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HomeMy WebLinkAbout09-08-08 (3)15056051058 '~ REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box 2aosol 21 08 0655 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 174-20-7104 06/09/2008 02123/1926 Decedent's Last Name Suffix Decedent's First Name MI WOLAND DOROTHY J (If Applicabte} Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW ~:; 1. Original Return THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS _~ 2, Supplemental Return .., 3. Remainder Return (date of death prior to 12-13-82) _ 4. Limited Estate ~ ~0 4a. Future Interest Compromise (date of ~"~ 5. Federal Estate Tax Return Required death after 12-12-82) n~ 6. Decedent Died Testate ~.~a 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will} (Attach Copy of Trust) 9. Litigation Proceeds Received _~ ~ 10. Spousal Poverty Credit (date of death _ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CQRRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD 8E DIRECTED T0: Name Daytime Telephone Number CHERYL STROUD, CO EXEC, (717) 236-8395 Firm Name (If Applicable) _ _ REGISTER OF WILLS USE ONLY F' t I' of address irs me 2629 BUTLER STREET ~ -- Second line of address _, =;~ ...! ~ ~ r , ; , .<3 r _ - .,_ _ a State ZIP Code City or Post Office 'mil DAB FIj~[~` r--r ! G'O ~ c . _ ~ -~ PA 17103 HARRISBURG "' '~ ~ _..._ v ' _ ~_ ~,a.j Correspondent's a-mail address: I _ ~~ c: _, i ~~ -~, Under penalties of perjury, I declare that I have examined this return, inGuding accompanying schedules and statements, and to the best of my knowledge and belief, it is l:rue, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. UIGN f~nOF PEQSOGi~ESPO~OsFj~ING R~n ~'A~ /yam ~AlE SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056051058 J 15056052059 REV-1500 EX Decedent's Name: DOROTHY RECAPITULATION _,. ~- ~~~~ -~ J WOLAND Decedent's Social Security Number 174-20-7104 1. Real estate (Schedule A) ........................................... .. 1. ' 0.00 2. Stocks and Bonds (Schedule B) ..................................... .. 2. 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 0.00 4. Mortgages & Notes Receivable (Schedule D) ........................... .. 4. ' 0.00 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ...... .. 5. 340,885.86 ' 6. Jointly Owned Property (Schedule F) _~::~ Separate Billing Requested ..... .. 6. ' 0.00 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property ~.m~ (Schedule G) "'°"' Separate Billing Requested...... .. 7. 0.00 8. Total Gross Assets (total Lines 1-7) .................................. .. 8. 340,885.86 9. Funeral Expenses & Administrative Costs (Schedule H) ................... .. 9. ' 25,544.78 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule 1) .............. .. 10. 0.00 11. Total Deductions (total Lines 9 & 10) ................................. .. 11. 25,544.78 12. Net Value of Estate (Line 8 minus Line 11} .. . ......................... .. 12. 315,341.08 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which "" "°' ~ `" °°"~ ° '" ~~""`" ~ ° '~"" ~ " `~ `~ ~ '°` an election to tax has not been made (Schedule J) ...................... .. 13.: 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... .. 14. I 315,341.08 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES ~ ~ ~ ~ ~~~~~ ~ ~-~~ ~ ~ ~ ~~ - ~~~~ 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 _ _ _ __ (a)(1.2) X .0_ 15. 'I6. _. __... ~.__._ .~ ____ , _ _._... .~._~ __~- Amount of Line 14 taxable ,... ~., ,_.a_~. „~__._w....__.. °~ ~ """~ ` at lineal rate X .0 _ 16. i '17. __ Amount of Line 14 taxable ~~ ~~~ _ ~ ~ _ ~ _ -~~~ ~ ~ ~ ~~~~~ at sibling rate X .12 17. I 18. Amount of Line 14 taxable ~~ ~ ~~ ~ ~ ~~~~~~~~ ~~~ ~~~~~~~315,341.08 '' at collateral rate X .15 ~ 18. ~~ 47,301.16 19. TAX DUE ....................................................... .. 19. ' __ 47,301.16 c:0. FILL 1N THE OVAL iF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 15056052059 REV-1500 EX Page 3 Decedent's Complete Address: _ File Number - _21 ~ 08 f 0655 _ _. __ DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER DOROTHY J WOLAND 174-20-7104 STREET ADDfiESS 1100 GRANON WAY APT NO 228 CITY MECHA,NICSBURG STATE PA ZIP 17050 Tax Payrnents and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit _ B. Prior Payments _ C. Discount 3. InteresUP~enalty if applicable D. Interest E. Penalty 2,365.06 Total Credits (A + g + C) (2) Total lnteresUPenalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter ttie total of Line 5 + SA. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT (1) 47,301.16 2,365.06 0.00 0.00 44,936.10 0.00 44,936.10 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 :.................................................................................... ...... ® ^ b. retain the right to designate who shall use the property transferred or its income : ...................................... ...... ® ^ c. retain a reversionary interest; or ................................................................................................................... ....... ~ ^ d. receive the promise for life of either payments, benefits or care? ................................................................ ...... ® ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................... ....... ® ^ 3. Did decedent own an "intrust for" or payab{e upon death bank account or security at his or her death? ....... ....... ® ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ......................................................... ........................................................ ® ....... ^ 4F THE ANSUVER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exemg; a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(x)(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(x)(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(x)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1508 EX+ (6-98) r' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, 8r MISC. PERSONAL PROPERTY ESTATE. OF FILE NUMBER DOROTHY J. WOLAND 21-08-0655 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 CITIZENS BANK CHECKING WITH INTEREST #621989-037-3 101 26 ~ . 2 CITIZENS BANK MONEY MARKET ACCT #621989-038-1 140,561.90 3 INTEGRITY BANK - 3 CERTIFICATES OF DEPOSIT #1015922, 1015914 AND 1015906 83,253.16 4 SOVEREIGN BANK -CHECKING ACCOUNT # 571131425 15,093.07 5 SOVEREIGN BANK -ACCOUNT #0021084300 94,106.23 6 SOVEREIGN BANK CERTIFICATE OF DEPOSIT #1995542527 5,406.65 © LOYALTON OF CREEKVIEW REFUND DUE 1,628.00 8 FREEDOM BLUE REFUND DUE 67.20 9 RETIREMENT CHECK DUE 668.39 TOTAL (Also enter online 5, Recapitulation) $ I 340,885.86 (If more space is needed, insert additional sheets of the same size} REV-151'1 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Dorothy J. Woland 21-08-0655 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Parthemore Funeral Home $7,873.88 Less Prepaid Funeral Expenses 7,805.00 Net Costs 68.88 e. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Schedule Attached Social Security Number(s)IEIN Number of Personal Representative(s) Street Address City .State Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Relationship of Claimant to Decedent 4, Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees ~. Zip Zip TOTAL (Also enter on line 9, Recapitulation) I $ (If more space is needed, insert additional sheets of the same size) 20,414.90 4,000.00 436.00 625.00 25,544.78 DOROTHY J. WOLAND ESTATE FIILE # 21-08-06555 SC;HEUDLE H - ITEM B -ADMINISTRATIVE COSTS ITEM 1 -PERSONAL REPRESENTATIVES S.S. 1$2-52-6137 Cheryl S. Stroud 2629 Butler Street Harrisburg, PA 17103 10,207.45 S.S. 207-34-7247 Connie I. Flauaus 10,207.45 505 Edward Street Harrisburg, PA 17110 Total Executrix Fees 20,414.90 REV-1513 EX+ (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER DOROTHY J WOLAND 21-08-0655 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)) SCHEDULE ATTACHED ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET ~ $ (If more space is needed, insert additional sheets of the same size) DOROTHY J. WOLAND ESTATE SCHEDULE OF BENEFICIAgIES Richard Butler (717) 657-0454 4501 Fritchey Street Harrisburg, PA 17019 Dennis E. Butler 5889 Fox Street Harrisburg, PA 17112 195-38-9188 $1000 husband's nephew 206-32-4427 $1000 husband's nephew James H. Woland, Jr. (717) 421-0097 184-38-0882 224 Verbeke Street $1000 Harrisburg, PA 17102 husband's nephew FILE ~~21-08-0655 Edward and Constance Vanish (302) 945-5118 Ed 184-34-4033 Connie185-36-8008 36810 Teal Road ll9 each of residue Longneck, DE 19966 friends Patricia and Robert Ellis (610) 678-8997 Patricia 191-40-7307 Robert 198-34-5756 237 Bradley Avenue 1/9 each of residue Sinking Springs, PA 19608 friends Betty Miller (717) 921-2955 177-24-6968 1120 Stoney Creek Road 1/9 of residue Dauphin, PA 17018 niece Cheryl Stroud, Co-Executrix (717) 236-8395 182-52-6137 