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Home My WebLink About05-14-09 (3)1505607122 REV-1500 EX (06-05) OFFICIAL USE ONLY ' PA Department of Revenue Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number PO BOX 280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 0 8 0 9 0 0 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 207 22 1884 ;08182008 0'5011924 Decedent's Last Name Suffix Decedent's First Name MI D A V I S RICHARD N (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW • 1. Original Return o 2. Supplemental Return c~ 3. Remainder Return (date of death prior to 12-13-82) c~ 4. Limited Estate o 4a. Future Interest Compromise (date c~ 5. Federal Estate Tax Return Required of death after 12-12-82) • 6. Decedent Died Testate c~ 7. Decedent Maintained a Living Trust 1 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) c~ 9. Litigation Proceeds Received c~ 10. Spousal Poverty Credit (date of death c~ 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 TO: Name Daytime Telephone Number E L I N O R A L B R I G H T R E B E R T 7 1 7 6 3 2 4 3 0 0 Firm Name (If Applicable) First line of address 5 1 5 C A R L I S L E Second line of address City or Post Office H A N 0 V E R S T R E E T State ZIP Code PA 17331 REGISTF~OF WILLS US~NLY L ~ v~ ^~ ' -rn ~. n ~'~ . -~ ' ~- '-~ C .: y-~. - ~~ '-' FILED Y .~ c.~ Correspondent's a-mail address: earebertCa~earthlink.net 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 information of which preparer has any knowledge. SIGNATU E OF PERSON RESPONSIBLE OR FILING RETURN DATE ~I ~ ,: ~'}'l ~~Gl~.i~ '~~ May 8 2009 ESS _213 George Street, Hanover Pennsylvania 17331 SIG ATURE OF P EP RER OTH R THA EP ESENTAT VE DATE P Ma 8, 2009 ADDRESS - 515 Carlisle Street, Hanover, Pennsylvania 17331 PLEASE USE ORIGINAL FORM ONLY Side 1 1505607122 1505607122 _~ J REV-1500 EX 1505607222 Decedent's Name: Richard N• D a v i s Decedent's Social Security Number 2 0 7 2 2 1 8 8 4 RECAPITULATION 1. Real estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c~ Separate Billing Requested 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 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. 16. Amount of Line 14 taxable at lineal rate x 0.045 1 5 3 1 7 9. 2 9 17. Amount of line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 19. TAX DUE 1.' 0 . D 0 2. 5 6 0 5 5.3 8 3., 0.0 0 a. 0 . D 0 5. 1 3 4 8 5.7 6 s. 7 4 5 5 1.0 1 7.' 2 4 '8 2 7.6 3 8. 16 8 9 1 9.7 8 a 15 0 1 3.1 5 1a 7 2 7.3 4 11. 1 5 7 4 0.4 9 12. 153 1 7 9.2 9 13. 0 . D D 1a. 153 1 7 9.2 9 15. 0 . D 0 1s. 68'93,07 17. 0 . O.D. 1s. D . D'D 1s. 6893.D7 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505607222 1505607222 c~ J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-08-0900 DECEDENTS NAME Richard N. Davis DECEDENTS SOCIAL SECURITY NUMBER 207-22-1884 STREET ADDRESS 238 East Garfield Street CITY Shippensbur STATE pA ZIP 17257 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) $6,893.07 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments $5,500.00 C. Discount 289.47 Total Credits (A + B + C) (2) $5,789.47 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (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) $1,103.60 A. Enter the interest on the tax due. (5A) $ 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) $1,103.60 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1 • Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ^ Q b. retain the right to designate who shall use the property transferred or its income; ^ [~J 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 Q ^ 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? ^ Q 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. 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 on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. 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-1503EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Richard N. Davis FILE NUMBER 21-08-0900 All property Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. 33 Shares, Common Stock, Prudential Financial, Inc. Holder Account #00004621875 IND. $2,408.34 Value as per Yahoo Finance: $72.98 per share. Dividends payable to shareholders of record on or immediately prior to the Decedent's date of death: NONE. 0.00 2. $25.00 Series "E" U. S. Savings Bond #Q6019839528E. Issued September, 1975. 133.15 Identified as #25 on Safe Deposit Box Inventory. Redemption Value as per U. S. Savings Bond Calculator. 3. 74 Series "E" U. S. Savings Bonds -See Attached Listing of Bonds. 43,471.49 Identified as #26 on Safe Deposit Box Inventory. Redemption Values as per U. S. Savings Bond Calculator. 4. 37 Series "EE" U. S. Savings Bonds -See Attached Listing of Bonds. 10,042.40 Identified as #27 on Safe Deposit Box Inventory. Redemption Values as per U. S. Savings Bond Calculator. NOTE: Some of the above-referenced U. S. Savings Bonds were registered in the name of the Decedent or his wife, Mary I. Davis. The said Mary I. Davis predeceased the Decedent on October 24, 1981. (If more space is needed, insert TOTAL (Also enter on line sheets of the same size) REV-1508 EX + (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN CASH, BANK DEPOSITS, & MISC. RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF Richard N. Davis FILE NUMBER 21-08-0900 Include the proceeds of litigation and the date the prooeeds were received by the estate. All property jointly-owned with the right of survivorship must tie disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 2004 Chevrolet Impala Sedan. Value as per Kelley Blue Book. $7,895.00 2. Checking Account #97204072, M >~ T Bank. 2,322.58 Balance as per letter from bank dated October 27, 2008. 3. Savings Account #21000001218040, M ~ T Bank. 1,574.90 Balance as per letter from bank dated October 27, 2008. 4. Prime Share Account #1473060-00, Patriot Federal Credit Union. 1,195.48 Balance as per letter from Credit Union dated October 28, 2008. 5. Cash found in Safe Deposit Box -See #22 on Safe Deposit Box Inventory. 125.00 6. Refund of Overpayment of 2008 U. S. Individual Income Tax, United States Treasury. 372.80 TOTAL (Also enter on line 5 Recapitulation) ~ $13 485 76 (If more space is needed, insert additional sheets of the same size) REV-1509 EX + (6-96) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF Richard N. Davis FILE NUMBER 21-08-0900 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Janice M. Davis 213 George Street Daughter Hanover, Pennsylvania 17331 B C JOINTLY-OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A. 11/81 House and Lot, 238 East Garfield Street, Shippensburg, PA. Situate in Shippensburg Borough, Cumberland County, PA. IT BEING the same tract of land which Richard N. Davis, Widower, by his Deed dated November 16, 1981, and recorded in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Deed Book Vol. P-29, page 823, granted and conveyed unto Richard N. Davis, Widower, and Janice M. Davis, as Joint Tenants with the Right of Survivorship. Fair Market Value as per Comparative Market Analysis by $92,500.00 50% $46,250.00 Harold Best of Hale Real Estate on November 15, 2008. 2. A. 12/90 6 Series "E" and "EE" U. S. Savings Bonds. 2,808.48 50% 1,404.24 & prior Identified as #24 on Safe Deposit Box Inventory. dates. Redemption Values as per U. S. Savings Bond Calculator. 3. A. 05/83 58 Series "EE" U. S. Savings Bonds. 14,232.40 50% 7,116.20 & prior Identified as #28 on Safe Deposit Box Inventory. dates. Redemption Values as per U. S. Savings Bond Calculator. 4. A 10196 Savings Account #08-00705, F & M Trust. 775.06 50% 387.53 Balance as per letter from bank dated November 7, 2008. SUBTOTAL FROM CONTINUATION PAGE -SCHEDULE F: 19,393.04 TOTAL (Also enter on line 6, Recapitulation) $74,551.01 more space is needed, insert additional sheets of the same CONTINUATION PAGE SCHEDULE F ESTATE OF Richard N. Davis FILE NUMBER 21-08-0900 ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 5. A 2 Certificates of Deposit. F & M Trust: Issue Date Certificate No. Date of Death Value 10/97 014-2956140 $ 2,350.09 $1,175.05 10/97 014-2963395 $14,195.85 7,097.93 Values as per letter from bank dated November 7, 2008. 6. A 5 Certificates of Deposit. M & T Bank: Issue Date Certificate No. Date of Death Value 03/99 31003913794292 $ 1,968.13 984.07 05/96 31003914492580 1, 305.36 652.68 04/96 31003914516819 2,626.09 1,313.05 04/96 31003914517982 2,611.98 1,305.99 04/07 31003916125163 13,728.53 6,864.27 Values as per letter from bank dated October 27, 2008. TOTAL $19,393.04 REV-1510 EX + (6-96) SCHEDULE G INTER-VIVOS TRANSFERS & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ara N. uavls FILE NUMBER 21-08-0900 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 THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACHACOPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1. Annuity Contract #010SP731341, Monumental Life Insurance Co. $19,527.20 100% $ 0.00 $19,527.20 Primary Beneficiary: Janice M. Davis [Daughter of the Decedent). Value as per letter from Monumental Life dated October 15, 2008. 2. Annuity Contract #ROS849439, Prudential Financial, Inc. 4,077.35 100% - 4,077.35 Primary Beneficiary: Janice M. Davis [Daughter of the Decedent]. Value as per letter from Prudential dated October 23, 2008. 3. Certificate of Deposit #31003918501634, M & T Bank. 4,223.08 100% 3,000.00 1,223.08 Issued May 29, 2008 and registered in the names of the Decedent and his daughter, Janice M. Davis. TOTAL (Also enter on more space is needed, insert additional sheets of the same size) REV-1511 EX + (10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT OF Richard N. Davis FILE NUMBER 21-08- 0900 Debts of decedent must be reported on Schedule I ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Fogelsanger-Bricker Funeral Home, Inc., Funeral Expenses. $9,322.40 2. Memorial Lutheran Church, Post-Funeral Gathering. 300.