HomeMy WebLinkAbout02-01-08
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Neil Warner Yahn, Esquire
Attorney J.D. No. 82278
Edward P. Seeber
Attorney J.D. No. 76084
James Smith Dietterick & Connelly, LLP
P.O. Box 650
Hershey,PA 17033
Attorneys for Petitioner
CHESTER L. V ALENCIK, JR.,
Petitioner
) IN THE COURT OF COMMON PLEAS OF
, ) CUMBERLAND COUNTY, PENNSYLVANIA
)
) ORPHANS' COURT DIVISION
)
) No. OC 2008 _ ldO
)
)
)
ESTATE OF BETTY R. V ALENCIK
TROY A. V ALENCIK,
Respondent
PETITION TO ENFORCE POWER OF ATTORNEY
TO THE HONORABLE JUDGE OF SAID COURT:
Upon information and belief, the Petitioner, CHESTER L. V ALENCIK, JR. (the
"Petitioner"), by and through his attorneys, JAMES, SMITH, DIETTERICK AND
CONNELL Y, LLP, files this Petition to Enforce the Power of Attorney (the "Petition") against
the Respondent, Troy A. Valencik (the "Respondent') for the following reasons:
1. Betty R. Valencik ("Betty"), an incapacitated person, resided at 5108 Inverness
Drive, Mechanicsburg, Pennsylvania 17050 with the Petitioner.
2. Betty is 85 years old and was born on November 5, 1922.
3. Betty was married to Chester Valencik, Sr., who died May 4,2004.
4. Betty and Chester, Sr. had one child, namely your Petitioner herewith.
5. The Petitioner currently resides at 5108 Inverness Drive, Mechanicsburg,
Pennsylvania 17050 and is a resident of Cumberland County.
6. Betty executed and granted the Petitioner the authority to act on her behalf as an
agent under the Power of Attorney attached hereto as Exhibit "A".
7. Betty was domiciled at the Petitioner's residence.
8. The Petitioner has two children, namely the Respondent currently residing at 73
Lick Run Road, Catawissa, Pennsylvania 17820 and Shelly Valencik Capozzi,
currently residing at 1655 South Holly Pike, Carlisle, Pennsylvania 17013 (herein
"Shelly").
9. The Petitioner is currently estranged from his two children.
10. The Respondent currently leases the farm situated at 73 Lick Run Road,
Catawissa, Pennsylvania 17820 (herein the "Farm") from an Irrevocable Trust
(Betty is the Settlor of the Irrevocable Trust).
11. Betty resided on the Farm for most of her adult life until on or about December
26, 2006, when Betty moved from the Farm to reside with the Petitioner for health
reasons.
12. Shortly after relocating to the Petitioner's residence, Betty suffered a mini stroke
and was transferred to and cared for at Geisinger Health Hospital (herein
"Geisinger").
13. Thereafter, on or about January 19,2007, she was admitted to Bloomsburg Health
Care Clinic (herein "Bloomsburg") for psychiatric reasons until February 23,
2007.
14. Upon Bett~'s release from Bloomsburg in late February of 2007, Comfort Care
Home Health Services (herein "Comfort Care"), evaluated the Petitioner and his
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residence and concluded that residing with the Petitioner was suitable for her
handicap needs.
15. On May 23, 2007, Betty suffered a major stroke, and was in ICU at Geisinger
until June 4, 2007 whereupon she was then transferred again to Bloomsburg and
then again to the Petitioner's residence.
16. Bloomsburg and Comfort Care once again engaged a thorough review of the
Petitioner's residence to assure Betty was able to receive the proper treatment.
17. At this time, Betty lost use of her left hand due to the stroke and suffered ancillary
ailments including, but not limited to, limited mobility and partial paralysis in her
left leg and arm.
18. On August 18,2007, Betty was released trom Bloomsburg to the Petitioner after
the residence was redesigned to care for Betty (including the following special
accommodations, handicap rail, etc).
19. Comfort Care monitored Betty's progress and engaged in extensive physical
therapy until November of2007.
20. Betty also received "in home care" three days a week to assist her in day-to-day
living at the Petitioner's residence (this also triggered the 100 day no-coverage
period for purposes of Betty's Long Term Care Policy for in home care).
21. Contemporaneous with the "in home care" Betty was becoming very ornery and
verbally abusive. Dr. Dennis M. Sheehe, MD, her primary caretaker attributed
this behavior to her major stroke and the impact on the occipital areas of the brain
in the trontallobe.
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22. In or about November of2007, Betty began to fixate on returning to the Farm and
in order to appease Betty, the Petitioner traveled with Betty to the Farm on
December 7,2007 to allow her to stay for the weekend with the Respondent.
23. Petitioner advised Respondent that the stay was temporary, and that due to her
medical problems, Betty would be required to return to the Petitioner's residence.
24. On or about December 8, 2007, Shelly called on behalf of the Respondent
averring the Petitioner was cruel for leaving Betty with the Respondent.
25. On or about the same date, Petitioner contacted Respondent who advised the
Petitioner he would not be permitted to see his mother, Betty, and that she was
staying with him on the Farm.
26. On or about December 11,2007, Petitioner received a letter from Bruce G. Baron,
Esquire, alleging Betty's revoking of any Power of Attorney executed by Betty
naming the Petitioner as agent.
27. Remarkably, the letter revoking the Power of Attorney exemplifies the cavalier
behavior exhibited by the Respondent because it presumes Betty has the capacity
to revoke the Power of Attorney (a copy of the letter is attached hereto as Exhibit
"B").
28. In actuality, Betty has been incapacitated since June of2007 after suffering the
major stroke and as further referenced in the psychiatric assessment attached
hereto as Exhibit "c" so Betty could not revoke the Power of Attorney.
29. Betty was evaluated on December 20,2007 by Dr. Dennis M. Sheehe, MD as
further set forth in Exhibit "C" (the "Medical Opinion"), which provides in
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relevant part that Betty's cognition is impaired due to cerebrovascular disease
resulting in dementia.
30. The Medical Opinion also provides that Betty's deficient judgment dates back to
June of2007.
31. Betty requires skilled transitional nursing care and residing with the Respondent is
inconsistent with the welfare and well being of Betty.
32. Petitioner believes this matter is ripe for this Honorable Court to intervene as
Betty is unable to make decisions for herself and the Respondent is exploiting her
impuissance and now disregarding the Power of Attorney granted to the
Petitioner.
33. Petitioner began acting under the Power of Attorney on or about June of2007 and
a compilation of his actions are set forth in Exhibit "D" and is only acting in the
interest of his mother (Betty).
34. On or about January 7, 2008, the Respondent filed a Petition for the Appointment
of a Permanent Guardian For the Person and Estate of Betty, to Vacate all Prior
Powers of Attorney and for an accounting ofthe Petitioner's actions as agent
under the Power of Attorney and Trustee under the Valencik Family Irrevocable
Trust Agreement dated August 4, 2005 (herein the "Columbia County Petition").
35. The Columbia County Petition is erroneous in that Columbia County does not
have jurisdiction in this matter as Betty is domiciled in Cumberland County and
Respondent has disregarded the Powers granted thereunder.
36. In the within matter, the facts demonstrate that Betty resided at the Petitioner's
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residence and therefore, venue is appropriate with this Honorable Court.
37. Respondent's credibility is strained in that in the present petition before the
Columbia Court, whereby Respondent concedes that Betty did not have capacity
in December of2007 and yet, the Respondent acting via his sister Shelly's
husband, Attorney Louis J. Capozzi, Jr., issued a letter averring she had the
capacity to revoke the Power of Attorney.
38. Petitioner is objecting to the jurisdiction of Columbia County Orphans' Court as
per 20 Pa.C.S S 5512 which provides in relevant part:
20 Pa. C.S. 5512 (a) provides that "A guardian of the person
or estate of an incapacitated person may be appointed by the
court in which the incapacitated person is domiciled, is a
resident or is residing in a long term care facility."
39. Petitioner requests a hearing be granted to enforce the Power of Attorney and
enjoin the Respondent from acting on behalf of Betty and such other relief as this
Court deems appropriate.
WHEREFORE, THE PETITIONER REQUESTS THE FOLLOWING RELIEF:
The Power of Attorney be enforced upon the Respondent, Troy A. Valencik, and he be
enjoined from acting on behalf of Betty R. Valencik, or in the alternative, a hearing be scheduled
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to determine the validity of the Power of Attorney, its enforcement and such other relief as the
court deems proper.
Date: February~, 2008
By:
Respectfully submitted,
\JAMES, SMITH, D1ETTERICK
0CONNELLy,L P
___ Ul
Neil W. Yah squ e
Attorney 1.D No. 82 78
Edward P. Seeber
Attorney 1. . No.7 084
134 Sipe Ave
Hummelstown, P A 17036
(717) 533-3280
Attorneys for Petitioner
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NOTICE
THE PURPOSE OF TillS POWER OF ATTORNEY IS TO GNE THE PERSON YOU
DESIGNATE (YOUR "AGENT") BROAD POWERS TO HANDLE YOUR PROPERTY,
WHICH MAY INCLUDE POWERS TO SELL OR OTHERWISE DISPOSE OF ANY REAL
OR PERSONAL PROPERTY WITHOUT ADVANCE NOTICE TO YOU OR APPROVAL BY
YOU.
TillS POWER OF ATTORNEY DOES NOT IMPOSE A DUTY ON YOUR AGENT
TO EXERCISE GRANTED POWERS, BUT WHEN POWERS ARE EXERCISED, YOUR
AGENT MUST USE DUE CARE TO ACT FOR YOUR BENEFIT AND IN ACCORDANCE
WITH THIS POWER OF ATTORNEY.
,YOUR AGENT MAY EXERCISE THE POWERS GWEN HERE THROUGHOUT
YOUR LIFETIME, EVEN AFTER YOU BECOME INCAPACITATED, UNLESS YOU
EXPRESSLY LIMIT THE DURATION OF THESE POWERS OR YOU REVOKE THESE
POWERS OR A COURT ACTING ON YOUR BEHALF TERMINATES YOUR AGENT'S
AUTHORITY.
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YOUR AGENT MUST KEEP YOUR FUNDS SEPARATE FROM YOUR AGENT'S
FUNDS.
