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HomeMy WebLinkAbout12-29-08 15056D7121 06-05 REV-1500 EX ( ) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes Coun Code Year ~ File Number Po Box 2sosol INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 0 8 0 1 0 7 2 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 0 1 6 2 0 0 8 1 2 2 4 1 9 1 6 Decedent's Last Name Suffix Decedent's Firs t Name MI S T R A I N I N G M A R T H A A (If Applicable) 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 a 1. Original Return 4. Limited Estate ^X 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust _ (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) 3. Remainder Return (date of death 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 DIRECTED T0: Name Daytime Telephone Number M A R C U S A M c K N I G H T I I I 7 1 7 2 4 9 2 3 5 3 Firm Name (tf Applicable) i REGISTfF3 OF WILLS USE"ONLY I R W I N & M c K N I G H T First line of address 6 D W E S T P O M F R E T S T R E E T Second line of address City or Post Office C A R L I S L E State ZIP Code P A 1 7 0 1 3 Correspondent's a-mail address: 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 complete. Declaration of preparer other than the personal representative is based on all informa arer has any knowledge. SIGNATURES PERSON RESPONSI E R FILING RETURN DATE ADDF;ESS 40°I E- FOURTH AVENUE LITITZ PA 17543 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDF;ESS 60 WEST POMFRET STREET CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY 1505607121 Side 1 1505607121 ~ ~ 1505607221 REV-1500 EX Decedent's Social Security Number Decedent's Name: f1ARTHA A• STRAINING RECAPITULATION 1. Real estate (Schedule A) ..................................... ... 1. • 2. Stocks and Bonds (Schedule B) ............................... ... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. ... 3. 4. (Mortgages & Notes Receivable (Schedule D) ..................... ... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) .... ... 5. 4 8 4 7 8 ^ 9 6. .Jointly Owned Property (Schedule F) ^ Separate Billing Requested .... ... 6• 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property uested arate Billin Re hedule G) ^ Se (S 7 7 2 6 2 6, 3 b g .... p q c ... . 8. Total Gross Assets (total Lines 1-7) ........................ ... 8. 1 2 1 L 0 4 4 5 9. F=uneral Ex enses 8 Administrative Costs Schedule H P ( ) ............. 9. ... 1 1 9 2 0• 6 2 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ......... ... 10. 1 6 9 3 • 4 5 11. Total deductions (total Lines 9 & 10) ........................ ... 11. 1r 3 6 1 4 . D 7 12. Net Value of Estate (Line 8 minus Line 11) ...................... ... 12.. 1 0 7 4 9 0 . 3 8 13. (:haritable 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. I, 0 7 4 9 D 3 8 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. P~mount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2)X.0 _ 0 0 0 15. 16. Amount of Line 14 taxable at lineal rate X .045 1 0 7 4 9 0. 3 8 16. 17. Amount of Line 14 taxable 0 0 0 a~d sibling rate X .12 . 17 18. Amount of Line 14 taxable 0 0 0 at collateral rate X .15 18. 19. Tax Due ............ .......................... ... ..... ..19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^. ^ 0 4 8 3 7. 0 7 0. 0 0 o. 0 0 4 8 3 7. 0 7 Side 2 1505b07221 1505607221, J l ~~ REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 08 01072 DECEDENT'S NAME MARTHA A. STRAINING _ STREET ADDRESS _- - -- -_-- 16 S. ENOLA DRIVE APARTMENT 110 _ CITY STATE ~~~ ZIP ~~~~ ~~ ENOLA IPA 17025 Tax Payments and Credits: 1 Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit _ B. Prior Payments C. Discount 3. InteresUPenalty if applicable D. Interest E. Penalty 241.85 (1) 4,837.07 Total Credits (A + B + C } (2) 241.85 Total InteresUPenalty (D + E) (3) 0.00 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) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 4, 595.22 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 4 595.22 Make Check Payable to: REGISTER OF W/LLS, 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 : ................................................................ . ^ .. 0 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 care? ................................................. ...... ...... ^ 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................................................................. ...... ^ 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ... ...... ^ ^ 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 lS 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 exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed cn 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 impos~sd 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)]. Asibling isdefined, under Section 9102, as an individual who has at {east one parent in common with the decedent, whether by blood or adoption. REV-1 K08 IEX + (6-98) SCHEDULE E COMI~IONWEALTHOFPENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER MARTHA A. STRAINING 21 08 01072 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. MEMBERS 1ST FEDERAL CREDIT UNION 11,834.69 SAVINGS ACCOUNT #14801-00 2. M8~T BANK -CHECKING ACCOUNT #9845525766 3,217.36 3. M$T BANK -SAVINGS ACCOUNT #15004215200095 30,249.54 4. PNC BANK -CHECKING ACCOUNT #5080393272 3,176.50 TOTAL (Also enter on line 5, Recapitulation) I $ 48,478.09 (If more space is needed, insert additional sheets of the same size) REV-1510 EX + (6-98) COtv1MONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF SCHEDULE G INTER-VIVOS TRANSFERS ~ MISC. NON-PROBATE PROPERTY F4LE NUMBER MARTHA A. STRAINING 21 08 01072 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 DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THETR.4NSFEREE.THEiRREUrioNSHiProDECEDENTAND THEDATE~FTRANSFER,ATTACHACOPYOFTNEDEEDFORREAIESTATE DATE OF DEATH VALUE OF ASSET °{°OFDECD'S INTEREST EXCLUSION {IF0.PPL:CABLE) TAXABLE VALUE 1. FRANKLIN TEMPLETON INVESTMENTS 72,626.36 100. 72,626.36 BENEFICIARIES: AVIS J. BEERS & BARBARA A. ZIMMERMAN TOTAL (Also enter on line 7 Recapitulation) ~ $ 72,626.36 (If more space is needed, insert additional sheets of the same sizel REV-1511 EX + (1Q-O6) COM1410NWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES 8~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER MARTHA A. STRAINING 21 08 01072 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1, RICHARDSON FUNERAL HOME 6,979.00 2. GINGRICH MEMORIALS 130.00 B 1 2. 3. 4 5. 6. 7. 8. 9. 10 ADMWISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative {s) Street Address City State _ Year(s) Commission Paid: Attorney Fees IRWIN & McKNIGHT 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 Probate Fees REGISTER OF WILLS Accountant's Fees Tax Return Preparers Fees PATRICIA A. ROSENDALE, CPA REGISTER OF WILLS -FILING FEE CUMBERLAND LAW JOURNAL -ESTATE NOTICE THE SENTINEL -ESTATE NOTICE NOTARY FEES Zip _ Zip 4,000.00 173.00 350.00 30.00 75.00 158.62 25.00 TOTAL (Also enter on line 9, Recapitulation) I $ 11,920.62 (ff more space is needed, insert additional sheets of the same size) REV-1512' EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE / DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8~ LIENS ESTATE qF FILE NUMBER MART(-IA A. STRAINING 21 08 01072 F;eport debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEAd VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. IENOLA COMMONS -RENT ~ 625.00 2. MESSIAH VILLAGE -NURSING a8.48 3. VERIZON -TELEPHONE 60.97 4. (REIMBURSEMENT OF SOCIAL SECURITY I 959.00 TOTAL (Also enter on line 10, Recapitulation) ` $ 1 693 45 (If more space is needed, insert additional sheets of the same size) REV-1513 E)C + (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER MARTHA A. STRAINING 21 08 01072 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustees) OF ESTATE I TAXABLE DISTRIBUTIONS (include outright spousaldisuibutions, and transfers under Sec. 9116 (a) (1.2)] 1. BARBARA A. ZIMMERMAN Lineal 53,745.19 409 EAST FOURTH AVENUE 1/2 REMAINDER LITITZ, PA 17543 2. AVIS .!. BEERS Lineal 53,745.19 220 WHITETAIL TERRACE 1/2 REMAINDER MARYSVILLE. PA 17053 II. ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION T,0 TAX IS NOT BEING MADE 1 13. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. 'TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I S (If more space is needed, insert additional sheets of the same size) ~ast ~VVi[[ and ~¢stament of ~artka ~ straining I, MARTHA A. STRAINING, of East Pennsboro Township, Cumberland County, Pennsylvania, declare this instrument to be my Last Will and Testament, hereby expressly revoking ail Wills and Codicils heretofore made by me. ONE: I direct my Executrix to pay all of my debts, funeral and administrative expenses as soon as may be done conveniently after my decease. Furthermore, I direct that all state, inheritance, succession and other death taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property composing of my gross estate for death tax purposes, whether or not such property passes under this will, shall be paid by the Executor of my estate. TWO. My Executrix may, at her discretion, compromise claims, borrow money, retain property for such length of time as she may deem proper; lease and sell property for such prices, on such terms, at public or private sales, as she may deem proper; and invest estate property and income without restriction to legal investments unless otherwise provided hereunder. I authorize and empower my Executrix to sell any realty and/or personalty owned by me at my death and nat specifically devised or bequeathed herein, at public or private sale or sales and to give good and sufficient deeds and/or bills of sale therefor, in fee simple, as I could do if living. My Executrix is authorized and empowered to engage in any business in which I may be engaged at my death, for such period of time after my death as seems expedient to said Executrix. THREE: I give, devise and bequeath all of my estate of every nature and wherever situate to my children, BARBARA A. ZI~IMER~~IAN and AVIS J. BEERS, in equal shares, per stirpes. If one of my aforementioned children should predeceased me, then said share of the predeceased child shall be equally distributed to the issue of the deceased child. If one my children has predeceased me without living issue, then the share of said child shall be equally distributed to my children then living. FOUR: I nominate and appoint BARBARA A. ZIMMERMAN, as Executrix of this my Last Will. If she has predeceased me, failed to qualify, or ceased to serve as Executrix, I appoint AVIS 3. BEER5 to be the Executrix of this my Last Will. FIVE: My Executrix may, at her discretion, compromise claims, borrow money, retain property for such length of time as she may deem proper; lease and sell property for such prices, on such terms, at public or private sales, as she may deem proper; and invest estate property and income without restrictions to legal investments. SIX: My Executrix acting hereunder shall not be required to post bond or enter security in this or any jurisdiction. i ' ~1 IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ )a day of July, 2005. jt'i--),,ry `%.Ll~ (~. '.~ l ,<l ~-yet 31 k; (SEAL) 1VIARTHA A. STRAINING ~' 2 Signed, sealed, published and declared by the above named Testatrix, 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 subscribed our names as witnesses hereto. f~~ _ 1 .~, ~~ '~ ~ i ACKNOV~'LEDGI~IENT AND AFFIDAVIT WE, MARTHA A. STRAINING, TRACI D. SMITH and CHERYL L. CLELAND, the testatrix and witnesses respectively, whose names are sinned 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 Will and that she had signed willingly, and that she executed it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the Will as a 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. _ ~ . ~, ,A;'.'_ is ~ `.~~%~.:e~ ±'~ /; ,! /may C'LC.- y^y?