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Home My WebLink About12-28-07 (3) ~ 15056051047 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 Date of Birth Decedent's Last Name Suffix Decedent's First Name MI (If Applicable) Enter Surviving Spouse's Information Below Souse's Last Name Suffix Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW _ 1. Original Return C) 4. Limited Estate C) 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required C) 2. Supplemental Return C) C) C) 4a. Future Interest Compromise (date of death after 12-12-82) C) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) C) 10. Spousal Poverty Credit (date of death C) 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 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes C) " ..' <--j ( ,,) .;;;-- Correspondent's e-mail address: N C /f/(I( 14&E /-. /1-/1/ L3 /J1 E CIf/l-/Vlcf /J'V;<' 6 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051047 15056051047 .-J ~ ---.J 15056052048 REV-1500 EX Decedent's Social Security Number Decedent's Name: 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) c:::> Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c:::> 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-.!iL) 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 15. 16. 17. 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT c:::> L Side 2 15056052048 15056052048 ---.J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME File Number STREET ADDRESS Gff<--.f:e JJJ- _n__ 0:..c? ~- ;--:10 V1-!.e~';/n_ -7Q~ _ nnC0-_[;/!.~--7~n- kg -1J2 CITY tit ec 40../,,(C5.61./, Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) ZIP / 7077;:; I 0 () L/ ' 3 5- ------:~Q, )-.6__ Total Credits (A + B + C ) (2) )0, J- ~ 3. Interest/Penalty if applicable D. Interest E. Penalty (3) (4) (5) (5A) (5B) Total Interest/Penalty ( 0 + E ) 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. ~,~p 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. c; 5-Lj, /3 A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. CJ 5~ LI . / 3 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 a. retain the use or income of the property transferred; .......................................................................................... 0 b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 c. retain a reversionary interest; or.......................................................................................................................... 0 d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ 0 No ~ 119 liJ ~ 52l ~ 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 PS. 99116 (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. 99116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. 99116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. 99116(1.2) [72 P.S. 39116(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. 99116(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-1508 EX+ (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Grace Mary Montgomery 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 CASH 51.00 2 1992 Buick Century VIN #1G4AG54NON6471147 Plate # DD01096 825.00 3 Refund Car Insurance MET LIFE AUTO 120.