A COURT CAN TAKE AWAY THE POWERS OF YOUR AGENT IF IT FINDS
YOUR AGENT IS NOT ACTING PROPERLY.
THE POWERS AND DUTIES OF AN AGENT UNDER A POWER OF ATTORNEY
ARE EXPLAINED MORE FULLY IN 20 P A.C.S. CR. 56.
IF THERE IS ANYTHING ABOUT TillS FORM THAT YOU DO NOT
UNDERSTAND, YOU SHOULD ASK A LAWYER OF YOUR OWN CHOOSING TO
EXPLAIN IT TO YOU.
I HAVE READ OR HAD EXPLAINED TO ME TillS NOTICE AND I UNDERSTAND
ITS CONTENTS.
AUG 0 4 2005
J ) I J ,-
B~;TY~~~1~~-
DATE
\'-
POWER OF ATTORNEY
',---
KNOW ALL MEN BY THESE PRESENTS:
That I, BETTY R. V ALENCIK, having my legal residence c/o Chester L. Valencik, Jr.,
5108 Inverness Drive, Mechanicsburg, Cumberland County, Pennsylvania, have made, constituted
and appointed, and by these presents do make, constitute and appoint my son, CHESTER L.
V ALENCIK, JR., my true and lawful agent, or, if he is unable or unwilling to serve, my son's
spouse, LINDA V ALENCIK, my true and lawful agent, or, if she is unable or unwilling to serve,
my grandson, TROY V ALENCIK, my true and lawful agent, to act as follows, that is to say:
GIVING AND GRANTING unto my said agent full power to buy, receive, lease, accept or
otherwise acquire; to sell, convey, mortgage, hypothecate, pledge, quitclaim or otherwise encumber
or dispose of; to contract or agree to the acquisition, disposal or encumbrance of any property
whatsoever and wheresoever situate, be it real, personal or mixed, or any custody, possession,
interest, or right thereon or pertaining thereto, upon such terms as my said agent shall think proper,
that is to say:
1. To engage in tangible personal property transactions.
2. To engage in real property transactions including the power to make, execute,
acknowledge and deliver good and sufficient deeds and conveyances for the same, either with or
'\,--- without covenants of warranty.
3. To engage in stock, bond and other securities transactions.
4. To engage in commodity and option transactions.
5. To engage in banking and financial transactions.
6. To borrow money.
7. To enter safe deposit boxes.
8. To engage in insurance transactions.
9. To engage in retirement plan transactions.
10. To handle interests in estates and trusts.
11. To pursue claims and litigation.
12. To receive government benefits.
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13.
To pursue tax matters.
14. To make limited gifts and, further, such other gifts, of whatever nature and in such
amounts as my agent, in my agent's sole discretion, determines appropriate. I authorize my agent to
make such gifts even if contrary to the provisions of 20 Pa.C.S. Section 560l(e). The foregoing
gifts maybe made for and on my behalf to my son, CHESTER L. V ALENCIK, JR.
15. To create a trust for my benefit, including the power to execute a deed of trust,
designating one or more persons (including my agent) as original or successor trustees and transfer
to the trust any or all property owned by me as my agent may decide, subject to the following
conditions:
A. The income and corpus of the trust shall be distributable to me or the
guardian of my estate, or be applied for my benefit, and upon my death, any remaining
balance of corpus and unexpended income of the trust shall be distributed to my estate.
B. The deed of trust may be amended or revoked at any time and from time to
time, in whole or in part, by my agent, provided that any such amendment by my agent shall
not include any provisions which could not be included in the original deed.
16.
\---- 17.
18.
19.
20.
To make additions to an existing trust for my benefit.
To claim an elective share of the estate of my deceased spouse.
To disclaim any interest in property.
To renounce fiduciary positions.
To withdraw and receive the income or corpus of a trust, including the power to:
A. Demand, withdraw and receive the income or corpus of any trust over which
I have the power to make withdrawals;
B. Request and receive the income or corpus of any trust with respect to which
the trustee thereof has the discretionary power t<;> make distribution to me or on my behalf;
and
C. Execute a receipt and release or similar document for the property received
under paragraphs A and B. .
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21. To authorize my admission to a medical, nursing, residential or similar facility, and
to enter into agreements for my care, including the power to apply for my admission to a medical,
nursing, residential or other similar facility, execute any consent or admission forms required by
such facility which are consistent with this paragraph, and enter into agreements for my care by
such facility or elsewhere during my lifetime or for such lesser period of time as my said agent may
designate, including the retention of nurses for me.
22. Subject to my desires set forth in a living will, if any, to authorize medical and
surgical procedures, including the power to arrange for and consent to medical, therapeutical and
surgical procedures for me, as well as the administration of drugs.
23. To appoint successor agent(s) if all of the agents in this Power of Attorney are
unable or unwilling to serve.
24. To make an anatomical gift of all or part of my body.
25. My agent shall be entitled to charge reasonable compensation for services rendered
and expenses incurred from time to time and at any time during the term of this Power of Attorney.
26. It is my intent that the authority granted above extend to records, including
records considered "Protected Health Information", as that term is defined by the Health
Insurance Portability and Accountability Act and the regulations promulgated thereunder
(collectively, "HIP AN'). I further intend that my agent be treated as a ''Personal Representative"
\\__ as that term is used in HIP AA, and that my medical and health care providers disclose such
Protected Health Information to my agent, consistent with the authority which has been granted
above. For purposes of such information and records covered by HIPAA, my agent's power to
act on my behalf shall be effective immediately regardless of my ability to make my own medical
or health care decisions. This authorization is intended to comply with HIP AA and all other
federal, state, and local laws, regulations, statutes, and codes related to privacy and the release of
medical and health care information. I intend that my agent shall have full authority to access
such information on my behalf effective immediately.
27. This Power of Attorney shall not be affected by my subsequent disability,
incapacity, or incompetence, since it is my desire that my son, CHESTER L. V ALENCIK., JR. , or,
ifhe is unable or unwilling to serve, my son's spouse, LINDA V ALENCIK, or, if she is unable or
unwilling to serve, my grandson, TROY V ALENCIK, has the power to act on my behalf as my true
and lawful agent should I become disabled, incapacitated or incompetent.
28.
by me.
This Power of Attorney shall revoke all other Powers of Attorney heretofore made
GIVlNG AND GRANTING unto my said agent full power and authority to do and perform
all and every act, deed, matter, and thing whatsoever in and about my estate, property, and affairs as
fully and effectually to all intents and purposes as I might or could do in my own proper person if
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personally present, the above specially enumerated powers being in aid and exemplification of the
full, complete, and general power herein granted and not in limitation or definition thereof; and
hereby ratifying all that my said agent shall lawfully do or cause to be done by virtue of these
presents.
AND, I hereby declare that any act or thing lawfully done hereunder by my said agent shall
be binding on myself, and my heirs, legal and personal representatives, and assigns; whether the
same shall have been done before or after my death, or other revocation of this instrument, unless
and until reliable intelligence or notice thereof shall have been received by my said agent.
this
IN A~SS WHEREOF, I, BETTY R. V ALENCIK., have hereunto set my hand and seal
~UG 0 It 2005 .
t3~J- Vab~l
BETTYQR.VALENCnc
ACKNOWLEDGEMENT
~
COMMONWEALTH OF PENNSYLVANIA
: ss
COUNTY OF DAUPHIN
On this AUG 0 4' 2005 , before me a notary public, the undersigned officer,
personally appeared BETTY R. V ALENCIK., known to me (or satisfactorily proven) to be the
person whose name is subscribed to the within instrument, and acknowledged that she executed the
same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seaL
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NoI8rimSeal
~l. BIker, '~PublJc
5 u...~~" l)"l'l>lWn COUftly
...., mlsSK . ..;;, _. 13,. 2007
~ber. Pennsylv';k.'.A~llC..ifiwUf....
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I, CHESTER L. V ALENCIK, JR., have read the attached power of attorney and am the
person identified as the agent for the principal. I hereby acknowledge that in the absence of a
specific provision to the contrary in the power of attorney or in 20 Pa.C.S. when I act as agent:
I shall exercise the powers for the benefit of the principal.
I shall keep the assets of the principal separate from my assets.
I shall exercise reasonable caution and prudence.
I shall keep a full and accurate record of all actions, receipts and disbursements on behalf of
the principal.
AUG 0 4 2005
aJL~uJj
CHESTER L. ENCIK, JR. .
Date
I, LINDA V ALENCIK, have read the attached power of attorney and am the person
1,,---- identified as the agent for the principal. I hereby acknowledge that in the absence of a specific
provision to the contrary in the power of attorney or in 20 Pa.C.S. when I act as agent:
I shall exercise the powers for the benefit of the principal.
I shall keep the assets of the principal separate from my assets.
I shall exercise reasonable caution and prudence.
I shall keep a full and accurate record of all actions, receipts and disbursements on behalf of
the principal.
AUG 0 4 2005
~~
LINDA V ALENCIK
Date
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I, TROY V ALENCIK, have read the attached power of attorney and am the person
identified as the agent for the principal. I hereby acknowledge that in the absence of a specific
provision to the contrary in the power of attorney or in 20 Pa.C.S. when I act as agent:
I shall exercise the powers for the benefit of the principal.
I shall keep the assets of the principal separate from my assets.
I shall exercise reasonable caution and prudence.
I shall keep a full and accurate record of all actions, receipts and disbursements on behalf of
the principal.
Date
TROY V ALENCIK
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Louis 1. Capozzi, Jr., Esquire*
D8tJiel K. Natirboff, Esquire
Donald R. R:eavev, Esquire
Bruce G. Baron, Esquire
Andrew R. Eisemann, Esquire
Timothy Ziegler, Reimb. Analyst
Karen L. Fisher, Paralegal
Jennifer Kain, Paralegal
'" (licensed in P A, NJ and MD)
2933 North Front Street
Harrisburg, PAl 711 0
Telephone: (717) 233-4101
Fax: (717) 233-4103
www.capozziassociates.com
Craig I. Adler, Esq.
Of Counsel
December 11, 2007
Chester L Valencik, Jr.
