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HomeMy WebLinkAbout08-25-0815056041147 -~ REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN 2 1 0 7 0 11 0 7 PO BOX.280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1!96 18 3646 11 29 2007 09 16 1923 Decedent's Last Name Suffix Decedent's First Name MI GATES BRUCE L (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW X 1. Original Return 2. Supplemental Return 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ' 4a. Future Interest Compromise 5. Federal Estate Tax Return Required _. --- (date of death after 12-12-82) - Decedent Died Testate 7 Decedent Maintained a Living Trust ~ 8. Total Number of Safe De osit Boxes X 6. (Attach Copy of Will) (Attach Copy of Trust) p 9. Litigation Proceeds Received ',~ ', 10. Spousal Poverty Credit (date of deam 11, Election to tax under Sec. 9113(A) __ between 12-31-91 and i-1-95) - (Attach SCh. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number A;MY M. MOYA 717 652 7323 Firm Name (If Applicable) L. O. OF SUSAN E. LEDERER First line of address 4811 JONESTOWN ROAD, STE 226 Second line of address City or Post Office State ZIP Code HARRISBURG PA 17109 Correspondent'se-mail address: Amy UeLedererlaW.COm Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and com te. De aration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGN URE F ON ON LE FOR FILING RETURN DATE +_., ,,y Frank Gates ~~/~~lg 1$09 Dogwood Road, Harrisburg, PA 17110 SIGNA URE OF PAR OTHER THAN REPRESENTATIVE DATE l~~~f/~ lr~t Amy M. Moya cF ~~/~j,~- 4811 Jonestown Road, Ste 226, Harrisburg, PA 17109 Side 1 15056041147 15056041147 J REGISTER OF WItiLS USE ONLY ,:7 ~ ~: ,_ _ . DATE~IL-HD ~ -~ -°-1 -, ,, REV-1500 EX Decedent's Name: BI'UCe i_. Gates RECAPITULATION Decedent's Social Security Number 196 18 3646 1. Real Estate (Schedule A) ............................................................__........................ 1. 2. Stocks and Bonds (Schedule B) ..............................__............................__............. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D) ..............................__........................ 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5. 6. Jointly Owned Property (Schedule F) ,Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers ~ Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ............. 7. 8. Total Gross Assets (total Lines 1-7) ..............................._.............................__..... 8. 9. Funeral Expenses ~ Administrative Costs (Schedule H) ...................................... 9. 10. Debts of Decedent, Mortgage Liabilities, 8 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/Sec 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, of transfers under Sec. 9116 (a)(1.2) X .00 0 0 0 15. 16. Amount of Line 14 taxable 6 6 0, 3 7 3. 7 0 16 at lineal rate X .045 . 17. Amount of Line 14 taxable 0 0 0 17 at sibling rate X .12 . 18. Amount of Line 14 taxable 0 0 0 18 at collateral rate X .15 . 19. Tax Due ............................................................. . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 15056042148 10,866.96 7,396.13 147,038.26 537,984.91 703,286.26 -- --- _ -- 18,555.62 24,356.94 42,912.56 660,373.70 660,373.70 0.00 29,716.82 0.00 0.00 29,716.82 Side 2 15056042148 15056042148 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-07-01107 Bruce L. Gates STREET ADDRESS 1000 West South Street _-- ---- CITY Carlisle _--T _ STATE ZIP PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 28,500.00 1,485.84 (1) 29,716.82 Total Credits (A + B + C) (2) 29,985.84 3. Interest/Penalty if applicable - -- p, Interest E. Penalty Total Interest/Penalty (D + E) (3) ___ 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT. (4) 269.02 Check box on Page 2 Line 20 to request a refund _ _ -- 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE (5) --_ - q. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (5g) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :............................................................................. x b. retain the right to designate who shall use the property transferred or its income :................................ x °° c. retain a reversionary interest; or ..............................__............................__............................_................. x -_ d. receive the promise for life of either payments, benefits or care? ........................................................... x 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without --- receiving adequate consideration? ................................................................................................................. x 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... _ x 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .............................._ . .................. x IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statutedoes not exempts transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Rev-1503 E};+I6-98) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Gates, Bruce L. 21-07-01107 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 693517106 216 shares of PPL Corp titled to Bruce L. Gates 50.31 10,866.96 TOTAL (Also enter on Line 2, Recapitulation) 10,866.96 (If more space is needed, additional pages of the same size) Copyrighlt (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev-1508 E:l(+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF (FILE NUMBER Gates, Bruce L. 21-07-01107 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 check from RiverSource Life Insurance Company (refund of premium) 1,212.79 2 check from Kindred Place (refund of housing) 1,534.29 3 check from Erie Insurance (refund of homeowners insurance -house was sold 240.00 prior to death) 4 Coins Eisenhower dollars, Kennedy half dollars (sale price) 56.00 5 check from Home Instead Senior Care/LDH Partners, Inc. (refund of nursing care) 700.00 6 check HCR Manor Care (refund of nursing home care) 1,276.76 7 check from RiverSource (reimbursement from long term care insurance) 2,145.00 8 Cash 212.00 9 Pennsylvania