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) 0.00 Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees -Elinor Albright Rebert, Esquire 5,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 0.00 Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills, Cumberland County 76.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. The News-Chronicle Company, Advertising Letters Testamentary. 104.75 8. Cumberland Law Journal, Advertising Letters Testamentary. 75.00 9. Register of Wills, Cumberland County, Filing Fees for PA Inheritance Tax Return and Inventory. 30.00 10. Register of Wills, Cumberland County, Additional Probate Fees. 105.00 (If more space is needed, insert SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS TOTAL (Also enter on line 9, Recapitulation) I $15 013.15 sheets of the same sizel REV-1512 EX + (12-03) SCHEDULEI COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN RESIDENT DECEDENT MORTGAGE LIABILITIES, & LIENS t~ is I ~ ~r Richard N. Davis FILE NUMBER 21-08- . 0900 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, include unreimbursed medical expenses. REV-1513 EX + (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Richard N. Davis FILE NUMBER 21-08- 0900 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Not List Trustee(s) M~OIlrlrgiSH4RE oFESrA~ TAXABLE DISTRIBUTIONS [include outright spousal distributions, and I transfers under Sec. 9116 (a) (1.2)J 1. Janice M. Davis Daughter 1. Jointly- 213George Street Owned Hanover, Pennsylvania 17331 Property 2.Annuity Proceeds 3. Inter Vivos Transfer 4. 100% Residuary Interest ENTER DOLLARAMOUNTS FOR DISTRIBUTIONS SH01MJ ABOVE ON LINES 15 THR OUGH 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 (If more space is needed, insert additional sheets of the same size) clasr w~c.c. ~Na r~sr~aM~Nr I, RICHARD N. DAMS, presently residing at 238 East Garfield Street, Shippensburg, Cumberland County, Pennsylvania 17257, being of sound mind, memory and disposition, do hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void all wills by me at any time heretofore made. FIRST. I order and direct the payment of all my legally enforceable debts and funeral expenses as soon as may be convenient after my decease. SECOND. I give, devise and bequeath all my estate, real, personal and mixed, whatsoever and wheresoever situate, to my beloved daughter, JANICE M. DAMS, presently residing at 843 Summit Avenue, Hagerstown, Maryland, on a per stirpes distribution basis, provided that she survive me by a period of sixty (60) days. THIRD.. In the event that my said daughter, Janice M. Davis, should predecease me or is not living on the sixtieth (60~') day following my death and the said Janice M. Davis should die without issue who survive me, I then give, devise and bequeath my said estate to my brother, LEROY J. DAMS, presently residing at 599 Baltimore Road, Shippensburg, Pennsylvania 17257. FOURTH. In the further event that both my daughter, Janice M, Davis, and my brother, Leroy J. Davis, predecease me and my said daughter dies without issue who survive me, I then give, devise and bequeath one (1) share of my said estate to each of the following persons and entity: A. One (1) share to my niece, LEDONNA D. DARHOWER; a~ ti ° -~~~•I B. One (1) share to my niece, BEVERLY D. DANKER; and ~ ~ ~ ~ ° cf ~ { T Vl;~ -i`d' ~~ C. One (1) share to my nephew, JOHN W. DAMS; and ' ~~o ~,. ~. ~ ., ~ D. One (1) share to my niece, CATIIY L. GRAHAM; and ~ ~ `° ~;~ ~ 4 E. One (1) share to my niece, CAROL A. RUSSELL; ands F. One (1) share to my niece, BETTY J. McCLANATHA~N, and G. One (1) shaze to the MEMORIAL LUTHERAN CHURCH, of 34 East Orange Street, Shippensburg, Pennsylvania 17257, to be used as the church council deems to be in the best interest of the church. I~ (SEAL) I •..~,.-, ~ r. AG'Gllf'IATCC or - GTTf1RNF_YS AT LAW - 126 EAST KING STREET - SHIPPiENSBURG, PA 17257-1397 FIFTH. In the event that any of the above-mentioned beneficiaries should predecease me or are not living on the sixtieth (60th) day following my death, I then direct that the share of any such deceased beneficiary shall pass to the surviving beneficiary only. SIXTH. I nominate, constitute and appoint my daughter, JAlVICE M. DAMS, to be the Executrix of this my Last Will and Testament; if she be unable to fulfill the duties of Executrix, I then nominate, constitute and appoint my brother, LEROY J. DAMS, to be the Executor of this my Last Will and Testament. SEVENTH. I direct that my personal rcprescntative(s) sha11 not be required to give bond for the faithful performance of their duties in any jurisdiction. EIGHTH. I direct my Executor to retain the services of JERRY A. WEIGLE, ESQUIRE, with offices located at 126 East King Street, Shippensburg, Pennsylvania 17257, with respect to the settlement of my estate due to his familiarity with my affairs. IN WITNESS WHEREOF, I, Richard N. Davis, have hereunto set my hand and seal to this my Last Will and Testament, written o two (2) pages, the first page signed for identification only, this ~ ~-' day of -~///~.-c,~,.,,e,~ , 2002. ~~ -~I ,.. ,(~~ ,~~'~--~~° (SEAL) i I I WEIGLE 6c ASSOCIATES, P.C. -ATTORNEYS AT LAW - 126 EAST KING STREET' - SHIP~PENSBURG. PA 77257-1397 I COMMON'~rEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND a ~ (~ 11`1 ~ h~ ~ -~ We, '~' ,the witnesses whose names are signed to the and ~f P N ,p RLr,9J1 ~- foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Richard N. Davis, the Testator, sign and execute the instrument as his Last Will; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator, signed the will as witnesses; and that to the best of our knowledge the Testator was at the time eighteen (18) or more years of age and of sound mind and under no constraint or undue influence. d Sworn or affirmed to and subscribed before me by ~ ~~<< - A ~i~.~-r and ~u~tPiJ (! 6~ ~ Q~. i witnesses, this~jl~~ day of a werg~; n-orary Publrc wry, PA Cumberland Ca talon Expires October' 7. ; wL/OLL i /. .JloC/ATit. RC_ -ATTORNEYS AT LAW - f20 Er43T K/NO STRGGT - SH/PPdN.~/URO. i!4 17YJ7 1.BD7 This instrument was by the Testator, on the date hereof, signed, published and declared by him to be his Last Will and Testament, in our presence, who at his request and in the presence of each other, we believing him to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses. .~-_ .---~ n COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS I, Richard N. Davis, the person whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me by Ric d N. Dav the T stator, thisr., ~' ~ day of ~'~~~~~02. ~~ II ".f 4.I ..~ , , r,. 1 T ~,. ,, ~' ~ t „~ ., ~ -~1,.Y .. '~ 'I '~.I :r Ay4fi.l+'.. ~r NOTARIAL StAL Jerry A. Weigle, Notary Public Shippensburg, PA Cumberland County 1Av Commission Expires October 7; 2006 WEIGLE & ASSOCIATES, P.C. -ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 SAFE DEPOSIT BOX INVENTORY RICHARD N. DAVIS ESTATE 1. PA Certificate of Title for 2004 Chevrolet Impala registered in the Decedent's name. VIN #2G1WF52E849389974 and Title #60755670302DA. 2. $14,000.00 Non-Qualified Annuity Policy #OlOSP731341, Monumental Life Insurance Company, 4333 Edgewood Road NE, Cedar Rapids, Iowa 52499. Telephone #1-800-553-5957. Monumental Premier Solution Plus Account #FDA 229802. Owner and Annuitant -Decedent. Issued 09/08/2000. Value as per statement dated 09/08/06 - $18,419.19. Certificate #3039, The Equitable Life Assurance Society of the United States. Issued to the Decedent on 03/18/57 through his employment at SKF. Life Insurance Accidental Death &x Dismemberment Surgical Coverage. Primary Beneficiary -Mary I. Davis. 4. Change of Beneficiary Form, The Equitable Life Assurance Society of the United States. Issued to the Decedent through his employment at SKF. Effective date - 01/29/48. Group Life Insurance + Group Accidental Death &z Dismemberment Policy #3179N and Certificate #207-22-1884. Home Health Care Policy #P268710, Penn Treaty Life Insurance Co. Issued in the name of the Decedent. 6. Prudential Life Insurance and Annuity Policies and corresponding documents: A. $5,000.00 Life Insurance Policy #73056383. Owner -Decedent. Insured - Janice M. Davis. Beneficiaries: (1) Decedent. (2) Mary I. Davis. Fully paid up policy. Issued in 1981. B. Annuity Contract #BR7099366 issued 10/13/83. Claim Settlement Certificate # DOY3800. Annuity Date and Settlement Date - 10/13/89. Monthly annuity payments to be made to the Decedent for life in the amount of $72.66. Beneficiary -Janice M. Davis. C. Life Insurance Policy #19549567. Primary Beneficiary -Janice M. Davis. Claim Settlement Certificate #ROS849439 - $4,077.07. Insured - Decedent. Payee -Decedent. Contingent Payee -Janice M. Davis. Settlement Date - 09/10/89. D. $1,000.00 Life Insurance Policy #17535232 issued 03/25/49. Fully paid up policy. Insured and Owner -Decedent. Primary Beneficiary -Janice M. Davis. E. Declaration of Lost Policy #M53-673-786. Declaration issued 05/05/78. Policy issued 10/10/60. $1,000.00 Life Insurance Policy insuring the life of Janice M. Davis. Beneficiaries -Richard N. and Mary I. Davis. 7. Deed of Jack T. Polk and Beverly J. Polk, his wife, to Richard N. Davis and Mary Ida Davis, his wife. Premises: 238 East Garfield Street, Shippensburg Borough, Cumberland County, PA. Dated 12/06/74. Recorded 12/18/74. Deed Book Vol. X-25, page 98. Deed corresponding Agreement of Sale + Certificate of Title Examination. 8. Dividend Certificate of Insurance #3775359, Combined Insurance Co. of America. Issued 10/30/68 under Policy #18662754 (PA Fire Police Association). Insured -Decedent. The policy issues coverage for: Extra Protection Accident Hospitalization and Indemnification. AARP Certificate of Insurance, The Prudential Insurance Co. Group Hospital Plan -Group Policy #G-36000-2. Account #24783051. Coverage effective 11/01/86. Insured -Decedent. 10. AARP's Certificate Rider for Recuperation Care, The Prudential Insurance Co. Account #24783051-1. Coverage effective 11/01/90. Insured -Decedent. 11. Lifetime Hunting License issued by the Commonwealth of Pennsylvania to the Decedent. 