2629 Butler Street 1/9 of residue and 3% executrix compensation Harrisburg, PA 17103 great-niece Walter Parmer, Jr. (717) 732-9403 164-28-5819 3 Ellen Drive 1/9 of residue Enola, PA 17025 Dorothy was married to his first cousin Robert McCullough (570) 326-3637 18 0- 4 6- 9 6 3 2 1041 Pleasant Hills Road $1000 Williamsport, PA 17754 nephew JoAnn Kitko (570) 368-1602 17 4 - 3 6 -13 5 9 1000 Allen Street $1000 Montoursville, PA 17754 niece Mary Steckel (610) 799-4086 2 0 0- 4 0- 2 2 71 1932 Georgia Drive $1000 Whitehall, PA 18052 niece DOROTHY Jo C~]OLAND ESTATE FILE ~~21-08-0655 SCHEDULE OF BENEFICIARIES Michael Zakis (717) 728-7677 192-30-0118 151 Kathryn Drive $1000 New Bloomfield, PA 17068 nephew Donna Sollenberger (717) 369-5427 161-32-2924 177 Edgewood Avenue $5000 St. Thomas, PA 17252 niece Doris Bartholomew (215)257-5335 160-36-3591 158 Heighes Avenue $1000 Sellersville, PA 18960 niece Edward Ickes (717) 234-0736 198-30-1451 160 Linglestown Road, Apt. 3 $5000 Harrisburg, PA 17110 nephew Connie Flauaus, Co-Executrix (717) 230-8401 207-34-7247 505 Edward Street 1/9 of residue and 3% executrix compensation Harrisburg, PA 17110 niece Deborah Johnson (717) 377-1563 178-48-0882 321 Feaster Road $1000 Chambersburg, PA 17201 niece Margaret Cecere (717) 561-4366 186-34-1318 551 Keckler Road 1/9 of residue Harrisburg, PA 17111 niece Diane McCleary (717) 267-7045 182-44-4961 5910 Cumberland Highway $1000 Chambersburg, PA 17201 niece Kenneth Barry Ickes (717) 582-4025 193-36-4090 cell (410) 713-9474 768 Clouser Hollow Road $1000 New Bloomfield, PA 17068 nephew Cathy Ickes Hill (717) 514-4953 194-42-8666 14 South Alydar Blvd. $1000 Dillsburg, PA 17019 niece RE:GI5TER OF WILLS CUMBERLAND COUNTY PENNSYLVANIA CERTIFICATE OF GRANT OF LETTERS No . 2008- 00655 PA No . 2 ~ - 08- 0655 Estate Of : DOROTHY J WOLAND (Firs!, Middle, Last! Late Of: HAMPDEN TOWNSHIP CUMBERLAND COUNTY Deceased Social Security No 174-20- 7104 WHEREAS, on the 17th day of June 2008 an instrument dated May 1st 2008 was admitted to probate as the Last wi.l1 of DOROTHY J WOLAND (First, Mild/e, Lasl1 1 a t e of HAMPDEN TOWNSHIP, CUMBERLAND County, who died on the 9th day of June 2008 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I , GLENDA EARNER STRASBAUGH Register of Wi I1 s in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: CONNIE l FLAUAUS and CHERYL S STROUD who have duly qualified as EXECUTORjR/X1 and have agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND CDUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 77th day of June 2008. **NOTE** ALL NAMES ABOVE APp~'~p /L'TT'^^' °`-'-_ r, t ~ ~~ ~~ ~ rN 1 _~~ ~~ ~ ~'_'' ~ LAST WILL AND TESTAMENT -` ~ -~- ~ `' OF ~-:' _' - _-~ DOROTHY J. WOLAND ~_m ..__ .1~ _--~ - --~ .: . , ~~~ , -- ~. 1, DOROTHY J. WOLAND, of Mechanicsburg, Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this, my Last Will and Testament, hereby revoking and making void all former Wills by me at anytime heretofore made. ITEM I. {order and direct all my legal debts, death taxes, funeral and administration expenses to be fully paid as soon as conveniently may be done after my death, costs of administration and other similar expenses from the principal of my residuary estate. ITEM 11. I give and bequeath certain items of tangible personal property that are solely owned by me at the time of my death and that are identified in any separate writing which is dated and signed by me at the end thereof, to those persons designated in such separate writing who survive my death by thirty (30) days. if any item of tangible personal property is identified in more than one separate writing, I direct that, unless stated to the contrary, the separate writing bearing the last date shall govern the disposition of such item. ITEM 111. BENEFICIARIES. A. I give $1,000.00 to each of the following persons: DORIS (SOLLENBERGER) BARTHOLOMEW; DIANE (SOLLENBERGER} McCLEARY; DEBRA (SOLLENBERGER} JOHNSON; MARY CATHERINE (McCULLOUGH} STECKEL; JOANN (McCULLOUGH} KITKO; ROBERT McCULLOUGH; BARRY ICKES; CATHY ICKES; MICHAEL tAKIS; JAMES WOLAND; DENNIS BUTLER; and RICHARD BUTLER, as are living on the thirty-first (31St) day after my death. If a named person does not survive me by thirty (30) days, then his or her share shalt lapse and be divided equally among the persons named in ITEM III(C). B. I give $5,000.00 to each of the following persons: DONNA LEE SOLLENBERGER and EDWARD L. ICKES, as are living on the