5108 Inverness Drive
Mechanicsburg, P A 17050
BY CERTIFIED U.S. MAIL
RE: Representation of Betty R. Valencik
Revocation of Power of Attorney
Dear Mr. Valencik:
Our Firm represents your mother, Betty R. Valencik, to assist her with the resolution of
some concerns she has about her funds and the Valencik Family Irrevocable Trust, of which you
are the Trustee.
Today, in our Office, she signed a Revocation of Power of Attorney, revoking any and all
Power of Attorney documents she signed naming you as her authorized agent. A copy of the
Revocation is enclosed to provide you with notice of the Revocation. The Revocation is being
recorded in Columbia County. The Revocation is effective today. We are requesting your help
to account for any and all transactions you may have conducted on her behalf, as her Power of
Attorney, from August 1, 2005 through to the date of your receipt of this letter and the copy of
the Revocation.
We are also requesting your help, as Trustee of the Valencik Family Irrevocable Trust, to
provide us, as your mother's representatives, with a copy of the Trust instrument and a statement
of the current assets of the Trust and any pending plans, actions, or proceedings involving the
Trust or the sale or transfer of any Trust property, as well as copies of the Trust's financial
statements for 2005 and 2006.
Your mother is currently residing at the Trust property at 73 Lick Run Road, Locust
Township, Catawissa, Columbia County, Pennsylvania. She is living there with your son, Troy,
and wishes to continue to reside there with Troy's assistance. She advised us that you are
planning to bring her belongings that were at your home during the time she resided with you
and deliver them to her at the Trust property this week. Please advise me immediately if you
have any objection to or concern about your mother and Troy living in the Trust property.
f1 .
Chester L. Valencik, Jr.
RE: Representation of Betty R. Valencik
Revocation of Power of Attorney
December 11, 2007
Page Two
While your mother was quite upset about her current situation while in our Office today,
she very much wants the family to resolve this situation together. Your mother was in good
health and positive spirits when we met today and is looking forward to sharing the coming
Holidays with her family.
Please let me know if you have any questions about this correspondence and if you have
an attorney who is representing you or the Trust in this matter.
Best wishes to you and your family for the Holiday Season and throughout the New Year.
Very truly yours,
CAPOZZI & ASSOCIATES, P .C.
~4
Bruce G. Baron, Esquire
Enclosure (Revocation of Power of Attorney)
cc: Betty R. Valencik
Troy Valencik
2
Valencik, BettyR (MR # 3104140)
DOB: 11/05/1922
progress Notes
'.~"'-",!,",.,-,-~ .",,--.. ,-. ,,,.,,,..."",,,,.~~ ,,,,,~'~""'~""-.::-
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,,-"'''_"~"_''''~,.'''''-!!'-I;t'1.,'<I''!II
Nota InlUatadJtt
Dennis M. Sheehe, MD
$.tIl1II.
Signed
L.u1..lIPIIIlLI
Dennis M. Sheehe, MD
Wi VR!IIJil
1212012007 11 :21 AM
Office visit is being accomplished at the request of Bruce G, Baron.
Apparently this patient requested that this law firm provoke Powers crf
Attorney and the point new health-care agent, grandson Troy [who lives as on
the farm].
When I asked her what is going on she gave some contradictory information.
Claims to have been dumped on the farm by son
Does not want to go back to Harrisburg with him
Nephew Troy & wife live with me and are there all of the time
Later said grandson living with her and nephew only there at times
She has regular appointment for blood work and physical in January.
MENTAL STATUS EVALUATION:
Appearance: within normal limits, age-appropriate, casually dressed and
smells like fireplace smoke.
Behavior: pleasant, fidgety and hypoactive
Speech: normal pitch, normal rate and normal volume
Mood: sad and apathetic
Affect: blunted and flat
Thought Process: totally oriented on single goal of living on the farm
Thought Content:
Delusions: No
Hallucinations: No
Obsessions: Yes, description living on the farm.
Homicidal: No
Suicidal: No
Sensorium: alert and oriented to person, does not know me
Cognition: impaired due to cerebrovascular disease
Insight: poor
Judgment: poor
",,""","
-ASSESSMENT-
"""""" ,
1. Dementia. Vascular dementia + possible Alzheimer's dementia.
2. Status post frontotemporal subdural hemorrhage
3. Status post frontal hemorrhagic cerebrovascular accident
4. Significant deficits in judgment and decision-making dating back to June
2007
5. Generalized cerebral atrophy
6. Hypertension
Printed 12/20/07 11:21 AM
Geisinger
Page 1 of6
Valencik, Betty R (MR # 3104140)
DOB: 11/05/1922
7. History of lymphoma
8. History of Bell's palsy
9. Restless legs syndrome
10. Depression
11. Gastroesophageal reflux
12. Hyperlipidemia
13. Not competent to manage financial affairs
14. Not competent to live independently. Needs 24-hour supervision.
15. Not competent to sign release
16. Not competent to make medical decisions
- PLAN -
Current outpatient prescriptions:
SYNTHROID 50 MCG OR TABS, one tab by mouth daily, Disp: 3 month supply, Rfl:
3
PREVACID 30 MG PO PACK, one daily in the am, Disp: 3 month supply, Rfl: 3
CELEXA 20 MG PO TABS, 1 tab daily, Disp: 90, Rfl: 3
MIRTAZAPINE 15 MG PO TABS, at bedtime, Disp: 90, Rfl: 3
MULTI-VITAMIN PO TABS, 1 tab daily, Disp: , Rf1:
Follow up: Return for re ck in Jan as sched on a wed am.
Dennis M Sheehe, M.D.
Associate Family Medicine
Geriatrics CAQ
Geisinger Medical Group Catawissa
353 Main St.
Catawissa PA, 17820
570-356-2351
Vitals
~~i~~~~~~1J~~:l;~~,!!~l~~B~~"'-~~~"l~~~~h~~~E~j,~~~~i::::~~=~~~;~~~~~~~~~~~E~~gf~
120/58 72 36.3 oC (97.4 oF) 16 51.256 kg (1131bs) Postmenopausal
(Oral)
YJlals Historv Recorded
ENC VITALS
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Pulse 72 -CL
,Ii _.,. -- _ _ _ :~tBiilEi _.'
Temp 36.3 oC (97.4
oF) -GL
7,~=::.;;::::.~~m;_lli~"ili!~~~~
Printed 12/20/07 11:21 AM
Geisinger
Page 2 of6
8ummary of Checking account since May 2007
check number June Check number
1185 200 1192
1186 281.98 1193
1187 349.8 1194 Chetlwork
1188 135.82 1195 well
1189 verizon 61.36 1196 verizon
1190 dish net 103.86 1197 well
1132.82
Deposits
5/30
6/1 8.8. Check
6/11 cd
6/11
Check number
1209
1211
1212
1214
1215
1216
1217
1219
1220 verizon
1221 dishnet
1222
Deposits
8/20
8/31 8.8. check
9/6
282.93
1138
14700.56
633.78
16755.27
6/18
7/3 ss check
7/12
8/3 ss check
September Check Number
11.54 1223
28.5 1224
1500 1225
368 1226
500 1227
42.75 1228
40 1229
304 1230
171.94 1233
103.86 1234
80
3150.59
806.03
1138
633.78
10/3 8.S. check
11/2 8.8 check
11/9
11/9
2577.81
July Check numb
14.54 1191
500 1198
5000 1199
1089.68 1200
95.15 1201
3725.9 1202
10425.27 1203
1204
1205
1206
1207
1208
1210
410.25
1138
806.03
1138
3492.28
August
200
105
648.06
150
500
200
500
595.34
1700
420.89
100
500
743.33
6362.62
October Check Numt November
209.88 1231 72
54.75 1232 16.63
500 1235 123
290.38 1236 150
75.45 1237 23
209.25 1238 400
94.5 1240 276
276 1241 287.5
1000 1244 276
389.5 1247 743.33
1248 500
3099.71 2867.46
1138
1138
806.03
172.25
3254.28
Total Banking Statement
PNC Bank
/
For the period 05/15/2007 to 06/14/2007
G
BETTY R VAlENCIK
73 LICK RUN RD
CATAWISSA PA 17820-8718
o PNCBANK
Primary account number: 90-1146-8865
Page 1 of 4
Number of enclosures: 0
Q For 24-hour banking, and transaction or
interest rate information, sign on to
tI' PNC Bank Online Banking at pnc.com.
For customer selVice call1-888-PNC-BANK
between the hours of 6 AM and Midnight ET.
Para selVicio en espafiol, 1-866-HOLA-PNC
Moving' Please contact us at 1-888-PNC-BANK
~ Write to: Customer SelVice
PO Box 609
Pittsburgh PA 15230-9738
Q Visit us at pnc.com
III TOO terminal: 1-800-531-1648
For hearing impaired clients only
Relationship Overview
Bank Deposit Accounts
;, Description
Interest Checking
Retirement Account(s)
Total Deposits
Account Number
90-1146-8865
Total of2
Deposit Balance
19,742.20
9,059.90
28,802.10
Senior Premium Plan
Interest Checking Account Summary
Account number: 90-1146-8865
Betty R Valencik
Balance Summary
Please see the Activity Detail section for
additional information.
Beginning
balance
Deposits and
other additions
16,756.91
Checks and other
deductions
4,138.11
1,152.82
Average monthly
balance
5,926.56
Endi ng
balance
19,742.20
Charges
and fees
20.00
Transaction Summary
Checks paid/
withdrawals
Check Card POS
signed transactions
Check Card/Bankcard
POS PIN transactions
4
o
Total ATM
transactions
PNC Bank
ATM transactions
Other Bank
A TM transactions
o
o
As of 06/14, a total of $4.96 in interest was
paid this year.
Interest Summary
Annual Percentage
Yield Earned (APYE)
Number of days
in interest period
Average collected
balance for APYE
O.33%'
31
5,886.30
o
o
Interest Paid
this period
1.64
FORM953R-l005
Total Banking Statement
"'"
8 For 24-hour information, sign on to PNC Bank Online Banking
on pnc.com.