12. Sales Agency Contract of Richard N. and Mary I. Davis to Colonial Realty of Carlisle, PA. Premises: Cabin in Hopewell Township, Cumberland County, PA. Sale Price - $16,000.00. Contract dated 11/18/77. 13. Montgomery Ward Refund Check issued to the Decedent in November, 1955 - $ 0.07. 14. Cemetery Deed and Perpetual Care Certificate issued to the Decedent, Spring Hill Cemetery Association. 15. Original Last Will and Testament of Mary Ida Davis dated 07/15/66. 16. Deed of Richard N. Davis, Widower, to Richard N. Davis and Janice M. Davis, as Joint Tenants with the Right of Survivorship. Premises: 238 East Garfield Street, Shippensburg Borough, Cumberland County, PA. Dated 11/16/81. Recorded 11/18/81. Deed Book Vol. P-29, page 823. Consideration - $1.00. 2 17. Certificates of Deposit, M Est T Bank (or its predecessor, Dauphin Deposit Bank and Trust Company) -Registered in the names of the Decedent or Janice M. Davis: Certificate No. Issue Date Principal Amount 31003916125163 04/09/07 $13,000.00 31003918501634 05/29/08 $4,200.00 1982069 03/12/99 $1,500.34 8140246379 04/30/96 $2,000.00 8140227501 04/19/96 $2,000.00 18. 2 Certificates of Deposit, M &z T Bank (or its predecessor, Dauphin Deposit Bank and Trust Company) - Registered in the name of Janice M. Davis: Certificate No. Issue Date Principal Amount 8140878278 07/17/97 $1,500.00 065877 02/19/84 $1,000.00 19. 2 Certificates of Deposit, F &r M Trust- Registered in the names of the Decedent or Janice M. Davis: Certificate No. Issue Date Principal Amount 063395 10/28/97 $9,983.59 014-2956140 10/28/97 $1,573.79 20. 2 Certificates of Deposit, PNC Bank -Registered in the names of the Decedent or Janice M. Davis: Certificate No. Issue Date Principal Amount 31900024749 01/19/96 $5,900.00 31700030515 03/09/96 $11,313.96 21. $2,000.00 Demand Promissory Note issued on 12/13/73 by Richard N. Davis and Mary I. Davis to The Peoples National Bank of Shippensburg, PA -Paid in full on 04/14/75. 22. U. S. Currency: 100 $1.00 Dollar Bills. 3 $5.00 Dollar Bills. 1 $10.00 Dollar Bill. 3 23. U. S. Savings Bonds -Issued in the name of Janice M. Davis: Denomination Bond Number Issue Date $100.00 C630556203EE 12/97 $100.00 C2057870270E 09/78 24. U. S. Savings Bonds - Issued in the name of Richard N. Davis or Janice M. Davis: Denomination Bond Number Issue Date $100.00 C2057870251E 07/78 $100.00 C250562868E 01/78 $50.00 L2110904627E 04/78 $50.00 L2015286073E 01/76 $100.00 C266012124EE 12/90 $500.00 D2210425EE 05/82 25. U. S. Savings Bonds -Issued in the name of Richard N. Davis: Denomination Bond Number Issue Date $25.00 Q6019839528E 09/75 26. Series "E" U. S. Savings Bonds -Issued in the name of Richard N. Davis or Mary I. Davis: Denomination Bond Number Issue Date $75.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 K103651140E C224223403E C2100394949E C2080764658E C2054708834E C2003198185E C2007102212E C2003198157E C2003198150E C2007102356E C2007102258E C2007102391E C2024223377E C2024223385E C2100394965E 05/75 04/77 04/80 11/79 06/78 03/76 04/76 02/76 01/76 09/76 06/76 11/76 02/77 03/77 05/80 4 $100.00 C054708808E 07/78 $100.00 C2072343034E 11/78 $100.00 C2080764668E 11/79 $100.00 C2080764664E 11/79 $100.00 C2054708854E 08/78 $100.00 C2080764687E 01/80 $100.00 C2080764704E 03/80 $100.00 C2100394936E 04/80 $100.00 C2080764692E 02/80 $100.00 C2072343186E 07/79 $100.00 C2072343161E 05/79 $100.00 C2072343172E 06/79 $100.00 C2072343165E 05/79 $100.00 C2057043588E 03/79 $100.00 C2054708843E 07/78 $100.00 C2072343154E 04/79 $100.00 C2072343149E 04/79 $100.00 C2072343063E 01/79 $100.00 C2064032481E 08/79 $100.00 C2064032510E 10/78 $100.00 C2057043584E 03/79 $100.00 C2072343212E 09/79 $100.00 C2080764655E 10/79 $100.00 C2100406985E 05/80 $100.00 C2024223393E 03/77 $100.00 C2024223436E 06/77 $100.00 C2024223360E 01/77 $100.00 C2057043577E 03/79 $100.00 C2057043574E 02/79 $100.00 C2054708769E 03/78 $100.00 C2054708827E 05/78 $100.00 C2054708814E 04/78 $100.00 C2038453611E 06/77 $100.00 C2024223371E 02/77 $100.00 C2007102239E 05/76 $100.00 C2024223408E 04/77 $100.00 C2024223418E 05/77 $100.00 C2064032530E 10/78 $100.00 C2064032487E 08/78 $100.00 C2072343054E 12/78 $100.00 C2064032518E 10/78 $100.00 C2072343042E 12/78 $100.00 C2080764695E 02/80 $100.00 C2080764702E 03/80 $100.00 C2003198179E 03/76 $100.00 C2045688015E 12/77 $100.00 C2072343176E 06/79 5 $100.00 C2054708759E 02/78 $100.00 C2072343069E 02/79 $100.00 C2054708822E 05/78 $100.00 C2100394996E 05/80 $100.00 C2080764675E 12/79 $100.00 C2072343045E 01/79 $100.00 C2072343197E 08/79 $100.00 C2072343202E 08/79 $100.00 C2072343190E 07/79 $100.00 C2080764684E 01/80 $1,000.00 M103342988E 05/75 $1,000.00 M103342990E 05/75 27. Series "EE" U. S. Savings Bonds - Issued in the name of Richard N. Davis or Mary I. Davis: Denomination Bond Number Issue Date $100.00 C13306487EE 10/80 $100.00 C23061280EE 07/81 $100.00 C23061286EE 07/81 $100.00 C12857236EE 09/80 $100.00 C23025330EE 06/81 $100.00 C12857293EE 09/80 $100.00 C12857164EE 09/80 $100.00 C35132635EE 02/82 $100.00 C23061132EE 06/81 $100.00 C23025230EE 06/81 $100.00 C18960975EE 04/81 $100.00 C18960642EE 03/81 $100.00 C18960771EE 04/81 $100.00 C18786233EE 03/81 $100.00 C17402071EE 02/81 $100.00 C17402050EE 02/81 $100.00 C18786154EE 02/81 $100.00 C14708002EE 11/80 $100.00 C13306544EE 10/80 $100.00 C24415740EE 09/81 $100.00 C24415881EE 10/81 $100.00 C18786309EE 03/81 $100.00 C23061311EE 07/81 $100.00 C23081345EE 08/81 $100.00 C23025082EE 05/81 $100.00 C18960881EE 04/81 $100.00 C230251S9EE 05/81 $100.00 C23061177EE 07/81 6 $100.00 C18961021EE 05/81 $100.00 C18960735EE 04/81 $100.00 C24415969EE 10/81 $100.00 C24415715EE 09/81 $100.00 C24440440EE 10/81 $100.00 C24408817EE 08/81 $100.00 C24408900EE 08/81 $100.00 C13306482EE 10/80 $100.00 C14704906EE 11/80 28 Series "EE" U. S. Savings Bonds - Issued in the name of Richard N. Davis or Janice M. Davis: Denomination Bond Number Issue Date $200.00 R6098910EE 12/81 $100.00 C37268698EE 04/82 $100.00 C48854087EE 03/83 $100.00 C37302763EE 05/82 $100.00 C37302429EE 05/82 $100.00 C3S132799EE 02/82 $100.00 C35132589EE 02/82 $100.00 C38304461EE 07/82 $100.00 C48854088EE 03/83 $100.00 C28440786EE 11/81 $100.00 C48870730EE 04/83 $100.00 C28465159EE 12/81 $100.00 C4S730429EE 11/82 $100.00 C38304673EE 07/82 $100.00 C38304609EE 07/82 $100.00 C38047273EE 06/82 $100.00 C37302670EE 05/82 $100.00 C38304366EE 06/82 $100.00 C38304539EE 07/82 $100.00 C37268682EE 04/82 $100.00 C39025264EE 08/82 $100.00 C37025598EE 09/82 $100.00 C48870729EE 04/83 $100.00 C48820498EE 01/83 $100.00 C48820499EE 01/83 $100.00 C48870731EE 04/83 $100.00 C38047047EE 06/82 $100.00 C37268841EE 04/82 $100.00 C35162109EE 03/82 $100.00 C48820475EE 10/82 $100.00 C48820474EE 10/82 7 $100.00 C48820476EE 10/82 $100.00 C39025232EE 08/82 $100.00 C39003579EE 08/82 $100.00 C37268514EE 03/82 $100.00 C48870468EE 02/83 $100.00 C48887931EE 05/83 $100.00 C39025599EE 09/82 $100.00 C45730430EE 11/82 $100.00 C45730432EE 11/82 $100.00 C45730431EE 11/82 $100.00 C35130873EE 01/82 $100.00 C37302488EE OS/82 $100.00 C48887930EE OS/83 $100.00 C28440627EE 11/81 $100.00 C39025600EE 09/82 $100.00 C35162209EE 03/82 $100.00 C28465048EE 12/81 $100.00 C45768314EE 12/82 $100.00 C28440744EE 11/81 $100.00 C32759174EE 12/81 $100.00 C45768312EE 12/82 $100.00 C45768313EE 12/82 $100.00 C48870466EE 02/83 $100.00 C48854086EE 03/83 $100.00 C45768315EE 12/82 $100.00 C48870467EE 02/83 $100.00 C32759442EE OU82 8 ~~ Prudential 088459 >~ I~ ~ IMPORTANT TAX RETURN DOCUMENT ENCLOSED """`AUTO"SCH 5-DIGIT 17225 000000286/000088459 ~ RICHARD N DAVIS ~ 238 E GARFIELD ST ~ SHIPPENSBURG PA 17257-2034 ~ In~lllnrlnl~l~l~l~l~nl~~l~lll~nnll~~lnl~~ll~lnlrl~rl~l ~omputershare Computershare PO Box 43033 Providence Rhode Island 02940-3033 Within the US, Canada & Puerto Rico 800 3D5 9404 Outside the US, Canada & Puerto Rico 73Z 512 3782 www.computershare.com Holder Account Number 00004621875 I N D Record Date Nov 26 2007 Check Number 0003003427 SSN/TIN Certified Yes __ OO1CS0107.DOM[,NGfiOS POIYRUZ32449 39/088459/088459/i Prudential Financial,-Inc. -Combined Dividend Payment / 2007 Tax Form 1099-DIV Payment Date I Class Description I Participating I Dividend I Gross I Deduction I Deduction I Net ShareslUnits Rate Dividend ($) Amount ($) Type Dividend ($) 21 Dec 2007 COMMON 33 $1.15000 37.95 0.00 N/A 37.95 Year-To-Date Pald 37.95 0.00 37.95 46UTX P R U '~ 1 002CS70004 n ....: 5' s ris~ '~'. s ~~ ~ . ~`` :r ~~"' <.~ 61478 Form 1099-DIV (Keep for your records) Dividend Confirmation OORXBA(1) PLEASE CASHIDEPOSR THIS CHECK PROArPTLY. PRU: Historical Prices for PRUDENTIAL FINCL INC -Yahoo! Finance Page 1 of 2 Yahoo! My Yahoo! Mail More Malte Y! My Homepage New User? Sign Up Sign In Help _ _ ~,~.i .lC\..J~,~ rg ~"" ~ ~~ N As E ' Starch ~_ WEB SEARCH ~ 1 Dow ~ 0.56% Nasdaq '11' O.Slo~u Saturday, January 24, 2009, 11:36AM ET - U.S. Markets Closed. ~~ ~ET Quotes Finance Search Prudential Financial Inc. (PRU) on )an 23: 25.47 ~ 1.sz ~s.7s~io~ .. .. ,~ l a d AMEB~'tEiRADIe, ,:` t#ABV' ~ No maintAnan¢e fia®s~, OUTTAKES. x .t ~ ciaecK m Historical Prices SET DATE RANGE Get Historical Prices for: ADVERTISEMENT C: Daily Start Date: Aug ~~ 13 2008 2003an >., ~^ Weekly End Date: Aug :~ 23 ~ 2008 ' (' Monthly !' Dividends Only °Get Prices =` First ~ Prev ~ Next ~ Last PRICES Date Open High Low Close Volume Add Clase* 22-Aug-08 71.54 72.93 71.03 72.09 3,082,200 69.63 21-Aug-08 69.96 71.64 69.01 70.88 2,549,300 68.46 20-Aug-08 69.25 71.01 68.99 70.78 2,886,500 68.37 19-Aug-08 71.02 71.16 69.44 69.69 3,742,600 67.31 18-Aug-08 74.21 74.21 71.74 72.06 2,342,000 69.60 15-Aug-08 72.24 73.98 70.24 73.75 3,234,900 71.24 14-Aug-08 70.81 73.27 69.69 72.13 3,283,600 69.67 13-Aug-08 72.26 72.94 70.05 71.37 4,307,300 68.94 Close pri ce adjusted for divid ends and splits. First ~ Prev ~ Next ~ Last r~i Downloa d To SDre adsheet ~~delity t>'f'f ~E-~"S a full ~an~e of fixt~+d- ~~~~~ C~'lOIC~S. LFARPV MC?RE - ;z;: !