thirty-first (31St) day after my death. If a named person does not survive me by thirty (30) days, then his or her share shalt lapse and be divided equally among the persons named in ITEM III(C). C. The rest, residue and remainder of my estate, I give said property equally to, BETTY (ZAKIS) MILLER; CHERYL (MILLER) STROUD; MARGARET (ICKES) CECERE; CONNIE (ICKES) FLAUAUS; WALTER PARMER, JR.; ED VALLTSH; CONNIE VALLISH; PAT ELLIS; and ROBERT ELLIS, as are living on the thirty-first (31St) day after my death. If a named person does not survive me by thirty (30) days, then his or her share shall lapse and be divided equally among the surviving named persons in ITEM III(C). 2 6 ~'' ,~ ~~ -~ ~i c)~ ~J ~_ ITENfi I appoint, CONNIE (ICKES) FLAUAUS and CHERYL (MILLER) STROUD, or the survivor thereof, as my Executor under this my Last Will and Testament. My Executor, shalt have the authority, in their sale discretion, to appoint another individual or bank as an additional or successor Executor, or to renounce appointment in favor of another individual or a bank. -1~~UY ~ ITEM I direct that no Executor created in this WiN be required to enter bond for the faithful performance of duty in any jurisdiction. ,~~' ITEM ~I. No beneficial interest under this W~11, whether m income or principal, sha11 be subject to anticipation, assignment, pledge, sale or transfer in any manner, nor shall such interest be liable for or subject to the debts, contracts, obligations, liabilities or torts of any beneficiary. IN WITNESS WHEREOl=, I have hereunto set my hand and seal to this my Last WiN and Testament, consisting of three (3) typewritten pages, this 1St day of May 2008. DOROTHYJ. WOLAND 3 ~,' y' We, the undersigned hereby certify that the foregoing Wili was signed, sealed, published and declared by the above-named Testatrix, DOROTHY ). WOLAND, as and for her last Will and Testament, in the presence of us, who at her request and in her presence, and in the presence of each other, have hereunto set our hands and seals the day and year above written, and we certify that at the time of the execution thereof, the said Testatrix was of sound and disposing mind and memory. _~..-- Residing at ~'~.3~ ~~c?G~C.~ ~~f ~~1~ ~ ~~ ~~-~~~ .~ ~~~ ~~l i ~~ l r~ 7/~-~~~~7wC~1~ .~cC~~c~, ~~~4 ~ Residing at _~~ ~ ' ~~:} lc - ~ 'L~~~ 4 (~,'C ~r COMMONWEALTH OF PENNSYLVANIA COUNTY OF ~~ SS We the Testatrix, DOROTHY J. WOLAND, and ~'~~ ~ ~~_ io'3z ~~d~. and ~.,~~~~ ~~ ~ I~r~j ~' ,the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Wiii and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of their knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. WITNESS: ~,,~' °~ i~ r~ h~~ _~..1~-~ DORO'TH~`J. W4L4ND ~4~ 1 ''~ ~ I-~e..~~ Subscribed, sworn to and acknowledged before me by the Testatrix, DOROTHY J. WOLAND, and subscribed and sworn to before me by i.~S~~~J~~, ~,~~~,,~~~ and ~ft~•.. ,~, ~'~S~ ,witnesses, this 1St day of /~ May, 2008. ~~~ ~ ! ~ BARRY K. TRE;XLER, J.t~. 551 WEST RRNE NOtary PUbi{1 NOTAR1Al SEAL HARRISBURG, PA 17111 BARRY K. TRE?(C~R 717-56b-T 7$2 NOTARY PUBtIC•NOTARY Ip 12i>J355 SWATARATOWNSHIP, DAUPHIN COU~ITY,PA, USA MY COMMISSION EXPIRES OC?:~1, ~OQ13 5 ~~ ~ Y~[ Ci - - O1~F1G1AL CFIECK a~ t~zens Bank ., .~ ~:~-, ~~~ ~~ a ,~, ~~ ;~ f~(,d~ t, r~r~? `3 '~~~M~' NON-NEGOTIABLE J ~~ ~ '; _~ ` ~ ~ ~~ a ~~ rr ~ ~`i n f PAY~LEiFI'1 ON ~-' ) ~ ,, ~ ~ t 1 ' ~.•ue~ r h tHgr, t, i if'iYrnr ian ,.Wane E» r ~ ,-ne. ~ S st = r ; i -"-"~'^- r ~. h.A f)t~n.car. C ~ ~rrL ~y'c-w _c, ~c,~ior: ~„ - ~.. ='~ • ' ~ µ ,x. .t ~ ,~ ti ' S:~VE Tfi1S RECORTj ~,,~,,;_ ;~ ~>~, ..~ -~ ~' ~'~ ~~ °E CANNOT G1YE dI~'FGR:~1AT10Y ~R SFnu~r, u~~F,~„_,..._ ~~~°~° CLOSING DE61T - (:MtC:KINIa to ~~' / :~~i .~ ~>.~ BanWBranch r JL~C..) / ~ `.~_? ~~ :Amount Debited $ ~ r~> ~ ;~ i~,, For: '~ ~' ~ amount has been charged to your account. Please adjust your records. Name ~!. \'.: i ,i' i : ~.! _?1...i Address ~.J" .k ~..i 1. .`;=11 ; ~,.y . -- _t. !' Debit Acct. ~G ~ ! ~ 1 r> ~ ~i U ~~ 1 ' `_..- Customg~ signature required when ~ ey Appr. By requests account be closed s I~w~t~'1~5 ~ 4LVSIIVta utlsl l - t,.re~~.n.e~al~a ate i.. •,r; L._; /`:.,,' ~" Bank/Branch ~Llr" fJ / ;.,~~? ! ; A,moun# Qebited ~ I --~ ~; `)~~ 1 ~i I ~, For: ~,.-4 ~~ 1.-, << Is amount has been charged to your account. Please adjust your records. `` Debit ~11 ; ~ ~ ~ ~~: ~ (1 V '`^.,~ ACC#. ~,,, :~ ~ C:~ ~~ ~ ~ ~a :~~`t.~ I Name ~ - f Address .y lG ~~ ~ ~j `jl.l,~r~ ~ ~ +' ,,~. ;. ~ ~ -~ /~7 ~ ~ / ~ .