Department of Revenue (income tax refund) 19.29 TOTAL (Also enter on Line 5, Recapitulation) I 7,396.13 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-1509 E:X+ (6-98) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Gates, Bruce L. 21-07-01107 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Calvin J. Gates 23841 Costa Del Sol Rd Unit 202 Son Bonita Springs, FL 34135 g. Carol Graham 5903 Eshenaur Drive Daughter Harrisburg, PA 17112 C. Frank K. Gates 1809 Dogwood Road Son Harrisburg, PA 17110 JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH ALUE OF ASSE % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1 A 8/28/1964 Checking Account held at M8~T Bank, 15,512.07 50.000% 7,756.04 Account No. 36581135, titled to Bruce L. Gates, Sr. and Calvin J. Gates (accrued interest $0.64) 2 A 8/18/2000 Certificate of Deposit held at M8r,T Bank, 33,033.58 50.000% 16,516.79 Account No. 031003913905592 titled to Bruce L. Gates, Sr. and Calvin J. Gates (accrued interest $33.58) 3 A 2/8/2002 Certficate of Deposit held at M&T Bank, 15,036.81 50.000% 7,518.41 Account No. 031003913906409 titled to Bruce L. Gates, Sr. and Calvin J. Gates (accrued interest $36.81) 4 A 2/22/1996 Certificate of Deposit held at M&T Bank, 40,020.34 50.000% 20,010.17 Account No. 031003914510936, titled to Bruce L. Gates, Sr. and Calvin J. Gates (accrued interest $20.34) 5 A 4/15/1997 Certificate of Deposit held at M8r.T Bank, 15,061.04 50.000% 7,530.52 Account No. 031003914561666, titled to Bruce L. Gates, Sr. and Calvin J. Gates (accrued interest $21.04) Total of Continuation Schedules See attached pa es TOTAL (Also enter on Line 6, Recapitulation) I 147,038.26 (If more space is needed, additional pages of the same size) Copyrighlt (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) Rev-1509 EX+ (6-98) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT continued ESTATE OF (FILE NUMBER Gates, Bruce L. 21-07-01107 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. JOINTLY OWNED PROPERTY ITEMI NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSE % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 6 A 9/26/1997 Certificate of Deposit held at M8~T Bank, 16,063.18 50.000% 8,031.59 Account No. 031003914581698, titled to Bruce L. Gates, Sr. and Calvin J. Gates (accrued interest $63.18) 7 A B 7125/2006 Regular Savings Account held at 109.05 33.000% 35.99 Members 1st FCU, Account No. 181238-00, titled to Bruce L. Gates, Carol Graham ,and Calvin Gates (accrued interest $.08) 8 B 8/18/2005 Certificate of Deposit held at Members 62,108.45 50.000% 31,054.23 1st FCU, Account No. 81238-45, titled to Bruce L. Gates and Carol Graham (accrued interest $202.78) 9 C 2/18/1999 Certificate of Deposit held at Sovereign 23,698.04 50.000% 11,849.02 Bank, Account No. 1715218051, titled to Bruce L. Gates or Frank K. Gates (accrued interest $631.75) 10 C 7/27/1999 Certificate of Deposit held at Sovereign 10,040.93 50.000% 5,020.47 Bank, Account No. 1715218580, titled to Bruce L. Gates or Frank K. Gates (accrued interest $40.93) 11 C 1/512000 Certificate of Deposit held at Sovereign 10,232.76 50.000% 5,116.38 Bank, Account No. 1715218762, titled to Bruce L. Gates or Frank K. Gates (accrued interest $38.36) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) Rev-7509 EXt (6-98) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT continued ESTATE OF (FILE NUMBER Gates, Bruce L. 21-07-01107 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. JOINTLY OWNED PROPERTY ITEMI NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH ALUE OF ASSE % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 12 C 9/311994 Certificate of Deposit held at Sovereign 10,029.09 50.000% 5,014.55 Bank, Account No. 1715220362, titled to Bruce L. Gates or Frank K. Gates (accrued interest $29.09) 13 C 3/4/1996 Certificate of Deposit held at Sovereign 11,067.94 50.000% 5,533.97 Bank, Account No. 1715220719, titled to Bruce L. Gates or Frank K. Gates (accrued interest $46.47) 14 C 3/24/1995 Certificate of Deposit held at Sovereign 12,046.85 50.000% 6,023.43 Bank, Account No. 1715221071, titled to Bruce L. Gates or Frank K. Gates (accrued interest $39.53) 15 C 1/23/2003 Certificate of Deposit held at Sovereign 10,026.37 50.000% 5,013.19 Bank, Account No. 1715426027, titled to Bruce L. Gates or Frank K. Gates (accrued interest $24.25) 16 C 1130/2003 Certificate of Deposit held at Sovereign 10,027.01 50.000% 5,013.51 Bank, Account No. 1715426613, titled to Bruce L. Gates or Frank K. Gates (accrued interest $26.30) TOTAL (Also enter on Line 6, Recapitulation) 147,038.26 Copyrighlt (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) Rev-1510 EX+ (6-98) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Gates, Bruce L. 21-07-01107 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. ITEM NUMBER DE RIPTION OF PR PERTY INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 Pre-paid Funeral Account with Zimmerman-Auer 7,525.00 100.000 7,525.00 Funeral Home 2 Certificate of Deposit held at Wachovia Bank, 100,187.34 100.000 100,187.34 NA, Account No. 6550, titled to Bruce L. Gates POD Calvin J. Gates, Carol Graham 8~ Frank Gates (accrued interest $187.34) 3 Checking Account held at Wachovia Bank, NA, 33,016.94 100.000 33,016.94 Account No. 0180, titled to Bruce Gates POD Calvin J. Gates, Carol Graham 8~ Frank Gates 4 Checking Account held at Wachovia Bank, NA, 216,266.80 100.000 216,266.80 Account No. 0193, titled to Bruce L. Gates POD Calvin J. Gates, Carol Graham 8~ Frank Gates (accrued interest $710.95) 5 Certificate of Deposit held at Members 1st FCU, 20,534.65 100.000 3,000.00 17,534.65 Account No. 181238-48, titled to Bruce L. Gates and Carol Graham (account opened within 1 year of death) (accrued interest $81.28) 6 Certificate of Deposit held at Members 1st FCU, 10,108.98 100.000 3,000.00 7,108.98 Account No. 181238-49, titled to Bruce L. Gates and Carol Graham (account opened within 1 year of death) (accrued interest $40.01) 7 Certificate of Deposit held at Members 1st FCU, 26,670.79 100.000 3,000.00 23,670.79 Account No. 181238-50, titled to Bruce L. Gates and Carol Graham (account opened within 