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HomeMy WebLinkAbout11-07-08 (2) J 15056051058 REV-1500 Ex (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN '"--- Hanisburg, PA ~~126-osol RESIDENT DECEDENT 21 OS (1003 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 283-07-5181 ~ -- ~ 10/01/2008 ~ L04 4/1915 _ Decedents Last Name Suffix Decedents First Name BREZINSKY _ ~ ~~ FRANCES .._.._.__...---._... ~ MI ,~ (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name ... .. S_u_ffix _ Spouse's First Name MI -__.......---___._..._--------------------------... ' _........._...._..---..........------ L-----..__..l _ I ~ i J Spouse s Social Security Number _ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRWTE OVALS BELOW C!D 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death O 4. Limited Estate O 4a. Future Interest Compromise (date of O death after 12-12-82) O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust ~ (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O between 12-31-91 and 1-1-95) prior to 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE D Name IRECTED T0: Daytime Telephone Number ra HAROLD S. IRWIN, III (717) 243-6090C m --;~ Firm Name (If Applicable) _..----------.._..-----_...._ Q ~ , ~ ...__..._......----- ---.._.___.._....-------.._-........_..---- _._.... ~ IRWIN LAW OFFICE I GISTER OR E ONL~C ~--- ~ ~ ~ ~ _ __.._..._.--_ ___ __._-__ ------- First Ilne of address _ ~' ~ J c.. GJ~ ~ ~~ _ _. ... 64 SOUTH PITT STREET ©TI 3 r t Y~' 1 ~ .,_. Second tine of address ~ ~ iV r-r-i r-, y, ~- ~ - •__ ..,; .i I'V City or Post Office State ZIP Code J DATE FILED CARLISLE PA 17013 L_.._ __ -------__--- ---_ _._._____ __ _ ---- -.--- _I -- correspondents a-mail address: irwinlawoffice~gmail.com Under penalties of perjury, I declare that 1 have examined this return, including acx:ompanying schedules and statements, and to the best of my knowledge and belief, lt is true, correct and complete. Declaration of preparer other than the personal re resentative is b d ll p ase on a inform ation of which preparer has any knowledge. ~SIGNATU E OF PERSON RESPONS LE FOR FILING RETURN DATE // ~ri ss-~D ~ /ADDRESS V REPRESENTATIVE 0. ~~ DATE OF ./2LC ~L~ r'~N !7 c7! PLEASE USE ORIGINAL ORM Side 1 15056051058 15056051058 15056052059 REV-1500 EX Decedents Social Security Number Decedents Neme: FRANCES J BREZINSKY ~ 283-07-5181 RECAPITULATION 1. Real estate (Schedule A) ............................................. 1. 0.00 2. Stocks and Bonds(Sc~edule B) ....................................... 2. 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 0.00 4. Mortgages 8 Notes Receivable (Schedule D) ............................. 4. 0.00 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ........ 5. 416,620.78 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ....... 6. 43,613.74 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested........ 7. 0.00 S. Total Gross Assets (total Lines 1-7) .................................... 8. 460,234.52 9. Funeral Expenses S~Administrative Costs (Schedule H) ..................... 9. 20,588.65 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................ 10. 338.50 11. Total Deductions (total Lines 9 8 10) ................................... 11. 20,927.15 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. 439,307.37 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. 