-t-~r~ d ~ MARTI~A A. ST~AININ TRACI D. S1C~IITH 1 q 7 ~) ``~'` 1 CHE L L. CLELAND COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUI~IBERLAIV'D . SS: Subscribed, sworn to and acknowledged before me by MARTHA A. STRAINING, the testatrix herein, and subscribed ~rf~l sworn to be~ore me by TRACI D. SiVIITH and CHERYL L. CLELAND, witnesses, this ~ ~~ day of ' r ~ t ~;%'~`~~, 2005. f j .. ~~ COMMONWEALTH OF PENNSYLVANIA `-' !I l~~ : w.~'; e'r-~~.. °`~' i ~h' ~' I -' Notarial Seal Martha u Noe{. Notary Public carii~ aoro, c.~r,beriand c«,~ty My comrrtissla~ E~ires seat. ~a, 2007 Member. Pz~~nyivania Association pf Notaries Nota>~~ Pu>kilic ~__ St MEMBERS 15t FEDERAL CREDIT ONION 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 Interested Earned 01101!2008 - 09!30/2008 Name of Joint Owner Estate of: MARTHA A. STRAINING Date of Death: October 16, 2008 Social Security Number: 184-12-4037 14801-00 06/11/1973 $11,827.83 $4.86 $11,834.69 $88.42 None E~~~~ s~~j~ ~ _I. LU~U '.~''J'Ji;~J ~ti 14'Ifi{iUl~l~~ r,',,, pF~iC.FS E BERS 1ST FEDERAL CREDIT UNION Danielle A Insurance Services Specialist November 19, 2008 5000 Louise Drive 1?O. f3oY -~O Mec}u~rii~sbur~r. l'ennsvlvani:~ 17(i=,~ ~s~ni~~ ~u~ ~~~~' - ----- p M~~ 499 Mitchell Road. Millsboro. DE 19966 Mail Code DE-MI3-]2 Phone (833) i02-43-19 Fax (302)934-29~~ tiovember 6. 2003 Law Offices Irwin & McKnight West Pomfret Professional Building 60 West Pomfret Street ~~'~4 Carlisle, Pennsylvania 17013-3222 ~`,~ }~~`r,r, Re: Estate ~f ~~lartha A Straining Social Seetarity: 18-~-12--037 Date of Death: October 16, ?008 Dear Sir or Madam: Per your inquiry dated November 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 ~l'urnher 98-t~.i2~i66 Oyvnership (~~'ames r~fj ~llcrrtha A Su•uining~` Opening Dine 11 i 1-1,'~ ~ Balance on Date o/~Deutlr S 3,21 ?.36 Accrued ln(er~•est S 0. t)D Torn{ .~ 3._'l'.3h 2. Type of ~Accoun[ .4ccotnt Number O~ti~nershrp /Ncones of) Opening Du1e Balance on Date c f Death Accrued Interest Total Scnln~~~s :-Iccount 1 ~ ~~-13I ~20009~ ,tlurtha.4 Str•uining~` 8/-l%(~8 S 30,338.77 S 10. %% S 30.3-~9.~~ _ Type of Accoamt Scn-ings Account/ Passbook Account Number 210000011-10631 Otivnership (Names of} dtartha A Straining* Opening Date 1/2-l/93 Closed ~/-1108** Please be advised, there was no safe deposit box found for the above decedent. ** t'lease contact the Summerdaie Plaza Branch fur all additional infonnatio~i on accounts closed prior to tine date of death. * If upon reviewing the information above, you believe there are additional accounts not referenced, please provide us with an account number andlor name of any possible joint account holder. For any additional information on the above accounts, including ownership and any changes, closures andlor reimbursement of fiords, etc., please contact our Summerdale Plaza Office # 717-2~~-22b 1. Sincerely, ~~~~ r~~ ~~G~~ Tracie Hare Records Management Kiev, 14. 200c 2:4~~r~~ u~~C BA~U~( 41~-10~-2747 ~~~ t.l?AbI1NG THE WdY November 14, 2008 Irwin c~ McKnight Attorneys at Law Marcus McKnight III Esq 60 W Pomfret St Carlisle, PA 17013 RE: Name: Martha S Straining SSN: 184-12-4037 DOD: 10-16-2008 Dear Mr. McKnight: Nc. X8'9 P. '%~ In response to your request for Date of Death (DOD) balances for the customer noted above, our records show the following: Checlung Account Account # 5080393272 Established: 01-24-1995 MARTHA A STRAINING DOD balance: $3,176.50 non interest hearing Please note that this office provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings). We do not process any financial transactions or provfde statements.. If you need assistance with a,oy of these items, please call 1-888-PNC-BANK (1-888-762-2265) ar stop by your local PNC Bank branch office. Sincerely, National Financial Services Center PNC Bank, N.A, Member FDIC UK IF YOU ARE REQUESTING A WAIVER ,ONWEALTH DF PENNSYLVANIA NOTICE OF tRANSFER vEPAP2TMENT OF REYENUE PLEASE CHECK THIS BLOCK 1UREAU OF INDIVIDUAL TAXES (FOR STOCKS, BONDS, SECURITIES OR DEPT. 280601 SECURITY ACCOUNTS HELD IN BENEFICIARY FORM) HARRI'BBURG, PA 171284801 DECEDENT NAME (LAST) j (FIRST) (MIDDLE INITIAL) INFORMATION ~, SOCIAL SECU ,ITY NNUMBER OF DECEDENT: DATE OF DEATH OF DECEDENT: (MM-DD-YYYY) oaf-~~-~oao a©-~o-~ao~ ADDRESS OF DECEDENT: CITY STATE ZIP CODE COUNTY /6 ~~ ~ ® /cf a ~ o c / 7~zs NAME OF CORPORATION, FINANCIAL INSTITUTION, BROKER OR SIMILAR ENTITY CORPORATIONN, FINANCIAL 1~ - ~r1 //~ ~ IOZ vhf ~~~j ~.S IN$T17UTION ADDRESS OF FIRM CITY STATE ZIP CODE BROKER !