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HomeMy WebLinkAbout01-09-09 (2) 1505607121 REV-1500 EX 06 O ( - S) .. PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOX 280661 INHERITANCE TAX RETURN Harrisburg. PA 17128-0661 RESIDENT DECEDENT 2 1 0 8 0 1 0 3 9 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 7 1 2 8 6 6 4 6 1 0 1 1 2 0 0 8 0 8 2 5 1 9 3 6 Decedent's Last Name Suffix Decedent's Firs t Name MI M c K E E R A L P H V (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name rytl Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS © 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death 4. Limited Estate ~ qa. Future Interest Compromise (date of prior to 12-13-82) ~ 5. Federal Estate Tax Return Required ® 6 D d death after 12-12-82) . ece ent Died Testate ~ 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) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number R O G E R B I R W I N E S Q U I R E 7 1 7 2 4 9 2 3 5 3 Firm Name (If Applicable) r•.a I R W I N 8 M c K N I G H T First line of address 6 0 W E S T Second line of address P O M F R E T City or Post Offce C A R L I S L E SIGt~AIt)RE OF PERSON RESPONSIBLE FOR FILING RETURN DATE REGISTER~F WILLS US NLY i~ CQ ~ ~~ ~ C~ ~ ( ': S T R E E T I ?I;rn ~ r r 1 ....~ r- , W i i i State ZIP Code ~ TE FILED .L` 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 We, coned and complete. Declaration of prepamr other than the personal representative is based on all informafion of which preparer has any knowledge. 139 HILL DRIVE CARLISL SIGNATURE P EPARERATHER T N REPRESENTATIVE f /~ ADDRESS 60 WEST 'OMF ET STREET CARLISL --~ PLEASE USE ORIGINAL FORM ONLY Side 1 1505607121 TE 1505607121 J\\~ J 1505607221 REV-1500 EX Decedent's Social Security Nu mber DecedenPS Name: RALPH V. McKEE 1 7 1 2 8 6 6 4 6 RECAPITULATION 1. Real estate (Schedule A) .................................... .... 1. 2. Stocks and Bonds (Schedule B) ............................... ... 2. 3 4 2 6 , ^ ^ 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. ... 3. 4. Mortgages & Notes Receivable (Schedule D) ..................... ... 4. 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) .... ... 5. 9 1 3 ^ . 7 3 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .... ... 6. 7. Inter-Vivos Transfers & Miscellaneous N n-Probate Property (Schedule G) ~ Separate Billing Requested .... ... 7. 1 2 ^ 3 1 ^ , 3 1 8. Total Gross Assets (total Lines 1-7) , , , , , , , , , , , , , g 1 3 2 8 6 7 , ^ 4 9. Funeral Expenses & Administrative Costs (Schedule H) ............. ... 9. 8 4 1 6 , ^ ^ 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ......... ... 10. 3 7 ^ 1 . 1 5 11. Total Detluctions (total Lines 9 & 10) ........................ ... 11. 1 2 1 1 7 , 1 5 12. Net Value of Estate (Line 8 minus Line 11) ...................... ... 12. 1 2 ^ 7 4 9 , 8 9 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. 1 2 ^ 7 4 9 , 8 9 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 16. Amount of Line 14 taxable at lineal rate x .045 1 2 0 7 4 9. 8 9 16. 5 4 3 3. 7 5 17. Amount of Line 14 taxable at sibling rate X .12 ^ ^ ^ 17. ^ ^ ^ 18. Amount of Line 14 taxable at collateral rate X .15 ^ ^ ^ 18 ^ , ^ ^ 19. Tax Due ................................................ 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 1505607221 Side 2 5 4 3 3. 