~ Add to Portfolio '~ Set Alert o Email to a Friend Get Historical Prices for Another Symbol: r-,~4,:1 Symbol Lookup • Stock Screener S tits http://finance.yahoo.com/q/hp?s=PRU&a=07&b=13&c=2008&d=07&e=23&2008&g=d 1/24/2009 PRU: Historical Prices for PRUDENTIAL FINCL INC -Yahoo! Finance Page 1 of 2 Yahoo! My Yahoo! Mail More Make Y! My Homepage New User? Sign llp Sign In Help ~~~oc~rrs F1IVANCE search _ I WEB SEARCH DOW j 0.56°/a Nasdaq t 0.81% Saturday, January 24, 2009, 11:37AM ET • U.S. Markets Closed. Finance Search Prudential Financial Inc. (PRU) ~] A~ERITNAD@. ~. NO rtlbtlltbrla[1Cb fe~8. i j ~ E~TIRAC I i i ~__ ~~~~ EygTRRDE SECURITIES LLC l,? Historical Prices SET DATE RANGE on ]an 23: 25.47 t 1.62 (6.79%) t~- ~ r s, `r Get Historical Prices for: ~- GO ADVERTISEMENT ~° C' Daily Start Date: Jul +` 1' 2008 zoo3an 1, ~- Weekly End Date: Sep ~ 30 2008 r Monthly r Dividends Only Get Prices Dividend data is unavailable for the specified date range. ,~l~il~l~~,~/. ,.< ~u{ t ~~ ~r ,.~. +V~~F4 .'1„ V ~ ~a a11# #o trade life d pra? ~ Add to Portfolio ~' t Alert ~ Email to a Friend Get Historical Prices for Another Symbol: r` G~ Symbol Lookup • Stock Screener SDIIt I 6ET 9tJIfaT~S http://finance.yahoo.com/q/hp?s=PRU&a=06&b=1&c=2008&d=08&e=30&2008&g=v 1/24/2009 Calculated Value of Your Paper Savings Bond(s) http://www. treasurydirect.gov/B C/SBCPrice Calculated Value of Your Paper Savings Bond(s) Registered in Richard N_ lXavis only Listing No. 25 Calculator Results for Redemption Date 08/2008 Total Price Total Value Total Interest YTD Interest $18.75 $133.15 $114.40 $0.00 Bonds: 1-1 of 1 Serial # Series Denom Issue Next Final Issue Interest Date Accrual Maturity. Price Interest Rate Value Note Q6019839528E E $25 09/1975 ~ 09/2005 $18.75 $114 40 $133 15 MA Notes NI ;Not Issued _.. _ __ NE ;Not eligible for payment P5 Includes 3 month interest penalty _ __. MA Matured and not earnin interest Totals for 1 Bonds ~ $18 75 ~ $114 40 $133.15. I l of l 10/21/2008 10:46 AM Calculated Value of Your Paper Savings Bond(s) Calculated Value of Your Paper Savings Bond(s) Registered in Richard N. Davis or Mary I. Davis Listing No. 26 Calculator Results for Redemption Date 08/2008 http://www.treasurydirect.gov/B C/SB CPrice Total Price Total Value Total Interest YTD Interest $6,881.25 $43 471 49 $36 590 24 $560.88 Bonds: 1-74 of 74 Serial # Series Denom Issue Next Final Date Accrual Maturity Issue Price Interest Interest Rate Value Note M103342990; E $1000 05/1975:._. ~ 05/2005;_. _$750.00:. ,$4,563,20: $5,31 3.20_ MA M103342988E E $11000 05/1975= 05/2005 $750:00' . $4,563.20; _ . $5,313.20 _ MA 02080764684E E $10.0, O1/1980_O1J2009' 0.1[2010 _ _ $75.00__, $341,.96;. _ _ 4.00%~ $416.96; 02072343190E C 0 E ~ $100; 07/1979_:.01/2009 07/2009•,_ _ $75.00 _$346.32 4.00% $421.32. 2 72343202E. E ; $100 08/1979 02/2009: 08/2009: - __ $75.00 . _$346.32~ 4.00% $421.32_ 02072343197E _ E_ _ ; $100; 08/1979 ' 02/2009T 08/2009_;_ $75.OOT $346.32 _ 4.0 0 % ; _ $42 1 .32; _ C2072343045E_ E $100' 01/1979_; 0.1/2009,',01/2009;. _ __ 75.00 _$ _ _ r _ _ $349.64 ' . _ _ o~ '~ 4.00 /o _ . __ -~ $424.64: _ C2080764675E' E ! _ $100 1.2/1979: 12/2008. 12/2009:__ _ 75.00; _ $ _ __ 341.96 _$ _ _ 4.00%; _ $416.96; _ C2100394996E_ E_ _ $100 05f 1980. 11/2008_ 0.5/2010 ` _ _ , $75.00 ~ __ _ _ _ $337.96; _ 4.00%_ _ __ X412.96_ C2054708822Ez E _ $100,05/1978;_. 05%2008•. ,_ 75^00 $ _ , ._,.$351.68 _ _ _ . _ $426.688 _ _ _ MA C2072343069E; E $100 02/1979:02/2009.• 02/2009 $75.00,; _ _ _ $349.64, .__. •, __ , 4.00% _ $424.64; . 02054708759E C2 E $10002/1978__ _ .02/2008'_ _ $75.00.: $438.80; . _ _ _ $51 3.80: MA 072343176E' E $100; 06/1979; 12/2008: 06/2009'_ _ $75.00 $346.32. 4.00% _ , $421.32 02045688015E ~ ' E $100 ; 12/1977 _ 12/2007 _ _ _ $75.00_ $438.80 ; . $513.80 MA C2003198179E: E $100 03/1976 03/2006, $75.00 _ $464.04' _ _ $539.04 MA 02080764702E E ~ $100.03/1980, 09/2008103%2010 ~ _ $75.00" __ _ _ _$333.80 4.00%_ $408.80 02080764695E ~ E _ $100 ; 02/ 1980; 02/2009 ~ 02f 2010T _ _ _ _$75.00 ' _ _ _ _ $,34l.96 _ _ 4.00% ~ _ $416.96 C2072343042E;_ E_,_; , $_100 ,12/1978_;_12/2008__ 12/2008., _ _ $75.00 µ _ $349.60; _ 4.00% _ _ $424.60 _ C2064032518E: 7 E $100, 10/1978: 1.0/2008,, 10/2008; _ $75.00; _ $344.48;_ _. _4.00%~__ $419.48r _ _ C20 2343054E. C2 E _ $100. 12/1978 ,12/2008,; 12/2008 $75.00 $349.60_ ,4.0 0°/a $424.60; 06032487E; E __ $100 08/1978:_ _ _ ;_08/2008,_ _ X75.00_, _ $352.88 , "„ $427.88 MA C2064032530E, ' E $100.10/1978;,10/2008;_10/2008] _ $75.00 __ _ $344.48 4.00% _ $419.48 _ C2024223418E E $100.05/1977, '05/2007 $75.00.;_ _$482.60; . _ ~ _ $557.60 MA 02024223408E E $100:04%1977: 04/2007 75.00: $ _ $477..16 • _ _ $552.16 MA 02007102239E E _ $100.05/1976: _ _:05/2006:,.__. ,.._$75.00_ ,.,,. ,$469 . 16, $544.16 MA 02024223371E: ..;~ C2038 536 1E E E $100.02/1977; _ 02/2007, . , $75.00. . _ _ _$477.16 _ .~.... __ $552.16: MA 4 1 ; 02054708814E ..~ ~E _ $100 06/1977 " j 06/2007:_ $100; 04%1978 04/2008 $75,OQ; __ $75 00 $483.,80_. $359 16 $558.80;__ 434 6 MA C2054708827E' E _ •, _ _ ___ - $100; 05/1978.;_ _ ~ 05%2008 __,• . ; __._ $75.00,_ _ __ ._ _ _ $351.68 ~ __ _. y __$ .1 $426.68 ~ MA MA C2054708769E~ ;._ E ~ _ $100 03/1978;__ •03/2008; - -~ $75.00 __ _ ._$359.16,_ _ _ _ _ _ . $434.16 M A C2057043574E' _ 0 E $100 02/1979 02/2009.; 02/2009; _ $75 00;__ _ $349.64_; ______ _ __ _4.00%~ _ $424.64 _ _ 02057 43577E' E $100'03/1979'.09/2008;03/2009;__ _ __$75.00___ _ _$,34132_x_ ._ 4.00%? __ ~41§.32 ___ 02024223360 _ E _ $100.0.1/1977 ~ _ x01%2007; _ _ , _ _ __$75.00;__. __$477.16; _ __ ~' $552.16, MA 02024223436E; E _ ~ $100 06/1977` _ _ ; 06/2007; . _ $75,00 ".__ __ _•_$483:80; ______, _ _ _ ,, _ _ Sb58.80 MA 02024223393E E $100 03/1977 ~ 03/2007 $75 00~ . _ $477 16_'.. __ _ ._ _ ~ __ ,._ $652.16 MA 02100406985E E $100 05/1980 11/2008 05/2010, $75 00 • $•337 96; 4.00% . $412.96 02080764655E E $100'_10/1979}10/2008;_,10/2009 _ $75.00,1 $338.08 : , _ 4.00%~ $41 3.08 : 02072343212E E $100.09/1979'09/2008' 09/2009; $75.00 _ $338.08 __ 4.00%' . _ _ $413.08: 02057043584E E $100' 03/1979: _09/2008;_03/2009,___ _$75.00'_ _ $341.32; 4.00%~ $416.32; 02064032510E; E $100. 10/1978;, 10/2008.;_ 10/2008; __ $75.00; _ _$344 48! 4 00%; __ $419.48; 02064032481E ; _ E $100 , 08/1979 ; 02/2009_; 08/2009 ~ _ _ _ $75.00; . _ _ _$346 32 _ ._ 4.00% j , $421.32 t 02072343063E: E _ $100; 01/1979; 01/2009; 01/2009; $75 00~ $349 64j _ _ . 4.00%0, _ $424.64 _ C2072343149E~ E ~ $100r04/1979~ 10/2008, 04/2009; $75 00_ _ $341 32; _ 4.00% . • _ $416 32 , 02072343.154E E $100 04/1979. 10/2008,04/2009 $75 00: _ $341 32- _ _ 4.00% . $416.32 C2054708843E; E $100_;07/1978'.._ 07/2008 _ - _$75.00;_._ _ _ __$35288 ; $427.88 MA C2057043588E. _ E ' _ $100: 03/1979 09/2008:.03/2009; $75.00: _ _$341 32 `. _ .,_. _ 4.00%' _ _ _ $416.32 ; C2072343165E~ E ~; $100 05/1979'11/2008:05/2009 $75 00 _ _ $345 36' _ _ 4 00% _ $420.36 of 2 10/21/2008 1:45 PM Calculated Value of Your Paper Savings Bond(s) http://www.treasurydirect.gov/BC/SBCPrice C2072343172E 2 ~ E $100.06/1979' 12/2008; 06/2009; $75.00; _ $346.32, 4 .00% ; $421.32 ; C 072343.161E ~ $100, 05/1979; 11/2008 05/2009' $75.00, $345.36 _ . _ 4.00% $420.36; C2072343186E ~ C2080764692E E $100 07/1979 01/2009 , 07/2009,; $100 02/1980 ~ 02/2009 02/2010 : $75.00 $75 00 _ $346.32 ,' 3 _ 4.00% ~ _ $421.32 C2100394936E C20 76470 E ~ ; . $100 04/1980::10/20,08' 04/2010_; 00 0 980 . ; $75..00 .$ 41.96 _$333.80 4.00%; 4.00%0.: $416.96_ $408.80 80 4E' 0 E $1 , 3/1 : 09/2008 _.03%2010', ' $75.00: $333.80' 4.00%: $408.80: C2 80764687E E $100 _01/1980.; 01/2009 '_01%2010._ . $7 5.00 _ - $341.96: _ _ 4.00%' $416.96: 02054708854E - E $100 , 08/1978 ; _ _ .,08/2008 ~. . $75.00 _ _ _ ,. _ $352.88 _ _ . ; _ , . _ _ . _ _ $427 88 _ _ MA 02080764664E E $100 11/1979 _11/2008 11/2009 , _ _ $75.00 ~ . _ _ _ $341.96 ~ _ 4.00% ~ _ . , $416.96 02080764668E' 2 ' E _ $100; 11/1979,_11/2008.11/2009; $7.5,_00 $341.96; _ _ 4.00% ~ _ _ $416.96_ _ C207 343034E E $100' 11/1978._.11/2008 11/2008 _ $75.00 _ $348.44 _ _ 4.00% ' _ $423.44 _ C054708808E- E $100; 07/1978; ; 07/2008: $75.00. 352.88: $- _ _ $427.88' _ MA C2100394965E. E $100 05/1980:11/2008.05/2010' $75._00 -. - - , $337.96; 4.00%. $412.96 : 02024223385E E $100, 03/1977; _ , 03/2007.: $75.00 $477.16 _ $652.16 MA C2024223377E; E $100.02/1977 02/2007 $75.00 $477.16 _ . $552.16 MA 02007102391E E $100; 11/1976.- _ 1.1/2006_ _$75.00 ; $475.60_; _ $550.60 MA 02007102258E 02007102356E E E $100 06%1976:- ' 06/2006;_ _ $100.09/1976 09/2006 _ $75.00 $75.00 _ . _ $470.36; $470 28 _ $846.36 545 MA 02003198150E 0 8 E_ $100, 0.1/1976,__ 01/2006;. _ _ - $75.00- _ _._ . T _$464.04: __ _ „__ $ .28 $539.04: _M9_ MA C20 319 157E._ 1 E $100' 02/1976 02/2006; $75.00: $464.04 $539.041 MA 02007 02212E 5 E $100:04/1976;_, 04/2006. --_, _ _ $75 00 _ _$464.04_ . $539.04 _ MA 0200319818 E _ _ _ E $100 ~ 03/1976;, ,.03/2006. _ $75.00 ~ $464.04 j ~ - $839.04 - MA 02054708834E E $100 06/1978.. _ , 06/2008;_ _. ._ _ $75.00; _ _ X352.76 _ _ _ _ X427.761 _ MA 02080764658E E $100'11/1979;1,1/2008;11/2009_ $75 00 _ $341 .96 . __ - o 4.00 /o ~ _ $416.96 : - 21.00394949E E $100.04/1980 10/2008_:04/2010 $75.00 _ _ _$333.80 4.00% _ $408.80 ~ C224223403E' E $100'04/1977 04/2007:_, ,$75..00 _ $477.16 $552.16 MA K103651140E ___ E $75.05/1975._ 05J2005;_ ~ $56.,25 _ __ _$342..24 X398.49 MA Totals for 74 Bonds $6 881 25 ~ $ 36,590.24 ; $43,471.49 Notes NI :Not Issued NE ;Not eligible for payment. _ _ __ __ -- P5 Includes 3 month interest penalty. _ _. MA Matured and not earnin interest I? of 2 10/21/2008 1:45 PM t;atcu~atea value or r our raper aavings tsona~s~ Calculated Value of Your Paper Savings Bond(s) Registered in Richard N. Denis or Mary I. Diavis Listiog No. 27 Calculator Results for Redemption Date 08/2008 Total Price Total Value Total Interest $1,850.00 $10,042.40 $8,192.40 of 2 Bonds: 1-37 of 37 uupa/ w w w. trca~tu yuu ccl.gu vi n~.i on~.r i tcc YTD Interest $252.64 Notes NI .Not Issued NE Not eligible for payment P5 Includes. 