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08-25-09
J 15056041114 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year Flle Number Bureau ollndivitlual Tazes INHERITANCE TAX RETURN PO BOX 280801 Hartisbum. PA 17128-0901 RESIDENT DECEDENT zt-o6-oloaz ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 10272008 06171927 Decedent's Last Name Suffer Decedent's First Name MI THUMMA ROBERT L (If Applicable) Enter Surviving Spouse's Informa0on 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 ® t. Original Return 0 2. Supplemental Return 3. Remainder Return (date of death pdor to 12-13-82) Q 4. Limited Estate ~ 4a. Future Interest Compromise (date of 0 5. Federal Estate Tax Return Required death alter 12-72-82) ® 8. Decedent Died Testate ~ 7. Decedent Maintained a Living Treat 1 8. TMaI Number of Safe Deposit Bozes (Aaach Copy of wllq (Adach Copy of Treat) ~] e. Litlga8on Proceeds Received 0 10. Spousal Poverty Cretlit (tlate of tleath Q 11. EVection to tax antler Sec. 8113(A) belvaDen 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 7eiephone Number STEPHEN D. TILEY, ESQUIRE Finn Name (If Applicable) FREY AND TILEY First line of address 5 SOUTH HANOVER STREET Second fine of address City or Post Office CARLISLE State PA CorrespondeM'se-mailaddress: STILEY@FREYT OF PERSON RESAQNSIBL~R FILING RETURN 4501 `RL~_~PPLE REPRESENTATNE CITY, NC 28 ZIP Code 17013 717-243-5838 REGISTER OF WILLS U~NLY - r~ ~ ~~': q -: ~ C ti -a Gy ~_ i ~ ~ ~ ~ ; : : - N ` = _r1 UI ~ n Z ,~ N ILED " <%% D ~ i7 i -, ~. .' _> Z.r; WAY, LEWES, DE DATE - y~..y - L ,~ S ADDRESS STEPHEN D. TILEY, 5 SOUTH HANOVER STREET, CARLISLE, PA 17013 PLEASE USE ORIGINAL FORM ONLY Sid®1 L 15056041114 15056041114 J J 1556042115 REV-1500 EX Decedent's Social Securky Number Decedents Name: ROBERT L THUMMA RECAPITULATION t. Real estate (schedule A) ........................................... 1. 91000.00 2. stocks and Bonds (scnedula B) ...................................... z. 2 0 9 9 3. 8 9 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Scheduk: C) ..... 3. NONE 4. Mortgages & Notes Receivable (Schedule D) ............................ 4. NONE 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ........ 5. 4 8 8 3 4 . 5 0 6. Jointly Owned Property (Schedule F) Separate Billing Requested ........ 8. NONE 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (soneduleG) ~separeteBillingRequested........ 7 6052.00 8. Total GrossAasets(totalLinest-7) ....:.............................. 8. 166880.39 9. Funeral Expenses & Administrative Coats (Schedule H) .................. . 9. 18 0 0 4 . 8 4 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............. .. 10. 6111 . O 1 11. Total Deductions (total Lines 9 & 10) ............................... .. 11. 2 4115.8 5 12. Net Value of Estate(LineBminus Line ll) ........................... .. 12. 192769.54 13. Charitable and Govemmontal Bequests/Sec 9113 Trusts for which an election to tax has not bean made (Schedule J) ...................... . 13. 0 . 0 0 14. Net Value Sublect to Tax (Line 12 minus Line 13) .................... 74 14 2 7 6 4 . 5 4 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 74 taxable at the spousal tax rate, or trensfers under Sec. 9116 (a)(1.2) X .0 ~ 15. 0. 0 0 16. Amount of Line 14 taxable at linealreteX.O 95 t6. 0.00 17. Amount of Line 14 taxable at sibling rate X • 12 17. 0.00 18. Amount of Line 14 taxable at collateral relax .15 $142,764.54 t8. 21415.00 19. TAX DUE ...................................................... . 19. 21415.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~ Side 2 L 1556042115 15056042115 J REV-1500 EX Paga 3 179-30-3533 Decedent's Complete Address: Flle Number DECEDENTS NAME DECEDENTS SOCIAL SECURITY NUMBER ROBERT L THUMMA 179-30-3533 STREET ADDRESS 3103 RITNER HIGHWAY CITY STATE ZIP NEWViLLE PA 17241 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPaymenis A. Spousal Poverty Credit (1) 21415.00 B. Prior Payments $18.750.00 C. Discount _ $988.81 Total Credtts (A + B + C) (2) 19736.81 3. Interest/Panahy if applicable D. Interest E. Penaky Total lnteresUPenaky (D+E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. FIII in oval on Pape 2, Llne 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) 1678.19 A. Enter the interest on the tax due. (5A) $7.12 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 1685.31 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: f tl Yes ^ No : ....................................... ene a. retain the use or income of the property trens b. retain the right to designate who shall use the property transferred or Fts income : ................ X 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 ti 7 ' ^ ^ X ............................................... on .. wRhout receiving adequate wnsidera 3. Did decedent own an "in trust for" or payable upon death bank account or sewrtty at his or her dealh7 .. ^ ^X 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which 0 ^ 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.t) ()]. For dates of death on or after January 1, 1995, the tax rate imposed on the nef value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9118 (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 childtwenty-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-1502 EX+ (N-08) pennsylvania SCHEDULE A DEPPRTMEH7 OF REVENUE INHERRANCETAX RETURN REAL ESTATE RESIDENT DECEDENT OF FILE Thumma Robert L. 21-08-01082 All real properly ownatl solaty or as a tenant M common must M reported at fair market wlue. Fair market value la tle8ned as the price at which property would be exchangetl between a willing buyer and a wilting seller, neither being compelled to buy or sell, both having reasonable knowletlge of the relewnt fads. e.,_~ ...,.....w, e.M r. rnlMlu~um.,1 urNh r4.ht of furvlvnnhlo must M diulosad on 9ehetlula F. Attach a copy of the settlement sheet H the property has ixen soM. VALUE AT DATE ITEM Include a copy of the deed showing dec:edenYs interest'rf owned as tenant in common. NUMBER DESCRIPTION OF DEATH t. Land situate at 3103 Rttner Highway, Newville, PA 17241 Parcel No. 48-09-0519-013 Assessment $55,430 times CLR factor 1.26 =$69,842 Sold at public auGion to Dennis J. Little, et ux. see Exhibit "A" attached $91,000.00 If more space is needed, Insert additional sheets of the same size. zn REV-1503 Exs (&98) COMMOMNEALTN OF PENNSYLVANIA INHERRANCE TAX RETURN SCHEDULE B STOCKS & BONDS Thumma Robert L. 21-08-01082 All property jolndy-owned with right of survlvorshlp must be disclosed on Schedule F. ITEM States safe deposit box inventory attached as Exhibit "B" Treasury Direct Valuation as of December, 2008 attached as Exhibit "C" (If more space is needed, insert additional sheets of the same size) VALUE AT DATE $20,993.89 ztr REV-1508 EX+(8-9a) SCHEDULE E CASH, BANK DEPOSITS, 8r MISC. COMMO ENRTANCE TAX RETURNANw PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF _ FILE NUMBER Thumma. Robert L. 21-08-01082 Indude the proceeds of Ittlgatlon and the date the proceeds were recalved by the estate. 1. I Mobile Home situate at 3103 Ritner Highway, Newville, Pensylvania 17241 1987 Shultz Title No. 39007511801. (Value included in sale of real estate) $0.00 2 I M& T Bank Account 15004201215298 I $5,034.45 Accrued interest to date of death $0.59 See ExhibR "D" attached 3. Citizen's Bank Account 621740-887-3 $2,200.21 Accrued interest to date of death $0.00 See Exhibit "E" attached 4. Farmers National Bank of Newville (Adams County National Bank) Savings Account No. 9623124 $17,072.84 Accrued interest to date of death $1.22 See Exhibit "F" attached 5. Farmers National Bank of Newville (Adams County National Bank) Checking account No. 2293528 $13,817.14 Accrued interest to date of death $0.12 See Exhibit "F" attached 6. 1998 Dodge Truck Title No. 64433225802 $1,700.00 See Exhibit "G" attached 7. Kepner Insurance -collision recovery for retained vehicle $739.42 Kepner Insurence -Recovered deductible $500.00 8. I Monumental Life Insurance Co Policy No. 1014272508 $500.00 Policy No. W95133993 $1,024.81 Policy No. MM1826497 $1,011.01 9 Monumental Life Insurance Co. Policy claim denied -Overage claim Policy No. MM 5438101 $84 75 10. Monumental Life Insurance Co. Policy claim denied - Retum of Premiums $827.68 Policy No. MM5438101 11. Proceeds from sale of household property, see Exhibit "H" attached (less items 12 & 13) $3,570.25 12. 1998 Plymouth Reliant K Title No. 40844363006, salvage parts (Sold as part of public auction), see Exhibt "H" attached $70.00 TOTAL (Also enter on line 5, Recapitulation) $ 48,755 (If more space is needed, insert additional sheets of the same size) REV-1508E1<+(8.a8) SCHEDULE E CASH, BANK DEPOSITS, 8r MISC. oo~xERrrwce nzRNEruaNµ~A PERSONAL PROPERTY OF FILE NUMBER Thumma Robert L. - Pa e 2 21.08-01082 Include the proceeds cf IRigation and the date the proceeds ware received by the estate. {If more space is needed, insert additional sheets of the same size) 217 REV-i510EX+(6-96) SCHEDU~,~ G INTER-ViVOS TRANSFERS & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY Thumma Robert L. 21-08-01082 r"i..~".d„m m„sr M.mmoleted end 51ed If the answer to any of questions 1 through 4 on the reverse e10e of gle REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDEnIENAI.~~FTI&TMNaFEREE,THEUtRElAT10N6HIPTOOECEDENT"NDT"EWTEOF Te"""~'"'TACMACOPVOF~°~°FOfl~"`~"~~ DATE OF DEATH VALUE OF ASSET %OFDECD'S INTEREST EXCLUSION ""P%1""" TAXABLE VALUE 1. Farmers National Bank of Newville 0 ( Adams County National Bank) 0 I RA Account No. 9000253 (Payable to Estate) $6,050.29 100.00% 8,050 Accrued interest to date of death $1.55 100.00°!° 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 TOTAL (Also enter on line 7 Recapitulation) $~ 8,052 (If more space is needed, insert additional sheets of the same size) REV-1737-e EX + (8-08) REVERSE pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Use Schedule H ONLY for proportionate method of tax computation. ESTATE OF FILE NUMBER Thumma, Robert L. 21-OB-01082 Debts of decedent must be re orted on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Ewing Brothers Funeral Home, Inc. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commission(s) Name(s) of Personal Representative(s) (Submit requested iMOmxttlon for atltlitlonal personal repreaentaWe's on additlonaf aheebr) Social Security Number(s) or EIN Number(s) of Personal Representative(s) Street Address(es) City(ies) Year(s) Commission Paid 2. I Attorney Fees Frey and Tiley 3. ~ Probate Fees 4. ~ Accountant's Fees State(s) ZIP(s) 5. Tex Return Preparer's Fees 6. Miscellaneous Expenses 7. Check printing fee 8. Advertising -Cumberland Law Journal 9. Advertising -The Sentinel 101) Auctioner's expenses -Sale of personal property 11. Dawn and Donald Lamison -disassembly and disposal of second mobile home on property 12. Cost of sale of real estate (see Exhibit "A") Notary fees Purchaser's title insurance Transfer Tax Auctioneer's fee County and Municipal Tax pro-ration more space is needed, use 41so enter on Line 9 sheets of paper of the same $4,742:60 $6,870.46 $185.00 $22.90 $75.00 $158.62 $965.00 $2,000.00 $10.00 $804.75 $910.00 $910.00 ($96.zn REV-1511 EX * (10.68) SCHEDULE H COMMNHERI~TANCE~AXERETURN ANIA FUNErRAL EXPENSES $ ESTATE OF FILE NUMBER Thumma Robert L. - Pa a 2 21-OS-01082 Debts of decedent must be re orted on Schedule 1. A. B. 1 1 EXPENSES: NINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Street Address CIy Year(s) Commission Paid: _ 2. 3. Altomey Fees Famiy Exemption: (tt rlecetlenYS atltlress is not Ne same as Galmanfs, attach explanation) Claimant StreetAdtlress City State Zip Reladonahip of Claimant to Decetlent 4. Probate Fees - 5. AccountanCa Fees 6, Tax Retum PrepareYa Foes 7. Additional Mscellaneous Expenses.:(costs of sale oNeal estate -CONTINUED) 13. Trash removal (escrow forfeited) $200.00 14. Filing fee -Inheritance Tax Retum $15.00 15. Additional probate fee $125.00 16. Reserve to file Account $180.00 17. check printing fee $22.90 carrover from previous page $17,461.94 State _ _. - Zip (If more space is needed, insen addilionai sheets M the same size) REV-1512 EX+(12-08) pennsytvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS Thumma, Robert L. 21-08-01082 Thumma, Robert L. SCHEDULE I-1 SCHEDULE I-1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS 2008 8-Dec Wast Management 8-Dec PP&L Electric 8-Dec Embazq (telephone) 8-Dec Americas 9-Dec PP&L Electric 9-Dec Embazq (telephone) 9-Dec Frey & Tiley -Reimburse for advances to Monumental Life Insurance Co. 10-Dec Foremost Insurance Co. (Home & Liability Ins. $16850) 20-Dec Americas 30-Dec Frey & Tiley -Reimburse for costs advanced to file Petition for Decree Awarding Real Estate in Josephine Thumma Estate 30-Dec Frey & Tiley -Reimburse for costs advanced to record Decree Awarding Real Estate in Josephine Thumma Estate 2009 7-Jan PP&L Electric 7-Jan Frey & Tiley -Reimburse for Filing Fee to Register of Wills for Inheritance Tax Return filed in the Josephine Thumma Estate 7-Jan Frey & Tiley -Reimburse for Additional Probate Fee to Register of Wills for due in the Josephine Thumma Estate 7-Jan Frey & Tiley -Attorney's fees -Estate of Josephine Thumma 16-Jan Embarq (telephone) 21-08-01082 103.12 8053 108.30 24.17 53.75 61.86 163.32 Void 219.78 20.00 48 SO 41.58 15.00 45.00 1,000.00 47.91 Schedule I-1 Page 1 of 2 Thumma, Robert L. SCHEDULE I-1 21-OS-01082 16-Jan Kemper Insurance 16-Jan First National Bank of Newville -Safe Deposit Box Key 17-Jan Americas 19-Feb PP&L Electric 20-Feb Americas 25-Feb Embazq (telephone) 25-Feb Wast Management of Central PA 9-Mar PP~&L Electric 26-Mar Deborah W. Piper -Real Estate Tax Collector 2009 County and Township Taxes 2b-Mar Embazq (telephone) 2-Apr Americas 24-Apr Americas 24-Apr PP&L Electric 24-Apr Cash -DEW - Portipotie 25-Apr Comcast 25-Apr Dawn & Donald Lamason Disassembly and disposal of Mobile Home 13-May PP&L Electric 13-May Embarq (telephone) 164.33 15.00 289.00 41.81 44258 48.36 101.46 40.32 151.70 50.01 14.21 382.93 35.53 85.00 113.11 2,000.00 61.89 40.95 6,111.01 Schedule I-1 Page 2 of 2 REV-1513 EX+ (11-05j OF Pennsylvania I SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN FILE Thumma. Robert L n• ne n~nen RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSONS RECEMNG PROPERTY Do NM Llst Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS pndude oubipht spousal dlatdbutlona antl transfers under Sec. 2118 (aj (1.2).] Margaret Thumma 4501 Red Apple Drive Bessemer City, NC 28016 Niece 50% 2. Anna Mae Campbell 104 Kimberly Way Lewes, DE 19958 Niece 50% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THR OUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. 11. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 2113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTONS TOTAL OFPART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ONLINE 13 OF REV•1500 COVER SHEET. S 0 d more space is needed, insert addPoonal sheets of the same s¢e. Settlement Statement A Tvee a/Loan mm nV .11Nw11nt\Ym4aw.R9w1 - U.S. DeparL\ront of Hombp etq. Urban DevebDment (1YA lnnm\.s11Jn eRM.nX[ r~vnlree 1119I1nIiI1e\ 1. ~fHA 2. OfmHA 3. OCanv. Unba 6. Fb Numbar 7. Wan Number 8. Mortgage Insurance Case Number 4. VA 5. Com.lne. 09.101 C.Note: waA.rlaa'b.F.eY'~Fn Pbe[[ae Y[ ewr.w rMw,ner.rarbromatlon p.w.rw.FMbtlWMbtl[row. TitleFxpress Se8lemen(system ~ "~" ~' eoa .e ~~. n ~ieu ~ M w ~ ~ ~ r i a ~r~°0A m iwm en r . a. : . 180 .e C e se 6 .~ A, w Pdn ed 0511912009 at 17:15 KM D. NAME OF BORRDWER: Dwfnb 1 LMS~ aM CdAy R. L1ttl~ DD SS: 7Oh~ba C+rlbb PA 17015 E. NAME OF SELLER: Eabb o(Rt1Mrt L Thummf ADDRESS: 3103 R9ner H New7411 PA 17241 F. NAME OF LENDER: - ADDRE S: G. PROPERTY ADDRESS: 3103 R9mr Hi9hwq, Nwwllb, PA 17211 Wat PwttvAwo T H. SE77LEMENTAGEM: Th~ Law ORke dAndtlerr FL BMw, PCr TNtphau: 717.24,}7135 P E GF NT: 100 8 liudro Bulb 11 PA 17013 I. S LEM Nf DATE: OSMA12009 100.6RO9S AYOUNi DUE FROM BORROWER 100. GROSS AMOUNT DUE TO SELLER - 101. Co d oaks 91000.00 401, et4en 81 D00.00 102. Pewonal Pe 103. senlemed b 6anower m 7a9o 1909.59 aa1. aa. t a55. nb for Aerne aaler h eavence ua5nenb for Sam eW aelbr b eevante 108. C 108, 107. Coon bzes 0919N8b127i1AK 9827 a07. fuse OSfl9109b12191 98.27 108. School byes OSMBABfo0813DN9 9812 408. OSV1910A ON9pPo9 8812 1(18. qOg, 119. at9. 111. Ott. 112, d12.. 120. GROSS AMWNT WEFROM 424 GRO89 AMOUNT DUE TO SELLER 91792.39 100. AMOUNTS PAID BY OR ON OF BOR ROWER 500. 1N AMOUNT DUE TO 207. «eamBelmon .00 W7. FxceeeDe see 8 00 202. Pdnd d a 1 dnew ban 811.75 203. bane ken su b u b 20M1• P d M Loan 205. fa7weh al 200A0 207. ' 209. fi09, Ip'90tMb 1t7f 9'iM ttY9e for Remo w ewllx 210. toes 510. 211. C tuea 11. fuse 272. School taxes 312 Shc0d hxe8 273. 51 . 214. 514. 215. 515. 216. 518. 217. 617, ~ 57 79. 61 . 220. TOTALPAI BYff BORROWER 8 .00 b2D.T AL REDUCTION AMOUNT DUESELLEFt 11734.75 300. GASH AT $ETTLEMFlIT FROM OR TO BORRO WER 800. CASH AT SETTLEMENT TO OR FROM SELLE R i. t .80 B01. msa 1 b few 4 91 19239 30, a n6 id r Ins 8800.00 802 Wee wd d n 5 11734.77 90.1. GASH FROM BORROWER 955.89 801 TO 8ELLER 7849.84 Blrl~BgeipnmVai' FqW 1LW BELIER cYAiaswrm iM Hernbtlen mnab.e nwn b bY+All W YYdmgbnrM beenp NNNr0 bM YunW amen arMlu. Yyw w nAWRe b MR • nbm. M Wi rCeiwm~iwYr MOw Fmurbbalew~eibbrrW~f YW Mn 4nP[FYb M bVAaC ne er FBeMrm[Ix Mq M M MnlepvlM. 1M Ca6W Bw Pb 0.ruIM0 en rou bFl«r[w erwbyvwar.e.n[.[q.R~Frarnroxcaaauesalwnw[mnnme.~b.riae.um rwror.ap16,wlob~.w~[aan.b~typ~p,~~smmman Iwnbn Ya nW a [Nrbb tlMA VbWW Fnae~l[MrRI CP w. NW W~[Ir aFe7MY.ItYtlMVW Mr,YMMIMn m AYYbmMY T/m11W we %ellellYArWI Abnerr. Tw:_ ~~ r_ _~ BELLaR(BI ENVMNBEIBk BELLERIB) Nfae xua.wo ADpaE8e: BELIEa(BI P,IONe MIYBFRB: _IM)_ _ rin 1~...' ~. sew s m asldx. hm HUb1 (3rtM1 MHFn®oot6"c5.z .S. DEPARTMENT OF HOUSING ANO URP"'DEVELOPMENT FlIE Number. 09 ~"1 PAGE2 vEOlt .. e.. .nl e.aa. OHn1aN fLA11000M a110~R] KM VGIILLIWYrrI VI/n~Yrr~~~r~ '~~' _. SETTLEMENT CHARGES 700. TOTA4 SALES/BROKER'S COMMISSION beeetl an lice E91 000.00 • PAID FROM BORROWER'S PAID FROM SELLER'S DlvisiondmmMSSion line 7W es kflows'. FUNDS A7 FUNDS AT 7 1 ro SETTLEMENT SETTLEMENT 702. to 703. Commission aid e<SeNlament 800. ITEMS PAYABLE IN CONNECTION WRH LOAN S 1. n ON Inalion Fee % 802. Loan Discount % 803. A ~ al Fee 804. Credit R 805. Lentlefs ins Fee 808. M kallon Fee 807, Asaum ' Fee ' 808. 809. 810. 811. 900. ITEMS REQUlREO BY LENDER TO BE PAID IN ADVANCE 901. In rest From ro 902. M elnau ce ium fa 903. H Inaurence Premium for 904. 