7 5 1505607221 ~~ ADDITIONAL Personal Representatives Estate of Ralph V. McKee - SS# 171-28-6646 Under penalties of perjury, the undersigned declare that they have examined this return, including accompanying schedules and statements, and to the best of their knowledge and belief, it is true, correct and complete. Signature ~~'~. ~C,,, l.~.i Name Sharon K. Sheaffer Address Line 1 100 Clearview Drive Address Line 2 City, State, Zip Carlisle, PA 17013 Date ~ - ~~- L~ REV-1500 F~c Page 3 File Number Decedent's Complete Address: 21 Ds o1D3s DECEDENT'S NAME RALPH V. McKEE __ ____ __ STREE? ADDRESS ~ ~~ 139 HILL DRIVE _ _ __ clrY srnrE zlP CARLISLE l PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 271.69 Total Credits (A + B r C ) 3. InterestPenalty if applicable D. Interest E. Penalty Total InteresUPenalty (D+E ) 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. 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. (1) 5,433.75 (2) 271.69 (3) 0.00 (4) 0.00 (5) 5,162.06 (SA) (58) 5,162.06 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 propedy lransferred : ................................................................. ..... ^ Q b. retain the right to designate who shall use the propedy transferred or its income : .......................... ..... ^ Q c. retain a reversionary interest; or ........................................................................................... ..... ^ ^X 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? .................................................................................. ..... ^ Q 3. Did decedent own an "in trust fol' 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? ............................................................................................. ..... Q ^ 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 i, 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) (ij). 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) (t.1) (ii)]. The statute does not exemol 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 a[ 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)I. 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(a111)I. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is hvelve (12) percent [72 P.S. §9116(a)(1.3)). Asibling is defined, under Section 9102, as an individual who has al least one parent in common with the decedent, whether by blood or adoption. REV-1503 EX « (6-96) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT RALPH V. MDKEE 21 OS 01039 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 300 SHARES OF ALLIED IRISH BANKS, P.L.C. 3,426.00 300 X $11.42 = $3,426.00 CUSIP 001 451 01922840 TOTAL (Also enter on line 2, Recapitulation) ~ $ (If more space is needed, insed additional sheets of the same size] REV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER RALPH V. McKEE 21 08 01039 Include the proceeds of litigation and the date the proceeds were received by the estate. _ All property Jointly-owned with right otsurvivorshio must be disclosed an Schedule F. ITEM I VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. M&T BANK -CHECKING ACCOUNT #59014393 6,340.53 2. (MEMBERS 1ST FEDERAL CREDIT UNION SAVINGS ACCOUNT #303497-00 2,790.20 TOTAL (Also enter on line 5, Recapitulation) I $ (It more space is needed, insert additional sheets of the same size) REV-1510 EX + (6-98) COMMONIWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER RALPH V. McKEE 21 08 01039 This schedule must be completed and fled 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 irvcwoE n~ervamc Or rHe rwnrvsr[acs, rneaaEUnorvsHwro oECEOErvrnrvo rME OarE Of raarvsrEa. anncH ncovr or rrvEOEEO Faaaeu [srnrE DATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST EXCLUSION lirnvvucnarel TAXABLE VALUE 1. AMERICAN HOME BANK 50,127.39 100. 