\---". usto siana a regwied Appr. By ~rohen customer requests account be Closed .~~ ~~~~~~~~ ~~~ Circle ~~ Account Statement ].-$8$-91b-~F4i)U ~ CAF 3 fall ciNtens'PhoneBank anytime foraccounC information; current rates anrJ answers to your questions, Begii7ning J;wne 05, 7.008 through July 03, 7.008 US259 BR307 2 2# DORQJHY J WOLAND ~b11~2I1'~S 2629 BUTt.ER STREET Summary:... Rage 1 HARRISBURG P A 1 7 1 Q 3 Checking wage 2 Circle Summary Account Account Number Balance Balance ItOROTNY J WOLANI) Last Statement This Statement Circle Checking with Interest DEP-051T BALANCE 621989-037-3 Checking Circle Checking with Interest 621989-037-3 101.26 .00 Circle Money Market 621989-038-1 140,561.90 .00 Savings Circle Savings 6251-715279 .00 .00 Monthly combined balance to waive monthly fee is - Your monthly combined balance this statement period is Total Deposit Balance .00 7,500.00 ~ TotalRelationshtp Balance 97,009.07 ~~ ,00 Member FDIC 1~ Equai lilousiny LenAer ~~ ~~'~~~~~~ ~~ ChecknL~ Account ~~ Statement 1-88'8-910-4100 ~ of 3 fall r.itizens' Pl~neBank anytirn= for arcoimt information, current ra'es and answers to yourqu2;tions: Beginning June 05, 2008 through July 03, 2on8 Checking s u M M A R Y DOROTHY J WOLAND Balance Calculation ga(anCe Circle Checking with Interest 621989-037-.3 Previous Balance Checks Withdr~v/als Deposits & Additions Interest Paid Current Balance 101.2f., Avernge Dmly &r(prlce .00 - Interest 101.26 - .00 + Cun~ent Interest Rnte .00 ~ Annirnf I'ercentdgeYield Earned Nurridr?r of Drays interest Erir`Neil ~0 _ TRANSl1CTIaN DETAILS Withdrawals Other Withdrawals Date Amount Description 06/2.4 101.26 Closing Withdrawal Interest Eanled ...Interest. Paid this Yens ' Previous Balance 101.26 /"~ Total Withdrawals 1 ,~""~i .101.26 /'"'\ Current Balance r ~ 1\`"~.~.. .00 Daily Balance Date Balance Date Balance Date Balance 06/24 .00 Checking SUMMARY Balance Calculation Balance Previous Balance 1.40,561.90 Avernge Doily 6~(nnce 133,533.80 Checks .00 - Interest Withdrawals 140,561..90 - Deposits & Additions .00 _+ Current Interest Rate . 90°h Annual l'ercentnge Yield Earner/ .00"~ Interest Paid .00 .+ Number of Drays InterestFnrned 20 Current Balance 00 = Interest Earned .00 Interest Pnid this Venn 7_,142.71 TRANSACTION DETAILS Withdrawals Other Withdrawals Date Amount Description 06/24 9.40,50,1.90 Closing Withdrawal 9b, 19 2.0% (1O°u 2v .OU .GG DOROTHY J WOLAND Circle Money Market (.,21989- 038-1 Previous Balance 140,561.90 n Total Withdrawals ~""~~ 140,561.90 Current Balance `"~- . 00 Memher FDIC t~ EGunl Housing LenAer /~ ~~yy ~~:.~~~IZ~~S A~~~ Checking'Account ~ t - C ~~ ement ~a 1-888,910-4100 ~ or 3 Calf Citizer' plione~83~k anyrime foreccounr_ information„ o~rrent~ ratan and answers ko your a~iesti'oiu. Begihning June b5 '2008 ' through July 03, 2008 Checkiilq continued from previous pcige Daily Balance DOROTHY J WO[AND Date Ba[ance Date Balance Date Balance OG/24 00 . Circle Money. Market.. b21989-038-1 Z NEWS FROM CITI ENS --IMPCIRTANT NOTICE/ChigNGE IN 7ERM5 Effective 5eptem$et 1, 2ooa, we will add an Jnar_tive Aa-ount Processing Fee to the Personal & Business Deposit Account Fees and Features GLride of your account. Tfie fee of $30 will apply to all accounts tlaat-17ave been inactive for 24 months of mire, and is in addition to any applicable monthly dormant acrnuntfee. Thisfee is not imposedon fVew Jersey based accounts that, have been charged the maximum. dormant accowit fee. --IMPORTAiNT NOTICE/CHANGE IN TERMS Effective September.l, 2008, our handling fee for certain court orders. and legalprocessing will be increased to $30 Eqr each item that we process against ynur arcnunt. This includes court orders, garnishments, attachments., tax levies, executions, and similar types of legal. process. Member FDIC >~ Equal Housing Lender NOTICE Tf? CUST01vfER - ~S A CONDff[ON TU TT{IS R.rSTiTliTIPN'S [SSIJANCI: OF TF[IS CHECK, PURCHASER AGREFS 'PO PROVIDE ru ~ AN fYDEMNFfY 6UND PRIOR TO THE REFUND UR ~ ~ ~ CASHIERS *vl AE K RE.I~7.ACEMEI`TI~ OF THIS CHECK iN TF1E GVENT IT iS LOST, MiSPi.ACED OR STOLEPI. ~ 0 $ 0 9 pu? 60-T87l0313 REMITTER -~ -" - - ., 3: , d i', . DRAWN TO THE i?RDER OF _. ~, , i _ . v ~ >, .,. _ _ .. -,- , _ .. s ~1:llt~~'1'1r~ ~ Camp Hitt, PA tTOII CUSTOMER'S MEMO: ~ - _. ~+"0 SO80 9++" ~:0 3 ~ 3 18 ?8 7A: S 2000000 10++' °~ , ,. l ,_- t ,.. ,~ 4'~~: ,_i ',. C~ ~ '~ IntegrYt~ JJ '/ ~\`~ B A N K INTEGRITY BANK CAMP HILL BRANCH 3345 