1000. RESERVES DEPOSRED WRH LENDER FOR 1 1 H Imurance Mro 1 . M Insurer Imo 1003 C' Pro Tas mo. Imo 1 . Gou Tml mD. 12.90 0 1 . Sdroo t~ 67.99 Imo 1009.A ale Anal bAdusmrem 0.00 0.00 1100. TRLE CHARGES 11 1. ement ar in lee 1102. Abshad artitle seamh 1103. TDIe 11 . Title i curence Finder 1105. DoLVment ratlan ro The Law OMlee of Andrew H. Shaw PC 11 . N Fees ro KrNdI L. Morn i OAO 8.00 10.00 1107. Arlan sfees Ind es above I(ems N 1108. Title I eurance to Law Offce of A. H. ShawISTGCOB Wes items No'. , 804.75 1109. Lenders Pdl 1110. Ownefs Pd' 91 000.00 •604.75 7111. 100 No Yd 300 Su 900 to Law Offee of A H. ShawI5TGC08 P.O.C. 150.00 B er 1112. 113. Cbsm veLe to Law Oifea of A. H. ShawISTGC08 P.O.C. 35.00 8 er 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 12D1. Recortlin F Deed 38.50 'M rt e 'Release 38.50 1 0. C ICaum tadstam 910.00 ~ M a e 910.00 1203. Tm! 10.00 910.D0 1 .UPI m Cumberland Cou Recorder of Deeds 10.00 1 . 1300. ADDRIONAL SETTLEMENT CHARGES 1301. Su 130 . P Ina i 1303. Ovem ht Fes ro The Law OIRee of Andrew H. Shaw PC 130 . A eer F Kevin M. Wfckard 910.00 1400. TOTAL 3ETTLEMENT CHARGES (emer on Iinea 103. Sedbn J aW 502, SeG.Bcn_K1 1083.50 2 534,75 MID CERTIFILAmDN OF BUYER AND HEELER «NPn RrWwCIM1F HU 1aPXMmxY8WnN 1wIMMMN aI mYI~MWFMa bW.Mb FNw Mq A.vAMYMNrmrYMtl~elps mOWMwnNI mFES anmY~ Ey ab~sCCO' I VWyBMII~rP fBP20Vb WPNUD-t aF11MTM151WmFn1. ~q ~~ Y ~ T® I~~Li IL p I •. ...I .. WARNIND: R19ALRIME TO IQIDWINDLT M41fE FPLBE BTATEMENTB TO THE TM MU0.1 SdMmM 9Ybmwil IIrM WOFM FC¢ulE Mtl6 IINRED BIATFAMTl116011 ANY 8BdRM FORM. PENALTEB WONCOIWICTON 1rPVtlYn llNnauW PV® tlIF F¢MpmnwW tlIM WIFTVA GN WCLUOEA F WE AND IMPmSONMENT. FOR pETAR4 SEE TOLE 18: U.B. LOGE 9ELTON 1 Wt AND SECTION 1010. ~ ' "~ BETREMENTAGENT: DAl@ ~~~ 485D0041046 REV-485 EX (05.04) SAFE DEPOSIT BOX INVENTORY rA uepenment of Revenue PLEASE Soda! Secudry ar Death Certlflcate Number Date or Death _ County, Code _ Year 179-30-3533 10/27!2008 _DecedenYs Last Name ~---- - ,. __..---- Suffix ~..-.__. Flrsi._ _._ ! L.__._. Namr. iE ORIGINAL FORM ONLY File Number ___~ L_ ---- - ~~i ~.~_i r`___ I Thumma --~ ` .- Robert + __. - I L - ADDRESS OF DECEDENT STREET: CITY: STATE: ZIP CODE: ~ 3103 Ratner H Newville PA 17241 NAME AND ADDRESS OF PERSON REOUE8TING THE OPENING OF THE SAFE DEPOSIT BOX NAME: Margaret E Thumma 1 STREET ADDRESS: CITY: STATE: . ZIP CODE: 4501 Red A le Dr Bessemer Ci NC 28016 • NAME, ADDRESS AND RELATIONSHIP (IF ANYi TO DECEDENT, OF PERSON(S) PRESENT.AT THE BOX OPENING e. NAME: REIATIONSHIPo II Margaret E. Thumma ,~ 1• < < ~ STREETADDRESS: CITY: STATE: ZIP CODE ' 4501 Red Apple Dr Bessemer City NC 28016 b. NAME: RELATIONSHIP: Anna M. Campbell ,getleq~F. ,,) I. ~ ! STREETADDRESS: CITY: STATE: ZIP CODE: 104 Kimberly Way Lewes DE 19958 a NAME: RELATIONSHIP: i i STREET ADDRESS: CITY: STATE: ZIP CODE: © NAME AND ADDRE88 OF FINANCIAL INS7RUTION WHERE 7HE SAFE DEPOSR BO% IS LOCATED NAME: Farmers Natl. Bank a division of Adams Co. National Bank STREET ADDRESS: CITY:. STATE: ZIP CODE: ~ 1 West Bi S Tin Avenue Newville PA 17241 NAME OF PERSON MAKING LAST ENTRY DATE AND TINE OF LAST ENTRY Ma aret E Thumma/Anna M. Cam bell 10/28/081:00 m DATE OF CONTRACT TD RENT BOX NUMBER OF BOX 1 Tn'LE UNDER WHICH BOX IS REOUEBTED 03118H974 80100056 Robert L. Thumma NAME AND ADDRE88 OF PERSON(S) HAVING ACCESS TO BOX '~ e. NAME: - b. NAME: I Robert L. Thumma , I STREETADDRESS: STREET ADDRESS: I 3103 Ratner Hwy. CITY: STATE: ZIP CODE: CITY: STATE: ZIP CODE; Newville PA 17241 NAME AND TRLE OF EMPLOYEE TAKING THE INVENTORY Brenda M. Shughart Service Manager WAB A WILL IN THE BOX? ~ VES ^ NO d yee, e. Dels of wVll: 04/10/2007 b. Neme end edtlroes of paroonel roprosentstiva, It named In the will NAME i STREETADDRESS: CITY: STATE: ZIP CODE: I, c. Name and etltlrow of attomeg If any NAME i STREETADDRESS: CITY: STATE: ZIP CODE: ~~ L 48500041D46 '48500041046 D~ eeg~ RFVdAR FX SAFE DEPOSIT BOX INVENTORY Page ~ of /d INSTRUCTIONS (1) Cash: Report total only. (2) Stocks: List In detail every common or preferred cenifcate, wanant or other dghts found M box. Sixks ars to be designated by name of cempeny, certificate number, date of certificate, name in which stock is registered, end number of shares and class of stock. (3) ODligatlons of U.S. Government: Number of Nems, date of issue, fare value, names in which registered and type of ownership, I.e., jointly held, payable on death, etc. (4) Bonds: Designate by name, amount, sedal number, w other designation. (Seater Bonds) (5) Bank and SaNngs and Loan Passbooks: State name of deposkor, number of book, last date eppeadng in book, name of bank and branch, erM balance. (S) Jewelry, Coins, Stamps, Mpnuscrlpta, etc: List and des«ibe as fully as possible. (7) Dwds, Mortgages, Currant InsDranes Policies or other rvltlances of Indebtetlnasa: List and describe as fuly es possible. (3) All other eordsnts, (fl) Rstum eompbted form to: NHERifAt1CE TAX D SIGN OIPT. 280801 HARRISBURG, PA 17128-0801 ITEM NO. REM DESCRIPTION pct. .~ r0..~L[_ Pr'r •' "-C ~, Cu '~66GS .~ Z f I ~ r r Gc ~ < UC ~ i G t- ~ (o DI° T H.nmo- Pr ~G 'c G g vd G 2 25"gDZ 'T ~, „„~, PC.t ,~w aF ~' a Gr' qT+~- bb !/got U S rf c5 ~f /io 2 D Q a 2 ~L 6 ~' ~ ~' fYi • ~/ •1 ~1 () n Qo ,xYn w ! L zZ s 9 z c m. w ~vp ~e u.n.ylrn C G 572 z-z ~E tit ,. Da Q prfiG,'~r~ ~ {/vo C Sz - ~ Jos t h,' 7` D obr -t x.71,. 'o 0 C DD r 1 C 0. O KO L.- ~t a/D(7 ! tiff ~ c ~ e c, N mv~ 91 00 C b 9 e ~ - h'ne m^ ad ~ berfi ~.IhNn,,,o,~, ~io0 yy ~ JD I~ c /~ a crf _ w b C G CI S y ~ fn ^ e a 7 a b er'l k rn SY /0 0 L ~Y33 $ ;= JoSP /, ~nc a PD t ~,, o. a lOD 632y33453EF oSe hone ry1.Tti~ o. Po obrrt l,.''9,u a Da L. b z 3 5Z FF o I' 1,; ~ vt w,.o. NO.,Q o~er-/ ~-•~tummr~ Y /oo L SG4 ffo3 y3 JOSP h,'rle A1- ^' a ma 0 ,Qaber-!' !^•~l-,Hnm~ ~ too LSs6 E' h` c ~AmmF D o Pr'f I^~~1hmm~ ~tvD I CERTIFY UNDER PENALTY OF PERJURY THAT TREASON RECORD IS CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. P RSO RECEIVING CO OF SAFE DEPOSR BOX INVENTORY: TORE aIONATURE .Y f PR NPME I PRI N ANO CHECK APPROPRIATES BELOW: M ` A/ l'C dA .._ V~Pr "{" { rrt t . >U / r Yrl PRINTTRLE DATE CHECK PROPRIATE BOX: Sef V t riC M 61ti~ C t^ /! 1 !. (f /~[ -/ - t~ ~Exewtorlvfz) ^ Adminletrebrlulx) , ~ EsLb Rep,eaenfaLw ~ Jdn! ownsr M eeb tlapoNl box NOTE: Attach add(tlonal 8'!." x 11° sheet(s) if naceseary or use dupgcates of this page of form. TM Depsdrnerlt M authDd:ad bylaw, 42 U.S.C. §405 (cU2uC)m, b cegidle datlosura d Soda) SecWty numbers in connection with administering staN taz laws. The Depamnem uses the Soael Seardy number N identlfy Me decedent eM paternal representetiwls of the estate. The CanstwrNroakh rtay ahD use tlIe mfonreGan m ezchenge of tax irdonneaon agreements wflh federal and local le)d augluiaes. The 518N law as the CorrmonweaM's rsannel irorn confldentlal tax irtlonnation exca for oBdal Dees. (P/6N /~I N. T/2~/68 v!i/o7 Y(t`~/o i 2 /D~9 ~~~ tl~ SAFE DEPOSIT BOX INVENTORY Page Z of I D REV-488 EX INSTRUCTIONS (1) Cash: Report total only. (2) 8toeks: List in detail every common or preferred certigwte, warrant or other rights found in box. Stocks are to be designated by name of company, certl6cata number, data of caAiBCate, name in which stock is registered, and number of shares and Wass of stack. (3) ODllgations of U.3. Govamment: Number of Items, date of issue, face value, names in which registered and type of ownership, i.e., Jointly held, payable on death, etc. (4) Bonds: Designate by name, amount, serial number, or other daslgnetlon. (Bearer Bonds) (8) Hank and Savings and Loan Passbooks: State name of depositor, number of book, last dale appearing in book, name of bank and brench, and balance. (6) Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible. (7) Deeds, Mortgages, Cut»nt Insurance Policies or other evldenl:as of Indebtedness: List and describe as fully as possible. (8) All otfur contante. (S) Retum Completed form to: DEPARTMENT OF REVENUE INHERRANCE TAX DMSK)N DEPT. 21A601 HARRISBURG, PA 17129A601 tT~ NO. rtEM DESCRIPTION ~ ~ ~ a~gg ~E ~. ~ c. ~,,,~.~ ~ E~ r ,~.~. ~-C. ~`SD.~- ~ a~7ro ~9~E ~. ~~~, r~~ ,~- 7 86 r/E umn~ 50. - L '7 863Ct ke lIYYiMI~ .~ L. ~ ~ - ~ , ~ ~s~_ ~-aaa 7 per is ~ ~a L. ~ ~a ~ ~ ,~, . ~ z. ~ ~ ~ ~ ~ ~ !~ 1 ~co31 ~~ lt~ rug -~ ,:IS. -- L 11363a ~L-' u,w+Yxa~ ,D (k~41~ ~ 0 -~ ~ cLxfln(~ ~, v` 0 /l3 / L-~' u umt~c. '"1? r -~ Adm. - Il3a ~ lte. umwtA. ?0; ~acb, _. ~- ~!%1 ~016`6L'~ tie ~ n~~uc. I ~ s~ ._ a 6 ~~ .~ ~A. ~i,o, d ~ L. ._ a ~ I D b.