Account number: 90-1146-8865 - continued
For the period 05/15/2007 to 06/14/2007
BETTY R VALENCIK
Primary account number: 90-1146-8865
Page 2 of 4
Activity Detail
Deposits and Other Additions
Date Amount Description
Deposit Reference No 026044446
Direct Deposit - Soc Sec
US Treasury 303 XXXXX2001D
Deposit From CDA 030 # 31500226437
Deposit Reference No 027419379
Interest Payment
05/30 282.93
06/01 1,138.00
06/11 14,700.56
06/11 633.78
06/14 1.64
There were 5 Deposits and Other Additions
totaling $16.756.91.
Checks and Substitute Checks
Check Date
number Amount paid
1185
1186
* Gap in check sequence
Reference
number
025298695
027575494
Check
number
200.00
281.98
05/18
OS/21
1187
1188
Online and Electronic Banking Deductions
Date Amount Description
06/04 103.86 Payment,E-Check Dishckpymt
Echostar Communi 1190
06/04 61.36 Payment,E-Check Check Pymt Verizon ARC 1189
Date
06/14
Amount
Description
Other Deductions
20.00 Calculated Service Charge
Type Hd
Date Reference
Amount paid number
349.80 OS/21 OS'!lOt385
135.82 OS/23 025802955
There were 4 checks listed totaling
$967.60.
There were 2 Online or Electronic Banking
Deductions totaling $165.22.
There was 1 Other Deduction totaling
$20.00.
Daily Balance Detail
Date Balance Date Balance Date Balance
05/15 4,138.11 OS/23 3,170.51 06/04 4,426.22
05/18 3,938.11 05/30 3,453.44 06/11 19,760.56
OS/21 3,306.33 06/01 4,591.44 06/14 19,742.20
SENIOR PREMIUM PLAN - Service Charge Explanation
Account type
Interest Checking
Certificate( s) of Deposit
Retirement Account(s)
Retirement Account(s)
Account number
Balance type
This Cycle Avg Balance
Current Value
Current Value
Current Value
As of
06/15
06/13
06/13
06/13
Balance
5,927.21
.00
1,566.31
7,493.59
XX-XXXX-8865
XXXXXX1206
XXXXXX8458
XXXXXX8379
These accounts were reviewed to meet
the balance requirements of your Senior
Premium Plan Account. Since balance
requirements were not met this month, a
$20.00 fee was deducted from this
account.
-.....
Total Banking Statement
e For 24-hour information, sign on to PNC Bank Online Banking
on pnc.com.
Accollnt number: 90-1146-8865 - continued
For the period 05/15/2007 to 06/14/2007
BETTY R VALENCIK
Primary account number: 90-1146-8865
Page 4 of 4
Retirement Accounts
115 Month( s) Fixed Rate
Betty R Valencik
Maturity date Interest Original or Current
rate renewal value value
03/18/2014 4.89% 7,849.97 7,493.59
Betty R Valencik
Maturity date , nterest Original or Current
rate renewal value value
02/28/2014 4.89 % 1,635.79 1,566.31
Total current value 9,059.90
Investment
number
Description
75500027320
115 Month(s) Fixed Rate
Investment
number
75100027411
Descri ption
Total Banking Statement
~ PNCBANK
a For 24-hour information, sign on to PNC Bank Online Banking
on pnc.com.
Account number: 90-1146-8865 - continued
For the period 05/15/2007 to 06/14/2007
BETTY R VALENCIK
Primary account number: 90-1146-8865
Page 3 of 4
IMPORTANT INFORMATION ABOUT TRANSACTIONS AT NON-PNC BANK ATMS
As a convenience, under certain conditions we will allow you to overdraft your checking or money market account when using your PNC
Bank Visa Check Card or PNC Bank A TM card at Non-PNC A TMs. At PNC Bank A TMs you are given an opportunity to cancel the
transaction if it would cause an overdraft. You will not receive this choice when using a non-PNC Bank ATM. If you would prefer not to
have overdraft access at non-PNC Bank ATMs, call our Telephone Banking service at 1-877-222-5401 between 6 am - 12 midnight, Eastern
Time, seven days a week.
If you have previously called to opt-out, you do not need to call again.
For more information, please see our Consumer Schedule of Service Charges and Fees, Other Account Charges and Services and/or Account
Agreement for Personal Checking and Savings Accounts, Withdrawals section.
Buying a New Home or Looking to Refinance? Let PNC Mortgage Show You How
We can help yon find the right mortgage to meet yonr needs.
> First time home buyer
> Building your dream home
> Purchase & Renovate(SM) loans
> Vacation & Second Homes
> FHA & VA Loans
Home Ownership Made Possible by PNC(SM)
For More Information:
> Ask to speak with your PNC Home Mortgage Consultant
> Visit pncmortgage.com
> Call 1-800-778-6678
Rest easy with the American Express Travelers Cheque Savings Offer. Purchase $500 or more in American Express Travelers Cheques and
get huge savings at leading hotels. Go online to American Express tcbonus.com to register and book your reservations.
Offer valid from 6/1/07 - 8/31/07. See www.tcbonus.com for complete terms and conditions.
COMPLIMENTARY FINANCIAL REVIEW
Chart Yonr Financial Futnre Today
Investments * Education * Retirement * And More
PNC Investments can help you plot the course of a solid fmancial joumey. Whether it's planning tor financial freedom, education or
retirement, PNC Investments can help navigate your future through our free monthly checkups and reviews.
June - Free College Planning Checkup
July - Free Retirement Review
August - Free Investment Checkup
For more infonnation call1-800-PNC-6111, stop by your local PNC Bank Branch, or visit pnc.com
Not FDIC Insured. May Lose Value. No Bank Guarantee.
Important Investor Information: Securities and brokerage services are provided by PNC Investments LLC, member NASD and SIPC. Annuities
and other insurance products are offered by PNC Insurance Services, LLC a licensed insurance agency.
FORM953R-1005
Total Banking Statement
PNC Bank
For the period 06/15/2007 to 07/16/2007
L
M
BETTY R VALENCIK
5108 INVERNESS DR
MECHANICSBURG PA 17050-8319
~PNCBANK
Primary account number: 90- 1146-8865
Page 1 of 2
Number of enclosures: 0
Q For 24-hour banking, and transaction or
interest rate information, sign on to
'It PNC Bank Online Banking at pnc.com.
For customer service call 1-888-PNC-BANK
between the hours of 6 AM and Midnight ET.
Para servicio en espanol, 1-866-HOLA-PNC
Moving' Please contact us at 1-888-PNC-BANK
I:!!s:J Write to: Customer Service
PO Box 609
Pittsburgh PA 15230-9738
Q Visit LIS at pilc.com
iii TOO terminal: 1-800-531-1648
For hearing impaired clients only
Relationship Overview
Bank Deposit Accounts
Description
Interest Checking
Retirement Account(s)
Total Deposits
Account Number
90-1146-8865
Total of2
Deposit Balance
11,677.36
9,098.78
20,776.14
Senior Premium Plan
Interest Checking Account Summary
Account number: 90- 1146-8865
Betty R Valencik
Balance Summary
Please see the Activity Detail section for
additional information.
Beginning
balance
19,742.20
Transaction Summary
Checks paid/
withdrawals
Total ATM
transactions
Interest Summary
Annual Percentage
Yield Earned (APYE)
0.50%
5
Deposits and Checks and other Ending
other additions deductions balance
2,360.43 10,425.27 11,677.36
Average monthly Charges
balance and fees
14,140.06 .00
Check Card pas Check Card/Bankcard
signed transactions pas PIN transactions
0 0
PNC Bank Other Bank
ATM transactions ATM transactions
0 0
Number of days Average collected Interest Paid
in interest period balance for APYE this period
32 14,073.43 6.15
o
As of 07/16, a total of $11.11 in interest was
paid this year.
FORM953R-1005
Total Banking Statement
g For 24-hour information, sign on to PNC Bank Online Banking
~ on pnc.com.
Account number: 90-1146-8865 - continued
For the period 06/15/2007 to 07/16/2007
BETlY R VALENCIK
Primary account number: 90-1146-8865
Page 2 of 2
Activity Detail
Deposits and Other Additions
Date Amount Description
Deposit Reference No 027431219
Direct Deposit - Soc Sec
US Tre;lsmy 303 XXXXX2001D
Deposit Reference No 024305801
Interest Payment
There were 4 Deposits and Other Additions
totaling $2.360.43.
06/18 410.25
07/03 1,138.00
07/12 806.03
07/16 6.15
Checks and Substitute Checks
Check Date
number Amount paid
1192 14.54 06/15
1193 500.00 06/18
1194 5,000.00 06/19
Reference
number
025382511
027325528 .- rZ<-1
024117979 '/l1~ fY"'" IIv"RIC 'fy,z.!...
Check
number
ll95
1197 *
Amount
] ,089.68
3,725.90
Date
paid
06/20
07/10
Reference
number
086737147 -()J'I
H220722063 -~d
* Gap in check sequence
There were 5 checks listed totaling
$10.330.12.
There was 1 Online or Electronic Banking
Deduction totaling $95.15.
Online and Electronic Banking Deductions
Date Amount Description
07/10 95.15 Payment,E-Check Check Pymt Verizon ARC 1196
Daily Balance Detail
Date
06/] 5
06/18
Balance
]9,727.66
]9,637.91
Date
06/19
06/20
Balance
14,637.91
13,548.23
Date
07/03
07/ ] 0
Balance
14,686.23
10,865.18
Date
07/12
07/16
Balance
11,671.21
11,677.c16
Rentel's, al'e your valuables covered? If a fIre or other unexpected event occurs, your landlord's insmance isn't likely to cover replacement
of your personal propelty. Renters inslU'ance can help you protect yomselt: For more infonl1ation and a free no obligation quote visit
pnc.com/insurance. Product not available in FL, NC and N1.
Your PNC Bank Visa Check Card offers convenience and rewards. Use your card to set up automatic bill payments without stamps,
checks, or hips to the post oflice. Plus, with your enrolled Visa check card, you'll eam Visa Extras Rewanls Points, redeemable for exciting
gins. It's free to set up at pnc.com/paybycard.
