF ACCOUNT Page 2 MAIN OFFICE: 403 N. 2nd Street P.O. Box B2 Harrisburg. PA 1 71 0 B JOINT OWNERS BETTY L WOLFE STATEMENT PERIOD From To 1201 PREVIOUS BALANCE ~ ~ SAVINGS 672955 1203 * PREAUTHORIZED AUTO TRANSF 682955 1231 DIVIDEND 683534 THE ANNUAL PERCENTAGE RATE IS 1. 00 THE ANNUAL PERCENTAGE YIELD IS 1. 00 THE ANNUAL PERCENTAGE YIELD EARNED IS 1. 00 1.00 061201 061231 1. 00 D 6823.09 1231 NEW BALANCE 683534 1201 PREVIOUS BALANCE ~ ~ HOLIDAY ~ 20024 1203 * PREAUTHORIZED AUTO TRANSF 10000 30024 1231 DIVIDEND 25 30049 THE ANNUAL PERCENTAGE RATE IS 1. 00 THE ANNUAL PERCENTAGE YIELD IS 1. 00 THE ANNUAL PERCENTAGE YIELD EARNED IS 1. 01 1. 01 061201 061231 1.00 D 293.78 1231 NEW BALANCE 30049 1201 PREVIOUS >>ALANCE ~ ~ CHECKING 97101 1203 * PREAUTHORIZED AUTO TRANSF 754250 -80000 17101 1214 PAYMENT VIA OFFICE/MAIL 20000 37101 1219 BELCO@NET TRANSFER -10000 27101 HTHLY PAYH'T 0103 * DIRECT DEPOSIT 3031036030 86 00 113501 us TREASURY 303 sac SEC 1231 NEW BALANCE 113501 TOTAL DIVIDEND YEAR- TO-DATE for all savings except IRA. Dividends shawn. if $1 0 or DYer. will be reported to the Inumal Revenue Service far this calendar year. "INDICATES EFFECTIVE DATE 64.48 TOTAL RNANCE CHARGE YEAR-TO-DATE far all loans . 259.75 NOTICE: See reverse side far important infonnation. 0701917 BELCO community Credit Union L getting you there II STATEMENT OF ACCOUNT Page 2 MAIN OFFICE: 403 N. 2nd Street P.O. Box B2 Harrisburg, PA 1 71 0 B BETTY WOLFE JOINT OWNERS SANDRA A. OLLEY STATEMENT PERIOD From To 0101 0126 VISA LOAN BEGINNING BALANCE BELCO@NET TRANSFER 8300 276349 268049 0126 0131 MTHLV PAVM'T TRANSFER/OTHER PRIME ACCT 754240 268049 NEW BALANCE-PERIODIC RATE.035589% (RATE IS ARIABL) >> ANNUAL PERCENTAGE RATE 12.990% << ******* CREDIT LINE SUMMARY ******** ** CREDIT LINE 0.00 CREDIT A AILABLE 00 00 0.00 TOTAL DIVIDEND YEAR- TO-DATE for all savings except IRA. Dividends shown, if $1 0 or over, will be reported to the Intimal Revenue Service for this calendar year. *INnU:ATES fFFFCTIVf DATE 0.09 TOTAL FINANCE CHARGE YEAR- TO-DATE for all loans. 0.00 NOTICE: See reverse side for important information. 0619187 ~!~2n (I L getting you there STATEMENT OF ACCOUNT Page 1 MAIN OFFICE: 403 N. 2nd Street P.O. Box 82 Harrisburg. PA 1 71 08 3252 1 AT 0.308 1...111...111.....1.1.1.1...1.1...11..1.1.1.1.11....11..1.1..1 BETTY WOLFE 6 LOUIS LN ENOLA PA 17025-2125 JOINT OWNERS SANDRA A. OLLEY STATEMENT PERIOD From To 0101 0103 * 0103 * 0105 PREVIOUS BALANCE S4 ~ CHECKING PREAUTHORIZED AUTO TRANSF 754240 PREAUTHORIZED AUTO TRANSF 461860 ACH DRAFT 1734 60000 -43004 -10000 79946 139946 96942 86942 * CHASE CHECK PYHT- TRACE # 021000027665881 DRAFT PAID 1735 ACH DRAFT 1732 CAPITAL ONE ARC CHECK PYHT- TRACE # 051405511972629 DRAFT PAID DRAFT PAID PREAUTHORIZED AUTO TRANSF DRAFT PAID BELCO@NET MBR TO MBR TO PAY BILLS TRANSFER WITHIN SAME ACCO NEW BALANCE -12606 -6000 74336 68336 0105 0108 0108 0112 0112 0116 0126 1731 1736 461860 1733 461860 -4032 -5760 30 00 -4782 -80000 64304 58544 885 4 83762 3762 0126 0131 -3762 00 00 ________________________ CLEARED DRAF SUMMA Y ------- 1731 **** 1733 **** 1735 1736 ------------------------------------------------------ **CONTINUED** TOTAL DIVIDEND YEAR - TO-DATE for all savings except IRA. Dividends shown. if $1 0 Dr over. will be reported to the Internal Revenue Service for this calendar vear. TOTAL FINANCE CHARGE YEAR-TO-DATE for all loans . NOTICE: See reverse side for inportant information. 0619186 .1..nl"AT~(! ~~~~"TI\I~ nAT~ !~~~2n . L getting you there STATEMENT OF ACCOUNT Page 1 MAIN OFFICE: 403 N. 2nd Stnlet P.O. Box 82 Harrisburg. PA 17108 4675 1 AT 0.308 1...111...111.....1.1.1.1...1.1...11..1.1.1.1.11....11..1.1..1 BETTY WOLFE 6 LOUIS LN ENOLA PA 17025-2125 JOINT OWNERS SANDRA A. OLLEY STATEMENT PERIOD From To 0201 0228 PREVIOUS BALANCE ~ ~ SAVINGS NEW BALANCE CLOSED: 012607 00 00 TOTAL DIVIDEND YEAR- TO-DATE for all savings except IRA. Dividends shown. if $ t 0 or over. will be reported to the Internal Revenue Service for this calendar vear. *INDICATES EFFECTIVE DATE 0.09 TOTAL FINANCE CHARGE YEAR-TO-DATE for all loans . 0.00 NOTICE: See reverse side for important information. 