1 year of death) (accrued interest $58.79) Total of Continuation Schedule ee attached page TOTAL (Also enter on Line 7, Recapitulation) I 537,984.91 (If more space is needed, additional pages of the same size) Copyrighlt (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) Rev-1510 EX+ (6-98) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN co ntl n ue RESIDENT DECEDENT ESTATE OF (FILE NUMBER Gates, Bruce L. 21-07-01107 ITEM NUMBF_R DESCRIPTION OF PROPERTY INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 8 56399.48 shares of MTB Money Market Fund - 56,399.48 100.000 56,399.48 Class A2, held at M8r,T Investment Group, Account No. AZD460699, Bruce L. Gates TOD Calvin Gates, Carol Graham, Frank Gates ($1.00/sh) 9 Certificate of Deposit held at Sovereign Bank, 22,207.48 100.000 3,000.00 19,207.48 Account No. 1995543293, titled to Bruce L. Gates and Frank K. Gates (account opened within 1 year of death) (accrued interest $49.48) 10 Riversource Annuity held at Ameriprise Financial 49,824.36 100.000 49,824.36 Services, Inc., Account No. 00000930075577633004, Bruce L. Gates, owner, Calvin J. Gates, Carol A. Graham, and Frank K. Gates, beneficiaries 11 403(b) Tax Sheltered Annuity held at Ameriprise 7,243.09 100.000 7,243.09 Financial Services, Inc., Account No. 0931 0102 8132 3 004, Bruce L. Gates, owner, Calvin J. Gates, Carol A. Graham, and Frank K. Gates, beneficiaries TOTAL (Also enter on Line 7, Recapitulation) 537,984.91 Copyrighlt (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) REV-1151 F:X+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES 8~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Gates, Bruce L. 21-07-01107 Debts of decedent must be reported on Schedule I. ITEIvI DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: Zimmerman-Auer Funeral Home 10,042.14 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees Law Offices of Susan E. Lederer 7,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Cumberland County Register of Wills 54.00 5. Accountant's Fees 6. Tax Return Preparer's Fees Steven W. FahnestoCk, CPA 340.00 7. Other Administrative Costs 1,119.48 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 18,555.62 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1502 EX+ (6-98) SCHEDULE H-A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Gates, Bruce L. 21-07-01107 Copyrighlt (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) Rev-1502 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued ESTATE OF (FILE NUMBER Gates, Bruce L. 21-07-01107 ITEM NUMBER DESCRIPTION AMOUNT 1 MSiT Bank -refund of PA Treasury Dept. Annuity 720.63 2 Vital Records (additional death certificates) 90.00 3 Executor's expenses (mileage, parking, etc.) 125.00 4 Bank fee for checkbook 13.85 5 Parks 8~ Company (fee to obtain previous accountant's notes) 100.00 6 Register of Wills (additional probate) 70.00 Subtotal 1.119.48 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1512 E:X+~6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF (FILE NUMBER Gates, Bruce L. 21-07-01107 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 United States Treasury (payment of Federal income tax) 18,611.00 2 Extra Hands Home Health (nursing care) 369.72 3 Pennsylvania Department of Revenue (payment of Pennsylvania income tax) 2,901.00 4 Parks 8~ Company (fee for tax planning) 100.00 5 Kindred Place at Harrisburg (beauty shop 8~ meals) 109.05 6 Millenium Pharmacy Systems (prescriptions) 24.95 7 United Church of Christ Homes/Sara Todd Memorial Home (nursing care) 1,604.45 8 PSERS (return of retirement funds not eligible to receive) 609.94 9 John F. Andren, OD (medical bill) 15.00 10 Verizon (final phone bill) 11.83 TOTAL (Also enter on Line 10, Recapitulation) I 24,356.94 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV-1573 EX+ (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER ~a><es, esruce ~. 21-07-01 107 NUMBER NAME AND ADDRESS OF RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) (Words) ($$$) I. TAXABLE DISTRIBUTIONS [include.outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] 1 Carol Ann Graham Daughter 227,991.17 5903 Eshenaur Drive Harrisburg, PA 17112 2 Calvin J. Gates Son 215,986.01 23841 Costa Del Sol Rd Unit 202 Bonita Springs, FL 34135 3 Frank K. Gates Son 216,396.52 1809 Dogwood Road Harrisburg, PA 17110 Total 660,373.70 Enter dollar amounts for distributions shown above on lines 15 through 18, as approp riate, on Rev 1500 cov er sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule) (Rev. 6-98) REV-1574 E:X+ (g_00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN (Check Box 4 on Rev-1500 Cover Sheet) ESTATE OF FILE NUMBER Gates, Bruce L. 21-07-01107 This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to 5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death on or after 5-1-89. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. ^ Will ^ Intervivos Deed of Trust ^ Other LIFE ESTATE INTEREST CALCULATION ~~^~~~~~~~ ~~ LIFE TENANT(S) DATE OF BIRTH NEAREST AGE AT DATE OF DEATH TERM OF YEARS LIFE ESTATE IS PAYABLE ^ Life or ^Term of Years ^ Life or ^Term of Years ^ Life or ^Term of Years ^ Life or ^Term of Years 1. Value of fund from which life estate is payable 2. Actuarial factor per appropriate table Interest table rate - ^ 31/2% ^ s% ^ 10% ^ Variablel~e 3. Value of life estate (Line 1 multiplied by Line 2) ANNUITY INTEREST CALCULATION $ 0.00 rvHiw~(a~ yr ANNUITANTS DATE OF BIRTH NEARESTAGE AT DATE OF DEATH ~ CKNI ~r TtHKJ HIVIVUI I Y IJ PAYABLE Bruce L. Gates 09116/1923 84 ^ Life or ®Term of Years 10 ^ Life or ^Term of Years ^ Life or ^Term of Years ^ Life or ^Term of Years 1. Value of fund from which annuity is payable ~ 69,678.34 2. Check appropriate block below and enter corresponding (number) 12.00 Frequency of payouts yy~dy(~ ^ gjyy~(~~ ®Morttll~f(12) ^ Quarberly(4) ^ Seri-amttahf(2) ^ AmuaN(1) ^ Otl>er 3. Amount of payout per period $ 632.68 4. Aggregate annual payment. Line 2 multiplied by Line 3 7,592.16 5. Annuity Factor (see instructions) Interest table rate - ^ 3112% ^ s% ^ 10% ®Variiable F~he 5.1167 6. Adjustment Factor (see instructions) $ 0.00 7. Value of annuity- If using 3 1/2%, 6%, 10% or if variable rate and period payout is at end of period, calculation is: Line 4 x Line 5 x Line 6 ~ If using variable rate and period payout is at beginning of period, calculation is: (Line 4 x Line 5 x Line 6) + Line 3 NOTE; 'The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13, 15, 16, 17 and 18. Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule K (Rev. 6-98) ~ c ~..~ ~(,;,~ ~~ D~~, ~~~ o y~oy/a8 - _.., BRUCE L GATES SR C/O FRANK K GATES EXEC 1809 DOGWOOD ROAD HARRISBURG PA 17110-3252 PPL Corporation Two North Ninth Street Allentown, PA 18101-1179 Dividend Check Account Number: 3099009732 Dividend Record Date: 03/10/2008 Payment Date: APRIL 1,2008 Check Number: 02756665 Amount: X72,36 Print Number: 67065001182 Number of Dividend Dividend Class of Stock Shares Rate Amount PPL CORP COMMON 216.000 .3350 72.36 You can have your dividends deposited directly into your bank account. To request a Direct Deposit Authorization form, or if you have any questions regarding your account, visit the Investor Center at www.pplweb.com or call toll free: 1-800-345-3085 To access your account online, please visit www.shareowneronline.com Please detach and retain this statement for your records. O1 PPL: Historical Prices for PPL C4RP -Yahoo! Finance Page 1 of 2 'fah0o! hiy YUhoo! Mdtl More Make Y? My Home Page New User% Sign Up Sign In Help ~.~~~'~•~ . ~ F ~ ~ ~ ~ ~ ~ Search ' WEB SEARCH Dow ~' 0.37% Nasdaq 't' 0.15% Tuesday, JUIy 22, 2008, 3:OtPM ET - U.S. Markets dose In 59 mins.. GET c?FJOTES ', Finance Search PPL Corporation (PPL) At 2:46PM ET: 49.13 i o.2~ to.a3°~ol ~, ~Ji AMBRITRAO@ Na rr~aintenwnGe fses ': f~ ~~ ~ ~'~"~ .~ ~ •1 `~ ~ ~ ~'~ '~ ~' ~,,~ }} ~~~~~~~. cp• ~ _ Trq~t , F~2EE `GRADES ".ls f "~ E~TRAC[ sccunrfer LL[ - ~ ~ Historical Prices Get Historical Prices for; GO SET DATE RANGE ADVERTISEMENT ~o! Daily Start Date: Nov `. 29 ;2007 2003an i, ;._ weekly End Date: ;Nov - : 29 ! 2007 ~ v ~ Monthly ;_ ~ Dividends Only Get Prices First ~ Prev ~ Next (Last PRICES Date Open High Low Close Votume Add Close• 29-Nov-07 50.33 50.70 49.91 50.42 1,546,900 49.45 " Close price adjusted for dividends and splits. First ~ Prev ~ Next ~ Last r~, Download To readsheet Add to 0 olio m Set Alert :~ Email to a Friend Get Historical Prices for Another Symbol: G~ Symbol lookug • Stock Screener Splits ~U.'~1 k of l (o 1~c~1'r 10. Cl http://finance.yahoo.com/q/hp?s=PPL&a=10&b=29&c=2(lm~~=tn~P_~oRr~ ~nn~Q.~-a ~~^^~^^~~ RiverSource Life Insurance Com/pang ~~J~~s ~~~ 70100 AmeNprise Financial Center ~ ` ~; Minneapolis MN 55474 (} / An Ameriprise Financial company X~ Claim Number 387682 ~'` December 07 2007 ~' Policy Number: 9100-4169919 ~ ~~° BRUCE L GATES r\ is f ~.~4; j ESTATE OF BRUCE L GATES ~~'~ ~ ° `~ ~ ~ ~ ~ "~~ ~ ,t~ ~f C/U CALVIN GATES UNIT 202 ~G~° '1 ~/~a'a' 1 23841 COSTA DEL SOL RD ~"~ ~~ ~~~ ~,}~ ~~ BONITA SPRINGS FL 34135-1788 ~~A, / ~ (~ ~~ `'~ ~ Dear Recipient: The attached check f r 1,212.79 r resents the death benefits due you under this contract.. These re made payable to ESTATE OF BRUCE L GATES. If you have questions,. please contact our office at the telephone number below. Our associates are available to assist you Mon~y though Friday from. 8 a,m to 5 p.m. Central time. ~, a-~ .~ Thank you, ~~ ~,'~ xY~' RiverSource Life Claims ~~~ ~~ ~ ~ (888} 320-8741 ~~ +~ ~~ .~' ~~ ~ ~ ~~~ ~ ~ ~., ,~, ~ ~. ~~ C~ try ~ ~_ ~~1- ~~ t7 Ineura~ue and annuities an issued 6y RIVNSOarG Lib lnsunnce Compdmr ('givar5ouree Lib) en Atneripr{se Financial compan}r. Riversoures Lite also sets as principal fn the zaL and distribution of its variable annuity contracts and varisWv life insuranu policies. Other intarmalinn regarding sxatution of rho tnncectioa including the time of the transaction will be Dravided usan vrriNen racuesl UNITED CHURCH OF CHRIS HOMES ~ /~ Q (] ACCOUNTS PAYABLE DA CHECK NO. OUN7 O `} ~ Z 9 9 Ol 2/2008 41299 1,534. MEMO ICE DATE INVOICE NUMBER AMOUNT DISCOUNT NET RESIDENT REFUND /12/2007 89-1 1,534.29 BRUCE GATES 534.29 KINDRED PLACE HBG 'ERIE INSURANCE EXCHANGE .~l,~faC1CE' P.O. BOX 1699 ERIE, PA 16530 NAMED INSURED COPY ~~~. E;~hn~,~e CANCELLATION NOTICE 100 Erie Ins. IPI. Erle, PA 16530 MAIL GATE 10/18/07 CANCELLATION EFFECTIVE BAL: $240.00 CR POLICY Nl:M9ER Q58 0601277 H 10/18f07 12.01 AM POLICY EFFECTIVE DATE 10/06/07 HOMEPROTECTOR POLICY STANDARD TIME NAMED INSURED BRUCE LYNN GATES 5824 MAYFAIR DR AA7785 HARRISBURG PA 17112 ~` 1b / WE ARE NOTIFYING YOU THAT THE ABOVE POLICY {S CANCELLED AS OF THE CANCELLA' EFFECTIVE HOUR AND DATE SHOWN ABOVE. 1F WE HAVE BEEN ASKED TO PROTECT INTERESTS, WE ARE REQUIRED TO ADVISE THEM OF THIS CANCELLATION. THE REASON FOR THIS ACTION : `~ilr REQUEST OF NAMED INSURED - SOLD t ' PREVIOUS BALANCE $.00 UNUSED PREMIUM $240.00 CR PRESENT BALANCE $240.00 CR REFUND CHECK ENCLOSED 00478 AA7785 STRO STROCK INSURANCE AGENCY ~ ~ n ~ ,' ;~ i ~ ~, `l/ , v (1 932EXC 6/OD Scl~ ~~ ~ c , c-,-~~- r ~ ~, ~~' ~ 7 fi ~~,w, ~~ fi ~-~y ~~5~,~~- ~c~~s, p~ ~~~ ~le~~~~ss~ ~o~~`~ ~~~~~ ~~~ ~~~r~ ~' rr M.L~ L7 C>7"~ JR. p1.TnIR~A7T0IIMlL`( . • CU{{~1:RfJ1N~ Govt+~•r or+~~couM'HbvsrsaVAhc CAJ1Lliltfr•f~iN131sYLYl~Nll~i 17019 ,• . _ f7i7) 07.0771 (7171 x71.72(0. ~.~2RBdI0U9 }!_ ETJ~LB •D81lLER 'i.'Rl1N3A~'1'ION REPORT i+i~=••a.slers• in gr~ttiou:•trt~t;xie,, ip Ctimb~rxt~td'ConnCyy musk aevu;ately• rtcoe-d ~•aotioa by' aoa~,Z~tiiit~ 'tbis'tpr}a. 9y law Cba •dcaZar is rcquirad• to I~~ap '~i~e. r~ ord fo>i• rt ~e~io8 0! oni (i) year, anb to 'forward a copy of ehis -t'o Che oQl~oe 'do a=tmaAt •desS;gnatio~ op your' liaonsa by the close 'ai business next working ~a~- •att's~ tbv day ol:the tra>ssadtioa. .Each i~eln purcha$cd .s catninid• is usia 'terad .cossr~J3tioa ~bz live, ~~I iulx warkitzy days after. the Por•,.~ narr.boap,.liled. t~ s3oller' is u•ml,,n~r .(un ez ~8~•yyears of age , vrYtton a~rn. by pa~dab o:r•gbb<rd~.8si•must 1~~ attidv ed to asid taaitlta~ned with this record ..,. ~ . .L CEN~ES IN80RNR',~~QkI • xxx$ r . J~DDRE53 ~,ICEIiSE II TRXNSACT~V[V 1.ruru~u+-r.cvn• _ /~ ~ .~. it ~ 1 ~` D~TL L TYxL OP ~ CTZGHi ~S t... . 3'xLLB~t' 8 Ii1LM$ ~ '• C~-L-~ ~-•' ~-~' .. eti: r.:.