~0 u~I~~rtJ ~ '' trrl£~~ btl- 4,q ,3 ~ 7/~e "~v~0 ,S~ INFORMATION TELEPHONE NUMBER EXTENSION 1 IF ANY ) ~c~a-®ao-o©®a oa^^^^ ACCOUNT TYPE OF ACCOUNT: CAPITAL STOCK REGISTERED BOND A SECURITY ASSET A SECURITY ACCOUNT r l ~ , ai L _J ~ j INFORMATION ATTACr+ inwEr~TOxr OfSECURrIY ACCOUNT BALANCE (INCLUDE ACCRUED INTEREST UNTIL DATE OF DEATH) ~ . 3` IDENTIFYING NUMBER OF ASSET ^^^^a^o®~ .000UNT LISTtN6 ALL ~~ ~ ~ l$$ETS AND DATE CfF DEATH VALUES ACCOUNT TITLE AS 1T APPEARS ON STOCK, BOND, SECURITY / SECURITY ACCOUNT ORIGINAL PURCHASE DATE OF A55ET BENEFICIARY NAME (Last) (First) (Middle Initial) 6 INFORMATION ~ ~,(~ 3 f} ~ ~ S ADDRESS ~o~ U ~~ c ~ QR-.r~C ~ CITY STATE ZIP CODE /h A,~-?~S y ~ t/ L~r Ft ~ ~S3 RELATIONSHIP TO DECEDENT I BENEFICIARY'S SOCIAL SECURITY NUMBER ~' BENEFICIARY TION NAME (Last) (First) (Middle Initial) ~ '~~ Q ~ INFORMA /4~ ~[7 ~-' ~/YI/h ~ , + ADDRESS ,I yo G ~ ~ CITY STATE ZIP CODE ' ~~~ RELATIONSHIP TO DECEDENT BENEFICIARY'S SOCIAL SECURITY NUMBER a~a-©o-o®©~ BENEFICIARY NAME (Last) (First) (Middle Initial) INFORMATION ADDRESS I, .: r CITY STATE ZIP CODE I f I rc ~~ RELATIONSHIP TO DECEDENT BENEFICIARY'S SOCIAL SECURITY NUMBER ^ ~ ~ ~ { ^^a-^^-^^^ ,- SIGNATURE OF PREPARER ~f~~ ~~3~~~~a~ DAYTIME TELEPHONE NUMBER Instructions for filing this not-ce are on the reverse aide. Free t~hecking Acc unt State ent For the period 7 1 /08/2008 to 1 ~'Q~/2008 MARTHA P STRAINING DECD 16 S ENOLA DR APT 110 ENOLA PA 17025-2723 F'Nl: t~AN Primary account number. 50-8039-3272 gage 1 of 2 Number of enclosures: 0 For 24-hour banking, anal transaction or interest rate information, sign on to 'a PNC Bank Oniine Banking at pnc.rom, For customer service call 1-883-PNC-BANK between the bows of 6 AM and Midnight ET, Para servicio en espariol, 1-866-HOLA-PNC Moving Please contact rrs at 1-88B-PNC-BANK ® Write to Customer Service PO Box 609 Pittsburgh PA 15230-9738 Visit us at pnc.com TDD terminal: 1-800-531-1643 hot l~carm~ iritlraireil rlirnr, oiih' Did you kno~t• that e~•el~' purchase nl~tde ~ti~ith hotly PNC Rank Visa Credit or Check Card (hroush the end oflhe year could mean a chancy lol you to help yourself and Sesame \~rorkshap'' Get a lol -and gi~~e a lot ~r-i!h PNC. Visit pnc.comh-isas~~-ceps lor~rronullional dctailti . . Did you know it is possible to have significantly more than $250,000 in deposits at PNC Bl+nk FDtC insured? Stop in any brTrlch tr review your account or call 800-PNC-BANK. Or ~o to PNC.cont or httpa/wwnv.fdic.aov/edie/ Tor more itlforntation Fr@9 ~hIBC~[~ng ACCOUOt SU~illilary Martha P Straining Decd Account numbber 50-3039-3272 Balance S'illfttnlary Please see the Activity Detail section for Beginning Deposits and Checks and other Ending additional information. balance other add+lions deductions balance 4,4:3h.5U 3;; f±.-?f) flilfi.-!n 3,%73.5<.) Average monthly Charges balance and fees Activity Detail - - Deposits and Other Additions Dat_ Amount D<_scrip;ion 1 l;'?8 3 ~.•lU hc•vcrse rlCFi ll~•hit 1.?/0.1 30,)-r)0 Direct. ])cl,~~sir - C',ivil Sc-v i-S Trc:rt uti• ;31 `: F 2"_~33U'? 11' CSI' Online and Electron C Banking Deductions Date A•r*fount DAscription 11;'l.a '-r~ ~r1.0U/i~irecl P:n•menl - ltover,~til _ iTS'1're.isur}' SU3 XX~,~iX<1037:1 71;"2G ~35.40 Direct 1'at•merit- Pat•uuntrec Veri~un ?C~XY~YY111.",3U Ot!>ter Deductions Date Amount Description 1`?%U9 L'.UU Ch~~cl: Inui~rs In 5lalemenl Fey There were 2 Deposits and Other Additions totaling $338.40. There were 2 Online or Electronic Banking Deductions totaliny 5994.40. There was 1 Otlier Deduction totaling $2.00. FOR M953n-1o0!