50,127.39 CERTIFICATE OF DEPOSIT #290003128 BENEFICIARY: TERRY E. McKEE 2. AMERICAN HOME BANK 50,134.97 100. 50,134.97 CERTIFICATE OF DEPOSIT #290004527 BENEFICIARY: SHARON K. SHEAFFER 3. AMERICAN HOME BANK 10,033.80 100. 10,033.80 CERTIFICATE OF DEPOSIT #290004654 BENEFICIARY: SHARON K. SHEAFFER 4. AMERICAN HOME BANK 10,014.15 100. 10,014.15 CERTIFICATE OF DEPOSIT #290005479 BENEFICIARY: SHARON K. SHEAFFER TOTAL (Also enter on line 7 Recapitulation) I $ 120 310 31 (If more space is needed, insert additional sheets of the same size) REV-1577 EX +(10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS w r H r c ~r - FILE NUMBER RALPH V. McKEE 21 OS 01039 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. HOLLINGER FUNERAL HOME 2,238.40 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representatlve (s) Street Address Ciry State Zip Year(s) Commission Paid: 2. Attorney Fees IRWIN & McKNIGHT 1,750.00 3. Family Exemptiore (If decedenYS address is not the same as claimant's, attach explanation) 3,500.00 Claimant TERRY E. McKEE Street Address 139 HILL DRIVE City CARLISLE State PA Zip 17013 Relationship of Claimant to Decedent SON 4. Probate Fees REGISTER OF WILLS 306.00 6 Accountant's Fees 6. Tax Return Preparers Fees PATRICIA A. ROSENDALE, CPA 350.00 7. REGISTER OF WILLS -FILING FEE 30.00 8. CUMBERLAND LAW JOURNAL -ESTATE NOTICE 75.00 9. THE SENTINEL -ESTATE NOTICE 166.60 TOTAL (Also enter on line 9, Recapitulation) I $ (If more space is needed, insert additional sheets of the same size) REV-1512 EX . (1203) SCHEDULE / COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, IN RES DENTEDECEDENT N MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER RALPH V. McKEE 21 08 01039 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. MEMBERS 1ST FEDERAL CREDIT UNION -LOAN #303497-01 824.71 TIMOTHY SHEAFFER, JR. - CO-BORROWER PRINCIPAL BALANCE - $1,649.41 2. MEMBERS 1ST FEDERAL CREDIT UNION -LOAN #257122-01 2,876.44 TOTAL (Also enter on line 10, Recapitulation) I $ 3.701.15 (If more space is needed, insen additional sheets of the same size) REV-7513 EX+(9-001 SCHEDULE) COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT RALPH V. McKEE ~~ nu n~nzo RELATIONSHIP TO DECEDENT y AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include oulrght spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. TERRY E. McKEE Lineal 60,374.94 139 HILL DRIVE 1/2 REMAINDER CARLISLE, PA 17013 2. SHARON K. SHEAFFER Lineal 60,374.95 100 CLEARVIEW DRIVE 1/2 REMAINDER CARLISLE, PA 17013 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET S (It more space is needed, insert additional sheets of the same size) ~~~~~ cZZ ~~t~ C~ e~~~nte~~ J I, RALPH V. McKEE, of Middlesex Township, Cumberland County, Pennsylvania, declare this instrument to be my last will and testament, hereby expressly revoking all wills and codicils heretofore made by me. 1. I direct my executors to pay all of my debts, funeral and administrative expenses as soon as may be done conveniently after my decease. 2. I authorize and empower my executors to sell any realty owned by me at my death, and not specifically devised herein, at either public or private sale, and to give good and sufficient deeds therefor, in fee simple, as I could do if living. 