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 996.00 REV-1509 E)(+ (6-981 SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FilE NUMBER Grace Mary Montgomery If an asset W;lS made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S: NAME ADDRESS RELATIONSHIP TO DECEDENT A. Sharon Stoll 702 Carriage Lane Mechanicsburg. Pa 17050 Daughter B C JOINTLY-OWNED PROPERTY: LErr'-::R DATE DESCRiPTION OF PROPERTY '"10 OF DATE OF DEATH itEM F QR JOINT MADE INC.UDE NAtv1f: OF FINANC1J..L iNSTITUTION .AI';[; BANK ACCOUNT NurvlBER OR S!MllAR DATE QF DEATH DECO'S VALUE OF NUMBER TENANT JOINT IOENTJFViNC~ NUMBER ATTA.CH DEFD FOR JOiNTl_Y.HELD REAL ESTATE VALUE OF ASSET INTEREST DECEDENTS INTEREST 1. A. 11/15/00 Sovereign Bank Savings Account ACCT:# 764031514 36,80379 50% 18,401.50 II 2 B 11/15/00 Sovereign Bank Checking Account ACCT:# 761023925 4,546.08 50% 2,27304 3 C 12/17/01 New Cumberland Federal Credit Union Savings ACCT# 079856 6,250,89 50% 3,125.45 TOTAL (Also enter on line 6, Recapitulation) $ 23,799.99 (If more space is needed, insert additional sheets of the same size) REV-1510 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF Grace Mary Montgomery This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. FILE NUMBER DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1. Sharon Stoll 1 Daughter 1 11/09/2007 6,000.00 50% 3,000.00 3,000,00 2 Craig Stoll 1 Son In Law / 11/09/2007 6,000.00 50% 3,000.00 3,000.00 3 Mark Montgomery / Son / 11/09/2007 6,000.00 50% 3,000.00 3,000.00 4 Deborah Montgomery 1 Daughter In Law I 11/09/2007 6,000.00 50% 3,000.00 3,000.00 TOTAL (Also enter on line 7 Recapitulation) $ 12,000.00 (If more space is needed, insert additional sheets of the same size) -. - -------------,._- --~----_. 1- SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS REV-1511 EX+ (12-99). COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETUF:N RESiDENT DECEDENT ESTATE OF Grace Mary Montgomery FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 3 FUNERAL EXPENSES: Carlucci - Golden & Desantis Funeral Home St Catherines Cemetery Interment Pesavento Monuments Engrave Date on Monument William Edwards Florist Funeral Flowers Anna Maria's Restaurant After Funeral Meal 8,251.00 720.00 130.00 360.40 783.63 2 4 5 B. ADMINISTRATIVE COSTS 1. Personal Representat ve's Commissions Name of Perso1al Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commi,;sion Paid 2. Attorney Fees 3. Family Exemption (If decedent's address is not the same as claimant's, attach explanation) 3,500.00 Claimant Sharon Stoll Street Address 702 Carriage Lane City Mechanicsburg State Pa Zip 17050 Relationship of Claimant to Decedent Daughter 4. Probate Fees 6000 5. .~ccountants Fees 6. Tax Return Preparer's Fees 10 Inheritance Tax Fil n9 Fee 15.00 15.00 8.00 15.00 7. JCP & Automation 8 File Will 9 Short Certificate 2@ $4.00 Ea TOTAL (Also enter on line 9, Recapitulation) $ (If more space IS needed, insert additional sheets of the same size) 13,858.03 REV-1512 EX+ (12'{)3) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF Grace Mary Montgomery 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 FILE NUMBER 1. 