-~• f. data r • 4._ pjtI~EFi~$ LICEN3Li : NyF~ /' • ' Ybobor Xei ~ Ha .,.,.~ . • (Check onF) • ~ • 5Y - • OTBER•`YDENTY~!,7CATYON. (NeoeeeaCy S! no driver ~ s licens~a 1 . '. 3. ,z'ypRf Numbers .~.. 2. ~i.,fP~.i' bi~umberr • . • .+av~arr- ---••. - }t~8 Ko~ov~t• ~ ;~ ~ ~u ~~~~~. ~• • STGt1ATU~8• -OF SP~~ . X ~~ '• ~~ ~ . ~' "! . DA"fBl ~.~ ... ~ .. sssw(.~..,._ 8 ~~$8 GROSS OMpOgI~SOr~ OR •GI.t~S~. •COHP H exc H t .,. .. . - - .. •~• 8xGt1ATURE Ole PERSpR COMpLETYrc (Livenaea or Agent of License) • ,•~~ ., 5 g ~, a o ti ; ~`:, O G '~" C3 O ~ r ~ O -„ r,,. ~ C ~ y x * ~,. 2 x O ~ ., 7 ~ ~~ F• ~ ~ `3;i O G 1"' * v W .' ~ ca? p4, m x ^_ r ~~ ~ ~ ~~ u. U c~ # ~, fi NQ * ~ ~ ~~ ~ tv W ~ + L'- C1 * . ~ N ~ ~ N • '~ .-+ • J ru ~ N w * ff1 * r'r1 '~ N '" r • ~ ~ W v,q~ # Uo+o ~ ~ Orr:, * O rn Za~~~ o ~ O T Q ~ ~ ~ "~ V Q.~7Q ~ ~ O ~ dW c~n~ ..+ W '~ Q C~ C ~ _ ~ ~~ ~ o o~ ~ nQ. O 5 ..^ a . 'o. :°' l i ± ~ ' i . r '~ ~ : : A ~ . N * - 9 # pp ;.o ; ~ ~ . ~ 0 ~ ~' ~ .~ i ~' :.t I. ~ } N 1 L ,. ..; 5 } .. Q :. i _ 4 ~ y i, t X ,~ ~ w.. L ~ . t ~ .-~ ~ ~ D ~ ~ ; a ~ ]Sr p~ ~ -.. ~~~ . 1 ~ ~ p. h K'it t' ~ v ~ PLJ ~ C ~'~ ~ ~r .. ~-_ cC .~3 ~ J t ftt r~ ~ ~: '~ ~ (p'-' M' i r~-- a~ fwo xa''.,~ ._ ~ ~~ . ~. __ IM .. F ~ ' ~ [ • f 2 ~{t Vry r ~ j ~ V/ Y y Ty ~ K ~' "~i." ~W ~ ~ti R " ~ .-a : R;~ , ~~ rU;~ i , I. 1 '. ~ ~ ^ y l ` ;mar ''s~ c .aa .-. ~N D - ~ ~ ~ Q , , ... ~ 9r n ~ V T T ~T h~ry~ :}~W~ J ~,~ ' ~~ o o,a o~ ~:t ~ fi+.Cx7 s 3 ~ 1 r~ A' ; O ~~ ..~. ~'Q` H ~c ~s _ ~ a~ a~. ~, ,`~::o ~`O :o. ~~ i.n . s: z, ~~ . ~ ~] '' O .c m '; 3 ~ ~ L~ l F4 i . ' ~ ym. ~;- r ; : ¢ ~~ " ~ l ~ w . '' ~ o . o a ... f-: :- p r i a. i ! ' 1 1 1 I ~ 1 i r E iciverSource ~, p~G~ ,~0~ INgUR~INCS DIVISION LIH~ Vl~ 24506-9939 000000085 8930082455 1 2 REGULAR Mgll 1,.11..1..1...11„I I..I.1....1 I I...I I,.I.I,.I„I, I.,.I.I.,1 I.I ESTATE OF BRUCE GATES 23841 COSTA DEL SOL RD., X202 BONITA SPRINGS PA 34135-1788 A142852 CLAIMANT NMIE: BRUCE L GATES Payment for Oct 12 2007 through Nov 29 2007 Deductible Period: Oct i 2 2007 through Oct 31 2007: 20 days Alternate Long Term Care Facility Oct 12 2007 through Oct 29 2007 Bed Reservation-60~o Oct 30 2007 through Nov 1 2007 lday@S~'5.00=S45.00 Total Bed Reservation used: 3 Nursing Home Facility Nov 2 2007 through Nov 29 2007 PAGE 1 OF 2 (888)320-8741 930082455 51- 119 HEC TV10 TIi0U5~D ONE FMVDREp ~TY F 1 0 0 / 'I~0 DOL U4RS ~ I ~ ' \ .. . ` PAY TO TH .ORDER OF ESTATE BRUCE 'GATES OID ER 18 DA' 23841 S.TA DEL SOL RD. : #202 ... BONITA: . . FRINGS PA,; .::3413 ... ,. - C ~ ,_ _ ..:.: ~~ :.,; :a ~ ~ _ , 93:1fi99I ~ ~ t r ~, , ~ _ 2852 ~'' :v~1++rierka. ra.~ ' _ ~ f r ` ` ~ ' . ., ,~~.aArz~,ab ~caNn~ancirr . F .. , ,. . . '., . . r . , fi .~ - ~~ ~- ~ ; ~ y , __ . .~ . f~lrawn _ - '• '... ~ (.- . r 4~ 'fr.t N ~, c r .:; 5.~... ~T A', ..'r~ fi, ~~'69 3008 24 5 5~i' ~:^i14nn~~_c.• ~~~,~ _ GbCdk•« ~ f1sa~., ey t ai.~ Z'~~ O'J c~tGa P~~~~. C~~m ~ ~'G ~ ~ eve ~ ~ Xtelli.~ t t~.,l f ~L ~Ia•t ~•`'.,~ o F ~,~ 7.S b fell fe K, S'4~~ Sea A Rae1.~.,. r.. ~' r------» +e (oG e.red ~,e.l ~.~.~ 31 ~ 3 Per dl+cpis~:t S!' ~ o 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Susan E Lederer Attorney At Law 4811 Jonestown Road, Suite 226 Harrisburg, Pennsylvania 17149 Re: Estate of Bruce L Gates Social Security: 196-18-3646 Date o~Death: November 29, 20D7 Phone (888) 502-4349 Fax (302)934-2955 January 11, 2008 Dear Sir or Madam: Per your inquiry dated January 03, 2008, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 9843491557 Ownership (Names of} Bruce L Gates Sr Opening Date 03/26/07 Balance on Date of Death $ 0. DO Accrued Interest $ 0.00 Total $0.00 2. Type ofAccount Account Number f~ ~-~ Ownership (Names of} `~., Opening Date Balance on Date of Death Accrued Interest Total Checking Account 36581135 Bruce L Gates Sr Calvin J Gates 08/28/64 Closed 1/10/08 $15,511.43 $ 0.64 $15,512.07 3. Type ofAccount Account Number Ow»ership (Names ofJ Opening Date Balance on Date of Death 4. Type ofAccount Account Number Ownership (Names o, f} ~~' ~, °# Opening Date Balance on Date of Death Accrued Interest Total $. Type ofAccount Account Number Ownership (Names o,~ ~1-~ ? Opening Date ~. Balance on Dare of Death Accrued Interest Total 6. Type ofAccount Account Number Ownership (Names o,~ ~ f-; Opening Date x '~, Balance on Date of Death Accrued Interest Total Savings Account 015004108552908 Bruce I Gates Sr Calvin J Gates * f 04/17!76 Closed 11/14/07 $ 0.00 ** Closed prior to the date of death Certificate of Deposit 031003913905592 Bruce 1 Gates Sr Calvin J Gates 08/18/00 X33,000.00 ~ 33.58 $33,033.58 Certificate of Deposit 031003913906409 Bruce 1 Gates Sr Calvin J Gates 02/08/02 $15,000.00 $ 36.81 ~-$75,036.81 ~-----~-~~ Certificate of Deposit 031003914510936 Bruce 1 Gates Sr Calvin J Gates 02/22/96 $40,000.00 $ 20.34 $40, 020.34 7. Type ofAccount Certificate of Deposit Account Number 031003914561666 Ownership (Names o~ Bruce 1 Gates Sr Calvin J Gates L:'~ J °, i , Opening Date 04/15/97 ~.-N. Balance on Date of Death $15,040.00 Accrued Interest $ 21.04 Total - ---------.-... - --- ----------~------------_-.__-------------- -__ $15,061.04 8. Type ofAccount Certificate of Deposit Account Number 031003914581698 Ownership (Names ofl Bruce 1 Gates Sr Calvin J Gates .~ ~; Opening Date 09/26/97 ~' Balance on Date of Death $16, 000.00 Accrued Interest $ 63.18 Total $16,063.18-------------------------------------------._._ Please be advised, there was no safe deposit box found for the above decedent ** Please contact the Colonial Park Branch for all additional information on accounts closed prior to the date of death. This customer may have had a Brokerage acrnunt with M&T that is not listed above. For information or questions regarding these types of accounts, please contact our Brokerage Department at 1-800-724-7788. * If ;you feel that any additional acrnunts should exist, please provide us with an account number and/or the name of any possible joint account holder. For further account information, regarding ownership and any changes, closures and/or reimbursement of funds, please contaM vur Colonial Park Branch at 4950 Jonestown Road, Harrisburg, PA 171(19, or # 717-255-2233. Sincerely, ~ar