Market Street Camp Hi11, PA 17011 ACCOUNT TYPE 6 - 11 MONTH CO ACCOUNT NUMBER 0000000001015922 ACCOUNT TITLE DOROTHY .J WOLAND ACCOUNT MAILING ADDRESS 1100 Crandon Way Apt 228 Mechanicsburg, PA 17050 TAXPAYER iD NUMBER 174-20-7104 ACCOUNT OWNERSHIP Individual Account NUMBER OF SIGNATURES REQUIRED OPENED BY JOHN T ROZMAN GATE OPENED August 24, 2007 AGREEMENT. By signing this signature card you agree that the account wilt be governed by our Time Deposit Agreement. Among other things, this means that each term defined in that agreement has the same meaning here, You acknowledge receipt of a copy of that agreement; our Privacy Notice; the Truth in Savings dis<losure, the fee schedule; and, it you have contracted for any electronic fund transfers, the disclosure and fee schedule for them; and any addenda to those documents. You have read those documents and agree to them, all of which are a part of this agreement. SIGNATURES OF ACCOUNT HOLDERS AND ANY AUTHORIZED SIGNERS X (Seal) DOROTHY J WOLAND Date THE INFORMATION BELOW MAY BE USED TO CONFIRM YOUR IDENTITY IF YOU TELEPHONE U5 OR IN OTHER CIRCUMSTANCES. Name: DOROTHY J WOLAND Street Address: 626 Wyndamere Road Etters. PA 17318 SSN'. 174-20-7104 Phone. (H) (717)938-2559 Phone: (W) (717)938-2559 Employment: Retired COB: February 23, 1926 ID: Driver's License/State 1D ID#. PA - 10025012 ID Verified Indicator Date ID Verified: T!N/BACKUP WITHHOLDING CERTIFICATION: Tax Identification Number. 174-20-1104 Important. Under penalties of perjury, f certify that the number shown above is my corcect taxpayer identification number and that (check appropriate box): t7 I am not subject to backup withholding because: (a) t am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that 1 am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding. ^ I am subject to backup withholding. I am a U.S. person (including a U.S. resident alien). X (signature of U. S. person) DOROTHY J WOLAND Date CONSUMER TIME pEPOS{T SIGNATURE CARD CONSUMER TIOJIE DEPOSIT SIGNATURE CARD D00035001 20062370 Printed 8/24/2007 11:58:00 AM DOROTHY J WOLAND / 0000000001015922 ©2006 Metavante Corporation o ° ~'l. Integrity B A H K {NTEGRITY BANK CAMP f-IILL BRANCH, 3345 Market Street, Camp Hill PA 17011 ~,~-~~,.,` CONSUMER TIME DEPOSIT SIGNATURE CARD ACCOUNT TYPE 10 - 20 MONTH PROMO ACCOUNT NUMBER 0000000001015914 ACCOUNT TITLE DOROTHY J WOLAND ACCOUNT MAILING ADDRESS 1100 Crandon Way Apt 228 Mechanicsburg, PA 17050 NUMBER OF SIGNATURES REQUIRED 1 OPENED BY JOHN T ROZMAN TAXPAYER ID NUMBER 174-20-7104 ACCOUNT OWNERSHIP Individual Account DATE OPENED August 24, 2007 AGREEMEPJT. i3y signing this signature card you agree that the account will be governed by our Time Deposit Agreement. Among other things, this means that each term defined in that agreement has the same meaning here. You acknowledge receipt of a copy of that agreement; our Privacy Notice; the Truth in Savings disclosure; the fee schedule; and, if you have contracted for any electronic fund transfers, the disclosure and fee schedule for them; and any addenda to those documents. You have read those documents and agree to them, all of which are a part of this agreement. SIGNATURES OF ACCOUNT HOLDERS AND ANY AUTHORIZED SIGNERS X (Seal) DOROTHY J WOLAND Date THE INFORMATION BELOW MAYBE USED TO CONFIRM YOUR IDENTITY IF YOU TELEPHONE US OR (N OTHER CIRCUMSTANCES. Name: DOROTHY J WOLAND Street Address: 626 Wyndamere Road Etters, PA 17319 SSN: 174-20-7104 Phone: (H) (717)938-2559 Phone: (W) (717)938-2559 Employment: Retired DOB: February 23, 1926 ID'. Driver's License/State ID iD#: PA-10025012 ID Verified Indicator Date ID Verified; TIN/BACKUP WITHHOLDING CERTIFICATION: Tax identification Number. 174-20-7104 Important: Under penalties of perjury, I certify that the number shown above is my correct taxpayer identification number and that (check appropriate box): D I am not sut~ject to backup withholding because: (a) I am exempt from backup wrthholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that f am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding. ^ I am subject to backup withholding. I am a U.S. person (including a U.S. resident alien). X (Signature of U.S. person) DOROTHY J WOLAND Date CONSUMER TIMF_ DEPOSIT SIGNATURE CARD p0003500 / 20062370 Printed 8/24/2007 11:55:00 AM DOROTHY J W01_AND / D000000001015914 ©2006 Metavante Corporation ~°~~ ~ Integrity B A N N INTEGRITY BANK CAMP HILL. BRANCH, 3345 Market