3. I give, devise and bequeath all of my estate of every nature and wherever situate to my two children, Terry E. McKee and Sharon K. Sheaffer, share and share alike, the child or children of any deceased child taking the share their parent would have taken if living. 4. I nominate and appoint Terry E. McKee and Sharon K. Sheaffer to be the executors of this my last will and testament, they are to serve as such without bond. 5. I hereby suggest that my personal representatives retain the services of Irwin, Irwin & McKnight, as attorneys in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this L}'~ day of November 1988. RA ~ H V. McKEE Signed,- sealed, published and declared by Ralph V. McKee, the above named testator, as and for his last will and testament, in the presence of us, who at his request, in his presence and in the presence of each other have subscribed our names as witnesses hereto. ACKNOWLEDGEMENT AND AFFIDAVIT WE, RALPH V. McKEE, BETZI A. MORRISON and SHARON L. SCHWALM, the testator and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as his Last Will and that he had signed willingly, and that he executed it as his free and voluntary act for the purpose herein expressed, and that each of the witnesses, in their presence and hearing of the testator, signed the Will as a witness and that to the best of .their knowledge the testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. COMMONWEALTH OF PENNSYLVANIA: ss. COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by RALPH V. McKEE, the testator, and subscribed and sworn to before me by BETZI A. MORRISON and SHARON L. SCHWALM, witnesses, this U '~ day of November, 1988. ~~ -, , N i:,kiAL SEAL ROvER 9. iRWIN, KO?ARY RUa! IC 'P.R! ISLe' eCROUGH. CUb18ERLA~\D COON? AIY G06!p9~E'ON E.KRIRES CCT. 3, 1992 SHARON L. SCHWALM Q MBTBank 499 Mitchell Road. Millsboro. UE 19966 Mail Code DE-MI3-I2 Law Offices Irwin & McKnight West Pomfret Professional Building 60 West Pomfret Street Carlisle, Pennsylvania 17013-3222 Re: Estate of.` Ralnh f~NlcKee Social Seczrrity: 171-28-66-16 Date olDealh: Ocloher I1 2008 Phone (888) 502-4339 Eav (302) 933-2915 October 22, 2008 RECEIVER OCT 2 4 20i!1 tRWlt~ & NrcKNIGH ~ tbW OFFICES Dear Sir or Madam: Per your inquiry dated October 17, 2008, please be advised that at the time of death, the above-named decedent had on deposit with [his bank the foflowine: Type ofAcawnt Checking Account Account Namber 3g0)3gg3 Ownership (Names o~ Ralph V McKee* Opening Date 5/2$179 Classed 10/1?/p8 Balance on Date ojDenth S 6, 3-10.39 Accnred Grterest S 0, ):/ Total S 6,3-l0.~3 ... _.. __. .. Please be advised, there was no safe deposit box found for the above decedent. ~ If upon reviewing the information above, yon believe there arc additional accounts not referenced, please provide us with an account number and/or name of any possible joint account holder. For any additional information on the above accounts, including ownership and any changes, closures and/or reimbursement of funds, etc., please contact our Carlisle West Office # 717-240-6717. Si ~ely, ~,~~ ~/~~ Tracie Hare Records Management St MEMBERS 1s1 FEDERAL CREDIT UNION SAVINGS ACCOUNT Account Number/Suffix 303497-00 Date Account Established 03/30/2007 Principal Balance at Date of Death $2,789.44 Accrued Interest to Date of Death $,76 Total Principal and Accrued Interest $2,790.20 Name of Joint Owner None LOAN ACCOUNTS RECEIVED OCT 2 3 2U08 IRWIN & McKNIGNi LAW OFFICES Account Number/Suffix Date Loan Established 303497-01• 257122-01* Principal Balance at Date of Death 03/30/2008 $1,649.41 04/03/2008 $2 876 44 Loan Type Interest Rate Share Secured , . Used Vehicle Collateral Held as Security 4 50% .Contractual Pledge 7 99% 1995 Toyota 4Runner/Contractual Pledge of Name of Co-Borrower Of Shares Timothy Sheaffer Jr Shares Ralph McKee 'Loans do not have Credit Life coverage ~BERS1sTFEDERA CRE I UNION ante a A. line Insurance Services Specialist October 22, 2008 Estate of: RALPH MCKEE Date of Death: October 11, 2008 Social Security Number: 171-28-6646 X000 Louise Drive L?O. l3os ~U Mech,miahw,y, Penntiyh,ania 171155 (`30O) ?y3-?3?g w~~w.mrmhersltir.ur~ AIB: Historical Prices for ALLIED IRISH PLC ADS -Yahoo! Finance Page 1 of 2 Yahoo' My YahOO' hlad More Get Yahoo! Toolbar Hi, Karen Sv.)n Jut Help YAHC7(a- FINANCE sear<n weesenRCli Dow j 1.25% Nasdaq j 0.80% Wetl, Dec 3, 2008, 1:SBPM ET - U.S. Markets close ip 2hr5 2mins. 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O S 2 ~ f- ~ NLL'J.N ~:IV m r v o m N N IfJ JJ f~ in cn m v m K v -r in 0 0 0 0 0 0 0 0 0 0 O O o O o T P 07 Ql OJ N N N N N G O O O O a a a n n ~ ~ ~ ~ 0 E E E' E E i- ~ i- ti i- ~ c v c c ~oooo, a G~ 0 l m O N E 0 N i U , i O a al Q i ~I U7 i L ¢~ U L i• 0 ~ : e y i m N K n 1 U, w ~ ~ ~ E c. ~ o ~i ~n " Q U ~J Z ~ o ~L t C O p _ ~ C ' _ " N . ~ O ., a L AMERICAN HOME BANK NA ~` , 3840 Hem land Road, Mountville, PA 17554.1500 ('a TIME CERTIFICATE OF DEPOSIT a NONTRANSFERABLE AND NONNEGOTIABLE `~ Account Title Account Type RALPH V MCKEE Tax a er ID Number P /' ~ `a _ 12-17 MONTH CD 171-28-6646 - - - j a . E ~*~~~ D~ ~~~fary~es~ ` TERRY E MCKE j ~. ~~ F~ Account Number Amount Date of/ssue Maturity Date Term ~ 0000000290003128 E 50,000.00 Jui 17, 2006 July 17, 20 12 Months /Automatic Renewal ~ Interest Rate Per Annum a 5.1 8 %with an annual percentage yield of 5.31 %. /nterest Payment Frequency / t ~ ,S/, J~ S.~ Monthly ,,,~~~ ` i /nterest Payment Disposition ~~ ~ Maii a check, payable to RALPH V __ N CKEE 134 Hill n. r~d~..~o on :; ,_ :~ a '~ AMERICAN a x `'. E HOME BANK,w /~ Remitter I°~:: 1 ~ hhdd II 7 - ,; r, is ."',.I fill I~1 hpf.Nl,~, I~1 ~~~, 71y1~„~~,~~~'~i1i~ iii ) ~ x iv( ~;? Pay '( la P y ~9 CN,. N e I t= to the order o~ 1 y _ 1t~; r;1,,, I ; rM r'.I I.; "f hll-l~l.;.jr~d Fi1~~rt+,'-F1aur• [iull•:a.r: arn~ u'? isentm ~:: ~ ~4 ~//r, darru~a~rt-/rnmrr mloredGruk~imvaa~ ~i~~~rvrGruulm Gadasi~audiua/iotratrrirrdsE~ Official Check ,,< DATE ~ ~ .,~ /• ~ I II~~;;~ 11.00853711' 'r03~3186931: OOOOi00C ~~RR~ny~~„ or: x ~~niv1.T. `fi'n-c~~ 853 601869/313 $ ~ ~ ~:,..,~ r5t~ e Date '~~~~ i Date °_~_ ~ TIME CERTIFICATE OF DEPOSIT NONTRANSFERABLE ANO NONNEGOTIAOLE D0001100 / 20061440 Printed 7!17/2006 12:05 PM RALPH VMCKEE /0000000290003128 O 2006 Kirchman Corporation AMERICAN HOME BANK, NA rp/and Road. Mounlville. PA 1 i TIME CERTIFICATE OF DEPOSIT NONTRANSFERABLE AND NONNEGOTIABLE ~~ Account Title Account Type Taxpayer lD Number ., RALPH V MCKEE 15 MONTH BUMP-UP CD 171-28-6646 ~ F,ER , ~~+ (e On OealR Ben, fl 115 ;: . ER `i Account Number Amount Date o(Issue Maturity Date Term ~V 0000000290004527 $ 50,000.00 August 24, 2007 November 24, 2008 15 Months /Single Maturity ~ Interest Rate Per Annum Interest Payment Frequency 4.94 % with an annual percentage yield of 5.06 % Monthly ly-~ `:~ Interest