Nancy Clagett Records Management St MEMBERS 1St FEDERAL CREDIT UNION REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued interest to Date of Death Total Principal and Accrued interest Name of Joint Owner Dates Joint Ownership Established CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death TotaN Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established 181238-00 01 /19/1999 $108.97 $109.05 Carol Graham 8~ Calvin Gates 07/25/2006 181238-45 181238-48 08/18/2005* 08/13/2007** `~' $61,905.67 $20,453.37 $202.78 $81.28 $62,108.45 $20, 534.65 Carol Graham Carol Graham 08/18/2005 08/13/2007 'Rollover from certificate 181238-43, originally established 08/15/2001. **Rol~over from certificate 181238-40, originally established 01/10/2007. CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established 181238-49 10/03/2007 $10,068.97 $40.01 $10,108.98 Carol Graham 10/03/2007 181238-50 11 /13/2007 $26,612.00 $58.79 $26,670.79 Carol Graham 11 /13/2007 Estate of: BRUCE L. GATES Date of Death: November 29, 2007 Social Security Number: 196-18-3646 EM ERS 1ST FEDER L CREDIT UNION nielle A. Kline Insurance Services Specialist January 15, 2008 5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283-2328 www.memberslst.org Sovereign Bank ESTATE OF SOCIAL SECURITY #: Bruce L. Gates 196-18-3646 DATE OF DEATH: November 29, 2007 Account #: 1715218051 Type: CD Open date: 2/18/1999 In the name of: Bruce L Gates Sr or Frank K Gates %;-,~-, Date of Death Balance: ~ $23,658.19 - ~,_ _ Int.(YTD) from 1/1/2007 to 11/18!2007 $631.75 Accrued interest to date of death: $39.85 Other Info: Account #: 1715218580 Type: CD Open date: 7/27/1999 In the name of: Bruce L Gates Sr or Frank K Gates Date of Death Balance: $10,000.00 Int.(YTD) from 1/112007 to = ~ ; 10131!2007 $389.37 v j t i ~_: Accrued interest to date of death: $40.93 Other lnfo: Account #: 1715218762 Type: CD Open date: 1/5/2000 In the name of: Bruce L Gates Sr or Frank K Gates Date of Death Balance: $10,194.40 '~} ~ ~~' Int.(YTD) from 1/1/2007 to 10/31/2007 $388.72 ~`~' Accrued interest to date of death: $38.36 Other Info: Account #: 1715220362 Type: CD Open date: 9/3/1994 In the name of: Bruce L Gates Sr or Frank K Gates Date of Death Balance: $10,000.00 Int.(YTD) from 1/1/2007 to 10/31/2007 $294.88 ~;~? Accrued interest to date of death: $29.09 Other Info: Account #: 1715220719 Type: CD Open date: 3/4/1996 In the name of: Bruce L Gates Sr or Frank K Gates Date of Death Balance: $11,021.47 fi `, Int.(YTD) from 1 /1 /2007 to 10/3112007 $429.77 ~-~" Accrued interest to date of death: $46.47 Other info: Page 1 of 2 t .: ~' ~, }~ L ~~""t'y, '3',y ~~ ~ V'R~~.1^~^~ t ~ .., ~, H~Fji~'.!Ea F ~. ~,dy .r~z' N3},t P -?1L ~,PN~ l~k 3 ~IW~ b$l 5 ;~~ ~4P?'"" ~m ~ .~, .~:.., h= r __ _ _ t ,_ J r~ k ~,1 c '> 2~ + ~ 4, .,F , .~L - ~~ i i ~F t ~' ...:y] 1 } t ~ t l 1 rS # < > ,, c ~° 1 ~J ~~~![P(t,~~ A 4 ~ 6te ~ d ~ , 3a1 FirRr~G'o ~~ ~l~K '~amtlyoPY~r`~;ti~~~'^~~~~~`~~~~~"~?'~~,~~ ~ s_, r ;5~,' ,~ ,,immermarr uer ~-~- x ,;: F,U;lV E 31 A L: #i O M E, I N C . 4100 JtmestowaRoad, Hartisbirrg; PA 1710p (717-545-4001. ~~ r ~S'CATSMBNi' OF?GOODS: AIVD SB1tVICBS SBLBCTRD' Charges are only for itemr: that yon selected or that 9re required. If we are rtxpilted by tae or 6y ti cettietery or_ txetuatoty to use tmydtems, ire sill +5cplilR' in wtiUag below fl ' ~o bave selected s taneral tku may require embalming, such as'a funeral with vieielag, you may have to pay for embdmiag: You do sot have to pay fat embtihuing yon did sot . approve s you selected urangements anch as direct cremation or leunediile bond. If we charged Eor embaming, we'will explain tvly below For the Sen(ce o[ ~ Wit fl `: Date of Death' /'tPE Nt~~ ... Charge to: FR,1 NK- A'7~ 5 I at f! S , ~ r ~ O. . Name Add ~~ Slate A: CAARCB FOR 38RVIt&Y SRLRCFRD: Other dolhmg ' f. PROFFSStONAL SElty1CFS.. ~ - _ _ . _ SenkaofibnenlOlrectoNStaB..______»...:.:j 15ZS• s : ' EmbalmMg:....._...._~...._.....».__ ....:........._...._ i 6 ... ~.. Crematlon urn .:__.... , _ ...._.:__..:j.- Dresaml,Castuiing.._....:._.....».....:........._»,..:..3 1'7 S• ,. (DexripUoa) ':;. . Olhtr prepan0o6 of body :._...,..».» ........:.:...... f Oi11HR - _ .:. 5116-TOTAL OF PROFESSIONAL$RRVICES .................................. Al S ~ 3 ~~]- _ _ • `. Z. SERVICES AT FUNERAL HOME OR 07FIER FACHA'[Y ' ' ~ ,- ' { ....: 3qG~ - . .. vfeMrm)/Yis+orlon......_._.V.......».._„...._....».... i 2oU'.' ' ~: TOTAL MRRCHANOFSB SE68CFED ,..:..-:. ...::... . 6 t .....» ~(.` C.seRC1ALC9ARCRS . • ..-..~ .. Fascist Ceremony _._..».__........._..:...:...... { _.Z.~.i~ ~ :.: '.. , _ Memorial Service ..__ _ . . Fotwardl~ of rmulm'b .. - - 3 Grnaide Setrlce.:....».._..__ :, .::.._.._ _ (FYamul,Home) ~ .: Other__._.»•.......__-........___.........._..::_»...__i ' Recdiltgoftemalmbom' r. _ ._ ~ (Altteralttome) 3 SUU-TOTAL OF FUNBRAL HOMR/FACILITY .. ......... .......... A2 S r ~ . ~ _ Immldiate 8uriil _,...., j ' .. 3. AUTOMOIIYB EQNPMENr Direct CreteaUOn. - - '. - ....... .... i ; . , Vehicle ro transfer resnilna to Funeral Rome. -.I ' TOTAL 0! SPRCIAL CHARORS . ;. C 3 , Hearse (Casket Coach) _ . D:-CASH ADVANCED toal :.....:....._»_...:...:......__...;._.__.»...» i LSU ."' kopenmg rave :..: :. 1' llmoasine CemeleryEqulpmeW.,~:~'t~ _.,.„. „_ (~5 • ,. lacal:..:.:::_ .. ...._.:,__ j .. totand Deed ....».. 3. FamNyCar "{r-Netrspape[NoUas-aocl. ; ~UU.~ . • NetvapapecNo6~q~f town :...,.. ._». 3 - .. Lod___:~...M.m..».»..».:---_.._..»... .___.».. _ 1'elephnne Rd'd~rams _ _ Rowerar or 9nral dis sittrn po .' . Aktare:...:.M ...... Loul._._.._ .............»..._..._.»_..:».».........._..».. j . x' Gergy/Mass OQerisg _.__.. 1 / Z S. ..:..........._ 0 tedralda~csr PaUbearen.:.... .....,__ .................»...~....~j • ......_ toal .._........:._...M_....»_...» ..................._...._... = I by..r ~ ~ _~ ~ v CertiOed Copies of the ~ ~ ~ ' ~ ~' Car ror pa6bearers lkatb CertlOcale»..» ~. ~.. ._ .....__.:. f °I D ~: PollttEsi:ort t,otat __.___ ..._.,....___•_..___--..._i =;>rAoerersfJ.?~'~` sf.'RAy : _....1-I5U-.r' Oot of lotin tnnaporheon :~. .:......:.... _ ;: ~ , . _ ~~ Vault Berates Charge, -.::.;. >!