3 Sovereign Bank ACCl # 0761023925 Check # 1077 129.27 Check # 1078 128.33 Check# 1079 25.43 Check # 1080 73.84 Check # 1081 51 .46 Check # 1082 210.70 2 4 5 6 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 619.03 ~" ~..", ,q ~:<':~ .t'::-r-. ~i/'" ~ I SCHEDULE J BENEFICIARIES :>y \,j()N\VEALTH OF PEM~S'r'LVA\IA Ir'jHERI'~/\!\jCE TAX PE-TURN RE S!DE NT DECEDENi FILE NUMBER ESTATE OF Grace Mary Montgomery RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE NUMBER NAME AND AD)RESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTION~; [include outright spousal distnbutions, and transfers under Sec. 9116 (a) (1.2)] Sharon Stoll702,Carriage Lane, Mechanicsburg Pa 17050 Daughter $11,159.46 2 Mark A Montgomery 4013 Summerset Drive, Portsmouth Va 23703 Son $11,159.46 , ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET = 11 -=1-NO~-~~AXABLE DISTRIBUTIONS I A. SPOUSAL DiSTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE i I B. CHARITABLE AND GCVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) Acct 0761023925 NOW ACCOUNT Rate index 310 Pg 1 of 2 Alpha key MONTGG..01 WAYP Branch 0076 Area 0076 Product D186 Officer -------------Amounts-------------- ------------Account Information------------- Ledger 4,546.08 Direct deposit 6 OD limit POST ALL Collected 4,546.08 Return cd 0 Unc funds cd 2 Sweep cd OFF ATM indicator 0 Last stmt 11/07/07 Lst cus dt 11/23/07 Last trans 11/23/07 Signature locator: (000100315324) 50 I.- to" <!C." 7'7 ~~_~ Doc::ument Name: untitled /7. ' /./(> .-, I( DDMAIN Demand Deposit Display Main Receipt bal Opened 4,546.08 Accrued int CTD Int paid YTD Fed tax withheld Int paid last year Last deposit 3.73 Last dep 2.95 ATM limit 0.00 Total ATM dep 2.95 ATM available DDDHIST DDDACCT COMMAND ===> 12/17/01 11/14/07 50,330.00 100.00 0.00 0.00 DDDOVERDRFT -...------------------------ 6017 11/23/07 DDDINT DDDFUND F2=Retrieve F3=Exit F8=Forward F6=Toggle F4=CRFwindow Date: 11/26/2007 Time: 2:48:56 PM 5r/ 1./ i:../ ~::" 7 -J /)r;i"'/ /-Z pa~ Doc~~ent_~~~~-=~tit~ed DDMAIN Demand Deposit Display Main 6017 11/23/07 Acct 0764031514 PMA ACCOUNT Rate index 611 Pg 1 of 2 Alpha key MONTGG..01 WAYP Branch 0076 Area 0076 Product D401 Officer -------------Amounts-------------- ------------Account Information------------- Ledger 36,803.79 aD limit POST ALL Collected 36,803.79 Return cd 0 Unc funds cd 2 Sweep cd OFF ATM indicator 0 Last stmt 11/07/07 Lst cus dt 11/19/07 Last trans 11/19/07 Signature locator: 11/01/07 (005500018036) 825.00 ---MMA COUNTERS---- 100.00 Chks/POS 000/00000 0.00 Trans/ELE 000/000 0.00 Drafts 000 DDDOVERDRFT DDDINT DDDFUND Opened 12/17/01 Receipt bal 36,803.79 Accrued int CTD Int paid YTD Fed tax withheld Int paid last year Last deposit 35.07 Last dep 155.84 ATM limit 0.00 Total ATM dep 176.70 ATM available DDDHIST DDDACCT COMMAND ===> F2=Retrieve F3=Exit F8=Forward F4=CRFwindow F6=Toggle Date: 11/26/2007 Time: 2:49:05 PM For Pllperwork Reduction Act Stlltement and Burden Estimate Statement See Reverse Side "Notice to Account Owners" Copy OMB NO: 1510-0043 EXPIRATION DATE: 2/28/96 FROM: NOTICE OF RECLAMATION DEFENSE FINANCE AND ACCOUNTING SERVICE-CLEVELAND CENTER P.O. BOX 998017 CLEVELAND, OH 44199-8017 ELECTRONIC FUNDS TRANSFER FEDERAL RECURRING PAYMENTS RECIPIENT AND/OR BENEFICIARY NAME