Payment Disposition `~ Mail a check, payable to RALPN V MCKEE, 139 Hill Dr, Carlisle, PA 17013-8472 TIME CERTIFICATE OF DEPOSIT Agreement. This Time Cenificate of Deposit is a part of; and governed by, our Time Deposit Agreement. Among other things, this means that all terms defined in that agreement have the same meanings here. You have received a copy of that agreement, the Truth in Savings disclosures (if applicable), and the fee schedule. You have read them and agree to them. Early Withdrawal Penally. We do not have to permit early withdrawals from the account. On each one we tlo permit, we can charge a penalty calculated as follows: For terms up to and including 12 months, 6 months simple interest on the amount withdrawn. For terms over 12 months, 12 months simple interest on the amount withdrawn. If there is enough accrued interest to cover the penalty, we deduct the penalty from it. If not, we deduct the remainder of the penalty from principal. If the account is a variable rate account, we will calculate the penalty using the interest rate being applied at the time of withdrawal. If the account is an Individual Retirement Account, the early withdrawal penalty will be in addition to any penalty imposed under the Individual Retirement Account (IRA) Disclosure Statement. The minimum early withdrawal penalty is seven days' simple interest on any amount withdrawn (a) within the first six days after the account is opened, or (b) within six days after a previous early withdrawal. NontransJJe able. This Time Certifcate of Deposit is nonnegotiable and nontransferable. All purported holders or assignees of it agree that our right/6f e o~~ff]]will have priority over/any of their claims. AMERICA PME BANK, NA / I. 9 By D BY: 7 Date 12-~ -~' ' Dalebb f ~~-5 {~] / Date TIME CERTIFICATE OF DEPOSIT D0001100 / 20061440 Printed 8/24/2007 9:32 AM NONTnANSFERA6LE ANp NONNEGOTIABLE p 2006 KirChmd^ Colporatien RALPH VMCKEE / 0000000290004627 3840 AMERICAN HOME BANK, NA TIME CERTIFICATE OF DEPOSIT NONTRANSFERABLE AND NONNEGOTIABLE Account Title Account Type Taxpayer lD Number RALPH V MCKEE 12-17 MONTH CD 171-28-6646 PayabN Oa fhafh BeneAcfary((esJ SHARONKSHEdFFER Account Number Amount Date o(Issue Maturity Date Term 0000000290004654 $ 10,000.00 November 19, 2007 November 19, 2008 12 Months /Automatic Renewal Interest Rate Per Annum Interest Payment Frequency 4.94 % with an annual percentage yield of 5.06 °/. Monthly Interest Payment Disposition Matt a check, payable to RALPH V MCKEE, 139 Hill Dr, Carlisle, PA 17013-8472 TIME CERTIFICATE OF DEPOSIT Agreement. This Time Certifcale of Deposit is a part of, and governed by, our Time Deposit Agreement. Among other things, this means that all terms defined in that agreement have the same meanings here. You have received a copy of that agreement, the Truth in Savings disclosures (if applicable), and the fee schedule. You have read them and agree to them. Early Withdrawal Penalty. We do not have to permit early withdrawals from the account. On each one wedo permit, we can charge a penalty calculated as follows: For terms up to and including 12 months, 6 months simple interest on the amount withdrawn. For terms over 12 months, 12 months simple interest on the amount withdrawn. If there is enough accrued interest to cover the penalty, we deduct the penalty from it. If not, we deduct the remainder of the penalty from principal. If the account is a variable rate