439,307.37 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or ~-- - --- t f d rans ers un er Sec. 9116 -~ ........------- __ .....................--------..__....__.--...----------- -....-...... (a)(1.2) x .o 0 00 _ . 15. 0.00 16. Amount of Line 14 taxable at lineal rate X .0 45 438,307.37 ~ 16. 19,768.83 17. Amount of Line 14 taxable at sibling rate X .12 0.00 ~ 17 0.00 1 S A f . mount o Line 14 taxable at collateral rate X 15 0 00 ~ . . 18 0.00 19. TAX DUE ................................. ........................ 19. 19,768.83 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 O 15056052059 REV-1500 EX Page 3 Decedent's Complete Address: 21 08 1003 DECEDENTS NAME DECEDENTS SOCIAL SECURITY NUMBER FRANCES J BREZINSKY 283-07-5181 STREET ADDRESS 770 SOUTH HANOVER STREET CITY STATE ZIP CARLISLE PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19} 2. CreditslPaymants A Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable D. Interest E. Penalty 18,750.00 988.44 (1) Total Credits (A + B + C) (2) Total Interest/Penalty (D + E ) 4. If Line 2 is greater than Line 1 + Une 3, enter the difference. This is the OVERPAYMENT. Fill in oval 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 the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) (4) (5) (5A) (5B) 19,768.83 19,738.44 0.00 0.00 30.39 0.00 30.29 Make Check Payable fo: 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 :................................................................................... ....... ^ b. retain the right to designate who shall use the property transferred or its income : ..................................... ....... ^ Q c. retain a reversionary interest; or ................................................................................................................... ....... ^ d. receive the promise for life of either payments, benefits or pre? ............................................................ 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 payable 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? .................................................................................................................. ...... © ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN -- ordates of death on or after July 1,1994 and before January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)], For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent (72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the onty 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 odor 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-1`502 EX + (12-85) COMMONWEALTH OF PENNSYLVANIA SCHEDULE A INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ca i n i e vr• FILE NUMBER FRANCES J. BREZINSKY 2008 - 01003 (Property jointly-owned with Right of Survivorship must be disclosed on Schedule F) All real estate should be reported at fair market value which is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to b or sell, both Navin reasonable knowle a of the relevant facts. ITEM DESCRIPTION VALUE AT DATE NUMBER OF DEATH NONE i v i n~ (Also enter on Line 1 Recapitulation) ~ NONE (If more space is needed, insert additional sheets of same size.) REV-1503 EX + (4-86) COMMONWEALTH OF PENNSYLVANIA SCHEDULE B INHERITANCE TAX RETURN STOCKS AND BONDS RESIDENT DECEDENT c.