Retirement Accounts
115 Month(s) Fixed Rate
Betty R Valencik
Maturity date Interest Original or Cu rrent
rate renewal value value
03/18/2014 4.89 % 7,849.97 7,525.75
Betty R Valencik
Maturity date Interest Original or Current
rate renewal val ue value
02/28/2014 4.89 % 1,635.79 1,573.03
Total current value 9,098.78
Investment
number
75500027320
Description
Investment
number
Description
75100027411
115 Month(s) FL'(ed Rate
Total Banking Statement
PN C Bank
0PNCBANK
For the period 07/17/2007 to 08/14/2007
Primary account number: 90-1146-8865
Page 1 of 3
Number of enclosures: 0
BETTY R VALENCIK
5108 INVERNESS DR
MECHANICSBURG PA 17050-8319
Q For 24-hour banking, and transaction or
interest rate information, sign on to
tr PNC Bank Online Banking at pnc.com.
For customer selVice call1-888-PNC-BANK
between the hours of 6 AM and Midnight ET.
Para selVicio en espano!, 1-866-HOLA-PNC
Moving? Please contact us at 1-888-PNC-BANK
l2!SI Write to: Customer SelVice
PO Box 609
Pittsburgh PA 15230-9738
Q Visit us at pnc.com
Ii TOO terminal: 1-800-531-1648
For hearing impaired clients only
Relationship Overview
Bank Deposit Accounts
Description
Account Number
Deposit Balance
6,433.87
9,134.16
15,568.03
Interest Checking
Retirement Account(s)
Total Deposits
90-1146-8865
Total of2
Effective October 9, 2007, PNC will mail paper advices of wire transfers only to those customers who have a Wire Transfer agreement with
PNC Bank, Treasury Management, or who notifY us that they wish to continue to receive mailed advices. Additionally, if you are a consumer
customer, who has signed a consumer Funds Transfer Agreement, PNC will no longer mail paper advices of wire transfers, unless notified that
they wish to continue to receive mailed advices. Please note that wire transfer transactions will continue to appear on your monthly account
statement. Online access to wire information is also available. Please go to pnc.com and log on according to your account type. For Personal
accounts, click on the Personal tab and log on to Online Banking. For Small Business or Corporate & Instihltional accounts, click on either
the Small Business or Corporate & Instimtional Tab and log on to Online Banking or PINACLE@ Web, respectively.
If you would like to continue to receive mailed paper advices of wire transfers, please submit your request in writing that you would like to
continue to receive mailed debit and credit wire transfer advices and include your account number(s), name(s) and address(es) and mail to:
PNC Bank, N.A.
500 First Ave
Mailstop: P7-PFSC-03-W
Attn: Mail Advice Change Request
Pittsburgh, P A 15219
After mailing your request, please allow at least 30 days for the change to be made. If you have additional questions, please contact your PNC
Bank branch or call1-888-PNC-BANK.
Let PNC Mortgage help you buOd your dreams.
Building your own home allows you to create a home truly suited to your needs, your family, and your desires. PNC Mortgage has a variety
of options specifically designed to simplifY new construction fmancing tor you.
We't'e here to help you find the program that best suits you.
For More Information:
> Ask to speak with your PNC Home Mortgage Consultant
> Visit pncmortgage.com
> Call 1-800-778-6678
Your individual account statements begin on the following page
FORM953R.l005
Total Banking Statement
g For 24-hour information, sign on to PNC Bank Online Banking
~ on pnc.com.
For the period 07/17/2007 to 0811412007
BETlY R VALENCIK
Primary account number: 90-1146-8865
Page 2 of 3
1 l (~Of. . l.; l ~ li.:l ,l 0 l 0 0' b , . 1 . U 0' ~ St:l . l;; . l,; (, ( I,,; ( ) '0 ef b C ( l
Secondary Mortgage Loan Licensee. PNC MOl1gage, LLC may not be availahle in yonr area. Credit snbject to approval. Information is accnrate as of the date of printing and is
suhjeet to chauge without notice. 102007 PNC M011gage, LLC. All Rights Reselveli 491736/07-9/07
Senior Premium Plan
Interest Checking Account Summary
Account number: 90-1146-8865
Betty R Valencik
Balance Summary
Please see the Activity Detail section for
additional information.
Beginning
balance
11,677.36
Deposits and
other additions
Checks and other
deductions
Ending
balance
6,43c~.87
1,139.13
6,382.62
Average monthly
balance
7,558.54
Charges
and fees
20.00
Transaction Summary
Checks paid/
withdrawals
Tolal ATM
transaclions
Check Card/Bankcard
pas PIN transactions
13
Check Card pas
signed transactions
o
o
Other Bank
ATM transactions
o
PNC Bank
A TM transactions
o
o
Interest Summary
As of 08/14, a total of $12.24 in interest was
paid this year.
Annual Percenlage
Yield Earned (APYE)
Average collected
balance for APYE
Interest Paid
this period
0.19%
Number of days
in interest period
29
7,558.54
1.13
Checks and Substitute Checks
Check Date
number ..n,mount paid
07/17
07/23
07/17
07/17
07/18
07/17
07/19
Date
07/20
07/23
07/31
Activity Detail
Deposits and Other Additions
Date Amount Description
08/03 1,138.00 Direct Deposit - Soe See
US Treasury 303 XXXXX2001D
08/14 1.13 Interest Payment
There were 2 Deposits and Other Additions
totaling $1.139.13.
Reference
number
Check
nllmber
Date Reference
.Amollnt paid number
595.34 07/23 08G625292
1,700.00 07/20 028092357
420.89 08/06 083778221
100.00 07/31 088497123
500.00 08/06 0285G841O
743.33 08/14 028089048
1191
1198 *
1199
1200
1201
1202 T
1203
200.00
105.00
648'(J6
150.00
500.00
200.00
500.00
0241150G3
026846422
028772456
028761831
027771031
026252146
024G30849
120'1
1205
1206
1207
1208
1210 *
* Gap in check sequence
"T" Teller Cashed Check
Dale
Amount
There were 13 checks listed totaling
$6.362.62.
There was 1 Other Deduction totaling
$20.00.
Other Deductions
08/1'1
20.00
Descri plion
Calculated SelVice Charge
Type Hd
Daily Balance Detail
Date Balance
07/17 10,479.30
07/18 9,979.30
07/19 9,479.30
Balance
7,779.30
7,078.96
6,978.96
Date
08/03
08/06
08/14
Balance
8,116.96
7,196.07
6,433.87
Total Banking Statement
0PNCBANK
Q For 24-hour information, sign on to PNC Bank Online Banking
on pnc.com.
Account number: 90-1146-8865 - continued
For the period 07/17/2007 to 08/14/2007
BEllY R V ALENCIK
Primary account number: 90-1146-8865
Page 3 of 3
SENIOR PREMIUM PIAN - Service Charge Explanation
Accou nt type
Interest Checking
Certificate(s) of Deposit
Retirement Account(s)
Retirement Account(s)
Account number
Balance type
This Cycle Avg Balance
Current Value
Current Value
Current Value
As of
Balance
These accounts were reviewed to meet
the balance requirements of your Senior
Premium Plan Account. Since balance
requirements were not met this month, a
$20.00 fee was deducted from this
account.
XX-XXXX-8865
XXXXXX1206
XXXXXX8458
XXXXXX8379
08/15
08/13
08/13
08/13
7,559.23
.00
1,579.15
7,555.01
Are you temporarily without health insurance? An illness or injury could set you back financially. Short Term Medical insurance can
provide health coverage with convenient payment options. To learn more visit pnc.com/insurance or call 1-877-284-4793.
Relax and let your PNC Bank Visa@ Check Card pay the bills. Use your card to schedule one-time or recmTing payments. You pay what
you need without looking for stamps, writing checks, or traveling to the post office. It's that easy. Find out more at pnc.com/paybycard.
Retirement Accounts
ll5 Month(s) Fixed Rate
Betty R Valencik
Maturity date Interest Original or Current
rate renewal value value
03/18/2014 4.89% 7,849.97 7,555.01
Betty R Valencik
Maturity date Interest Origi nal or Current
rate renewal value value
02/28/2014 4.89% 1,635.79 1,579.15
Total current value 9,134.16
Investment
number
75500027320
Description
Investment
number
Description
75100027411
115 Month(s) Fixed Rate
FORM953R.1005
'fo.~ t.-. I
Reviewing Your Statement
Please review this statement carefl1lly and reconcile it with your records. Call the telephone munber on the upper right side of the first page
ofthis statement if:
· you have any questions regarding your accounts(s);
· your name or address is incorrect;
· you have a business account and your tax identification number is missing or incorrect;
· you have any questions regarding interest paid to an interest-bearing account.
Balancing Your Account
Update Your Account Register
Compare:
Check Off:
TIle activity detail section of your statement to your account register.
All items in your accOlmt register that also appear on your statement. Remember to begin
with the ending date of your last statement. (An asterisk {*} will appear in the Checks
section if there is a gap in the listing of consecutive check numbers.)
Any deposits or additions including interest payments and A TM or electronic deposits
listed on the statement that are not already entered in your register.
Any account deductions including fees and A TM or electronic deductions listed on the
statement that are not already entered in your register.
Add to Your Account Register
Balance:
Subtract From Your Account
Register Balance:
Update Your Statement Information
Step 1:
Add together
deposits and
other additions
listed in your
account register
but not on your
statement.
Step 2:
Add together
checks and other
deductions listed
in your account
register but not on
your statement.
Date o' Deposit
Amount
Total A
Step 3:
Enter the ending balance recorded on your statement $
Add deposits and other additions not recorded Total A + $
Subtotal= $
Subtract checks and other deductions not recorded Total B - $
TIle result should equal your account register balance $
Check Number or
Dedactio. Description Amount
Total B
Verification of Direct Deposits
To verify whether a direct deposit or other transfer to your account has occurred, call us 7 days a week from 6:00 A.lVI. to Midnight (ET) at
the customer service number listed on the upper right side ofthe first page ofthis statement.
Electronic Funds Transfers
In case of elHlrs or questions abont your electronic transfers or if yon need more infOlmation ahout a trausfer, call us 7 days a week fmm 6:00 A.M. to Midnight (El) at the
customer selVice number listed on tbe upper light side of the fIrst page of this statement. Or, if you prefer, please Wiite us at: Customer Selvice, P.O. Box 609, Pittsburgh, PA
15230-0609. If yon helieve there is a prohlem, you must contact us no later than 60 (L'IYs after the ending (L'Ite of the first statement ou which the ell"Or or problem appeared.