0604675 t:lEV-1511 5.X+ (12-99). SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF Betty L Wolfe Debts of decedent must be reported on Schedule I. ITEM NUMBER A. FUNERAL EXPENSES: Openning Grave Vault Head Stone Casket Death Certificates Newspaper, Clergy, Organist, Sexton, Flowers Professional Services, Equipment, Automotive 1. 2 3 4 5 6 7 B. ADMINISTRATIVE COSTS: 1 . Personal Representative's Commissions Name of Personal Representative(s) DESCRIPTION AMOUNT Rolling Green Memorial Cemetary Richardsons Funeral Home Rolling Green Memorial Cemetary Richardsons Funeral Home Richardsons Funeral Home Richardsons Funeral Home Richardsons Funeral Home 1,195.00 695.00 1,671.00 1,197.00 150.00 729.00 3,190.00 Street Address Social Security Number(s)/EIN Number of Personal Representative(s) City Year(s) Commission Paid: 2. Attorney Fees ,State Zip Claimant 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Street Address City Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. State Zip 99.00 8,926.00 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Cumberland County - Register Of wills One Courthouse Square Carlisled PA 17013 /- 1ff3'?f-tn1-o37/ Recetpt Date: Recelpt Time: Receipt No.: 1/26/2007 13:44:30 1047131 WOLFE BETTY L Estate File No. : Paid By Remarks: 2007-00088 OLLEY SANDRA A AJW ------------------------ Receipt Distribution ------------------------ Payment Amount Payee Name - Fee/Tax Description PETITION LTRS TEST WILL SHORT CERTIFICATE JCP FEE AUTOMATION FEE Check# 2612 Total Received......... 45.00 15.00 24.00 10.00 5.00 ---------------- $99.00 $99.00 CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN BUREAU OF RECEIPTS & CNTR M.D CUMBERLAND COUNTY GENERAL FUN --...~ ROLLIHG GREEH CEtETERV 1811 CARLISLE ROAD C~ 17011 0u6911572 TERHIIIAL 10: '~:001611996 t{RCHAHT II: ~~'287590006014 ~f.? 91/98 SALE INVOICE: 947m BAlCH: 800047 TIll:: 15:32 DAlE: JAM 22, 87" AUTH HO: 624659 SQ: 082 TOTAL $1195.99 ROLLING GREEN CEMETERY COMPANY 1811 CARLISLE RD CAMP HILL, PA 17011 '717 -761.,4055 DATE ! .... i (~~) (~~?:'0 ~)c~ ACCVCONT'N~ ( RECEIVED FRltM~~-;t;::::. ',......"".,;:.0. l \ \. \ [ \~~"'/'J"I\ if" '~V-'_' """-..(-""('.::,\ C', ..... ....~-.... DESCRIPTION .." ~>\,~::l_""..../ (v\ (, if".. . "" \ I BY . -~-......."..." ", i. td-\/\. tOot.),.; 'C'" o CHECK OCASH}K1.CREDT CARD TOTAL I J C):;'" OU THANK YOU ) ., ';::1 'J ;,j .i .:<! ---...... f ~.>"} i< GEN 8001 (5/04) N"'- '~R~ :r co , ~il~ ", Ir z:s:~ "'.....' Sin; n ;:' , ~c:s :t .... .", >>16: ;IIi....- z=: j :!i5= ...,~: ~......= , :::;iii n g~-. o 'S"'''' ." : .....=j; '<: ;II:I:za. i ~~~ r ~=s~ , ~ ACCOUNT NO. ACCT/CONTR. NO. .-,.-'" .'..~..-... _.~- CK #(!-:C. APPROVAL~ "'-----.--. .--.- -" Vr .. ....'>.,.. ,~ C.C. TYPE : '_.' '... -I o -I >> r- ~g~(.I):I:::; .~;;;;:;%>..CD ="~r-N- .....~-",Q) -= " :::::~ UI ~...... '" ~ = = = Q'l = - ... ... ~,~ .. :Z:;:::=:~.... i!!5~~=,"... " .. .. " Q) .... - ......---..... ....~............ 0...... CEI....... iUlc...a"OCD '-O~~Q:Il !~ ~ai :~ _r- -... ..- -- .... .., == ........ ........ ........ ....- ........ .......... ......... ~......~ ..-_r- -... -:z: e;~cn r->>gl;l r-r-m ~ "'m "'QI!!:Z: -....... -...:it ~=;;: - ... -<: .. .. ... ... '" UI I = = 624 No.0015425 :j i '\j '~ i :j J INDIVIDUAL CASH RECEIPT~~i j iO'lu:oL $ ~~;.= (<..~, '.'t CiS) $ I ..... --\1 ,/ l (~~..,C) t() ~:::::;"'~'f ~,O .":1 7 /iC'''~ .')0., I // ~)~ C:(.~; j --:";1 6r-~ $ i j :j :.t 'I TRUST NO. G/L ACCT. $ , .:;1 . ~':i ROWNG GREEN CEMETERY 1111 CAIUU" · CAMP II1II" fA non . 1717) 761-4l1li N2 803806 THIS AGREEMENT PROVIDES FOR ENDOWMENT CARE CEMETERY INTERMENT RIGHTS, MERCHANDISE AND SERVICES PURCHASEJSECURITY AGREEMENT Date: f-~..:l.. 0'1 624 No. I ()l lP64 The under.lgned, referred to as "Purcha.er", hereby agrees to purcha.e the Interment Rights, Merchandise and Services de.cribed herein, .ubject to acceptanc and approval of the above named cemetery, hereinafter referred to a. "Seller". PURCHASE TELEPHONE: '7 1'1- 7_ '{:J -NO 1f.e, ADDRESS ..... ZIp Description of Interment Rights: Issue Certificate of Interment Rights to: Address. INTERMENT RIGHTS MERCHANDISE AND SERVICES Interment Rights (including Endowment Care of$ - ) 5 ................................................................... 