3 month interest enalty Serial # Series Denom Issue Next Final Issue Interest Date Accrual Maturity Price Interest Rate Value Note C14704906EE, EE $.100 11/19.80; 11/2008 11/2010'. _ $50.00' $227.92 4.00%~ $277,82' C13306482EE EE $100 10/1980;10/2008 10/2010 ``-' C24408900EE- EE $50.00; $253.24 4.00% $303.24; $100: 08/1981.02/2009; 08/2011; $50.00; $210.88: .4.00%' $260.88 -_ C24408817EE' EE $100 08/1981: 02/2009 08/2011, _ $50.00' $210.88_ _ 4.00%• _ _$260.88 C24440440EE EE $100 10/1981,10/2008:10/2011: $50.00 0 ~-- '- C24415715EE EE - , . _ $?05.76 ~ 4.00 /o ; _ $255_.76 _ ., _ _ _ $100 , 09/1981.09/2008 ,_ 09/2011,', - __ _ _ .,$50.00 ; _, ., _ $205.,76 4.00%; . _ $255 76 , - _,_. . 9EE~ EE $100 10/1981'10/2008110/2011; ~ ' „ $50.00:,,,_ _ $205.76; 4.00%;_ X255 76; C18960735EE EE _ ... $10004/1981; 10/2008 04/2011' _ $50.00; _ _ $222.48 4.00%~ _ $272 4g _ C18961021EE' EE $100; 05/1981' 11/2008x 05/2011. $50.00' _ $210.88 4.00%' _ $260.88' _ - ~- C23061177EE EE $100 07%1981!01/2009 07/2011 - - C23025159EE' EE - ._$50.00' $210.88 4.00%~ $260 88 $100 05/1981; 11/2008. 05/2011.- $50.00 $210.88 _4.00%_~ $260.88 C18960881EE EE $100':04/1981; 10/2008, 04/2011 $50.00: _ $222.48 4.00% $272.48 C23025082EE EE $100.:05/198111/2008 05/2011: - - - $50.00 _ $210.88;_ 4.00%, _ $260.88' C23081345EE EE $100 08/1981 ~ 02/2009 ~ 08/2011; $50.00 ~ _ _$210..88 4.00%' $260.88 - - _. _-._ C23061311EE; EE _, $100 07/1981;01/2009' 07/2011 -- -~ - -` -- C18786309EE; EE • ---- _..._ $50.00 _ $210.88 4.00% $260.88 _ $100'03/1981'09/200803/2011:,_- -$50.004._._.,$222.48,_,._4.00% ,_$272.48 C24415881EE:_EE $100 10/1981 10/2008 10/2011 0 "- . _ _ ,. _ _ _ „ _ _ _ _ $50.00 ~ . " $205.76 4.00 %' $255.76: C24415740EE EE $100'09/1981'09/2008_09/2011; o"~ - ' C13306544EE EE "- - _. __..$50.00; _ $205.76 4.00 /o: $255.76; $1.00 10/1980.10/200810/2010 - - ._,.,._$50.00;__,_$253.24 4.00%. __ $303.24 C14708002EE EE $100 11/1980 11/2008 11/2010 - -- C18786154EE- EE _ __$50.00,... $227.92, 4.00% . $277.92; ,.. $_100 02/1981; 02/2009. 02/2011 ' X50.00 _ $227.92 4.00% _ , C17402050EE EE $100 02/1981:.02/2009: 02/2011 "" --- o $27792' _ _ _ _ 50_._0.0 $227.92 4.00 /o $277.92; C17402071EE' EE _$100 02/1981 02/200902/2011: ~~ C18786233EE EE ~ - - $50.00 $227.92: 4.00%: $277.92; _ $100; 03/1981 _09/2008 ~ 03/2011 _ _ $50.00;_ _ _ $222.48' 4.00%; C18960771EE EE $100 04/1981.10/2008;_04/20.11 `""-" $272.48` - C18960642EE ~ EE . _ . _. _ $50.00' _ . $222.48..; _ _ 4.00%; _ ,.$272.48'. $100;03/1981;09/2008;03/20,11• • - _ . _ _„$50.00, _ $222.48: 4.00%;_„ . $272.48. C18960975EE; EE_ ~_ $100: 04/1981; 10/2008'04/2011 • ....... $50.00 ___ $222 48, __4.00%, _ $272.48. C23025230EE EE ~ `" ~" _ $100 06/1981 ` 12/2008 ~ 06/2011;_ _ $50.00 ~ _ $210 88 ~ 4.00% ~ _ $260.88_ C23061132EE EE $100:06/1981x12/2008' 06/2011T_ __ $50.00 $210.88'_ 4.00%' $260.88, __... C35132635EE EE $100 02/1982:02/2009 02/2012; X50.00 $205.76; 4.00% ; .- .......$255.76 C12857164EE EE ~ - $100;09/1980;09/2008. 09/2010 _$50.00'. $253 24~ 4.00%~ _ $303.24- C12857293EE EE $_100 09/1980; 09/2008;_ 09/2010' _ _$50.00 ~ _ _ $253 24.' 4.00%;_ $303.24' C23025330EE _ EE - - - - - _ __. _ . $100 06/1981'12/2008 06_/2011- _ $50.00; $210.88 4.00% $260.88 C12857236EE EE ___ $100 09/1980;09/2008; 09/2010; $50.00 $253.24; ..4.00%' $303.24:. C23061286EE EE $100 07/1981; 01/2009 ~ 07/2011: $50.00. $210.88: 4.00%' $260.88; C23061280EE; EE ~ $100 07/1981'01/2009; 07/2011; .50.00, $210 88' 4.00%; $260.881 C13306487EE, EE - _ _____._ ...__ _ . - . $100 10/1980, 10/2008; .10/2010 ~ $50.00 $253 24 4.00% $303.24;_ _ _ Totals for 37 Bonds $1,850.00 $8,192.40 $10,042.40 :. 10/23/2008 10:02 AM Kelley Blue Book -Private Party Pricing Report -Chevrolet, Impala -Official Kelley Blu. K~ileY Niue ~ THE TBUSTEt3 RESQURCE ..._.~,.~~..._._.,__.... _... iirb.c•i• 2004 Chevrolet Impala Sedan 4D g1.UE 8aQ1(~ PRIY~dTE PARTY'VALUE Condition Value Excellent $8,445 Good $7,895 (Selected) Fair $7,195 :vehicle Highlights ;Mileage: 25,000 'Engine: V6 3.4 Liter Transmission: Automatic Drivetrain: FWD iSelected Equipment :Standard 'Air Conditioning Tilt Wheel Dual Front Air Bags 'Power Steering Cruise Control Alloy Wheels ;Power Windows AM/FM Stereo :Power Door Locks Single Compact Disc Blue Book Private Party Value Private Party Value is what a buyer can expect to pay when buying a used car from a private party. The Private Party Value assumes the vehicle is sold "As Is" and carries no warranty (other than the continuing factory warranty). The final sale price may vary depending on the vehicle's actual condition and local market conditions. This value may also be used to derive Falr Market Value for Insurance and vehicle donation purposes. _. _ __ __ ....,. Vehicle Condition Ratings Excellent ~~ $8,445 • Looks new, is in excellent mechanical condltion and needs no reconditioning. • Never had any paint or body work and is free of rust. • Clean title history and will pass a smog and safety inspection. • Engine compartment is clean, wlth no fluid leaks and is free of any wear or visible defects. • Complete and verifiable service records. Less than 5% of all used vehicles fall into this category. GOOd (Selected) Page 1 of 2 Send to Printer http://www.kbb.com/KBB/LTsedCars/PricingReport.aspx?WebCategoryId=3 8&Yearld=2... 10/13/2008 _. ..... .... .. __ _ __ advertisement Close Window Kelley Blue Book -Private Party Pricing Report -Chevrolet, Impala -Official Kelley Blu... Page 2 of 2 $7,895 • Free of any major defects. • Clean title history, the paints, body, and interior have only minor (if any) blemishes, and there are no major mechanical problems. • Little or no rust on this vehicle. • Tires match and have substantial tread wear left. • A "good" vehicle will need some reconditioning to be sold at retail. Most consumer owned vehicles fall into this category. Fair $7,195 • Some mechanical or cosmetic defects and needs servicing but is still in reasonable running condition. • Clean title history, the paint, body and/or interior need work performed by a professional. • Tires may need to be replaced. • There may be some repairable rust damage. Poor ~" , ; ~. NSA • Severe mechanical and/or cosmetic defects and is in poor running condition. • May have problems that cannot be readily fixed such as a damaged frame or crusted-through body. • Branded title (salvage, flood, etc.) or unsubstantiated mileage. Kelley Blue Book does not attempt to report a value on a "poor" vehicle because the value of these vehicles varies greatly. A vehicle in poor condition may require an independent appraisal to determine its value. * Pennsylvania 10/13/2008 http://www.kbb. com/KBB/UsedCars/PricingReport. aspx?WebCategoryId=3 8&Yearld=2... 10/ 13/2008 p~~ 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Phone (888) 502-4349 Fax (302)934-2955 October 27, 2008 Elinor Albright Rebert Attorney At Law 515 Carlisle Street Hanover, Pennsylvania 17331 Re: Estate of Richard N Dctvis Social Security: 207-22-1884 Date of Death: August 18, 2008 Dear Sir or Madam: Per your inquiry dated October 22, 2008 , please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 97204072 Ownership (Names o~ Richard N Davis Opening Date 1/28/80 Balance on Date of Death $ 2, 322, SI Accrued Interest $ 0.07 Total - ----------------------------------- ------------------- -- $ 2, 322.58 -- ------- ------------------- 2. Type of Account Account Number Ownership (Names o~ Opening Date Balance on Date of Death Accrued Interest Total Savings Accound Passbook 21000001218040 Richard N Davis 1/2/70 Closed 9/4/08 $1,574.59 $ 0.31 $ 1,574.90 3. Type of Account Account Number Ownership (Names o~ Opening Date Balance on Date of Death Accrzzed Interest Total 4. Type ofAccozmt Account Number Ownership (Names ofJ Opening Date Balance on Date of Death Accrued Interest Total 5. Type of Account Account Number Ownership (Names ofJ Opening Date Balance on Date of Death Accrued Interest Total 6. Type of Account Account Number Ownership (Names ofJ Opening Date Balance on Date of Death Accrzzed Interest Total Certificate of Deposit 31003913794292 Janice MDavis* Richard N Davis 3/12/99 $1,964.68 $ 3.45 ----------------------------------- $ 1,968.13 Certificate of Deposit 31003914492580 Janice M Davis Richard N Davis 5/6/96 $ 1,301.94 $ 3.42 _. $ 1.305.36 Certificate of Deposit 31003919516819 Janice MDavis* Richard N Davis 9/19/96 $ 2, 616.98 $ 9.61 . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . . $ 2, 626.09 Certificate of Deposit 31003919517982 Janice M Davis Richard N Davis 9/30/96 $ 2, 609.17 $ 7.81 ----------------------------- $ 2,611.98 7. Type of Account Certificate of Deposit Account Number 31003916125163 Ownership (Names o~ Janice MDavis* Richard N Davis Opening Date 4/9/07 Closed 9/4/08 Balance on Date of Death $13, 720.99 Accrued Interest $ 7.54 Total ..................................................................................................................... $ 13, 728. S3 _..........._ ........................_... 8. Type of Account . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . _ . . . .. . . .. . . .. . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . Certificate of Deposit Account Nuttzber 31003918501634 Ownership (Nantes o~ Janice MDavis* Richard N Davis Opening Date 5/29/08 Balance on Date of Death $ 4, 217 37 Accrued Interest $ 5.71 Total $ =1,223.08 9. Type of Account . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . . .. . Safe Deposit Box Box Number/Location 0000089/ Walnut Bottom Ownership (Nantes o~ Richard N Davis Janice MDavis Opening Date (/26/96 * If upon reviewing the information above, you believe there are 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 Walnut Bottom Office # 717-532-2414. Sincerely, ,~lJA Ctn. ~C'Z'ryL.s~...