~rf- L- ru~+nfa. ~ _ I CERTIFl' UNDER PENALTY OF PERJURY THA THE A80VE RECORD IS CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. PER80N R C NG CO OF SAFE DEPOS{T BOX INVENTORY: SVGNATURE SIGNATURE PRIM NAME PRINT NAME AND CHECKAPPROPRIATE 80X aKOW: PRedT TITLE DATE CNECKAPPROPRIATE BOK EvoWOnirl%) ~ AdmlNaeetoNdx) Estate Reprsonbtlve ~ Jdnt owner desk depose box NOTE: Attach additional 8'/x" x 11" shoat(s) if necessary or use duplicates of this papa of form. The DepeMnm Is authorized by law, 42 US,C. §4D5 (c)(21(C~I), m regWre d{Edosue W Soda) SeoxNy numhels in connection wHh erhnirdsteMg state tax laws. The Depatruent uses tl1e Sodel Sewdty number b IdentlN the decedent end paswlel representadvas W 91e . The Commom+eatlh may also use tl~e IntomMtlon In ezdange of fez hiormetion agreements wMh Federel and brat aualorlties. The state law rohiblls the Comnanweetlh's d Imm died confidential lal inlorme6orl t is oifldal '~ ... SAFE DEPOSIT BOX INVENTORY Page ~ of /~ REVABS EX INSTRUCTIONS (t) Cash: RepoA total only. (2) Stooks: List In detail every common or preferred ceAificete, warrant or other rights found In box. Stacks are to be designated by name of eomparpr, certificate number, date of certificate, name In which sloGr h reglstered, and number of shares end class of stock. (3) Obligations of U.S. Government: Number of items, date of issue, face value, names In which registered and type of ownership, I.e., jointly held, payable on death, etc. (4) Bonds: Desipnete by name, amount, sadal number, or other designation. (Bearer Bonds) (~ Bank and Savings and Loen Passbooks: State name of depositor, number of book, last date appearing fn book, name of bank and brench, and balance. (~ Jewelry, Coins, Stamps, Manuscripts, eta List and describe as fully as possible. (T) Deeds, Mortgages, Current Insurance Polleles or other evldenees of Indebtedness: List and describe as fugy as posstbte. (B) All other contents. (B) Ratum Completed form to: OEPPftTMENT OF REVENUE INHERRANCE TAX DNISION DEPT. 290&01 HArtR1SBURG, PA t7t29-O6D1 rTEM NO. ITEM DESCRIPTION L 7 ~ ~~` . ~t ~G ~,r- 57 057 E~ 11,e. ~ ~2~r~-L . ,urz, ~ 117- 9 '? ~ E D, -~ rn•~ /~ Q DEL' a rna_ ~er~' L _ cu~~ ~ r aa9 o s ~ t' ~ ~ ,~ ~-- ~ a s ~~ ~ ~- ~ ~ ~ ~~ GG ~~ uxP .D . ~ f rg ~ - E~' uvrln~ .p. ~. L ~7o POto ~~ _ ~- -~ L , u~nu ~r- z 95E&' rx~, L. ~ ~- ~~ rice 1 0 ~ vus8 ,0, ~ ~ C '~ '1 ~ rxa- . dl um~ /~ 9vaa ~~ 1 ~ . ~ ~ ~~ ~- goaa ~~: '' ~~~~d, ~ U '73 ~ rna. .d . ~ L u.~run~ /C~, _ I CERTIFl' UNDER PENALTY OF PERJURY THAT THE ABOVE RECORD 19 CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. -PERSON RECEIVING COPY OF SAFE DEPOSR BOX INVENTORY: SIGNATURE SIGNATURE PRINT NAASE PRINT NAME AND CHECKAPPROPRIAIE BOX BELOW: PRINTTmE DATE CHECKAPPROPRIATE BO% ^ ExecularllA<) ^ AdmlMS4ebr(bk) ' ^ I:H~b MPrewnlatlw ^ JNnI Px1Yr AaNs MWve boa NOTE: Attach eddittonal 8'/~ x 71° sheet(s) If necessary or use duplicates of this page of form. The Department re eumorized by aw, 42 U.S.C. §4D5 (c)(2)(C)n), W require dsdaiae ot5otlel Sacutily numbers n conrectlon cash adminlstedng stare tax laws. The Depafilem uses ere Socbl Security camber b reenBll'the decedent and personal regesentaGves of the estate. The Commomveaflh may also use fIe Wamafion b exdange of tax InfomGtlorl agreements wet Federal end hxaf eultxx{Des. The dale law Iblre 91e Commanrredh5 el trap disdodn confidentld tez mtormetbn exce for ofidel u see. ~- •~~_ h V:°~ SAFE DEPOSIT BOX INVENTORY page_J_Df ~0 REV.485 EX INSTRUCTIONS (1) Cash: Report total only. (2) Stocks: Lislin detail every common or preferred cenificate, wanant or other rights found In box. Stocks are to be designated by name of company, certificate number, date of ceNhcate, name in which stock is registered, end number of sherea end doss of stock. (3) Obligations of U.S. Government: Number of Items, date of Issue, face value, names in which registered end type of ownership, I.e., jolndy held, payable on death, etc. (4) Bonds: Designate by name, amount, sedel number, or other designation. (Bearer Bonds) (5) Bank and Savings and Loan Passbooks: State name of depositor, number of txwk, last date appearing in book, name of bank and branch, and balance. (s} Jewelry, Colna, Stamps, Manusedpts, ate: List and describe es fully as possible. (7) Deeds, Mortgsges, Current Insurance Policies or other evidences of Indebtedness: List and describe es fully as possible. (B) All other Contents. (8) Rotum Completed forth to: DEPARTMENT OF REVENUE INHERITANCE TAX DNISION DEPT. 280801 HARRISBURG, PA 17128-0601 ITEM NO. REM DE8CRIPTION /-~ 7v C~ L. ~~a ~'iaa 0 !off L' /rxt- L 8 ~J ~ 1, uv4 ba ~~ ~ ~~. - g~~ ~ ~i~ ~ ytor8~l ~ ;~.~ ~. g ivLe ~ ua r~._-) .~ d .~ ~7r.D. ~I e' >L C. ~ ~ I _ L rna. / C tot ~ tae ~ ~ , C ~9 ~ ' rn L. inat. /lei. C ~'79S~Zr 'l• Rco~- /l't~ C 1 EE ;1e ~. d Hco., ~ ~l nu. L. rue. ~ C ~g988 ~~ ~ , , l~~ !; = , E' ~a ~- urrn rn~. ~ ~ E'ri' w~' ~D , ~ 1 CERTIFY UNDER PENALTY ERJURY THAT ABOVE RECORD IS CORRECT AND COMPLETE TO THE BE8T OF MY KNOWLEDGE AND BELIEF. PERSON RECEIVI G COPY F SAFE DEPOSIT BOX INVENTORY: SIGNATURE SIGtU7URE PRINT NAMfi PRINT NANE AND CHECK APPROPRIATE BOX BELOW; PRINTmTLE DATE CHECN APPROPRIAT BOX E r -T E%~MOr(Wz) Q AtlminlMbr(tr'v) Eemta RWruMmaW ~ JdM Caner of ur° avpovn Eox NOTE: Attach addttlonal 8'/~ x 71° sheet(s) if necessary or use duplicates of this page of form. Tns DeperhnaM 15 eu8talzed by law, 42 U.S.C. §4D5 (c)(2)(C)(Q, b reQlibe disdoare of 8odal Sealriry rxunbers in cainection with edMnistering stale fax laws. The DepaNNtM uses Me Sodel Sewdly number b iderNfy the decedent end personal repreeentatlves d hie estate. The Camnomea6h maY also uae the Infamelion in exchange of fete Infame6on agreements wNh Federal eM kxel au6wNiec The sm~ law the Caalromse»h's Iran 8iedapn calM1dentlel taz ntomafian exce fa oRidel r lFd~~IrUa_°JUU U Page ~ of ~~ RFVdRF FX SAFE DEPOSIT BOX INVENTORY INSTRUCTIONS (1) Cash: Report total only, (2) Stocks: List in detail every common or prefamed certificate, warrant or other dghts found In box. Stocks ere to be designated by name of company, wnlrlcete rwmber, tlate of certifipte, name In which stock is reglsteretl, and number of shares and class of stock. (3) Obligations of U.S. Government: Number d items, date of Issue, face value, names In which registered and type of ownership, i.e., Jointly held, payable on death, eta (4) Bonds: Designate by name, amoum, sedal number, w other designation. (Bearer Bonds) (6) Bank and Savings and Loen Passbooks: State name of depositor, number of book, last date appeadng In book, name of bank end branch, end balance. (6) Jewelry, Coins, Stamps, ManuseHpts, etc: List and describe as fully as possible. (T) Desds, MoRgagss, Currant Incurancs Policies or other evidences of Indebtedness: List end describe as fully es possible. (B) All other contents. (9) Return Completed form to: DEPARTMENT OF REVENUE INHERRANCE TAX DNISION DEPT. 280807 HARRISBURG, PAt7t28-0801 REM N0. REM DESCRIPTION C7! GJ '7!a - u~tt ~ GYI,-- ! a ~ u e L. e~ L. ~' s- 1 y EE ~, . l). ~ 75 r7 c>~ L. 0 ~ ~ ~' d / - 5 '7 ? v~aai? ,L L ~ nta_ ~ g ~ ~ ne ~ , l ~xa. l_5 ~q 16~ ~ ~ .17, C.71(, nlv~ ~~ 5 D ~1 ~ ~~" ~ ' , D, ~ /Lb via-- ~ ily E~ f~tn. .~. .' G. ~ 1 CERTIFY UNDER PENAL PERJURY THAT THE BOVE RECORD I9 CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. PE ON RECEI NG COP OF SAFE DEPOSR BOX INVENTORY: BKiNATURE &IGNANRE PRafT NAME PRINT NAME ANO CHECK APPROPRIATE BOX BELOW. PRINT TRLE DATE CHECK APPROPRIATE BOX: ^ Executor(Vix) ^ A4mNMtor(Nx) ^ Eshb Repreeentatlxe ^ JaNt owner of eMe tlepma box NOTE: Attach additional 8'/:" x 11" sheet(s) ff necessary or use duplicates of this page of form. Ths DepanrnNlt is eulhodrad bylaw, 42 U.S.C. §405 (ci(2i(C)(p, b mQlAre disdouae of Sod¢I Seadly numben m conrxlcfion wah adMNstedng stale taz laws. The Depvanent uses the 5edel SeLtaay numbx to identify the decadelll and personal mAeeentatlves W the estate. The Carunonweeah may also use tlH bfonnetlon N exdanga of tax infamalbn agreements ws: Federal and locef 1 autlwdlfes. The stele law bas ale ComnonwBdih's el from disdosin confidmsiel tax hfarrrelion ezce im ofidel s Page ~D of ~ ~ REV-4R5EX SAFE DEPOSIT BOX INVENTORY INSTRUCTIONS (t) Cash: Report tolel only. (2) Stocks: List in detail every common or preferted ceNflwte, warrant to other dghts found in box. Stocks are to be designated by name of company, cedificafe number, date of certlficate, name In which stock is registered, and number of shares and dass of stock. (3) Obligations of U.S. Oovamment: Number of dams, date of issue, face value, names In which registered and type of ownership, i.e.; joingy held, payable on death, etc. (;) Bonds: Designate by name, amount, sedal number, ar other designation. (Bearer Bonds) (5) Bank and SaWngs and Loan Passbooks: State name of depositor, number of book, Wet dale appearing in book; name of bank and branch, end balance. (S) Jewelry, Coins, Stamps, Manuscripts, efe: List end descdbe es fully as possible. (T) Deeds, Mortgages, Current Insurenoe Policies tx other evidences of Indebtedness: List and describe as fully es poaslble: (S) All other contsnN. (B) Retum Completed form to: DEPARTMENT OF REVENUE tNHERRANCE TA% DIVISION DEPT. 280801 HARRISBURG, PA 1712a-0901 ITEM NO, REM DESCRIPTION 25 D$ F C ~ n u ar ~nm q# yU 80I .~n5< ht^n c. am a U/~ N ~. NW1N'1 Gl Y~t`JD C .2(0 (p 7 ( '-l $ J ~+w.vna PO 4 d rl- k ~ CJ Zto %/ Kgj VvSP IniY~C dl~• vrn () z L• ~'IxAmvr+c S~lDD yb L' r~i~G K Q 0 Nt+'I A 1? br L- w a C2G•G f ,ns "Ins wmx.•.~. (1 a 2 Llt~ .~o tit M '?rlum +~ 0 (tiDbP 1.. r vy 2 2 1 7 .~ rin - ~ Q r ~' c. 4 `P 200 0 ` .l ose kl o crest ~- u ~y ~ v o 3 usC GI k a 0 Q rr~ m a IOU ~20o v 2 Jo /1~r1C N ,M- d0 ber~ ksn O L. ,1 v c C ~ v N,ti r^ ~ c o o J c µ Poo n erg a D~ 2,72(0 c1 i c um u ~~ er'f c., rl JD Gr'nC '1 • ummrn r~ ~- Km 0 U9 2 r ~, 09 S ~7 V OS ~ s~ 0 6Pr'~ ~ , u r~ o C, D 62 o c ~ ~ w 17.0 ~ '~ o 2~ r2.~ P ~ ~. ~ en o P ,.. .