00 Interment Fees .... .......... ....... ....... ............. ......................... .......... ............. .................................................................... I I 'is MemorialiZ\tion - Type ............................ Size Design - ........................... Memorial Base - Type ............................ - Size Color ........................... Memorial Endowment Care of .................................................................................................................................. - Memoriallnstallation/Inspection Fee ................................. .... ... ................................................................................ - Outer Burial Container - Material ............................ "- Model Supplier ........................... Cremation Charge ...... ................................ ............................. .............................................. ....................................... - Urn - Type Size ........................... - F1owerVase-Type ............................ - Nameplate..................................................................................................................................................................... -- Lettering - ....................................................................................................................................................................... Other -- ........................... Other - ............................ Sales Tax r ..................................................................................................................................................................... J!-o TOTAL CASH PRICE ............................................................................................................................ -It CJf" LESS: ......~...v..,~";;;.~........................................... Down Payment Cash $ } }0 ?'.60 Other Credit - 0 - ................................................................................................ Total Down Payment ............................................................................................................................. 5< It fs, 0--' > UNPAID BALANCE OF CASH PRICE $" -0 - ............................................................................................. REMARKS: ~ -- CIIl ..... ZIp TERMS-CASH SALE The Total Cash Price is due and payable as of the date of this Agreement. A delinquency charge of - percent will be assessed monthly on any balance not paid within 30 days of the date of this Agreement. If less than full payment is received, Seller shall deduct the accrued delinquency charge from the amount received, and credit the remainder of the payment received to the Unpaid Balance. SECURITY INTEREST: Seller (or its assigns) will have a .ecurity interest in the Interment Rights and Merchandise being purchased as described above. Seller will retain title to said Interment Rights and Merchandise until the Total Cash Price, together with any delinquency charges thereon have been paid by Purchaser to Seller. Purchaser agrees that all rights conveyed under this Agreement are subject to, and Purchaser agrees to at all times comply with, the present (and as may be hereafter adopted amended or altered) Rules, Regulations and Bylaws of Seller, which are available for examination in Seller's office. NOTICE: BY SIGNING THIS AGREEMENT, PURCHASER IS AGREEING THAT ANY CLAIM PURCHASER MAY HAVE AGAINST THE SELLER SHALL BE RESOLVED BY ARBITRATION AND PURCHASER IS GIVING UP HISIHER RIGHT TO A COURT OR JURY TRIAL AS WELL AS IUSIHER RIGHT OF APPEAL. Signed this Z. 'L. day of 5 fTl.I Nh..~ , 20~ ikPurchas~ ,,4/.,..~ ~~AccePtedb'. ,^D ~qt /tf - ~G/ -.5 0,/& Coonselo ~ RelatlouJalp SCI PENNSYt VANIA FUNERAL SERVICES, INC. dba ROlliNG GREEN CEMETBlY 1111 c:AIUI&I Ill. . CNI# II1II. 'A IJOII NOTICE: SEE OTHER SIDE FOR ADDmONAL TERMS AND CONDITIONS WHI -61 FORM 220PA. REV (04104) WHITE - CEMETERY COPY YE1l.QW - APPROVED CUSTOMER COPY PINK - CUSTOMER COpy lOLLING GREEN CEMETtilY tiU '~Il.e lID. · CAMP...... M IJlII · \1I1}761-4U6 :,J~ 803873 THIS AGREEMENT PROVIDES FOR ENDOWMENT CARE CEMETERY INTERMENT RIGHTS, MERCHANDISE AND SERVICES PURCHASE/SECURITY AGREEMENT Date:':!,. '-~ lr' . n L-- 624 No. I \)'1 CD t,' I The undersigned, referred to as "Purchaser", hereby agrees to purchase the Interment Rights, Merchandise and Services described herein, subject to acceptance and approval of the above named cemetery, hereinafter referred to as "Seller". PURCHASER ~_,C\ I-A- ~ r>.