Street, Camp Hill, PA 17011 ~-+' "~ ~-~ ~ ~ CONSUMER TIME DEPOSIT SIGNATURE CARD ACCOUNT TYPE 12 - 23 MOfJTH CD ACCOUNT NUMBER 00000001)01015906 ACCOUNT'fITLE DOROTHY.) WOLAND ACCOUNT MAILING ADDRESS 1100 Crandon Way Apt 228 Mechanicsburg, PA 17050 TAXPAYER ID NUMBER 174-20-7104 ACCOUNT OWNERSHIP Individual Account NUMBER OF SIGNATURES REQUIRED 1 OPENED BY JOHN T ROZMAN DATE OPENED August 24, 2007 AGREEMENT. By signing this signature card you agree that the account will be governed by our Time Deposit Agreement. Among other Things, this means that each term defined in that agreement has the same meaning here. You acknowledge receipt of a copy of that agreement; our Privacy Notice; the Truth in Savings disclosure; the fee schedule; and, if you have contracted for any electronic fund transfers, the disclosure and fee schedule for them; and any addenda to those documents. You have read those documents and agree to them, all of which are a part of this agreement. SIGNATURESi OF ACCOUNT HOLDERS AND ANY AUTHORIZED SIGNERS X (Seal) DOROTHY J WOLAND Date THE INFORNIATION BELOW MAY BE USED TO CONFIRM YOUR IDENTITY IF YOU TELEPHONE US OR IN OTHER CIRCUMSTANCES. Name: DOROTHY J WOLAND Street Addre;>s: 626 Wyndamere Road Etters, PA 17319 SSN: 174-20-7104 Phone: (H) (717)938-2559 Phone: (W) (717)938-2559 Employment: Retired DOB: February 23, 1926 ID: Driver's License/State ID ID#: PA - 10025012 ID Verified Indicator: Date ID Verified: TINIBACKUP WITHHOLDING CERTIFICATION: Tax Identificaltion Number. 174-20-7104 Important. Under penalties of perjury, I certify that the number shown above is my correct taxpayer identification number and that (check appropriate box): ~ I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report atl interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding. ^ I am subjec4 to backup withholding. 4 am a U.S. person (including a U.S. resident alien), X (Signature of U.S. person) DOROTHY J WOLAND Date CONSUMER TIME DEPOSIT SIGNATURE CARD D0003500 / 20062370 Printed 8/24!2007 11:52:00 AM DOROTHY J WOLAND ! 0000000001015906 © 2006 Metavante Corporation Close Account Balance Today is: 06/1712008 User: mweidenh Name: Missy A Weidenhof i ~ r w ai ~i n i w CLt~SE ACCOUf~ T Mid Atlantic [60171 CONTACT INFORMATION DOROTHY J WOLAND SSN/TIN: 174-20-7104 Email: Home Phone: (71 T) 236-8395 Work Phone: Ce11 Phone: Fax Phone: CONNIE l FLAUAUS AND ,•.E CHERYL S STROUD ARE ATTY IFF FOR DOROTHY ON ri CLOSE ACCOUNT -CLOSING BALANCE 1. Review the "Close Account. Wrap-up instnrctions." 2. Select "Submit." Log A Customer Problem ^:;°.I_~},~.a1N~ HALANf;t~ - ACCGt,a?~t Nt~mtaer IJ;i7113142a Close Account Wrap-up Instructions: 1. Confirm that you have definked this account from any bankcard(s), if appiicable. 2. Notify tt~e customer to cancel any external pre-authorized debit or credit transactions associated with this account. Page 1 of End. Customer Session _..w._~._..., To complete the closing of this account, fill out the Checking., Savings __and Money_Market Close-Out Withdrawal tickek with the closing balance amount of: $15,p93.Q7 The closing balance was derived from Ledger Balance $15,093.07 $0.00 ($1.48 Accrued Interest was forfeited) $0.00 (Memo Credits) $0.04 (Mutual Funds) $0.00 (Temporary Holds) $0.00 (Fed Tax Withheld} Closing Balance $15,093.07 .T 1 htt„•I/mirirlle~ware mvereianhank ~nm(~lnevn~..~•-~+rr~..--- ~ ______ Cary, ~oaavennent Bai~kiaag. Checking ~ Savings ~ Loans ~.8"77SC?V.BANK I sovereignbank.com ~~ ~ S1JV~r~l~Z1 B ,~~~ CUSTOMER RECEIPT Q ~9ROC)08 9l~7 ~"~"~ MemUer FDIC ~~c~~~~ Statement`Period p6/09/08 Td b7106/08 SOVEREIGN PREMIER'CHECKING 1 T 985 -14922 DOROTHY J W OLANb For your convenience our Customer Service Center CIO CHERYL S STROUD is available from l am - 71 pm SST, 7 days a week. 2629 BUTLER ST Cap us at ~-877-768-1143. HARRISBURG PA 171.03-2030 Hearing impaired may ca1J 1-800-428-9121 (`r7YrrDn), www. so vere ignbank: com .~. iQ060 ;_ -~.~.. SfjOQ51002" ~ ...`.~.. ~~ ____. _:~. .r..... Please note €he following product and fee changes: * Effective September l5, 200&, if you have a Sovereign ATM Card or visa CheckCard and make a purchase or ATM ~x~ithdrawal in a foreiglz "` of he tr ~ the Foreign Currene Exchan e fee will be 3°%`of the amount y g ansaction in US dollars.. .-.