Yon will need to provide the following information:
· Your name and account number(s);
· A descriptiou of the ell"Or or the tHIns fer you are questioning. Please explain as clearly as you cau why you need more infolmation or wiLY you helieve an emlr was made;
· llte (Iollar amount of the suspected en-or.
We will investigate your complaint and will cOlTee! any enor promptly. If the investigatiou takes louger thau 10 business days, we will credit your acconnt for the
amount you think is in en'or, so that you will have use of the fund~ during the time it takes us to complete our investigation.
Member FDIC
~ Equal Housing Lender
Total Banking Statement
PNC Bank
o
For the period 08/15/2007 to 09/13/2007
BETTY R VALENCIK
5108 INVERNESS DR
MECHANICSBURG PA 17050-8319
(;) PNCBANK
Primary account number: 90-1146-8865
Page 1 of 3
Number of enclosures: 0
Q For 24-hour banking, and transaction or
interest rate information, sign on to
'tr PNC Bank Online Banking at pnc.com.
For customer service call1-888-PNC-BANK
between the hours of 6 AM and Midnight ET.
Para servicio en espar'iol, 1-866-HOLA-PNC
Moving? Please contact us at 1-888-PNC-BANK
181 Write to: Customer Service
PO Box 609
Pittsburgh PA 15230-9738
Q Visit us at pnc.com
;]
TDDterminal: 1-800-531-1648
For hearing impaired clients only
Relationship Overview
Bank Deposit Accounts
Description
Interest Checking
Retirement AccOlmt(s)
Total Deposits
Account Number
90-1146-8865
Total of2
Deposit Balance
5,841.75
9,170.90
15,012.65
Senior Premium Plan
Interest Checking Account Summary
Account number: 90-1146-8865
Betty R Valencik
Balance Summary
Please see the Activity Detail section for
additional information.
Beginning
balance
6,433.87
9
Deposits and Checks and other Ending
other additions deductions balance
2,578.47 3,170.59 5,841.75
Average monthly Charges
balance and fees
5,562.94 20.00
Check Card POS Check Card/Bankcard
signed transactions POS PIN transactions
0 0
PNC Bank Other Bank
ATM transactions ATM transactions
0 0
Number of days Average collected Interest Paid
in interest period balance for APYE this period
30 5,447.27 .66
Transaction Summary
Checks paid/
withdrawals
Total ATM
transactions
Interest Summary
Annual Percentage
Yield Earned (APYE)
0.15%
o
As of 09/13, a total of $12.90 in interest was
paid this year.
FORM953R.1005
Total Banking Statement
Q For 24-hour information, sign on to PNC Bank Online Banking
on pnc.com.
Account number: 90-1 I 46-88f:i5 - continued
For the period 08/15/2007 to 09/13/2007
BETTY R VALENCIK
Primary account number: 90-1146-8865
Page 2 of 3
Activity Detail
Deposits and Other Additions
Date Amount Description
Deposit Reference No 027107175
Direct Deposit - Soc Sec
US Treasmy 303 XXXXX2001D
Deposit Reference No 027663146
Interest Payment
08/20 806.03
08/31 1,138.00
09/06 633.78
09/13 .66
There were 4 Deposits and Other Additions
totaling $2.578.47.
Checks and Substitute Checks
Check Date
number Amount paid
1209 11.54 08/16
1211 * 28.50 08/15
1212 1,500.00 08/16
1214 * T 368.00 08/24
1215 T 500.()O 08/28
* Gap in check sequence
Reference
number
027436602
087087279
087322626
026146] 59
027631454
"T" Teller Cashed Check
Check
number
1216
1217
1219 * T
1222 * T
Online and Electronic Banking Deductions
Date Amount Description
""
09/07 171.94 Payment,E-Check Check Pymt VeI'izon ARC 1220
\. 00/10 103.86 Payment,E-Check Dishckpymt
Echostar Communi 1221
Other Deductions
Date
09/13
Amount Description
20.00 Calculated Service Charge
Type Hd
Date Reference
Amount paid number
42.75 09/05 086132028
40.00 08/31 028054528
304.00 09/04 027236907
80.00 09/11 020510502
There were 9 checks listed totaling
$2.874.79.
There were 2 Online or Electronic Banking
Deductions totaling $275.80.
There was 1 Other Deduction totaling
$20.00.
Daily Balance Detail
Date Balance
08/15 6,405.37
08/16 4,893.83
08/20 5,699.86
08/24 5,331.86
Date
08/28
08/31
09/04
09/05
Balance
4,831.86
5,929.86
5,625.86
5,583.11
Date
09/06
09/07
09/10
09/11
Balance
6,216.89
6,044.95
5,941.09
5,861.09
Date
09/13
Balance
5,841.75
SENIOR PREMIUM PLAN - Service Charge Explanation
Account type
Interest Checking
Celtificate( s) of Deposit
Retirement Account(s)
Retirement Account( s)
Account number
XX-XXXX-fl865
XXXXXX1206
XXXXXX8458
XXXXXX8379
Balance type
This Cycle Avg B,,\ance
Cunent Value
Current Value
Cunent Value
As of
09/14
09/12
09/12
09/12
Balance
5,563.61
. .00
1,585.50
7,585.40
These accounts were reviewed to meet
the balance requirements of your Senior
Premium Plan Account. Since balance
requirements were not met this month, a
$20.00 fee was deducted from this
account.
Pick up a bilingual Sesame Street "Happy, Healthy Ready for School" kit at any PNC Bank branch. It's all new and FREE.
Elmo and friends him everyday moments into fimleaming opporhmities. Includes a DVD, a magazine for parents and caregivers, an activity
book and activity cards.
Total Banking Statement
o PNCBANK
Q For 24-hour information, sign on to PNC Bank Online Banking
on pnc.com.
Account number: 90-1146-8865 - continued
For the period 08/15/2007 to 09/13/2007
BETlY R VALENCIK
Primary account number: 90-1146-8865
Page 3 of 3
Retirement Accounts
75100027411
115 Month(s) Fi.."ed Rate
Betty R Valencik
Maturity date Interest Original or Current
rate renewal value value
03/18/2014 4.89% 7,849.97 7,585.40
Betty R Valencik
Maturity date Interest Origi nal or Current
rate renewal value . value
02/28/2014 4.89% 1,635.79 1,585.50
Total current value 9,170.90
Investment
number
75500027320
Description
115 Month(s) Fixed Rate
Investment
number
Descri plion
FORM953R-1005
Reviewing Your Statement
Please review this statement carethlly and reconcile it with your records. Call the telephone mmlber on the upper right side of the fIrst page
ofthis statement if:
· you have any questions regarding your accoU11tS(S);
· your name or address is incorrect;
· you have a business account and your tax identifIcation number is missing or inconect;
· you have any questions regarding interest paid to an interest-bearing account.
Balancing Your Account
Update Your Account Register
Compare:
Check Off:
The activity detail section of your statement to your aCCOtUlt register.
All items in your accoU11t register that also appear on your statement. Remember to begin
with the ending date ofyourlast statement. (An asterisk {*} will appear in the Checks
section ifthere is a gap in the listing of consecutive check nwnbers.)
Any deposits or additions including interest payments and A TM or electronic deposits
listed on the statement tllat are not already entered in your register.
Any account deductions including fees and A TM or electronic deductions listed on the
statement that are not already entered in your register.
Add to Your Account Register
Balance:
Subtract From Your Account
Register Balance:
Update Your Statement Information
Step 1:
Add together
deposits and
other additions
listed in your
account register
but not on your
statement.
Amount
Step 2:
Add together
checks and other
deductions listed
in your account
register but not on
your statement.
Date of Dep08it
Total A
Step 3:
Enter the ending balance recorded on your statement $
Add deposits and other additions not recorded Total A + $
Subtotal= $
Subtract checks and other deductions not recorded Total B - $
The result should equal your account register balance $
Check Namber or
Deductioa Descriptio. Amount
Total B
Verification of Direct Deposits
To veritY whether a direct deposit or other transfer to your account has occurred, call us 7 days a week from 6:00 A.M. to Midnight (ET) at
the customer selvice number listed on the upper light side ofthe fIrst page Oftllis statement.
Electronic Funds Transfers
In case of enurs or qllestions about your electronic transfers or if you need more information about a transfer, callus 7 days a week from 6:00 A.M. to Midnight (El) at the
customer service lIumber listed ou the IIpper right side of the fll'St page of this statement. Or, if yo II prefer, please write us at: Customer Selvice, P.O. Box 609, Pittsburgh, PA
15230-0609. IfyolI believe there is a pmblem, YOII must contact us no later than 60 days after the ending date ofthe first statemellt on which the error or problem appeared.
You will need to Ilrovide the following information:
· Y ollr name and accollnt number(s);
· A description of the enur or the transfer you are questioning. Please explain as clearly as you can why YOII need more information or why YOII believe an ermr was made;
· The dollar alllollnt of the sllspected error.
We will investigate your complaint and will correct any error promptly. If the investigation takes longer thall HI business days, we will crellit YOllr account for the
amount you think is in enOl', so that you will have use of the fuuds dming Ute time it takes us to complete olu'investigation.
Member FDIC
~ Equal Housing Lender
Total Banking Statement
IQ] For 24-hour information, sign on to PNC Bank Online Banking
.!2. on pnc.com.
Account numher: ~Hl-1141i-88(i5 - continued
For the period 09/14/2007 to 10/15/2007
BETTY R VALENCIK
Primary account number: 90-1146-8865
Page 2 of 2
Activity Detail
Deposits and Other Additions
Date
10/03
10/15
Amount Description
1,lc18.00 Direct Deposit - SOl' Sec
US Tlels11lY 3m XXXXX200lD
.68 Intel'est Payment
There were 2 Deposits and Other Additions
totaling $1,138.68.