- ~\ ADDRESS (, \. '<I'" ~. (. r'\~ _ Street Name of Deceased-[~t' \--\ ~. I \ _ ' - 'c Description of Interment Rights: ~~ - Issue Certificate of Interment Rights to: Address D\ \r~ I (- \ {~Ii\ ( \"'- "" \ c, ---I ~ l J.') (~; \ \~> \L:Y~C - 1..\ \ r\(),;L5 City i) \--1 rj'? ~. ("/ ' TELEPHONE: I' .' ,,"\ .-J..' {, () Ie State Zip Street City State Zip INTERMENT RIGHTS. MERCHANDISE AND SERVICES Interment Rights (including Endowment Care of$ -' ) ................................................................... $ Interment Fees .............. ........ ........ ......... ............. .......... ....... .......... .......... ........ ... ....... ....... ........ ............ .................. ..... Memorialization - Type C:< p, f \ l . ~ '0' .~ ('~ ............................ Size .-{ L\. y.. \ ~). , Design ........................... Memorial Base - Type ( -;. f ;,... r"\ \ -\ 'c. ............................ Size (ell X I,lo Color ...s\ c< \.c. ........................... Memorial Endowment Care of .................................................................................................................................. Memorial InstallationlInspection Fee ............... .................... ................ .................. ...... .......... ...... ............................. Outer Burial Container - Material ............................ .,~ -, 'J. '-'""\ ".t"." ,^,...J -'. _ ''''' , l-~' C) \ ..... [;'0 t dO to :lL.~ .. C6 Model Supplier ........................... Cremation Charge ........................................................................................................................................................ Urn - Type Size ........................... Flower Vase- Type ............................ Nameplate ............................................................................................................................... ...................................... Lettering..... ...................... ...... .1"-.,. ......... ........ ......... ..................... ....... .......... ...... ....... ........... ...... .... ............................ Other f~ r:./ f" .c,,";, \ ,,,,,- .,0\ .\ ... '-=- ........................... Other q ~~ (:;0 Sales Tax ................ ........ .......... ..................... ........ ...... ... ..... ...... ... ........ ......... ........ ...... ........ ......... ........... ........ ....... ...... TOTALCASHPRICE............................................................................................................................ \~ ~'\ \ .00 LESS: ..~, CII'H ,o'lll.o,r"", $ II '\ I .,OOOD Down Payment Cash .~t.:J...........y..............::>.!...c..t..,;..~J.................................. ~ . fJ{ichardson guneralrJ{ome, &nc. STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED Chargts are only for those items that you selected or that are required. If we are required by law or by a cemetery or crematory to use any items, we will explain in writing below. If you selected a funeral that may require embalming, such as a funeral with viewing, you may have to pay for embalming. You do not have to pay for embalming you did not approve if y~lected arrangements such as a direct cremation or immediate burial. If we charged for embalming, we will explain why below. For the Service of e #7 L.. ..?t.... D , ~ f!'> Date of Death / / 2 C'~/ .2. 0 0 ~7 Charge to: ,_S"uAr::I/C4.. ~. ~./~~ (;;.L '(,1" ~I ,,~"! ~_.