account, we will calculate the penalty using the interest rate being applied at the time of vn(hdrawal. If the account is an Individual Retirement Account, the early withdrawal penalty will be in atldition to any penalty imposed under the Individual Retirement Account (IRA) Disclosure Statement. The minimum early withdrawal penalty is seven days' simple interest on any amount withdrawn (a) within the first six days after the account is opened, or (b) within six days after a previous early withtlrawal. Nontransferable. This Time CertiOca(e of Deposit is nonnegotiable and nontransferable. All purported holders or assignees of it agree that our right of setoff will have priority over any of their claims. AMERICAN HOME BANK, NA y~//f / BY /~l" ( //~ ~g-~U~ BY: 12~5-~~Y Ir - -~ Date U~ f ~~ ~ ~ / 1 TIME CERTIFICATE OF DEPOSIT D0001100 / 20061860 Printed 11/19!2007 3:09 PM NONTfiAN6FERABLE AND NONNEGOTIABLE RALPhI V MCKEE/ 0000000230004654 O 2006 Melavanle Corporation AMERICAN HOME BANK, NA TIME CERTIFICATE OF DEPOSIT NONTRANSFERABLE AND NONNEGOTIABLE Account Title Accounl Type RALPH V MCKEE 12-17 MONTH CD ru.xe~ oaf. n.w... Account Number I Amount I Date of Issue Maturity Date Interest Rate Per Annum 3.44 °/ with an annual percentage yield of 3.50%. Taxpayer lD Number 171-28-6646 Term 12 Months / Aubmatic Renewal Interest Payment Frequency ~ AMERICAN / HOME I3f1NKN~ ,~ '~.: K Remitter n~ ~AI_~%p,W hI'','::~Ilij`i~~;'+'s I^I~'~'II~11.1~•~iLi~~ II';„41,iljl,l > x . _. ~ Q l u•008 5 3gu' `i'0 3 >, 3 1869 3t: OOOO 00064(1' ~~ SURRENDERED BY: c~ ` 853 fi0.1869/313 DATE j ~'i 1!» !r', r•, r'11 I i~ q i_I 1 4~ u t~ T~ ~DOi r:! .. ..~ Imo' Pay .;,(Id.P~J~I f •;:Irlw~i.'ff'a't eo the order of ::~^+I,~~;;I{_,,,~ TFIIVIiI.";,~I~r~ ':~~',r~fl1;'I,°.~l+~fl~: [il:tL~~a.Y~_ NI'11j ~~:~ ~.e~l~:~.~;;; n~~ir rlontneriu-./uu'-acv/nrer(Grukyrotuul, .~T'o!/. ~mirlmt2/aLrubsrilo onr/unliomalrrnuu~.'a Official Check Date I~-~-S°c~8" Date Date j ~G •~r .-_ TIME CERTIFICATE OF DE P061T ~ _ NONianNSrERnn LE nNG NONNEGOI1neLE D0001100 / 20000940 Printed 9/29/2008 10:31:00 AM RALFH V MCKEE / 0000000290005419 ©2009 Metavante Corporation ~::. Hollinger Funeral Home & Crematory, Inc. Eric L. HoIlinger Supervisor November 24, 2008 Terry E. McKee 139 Hill Drive Carlisle, PA Tiie Funeral Service icr Raiph V. ivicKee: We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please feel free to contact us if you have any questions in regard to this statement. THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT, AND MERCHANDISE THATYOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS. Professional Service Cremation Package A-Direct Cremation $1350.00 Merchandise Keepsakes-Silver Four Leaf Clover (2 @ $130) $260.00 Keepsakes -Sterling Silver Cylinder (2 @ $150) 300.00 Keepsakes-Silver Dolphin 150.00 ATTHE TIME FUNERAL ARRANGEMENTS WERE MADE, WE ADVANCED CERTAIN PAYMENTS TO OTHERS AS AN ACCOMMODATION. THE FOLLOWING IS AN ACCOUNTING FOR THOSE CHARGES. Cash Advances Newspaper Notices -Sentinel $81.40 Certified Copies of Death Certificate (12 @ $6) 72.00 Cumberland County Coroners Authorization 25.00 Total Charges $2238.40 Less: Eagles Aerie #1299 Fraternal Benefit 500.00 Sharon Sheaffer Ck#351 350.00 White Circle Club 200.00 Sharon Sheaffer Ck#358 360.00 Current Balance: $828.40 ,., T _:~ 501 NORTH BALTIMORE AVENUH • MOUNT HOLLY SPRINGS. PENNSYL~7ANfA-~I'7065 • (717j 43b 3 t33 • FAX (7 i7) 48a-3215 www.hollingcrluncralhome_com