~ ~.... s * The fee to use another bank`s AT1~1 will be $2.00 begi>~ning with the ' _____ first statement period beginrxing on or after August 15, :2008,(1), - , ,.._ * Effective September l ~, the first $200 of Iocal and non~local checks you deposit will be available the nett business day: This also applies to the first $200 of funds where availabilitys further delayed.(2~ ..~ ~. (1) This fee does not apply to, the following;:: Sovereign Premier, Sovereign Free Interest, Sovereign Partnership,. Sovereign One, - Sovereign Student, Team Member, & America's Best Checkiryg, .Passbook Savings & Club Accounts,& IndvidualDevelopmerlt-lccouiits. (2} All deposits, to Sovereign Premier, Private Client and Team Member C1lecku~s~ accounts continue to be availablethe next business day. ~wereign Premier Account Notice , , E$tecti~e September 1 ~, ~OU~, a S~Cr Insufticieni Funds and a 52~) >`~uavailableEunds Feewli apply to all Sovereign Premier accounts, This fee is charged for each item, i~ciuding ptirehases anzl withdrawals you snake using your ATM or Visa CheckCard, that is res p ented against insufficient ar unavaitable funds. page .l of 3 oEPOSirs t~suxsn aY Fntc a c~ r r s ~ e ~ s ~~ c~~rei -r~~~~~~~ ~~ 1~~~~~~~~ Statement Period-06109108 TO 07/06/08 1-877-768-1143 wwwsavereignbank.com SQVEREIGN PREMIER CHECKING. - - ~ DCR07HYJWOLAND , Account # 571131425 Your account is currently at a zero balance. If your account remains at a zero balance :for two entire statement. cycles with na activity, it wilt. be closed. Please deposif funds into this .account quickly to .prevent it frorrr closir7g. If this account is not meeting your needs,'it would be our pleasure'todiscuss otheroptions ~ ~~ ~Nith you. _...... .,.~.... ,_.._. ~_ _~ Balances .,_, Begi~r~g 6~1~~c~ + ~ y "I`~ ~ ~"{,~15'~n~3 Q~ ; ~wrr~ilE~~ai~cs gq.00 ",,...- Deposits/Credits + $0.00 A ierage Daily Balance ~T ~zo,3a5.3 ~CHt~~rar~ral~~t~ x `` ~ ~~ OtJ~,. ~ .~.... ~: ~_ ~,$~ ~ .Q ._~.. ,,, .. . .. ,~~ , ~. ..., Interest g ,,i~~ ,~a ,: _ . , ~„ ~~rS~'~~S J~~n~yt ~' ~`.. t~ F '~ $~0`b~ `' ~' f't't't;~'' d'arn'' ' i5~aA •. ~.~ ~~ ~- ~, = ~'. ;.. ~ .. 0 0.00 P ~Ua} ,G .. N. ,.~~ 0.€16!0 .~~. 4 ~ ,~..~.~.. Earrled this Period ~a~t Year $38 22 "-. S~Id Year 7a-bate $ 2~ BQ ~`~,r+ ~, ~^~ ~.n~~ f Y!N.F"n ~^..,.~ ~ : h~ 7 N„T.rmv'~ u ~',tf ~~~',. w7.. - .i a - s,v:~ .nyw y~ aD~~ e. "7he interest ea'rred and the interest paid may differ depending cn wtlen !nterest is credited to your account "^-' ~~ Accoc~nf Ao>tiivity~ _ gate Description Additions Subtractions Balance ""~- 06 09 Beginning Balance """"" 'f~~~'7<: rh 74L~~~;i~~~~'~'a`f';~15`~~~'I;~I~ ~','~r _'r~ ~r~{ t r ,, i w ~ r $15 093 07 .. ,~-.,. ~ .,r u,,, v, - ,r „k r,~, „"~ r~ ;$~I~tyg3~C}7~~~,~~'Jr } o.~~ av~;f~.~1~. 07-06 Ending Balance ` . . $0.00 page 3 of 3 571131425 blase ~ccolunt Balance Today is: Ofi/1y^712008 User: mweidenh Name: Missy A Weidenhof 1^J i r CR.,OSE P,rGC?UI~T' Mid Atlantic 160172 CONTACT INFORMATION CLOSE ACCOUNT -CLOSING BALANCE DOROTHY J WOLAND 1. Review the "Close Account Wrap-up instructions." SSN/TIN: 174-20-7104 2. Select "Submit." Email: Home Phone: (717) 236-8395 Work Phone: ~ Log A Customer Problem CeH Phone: Fax Phone: CONNIE I FLAUAUS AND ~_ CHERYL S STROUD ARE ATTY IFF FOR DOROTHY ON ,~'~ C:_O algid c`3.'atr~4Nt,l~ - A.rcc.~urat N~.a~tfaer Ot221084.300 Close Account Wrap-up Instructions: 1. Confirm tha4 you have delinked this account from any bankcard(s), if applicable. 2. Notify the customer to cancel any external pre-authorized debit or credit transactions associated with this account. Page 1 of 1 End Customer Session To complete the closing of this account, fill out the Checking,_Sayin.gs,_and Mone~y_Market Close-Out Withdrawal ticket with the closing balance amount of: $94,1 U6.2~ The closings balance was derived from Ledger E3alance $94,106.23 $0.00 ($97.18 Accrued Interest was forfeited) $0.00 (Memo Credits) $0.00 (Mutual Funds) $0.00 (Temporary Holds) $0.00 (Fed Tax Withheld) Closing Balance $94,106.23 V~ ~, Easy, Convenient Baaiking. ~ Sovereign B Checking I Savings I Loans ~ ~ 1.S77.SOV.BANIC I sovereignbanSc.com CUSTOMER RECEIPT ..,: ...... -~~. r:.. , :: ,,..::.. .. ; „v .. , t. . ~.:: ..:. , ,.: ,:.:: ~ ~::, . ,; ; :.y l~~i~i~"-. ... ... .. .. .?'? fir r~_; it ~:. .. .i l ?.._~~i trig. i~j~i'. ,~~t: .f.~:.i .i. •.°:i{i._'~~~ 1: t~) t,l i Easy, Convenient Banking. ', ;GSoVereigri Bi Checking ~ Savings ~ Loans %'-,~? 1.877.SOV.BANK I sovereignbank.com CUSTOMER RECEIPT ._ .: , : _ ..; ~ ., ~ , .i ... _ ~ . . .:t .... ...... ,_..... ,..~. .. ... J DROOOA 9/07 . '..-... ~~ ..~,~ U 1, . ~, L:.. Q Member FDIC .l'..