~.. ..e-A'iJ ~ fi /7<4.;z j- Name ddress Cuy State A. CHARGE FOR SERVICES SELECTED: Other clothing 1. PROFESSIONAL SERVICES Services of Funeral Director/Staff. . .. S_ Embalming ...................... S_ Other preparation of body - ...............................S_ SUB.TOTAL OF PROFESSIONAL SERViCES......... Al S_ 2. FACILITIES AND SERVICES Use of facilities and services for viewing (Visitation/Wake)......... S_ Use of facilities and services for funeral ceremony . . . . . . . . . . .. S_ Use of facilities and services for Memorial Service ............... S_ Use of equipment and services for graveside service............. S_ Other use of facilities ...............................S_ SUB.TOTAL OF FACILlTIES/EQUlPMENT........... A2 S_ 3. AUTOMOTIVE EQUIPMENT Vehicle to transfer remains to Funeral Home. Local. . . . . . . . . . . . . . . . . . . . . . . . . . . S_ Hearse (Casket Coach) Local........ ............... .... S_ Limousine ,Local........................... S~ Family car Local........................... S_ Flower car or floral disposition Local........................... S_ Lead car/clergy car Local........................... S_ Car for pallbearers Local........................... S_ An. ^, .,.'\'t'..,,.. tMnennrt~tinn I 29 SOUTH ENOLA DRIVE ENOLA, PA 17025;:/. 730 (717) 732"()587 0 -I . I MICHAEL G. MUR AY SUPERVISOR S_ S_ Cremation urn . . . . . . . . . . . . . . . . . .. S_ (Description) ,) , OTHER S_ S_ S_ TOTAL MERCHANDISE SELECTED.................. B S_ C. SPECIAL CHARGES: Forwarding of remains to S_ <AEuJ1!:ra,1 Home) Receivipg of remainS from S_ (Funeral Home) Immediate Burial. . . . . . . . . . . . . . . .. S_ Direct Cremation. . . . . . . . . . . . . . . .. S_ S_ SUB.TOTAL OF SPECIAL CHARGES................ C S_ D. CASH ADVANCED . /. Opening Grave .................. S_ Cemetery Equipment. . . . . . . . . . . . .. S_ Lot and Deed.... ............. ... S_ Newspaper Notices-Local......... S~. c, .., Newspaper Notices-Out.of-town. . .. S_ Telephone & Telegrams........... S_ Airfare......................... S_ Clergy/Mass Offering.............. ~II)C. (',i ~ Pallbearers. . . . . . . . . . . . . . . . . . . . .. S_ o Certified Copies of the Death . . Certificate.. . .. .. .. .. . .. . . .. . ... S/ ')C ..;J '" Police Escort. . . . . . . . . . . . . . . . . . .. S_ Flowers ........................ s,~ ~.I...' Vault Service Charge. . . . . . . . . . . . .. S_ S_ S~O;:i"" S/"." . C;i.... S_ S_ (0'"7 ' ,.) , ,,'''' ;r 6.'()v.2;(....<I) :/'~' .,. . I"- ,-"",.tl{_t' b <'1 tREV-1512 E~ (12-03) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER ESTATE OF Betty L Wolfe Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. BJ's Joint Credit Card 5417127210349046 $3,685.61 1,842.80 Discover Joint Credit Card 6011002697502011 $3,830.44 1,915.22 Chase Joint Credit Card 5188635200652788 $2,993.29 1,496.64 Lowes Joint Credit Card 82220390715769 $847.63 423.82 Bank of America Joint Credit Card 4888607008985351 $2,591.55 1,295.78 Belco Joint Visa Credit Card 754250 Visa $2,680.49 1,340.24 Belco Personal Credit Card 754240 Visa 2,134.13 GM Personal Credit Card 5437000416403121 388.90 Zion Luthern Church (as stated in her will) 1,000.00 2 3 4 5 6 7 8 9 11,837.53 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) . . ~ Oponing/Closing Date: Payment Due Date: Minimum Payment Due: 01/15/07 - 02114/07 03111/07 $99.00 MASTERCARD ACCOUNT SUMMARY Account Number: 5417 1'272 10349046 Previous Balance $3,723.91 Total Credit Line $5,800 Payment, Credits -$101.00 Available Credit $2,114 Finance Charges __...+$Q2.IO . Cash Access Line $5,800 New Balance ( $3,685.61' ";,Available for Cash $2,114 -~_..----- L~ . J.U./ 0 '7 pL" 1.A-- 'G.Lllc y 0.J!.~ OJ- CUSTOMER SERVICE In U.S. 1-800-224-2984 Espanol 1-888-446-3308 TDD 1-800-955-8060 Pay by phone 1-800-436-7958 Outside U.S. call collect 1-302-594-8200 ACCOUNT INQUIRIES P.O. Box 15298 Wilmington, DE 19850-5298 PAYMENT ADDRESS PO. Box 15153 Wilmington, DE 19886-5153 VISIT US AT: www.chase.comlcreditcards Earn up to $500 every year redeemable at BJ's. e.4~~e.lJ~I<S.B~WARPS ~!JMMARY._______.._.____ Previous rewards balance $13.05 Rewards earned on partner purchases at 1.5% $0.00' , Remaining balance $13.05 Total earned this year $0.00 TRANSACTIONS Trans Date Reference Number Merchant Name or Transaction Description Amount Credit Debit 01/27 10270270206044207352114 Payment Thank You Electronic Chk $101.00 FINANCE CHARGES Category Purchases Cash advances Daily Periodic Rate Corresp. 