MONTGOMERY GRACE M AGENCY DATE OF AND/OR PAYMENT TYPE OF PAYMENT DATE: 20071126 CLAIM NUMBER 161-22-2815 P18A94 DA TE OF DEATH 20071121 TRACE NUMBER TYPE OF ACCOUNT DEPOSITOR ACCOUNT NUMBER AMOUNT 20071203 USA ANNTY 041036007014562 s 0764031514 825.00 AMOUNT OF PAYMENTS RECEIVED . WITHIN 45 DAYS OUTSTANDING TOTAL 825.00 NOTICE TO ACCOUNT OWNERS FROM THE GOVERNMENT The Government has received information that that the person named on this notice is deceased. The purpose of this notice is to inform you that by law entitlement to Government benefits for this person ended at death. Therefore, the Government must recover all payments made after the date of death. If there has been an error and this person is not deceased, or if the date of death is wrong, this notice explains how to correct the mistake. If you do not understand this notice, please get help from either your financial institution or the Government agency that was making payments. PAYMENTS TO THIS PERSON HAVE BEEN STOPPED Your financial institution has been asked to return the payments shown on this notice to the Government because they were issued in error. The Government has asked your financial institution to send this notice to you, the aCCQlmt owner. Your financial institution must notify you if it has taken action to recover these funds from the account. Contact your financial institution immediately if you do not understand its actions. If the Government is unable to collect from the financial institution the full amount of the payments made after death, you may be contacted by the agency which made the payments. IF THE PERSON IS NOT DECEASED If the person \s not deceased, immediately contact both. your fi.nancial ~nstitution and the agency th~t m~de. the. payments to correct the error. The Government regrets any mconvemence this error m.ay c~use. Your fmanclal institu- tion can correct the collection action if it is given satisfactory proof that the person IS alive. NOTE: YOU MUST CONTACT THE AGENCY THAT MADE THE PAYMENTS BECAUSE THIS ERROR HAS STOPPED FURTHER PAYMENTS. ONLY THE AGENCY CAN RESTART THE PAYMENTS. ~ - -- ...- _......,~"^ <<f Sovereign Ban]{ STATEMENT OF ACCOUNTS 113653 -2838 GRACEMONTGOMERY SHARON STOLL 702 CARRIAGE LN MECHANICSBURG PA17050-2273 ~t~~t~er1t .Pe~()f:J 1"O${07~Q.~~99/07 < SOVEREIGN'PREMJER(:HSCKING For yourconveh,enceour Customer Servl~Center is availablefrorn 7 am - 14 pm EST, 7 days awe$k. . .. Call usaf HJ77-7$a..1143. HearinglmpEi,redpay call14J00-428-9121 (TTJ/TDD). , www.sovereignbank.com 31 7007 0 100315324 . . . . , = - .. . - . iii II !II . II . . Happy Holidays from Sovereign Banld Wishing you and your family a joyous Holiday Season and a pr<>sp.~rQus New Year. We look forward to serving you in the upcoming year. ' Know how to.protect yourself against check scams. Scams and schemes involving fraudulent checks are springing up everywhere. At Sovereign., we want to make sure you know what to look for, so you can protect yourself. Here are some ofthe IUost COlUlUon fake check scams: - Foreign Lotteries - Foreign Business Offers - Online Auction OverpaYments - Apartment Rental/RQpmmates - Dating Web siteslRomanticChatrooms - Work-at-Home Ads Being aware is your