~-~ Tracie Hare Records Management Elinor Albright Rebert 515 Carlisle Street Hanover, PA 17331 RE: Estate of Richard N Davis To ~'Jhom It May Concern: October 28, 2008 I am writing in regards to your request for date of death values on the above referenced member. This account was owned individually. Account 1473060 Date of Death Principal Accrued Interest to DOD Prime Share (00) $1,194.66 $0.82 If you have any questions with regard to the above balances, or need additional information, please contact a Membership Officer at 717-263-4444. Sincerely, Patriot Federal Credit Union 800 Wayne Avenue, Chambersburg, PA * (717) 263-4444 * Mailing Address: P.O. Box 778, Chambersburg, PA 17201-0778 f01-BT-Warranty Ded, Short Pbrm. Aat of 1808. Single Sheet. Hurry Hall, Ina., Indiana, Pa. RECOfiAE^. ;r- Di cue CUHBE~iL"+h~] vU~NTY ?F.NkSYLYANIA ~ ~OV ( 8 ( 03 ~~ t 8 ~~ ~~~ da of ~4C^ tC'l'L~''L' MADE THE y ~' in the year of our Lord one thousand nine hundred eighty-one (1981) BETWEEN RICHARD N. DAVIS, widower and single man, of 238 East Garfield Street, Shippensburg, Pennsylvania, hereinafter called the Grantor and RICIiARD N. DAVIS, widower and single man, and JANICE M. DAVIS, as point tenants with right of survivorship, both of 238 East Garfield Street, Shippensburg, Pennsylvania, hereinafter called the Grantees , WITNESSETH, that in consideration of ONE DOLLAR ($1.00)_________________________________ --------------------------------------------------------------- - Dollars, in hand paid, the receipt whereof is hereby acknowledged, the said grantor do ea hereby grant and convey to the said grantees their heirs and assigns, ALL that certain lot of ground with dwelling house erected thereon, situate on the South side of East Garfield"Street, in the Borough of Shippensburg, Cumberland County, Pennsylvania, bounded 'and described as follows: ON the North by Garfield StYe~'t; on the East by Lot No. 19, now or formerly of Ronald J. Ordway; on the Soutfi by a fourteen (14) foot alley; on the West by Lot No. 17, now or formerly of Samuel J. Furry, Jr. BEING known as-Lot No. 18, and having a frontage on Garfield Street of thirty two (32) feet and from curb on Garfield Street extending at an even width to the said alley in the rear one hulidred sixty-seven (167) .feet. BEING the same which Jack T. Polk and Beverly J. Polk, his wife., by their deed dated December 6, 1974, and recorded in the Office of the Recorder of Deeds, in and for Cumberland County, Pennsylvania, in Deed Book "X", Volume 25, at Page 98, conveyed to Richard N. Davis and Mary IdA Davis, his wife; and the said Mary Ida Davis passed away on .October 24, 1981, thereby vesting her entire fee in Richard 1~. Davis, the Grantor herein. THIS IS 14 CONVEYANCE FROM PARENT TO PARENT AND CHI,IrD,;; - ' AhID the said grantor hereby covenant a and agree sthat they and each of them will warrant generally the property hereby conveyed. BODK~',~ i'iuc :.~ IN WITNESS WHEREOF, said grantor ha s .hereunto set his hand and seal the day and year first above written. ~~ (ii$neD, ~eakD.gnD ~eliUSraD •~ - •---- =-~•.~---/xy--.~?'~'~.~.._._._.,_.. smar. Richard IJ. avia in tl}s ~seswuc of l~ _-_ _. - ____-_-_~__.__~---------------------. sss~r. ----__~~~~_.__..__~.-------.._._. sm~ `^V V State of PENNSYLVANIA ss. /- . " County of CUMBERLAND /lGLZUjyH.~GLI~ On this, the ~6 ,~~, day of 1961 ,before me, a Notary Public in and for said County and State the undersigned officer, personally appeared Richard N. Davis known to ma (or satisfactorily proven) to be tho person whose nam• is subscribed to.ftre'~%'I in instrument, and acknowledged that he executed same for the purposes therein c(ir~i b~cf3d; IN WITNESS WHEREOF, I hereunto set my hand and ofRcial seal. ~ / li'~ ;.•a~la £~,~.. the within nomad grantee is .b s+ 3 b 3 H sTi A z ~ moo H M FG W Shippensburq, PA Cumberland County Title of Of[t~gr~3 ;' •.~ S ~~ S~/ '•. O '~~.~ ._~y, ~,W. '.`~; . ~. Q has do hereby certify that The precise residence and complete post oft-ca addresf 238 East Garfield Street, Shippensburg, PA 17257 19 81 ~ G --r.---.____...... ~~._..~~~~... Attorney for ......~`~~- ---...------------._.. E m vi H q d at q w 0 ~ ~ 'ob 0 ~z.H ,y ~ Ci ~ Vl Fa C ral z m "~ ~ ~aa W N M~j O1 I~ COMMONWEALTH PENNSYLVANIA ~~~jj~~ ~~, ~ ss. County of _._ . - l.~GI.CrLLI..I.~ RECORDED on this __....._~9_._....._. _._....__.__. J ~(~/rJ_~ .. day of ....... _._. --- A. D. 19.~/_...., in the Recorder's office of the said County, in Deed-. Book/ Vol. ......___.-, Page --...._.. Given under my hand and the seal of~fhe said~~office, tha dctp`above writteh. ....._._.__••-•-~-~.~. ....-~c•-• t i-1~~~y; Re,Eorder. a H Page 1 of 2 Metropolitan Regional Information Systems, Inc o9-May-2009 Residential CMA Pricing Analysis 7:47 pm Subject rt ~ ,''r 218 E GARFIELD ST SHIPPENSBURG, PA 17257 Comparable 1 ~ 1~ 118 FAYETTE SHIPPENSBURG Ad' Comparable 2 --- - t ~y 223 ORANGE ST E SHIPPENSBURG Ad' Comparable 3 No Photo Available 144 ORANGE ST W SHIPPENSBURG Ad' MLS#: B 77 1 1 7 7 List/Rent Price 79 900 0 84 900 0 99 500 0 Sold Price 0 0 80 000 0 Status ACTIVE 0 CONTRACT 0 SOLD 0 Leg Subdivison 0 0 0 Contract Date 0 26-A r-2009 0 25-Se -2008 0 Settled Date 01-Ma -2009 05-Nov-2008 DOMM 191 0 106 88 0 Total Assessed $0 0 0 0 $0 0 Lot Size (Sgft) 636.6 7,500 0 9,147 0 13,503 0 FinSQFTAG 1344 1,216 0 1,630 0 1,504 0 Unfin SQFT AG 0 0 0 Style Traditional 0 Other 0 Traditional 0 Type 2 Story Detached 0 Detached 0 Detached 0 Year Built 1900 1940 0 1900 0 1900 0 Exterior Constr Vynl siding Other 0 Other p Vinyl Siding p Total Bedrooms 4 3 0 3 0 3 0 Full Baths 1 1 0 1 0 1 0 Half Baths 1 0 0 0 # of Garage Spac 1 1 0 0 1 0 # of Carport Spa 0 0 0 # of Assigned Spa 0 0 0 Basement Type Unfinished artial,Unfinished,Walkout Level 0 Unfinished 0 Partial p # of Fireplaces 0 0 0 0 0 0 Heat System Hot Water Baseboard p Forced Air 0 Hot Water 0 Heat Fuel Oil Electric,0il 0 Natural Gas 0 Natural Gas 0 Cooling System None p None 0 None 0 Cooling Fuel Syste None 0 None 0 Natural Gas,None 0 Exterior Features Porch Porch-front,Porch-rear 0 0 0 Property Cond Average ;rized,Fixer-Upper,Needs work 0 As-is condition 0 0 Seller Subsidy 0 0 0 0 0 0 0 0 0 0 0 Total Adj $0 $0 $0 Total Adj. Value $ 79 900 84 900 80 000 Courtesy of: Harold Best Copyright (c) 2009 Metropolitan Regional Information Systems, Inc. Home: (717) 532-4600 Office: (717) 532-2814 Information Is believed to be accurate, but should not be relied upon without verification. Cell: (717) 816-4600 Email: haroldbest@comcast.net Accuracy of square footage, lot size and other information Is not guaranteed. Company: Hale Real Estate Office: (717) 532-2814 Fax: (717) 532-5463 COMPETITIVE MARKET ANALYSIS DISCLOSURE: This analysis is not an appraisal. It Is intended only for the purpose of assisting buyers or sellers or prospective buyers or sellers in deciding the listing, offering or sale Drice of the real property. Page 2 of 2 Metropolitan Regional Information Systems, Inc os-nnay-2oo9 Residential CMA Pricing Analysis 7:47 pm Subject 218 E GARFIELD ST SHIPPENSBURG, PA 17257 Comparable 4 l 338 E GARFIELD STREET SHIPPENSBURG Ad' Comparable 5 ~ ~~ ,t 324 ORANGE SHIPPENSBURG Ad' MLS#: 74 LisURent Price 95 000 0 82 500 0 Sold Price 85 000 0 80 000 0 Status SOLD 0 SOLD 0 Leg Subdlvison 0 0 Contract Date 26-Jan-2009 0 13-Feb-2009 0 Settled Date 09-Mar-2009 27-Mar-2009 DOMM 101 0 13 0 Total Assessed 0 0 0 0 Lot Size (Sgft) 636.6 3,049 p 5,504 0 Fin SQFT AG 1344 0 1,464 0 Unfin SQFT AG 0 0 Style Traditional 0 Traditional 0 Type 2 Story Detached 0 Detached 0 Year Built 1900 1920 0 1900 0 Exterior Constr Vynl siding Alum/Steel Siding p AIuMSteel Siding,Vinyl Siding p Total Bedrooms 4 4 0 g p Full Baths 1 1 0 1 0 Half Baths 1 p p # of Garage Spac 1 0 1 0 # of Carport Spa 0 0 # of Assigned Spa 0 0 Basement Type Unfinished Full p ~ther,Unfinished,Walkout Stairs p # of Fireplaces 0 0 0 0 Heat System Hot Water Baseboard,Hot Water p Forced Air p Heat Fuel Oil Electric p Oil p Cooling System None p Ceiling Fan(s), Window Unit(s) p Cooling Fuel Syste None p Electric p Exterior Features Porch p Other,Porch-front,Sidewalks p Property Cond Average p As-is condition,Shows Well p Seller Subsidy 0 0 2 400 0 0 0 0 0 0 Total Adj $0 $0 Total Adj. Value $ 85 000 80 000 Courtesy of: Harold Best Copyright (c) 2009 Metropolitan Regional Information Systems, Inc. Home: (717) 532600 Office: (717) 532-2814 Information Is believed to be accurate, but should not be relied upon without verification. Cell: (717) 816-4600 Email: haroldbest@comcast.net Accuracy of square footage, lot size and other information is not guaranteed. Company: Hale Real Estate Office: (717) 532-2814 Fax: (717) 532-5463 COMPETITIVE MARKET ANALYSIS DISCLOSURE: This analysis is not an appraisal. It is intended only for the purpose of assisting buyers or sellers or prospective buyers or sellers in deciding the listing, offering or sale price of the real property. ~o~oo ~v-.m ~ .~, j..~ ;~ ~ ;~ ~_~~~, W~~W= N ~ ~ N ~ N~o~o ~mOrna A y O ~ m T~ mp X °'. ~ V S .-. ..v. N ~ O O v W a ... 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D ~ j 3~3 ~_ ~ 3 0 ~ 3 ~ ~ '~ ~' ~ ~ ~ 0o D ~ c ~ (n •+ V y ~ m cn UJ A n 1 N e IC v ei A O ~O ~ ~ ~ V ~ v N '~ O O O 3 ~ ~ O f~_D O O 3-3~ ~D~ jmu ~~~~~ ~_~~~, W~~W= N ~ ~ N ~ N ~ O ~ O wy orna am °~ w m m~ mp °7 3 ~ x y s :.: °1 ~ ~ V W d ~• N ~ W CT (/i N ? ~ N rn ~ W n O A 3 N_ 7 .~~. :~ ~. 3 ° ~ v 3 m m o; n ~ rn ^ ~ v° c ~ ,~ ~ 3 m o 7pC o n R ry ~ ~ O~ v a °c D ~ m N n ~ ~ ~ ^ ~ a ~ ~ o c `~ '~ o ~ d d 3 ~ y U1 ,p m N ~_ in ~ ~ v o N ~ Ort n a0 >n ,~~_ .c .o r o d a Q 0 m c J ~ ~ C > o .~ a A n o ~ o m o c ° ~ ~ ~ a ~~ °' a w gym' ~ a d ~ ° o J.~< °:° N V N' O J N ~` ~ ~ J f. o S ~ J ~ ~ J d ~ ~ ~ ~ ~ - Q v c m m ~~a ;ate ~a,~ ;, ,, ° ~ u ~ n 3 ~ a~ ~m t~0 t~O N N O W O W O W a a O +D O QOf O V ~ ~ o in o w u~ a00o v w i N 0 J r t0 O V O .~ V A OWO A O m O Or d G) m p ~d~ ~~~ ~ a i ~ ~ m 3< w r °' m 1 y ' ~ _i Z ^ ^ Y! r rN- a N 0 N W i f 0 U ~ A A U1 O G1 ~ fD t0 O O O f1 O O 0 0 0 IC O O y O a N d- O U1 O y t0 10 n~ O O O O O O O O N O O \° (O O W ~ A o w ° °f O1 w ~ J J v 0 O O W ~ O O -1 -I ~ N n a a ~ - - - '~ > > c~ w d o r '<' A A a W A W p -• -~ -+ W Z o ~ ~ v r N W N < w '~ 0 0 o w J 1 N N N O N O W O O O .T O O O ~ W O -+ IBC ~ V W b CJf ~ W ~ O CnLT ,~„ ~ ~ a v 0 0 0 01 ao cc m A U7 f0 V C Z ~ ~ Q < °' d v obb °; w o o A N N ~ 0 0 °o ~ w .a .i N 0 N i0 O O iv N N W O O Z ~ ~ m ~ ; < ~ A r 1 ~, N ' A _i Z ^ YJ r M A y tV0 tV0 1~ ~ ~ O n O O O IC O O 0 ~ V V ~ fD y t0 ~O O '~. t0 i0 O ff O O O IC O O e e O O °~ 0 ° ° ~ o o v 0 3 O '9 '° '° ~ J fp m ~ r o a x W W ~ ~ I = J W r N < w o w N ~ r f0 O .Z' O n N A -~ N N ~ O .