~ ~ ~~ G ,~vxC 4 QO1Jp ~ M ~+. T D'D I CERTI FY UNDER PENALTY OF PERIURY THAT T E ABOVE RECORD G PERSON R CE VING CO Y OF CORRE CT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF SAFE DEPOSIT BOX INVENTORY: SUiNATURE aIGNATURE pRIM NyAE PRINT NAME AND CHECK APPROPRIATE a0%9E10W: PmNT TIRE DATE CHECKAPPRDPRIATE BOX; Exacub~(trix) ^ AdmfMx4aroRtrd) EWN Regaxanbaw ^ JoMI own"r of xab depwit box NOTE: Attach additional B'/:" x 11" sheet(s) it necessary or use dupiieetes of this page of form. the Depadment S eulha¢ed bylaw, 42 U.B.C. Qd05 (cj(2)(CJp), to ragWre tliadosuN of Sodal SswMynumbers'm conrNCdon w8h edmiNstedng stale tax laws. The Depsnnant uses dN Sodel Seasity number b IdeIVB)'the decedent aM personal representetlves of g)e eaaU. fie Catmwnweallh nay also use the iMgmatlal h exchange of tax hlformatbn egreerrwnta wtlh Federal eM lod fed autlwlBea. Tha slaty law hbds 81e Commonwealh's from d cotddential tax iMamatlon fcr ofidai ea. SAFE DEPOSIT BOX INVENTORY Page_Lof r~ REV-485 EX INSTRUCTIONS (1) Ceah: Repon total only. (2) Stocks: List In detail every common or preterted cedificate, warrant or other rights found in box. Stocks are to t>e designated 6y name of mmpany, ceniflcata number, date of cenifuste, name In which stock is registered, and number of shares and doss of stodr. (3) 0611ga8ons of U.S. Government: Number of hems, date of Issue, face value, names in which registered anotype of ownership, i.e., jointly held, payable on death, etc. (4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds) (S) Bank end Savings andLoan Passbooks: State name of depositor, number of book, last date appearing in tXwk, name of bank and breach, and balance. (8) Jewelry, Coins, Stamps, Manuscripts, etc: List and describe es fully as possible. (T) Deeds, Mortgages, Current Insurance Policies or other evidences of Intlaldsdnesa: List and describe as fu8y as possible. (8) All other convents. (B) Return Completed form to: DEPARTMENT OF REVENUE INNERRANCE TAXONIBN)N DEPT. 2811801 HARRISBURG, PAtT12BA604 REM NO. ITEM DESCRIPTION C 9 5 ~3z ~E J r ~ Po Q. ~ z,.77~N ~,~. 4~ 306 2 o h e ti a D /Zvberf L. ummH a ~ ~.~ Sz 2g5 Josr t' e K uber'"l G,. L. c~ x 5~ q off, 7'77 ~o h~v um DD ~o cr 7 O C 2 772 d ,~ 'la F ,'l,~L w ~ P~ ti +r! 2 Jos e (~ D o ~,, ~, '1 ! g "tee u o(~ r'~ m a/ C 31 S 4 .~ o ">1 c 0 l~ - on Jt SI .{o ti°„~ ~ Pao 2 >p, D9 2 hl~nc um ~ ~. 2 wm o. k uo V '0.s !1 ~ e u d o ~f m m +10 D G 3 ~ os r "n <- A'1 • K m vn O ID d p r'~ G.. 'N m ~+ 3 /o C o b .~o h "nc a DD O n H 0.~ ~ ~~3 J SC' r`I C N Q ~L YC Pf~ I'•-I'~N ~- (yL G 4lK 9 J05t? r'Llc. ~ c. ~(~~ RebP~~ h. IA o. ~-!UD D v h m. u O,D rl- ~ A rv !. P h c rYl • u a D rr~ !_. v< q ~ 3 t~ J ~.. ( t 0~ ~1oSP ~ ~ ,?D br Karr,ti ~ C ~ 3 1 t" h" C <I't- ~nmmo. ~~Q Qobr '~ Km Ytt7 I CERTFY UNDER PENALTY OF PERJURY TNAT THE A OVE RECORD i8 PER N RECEIVI G COPY OF CDRRECT AND COMPLETE TO THE BEET OF MY KNOWLEDGE AND BELIEF. SAFE DEPOSIT BOX INVENTORY: SIGNATURE SIGNATURE PRINT NAME PRINT NAME AND CHECKAPPROPRIATE BOX BELOVF. PRINT TRLE DATE CHECK APPROPRIATE BOX: ' Eaeculor(trix) ~ Atlminletrator(WZl Eclats Rapreeenleaw ~ JRint amsr of seta tlepONl bw NOTE: Attach additional 8'1:" x 71" sheet(s) If necessary or use duplicates of this page of form. The Depemrent is auflor'vad bylaw, 42 U.S.C. §405 (c)(2)(C)(), N reqube disdosule d SDdal Sewdry nurtlbers in connec8on whh atlldrtisterirq state tax laws. The DepaMleM uses de Sodel Seaahy number b identlfy the decedent and personal repesentatlves of 8e estate. The Comrlxmvea8h may also use tl:e infalmetial N exchange of tau infame8an epreements wih Fadarel and bni eutlnrNes. The ateie law Ne Commonwredlh's horn dsdoein oontdendal tax Informedon exce for oRldal SAFE DEPOSIT BOX INVENTORY Fage~of t7 REVd85 EX INSTRUCTIONS (1) Cash: Report total only. (2) Stocks: Llst in detail every common or preferred CertiScale, warrant or other dghls found in box. Stocks are to be designated by name Dt company, certificete number, date of certi5cate, name In which stock fs registered, and number of eha~es end Gasa of stock. (3) Obligations of U.S. Government: Number of Items, date of Issue, face value, names In which registered and type of ownership, I.e., Joinay held, payable on death, etc. (4) Bonds: Designate by name, amount, sedel number, w other designation. (Bearer Bonds) (5) Bank and Savings end Loan Passbooks: Stele name of deposkor, number of book, last date appeadng in book, name of bank and branch, and balance. (6) Jswslry, Coins, Stamps, Manuscripts, etc: Vat and describe ea fully es possible. (T) Deeds, Mortgages, Curtent Insurance Pollciee or other evldenees of Indebfedneee: List and desedbe as fully as possible. (6) All other contents. (S) Return completed form to: DEPARTMENT OP REVENUE INHERrfANCE TAx DNISION DEPT. 280801 HARRISBURG, PA 17128-0801 fTEM NO. REM DESCRIPTION r. //~~ /J y / ~a Z~4 -~03P hr1C 0. ~4 K.ObMI h. N % ~O9 5877365L~C osC GII'nC u b eF} um a yt ou g7 ~ &1: sc I: a Po o rt t • ti ,~ yo 5 7 3b3 aF S c u o 0 2 r'1 ~• ~n um a s o>, L u 1 2,~55'7F~ Jos wrn o. Pb D rr l (,. ~. o K asr r, , ~~ ~ v0 R P fi I,. w ~ i~ 0 4%yz r~ ~asf h^ne ~ ~ Od o ~'f ~• „ ~ luv '~ gL I ~ ~ J05C Gt' c uw~ PD obtr~/ L.: u a. /0 30 0 F ~~st' h,~1c u,,, u ('OD Ra I~•INMWI ~. strop o(nPr~ ~-• u w1A ~ L ~ 2 Z:L ^ ~ ~C I1N 1nm c~ Q~ nn (.y 67$ ~''ti Jo h'Yte Km i.pbert ~.• KM,r.o.~ ~ t1 2 7 .l ~3P ~[ 1u nt w1~ Ober ~• umv>`c. ~ 6~ X60 ~ o5t' Y`I^ht //')- I.L ,r,a •9 bPNf Km `( (o •, Qf Gt,hc K D ber~ !,• u a ~lbU 'f~ (02 ~ h" e mc. P A ~ 67o Jo -t un '' C D v Jos e w w ~a ~ 4 ~ 6` J h,hc .y1 • ~m mw 90 ~ r76Pr wm .sl- oc 53`1 3y ~ Dse ln;ne N D obP u u sf /o C ~ y ~3 ~o P hl'l,e ~tmrn~ PvD ,QobP~~ (,- w.n Ov I CERTIFY UNDER PENALTY OF PERJURY THAT THE OVE RECORD IS CORRECT AND COMPLETE 70 THE BEST OF MY KNOWLEDGE AND BELIEF. P ON CEIVING C PY OF SAFE DEPOSR BOX INVENTORY: SIGNATURE SIGNATURE PRUfI' NPME PRINT NAME AND CHECK APPROPRIATE BOX BELOW. PRIM TRLE DATE CHECKAPPROPRIATE 90X: ExeMalrix) ^ AtlminisVab,(V4) Ecleb Repeesnbew ~ JoMI ownw of Leh tlaposlt box NOTE: Attach additional 8'/, x 11" sheet(s) if necessary or use duplicates of this page of form. The Depenmant h eutltatrad by law, 42 U.S.C. §405 (c)(2)(C)(i), b require dsdonure of Sodal Security rMmbers in connetlion wllh edmiNstering slate taz laws. The DepadrtleM uses t1w Sodel Seppity marlter ro Wentlfy the decedent and personal regasentetl~es of Bre estate. The CormanwmMh may also use tla RlfosneGw in exchange of fax mfame8an a9reenanls wMh FadenV aM lord nutlod8es. The alab law ibis 8u: Commomwegh's Nalalel from diadosin mnfider8ial tax kdannalial exce t iw oRidel es. REV485 EX SAFE DEPOSIT BOX INVENTC)RV pogo q of lD INSTRUCTIONS (1) Cash: Report total only. (2) Stocks: List In detail every common or preferred cedl8cate, warrant a other rights found in box. Stocks are to be deslgneted by name of company, certificate number, date of certlficata, name in whldl stock Ic registered, and Iwmber of shares and class of stock. (3) Obligadons of U.S. Government: Number of hems, dale of issue, face value, names In which registered and type of ownership, i.e., )Dingy held, payable on death, etc. (4) Bonds: Designate by name, amount, serial number, or other designation. (bearer Bonds) (5). Bank and Savings and Loan Peashooke: State name of depos8or, number of book, last date appearing in book, name M Dank end branch, and balance. (S) Jewelry, Colns, Stamps, Manuscrtpts, ate: list and descrlba as fuly as possible. (7) Deeds, Mortgagor, Currant Inadranee Policies or other evldenees of Indebtedness: List and describe as fully as possible. (8) All dther wntents. (9) Return completed form to: DEPARTMEN70F REVENUE INHERITANCE TAX DMSION DEPT. 200801 HARRISHURO, PA 1712&0001 ITEM NO. REM DESCRIPTION c r;2 a3r J ~~ ~ ~ Po. Rab~l,. u M~ $~o~ C 562321`E Jo.SP h,1~L a PO/J RP er-l~. u a ~ 100 / I ?RS C!_" .lose ,"nc /N ~ ~. PO r~db~r-t !:, o, s~ C lll)S ~' Jos h~ ,r, ~, Pop ~eb~ ,J ~u ~ o ~' ~ os l'l,iT c M, h u !).~ r'~ ti a rt / o v GO 8 75~ ~E e a 0 o~r~ L' Glwnwta tt/OD C Du 759,E h" - kurvlmq ~ob G". um7 a .Y 100 0 9760 f~E S 'nc (~1 • u ,n o. ?0.~ 6P L. u G % Oo g 3/ EE .1os h; n~ ?1 •`~tyM, q f ~ D ~.. u o. sk 10D y GE ~ o GI,'n~ .'lnu a PO .Qo(xi~/ (-. um strop ` 63 OU e E SoSP h'n yr 0 obe ~-. k y Op ~. 6 L O' SS.~'~ ~o ~ c , rn 0 ..gym q & O 3o i1SP H " ,~ MA { O (_. fYl N A $ 1 p b`2 (c ~ ~E d ,i~C H A r D ObPr'f ~.. Nm A ffi( C 621g~(o S f,'(= DS h,"nc. timm~ f0 abet'/ ~. Mn, q S~~o~ L 6 o ins ,Am o. 0 obfr~ ~.,, aNT a w~o-D 03617 / .