first defense against being a victim of check fraud. To learn more, stop by your local Sovereign Community BankingOffiye or visit Fakephecks.org today! page 1 of7 DEPOSITS INSURED BY FDIC EQUAL OPPORTUNITY LENDER 761023925 c~ Sovereign BanK STATEMENT OF ACCOUNTS 1-877-768-1143 WW'N.sovereignbank.com State,ment Period 11/0al07 TO 12109/07 ~C)VEItEIGN, PItEMIER CHECKING Financial Summary Statement Period 11 '03,07 12 J~) 07 GRACE MONTGOMERY SHARON STOLL '1 Deposit Accounts Account Number Average Dally B,l,nce Current Balarice ~ :""!'~';"~ ..":j~" ~..,'{;'1~..>!::\t..,y:;'''1'' "'i'~(: ", .~> ':h~~'~:r.~:..'" \'." "t;;l:,-;-;' l"'~ ,~,~ r~' }" ~'<,\~ f'..;). ,~ . .~...~,..,,,# · >:^,-ii{\:~"~J3,jl!~",J.~)~.k:"{""~~h;J~~.,..~",,,.,,. ..,. _,..~:i1":fl~k.,: 1'~!&1;.,,}!tW:,.~:..! <:_ > '-, ,,:. } ,,),!'(:/<:l.,!,c.', "I' " " >'.'1.'1'!'\""~, 7604031514 $3d37.12 . $26.803.79 '$32,099.75 .., ~ I - .,1:,= ;'" .g ,. , !!! .. . . STATEMENT/SAVINGS ACCOUNT T otalDeposlt SOVEREIGN PREMIER CHECKING Statement Pc;r'od 11 08 07 - 12;09 07 GRACE MONTGOMERY SHARON STOLL "">f"',::::-.,' . ",,-; . '; ,:<,-:,'-":>';:?;<"':,;"':;'~'""":/+;;-(('''' ........,- . AccountH761023'92S " Balances . : f~1h~i~;E~~~~r!~~~~;~~:~~~~:: ~?1~}~~ ~~~~~:~~;:;~~ivti:~~0~~~:~~rr;=~'i~~:'l;Yl:~ ~~-: ~~ ~~-r~~~ ~~~~~ ~r:~. ~ : '~~ f.~~ .' ;. ,~: :!:;i:~ ~. ("~~"J _, ,>,_ .....,.".... '" "".r .,.>.., , ~~..~' ,oJ",,""''' "i' *~""" ~~ ',."~ j ^~ (""~' ~ ,'" - >, "'" ", , ". ~.... ,"~,(, dH""~ ~ "'~ ."~'}f t""'" '~..>.", ."',>,."... '"'''' ~'t~ ^'i....., , "~""""">"'~~~'" ,,"... > f5:' .'>"c~ 1: .*',.... . .' 'i, ~ '>~~'Q-' ! ~f"f:r '>"'r",\:""'!"Th ~~M~::~':Q~,,~:~~~~~">~'Z ,;~;,(:,1__J; ~>J~<~l~'~'~ ,:' :~:4,~!~:~ ~~~:";[~}.)'~1' ~< ~.'~~~t:..~ ::!' ;'.~ " .."'~:'~')~~~~~>.f~,t" '> '" '~~~~~1~~ "The interest earned and the Inter~tpaid[lay.qifferdependinsoll'Ntlen interest is credited to,you~~c9b,.unt. .." ,.. . . ,..., ". .....,. c ... ,.,; Checks Posted Check # Date Paid Amount Reference # Check # 1075 Date Paid 11/21 Amount Itefel'fnce # 616.176570 $24.000.00 1071" 1 1073 11/09 $54.21 "698404790: ~"""".1'E.'}~.""..,~;...'i'~ ~. ,~"""' ",."" ";li~'''''""'"< ,<<.'''' -'''l':r.'i~' ~,'!'~JJ_~::t~~:::l.;~l,~i?t.~l~:!;':{t~/, ~~ ~ ~ ~~T'~",::~:r~_e)~~;;)'.~'~:' ~~'~;h~>};A';~~-J~!' 1078* 11/23, ' $128.33 $40940230 11/14 $21.19 . 692367160 .';,'''''....'\;/>1'' (i r"" ;.... <' '" I -,.., '>!, ", ",.~ f" , -. 'I ;p.~ :::i J~}'t~./ ";:: ~~~ , " JHt'.f',\, : '. '" :)~,j.(~) . . ;) ;-ll,;~r;{.:l,'J, ~~ !f~ l' \ ", ..~ ~~,,,' ~ ~._, < .' ~ ,. ~ . ~ _ ., ~ 1080 1.1/26 i., .$73.84 page 3 of7 761023925 .,."....,.,_.,' :Statementperlpct,11lQ8I07 TO 12/09/07 . SOVEREIGN PREMIER CHECKING Amollnt Reference # 1~;' :':'I1I2fl';>I'[" $210.10 618995430 v'."'.'. . ",." .... ....... .'. ..... i>. . '.... ..... '( f' 1~.~he~k(') po~!ed.$5~t5~~:5~i ~/t~~!~rlS,~{*.)I(ldl~te~a ~~Pt.I"'~AAu~tlal check numbers which may be caused by one of the following: . ii- Ac:I1~.!1OtY~tr~IV~.; c . . '. .' '.Ac:h~ ~twasCQn\I~18dte an.electronic transaction. which will be listed in the "Electronic Checks Posted" section below. If nochElCf~ were electronically converted. this section will not appear. ('f..' '''''1','' "~b"'U < .~;.. ':':>' i".