+ 1 b m co ~e w O N 0 O O V Oo ~ ~ ~ ~ m r --I ^Z YJ r M v co 9 1 0 {7 O IC Q V ~ f0 ~ O f> O A \° o v o ~ 0 f0 ~ ~ to a ~ _ m o' m r N < rn a W W T ~ W o = W r N < w T 9 o a d N ti 3~3 A W O w O H ._ V N N ~ fD ~ v m ~ A I AI. i ~ n :I op °o~ N I~ L m ~ ~ v m N ~ ~ o ^m ^~ u/ W ~ 7 3 m Q. D ~, ~ ~ ~ ~ C p~ a d O C O O a ~ ~ ... D ~' fD V N N ~ ~_ n 0 o ~ ~ m V ~ O m ~ O M 3 CO N o m o 0 e ~'v-.mom .~,;..~ ,~ v ;~ ~_~~~, W~~W= N ~ ~ N ~ N ~ ~ ~ O ~ d p ~ d ? tTI O ~ N N d ti T ~ Ill Q X ~ v ? ~ N ~ ~ O v w a " N ~ W ? N N ~ ~ N W ~ OD O ? 7 N Cl ~ 3 ~ ~ m m° o rn ,~ ~ 3 m o D m 70 a~~ ~" a c D ^ °o D ~° ~ d ~ ~_° ~_ O ~ ~ n ~ ~ r m a rn ~ o •~ o ~ ~ °' m d tea= v o a A N ~ ~ N T ~ N ~ ~ O ~ ~ ~ a a a ~ v o '~ ~ m tea" boa ~D 0 ? 0 3 ~ ~ f a ,~ r r of r p~ r ~^• N ~ ~ .wi ~ ~ N ~ 1P .. A 0 'C _~ enMaa ID ~ y D ~ ~ A O A + O O O O (n S F C ~ y d 3 O ~p N N! 6 ~ y O ~ ., ~ p, A ~ ~ ~ .. ~~ NI ~ o o~ I I o f 3 ~ °o a m v 0 v ~ 3 ~ ~ N ~ V to N ~ C N W a m ~ ~ - m /~ N ~ O m ~ ~ v sv ~ 3 rn ~ D ~ ~ N ~ ~ C p~ ? 3 n d o ~ ~ ~ v~ ~ ~ a ~ ~ ~ ~ D ~' v ~ N N cn v ~ n O ~ ~ v ~ t0 N V N N ~ 0 0 3 t~D N Metropolitan Regional Information Systems, Inc Page 1 of 2 09-May-2009 Residential CMA Summary Detail -Photo 7:47 pm SUBJECT PROPERTY 218 E Garfield St Shippensburg, PA 17257 BR FB HB Lvls Fpls Lot SQFT Yr Built Sugg Price 4 1 1 2 636.6 1900 ACTIVE 1 LISTING 118 Fayette SHIPPENSBURG, PA 17257 066910277 Orig. Price Llst Price %Diff DOMM DOMP BR FB HB Lvls Fpls Gar Lot Sgft Liv Sgft Built $79,900 $79,900 .00 191 191 3 1 0 2 0 1 7,500 1,216 1940 List Date 29-Oct-2008 Adv Sub: SHBG BORO Model: ~~~~ Total Assessed: $0 Style: Traditional Bsmt: Yes, Partial,Unfinished,Walkout Level Total Taxes: $1315.00 Type: Detached Water Oriented/Front/Access: No// ACTIVE List Price Orlg. Price % Dif DOMP Lot Sgft Average $79,900 $79,900 0.00 191 7,500 Median $79,900 $79,900 0.00 191 CONTRACT 1 LISTING 223 Orange St E SHIPPENSBURG, PA 17257 068959101 ~~ Orig. Price List Price %Diff DOMM DOMP BR FB HB Lvls Fpls Gar Lot Sgft Liv Sqft Buflt $89,000 $84,900 -4.61 106 0 3 1 1 2 0 2 9,147 1,630 1900 Contract Date 26-Apr-2009 Adv Sub: SHIPPENSBURG BOROUGH Model: Total Assessed: $0 Style: Other Bsmt: Yes, Unfinished Total Taxes: Type: Detached Water OrientedlFrontlAccess: No// CONTRACT List Price Orlg. Price % Dif DOMP Lot Sgft Average $84,900 $89,000 -4.61 0 9,147 Median $84,900 $89,000 4.61 0 SOLD 3 LISTINGS r 324 Orange SHIPPENSBURG, PA 17257 CB6974992 Sold Price List Price %Diff DOMM DOMP BR FB HB Lvls Fpls Gar Lot Sgft Liv Sgft Built $80,000 $82,500 -3.03 13 13 3 1 1 2 0 1 5,504 1,464 1900 Seller Subsidy $2,400 Sold Date 27-Mar-2009 Adv Sub: SHBG BORO Model: Total Assessed: $0 Style: Traditional Bsmt: Yes, FuII,Other,Unfinished,Walkout Stairs Total Taxes: $1140.00 Type: Detached Water Oriented/Front/Access: No// 338 E Garfield Street SHIPPENSBURG, PA 17257 068900945 u Sold Price Llst Price % Dlff DOMM DOMP BR FB HB Lvls Fpls Gar Lot Sgft Liv Sqft Built $85,000 $95,000 -10.53 101 101 4 1 1 3 0 3,049 0 1920 Seller Subsidy $0 Sold Date 09-Mar-2009 Adv Sub: NONE Model: Total Assessed: $0 Style: Traditional Bsmt: Yes, Full Total Taxes: Type: Detached Water Oriented/Front/Access: No/! Courtesy of: Harold Best Copyright (c) 2009 Metropolitan Regional Information Systems, Inc. Home: (717) 532-4600 Office: (717) 532-2814 Information is believed to be accurate, but should not be relied upon without verification. Cell: (717) 816-4600 Email: haroldbest@comcast.net Accuracy of square footage, lot size and other information Is not guaranteed. Company: Hale Real Estate Office: (717) 532-2814 Fax: (717) 532-5463 COMPETITIVE MARKET ANALYSIS DISCLOSURE: This analysis is not an appraisal. [t is Intended only for the purpose of assisting buyers or sellers or prospective buyers or sellers in deciding the listing, offering or sale price of the real property. Metropolitan Regional Information Systems, Inc Page 2 of 2 Residential CMA Summa Detail -Photo o9-May-2009 ry 7:47 pm SUBJECT PROPERTY 218 E Garfield St Shippensburg, PA 17257 '~~ ~ BR FB HB Lvls Fpls Lot SQFT Yr Built Sugg Price 4 1 1 2 636.6 1900 144 Orange St W SHIPPENSBURG, PA 17257 CB6807587 Sold Price List Price % Diff DOMM DOMP BR FB HB Lvls Fpls Gar Lot Sgft Liv Sgft Built No Photo $80,000 $99,500 -19.60 88 88 3 1 0 2 0 1 13,503 1,504 1900 Available Seller Subsidy $0 Sold Date 05-Nov-2008 Adv Sub: SHIPPENSBURG BOROUGH Model: Total Assessed: $0 Style: Traditional Bsmt: Yes, Partial Total Taxes: Type: Detached Water Oriented/FronUAccess: No!! SOLD List Price Sold Price % Dif DOMP Lot Sgft Average $92,333 $81,667 -11.05 67 7,352 Median $95,000 $80,000 10.53 88 Report Totals Properties: 5 Avg List Price ;88,350 Avg Sold Price ;81,887 Avg DOM-P 79 Median List ;84,900 Median Sold Pric ;80,000 Median DOM-P 88 Cow Liat Price: ;79,900 Low Sale Price: ;80,000 High List Price: ;99,500 High Sale Price: ;85,000 Courtesy of: Harold Beat Home: (717) 532-4600 Office: (717) 532-2814 Cell: (717) 816-4600 Email: haroldbest@comcast.net Company: Hale Real Estate Office: (717) 532-2814 Fax: (717) 532-5463 Copyright (c) 2009 Metropolitan Regional Information Systems, Inc. Information Is believed to be accurate, but should not be relied upon without verification. Accuracy of square footage, lot size and other information is not guaranteed. COMPETITIVE MARKET ANALYSIS DISCLOSURE: This analysis Is not an appraisal. It is intended only for the Durpose of assisting buyers or sellers or prospective buyers or sellers In deciding the listing, offering or sale price of the real property. ~o~o 0 c ~m~m~ ;~~;~ ~_~~ ~, w~~W= N ~ ~ N W 0 ~~ °orn a A ~ O ~ W N '- T~ mp °7 3 x ~ ~~ m ~ O v W fl ... N Q ~ N N ~ ~ N {,~ ~ w O ? .y~. 7 :~ 0 b O 0 ?~v _< > a ~ o n j ~ N ~ A O > C ~ ~ u 3 ~ [D > ~ Q O .Ci ~ O_ ? rr j O d ~ C_ J i n F ~ ~ ~ ~ O ~ ~ d (D I~ a 7 i C ~ ~ V ~ m f. o ~ - ~ ~ C IA 1 ~ m fD a ~ i o ~ i ~ n 0 0 < 3 = o y a z F {c ~ N r C 00 OD tD V ~ OD A {O /0 ~ ~ w io a ~ ei ?; O O O O ~ ~ rA ~ ~ IC r aaaa ,y.. {O 07 {D V ~ O {O t0 {O ,~ O t0 10 ~j W O O O ~ O O O O II 0 W 01 A O ~ i71 O O P ~ N 1D Of O .'!' 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C v v C ~G - r '~ N N N N w II ~ O iO0 i0O tV0 ~ ~+ O t0 t0 ~ N N N N ~ d9 fA lp '~ 07 O O O O O O O ~ O O 0p V O O N V O ~ CJI V J " y ID Q, p p V O O O II O O O ~ O O t0 O c ~ W O, A O .~ N tO0 W O ::' O O ~ N N N N ~ N ~ ~ ~ f0 fD 10 Op W t0 t0 N f0 t 0 t0 N y .=t ~ f0 ti, f0 O, <il CC fit 1 ~ p V O O O O O O ~ ~ n n C7 ,~ N N N N 3 ~ O 107, 0 ~ f~pp 0O'r tO7, + O pppp O tlOi A ~ ~ Of O O O n ~ 0 N 0 + m O ~ y Ul ~• Of O O O V O O O t 7 O 0 0 O f O ,~~! ' N ~ .~ O N c o n N Q N LS O A M O N O C7 Cis O p N O N O N O O O O LL ~G y ~ 0 0 0 B 0 V O O O I C ~ -. ~ , ~ II y N N N (p Z N N A N N N N N O ~ O N O N N N O a O O f 1, V ~ O O O O O O O K N O O O OI V O O O ~ n II ~ A Z cD ~ V N N N V M ~ D O D O D O OD C7D ~ ~ ~ 3 O O N V O (71 ~I ~ w ~ ~ ~ w 3 OD O O 01 ° ° ° O ° O ° 07 ° ~ ~ ~ o o o o o o ~ A _ O D r y ~ M N N N EA lilt fii N Oi y O N a . i ~ V O 10 N N t 0 CO il f N ~ t0 0+ 0 W O tl, N Cil O U1 W O O O O O O ~ D W O O D O O O ~ r 10 O O O, ~ II V /0 t0 t0 O ~ V t 0 A O O f 0 A e t0 A O A A A O 0 O V Of O O V Cn 0 0 O cD O 0 ~ W V O ODD ~ W ~ ~ N O o ~ 07 O O + r ~ ~ V m .a w ~ ~ W ~ V ~ A D m ~ 0 0 o m o ao o m N A N t0 f0 <O fD f0 f0 tp ~ W M ~ N Calculated Value of Your Paper Savings Bond(s) http://www.treasurydirect.gov/BC/SBCPrice Calculated Value of Your Paper Savings Bond(s) Registered in Richard N. Davis or Janice M. Davis Listing No. 24 Calculator Results for Redemption Date 08/2008 Total Price Total Value Total Interest YTD Interest $525.00 $2,808.48 $2,283 48 $58 34 Bonds: 1-6 of 6 Serial # Series Denom Issue Next Final Date Accrual Maturity Issue Price Interest Interest Value Rate Note D221Q425EE; EE _$500 05/1982;, 11/2008;.05/2012 $250,.00 _ $1,003.80 4_.00%~ $1,253.80 , C266012124EE EE $100 12/1990 12/2008 12/2020 ~ $50.00 ~ $76.40 ~ _ 4.00%' $126.40 L2015286073E E _ . _ $50 01/1976; _ _ _01/2006,;_ $37.50, $232.02 _ - _ .. $269.52 MA L2110904627E' E $50' 04/1978, 04/2008 $37.50' $179.58 $217.08 MA C250562868E~ E ` $100: 01/1978; __ 01/2008', ,$75.00 . $438.80, $513.80 MA 02057870251E _. E $100; 07/1978, _. _.._. __07%2008; _ _ $75.00: _ ... , _ „,$352.88; _. _ ., $427.88 _. __. MA Totals for 6 Bonds ~ $525 00 ~ $2,283 48 ~ $2,808 48 Notes NI ': Not Issued NE .Not eligible for payment P5 Includes 3 month interest penalty MA Matured and not earnin interest 1 of 1 10/21/2008 10:44 AM Calculated Value of Your Paper Savings Bond(s) http://www.treasurydirect.govBC/SBCPrice Calculated Value of~Your Paper Savings Bond(s) Registered in g~chard N. Davis or Janice M. Davis Listing No. 28 Calculator Results for Redemption Date 08/2008 Total Price Total Value Total Interest YTD Interest $3,000.00 ~4;~483-~t6- $11,483.16 $360.84 14,232.40 Bonds: 1-59 of 59 58 Serial # Series Denom Issue Next Final Date Accrual Maturity Issue Price Interest Interest Rate Value Note c48820476ee~, EE ' $100; 10/1982; 10/2008; 10/2012; 50.00; $195.84- 4:00%~ $245.84 c32759442ee~ EE , $100;01/1982;01/2009: 01/2012' $50.OOi $205.76; . 4.00%; _ $255.76; --- c48870467ee_ EE - - - --- $100: 02/1983: 02/2009 ~ 02/2013 $50.00 $184.56, 4.00%; - -- $234.56• c45768315ee; . ._ EE _ _ _ _ _ ~ $100. 12/1982 ; 12/2008; 12/2012_ __ $50.00 $184.56 _ 4.00%: $234.56 c48854086ee _ EE _ _ _. $100 03/1983.09/2008 03/2013 _ ._ . $50.00 _ $154.80 3.69%; _ $204.80 c48870466ee EE $100, 02/1983, 02/2009; 02/2013: $50.00 ; $184.56 4.00% -- $234.56: c45768313ee: EE _ $100: 12/1982; 12/2008 ; 12/2012` , $50.00: $184.56: 4.00%; $234.56; c45768312ee; EE _ $100: 12/1982; 12/2008; 12/2012; $50.00: $184.56 4.00%~ _ $234.56 c32759174ee. EE ~ $100; 12/1981; 12/2008; 12/2011; $50.00; $205.76' 4.00% $255.76 c28440744ee~ EE . $100; 11/2981; 11/2008; 11/2011; _ _ $50.00: $205.76 _ 4.00%~ $255.76; c45768314ee EE _- $100; 1 2/1982 ; 12/2008 ; 12/2012, $50 00 _ $184.56 , _ 4.00% $234.56; _ c28465048ee! EE ; . _ _ _ $100: 12/1981; 12/2008 12/2011; • . $50.00; , -- $205.76; 4.00%~ $255.76 c35162209ee, __. __ EE ~ _ $100; 03/1982. 