~osc' h," e 71-~1'lumtW~ P00 obe 1 CERTIF W ti s o0 Y UNDER PENALTY OF PERJURY THAT THH ABOVE RECORD IS PERSON R CEIVING COPY OF CORREC T AND COMPLETE TO THE BEST OP MY KNOWLEDGE AND BELIEF. SAFE DEPOSIT BOX INVENTORY: SIGNATURE BKeNATURE PRINT NAME PRIM NAMEANO CHECK APPROPRIATE BO%HELOW: PRIM TITLE GATE CHEAKPPPROPRIATE BOX: ^ Exswmr(hix) ^ Atlmhheabr(bk) Eeuh RepneeMetlw ~ JoNt tamer or ceh depoell box NOTE: Attach addlticnal 8'/:' x 11` sheet(c) If necessary or use duplicates of this page of form. Tha DepeMlantis euNatzed bylaw, 42 U.S.C. §405 (c)(2)(C)(i), b requha diedosure dSoda/ Security numbers In cannecOOn wih edminisleling slate tax laws. The DepalOnem usec the Sods/ Security number to klarltlfy Ole decetlent end persolld representedvea of th estate. The Conslenwealtll may also use ON idamadon b exchange d lax information agremnentc wdh Federel end IorJil ludo euOloridae. The dale law lohlbis Ole COrmlalweadKC rsoNxl from ' canfidengel tax information ex for oAldel Dees. SAFE DEPOSIT BOX INVENTORY Page /~ Df ~~ REV-0BS EX INSTRUCTIONS (1) Cash: Report total only. (2) Stocks: List in detail every common or preferred ceriificate, warcent or other rights found in box. Stwks are tD tHi designated by name of company, ceAificate number, date of cenficale, name in which stock b reg{slered, and number of shares end loss of stock. (3) Oblipatlons of U.S, Government: Number of kerns, data of Issue, face value, names In which registered and type of ownership, I.e., foinky heltl, payable on death, etc. (4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds) (5) Bank end Savfnps and Loan Passbooks: Stele name of depositor, number of book, fast date appearing in book, name of bank and breech, antl balance. (s) dewslry, Coins, 3famps, ManuseNpb, etc: List antl describe as fully as possible. (7) Deeds, Mortpapee, CulTent Insurance Pollelas or other evidendes of Intlebtsdnass: List and describe as fuly as possible, (s) All other wntents. (s) Return completed form to: DEPARTMENT OF REVENUE INHERRANCE TAX DNISION DEPT. 2ti0801 HARRISBURG, PA 17128-0aDt REM NO. rtEM DESCRIPTION c 5sy ~~D~~ S c VYt • .A qQ o rrfi (. N ~ OU C 'g 3i ~~ C V ~ rv1//lq P /( ~arr ~~ WY»tn0. UO GS6 ~c~2Sz3 ~, D fi l,. ioo C ~o O 2 Z ~-/ GSi° - C /N • K A 0 ~ 1. - wl Pn l7fl C o2 2S Jos h !~'1 u u .0 0 <r ,TO` /oa S 675/2 J3 .~ u DD Dberf l,. H rn o b' 2 L u aL ~ rf 1.. un~n, o. d 5izJ5 J ~~,~ p tl,. ti C S 3 0 3/ / J c. w p ~ er- /oo O J c u cA. D D ~ ti vn ti 3 D$' $ ,~ G u.hrn 0.p(] r c.. !U D 7 78~ rite I.Lmrna Op ~b fi l„ Oo 7((0 o s s e ~, D Q 0~1~ 2 b v um m 00 be'`t L.-'~,um~n a., ~ C '/ I ~ ~ 6 h ~+1 t M~ vi vr~ A ~ Q r/' u mtti. 0~ I CERTIFY UNDER PENALTY OF PERJURY THAT THE ABOVE RECORD IS CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. PERSON R CEIV G COPY OF SAFE DEPOSIT 80x INVENTORY: SIDtUTURE a1DNATURE PRINT NAME PRINT NAME AND CHECK APPROPRIATE BO%6ELOW: PRINT TITLE DATE CHECK APPRDPRIATE BOX Exeamr(Ma) ^ AEminNtraronh4) EeleM Reprewntadve ~ JaNt owlw a/aeh tleporx boz NOTE: Attach additional 8'/~" x 11"sheet(s) if necessary or use duplicates of this page of form. The Department is aulhorired by bw, 42 U.5.C. §405 (c)(2)(C~I), b require diadosure dSodal Sewriry embers h cannacbon wkh admlriaterhp state fez laws. The Deperfinenl uses the Sods) Seaaay nurnhBr b Idendfy dre deradeM and personal represenatllres d the estate. The CorrrrwnweaMh may also use ale mforme5on m exchange d fez informadon egreelrena wph Fer»ral and IoW b autlndkes. The stab law tlIe Corlnrwnweeftlfc rsonnel from disdosfi canEdNlBel tax infarmafbn exce t for olRdel `~ Calculate the Value of Yow Paper Savings Bond(s) Page I of 5 n ~ ~ ~ ~~~~x Home Individual ~- TouL ~• Calculate the Value pf Your Paper Savings Bond(sj Calculate the Value of Your Paler Savings Bond(s) SAVINGS BOND CALCULATOR ~ in5tiuttiOn: Value as ot: '~ How to Use the t ~22W8 UPDATE ~ ii~1 ~' ~ CalculaYOr . H¢1p - Notes Desci Series: Denomination: Bond serial Number: Issue Date: EE Bonds ~ 100 ~ ~~ r- ~ NI Not Issue NE Not eVigit ~ PS Includes - HOW TO SAVE YOUR INVENTORY i interest E MA ~ Matured . interest Calculator Results for Redemption Date 12/2008 Total Price Total Value Total Interest YTD $8,600 .00 $20,993. 69 $1 2,1 93.89 $7 Bonds: 1-293 of 193 Serial # . Series Denom Issue Next Fnai Issue Interes t Interest Value ' Date Accrual Maturity Price Rate c277169906 EE $100 01)1991 01)2009 01/2021 $50. 00 $76. 40 4.00% - $126.40 1277169905 EE $100 01/1991 01/2009 01(2021 $50. 00 $76. 40 4.00% $126.40 0308675766 EE $100 04/1991 04/2009 04/2021 $50. 00 $76. 40 4.00% #126.40 c308675787 EE $100 04/1991 D4J2D09 04/2021 $80. 00 §76. 40 4.00% 4126.40 1277169904 EE $100 01/1991 01/2009 01/2021 $50. 00' $76. 40 4.00% 3126.40 1553031514 EE $100 01/1996 01/2009 01/2026 $50. 00 $31, 24 2.58% ;81.24 c576751275 EE $100 08(1996 02/2009 08/2026 $50. 00 $29. 40 2.58% 379.40 c576751274 EE $100 08/1996 02/2009 08/2026 $50. 00 ,$29. 40 2.58% 379.40 c308675788 EE $100 0411991 04/2009 04/2021 $50. 00 $76 .40 ~ 4.00% $126.40 c567702525 EE $100 05/1996 05/2009 05/2026 $80. 00 $30 .44 2.65°h $80.44 c5fi7702524 EE $100 05/1996 05/2009 05/2026 $50. 00 $30 .44 2.65% 390.44 c567702523 EE $100 OSj1996 OS{2009 05/2026 $50. 00 $30 .44 ~2.fi5% $80.44 c576751273 EE $100 08/1996 02/2009 06/2026 $50. 00 $29. 40 2.58°h ;79.40 c584989311 EE $100 11/1996 05/2009 11/2026 $50. 00 $28 .64 2.65°b $78,64 1584969310 EE $i00 11/1996 05/2009 11J2026 $50. 00 $28 .64 2.65°h $78.64 c514496238 EE $100 03/1995 03/2009 03/2025 $50. 00 $38 .48 2.60% $88.48 1584989312 EE $100 11/1996 05/2009 11/2026 $50. 00 $28 .64 2.65% $78.64 1514496236 EE $100 03/1995 03(2009 03/2025 $50. 00- $38 .48 2.60% $88.48 c546334614 EE $100 ~ 10/1995 04/2009 10/2025 $50. 00 $33 .40 2.58% 383.40 0514496237 EE $106 03j 1995 03)2009 03/2025 $50. 00 $38 .48 2.60No $98.48 c95017747 EE $100 09/1985 03/2009 09/2015 $50. 00 $124 .80 4.00°k $174.80 c95017746 EE $100 09/1985 63/2009 09/2015 $50. 00 5124 .60 4.00°h §174.80 c71664763 EE $100 12(1984 06(2009 12{2014 $50 .00 $131 .88 4.00% ;181.88 [95017745 EE $100 09/1985 03/2009 09/2015 $50. 00 $124 .80 4.00°!° $174.80 h ttp://~vw.treasurydirect.govBC/SBCPrice "~~~ 12/10/2008 Calculate the Value of Your Paper Savings Bond(s) a~ Page 2 of`_ [95017743 EE $100 09/1985 03/2009 09/2015 $SO.UO $124.80 4,00% $174.80 [95017744 EE $300 09/1985 03/2009 09/2015 $50.00 $124,80 4.00% -$174.80 1176521765 EE $50 07/1984 01/2009 07/2014 $25.00 $65.94 4.00% $90.94 1176905384 EE 450 12/1984 06/2009 12(2014 $25.00 $65.94 4.00% $90.94 1552653590 EE $BO 11/1996 05/2009 11/2026 $25.00 ~ $14.32 2.fi5% $39.32 1535334256 EE $50 03/1995 03/2009 03/2025 $25.00 $19,24 2.60% $44.24 1546841689 EE $50 05/1996 05/2009 05/2026 $25.00 $15.22 2.65%~ $40.22 r19231993 EE $200 12/1984 06/2009 12/2014 $100.00 5263.76 4.00% $363.76 r19231992 EE $200 12/1984 06/2009 12/2014 $100.00 $263.76 4.00% ;363.76 k37311494 EE $75 03/1985 - 03/2009 03/2015 $37.50 $9b.21 4.00% $133.71 k44064989 EE $76 09/1985 03/2009 09/2015 $37.50 $93.60 ~ 4.00% $131.10 k33950617 EE $75 03/1985 03/2009 03/2015 $37.50 $96.21 4.00% ;133.71 k33939148 EE $75 03/1985 03/2009 03/2015 $37.50 $96.21. 4.00% $133,71 [189881407 EE $100 01/1989 01/2009 01/20'19 $50.00 $86.80 4.00% $136.80 [189881406 EE $100 01/1989 01/2009 01/2019 $50.00 $86.80 4.00% $136.80 [189881444 EE -. $100 04/1989 04/2009 04/2019 $50.00 $66.80 4.00% $136.80 [169881406- EE $100 01/1989 01/2009 01/2019 $50.00-~ $86.80 4.00% ;136.80 [200461798 EE $100 08/1969 -02/2009 06/2019 $50.00 $84,12 4.OOM° j134.12 [200461799 EE $100 08/1989 02/2009 08/2019 $50.00 $84,12 4.00% $134.12 [200461800 EE $100 08/1989 02/2009 08/2019 $50.00 $84.12 4.00% $134.12 [169681443 EE ,$100 04/1989 04/2009 04/2019 $50.00 $86.60 4.00% ;136.50 [200461846 EE $100 10/1989 04/2009 10/2019 $50.00 $84.12 4.00°Po $134.12 1200461847 EE $100 10/1989 04/2009 10/2019 $50.00 $84.12 4.00% 5134.12 [200461648 EE $100 10/1989 04/2009 10/2019 $50.00 $84.12 4.00°Po $134.12 [200461801 EE $100 08/1989 02/2009 08/2019 $50.00 $84.12 4.00% $134.12 [170390169- EE $100 02/1988 02/2009 02/2018 $50.00 $92.36 4.00% $142.36 1434494024 EE ~ $50 09/1989 03/2009 09/2019 $25,00 $42.06 4.00°h $67.06 1386959234 EE $50 01/1989 01/2009, 01/2019. $25.00 $43.40 4.00°h $68.40 - 1418805086 EE $50 04/1989 04/2009 04/2019 $25.00 $43.40 4.00% $68.40 [170390171 EE $100 02/1988 02/2009 02/2016 $50.00 $92.36 4.00% $14236 [170390172 EE $100 02/1988 02/2009 ,02/2018 $50,00 ~ $92.36 4.00% $142.36 [170390173 EE $100 02/1986 02/2009 02/2018 $50.00 $92.36 4.00°h $142.36 [170390170 EE $100 02/1988 02/2009 02/2018 $50.00 $92.36 4.00% $142.36 [170390224 EE $100 DS/1966 05/2009 05/2018 $50.00 $92.36 4.00% $142.36 [170390223 EE $100 05/1968 05/2009 05/2018 $50.00 $92.36 4.00% $142.36 [174754273 EE ~ $100 07/1966 01/2009 07/2018 $50.00. $89.56 4.00% $139.56 [170390225 EE $100 05/1988 DSj2009 05/2016 $50.00 $92,36 4.00% $142.36 0178000387 EE $100 1011988 04/2009 10/2018 $50.00 $89.56 4,00% $139.56 [178000388 EE $100 10/1988 04/2009 10/2018 $50.00 $89.56 4.00% $139.56 [178000389 EE $100 10/1988 04/2009 10/2018 $50.00 $89.56 4.00% $139.56 [174754272 EE $100 07/1988 01/2009 07/2018 $50.00 $89.56 4.00% $139.56 [142295047 EE $100 09/1987 03/2009 09/2017 $50.00 $95.20 4.00% $145.20 - t142299045 EE $100 09/1987 03/2009 09/2017 $50.00 $95.20 4.00% ;145.20 [142295028 EE $100 06/1987 06/2009 06/2017 $50.00 $98.08 4.00% $149.08 [142295027 EE $100 06/1987 06/2009 06/2017 $50.00 $98.08 4.00% $148.06 [142295046 EE $100 09/1987 03/2009 09/2017 $50.00 $95.20 4.00% $145.20 0125748057 EE $100 04/1987 04/2009 04/2017 $50.00 $98.08 4.00°/a $145.08 1281246170 EE $50 01/1987 01/2009 01/2017 $25.00 $49.04 4.00% $74.04 1281246169 EE $50 01/1987 01/2009 01/2017 $25.00 $49.04 4.00°k $74.04 1261113632 EE - $90 08/1986 02/2009 08/2016 $25.00 $59.00 4.00% $84.00 1281246168 EE $50 01(1987 01/2009 01/2017 $25.00 $49.04 4.00% $74.04 l++fn•/%xn~~.~,t~Pacnn~riirPr•.tonv/R('/CR(:Prir.P '"°~B~ 12/10/2008 .lculate the Value of Your Paper Savings Bond(s) Page 3 of 5 1281246172 EE $SO 01/1987 01(2009 01!2017 - $25.00 $x9.04 4.00°Po $74.04 1297811335 EE $50 0411987 04/2009 0412017 $25.00 $49.04 4.OOM° $74,04 1309899585 EE $50 09/1987 03/2009 09/2017 $25.00 $47.60 4.00% $72,60 1385476095 EE - 850 10/1988 04/2009 10/2018 $25.00 $44.78 4.00°!