Checks and Substitute Checks
Check Date
number Amount paid
1223 209.88 09/19
1221 54.75 10/01
1225 !iOO.OO 09/24
122() 290.:38 09/24
1227 7!i.4!i HV 11
Reference
number
0253583fi4
0286]85]5
02.16694%
087] 26%2
0280387fi6
Check
number
1228
1229
12,10 T
12~1~1 *
12,14 T
* Gap in check sequence
"T" Teller Cashed Check
Other Deductions
Date
10/15
20.00
Descri pti on
Calculated Service Ch;llge
Type Bel
Amount
Date Reference
Amount paid number
299.25 10/01 028025252
94.!i0 10/11 0281l3S7G5
27G.00 10/09 027GHGJ!'i1
1,000.00 10/12 0831\%461\
389.!iO W/l!i 0261G28ri9
There were 10 checks listed totaling
$3,189.71.
There was 1 Other Deduction totaling
$20.00.
Daily Balance Detail
Date
09/ 1 .1
09/19
mV24
Balance
5,841.7!i
!i,ml.87
4,8.11.49
Date
10/0]
10/03
10/09
Balance
4,487.'19
!i,62!i.49
!i,349.49
Date
10/11
10/12
10/15
Balance
!i,17954
4,1795'1
c1,770.72
SENIOR PREMIUM PLAN - Service Charge Explanation
Accou nt type
Intel'est Checking
RetiH~IIIellt Account(s)
Retirement Accoll\lt(s)
Account number
XX'XXXX-8865
.XXXXXX84!i8
XXXXXX8379
Balance type
This Cycle Avg B;llance
Cunent V;llue
Cunent Value
As of
10/16
10/12
10/12
Balance
5,19357
1,592.30
7,617.%
These accounts were reviewed to meet
the balance requirements of your Senior
Premium Plan Account. Since balance
requirements were not met this month, a
$20.00 fee was deducted from this
account.
Take contI'ol with your I)NC Uank Visa@ Check Card. Use your card to pay your bills automatically - set payment schedules, amounts,
even the number of bills YOll want to pay. The 11.lI1ds come right from your checking account and the payments are listed on your monthly
.statement. Leamll1ol'c at pnc.com/paybycanl.
Retirement Accounts
Investment
number
7!i.",00027320
Investment
number
75100027.11 ]
Description
l1!i MOIlth(s) FL"ed Rate
Description
ll!i MOIllh(s) Fixed Rate
Betty R Valencik
Maturity date Interest Original or Current
rate. renewal value value
03/18/20H 4.89 % 7,849.97 7,GI7.%
Betty R Valencik
Maturity date Interest Original or Current
rate renewal value value
02/28/2014 4.89 % 1,63!i.79 ] ,592.:10
Total current value (1,210.25
Total Banking Statement
PNC Bank
o PNCBANK
For the period 09/14/2007 to 10/15/2007
Primary account number: 90-1146-8865
Page 1 of 2
Number of enclosures: 0
T
BETTY R VALENCIK
5108 INVERNESS DR
MECHANICSBURG PA 17050-8319
a For 24-hour banking, and transaction or
interest rate information, sign on to
1r PNC Bank Online Banking at pnc.com.
For customer service call1-888-PNC-BANK
between the hours of 6 AM and Midnight ET.
Para servicio en espanol, 1-866-HOLA-PNC
Moving? Please contact us at 1-888-PNC-BANK
18:1 Write to: Customer Service
PO Box 609
Pittsburgh PA 15230-9738
a Visit us at pnc.com
iii TDDterminal: 1-800-531-1648
For hem'ing impaired clients only
Relationship Overview
Bank Deposit Accounts
Description
Interest Checking
Retirement Account(s)
Total Deposits
Account Number
Deposit Balance
90-1146-8865
Totalof2
3,770.72
9,210.25
12,980.97
Set up a solid financial plan for any goal; education, retirement or a new home. With PNC Investments as your trusted guide, you can
detennine a strategy to help you reach your goals. Call us at 1-800-PNC-6111 to schedule a complimentary fmancial assessment.
Not FDIC In~ured. May Lo~e Value. No Bank Guarantee. Important Inve~tor InformatIon: Securities and brokerage setvices are provided by PNC Investments LLC,
member FINRA and SIrC. Annuities and other mSID'311ce products are offered by PNC Insurance Selvices, LLC a licensed mSID'ance agency.
Senior Premium Plan
Interest Checking Account Summary
Account number: 90-1146-8865
Betty R Valencik
Beginning
balance
5,841. 75
Deposits and
other additions
1,138.68
Checks and other
deductions
3,209.71
Endi ng
balance
Please see the Activity Detail section for
additional information.
Balance Summary
3,770.72
Average monthly
balance
5,192.94
Charges
and fees
20.00
Transaction Summary
Checks paid/
withdrawals
Check Card pas
signed transactions
Check Card/Bankcard
POS PIN transactions
10
o
o
Total ATM
transactions
PNC Bank
ATM transactions
Other Bank
ATM transactions
o
o
o
Annual Percentage
Yield Earned (APYE)
0.15%
Number of days
in interest period
Average collected
balance for APYE
Interest Paid
thi s period
As of 10/15, a total of $13.58 in interest was
paid this year.
Interest Summary
32
5,192.94
.68
FORM953R-1005
o PNCBANK
PNC BANK, NATIONAL ASSOCIATION
RETIREMENT SERVICES
P. O. BOX 3499
PITTSBURGH,PA 15230
000030
Tel 1-888-762-4727
Bank Fin 22-1146430
BETTY R VALENCIK
73 LICK RUN RD
CATAWISSA PA 17820-8718
Statement Period
01-01-07 Thru 06-30-07
Date
07-24-07
Page
1
Plan Type: TRADITIONAL IRA
Plan Number: 6000828379
Social Security #XXX-XX-3836
Principal Balance as of 01-01-07
Contributions Information
Current Year
Prior Year
Rollover
Interest Credited
Distribution Information
Principal Balance as of 06-30-07
Interest Accrued, Not Yet Credited
7,318.19
0.00
o .00
o .00
0.00
180.41
0.00
7,498.60
12.07
SUMMARY OF INVESTMENTS
Account Maturity Interest Current Interest Total
Number Rate Date Credited Value Accrued Value
75500027320 4.894 03-18-14 180.41 7,498.60 12.07 7,510.67
---------- ------------ ---------- -------------
Summary Totals 180.41 7,498.60 12.07 7,510.67
NOW IS THE PERFECT TIME FOR AN IRA CHECKUP!
CALL 1-888-PNC-IRAS (1-888-762-4727) AND HAVE ONE OF OUR
SPECIALISTS REVIEW YOUR IRA TODAY. MEMBER FDIC.
IRAC0911103
FORM953R-1005
Notice of Withholding on Distributions from Retirement Accounts
If federal income taxes have been withheld from the distribution or withdrawal payments you are receiving and if you do
not wish to have taxes withheld, you should notify PNC Bank. However, if you elect not to have withholding apply to your
distribution or withdrawal payments, or if you do not have enough Federal income tax withheld from your payments, you
may be responsible for payment of estimated tax. You may incur penalties under the estimated tax rules if your
withholding and estimated lax payments are not sufficient.
If federal income taxes are not being withheld from your payments because you have elected not to have withholding
apply and if you wish to revoke that election and have federal income taxes withheld from your payments, you should
notify PNC Bank.
~ PNCBANK
PNC BANK, NATIONAL ASSOCIATION
RETIREMENT SERVICES
P. O. BOX 3499
PITTSBURGH,PA 15230
000030
Tel 1-888-762-4727
Bank Fin 22-1146430
BETTY R VALENCIK
73 LICK RUN RD
CATAWISSA PA 17820-8718
Statement Period
01-01-07 Thru 06-30-07
Date
07-24-07
Page
1
Plan Type: TRADITIONAL IRA
Plan Number: 6000828458
Social Security #XXX-XX-3836
Principal Balance as of 01-01-07
Contributions Information
Current Year
Prior Year
Rollover
Interest Credited
Distribution Information
Principal Balance as of 06-30-07
Interest Accrued, Not Yet Credited
1,532.10
0.00
0.00
0.00
0.00
37.77
0.00
1,569.87
o .00
SUMMARY OF INVESTMENTS
Account Maturity Interest Current Interest Total
Number Rate Date Credited Value Accrued Value
75100027411 4.894 02-28-14 37.77 1,569.87 0.00 1,569.87
---------- ------------ ---------- -------------
Summary Totals 37.77 1,569.87 0.00 1,569.87
NOW IS THE PERFECT TIME FOR AN IRA CHECKUP!
CALL 1-888-PNC-IRAS (1-888-762-4727) AND HAVE ONE OF OUR
SPECIALISTS REVIEW YOUR IRA TODAY. MEMBER FDIC.
IRAC0911103
FORM953R-1005
Notice of Withholding on Distributions from Retirement Accounts
If federal income taxes have been withheld from the distribution or withdrawal payments you are receiving and if you do
not wish to have taxes withheld, you should notify PNC Bank. However, if you elect not to have withholding apply to your
distribution or withdrawal payments, or if you do not have enough Federa! income tax withheld from your payments, you
may be responsible for payment of estimated tax. You may incur penalties under the estimated tax rules if your
withholding and estimated tax payments are not sufficient.
If federal income taxes are not being withheld from your payments because you have elected not to have withholding
apply and if you wish to revoke that election and have federal income taxes withheld from your payments, you should
notify PNC Bank.
0PNCBANK
Total Banking Statement
PNC Bank
For the period 10/16/2007 to 11/14/2007
Primary account number: 90-1146-8865
Page 1 of 3
Number of enclosures: 0
BETTY R VALENCIK
5108 INVERNESS DR
MECHANICS BURG PA 17050-8319
Q For 24-hour banking, and transaction or
interest rate information, sign on to
'ft PNC Bank Online Banking at pnc.com.
For customer service call 1-888-PNC-BANK
between the hours of 6 AM and Midnight ET.
Para servicio en espanol, 1-866-HOLA-PNC
Moving" Please contact us at 1-888-PNC-BANK
181 Write to: Customer Service
PO Box 609
Pittsburgh PA 15230-9738
.l5il Visit us at pnc.com
Iil TDD terminal: 1-800-531-1648
For hearing flnpaired clients only
Relationship Overview
Bank Deposit Accounts
Descri ption
Intel-est Checking
Retirement Account(s)
Total Deposits
Account Number
Deposit Balance
90-1146-8865
Total of2
2,999.97
8,646.28
11,646.25
Give the gift ofPNC Bank Visa@Gift Cards this holiday season. Pelfect for everyone and available in whole dollar amounts up to $500. Stop
~ a patticipatin~ PNC Bank branch for more details.