„ ~. _ . :_.: ., `Gd r` 3 - SUt470TAL OF AUI'OMtFFIYR 6QUIPMRNT ...................... ...:.:.... A3 i -. . ' : _ - : '. ~ . . , . 'roTAh op rROPSSSIDNAL sERVICBS, i ; FUNERAL AOMElFACIL1Tf AND AUFOMb'I'IVE BQDRMBNT.:.... ....................:.:..... ' .....:... A ~ / ~ 5 _ `~~ a CFUIRGB POE MERCSANDISg SBLECT6D: TOTAL OF ADYMICRS ........ ......... s......... ... ..... ; ~ S..~ +- Y / t.t 2~0• ` 'ptchage yob for oar serrlces in obtaiamg: Casket l.~.~.;~..~..._......... e~......_.._._...........__ 3 _ , C,t~W-A t: ~ !+1 t DN IdN T- (apecity cash adnaca that are marked-op) . , .:. wl.>5..1~'TtaR/VtNO(aR~lt:~s <C~~P~€~ _ _ .' Otber Reieptade __..._......._.._ ............._........._ _ ; : SUMMARY OF CHAR6Rg . . °~. , (DesnlpUoo) -. A. Protesslonil SerWCla Funeral AomdFacillly 'Aotombtire'F,tjaipmep(. ,.. M j ~ ~ ~.~ • ?Omer berial conutner 141.1 ~ (~ ~'T.._......_ j I U'~ `. • , & Merc~ j ~~i S ;~ - G ~ t SCAtYN 1 i (DescilpUOa) tnva "T lc ~ u:.v ' - .Cub Advances .~ _ :, , D TO7NL OF ALt, 5BCT10NS ~... ....... ......... ............ ~ ~S , • • Acknowledgemem ardf ,..:..., j I S - - , 1'AIO'AT'ftMR OF OR P1ftOR 7'0 ~ ~ -y Regtsler book(s) I. _ _ ~ r ARRANCSAIERTS j f d~ ~ ; • •' ~ ` ~- kleaWtyfolden ~'..s.- ~ ..,. 'I ......»_.' ..... =.l.. {~~+ !' :-, , • ^ :f : ".6AIi1NGR Dl)E~.; r y s ..r ~t :..T. .'~ ~.. . -6 x: axe ~... ..., 1 `~ Phyer ards_ ».:. i t REAS FOR RafBALMINC •. ~ ~^' i / r _, Temponry.gtate marker ' ~ - _ .~: Bttrial~dolhln ~ '. ilemi } ~ ab.rie~ o erMldorj regbi eats hale required the rchaae of any oI the ~ ' g ... ..:,_. .. 3 a~ _. ..__._. -the IaW of r`egeirement N ezplmned helm', . ~ ': :r: ~,~.:F'I+~[(-[rv 1"Q9v,~P,c y,rtcr":.bv~.r.l'.Co•~'I'~:re(` T-r t agree tiro I Fax examined the Items of goods and sesNces selected atiore slid toond them to be correct aed atcordig6 ro the axalt~emedb t bare regae.+ied I tieknmrledge receipt of a espy o[ mh Statemem otEanenl Goods and Serrlcec Selected. I represent that I bare to®dmt fonds avsilable tot papmrnl of the Cash puce fat tke gobde and senlces'adeded:I rho agree b make payment of i _ widda dap. I. agree Ib lx loin0y sari sevecalt/ Dable lvltk a(iyone else she. Bigbs 6etow. a We cbsr6 of per month atooun0ng to _ per year will be applkd to the unpaid balance beginning - ' .. days ham the dale d thh agreemrnl I.wlli also pay ro the Foitenl INtetxor tdV miaooable ~: cosh pstd br the FLnmllNrector ro rnseci amounts 1 owe under ddaagreemrnW Those cWta may Include attorney!' fees coat[ ces~s and olbereosb. My addltlonal serdcea or merchandise ordered or datByj thl ml wW be comidered part of tkis'agreement ~hd tke cost Wereof wilt be rlQlded a UrE Ohtl bW o[ slatemeat. ' ~/ fl ~I`'. 07 . (Seaq , .(Purchaser) - ., , . (D?te) , (Seal) ;, (Purchaser) '• : (IJcensed I+unetd Director)' . O P6nnsyNanla Funeral Diron^loia Aasodatbn - ~ ~ - ~ ~. ' FORM - 000 REVISED 4/2004 : YJHIFE Poneni iNrenor YRI].OCV' Fmenl Director PINK Cbatomer ; ver Fax Transmission 1/12/2008 9:34 AM PAGE 1/002 Fax Se r ,/ Wachovia Bank N.A. Balance Confirmation Services P O Box 40028 Roanoke, VA24022-7313 January 12, 2008 SUSAN E LEDERER LAW OFFICES 4811 JONESTOWN ROAD SUITE 226 HARRISBURG, PA 17109 Reference ID: 2296088 SUBJECT: Verification / Confimoation of Account and Balance Information provided for: Customer: BRUCE L GATES SR (SSN# XXX-XX-3646) Date of Death: November 29, 2007 Deuosit Account Information Account Account Date of Death Average Date Maturity Interest Acctued YTD Date Type Number Balance Balance' Opened Date Rate Interest IaterestPaid Closed GERTIFICATE.OF 7i7CKX~:XX70{XX6550 5100,000.00 8/16/2007 5187.34 51,232,47 12/13/Z007 DEPOSIT LEGALTIILE: BRUCE L GATES ' v POD CALVIN J GATES, CAROL GRAHAM do FRANK GATES CLOSINGBAI,ANCE: 533453.87 CHECKING X70{X700C1~'X0180 532,968.83 9l11R007 548.11 545.04 12/17/2007 LEGAL TITLE: BRUCE L GATES SR /-- ~ CALVIN J GATES POA ~ j POD CALVLIN & FRANK GATES & CAROL GRAHAM CLOSING BAI:ANCE: 511428.37 CHECKING }Q{7~O~CX0193 5215,555.85 9/11/2007 5710.95 5210.87 12/13/2007 -~ LEGAL TTILE:: BRUCE L GATES SR ci.'` CALVIN J GATES POA ~, .... POD CALVLIN & FRANK GATES & CAROL GRAHAM CLOSING BAILANCE: 5216632.19 CHECKING XXJOOCXXXX4713 8/16/2007 9/11/2007 LEGAL TIfLEi: BRUCE L GATES CALVIN J GATES POA CLOSING BAILANCE: 50.00 Fax Transmission 1/12/2008 9:34 AM PAGE 2/002 Fax Server Reference ID: 2296088 ' Datc of death balance does not include accrued interest. ' I f date of death occurrs on a weekend or a holiday, date of death balance does not include a~ transactions that were made during that time period. ~~ Jennifer Straub Servicenter Associate Phone: (540)563-7323 t6; js Sc i,.~ r~,U 1- ~~ , d -1~.,~, 5 s - --T st MEMBERS 1St FEDERALCR.EDrr TJNION REGULAR SAVINGS ACCOUNT: Account Numl~erl Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established 494238-00 01/19/1999 $108.97 $.08 $109.05 Carol Graham & Calvin Gates 07/25/2006 18'1238-45 181238-48 08/18/2005* 08/13/2007** $61,905.67 ~ j $20,453.37 $202.78 $81.28 $62,108.45 $20,534.65 Carol Graham Carol Graham 08/18/2005 08/13/2007 *RoNover from certificate 181238-43, originally established 08/15/2001. **Rol~over from certificate 181238-40, originally established 01/10/2007. CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established 181238-49 10/03/2007 ~~ $10,068.97 ~~:? $40.01 $10,108.98 Carol Graham 10/03/2007 181238-50 11 /13/2007 $26,612.00 ~ ~ $58.79 $26,670.79 Carol Graham 11 /13/2007 Estate of: BRUCE L.. GATES Date of Death: November 29, 2007 Social Security Number: 196-18-3646 EM{ ERS 1ST FEDER L CREDIT UNION nielle A. Kline Insurance Services Specialist January 15, 2008 5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283-2328 wwwmemberslst.org `~I M&T Investment Group M&T Securities, Inc. 285 Delaware Avenue, Suite 2000, Buffalo, NY 14202-1885 Law Offices of Susan Lederer 4811 Jonestown Road Suite 226 Harrisburg, PA 17109 Date of death valuation For the account of Bruce Gates -Transfer on death Beneficiaries- Calvin Gates, Carol Graham, Frank Gates Account # AZD460699 opened 3/22/07 Date of death 11 /29/07 Description of Security Quantity Valuation Date 11 /29!07 Price per share MTB Money Market Fund 