° §fi9,78 1370914806 EE $50 07/1988 01)2009 07/2018 $25.00 ~' $44.78 4.00°k $69.78 1281246171 EE 550 D1/1987 01/2009 01/2017 $25.00 $49.04 4.00% $74.04 r029191131 EE $200 03/1986. 03/2009 03/2016 $100.00 $242,72 4.00°h $342.72 x029191130 EE $200 03(1986 03(2009 03(2016 $100.00 $242.72 4.00% $342.72 x37292240 EE $200 04/1987 04/2009 0412017 $100.00 $196.16 4.00°k $296.16 e029191132 EE $200 03/1986 03/2009 03/2016 $100.00 $242.72 4.00°f° $342.72 [308928235 EE $100 07/1991 01(2009 07(2021 $50.00 $73.92, 4.00°h $123.92 [309382726 EE $100 1111991 05/2009 11/2021 $SO.DO $73.92 4.00°h $123,92 1261113630 EE $50, 08/1986 02/2009 08/2016 $25.00 $59.00 4.00% $84.00 1222769860 EE $50 .07/1986 01/2009 07(2016 $25.00 $59.00 4,00% $84.00 1222769865 EE $50 0711966 0812009 07/2016 $25.00 $59.00 4.00°h $84,00 1261113631 EE $50 08)1986 02/2009 08/2016 $25.00 $59.00 4.00°k $84.00. 1222769863 EE $50 07/1986 01/2009 07/2016 $25.00 $59.00 4.00% $84.00 1222769864 EE $50 07/1986 01(2009 0712016 $25.00 $59.00 4.00°Po $84.00 1222769861 EE $50 07/1986 01/2009 ~ 0712016 $25.00 $59.00 4.00% ¢84.00 1222769866 E£ $50 07/1986 01/2009 07/2016 $25.00 $59.00 4.00% 584.00 1222769662 EE $50 07/1986. 01/2009 07/2016 $25.00 $59.90 4.00°Po- $84.00 1189248809. EE - ~ 550 03(1986 03J2009~ 0312016 $25.00- $60.68 4.00°k $85.68 822769859 EE $50_- 07/1986 01/2009 07/2016 $25.00 $59.00 4.00°!° '584.00 1477430340 EE $50 01/1991 01/2009 01(2021 $25.00 $38.20 4.00°k $63.20 1479054393 EE $50 11!1991 05/2009- 1112021 $25.00 $36.9b ~ 4.00% $61.96 [309382727 EE $100 1111991 08/2009 11)2023 $50.00 $73.92 4.00% $123.92 [308928233 EE $100 07/1991 01/2009 07/2021 $50.00 $73.92 4.00% $123.92 [309382729 EE $100 11/1991 05(2009 11(2021 $50.00 $73.92 4.00% $123,92 [309382728 EE $100 L1/1991 05(2009 11/2023 $50.00 $73.92 4.00°Po $123.92 [308928234 EE $100 07/1991 01/2009 07/2021 $50.00 $73.92 4.00% $123.92 [200410963 EE $100 01/1990 01(2009 -01(2020 $50.00 $81.52 4.00%; $131.52 [200410964 EE $100 01!1990- 01/2009 01/2020 $50.00 $81.52 4.00% $131.52 0257325617 EE $140 0711990 01/2009 07/2020 $50.00 $78.92 4.00% $128.92 [290410962 EE $100 01/1990 01/2009 01/2020' $50.00 $81.52 4.00% $131.52 066719466 EE $100 10/1990 04(2004 1012020 $50.00 $78.42 4.00°h $128.92 [266719487 EE $100 10(1990 0412009 10/2020 $50.00 $78.92 ~ 4.00% $128.92 066719485 EE $100 10/1990 04/2009 10/2020 $50.00 $78.92 4.00% $128.92 05732561b EE $100 07/1990 01/2009 07(2020 $50.00. $78.92 4.00% $128.92 1473595397 EE $50 07(1940 0112009 0712020 $25.00 $39.46 4.00% $64.46 ' [447424440 EE $100 01/1994 01/2009 01/2024 $50.00 $42.40. 2,79% $92.40 [447424439 EE $100 01/1994 01/2004 01/2024 $50.00 $42.40. 2.79°h $92.40 1413943089' .EE $50 '01(1990 01(2009 01/2020 $25,00 $40.76 4.00% $65.76 [254938014 EE $100 0413990 04/2009 04/2020 $50.00 $81.52 4.00% ;191.52 [254938015 £E $100 04/1990 04/2009 04/2020 $50.00 $81.52 4.00% ;131.52 [254938016 EE $100 04/1990 04/2009 04/2020 $80.00 $81.52 4.00% $131.52 [266719484 EE. $300 10!1990 04(2009 10/2020 $50.00 $78.92 .4.00% $128.92 [468094032 EE $100 05/1994 05/2009 05/2024 $50.00 $41.76 2.44% ;91.76 _ [48]315896 EE $100 08/1994 02/2009 08/2024 $50.00 $40.48 2.83% 590.48 [481315895 EE $100 08/1994 02(2009 08)2024 $50.00 _$40.48 2.83% $90.48 1468094033 EE $100 05/1994 0812009 05/2024 $50.00 $41.76 2.44% $91.76 [447424437 EE $100 01/1994 01/2009 01/2024 $50.00 $42.40 2.79M° $92.40 http://~wwv.treasurydirect.gov/BC/SBCPrice °'~ 12/10/2008 Calculate the Value of Your Paper Savings Bond(s) Page 4 0. c468094035 EE $100 05(1994 05(2009 05(2024 550.00 $41.76 2.44°7° ;91.7fi c468094034 EE $100 05/1994 05/2009 05/2024 $50. 00 $41.76 2.44°.~° ;91.76 c4A7A24438 EE $100 01/1994 01/2009 01/2024 550,00 $42,40 2.79°f° $92.40 c393534632 EE $100 03/1993 03/2009 03(2023 $50,00 $47.00 2.73°f° $97.00 c393534833 EE $100 03/1993 03/2009 03/2023 $50.00 $47.00 Z.73% ;97.00 c494027721 EE $100 11/1994 05)2009 11/2024 $50. 00 $39.60 ~ 2.48°k .$89.60 c494027720 EE ;100 11/1994 05/2009 11/2024, $50. 00. $39.60 2.48°h 589.60 c494027719 EE $100 11/1994 05/2009 11/2024 $50. 00 $39.60 2.48% $89.60 c481315894 EE $100 08/1994 02/2009 08/2024 $50. 00 $40.48 2.83°k ;90,48 [409199889 EE $100 06/1993 06/2009 06/2023 #50. 00 $45.84 2.65% $95.84 1409199890 EE $100 06/1993 06/2009 06/2023 $50. 00 $45.84 2.65°h ;95.84 c409197670 EE ~ $300 06/1993 Ofi/2009 06/2023 $50.00 $45.84 2.65% $95.84 c393534834 EE $100 03/1993 03/2009 03/2023 $50. 00 $47.00 2.73°/° $97.00 c433644861 EE. $100 09/1993 0312009 09/2023 $50. 00 $44.66 2.45°b $94.68 c433644860 EE $100 09/1993 03/2009 09/2023 $50. 00 ;44.68 2.45°h $94.68 1527382265 EE $50: 08/1994' 02/2009 08/2024 $25. 00 $20.24 2.83°k y15.24 1530685299 EE $50 11/1994 05)2009 1112024 $25. 00 $19.80 2.46% $44.80 1505405279 EE $50 03/1993 03/2009 03/2023 $25. 00 $23.50- 2,73% ;48,50 1515216522 EE $50 09/1993 03/2009 09/2023 $25. 00 $22.34 2.45% $47.34 - c433644862 EE $100 09/1493 03(2009 09/2623 $50. 00 $44.66 2.45% $94.68. c333094840 EE $100 03/1992 03/2009 03/2022 $50. 00 $71,48 4.00% ;121.48 c333094841 EE $100 03/1992 03/2009 03/2022 $50. 00 $71.48 4.00°k ;121.48 1511647078 EE $50 06/1993 06/2009 06(2023 $25. 00 $22.92 2.65% ;47.92 c333094843 'EE $100 03/1992 03/2009 03/2022 $50. 00 $71,48 ~ 4.00°k $121.48 1481029557 EE $50 06/1992 06/2009 06/2022 $25. 00 $35.74 4.00°k $60.74 1345877363- EE $100 06/1992: 06/2009: 06(2022 $50. 00' $71.48. 4.00% $121.48 c333094642 EE $100 03/1992 03/2009 03/2022 $50. 00 $71.48. 4.00% $121.48 c362186655 EE $100 12/1992 06/2009 12/2022 $50. 00 $69.12 4.00% $119.12 1362186656 EE $100 12/1992 06/2009 12/2022 $50. 00 $69.12- 4.00% ;114.12 0362186657 EE $100 12/1992 06/2009 12/2022 $50. 00 $69.12 4.00°h $119.12 c361758154 EE $100 08/1992 02/2009 08/2022 $50. 00 $69.12 4.00% ;119.12 c345877365 EE $100 06/1992 06/2009 06/2022 $50. 00 $71.48 4.00% $121.48 0361758152 EE $100 08/1992 02(2009 08/2022 $50. 00 $69,12 4.00% $119.12 c361758153 EE $100 08/1992 02/2009 68/2022 $50. 00 $69.12 4.00% ;119.12 c345877364 EE $100 06/1992 06/2009 06/2022 $50. 00 $71.48 4.00°b $121.48 c667548630- EE $100 06/1999 01/2009 ~O6/2029 $50 .00 $22.32 2.80% ;72.32 0667548631 EE $100 06/1999 01/2009 06(2029 $50. 00 $22.32 2.80°h' ;72.32 c604789760 EE ~ $300 03/1997 03/2009 03/2027 $50. 00 $27.64 2.58% ;77.64 c667548632 EE $100 0611999 01/2009 0612029 $50 .00 $22.32 2.80% ;72.32 c663630488 EE $100 02/1999 01/2009 02/2029 $50. 00 $23.56 2.74% ;73.56 c663630490 EE $100 02/1999 01/2009 02/2029 $50 .00 $23.56 2.74% $73.56 c6636304B9 EE $100 02/1999 01/2009 02/2029 $50 .00 $23.56 2.74% $73.56 0663630487 EE $100 02/1999 01/2009 02/2029 $50. 00 $23.56 2.74% ;73.56 0621356232 EE $100 10/1997 01/2009 10/2027 $50 .00 $29.44 2.74% $7944 c621356233_ EE $100 10/1997 01(2009 1OJ2027 $50 .04 $29.44 2.74% ;79.44 1556543786 EE $50 03/1997 03/2009 03/2027 $25 .00 $13.82 2.58% ;38.82 c611115795 EE $100 06)1997 01/2009 06/2027 $50 .00 $30.Sfi 2.80% $80.16 0611115794 EE $100 06/1997 01/2009 06(2027 $50 .00 $30.16 2.80°1° $80.16 c604769756 EE $100 03/1997 03/2009 03/2027 $50 .00 $27.64 2.58% ;77.64 c611115743 EE $100 06/1997 O1/2009 Ob/2027 $50 .00 ;30.16 2.80% ;60.16 c604789759 EE $100 03/1997 03/2009 03/2027 $50. 00 $27.64 2.SBW° ;77.64 http://www.treasurydirect.govBC/SBCPrice t ~n nr~nnQ calculate the Value of Your Paper Savings Bond(s) Page 5 of 5 [63994544 EE $100 04/1998 01/2009 04/2026 $50. 00 $27.20 2.74% ;77.20 c639945446 EE $100 04/1998 01/2009 04/2028 $50. 00 $27.20 2.74% §77.20 1650114089 EE $100 08/1998 01/2009 08/2028 $50. 00 $25.48 2.74% §75.48 c639945448 EE $100 04/1998 01/2009 04/2028 $50. 00 $27.20 2.74% §77.20 c632433952 EE $100 01/1998 01/2009 01/2028 $50. 00 $27.72 2.74% $77.72 0632433953 EE $100 01/1998 01/2009 01/2028 $50. 00 $27.72 2.74°/a $77.72 c632433954 EE $100 01/1998. 01/2009 01/2028 $50. 00 $27.72 2.74% ;77.72 1560803943 EE $50 10/1997 01/2009 10/2027 $25. 00 $14.72 2.74% $39.72 1565225952 EE ;50 01/1998 01/2009 01/2028 $25. 00 $13:86 2.74% ;38.86 1567792566. EE $60 04/1998 01/2009 04/2028 $25 .00 $13.60 2.74% 538.60 1569121033 EE '$50 08/1998 01/2009 08/2028 $25. 00 $12.74 2.74°!° ;37.74 0655782821 EE ~ $100 11/1998 01/2009 11/2028 $50 .00 $24.04 2.80% 574.04 c650114067 EE $100 08/1998 O1/2009~ 08/2028 #50 .00 $25.46 2.74%: ;75.48 c655782823 EE $100 11/1998. 01/2009 11/2028- $50 .00 $24.04- 2.80% ;74.04 1655782822 EE $100 11/1998 01/2,009 11/2028 $50. 00 $24.04 2.80% 574.04 c650114088 EE $100 OB/1996~ 01/2009 08/2028 $50 .00 $25.48 2.74% §75.48 CA.