31 days in cycle APR .05477% 19.99% .05477% 19.99% Average Daily Balance $3,692.45 $0.00 Finance Charge Due To Periodic Rate $62.70 $0.00 Total finance charges Transaction Accumulated Fee Fin Charge $0.00 $0.00 $0.00 $0.00 FINANCE CHARGES $62.70 $0.00 $62.70 Effective Annual Percentage Rate (APR): 19.99% Please see Information About Your Acoount section for balanoe oomputation method, graoe period, and other important information. The Corresponding APR is the rate of interest you pay when you oarry a balance on any transaotion category. The Effective APR represents your total finanoe oharges - including transaotion fees such as cash advanoe and balance transfer fees - expressed as a percentage. IMPORT ANT NEWS Enjoy low web rates, special offers and a discount too when you use your Chase/Hertz disoount code CDP# 374210 at hertz.com. EXCLUSIVE OFFER! Get all 40 Uncirculated Statehood quarters from 1999-2006 for just $19.95. You'll SAVE 69% off regular prices! Hurry - this offer ends on March 31, 2007! To order now, go to: LittletonCoin.comlQuarters Why pay a higher rate with other cards, when you may be able to consolidate your balances and save on interest at the same time? Please call the Balance Transfer Hotline at 1-800-945-2014 to see if you qualify today! X 0000001 FIS33335 C 3 Page 1 of 3 000 N Z 14 07102114 06218 MA MA 14382 04510000030661438201 ., ~ - - - - == - - iCashback Bonus" - !!iii5 iiii Cashbac::k Bonu. Anniversary Date: July 4 - -- How Can We Help You? ii!!ii ... Plea.. haw your Discovw Card available. - Manage your account online at Discovwcard.com Customer Service: 1-800.DISCOVER (1-800.347-2683) latinum Card Account Summary ar em r since 1986 Closing Date: February 4, 2007 poge 1 of 3 Account Number 6011 002697502011 Previous Balance $3,850.80 Payment Due Date March 3, 2007 Payments And Credits 76.00 Minimum Payment Due $76.00 Purchases 0.00 Credit Limit $13,300.00 Cash Advances 0.00 Credit Available $9,.469.00 Balance Transfers 0.00 Cash Credit Limit $6,700.00 Finance Olar s .64 Cash Credit Available $6,700.00 New Balance $3,830.44 You may be able to avoid Periodic Finance Charges, reverse side for details. fl ~ I J...; full Opening Cashback Bonus Balance New Cashback Bonus Earned $ + , , .72 0.00 11.72 0.00 Cashback Bonus Balance Available 10 Redeem $ $ For kcount Inquiries, wri!. to us at: Discover Platinum Card, PO Box 309.43 Salt lake City, UT 84130 TDD !Telecommunications Device for the Dea~: For assistance, see reverse side. Transactions Payments ond Credits $0 Fraud Uability Guarantee Use y"ur Discover Card with confidence. Trans. Post Date Date Jan 27 Jon 27 PAYMENT. THANK YOU $ -76.00 Information For You . :: U.. your Discovw(R) Card to make a $100 donation to Th. Statue of Liberty-Ellis Island Foundation, Inc. and you can have the name of someone you care about engraved on The American Immigrant Wall of Honor(R), built to celebrate freedom and commemorate American Dreams. For more information log on to Discovercard.com ... 0> ... "" <0 Finance Charge Summary Balance Tran_ offer for current bUling period: Daily Periodic Rate: 0.013.42%; corresponding ANNUAl PERCENTAGE RATE: 4.90%. Rate is subject to the terms of the offer including expiration. Nominal ANNUAL ANNUAL PERCENTAGE PERCENTAGE RATES RATES Average Daily ~ current billing period: 31 days Purchases $3855.70 0.04655% 16.99% F 16.99% Cash Advances $0 0.06025% 21.99% F 21.99% The rates that apply to your Account are either Axed (F) or they may vary (V) as noted above. Daily Periodic Rates Periodic FINANCE CHARGES Transaction Fee FINANCE CHARGES $55.64 $0 none $0 It~.. DISC.VEI' ~ ~ CHASE 0 Opening/Closing Date: Payment Due Date: Minimum Payment Due: 01/05107 - 02104/07 03/01/07 $82.00 MASTERCARD ACCOUNT SUMMARY Account Number: 5188635200652788 Previous Balance Payment, Credits Finance Charges New Balance $14,700 $11,706 $2,940 $2,940 $3,059.14 Total Credit Line -$117.95 Available Credit ~~ash Access Line ~ .vailable for Cash ~ i; :~f CUSTOMER SERVICE In U.S. 1-800-945-2000 Espanol 1-888-446-3308 TDD 1-800-955-8060 Pay by phone 1-800-436-7958 Outside U.S. call collect 1-302-594-8200 ACCOUNT INQUIRIES P.O. Box 15298 Wilmington, DE 19850-5298 PAYMENT ADDRESS P.O. Box 15153 Wilmington, DE 19886-5153 VISIT US AT: www.chase.comlcreditcards CHASEJ)EBft;~I~ABP BEWA8.PS ~UMMAB'L. Previous balance Rebates earned from purchases Total remaining rebates $0.00 -$0.35 -$0.35 For questions about your account please call Cardmember Services at 1-800-945-2000. $0.00 rebates to expire on statement date in With PerfectCard, earn a 3% rebate on eligible gas purchases and a 1% rebate on all other purchases. Rebates are automatically credited to your account. See Program terms for details. TRANSACTIONS Trans Date Reference Number Merchant Name or Transaction Description Amount Credit Debit 01/09 55432867009000332284400 BAC-BACK IN THE SADDLE 800-435-3633 CO $34.95 61/27 loifo27020604820735219S-Payment ThanrV ou 'Electronic Ctik----------~--.