56399.48 $1.00 Glass A2 Interest 11/1-11/29/07 $0 1Me have received the information presented above from sources, which we believe to be accurate. However, we do not guarantee their accuracy. The price per share on valuation date is the closing price on that date. Please contact Client Solutions with any further questions, or if we may be of further assistance to you at 1-800-724-7788, Option #1. Thank you. Sincerely, /~~~ Robin Brown M&T Securities, Inc. Investment and Insurance Products: • Are NOT Deposits • Are NOT FDIC-Insured • Are NOT Insured By Any Federel Government Agency • Have NO Bank Guarantee • May Go Down In Value M&T investment Group'" Is a service mark of M8T Bank Corporation and consists of M8T Securities, Inc., the irneslment-related areas of M&T Bank and investment advisory firms MTB Investment Advisors, Inc., and Zirkin-Cutler Investments, Inc. erckerage services and insurance products are offered by M8T Securities, Inc. (member FINRA/SIPC), not by M&T Bank. M&T Securities, Inc. Is licensed as an insurance agent and acts as agent for insurers. Insurance policies are obligations of the insurers that issue the policies. Insurance products may not be available in all states. ~ c~~. c~ ~l~,C ~ ~.~. v~ ~ o A~IaisorGvmpass r'1xn~ri ~ris~ - Qniinn Senri~ce and'>iransacti~ns ~ f~'i~tti~,i.-irtl Training Account Profile - ANNUITIZATION close Window Account Profile ~ Activi ~ Checks Issued ~ Arrangements Transaction Wizards ,_-.m.~~-.. r,,T_~ .. Move Money ~ Move Money ~ S stematic ~. ~ .New Money In Y out of Account I Within Account ~ k Move Money ~~ Fir:~t Account Next Account d~vvners~ip Intorrnatic~n Account #: 0000 0930 '0755 7763 3 004 Account Status: ACTIVE Opened Date: 07/05/2005'. Ownership: BRUCE L GATES Plan Type: NON-QUALIFIED Associated TIN: 196-18-3646 Taxpayer's Current Age: 84.0 Associated Group Its - Select Group Account List Group ID Group Type 0247 3440 2 001 HOUSEHOLD Associated Olient IDs - Select Olier~t Profile Client ID Client Name Role 1140 3100 8 001 MR BRUCE L GATES OWNER ANNUITANT TAXPAYER ~eneticia Infc~rrriation PRIMARY BENEFICIARY LIVING, LAWFUL CHILDREN IN EQUAL SHARES 100.00% CALVW J GATES SON CAROL A GRAHAM DAUGHTER FRANK K GATES SON l~ayo~~t status: In Payout Payout Type: LIFE INCOME WITHIN 10 YR CERT https://www8.ex.is. ameriprise.corn/Ost/Secure/AccountProfile/AccountProfile.asp?alKey... 11 /15/2007 vvi Allocation -Fixed: 100% Allocation -Variable: 0% Percent of Stepped Increase: 0% Fixed Amount: $632.68 Federal Tax Withholding %: 0% State Tax Withholding %: 0% Frequency: MONTHLY Next Payout Date: 12/05/2007 Payout Start Date: 08/05/2005 Value at Settlement: $69,678.34 Last Guaranteed Payout Date: 07/05/2015 Payouts in 2007: $6,959.48 Taxable Amount in: 2007: $6,959.48 Payouts to Date: $17,715.04 Delivery Option: DIRECT DEPOSIT C~~Ir~rrpu~a~Zle Values VALUES NOT AVAILABLE Ac~c~ress Address: C/O CALVIN GATES UNIT 202 23841 COSTA DEL SOL RD BONITA SPRINGS, FL 34135-1788 Vew Corporate Entities and Important Disclosures, Web Site Rules and Regulations, Pn'vacy Statement and About E-mail Fraud. Copyright ©2003-2007 Ameriprise Financial. All Rights Reserved. Users of this site agree to be bound by the terms of the Ameriprise Web Site Rules and Regulations. https://www~. ex.is. ameriprise.com/Ost/Secure/AccountProfile/AccountProfile.asp?alKey... 11/15/2007 C t~tx c~U ~-'' ~~ , ~ -~-vn j U Annuity, Life Estate, and Remainder Factors 2/22!2008 Transfer Date: 1112007 §7520 Rate: 5.20% Calculation Type: Term Aggregate Annual Payments: $7,592 Term: 8 Payment Timing: End Annuity Factor: 6.4113 Factor Value Annual 1.0000 $48,675.62 Semiannual 1.0128 $49,298.66 rly 1.0193 $49,615.05 onthl 1.0236 $49,824.36 W ee y 1.0253 1 io-r T'.he Personal Advisors of A.-meriprise Financial Joseph L Baird, CPA Ameriprise Flnancial Services, Inc. Financial Advisor Suite 100 523 West Chocolate Avenue Hershey, PA .17033 Tel: 717.534.9980 Tel: 800.995.4223 Fax: 717.520.9780 joseph.l.bal rdG~a m pf.com December 19, 2007 Mr. Frank K. Gates 1809 Dogwood Road Harrisburg, PA 17110 RE: Estate of Mr. Bruce L. Gates 2625 Ailanthus Lane Harrisburg; PA 11110 Dear Mr. Gates, Please accept my condolences on the death of your father. I am the Ameriprise Financial advisor who managed your father's accounts. The following are the Ameriprise accounts owned by your father: Ameriarise Accounts owned bY,Bruce L_. Gates Balance as of November 29, 2007(1) 403(b) Tax Sheltered Annuity(Qua{ified Deferred Annuity) $7,243.09 RiverSource Annuity (in payout mode) $632.68 paid per month for life with a guaranteed period of 10 years; began 8/5/2005; 10 yr certain period ends 7/5/2015 (1) -information obtained from the Ameriprise On-Line Service and Transaction Screen dated 11!29/07 As a beneficiary of his account, I am sending to you an~Annuity Death Claim Statement to be completed and returned to me to be processed. Please complete the following information on this form: Part 2: #4a, 6, and 8 Part 6: Taxpayer Identification number Part 7: Amount of federal taxes to be withheld Part 8: Please sign and provide driver's license #, state, and expiration date Pages?-10: Keep for your records Please note that the only options available to you for receiving the monies is as a lump sum by check for the qualifted deferred annuity and a continuation of one-third of the monthly payment by check for the annuity in payout. This monthly payment will continue until July 5, 2015 An Ameriprise associated franchise. Ameriprise Fnancial Services, Inc. offers financial advisory services, investments, Insurance and annuity products. River:>ource~ products are offered by affi4iates of Ameriprise Flnancial Services, Inc., Member NASD and SIPC. EP 14 JANUARY 2004 "APE ©1995 USPS ~ N tiJ N ~j ~ Vn d !'7 U' This packaging is the property or me u.~. r~sua~ x,v~~,c -a,,,, ,,, N,,,,,,,,,~, „~.,,., .~. ___ .. Misuse may be a violation of federal law. ' "` /O V ,,wws vA/ 1~~i N ~.b`t~unn~~~SJ„Z ~~ -'~ ~~. uV A~~ _,' .' .,~ %~~ f ,,>, ; ~a~.`. ,a,~..; . ' ..~' E ~ O o ,--, O G-. H f7 O M ~ '--~ ~ O ~ ~ O ^' U ~ ~ ~ ~ ~ ~ ~ .~ ~ cr' '~ U ~ ~ ~ ~ ~ o ~ oa+ ~ ~~ ~ ~ ~~ .~ ~ U •~ ~' ~ o ~U--~U