~in~cvr FRANCES J. BREZINSKY F NUMBER NONE FILE NUMBER 2008 - 01003 OF DEATH TvTAL (Also enter on Line 2 Recapitulation) ~ NONE (lf more space is needed, insert additional sheets of same size.) REV-1504 EX + (3-92) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C CLOSELY HELD STOCK PARTNERSHIP AND PROPRIETORSHIP FRANCES J. BREZINSKY FILE NUMBER 2008 - 01003 OF DEATH NONE TOTAL (Also enter on Line 3, Recapitulation) ~ NONE (If more space is needed, insert additional sheets of same size.) REV-1507 EX + (6-86) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FRANCES J. BREZINSKY F SCHEDULE D MORTGAGES AND NOTES RECEIVABLE NONE FILE NUMBER 2008 - 01003 LUE AT DATE OF DEATH TvTAL (Also enter on Line 4 Recapftulation) NONE (If more space is needed, insert additional sheets of same size.) , REV-1'508 EX + (2-87) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY ESTATE OF FILE NUMBER FRANCES J. BREZINSKY 2008 - 01003 (All property jointly-owned with Right of Survivorship must be disclosed on Schedule F.) ~ ~ ~m DESCRIPTION VALUE AT DATE NUMBER OF DEATH 1. PNC BANK INVESTMENT ANNUITY ACCOUNT NO. 17367326 (See Exhibit "A") $ 105,934.02 2. PNC BANK - CD Account No. 11020090634 (See Exhibit "B") 26,101.80 3. PNC BANK - CD Account No. 11020090636 (See Exhibit "B") 13,069.39 4. PNC BANK -Savings Account No. 5111841382 (See Exhibit "B") 80,710.05 5. SUSQUEHANNA BANK - CD Account No. 40660000114210 (See Exhibit "C") 32,643,74 6. SUSQUEHANNA BANK - CD Account No. 406600006026 (See Exhibit "C") 11,896.83 7. SUSQUEHANNA BANK - CD Account No. 406600000367 (See Exhibit "C") 55,004.84 8. SUSQUEHANNA BANK - CD Account No. 406600000474 (See Exhibit "C") 34,098.03 9. SUSQUEHANNA BANK - CD Account No. 40660000113410 (See Exhibit "C") 33,939.81 10. SUSQUEHANNA BANK - CD Account No. 406600004039 (See Exhibit "C") 10,846.29 11. BRIDGES AT BENT CREEK Unearned Rent Refund 2,304.00 12. BLUE CROSS -Refund 72.00 TOTAL (Also enter on Line 5 Recapitulation) ~ ~ 418,620 78 (If more space is needed, insert additional sheets of same size.) REV-1509 EX + (12-88) COMMONWEALTH OF PENNSYLVANIA SCHEDULE F INHERITANCE TAX RETURN JOINTLY-OWNED PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER FRANCES J. BREZINSKY 2008 - 01003 Joint A. BERNICE T. HARMON B. LAYTON HARMON C. Jointly-owned orooerEv~ 28 LITTLE KNOLL DRVE DAUGHTER HANOVER, PA 17331 28 LITTLE KNOLL DRIVE SON-IN-LAW HANOVER, PA 17331 ITEM NO. LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY TOTAL VALUE OF ASSET DECD'S % INT. DOLLAR VALUE OF DECEDENT'S INTEREST 1. A. Pre-2007 SUSQUEHANNA BANK -Checking Account No. ~ 5,415.99 50% S 2,708.00 166133994 (See Exhibit "C") 2. A. 01/30/07 SUSQUEHANNA BANK - CD Account 406600003049 7,141.12 50°h 3,570.56 (See Exhibit "C") 3. B. 11/13/06 SUSQUEHANNA BANK - CD Account 40660000166211 17,457.47 50°~ 8,728.74 (See Exhibit "C") 4. B. 07/23/07 SUSQUEHANNA BANK - CD Account 406600008378 49,109.82 50°~ 24 554.91 (See Exhibit "C") , 5. B. 06/12/06 SUSQUEHANNA BANK - CD Account 366181212 (See 8,103.05 50% 4 051.53 Exhibit "C") , ~. ~ ~+~. tnis~ enwr on une o, KeCaplLUlatlOfl) ~ 43,613.74 (lf more space is needed, insert additional sheets of same size.) REV-1510 EX + (2-87) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G TRANSFERS FRANCES J. BREZINSKY 2008 - 01003 THIS SCHEDULE MUST BE COMPLETED AND FILED IF THE ANSWER TO ANY OF THE QUESTIONS ON THE REVERSE SIDE OF THE COVER SHEET IS YES. ITEM DESCRIPTION OF PROPERTY EXCLUSION TOTAL DECD.'S DOLLAR NUMBE /ndude name orthe trensfbree, theirieietionship ro decadent, date ortrensrer VALUE % OF INT. VALUE OF R OF ASSET DECEDENT'S NONE TOTAL (Also enter on Line 7 Recapitulation) NONE (If more space is needed, insert additional sheets of same size.) REV-1511 EX + (7-88) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES ~.