__.----.--83.00-~ ..- FINANCE CHARGES Category Purchases Cash advances Daily Periodic Rate Corresp. 31 days in cycle APR V .05546% 20.24% V .06642% 24.24% Average Daily Balance $3,029.91 $0.00 Finance Charge Due To Periodic Rate $52.10 $0.00 Total finance charges Transaction Accumulated Fee Fin Charge $0.00 $0.00 $0.00 $0.00 FINANCE CHARGES $52.10 $0.00 $52.10 Effective Annual Percentage Rate (APR): 20.24% Please see Information About Your Account section for balance computation method, grace period, and other important information. The Corresponding APR is the rate of interest you pay when you carry a balance on any transaction category. The Effective APR represents your total finance charges - including transaction fees such as cash advance and balance transfer fees - expressed as a percentage. IMPORT ANT NEWS Enjoy low web rates, special offers and a discount too when you use your Chase/Hertz discount code CDP# 374210 at hertz.com. Visit www.chase.comlcreditcards to manage your account online. You can sign up for em ail alerts and paperless statements, check your account balance and pay your bill. Get more with your Chase PerfectCard! X 0000001 FIS33335 D 6 000 N Z 04 07/02/04 Page 1 of 3 05686 MA MA 80584 0351 0000060438058401 .. .. LOWE.S EIIlng"''' ceI1IIIClI..lD your ~'. 8lore lD rwceIve.. ..-.1 oller. Ao........' Pi.... _n 1111. bar cado .nd ro1urn ..rtIl_ II> a_r. For 12 Months If paid in full within 12 months. IIII111 On all purchases at $299 or more made on your lowe's Consumer Credit Card Feb ruary 7 through February 19, 2007. 4 0 0 0 0 1 0 7 1 8 7 8 "ApplieS to a singlMCeipl, in-slore purchase of $299 or more made FeblU8lY 7lhrough FebRJalY 19, 2007 on a Lowe's GonslJller Gred~ eM! accollll No I1IOftif paymanlll will be required and no finance charges I'otl be assessed on !his prOIOO plllChase K you pay lIleloDowing iI1lull wh 12 months: (1) 1he promo purchas8 amount, alll(2) any ~ optional c:redlt Insuranc:e'debt cancelallon charges. 0 you do not, IlnanCIl charges v.1II be assessed on the promo purcl1ase amount from 1118 datB of pun:hasll and monIh~ JlIlYI1l8~ v.il be required. SIaOOard aa:ountlenns apply 10 non-pnroo pun:has8s. Please S8ll your cr9dil wd aoreefll8lll (as mrd8d) loryourstlllclarll'larms. Ofter Is subject to credO approval. Excludls Business Credit Accounts an~ Lowl's Prlted Card Accounts. @ z007 by l1Me~.}JI rights reserved. Lowe~ and the gable design are registered 1rademarks of LF, Lie. Lowe's Account Statement Aooount Number: 82220390715769 Account Holder: SANDRA A OLLEY Billing Date: 01/28/07 Payment Due Date: 02123/07 '1E1~a..:ANCe$IJMMA,FlY C> Plan PreviOUS - payments +/- FINANCE + +/- Debt Cancellation, = New Minimum .bIlL Balanoe & Credits CHARGE rnetl Purchases Insurance & Adlustments Balance Payment REG $803.11 $0.00 $14.52 $0.00 $46.00 TOTAL: $803.11 $0.00 14.52 $0.00 $46.00 - - - - - - - !!!! - iiii ~ - - - - - !!!! Tran Date 01/25 01/28 ...FJ~~,qI;Ptl'~~~~~~MM~R... CorresjlondlnU.- ANNUAL Days This FINANCE Balance PERCENTAGE RATE Billing Period CHARGE..M!!!!!!!!... 21.00% 31 $14.52 2D 15.48% 31 $0.00 2D Total Periodic FINANCE CHARGE: $14.52 - Plan Tvpe REG BIG Balance Subject To Finanoe Charqe $813.95 $0.00 Dally Periodic Rate .05754 % .04242 % - - - - - iii !!!! = - ...CARbl't()I.;PI;~'.flI~~..~I,~~~~~~~~i .................................-...........-............--.... .......-.............-...................-...-.........-.........'.-, .........-.........-.-.............-.........-.........---.....,. .......-.-...........-...............................-.-....... .....-.-........................