09/2008; 03/2012__ .- _ $50.00 $200.76 -- _ 4.00% $250.76 -- - DL _ c39025600ee EE --- _ $100 09/1982; 09/2008 09/2012; _ $50.00: $195.84 4.00%; , _ $245.84 c28440627ee; EE ~ $100; 11/1981 11/2008; 11/2011; _ $50.00: $205.76; 4.00%; _. . . $255.76; 48887930ee EE $100:05/1983.: 11/2008: 05/2013^ $50. 00; $.147.48 • 2.53%~ _.._. $197.48. c37302488ee EE $100 05/1982; 11/2008 05/2012, _ _ $50.00 , $200.76: 4.00%; $250.76 c35130873ee EE ~ _ . _. $100, 01/1982; O1/2009~ 01/2012 _ _ $50.00 ___. $205.76 _ 4.00% _ $255.76. c45730431ee~ EE . $100; 11/1982 11/2008 11;2012 _ _ $50.00 $184.56 4.00% $234.56 c45730432ee EE $100. 11/1982 11/2008 11/2012 _ $50.00. $ 184.56, 4.00% $234.56; c45730430ee: EE ' _ ._ $100; 11/1982:, 1 1/2008; 11/2012: __ $50.00; _ _ $184.56; _ 4.00%; . _ $234.56. c39025599ee; EE . . _ $100; 09/1982; 09/2008; 09/201 2; $50.00 $195. 84; 4.00%, $245.84; c48887931ee; EE ~ _ _ . _ $100;05/1983_ 11/2008; 05/2013_ $50.00 _ _ $147.48 ; _ _--- -. 2.53%, .. $197.48' c48870468ee; _. EE _ _ $100 02/1983: 02/2009; 02/2 013 __ $50 00; __ . x 184 56; _ -- 4.00%; __ $234 56 _ c37268514ee EE . . $100 03/1982; 09/2008; 03/2012; . $50.00: _ . $200.76; 4 00% _ ..._ $250.76; [39003579: EE ~ . _ , _ $100 ' 08/1982: 02/2009; 08/2012, _ $50. 00: _ _ , _ $200.76; _ 4.00%; __. $250.76 c39025232ee; EE , . _ $100; 08/1982: 02/2009 08/2012 _ . _ . _ $50.00; __ $200.76: 4.00% _ $250.76 C48820474EE EE ! . $100__ 10/1982 _10/2008' 10/2012 ~ _ $50.00_:. ___ _ $,195 84! _ 4.00% . $245.84 _ C48820475EE: EE $100 10/1982; 10/2008 ; 10/2012; $50.00!. $195.84'. 4.00%; _ _ $245.84 C35162109EE EE ,_ . _ $100, 03/1982 09/2008': 03/2012; . $50.00; $200.76' 4.00%~ $250.76: C37268841EE~ EE $100 04/1982' 10/2008 04/2012 $50.00: $200.76 _ 4.00% $250.76; C38047047EE EE $100 06/1982 12/2008; 06/2012. $50 00 $200 76 _ 4.00% X250 76 C48870731EE EE ~ _ . $100; 04/1983; 10/2008; 04/2013' _ _ $50.00: $154.80; 3.69%: ~__ . $204.80' C48820499EE EE $100~ O1/1983; 01/2009; 01/2013^ $50 00 $184.56; 4.00% --- $234.56., _ C48820498EE~ _ EE _ _ ' 01/1983; 01/2009; $100 01/2013; _ $50.00; _ $184.56; 4.00%; _ _ $234.56 C48870729EE; _ EE _ _ $100:04/1983:10/2008:04/2013' $50.00; __ __ $154.80; _ __ 3.69%: __ $204.80 C37025598EE _ EE $100 09/1982; 09/2008' _09/2012,. . _ $50.00; $195.84; 4.00%: $245.84; C39025264EE'; EE ~ , $100108/1982;02/2009; 08/2012 $50.00; $200.76 4.00%; $250.76; C37268682EE EE $100 04/1982; 10/2008. 04/2012 _ - _ $50.00; $200.76 4.00% _ _ $250.76 C38304539EE. EE $100; 07/1982 01/2009; 07/20 12: $50 00; $ 200.76; 4.00% $250.76 C38304366EE; EE . , • $100; 06/1982' 12/2008 06/2012. $50.00: , , $200.76; 4.00% $250.76; c37302670ee; EE 05/1982; 11/2008; 05/201 2. $100; $50 00; $200 76; 4.00% $250.76. c38047273ee' _ EE . ._ _ $100; 06/1982; 12/2008; 06/2012; $50.00: $200.76; _ 4.00%~ : ._ $250.76; Licate of 2 10/23/2008 3:23 PM Calculated Value of Your Paper Savings Bond(s) http://www.treasurydirect.gov/BC/SBCPrice c38304609ee EE $100;07/1982_'01/2009,::07/2012' $50.00 $200.76; 4.00% $250.76_ c38304673ee: EE _$100_07/1982; 01/2009: 07/2012:, $50.00. $200.76 4.00%~ $250.76 c45730429ee; EE _ $100;.11/1982_:11/2008 11/2012:_ $50.00: _ . $184.56 , 4.00% $234.56 C28465159EE, EE ~ $100 12/1981; 12/2008: 12/2011: $50.00 $205.76' . 4.00% $255.76 C48870730EE' EE $100 04/1983.10/2008; 04/2013:__ _ $50.00 $154.80 3.69%~ $204.80 C28440786EE' _ _ EE $100;_1.1/1981:11/200811/2011 _ $50. 00' _ _ $205.76 4.00%: _. $255.76. C48854088EE EE, $1.00:.03/1983.. 09/2008.:03/2013 _ $50.00,.;, _ _ _ $1 54.80 3.69% _ __ $ 204.80 C38304461EE~ EE $100:_07/1982_; 01%2009 : 07/2012: $50. 00} . $200.76' 4.00%' , $250.76: c35132589ee ~ - - ... EE _ $100' 02/1982,_02/2009: 02/2012. _ _ $50.00 $205.76 .4.00%; _ $255.76 C35132799EE EE ! $100._02/1982:_02/2009 02/2012; - $50.00_ $205.76 4.00%' $255.76' C37302429EE . EE _ _ _ 100 ~ 05/1982 ~ 11/2008; 05/2012 $50.00. _ $200.76_. 4.00% .._ $250.76 ~C37302763EE EE $100,05/1982.:11/2008'05/2012 $50.00; _ $200.76 _ 4.00% $250.76: C48854087EE __ EE ~ $100: 03/1983 ~ 09/2008 03/2013 ~ $50.00 ; $154.80 . 3.69% ~ $204.80 ; C37268698EE - _ EE .$100; 04/1982; 10/2008_ 04/2012'_ $50.00 _ _ $200.76 _ 4.00% _ $250.76 , R6098910EE' .... EE __ $200. 12/1981; 12/2008 12/2011 $100.00' _ $411.52' . 4.00%: _ ,$511.52; Totals for 69 Bonds- $3,000.00: $11,483.16 d. ~w wn.i rte. ~~ Notes NI Not Issued NE ~ Not eligible for payment .._ P5 ;.Includes 3 month interest penalt _ _ _ __. --- MA :Matured and not earnin interest 14,232.40 of 2 10/23/2008 3:23 PM November 7, 2008 Elinor Albright Rebert Attorney At Law 515 Carlisle St Hanover, PA 17331 To Whom It May Concern: RE: Richard N. Davis In reference to the above customer, our records show the enclosed information to be accurate of today's date. If I may be of any further assistance, please contact me. Sincerely, Tricia Ganoe Deposit Operations Manager 717-261-3624 717-264-6116 888-264-6116 P.0. Box 6010 Chambersburg, PA 17201-6010 FINA.N.CI`AG S'O.L-U"TLONS,.. 'FROM P.EOPLE`YAU KNOW•~ rn c 0 .m m L f0 N 0 r O N ff) ~ ~ 0 Q N Z ~ N N L ~ U 7 Q-' Q N L Z ~ ~ ~ (U ~.- O O O N (6 U ~ L N ;a CO fA rn ~ ~ fn n ~ m fo N LLl ~-- ~ N O N ~ N C O O O _ O O U U C f0 C N ~ O Z ~> ~ '> O N ~~ > ~ c O fv ~ C O L fo ~ > m Q Z Q ~ fo U 0 ~ ~ cv U ~ ~ ~ C U U _ _ CU C m m O O ~ O ~ O M ,a O O S O pp O p O O O p S O F- f~ 69 N b9 Efl 0 G9 0 to 0 f~9 0 d9 0 d3 0 d9 0 EA 0 EA 0 69 0 Ef3 C U 2 ~ U CV ~ N Q fag 69 d9 O O ~ ~ O O N f0 ~ ^ W N O ~' m ~ O d9 (U O N N O U p~ ~ f0 S f~ ~ ti m lU N N N O O r O O r N ~ j p ~ ~ M Z ~ ~ fMp j ~ N ~ N ~ O _ U Q O O N lU (U ~ N C f0 ~U !'_ N ~U !~_ U ff) N N cA U U Nav, ... [U9~ 1C-;33Rrir 5r., ~~1Qf thew lu±~erar 4hurcr h1aI~JLJ.CV~EN'TAT, L',IFE ~. INSLTRAAY~S CQMPANY :4ioaumantsl :Life inwiogce Craapmx~ hda,luidl:etire ~ffia: x)39 L+dsesvuod Acud N.t". lK7 9or 3~$3 Gedac Ttaplds, luau 524c16-3193 pCtcbr~r 15, 2003 ~allif~e ~ DaVi~ 2 L3 (~eQrye ~t Htnnover I'A 1731 AL"t ~uitiy.N`titrt}~er. t~} 430gY731341 D+?2z' Janice M Davis Ule have ret~r~ivec~ noi:%fiCation, ilichard N Davis, c~.nll~.iltl3lt of the alcove 1.~.sted n~ri-~,ut~Zif~ ed tax. deferrecY annuity is deceased, Qur offico cvi.r:3Yses to eXCend, sitzCOrl~ ~coridolences far your loss , The fc3,3.c~wing is the e+trrent i.nfr~rm~.ti.c~n on. t~!is annuity: A,:ul~aitat]t : R1G.11a~'Ci IV I3aV~.~ Owxlex : Richard Td Davis Primary Fieii,efiGielry: ~7aniCtir M. l]~:vie Anlluity.~PGlicy, Da~Ce: 5~aptelttber O8, 2000 ;'uli Va1ur~ as of 10,/1.G/ZGO$: $19,62(3.2 z~axabl.e Partinn: $ 5,520.52 I~uil Value as of Q~1i$/2~08: ~19,527,2u Tk~e attached document reflects tha options availa}vle tv the bene~f irisx'y . Thca fu11 .value as of the date of death i;a for tax pur~~ases c~fily and i5 not a guaranteed death 'pi'r~e~it alnc~unt. Operations performed ors arz autonlatia baai, when applicab:~e h«ve been te:rmirated, .such aea Syste~-natic 2ayo~ats or Autalnutic Bill.9.ng. •rhe atL-achrad tlocunlent~ contains yerleral ta,c inforinatiora t,ased on Moriumentai Life Insurance Company's i.nterpretatiolz and should not be relied upon far yaur personal tax planning, _~. you have cttleetiGns~ concerning the c~ix•eat tax coti5e~:.ences when selecting are option, you may wash to cor~sult a ta.~c adv.sc~r. ~s.: ~z. ,.: Mtinbet dF fhe, ~~QM. G[6up `'~' , -- r, .w . ~i Pr~(i~~~fi~I ~~ ~atvllf:v or RICHARC~ n€~v14 c38 F ~ARFlFLQ S"I' ~F{IPP~itiSQllt3C~ !='A 17257 . Jt7sepit i~7orre Vice Pre4iclent, A~~rnrity C?peraii~ns ~Tf1e Prttciential insurance Gampany of ~1n~rric:=~ A Praci611!ial FinartGir:.l col»17any ArtltsilV services F.t~. 8cax 79hE~ Plliladel~hit~, PA -i;3#76 (He#~~ 77H-28EtH ~~~tv~rr.l~rud>r~ntl~i.vurll Owner' I~IGHAf-iU N Dr4~l!5 Atr'NIJI'fAfd"i. ftICHARC N Df:~r'iS C~.lnirect ,."Jumb~r; HC)Sk14434J3 Derr THE FAMILY C7i=' RICK-1AFrU U~1+!!S, Octatler 23, 2008 Ther7k you fir rtot:fyini~ ~~ ~~f RICHARC] Pd DAV!S'3 death. pltrii32 aGGe(~t 0:.1!' Slri4eC6 condolences for ycyur ions. l~:~r cJuai is to rnPke the procassinr~ of yp~Ir request ?car e;at~efits as pramp# ~rtd c.onvenier~t for you as p09ssl7it, According to the #r~rms of tnls c;~ntrac?, fha rernialn;ng i~~inetits are ,layab!e as a Iu1i~(~ 5~:tr1 paym~:nt trt the arrotrr;i of $4C177.~5. Cur ravords indic~cte itlat ttls b~neficiary(ies) 1c~r an~r ber~efit3 ur~ydbl~ untfnr this t0"~#ract aye as f~Nouis: JA(d1~E M l~AVt~, DALiGHTER ct RIUt~IAi~U N ~A1flS ~'Vc~ would apprecieta your hgip ir1 oat~iining the fallowing iliforrn'~'ti~an: • Ulain7ing insurance 5en8ftt5 fora • A certified Ya~~ ^f tre death certiticate • 7h~ Contract or Claim StrttlEnldnt CE}rlifice.te {if it is availr~lfe; We'haue enclosed a reply envelope for yc+~r car~veniertee ir5 rr~turning thtlse forms. ~71'lcrr vve recaivP tt-tem, ws car, st£rCt #t~o ciaim procese. Fle3orretl Aa~~~e~~kGr~ FluStpllal rV41siti2s~JixY~.,Liie, k!. A 4'tiltl91lii5i FYt~CH! S?:Ippif J Ua~ l%ertxKn~a u'rix t?L^.) 6;b3-tlWy 0^T-27-2Q05 1.4:39 Frarn:PN~ L~F/i'dY.- ?17 6.32 5645 To:77.'-1532+ci4ki F'. 1'1 Elir~r~r P.lbrig_~t Rebert 5 i.5 C:arla.~ly Str~~t ~'~~7,Itt7VC3", ~A 1 x'331 Uat~~}~r ?.7, 2f}~8 Attn: Scutt T] Ttc;bcat ~1C~r Jcutt, According to ~1~C. I~~t~k. rccprcix, the twu C'cnsiic;atc• of L?cpasi~~ :ctcsci>Ced fn your lattt•.r rcqu~t~i+'t~ date c~i'r?esin vrtluch x~r ~tichard N Davis, arc not current vatic; acc~utYt ntsntbers. '1'1~ast nuulbtrs rither are int;~src~:1 ur ~,var; red~o~ed prior tc~ ~C}t~l iu wY:ioh u~lr current recurcis Rio not rei~c:•c~.. !u rtdditivu, .r,u:lh~.;r the Social stx:urity number of I~4r Davis, uc+^ a search fir l7is rumeii~cltiress ha~c rusu:t4ti° iii ariy cinta. t1`y;~u hive turtfica quc•:+tic.~xts, ple,~se cont2rt trte aC 717-ti32-2070 Tha~ik )•tru, Michelle Shill;ng ''~ HrauYeJ~. ~~fai~dvr IVIo5henystown ftf~iee #18:y R m~rnher Gf tho PNC Flrwnrlal SCrvIGC.:s ~uw d39 ~vutli ~trelet, tNcShtrrya4owr., PA X7:144 ~xww.piur.~nh.~rn ~~ `J ~'~ ~~~J