~ ~ n ~ c yr FRANCES J BREZINSKY FILE NUMBER . 2008 - 01003 ITEM NUMBER DESCRIPTION AMOUNT A. Funeral Expenses: 1 • HOFFMAN-ROTH FUNERAL HOME, INC. -Funeral Bill 2,443.65 2. OAKLAND MEMORIAL COMPANY -Grave Marker Engraving 150.00 3. 4. B. Administrative Costs: 1. Personal Representative Commissions: Social Security Number of Personal Representative:: Year Commissions Paid: 2• Attorney Fees: HAROLD S. IRWIN, III 17,500.00 3. Family Exemption: Claimant Relationship Address of Claimant at decedent's death: Street Address City State Zip Code 4• Probate Fees:. REGISTER OF WILLS 465.00 C• Miscellaneous Expenses: 1 • REGISTER OF WILLS -File Inventory and Appraisement 30.00 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. TorA~ (Also enter on Line 9 Recapitulation) ~ ~ 20,588 65 (If more space is needed, insert additional sheets of same size.) REV-1512 EX + (1-93) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FRANCES J. BREZINSKY FILE NUMBER 2008 - 01003 NUMBER 1. CUMBERLAND-GOODWILL FIRE/RESCUE -Medical Bill 2. MILLENNIUM PHARMACY -Medical Bill 147.00 191.50 rvTAL (Also enter on Line 10, Recapitulation) a .338.50 SCHEDULEI DEBTS OF DECEDENT, MORTGAGES, LIABILITIES AND LIENS (lf moro space is needed, insert additional sheets of same size.) REV-1513 EX + (2-87) COMMONWEALTH OF PENNSYLVANIA I SCHEDULE J INHERITANCE TAX RETURN RGCIf1FNT r)Gf'Gr1FIJT BENEFICIARIES FRANCES J. BREZINSKY 2008 - 01003 ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE OF ESTATE A. Taxable Bequests: 1 • BERNICE T. HARMON DAUGHTER 100% Residue 28 Little Knoll Drive Hanover, PA 17331 2• LAYTON O. HARMON SON-IN-LAW X37,185.66 28 Little Knoll Drive Hanover, PA 17331 NUMBER B. Charitable and Governmental Bequests: NONE enter on Line 13, (If more space is needed, insert addiNona/ sheets of same size.) EXFIIBIT ^A^ +~ VVL/ VVJ _:y ESTATE aE FRANCES ~, BRENZ[NSKY BERN~e~ HAR~aN ~oA (QOD VALUATION 1 OCTOBER 2008) The information provided in this report is believed to be reliable, but its accuracy cannot be guaranteed. ' A mean price is calculated as an average of the high and low on .the valuation date when available. if these prices are not available, such as on weekends or holidays, the mean price is the inversely weighted average of the high and law on the nearest trading dates before and after, when these prices are available within one week of the valuation date, If actual trades are not available, the nearest bid and ask prices are substituted. Note that securities traded on the Toronto Exchange are in Canadian dollars. If an equity is ex-dividend for a cash distribution on or before the valuation date but is of record after the valuation date, the dividend is included in the valuation report and is added to the security's value. This is reported as an adjusted value on the report. if the date of; death is on or after the record date and the dividend is payable after. that date, the accrued dividend is listed separately on the report and added to the portfolio's total value. Prices for which daily updates are not available are priced according to~a Corporate Pricing Cycle. These pricing dates occur on the last business day of the week, and the Last business day of the month, unless the end of the week update falls within three business days or less, ;of the end-of month update. ared 14 :Qctober 2008 1 . UUJ/ UUJ .