-........-............... .-....-.................................-....... .....n........_._........,...._....... .. ....--_.......................... ............,...-..'. = YOUR ACCOUNT HAS 2 PAYMENTS DUE. PLEASE MAIL THE MINIMUM PAYMENT DUE TODAY. PLEASE DISREGARD IF MINIMUM PAYMENT DUE HAS ALREADY BEEN MADE. Please Note: When oontacting the Lowe's Credit Center, you must be listed as an account owner to obtain information about the aocount. We oannot disclose information to authorized users or third parties. Monitor your aocount 2417. Enroll in free eServicing at www.lowescredit.com and take advantage of the easy way to: view recent transactions, oheck your balance, update personal information and much more. CUSTOMER SERVICE: For account information oaIl1-800-444-1408 NOTICE: PLEASE SEE REVERSE SIDE FOR BilLING RIGHTS AND IMPORTANT INFORMATION. PAYMENT DUE BY 5 P.M. ON THE DUE DATE. We may convert your payment into an electronic debit. See reverse for details. 7009 0002 9WD 2 7 28 070128 D Page 1 of 2 9294 0010 ""76 24596 .. " . Prepared for: f;'~\ ~.G~ ,~\V- \\ t.,,}Jf". ... ~""j . \ f'~;~~ BankOf~erica~ . I SANDRA A OLLEY BEllY L WOLFE 4888 6070 0898 5351 February 2007 Statement Credit Une: $15,100.00 Cash or Credit Available: $12,508.45 Summary of Transactions Previous Balance Payments and Credits Cash Advances Purchases and Adjustments Periodic Rate Finance Charges Transaction Fee Finance Char New Balance Total +. + + $2,621.78 $65.00 $0.00 $0.00 $34.77. Billing Cycle and Payment Information Days in Billing Cycle 29 Closing Date 02107/07 Payment Due Date .c.urr~ntPIlYlTl8l1t.Due Past Due Amount Total Minimum Payment Due + 03/03/07 $60.00 .$0.00 Posting Transaction Date Reference Number Account Number Cate 0 Amount Pa ments and Credits Finance C./large Schedule. "._. . Category Cash Advances A. Balance Transfers, Checks B. ATM, Bank C. Purchases Annual Percentage Rate for this Billing Period: (Includes Periodic Rate Finance Charges ,and Transaction Fee Finance Charges.) . Periodic Rate May Vary Periodic Rate Correspondmg Annual Percentage Rate Balance Subject to Finance Charge 0.045863% DL Y . 0.066410% DLY* 0.045863% DLY' 16.74% 24.24% 16.74% $0.00 $0.00 $2,613.97 16.74% Important Information About Your Account DON'T LET UNEXPECTED EVENTS AFFECT YOUR HARD EARNED CREDIT. TO PROTECT YOUR ACCOUNT, CALL 1-888-668-6938 TODAY. PAY YOUR BILL QUICKLY WITH THE PAY BY PHONE SERVICE. CALL 1-866-297-9258. MAKE BUDGETING AND TAX PREPARATION EASIER WITH THE 2006 YEAR-END SUMMARY. ORDER THIS DETAILED SPENDING SUMMARY FOR $4.95 BY CALLING 1-866-491-1141 TODAY. II \ GM Card Account Number Total Credit limit Total Cash Advance limit Available Credit Available Cash Advance # Days this Billing Cycle Page 5437000416403121 $10,000 $10,000 $9,611 $9,611 30 1 of 1 ---- - = Customer Center - 1-800-947-1000 PO BOX 80082 = Salinas, CA === 93912-0082 - - Payment Address: Cardmember Svcs PO BOX 37281 BALTIMORE MD 21297-3281 Current Payment Due. "'See reverse side for an explanation of these amounts - Visit us at www.gmcard.com - - ---- - 01-01 004082/BM BGA 1 ---- ~ === - - - - - - === 01/28 01/29 PAYMENT - THANK YOU $15.00 CR 2012807 A025991241263301 - - - - === Previous Balance _ Payments and Other CredIts + Purchases, Cash Advances, + Finance Charges I = New Balance Fees and Other Debits $397.59 $1500 $0.00 $6.31 $388.90 - ~ Purchases Cash Advances Average Daily Daily Periodic Nominal Annual Finance Cash Advance/ !!!m!ID 8alance Rate Percllntaae Rate Charae TIClII::.d.f,,;OOII Ft1dS Percentaae Rate $395.66 0.05315% 19.40% $6.31 $0.00 19 400% $0.00 0.00000% 23.65% $0.00 $0.00 0.000% ---- ~ '::!!:;"':':i:i:Ul::::::::::Eld!nr:'lii:amuOi!i'::i Previous Earnings EarOlngs Received Additional Earnmgs Earnings Adjustments Current Penod Earnings $13574 $0.00 $0.00 $0.00 $0.00 New Earnings Total AnOlversary Date AnOlversary Y -T-D Earnings lifetime Earnings Redeemed Expired in February 2007 Expinng in March 2007 Expiring in April 2007 Expiring in May 2007 $0.00 $0.00 $3.88 $1.12 $135.74 11/14/93 $0.00 $0.00 100200 06 STMT16 3 (Please detach and return bottom portIon WIth payment and retam top portion for your records Do not staple or clip your check to the form below.)