Senior Premium Plan Betty R Valencik
Interest Checking Account Summary
Account number: 90-1146-8865
Balance Summary
Please see the Activity Detail section for
additional information.
Beginning
balance
3,770.72
Transaction SI.mmary
Checks paid/
withdrawals
Total ATM
transactions
11
Deposits and Checks and other Ending
other additions deductions balance
2,116.71 2,887.46 2,999.97
Average monthly Charge,
balance and fees
3,608.25 20.00
Check Card POS Check Card/Bankcard
signed transactions POS PIN transactions
0 0
PNC Bank Other Bank
A TM transactions ATM transactions
0 0
o
Interest Summary
As of 11/14, a total of $14.01 in interest was
paid this year.
Annual Percentage
Yield Earned (APYE)
0.15/.
Number of days
in interest peri ad
Average collected
balance for APYE
Interest Paid
this period
30
3,504.52
.43
FORM953R-1005
Total Banking Statement
8. For 24-hour information, sign on to PNC Bank Online Banking
on pnc.com.
Account number: 911- t 146-8865 - continued
For the period 10/16/2007 to 11/1412007
BETTY R V ALENCIK
Primary account number: 90-1146-8865
Page 2 of 3
Activity Detail
Deposits and Other Additions
Date Amount Description
t l/02 1,lg8.00 Direct Deposit - Soc Sec
US TleastllT 303 XXXXX200 I D
Deposit Refet'ence No 1'0400117020117
Deposit Reference No T040011702011!1
Interest P:lyment
1l/09
11/09
1l/14
806.0:3
172.2!1
.43
There were 4 Deposits and Other Additions
totaling $2.116.71.
Checks and Substitute Checks
Check Date Reference
number Amount paid number
1231 72.00 10/22 026698756
]999 Hi.63 10/18 0192::Q669
.. ~J....
123!1 '" 123.00 10/22 026698757
12~H) l' 1!10.00 ]0/29 026300472
12:17 23.00 10/26 026745256
1238 l' 400.00 1 ()/26 02602758<1
Check
number
1240 '" l'
12'11 l'
1244 '" l'
1247 *
1248
* Gap in check sequence
"T" Teller Cashed Check
Other Deductions
Date
Amount
Descri ption
Calcubted Service Chat"ge
Type Hd
11/14
20.00
Daily Balance Detail
Date Balance
lO/lG 3,770.72
10/]S 3,754.09
10/22 3,!159.09
Date
10/26
10/29
] l/02
Balance
3,136.09
2,710.09
3,848.09
Date
1l/0!'i
1l/ 09
] 1/14
Balance
3,5(,0.59
4,538.87
2,999.97
Date Reference
Amount paid number
276.00 10/29 026300473
287.50 ] 1/05 0277913;'2
27G.00 11/14 02-1227855
7 43 .3~~ 11/14 02 l:H;,972
500.00 11/14 027050766
There were 11 checks listed totaling
$2.867.46.
There was 1 Other Deduction totaling
$20.00.
Account type
. Interest Checking
Retirement Account(s)
Retirement Account (s)
Account number
XX-XXXX-8865
XXXXXX8458
XXXXXX8379
Balance type
This Cycle Avg Babnce
Current Value
CUrI-ent V:llue
As of
11/]5
11/13
11/13
Balance
SENIOR PREMIUM PLAN - Service Charge Explanation
3,608.92
1,495.00
7,151.28
These accounts were reviewed to meet
the balance requirements of your Senior
Premium Plan Account. Since balance
requirements were not met this month, a
$20.00 fee was deducted from this
account.
tvlake your hol iday shopping easy and rewarding this year when you use your PNC Bank Visa@ Check Card. or PNC Bank Visa@ Platinum
Credit Card. Accepted at more than 20 million locations worldwide and online.
Have a goal'? Get a plan. Come in for your complimentary financial assessment.
You have a better chance of realizing your goals when you write them down. That includes financial goals. A PNC
Financial Consultant can help you create a plan for education expenses, a new home, retirement and any dream you
have. Call1-800-I>NC-Ml1. visit us at pnc.com or stop by the nearest PNC Bank Branch.
Not FDIC In~ured. May Lo~e Value. No Rank Guarantee. Important Inve~tor Information: Seclllilies and brokernge services :m: I,rovided by PNC lnvesbnents LLC,
memher FINRA ami SIrC. Annuities and oUter insumnce products are oflcred hy PNC Insnrance Services. LLC a licensed insumnce agency.
Total Banking Statement
~PNCBANK
Q For 24-hour information, sign on to PNC Bank Online Banking
on pnc.com.
Account number: 911-1146-8865 - continued
For the period 10/16/2007 to 11/14/2007
BETTY R V ALENCIK
Primary account number: 90-1146-8865
Page 3 of 3
Retirement Accounts
c//'
Betty R Valencik
Maturity date Interest Original or Current
rate renewal value value
03/18/2014 4.89% 7,849.97 7,151.28
Betty R Valencik
Maturity date Interest Original or Current
rate renewal value value
02/28/2014 4.89 % 1,635.79 1,495.00
Total current value 8,646.28
Investment
number
Description
"
/
75500027320
115 Month(s) Fi.xed Rate
Investment
number
Descri pti on
v
75100027411
115 Month(s) Fixed Rate
FORM953R-1005
Reviewing Your Statement
Please review this statement carelhlly and reconcile it with your records. Call the telephone number on the upper right side ofthe first page
orthis statement if:
· you have any questions regarding YOUT accotmls(s);
· your name or address is incolTect;
· you have a business account and your tax identification numher is missing or incorrect;
· you have any questions regarding interest paid to an interest-hearing account.
Balancing Your Account
Update Your Account Register
Compare:
Check Off:
'Dle activity detail section of your statement to your account register.
All items in your account register that also appear on your statement. Remember to begin
with the ending date of your last statement. (An asterisk {*} will appear in the Checks
section if there is a gap in the listing of consecutive check numbers.)
Any deposits or additions including interest payments ahd ATlV! or electronic deposits
listed on the statement that are not already entered in your register.
Any account deductions includil1g fees and A TrvI or electronic deductions listed on the
statement that are not already entered in your register.
Add to Your Account Register
Balance:
Subtract From Your Account
Register Balance:
Update Your Statement Information
Step 1:
Add together
deposits and
other additions
listed in your
account register
but not on your
statement.
Step 2:
Add together
checks alld other
deductions listed
in your account
register but not on
your statement.
Date of Deposit
Amount
Total A
Step 3:
Enter the ending balance recorded on your statement $
Add deposits and other additions not recorded Total A + $
Subtotal= $
Subtract clll;\:ks and othl;l' deductions not recorded Tolal B - $
lh:~ result should equal your account register balance $
Check Number or
Deduction Description Amount
Total B
Verification of Direct Deposits
To veritY whether a direct deposit or other transfer to your account has OCCUlTed, callus 7 days a week Hum 6:00 A.M. to Midnight (ET) at
the customer service number listed on the upper light side onlle tiTSt page ofthis statement.
Electronic Funds Transfers
In case of em'rs or questions ahollt YOllr electrollic transfers or if yo II need more infotUlation ahollt a h,ll1sfer, call us 7 days a week fmm 6:00 A.M. to Midnight (El) at tbe
cnstomer sen'ice nllmber listed on tbe "1'I'er light side oftbe first I'age of this statement. Or, if yo II I'refer, I'lease write I1S at: Cl1stomer Selvice, P.O. Box 609. Pitt.shurgh, PA
15230-0609. TrYOII helieve tbere is a I'roblem, YOII mllst contact liS no later tban60 days after tbe ending date oftbc first statement 011 wbich tbe enur or problem al'lleared.
You will need to pnwide the following information:
· YOllr lIame and accoullt III11l1bel'(s);
· A dcsctiptiol1 of tbe enul' 01' the transfer you are questioning. Please eXI'laiu as clearly as you can wby YOI1 lIeed more infol1.natioll or why YOII believe an emlT was made;
· lbe dollar amoul1t ortlte susl'ected em)r.
We will investigate your complaint aud will conect any etTor promptly. If the investigatiol1 takes longer tIlan 10 bllsiness days, we will credit YOllr accol1nt fOT tile
amollnt YOII think is in em,r, so tItat yon will bave use of tile fllnds dming tIlC time it takes us to complete our investigation.
Member FDIC
~ Equal Housing Lender
VERIFICATION
I, CHESTER L. V ALENCIK, JR., verify that the facts set forth in the foregoing
document are true and correct to the best of my information, knowledge and belief. I understand
that false statements herein are made subject to the penalties of 18 Pa. C.S. 94904, relating to
unsworn falsification to authorities.
(~~ j (;.jlm!J O/.
CHES L. VALENCIK,JR IlL
Neil Warner Yahn, Esquire
Attorney J.D. No. 82278
Edward P. Seeber
Attorney J.D. No. 76084
James Smith Dietterick & Connelly, LLP
P.O. Box 650
Hershey, P A 17033
Attorneys for Petitioner
TROY A. VALENCIK,
Respondent
) IN THE COURT OF COMMON PLEAS OF
) CUMBERLAND COUNTY, PENNSYLVANIA
)
) ORPHANS' COURT DIVISION
)
) No. OC 2008
)
)
)
ESTATE OF BETTY R. V ALENCIK
CHESTER L. V ALENCIK, JR.,
Petitioner
CERTIFICATE OF SERVICE
l, Neil Warner Yahn, Esquire, do hereby certify that I served a true and correct copy of the
foregoing PETITION TO ENFORCE THE POWER OF ATTORNEY upon the following
below-named individuals by U.S. Mail, first class postage prepaid, at Hershey, Pennsylvania this
~ day of February, 2008.
SERVED UPON:
Bruce G. Baron, Esquire
Capozzi and Associates, P.c.
2933 North Front Street
Harrisburg, P A 17110
Telephone: (717) 233-4101
u.