> r' bate .of Death: 10/01/2008 Valuation Date: 10/01/30D8 BrOCe88ing Date: 10/14/2008 BhdTee Security or Par Description ---~.`_ 1? 51833.38 ALLBTATS LTFk IAS Cp. (EVPDl) ALL8TAT8 ORERO]}C& FLDB 1a/o1/2ooe. Za 54100.69 ALLSTATB LIFE INS, CQ, (gVp0y1 SO O1 800 ~ Total Valve: Total Accrual: Totai: $105,934.Q2 Ratate Valuation sseate of: FRANC88 1. BRBNZINS&St Account: 1736.7326 Report Type; Date of Death DTOmber of 8ecuritias: 2 File ID: BRSZINTBEY,FRANC~ Aigh/Bak Low/Bid A ~°O& accrue lint ~~1ty ---•--. 1.00000 1.00000 1.040400 51,833.38 1.00000 1.00000 1.000000 54,100.6+ $0.-00 +105,934.02 page i This repork was groduced w1~h B6tateVal, a praduck o£ Netate Valuatl,on6 & Pr1ci~ Systems, IAC. I£ y+ou have questions, please contact sVp System8 at {818} 313-6300 ar www.evpsys.cam. (Revision 7.0.4} f li:A~WQ't'FiE'1AtA~ October 15, 2008 Hazold S Irwin III Attorney at Law 64 S Pitt St Cazlisle, PA 17013 RE: Frances Brezinsky SSN: 283-07-5181 DOD: 10-01-2008 Deaz Mr. Irwin; In response to your request for Date of Death-(DOD) balances for the customer noted above, our records show the following: Certificate of Deposit Account # 11020090634 Established: 06-02-2005 FRANCES BREZINSKY DOD balance: $ 2,942.22 + 159.58 accrued interest Account # 11020090636 Established: OS-12-2008 FRANCES BREZINSKY DOD balance: $ 12,894.92 + 174.47 accrued interest Savings Account Account # 5111841382 Established: 06-10-1998 FRANCES BREZINSKY DOD balance: $.90,628.88 + 81.17 accrued interest Investment Account The decedent maintained Investment Account 17367326. For further information, you may call the Brokerage Department at 1-800-762-6111. Page 1 of 2 !~ i 01, - ,Susquehanna Bank PA South Hanover Office 1345 Baltimore Street Hanover,PA 0173310000 717-633-6233 Portfolio for FRANCBS J BRBZINSRY Aggregate Deposit Balaace $265,656.97 Aggregate Loan Balaace $0.00 Aggregate Loan Liability $0.00 CHECKING/MONEY MARKST ACCOUNTS Account # Opened Rate SENIOR CHECKING 166133:994 5/03/2006 0.100000 Total CERTIFICATES OF DEPOSIT Account # Opened Rate Term (/12-17 MONTH <100,000 406600003049 1/30/2007 4.2700 13 Months (/ 12-17 MONTH <100,000 40660000113410/16/2006 3.4500 17 Months ~2-17 MONTH <100,000 406600000474 9/13/2006 3.4500 17 Months ~2-17 MONTH <100,000 406600000367 9/11/2006 3.4500 17 Months ~ 18-23 MONTH <100,000 406600008378 7/23/2007 5.0800 22 Months X18-23 MONTH <100,000 406600006026 5/09/2007 4.8900 22 Months ~4-29 MONTH <100,000 40660000166211/13/2006 4.4100 24 Months ~ 24-29 MONTH <100,000 40660000114210/16/2006 4.4100 24 Months ~24-29 MONTH <100,000 366181212 6/12/2006 3.4500 27 Months x/30-35 MONTH <100,000 406600004039 3/03/2007 5.1300 33 Months Iatareat Paid Matures $529.38 1/30/2009 $2,493.48 8/16/2009 $3,102.52 8/13/2009 $5,004.84 8/11/2009 $2,829.45 5/23/2009 $751.89 3/09/2009 $1,353.75 11/13/2008 $2,643.72 10/16/2008 $817.58 9/12/2010 $846.29 12/03/2009 Total OTHER ACCOUNTS Account # IVR 990100027750651 Prepared by: Julaine Roth Total 10/08/2008 Current Balaace $5,415.99 $5,415.99 Current Balance $7,141 .12'~ $33,939.81' $34,098.031 $55,004.84 $49,109.82 $11,896:83' $17,457.47 $32,643.7 2 $8,103.05) $10,846.29 $260,240.98 Current Balance $0.00 $0.00 Page 1 r Susquehanna Date 10/06/08 Primary Acct ~ Enclosures FRANCES J BREZINSKY BERNICE T HARMON 28 LITTLE KNOLL DR HANOVER PA 17331 N ,~~ O O ~ N p o o • »» S U M M A R Y ACCOUNT NUMBER 166133994 SENIOR CHECKING 406600000367 12 - 17 MONTH CD 406600000474 12 - 17 MONTH CD 406600001134 12 - 17 MONTH CD 406600003049 12 - 17 MONTH CD 406600006026 18 - 23 MONTH CD 406600008378 18 - 23 MONTH CD 366181212 24 - 29 MONTH CD 406600001142 ~ 24 - 29 MONTH CD 406600001662 24 - 29 MONTH CD 406600004039 30 - 35 MONTH CD O F A C C O U N T S «« ENDING BALANCE 5,415.99 55.004.84 34,098.03 33.939.81 7,141.12 11.896.83 49,109.82 8.103.05 32,643.72 17,457.47 10.846.29 Page 1 166133994 » » » » » » » » » » C H E C K I N G A C C 0 U N T S « « « « « « « « « « ACCOUNT TITLE: SENIOR CHECKING Account Number Previous Balance Deposits/Credits 2 Checks/Debits Service Charge Interest Paid Ending Balance FRANCES J BREZINSKY BERNICE T HARMON Number of Enclosures p 166133994 Statement Dates 9/08/08 thru 10/06/08 5,507.87 Days in Statement Period 29 .00 Average Ledger 5,476.92 92.31 Average Collected 5,476.92 .00 Interest Earned .43 .43 Annual Percentage Yield Earned 0.10% 5.415.99 2008 Interest Paid 14.70 DEPOSITS AND CREDITS Date Description Amount 10/06 Interest Deposit .43 SIJMNIARY BY CHECK NUMBER Date Check No Amount Reference Date Check No 9/25 120 39.73 0600155770 9/29 121 ' Indicates Skip in Check Numbers Date 9/08 SUMMARY OF DAILY BALANCES Balance Date Balance Date 5,507.87 9/25 5,468.14 9/29 Reference Amount Reference 52.58 0903159930 Balance 5,415.56 `~ ~ Susquehanna ,, . FRANCES J BREZINSKY BERNICE T HARMON 28 LITTLE KNOLL DR HANOVER PA 17331 SENIOR CHECKING Date Balance 10/06 5,415.99 Date 10/06/08 Primary Acct ~ Enclosures 166133994 (Continued) SUMMARY OF DAILY BALANCES Page 2 166133994 rrrrrrrrrrrrrrrrrr:rrrrrrrrrrrrrrrrr:rrrrr*rrrrrrrrrrrr~rrrrrrrrrrrrrr,rrrr•rrrrr,, »»»»»»» C E R T I F I C A T E S O F D E P O S I T ««««««« ACCOUNT TITLE: .FRANCES J BREZINSKY 12 - 17 MONTH CD Account Number Balance Interest Rate Maturity 2008 Interest 406600000367 55,004.84 3.450000% 8/11/09 1.643.01 lrrrrfr4rrfrrfrir#rrrrrrrrrrrrrrrrfrrfrrrrrrfrlrrrrrrrrrrrrrrrrrrrrrrrrrr#rrrrr ACCOUNT TITLE: FRANCES J BREZINSKY 12 - 17 MONTH CD Account Number- Balance Interest Rate Maturity 2008 Interest 406600000474 34,098.03 3.450000% 8/13/09 1.018.49 r*rrrr*r***rrr***r*rrrr******rr+-rrr*rrrrrrrrrrrrrrrrrrrrrrr•rrr***rrrrrrrrrrrrr ACCOUNT TITLE: FRANCES J BREZINSKY 12 - 17 MONTH CD Account Number Balance Interest Rate Maturity 2008 Interest 406600001134 33,939.81 3.450000% 8/16/09 927.95 rrrrrrrrr•rrrrrrrrrr rrrrrrrrrrrrrr**r*r****r*rwrwrrr rwrr*r*r*rrrwrrrrrrrrrrrrrr .~~ ACCOUNT TITLE: FRANCES J BREZINSKY N BERNICE T HARMON .~.o 0 ~' N p o 12 - 17 MONTH CD o Account Number Balance Interest Rate Maturity 2008 Interest ~~ ~ 406600003049 7,141.12 4.270000% 1/30/09 224.28 .~~ rrrrrrrrrrrrrrrrrrrr rrrrrrrr:r:*rrrrr:rrrrrrrrrrrrr: rrrrrrrrrrrrr+rrrrrrrrrrr: ACCOUNT TITLE: FRANCES J BREZINSKY 18 - 23 MONTH CD Account Number Balance Interest Rate Maturity 2008 Interest 406600006026 11.896.83 4.890000% 3/09/09 428.41 rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr:arrr::rrrrr:•rrrrrrrwrrrrrrrrrrrrrrrrrrrrrrrr ACCOUNT TITLE: FRANCES J,BREZINSKY LAYTON O HARMON