~.. , ." li>'J\I~.t.. "'" '';: i~f ,.:\1,1 "".,,,."!'j. .1. :. "''''V_3--~~'''..:! ~'",,;";;:'Y~""~,,",:o' .I'll-.. ;,>o_..:.<:~~~'"'___= _~i:'~"'~J.:::",,;:"!iI:;- ''';;.,' Payee Check # Date Paid Amount Payee If/-V' "~~~":~: ~~~Yi~ .",,~ "::":~1Pb'~~'i~{1~(,~~:~u.J~,~~! .^ . " ~ \.'" :":O>^r,>".:?~"<-"':::...:.~:-!.:i.~. '~~~~1 .:) i,: h,-~ :-'--1 t..: :"~,h;','-L ,'~'.:::'_ .:~,;' ~~ :' :'. :::> t-i:: !':.~,;;\";Tt!~;' .~. ,(.:",-, 1 ~h.C;k(8) PostedElecfrO"lh~!Iy"" $129.27 }"l/':;',:';' Please note: "'''', ", TIle m.erchant YO\lpald has conve~ these checks Into an electronic transaction. Beca\lse we did not receive the original chec;kor a copy of the check. we cannot provide the check with this statemenl Ifthecheckn\lmberlS zero, It m8!l~sthemerchant did not provide the check n\lmber In the proper formal Please refer to[the;Acco\ll1tActivltysection belpw to locate the check n\lmber In the transaction description. r, !\;..:..,:,::;",:",--",', . ~c:count Activity. Date Description Additions Subtractions Balance page 4 of7 761023925 .~ Sovereign Bank STATEMENT OF ACCOUNTS 1-877-768-1143 www.sovereignbank.com $t~~rneotPe~P!J 11l08107TO ~2109l07 , $OVEREIGN PREMIER~HECKlNG STATEMENT SAVINGS ACCOUNT Statement r'(;rIOC 11,08,07 - 12,CJ9107 GRACE MONTGOMERY SHARON STOLL ': ' Account ',7621031514, <. . '.. . - ,'_ " - - . ',' _ ':", "':'-. " ,'_ ,<' ,'- __ " _ _ _', _,;",_., ,', _..,'_" _': _,~,':~_,n~-T. "The interest ~med and the interest paid,maydifferdepending on when interest is Creditecftoyoutaecpunt. Account Activity Date Description Additions Subtractions = , Ti ;a Balance II I . I I I ,,~ - :,';! ;;--~}-/j1 12-09 page 5 of7 761023925 .... NCFCU P.O. Box 658 New Cumberland, PA 17070 www.ncfcuonline.org (717) 744-7706 (800) 716-2328 Fax: (717) 744-7996 NEW CUMBERLAND FEDERAL CREDIT UNION Your Community Creait 'Union GRACE M. MONTGOMERY 702 CARRIAGE LANE MECHANICSBURG PA 17050-2273 INQUIRY ON 112607 03:39 PM ON 112607 EFFECTIVE 112607 TLR: 161 -DIRECT ACCOUNT NUMBER 079856 -------------- SHARE 1 TRANSACTIONS -------------- TRAN TLR TRANS- EFF TRAN ENDING FEE DRAFT PAYEFF DATE IBR ACTION DATE < AMOUNT> < B A LAN C.f > WITH <NUMBER> DATE 111407 83 1 WITHDRAWAL 111407 50000.00 6250.89 0.00 OTHER 110107 DEPOSIT 110107 396.00 56250.89 0.00 102 LOCATION: US TREASURY 312 ICIVIL SER 103107 DIVIDEND 103107 35.56 55854.89 0.00 , 2ND LOCATION: 0.75 071001 071031 0.75 8 55819.33 100107 DEPOSIT 100107 396.00 55819.33 0.00 102 LOCATION: US TREASURY 312 ICIVIL SER 093007 DIVIDEND 093007 34.14 55423.33 0.00 , 2ND LOCATION: 0.75 070901 070930 0.75 B 55389.19 090107 DEPOSIT 090107 396.00 55389.19 0.00 102 LOCATION: US TREASURY 312 ICIVIL SER 083107 DIVIDEND 083107 35.01 54993.19 0.00 , 2ND LOCATION: 0.75 070801 070831 0.75 B . 54958.18 080107 DEPOSIT 080107 396.00 54958.18 0.00 102 - /' ~ - LOCATION: US TREASURY 312 /CIVIL SER -.-' 81 - Regular Shares 83 - Money Market S8 - Xmas Shares Proceeds as described above received by: $2 - IRA Shares $4 - Share Drafts 89 - Vacation Shares AUTHORIZED SIG'> ....--...--.1 _...---...,~..... .............-...-...-....1 -.....----o-....-r--.. -----, ----.--" a.<<elley Blue Book . 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