~CULATE ANOTHER BONA How would you rate this'tool7 ~ Excellent: ~ Good Fair Poor EcEedD.m of lRforrpzb_pn_Att I laW_& GLidantfl I PtlYacy Zx 1-E9at. Nptice,; I lyebsite Terms PA Contlition 1~._ D~aCtrrlgOS of the.zrQBsury, Bureau of the Pu6~IC .Qetrt J httn•//ww~utreacnrvAirrctanv/R('/CR(`Prirn 'inn/onno p ~s~ 499 Mitchell Road, Millsboro, DE 19966 Mai! Code DE-MB-12 Phone (868)502-4349 Fax (302)934-2955 January 20, 2009 Frey & Tiley Attorneys At Law 5 South Hanover Street Carlisle, Pennsylvania 17013 Re: Estate of Robert L. Thumma Social Security: 179-30-3533 Date of Death: October 27, 1008 Dear Sir or Madam: Per your inquiry dated January l2, 2009, please be advised that at the tune of death, the abovo-named decedent had on deposit with this bank the following: I. T}pe ofAccount Account Number Ownership (Names o,0 Opening Date Balance on Date ofDeath Accrued Interest Total Savings Account 15004201215298 Robert L Thumma* 6/5/98 Closed 10/31/08 $ 6, 034.46 $ 0.59 $ 6,035.05 `------------------_ Please be advised, there was no safe deposit box found for the above decedent. * If upon reviewing the information above, yon believe there are additional accounts not referenced, please provide us with an account number and/or name of any possible joint account holder. For soy additional information on the above accounts, including ownership and any changes, closures and/or reimbursement of funds, etc., please contact our High Street Carlisle OPiice # 717-240-4536. Sincerely, ~ (/,, Trade Haze Adjustment Services r~ ~~u. t. tvv~ ~. v ~ Angost 12, 2009 STEPI3EN 1) T1LEY Ssq 5 S FIANOV>rR ST CA1tIdSLEPA 17013-3385 Estate of ROBERT L THU1vIl~4A Data of Death: Oct 27, 2008 SSN: 199-30-3533 Dear Sir/Madam: 14U, U I tl Y, 525 William Penn Place Suite 153-2618 Pittsbiugh,PA 15219 In accordance with your request, the attached i~'ormation sheet has been provided in the above deeedeat's name as of his date of death. The decedent had 1 active account at the time of his death and he had no Safe Deposit Box, For 1L or LC accounts, contact our Loea Department at 1-800-705-6680. For all other inquiries, please call 1-8SS-999-6884. Sincerely, Phillip Lynch Opemdons Se[vices ~~u. c cvv~ ~. u r _ _NU. Ultl ~ j Account Number 6219408873. Account Title ROBERT L TFiUMMA Data eaed 11/26/2007 Account T a Chec ' Pfinci al Balance as of DOD $2200.21 Interest from Last Po to DOD $ .0 Account Balancc e9 of DOD $2200.21 YTD Interest to DOD $ .00 aa~+o NATIONAL BANK January 15, 2009 Frey & Tiley Attn: Stephen D Tiley 5 5 Hanover St Carlisle PA 17013 RE: Estate of Robert L Thumma Deaz Mr. Tiley: The following information is being provided as per your request: Acct. Type Account No. Account Accrued Ownership Principal on Interest to D.O.D. D.O.D. Esteem 2293528 $13,817.14 $0.12 Individual Date Opened 11/27/07 Checking Account FNB 9623124 $17,072.84 $1.22 Individual 12/19/94 Passbook Savings Account Certificate of 9000253 $6,050.29 $1.55 Individual 8/28/92 Deposit Inquiries concerning ACNB Corporation stock information should be duetted to the Registraz and Transfer Company at 1-800-368-5948. If you need any additional information, please contact me at (717)339-5122. Sincerely, • Bazbara J W ~~ Adams Co ational Bank Deposit Serv ces Representative R PO Box 3129, GE17Y~7mG, PA 17325 ~ moHE 717.334.3161 ~ rou ~ 868.3342262 ~ wwwarnb.mm 7p.Z88f•9897 ~SaatnMs, pY~ f801f ~ %~ B~m~SJ 1~%N ~ 13'7GG~.xotiw.SS y5-335 w~A. ISy,ooG `~.' und~rn. r~ .~a. ~ 1'70 r ' %~/ ~ °'r~'~ ~yS ~fh ~Qo-~ o-~ No~en~.er~Y 8' (~, fA-1M%SflaA ex~i~s lZ.f2z~0b ~~~ di~f ohh`yI ~:. n .. ,7 '~:: T~f~I Scrl~. ~3,7~0. ~5 FINAL SETTLEMENT DATE OF SALE r ~ r~,~ PHONE ZIP LOCATION OF IS/ALE 5~ fpY1 F Qll''S rZ ~ r7Ve AUCTIONEER-,~ e J ~ n + ~~ ~ VV ! C k d rd PHONE ~ 17' o~ ~} I - Cj 3 $ 558, 0'~ CLERK ~ ~`Zj $ CASHIER Ac9~1~r-~i s i r, a-. $ 40 7, ~ o GLc,G ~` `~ ~ J $~- I °/a o f Rer~ ~ $ Cs+i+P c~ ooo. $ 910,00 $ .a $9ro.oo $ $ vv 7 .~ ~ 7 ~4r'~LL,V~4, v '.w ..W <. ,. CASH $ I !~ 73,'75 CHECKS $ ~ ~ `f~ . ~b OTHER RECEIPTS $ $ TOTAL RKEIPTS LE55 TOTAL EXPENSES $ ~+ ~`~' fi'gGmt WFH~'KN4 r+eC~S~"p'~z~ l'~.'~u-vf' "~ +y 6 4 n 54` m i , fat ~h~ET PR4C!CEEDS 1°AYA9LE TO£SELI.ER $ 7 ~ ~,~ ~ n,A~V^Va'4t S~a~~•~ ~1~:~L~ ~Y w. ~ wL. ~ n a;;iM, I (or we), the seller, accept this settlement and acknowledge receipt of the above specified net proceeds From the auction of my goods and properly sold on the above date. I accept all responsibiliy for providing merchantable title to all goods, and properly sold, and for delivery of title to the purchaser. ~~..•,y.,.2/~~.,,/ ~ Date ~.SYJ Auctioneer or Cashier's Signature (Seller's Signature) y-°~~-a 5 Date Date 00~ (Seller's Signature) SELLER NAME ~~it~ I P 0~'~ ~ob~rt ~ se~hin~ THumm~ LAST WILL AND TESTAMENT OF ROBERT L. THUMMA I, Robert L, Thumma, of 3103 Rimer Highway, Newvilte, Cumberland County, Pennsylvania 17241, being of sound and disposing mind, memory and understanding, do hereby make, publish end dedare this as and for my test Will end Testament, hereby revoking and making void any and all Wills and Codicils heretofore made. FIRST I direct the payment of my just debts and funeral expenses as soon after my death as may be convenient. I direct mat all federel and Pennsylvania estate taxes, Pennsylvania inheritance taxes, and generation-skipping transfer tax payable as a result of my deem, not limited to taxes attributable to property passing under this Will, shall be paid by my Fxewtor from my residuary estate, induding any part of my.residuary estate that othewise qualifies for a deduction for federal estate tax purposes, however, no federel or Pennsylvania estate tax, Pennsylvania inheritance tax, orgeneration-skipping transfer tax shall be payable from or chargeable to any property mat passes to my surviving spouse, whether under this Wlll or otherwise, and that qualifies for the federal estate tax marttal deduction. I direct my Executor not to seek relmbureement for any tax so paid from any benefldary under this Will, heir of mine, or other transferee of property included in my gross estate. SECOND 1 declare mat 1 am now the widow of Josephine M. Thumma. We had no childrtn. I have no deceased dt(Idren nor any omer children living by my w'rfe or otherwise. THIRD All the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath, in two (2) equal shares, per stirpes and not per capita, unto my nieces, Margaret Thumma (who goes by "Peggy' of 100 Grant Howard Trail, Bessemer Clty, NC 28016; and Anna Mae Campbell, of 104 IOmberly Way, Lewes, DE'19958, provided they shall survive me by ninety (90) days, but should either of them fall to so survive me then the share such deceased rtlece of mine would have received shall pass to such of her Issue as shall survive me by a period of ninety (90) days, per stirpes, and if there be no such Issue the same shall lapse and be added tome remaining share or shares. FOURTH 1 hereby nominate, constitute and appoint my said nieces, Margaret Thumma and Anna Mae Campbell, as Co-Executrixes of this my Last Will and Testament, or the successor or survivor of them alone as sole Executrix. I further direct that no bond or other security shall be required of any Executor or Executrix. appointed in this Will for the performance of. his, her or Its duties in any jurisdiction in which he, she or it may be called upon to act The terms Executor or Executrix may l>e used interchangeably In this Wlll and shall refer to any Executor or Executrix appointed In this will, or any other Administrator appointed by a court of competent jurisdidfon, [MWAlvd7m+ameNOjRObertL ihwrvna ~ P"8<r oj3 Exhibit 'R" FIFTH In addition to, and not in limitation of, the powers conferred by taw or by other provisions of this Will, my Co-Executrixes shall have the following powers, each of which may be exercised from time to t(me by my Co-Executrixes In their sole discretion: (a) To retain in the forth received, and to sell either at public or private sale, or to distribute in kind, any real or personal property. (b) To manage both real and personal property. (c) To Invest and reinvest in all forms of property, notwithstanding the fact that any or ail of the Investments made are of a character' or size which but for this expressed authority would not be considered proper for an Executrix. (d) To exercise any option or rights arising from the ownership of .Investments. (e) To compromise claims without court approval and without the cronsent of any beneficiary. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament, written on three {3) pages (including notary page), this 10th day of Aprli, 2007. ~L`. TLhumm `~ (SEAL) Signed, sealed, published, and declared by Robert L. Thumma the Testator .above named, as and for his Lest Will and Testament, In our presence, who, in his presence, at his request, and In the presence of each other, have hereunto subscrtbed our names as attesting witnesses. laR WYInM RSIm„enf afRObsrtL Thwvu p~2af3 Exhibit "I" COMMONWEALTH OF PENNSYLVANIA ) SS: COUNTY OF CUMBERLAND ) We, Robert L Thumma, the Testator In, and Stephen n. They and Robert G. Frey ,the witnesses, to the Last Will and Testament, the attached or foregoing instument; who have signed the instrument, having been duly qualified according to few do depose and say: a. that I, the Testator, do hereby acknowledge that l signed and executed the Instrument es my Last Will and Testament, that I signed it wlllingfy and as my free and voluntary act for the purposes therein expressed; and b. that we, the witnesses, were present and saw the Testator sign and execute the (nstrument as his Last WIII and Testament, that he signed it willingly and 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 Last Will and Testament as a witness end that to the best of our knowledge the Testator was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. ~? ~ 'rt L. Thumma r ' ~ s7 Y ~J Subscribed, sworn to and acknowledged before me by the Testator and the witnesses above-named, this 10th day of April 007. / r /1Dti / Notary Public tVDTAWALBEAL 7AIStN A. LIEaS, Mdery Pubic tlomuih of Car6k, Cumb. Canty, PA MY ComfYrbn F~ ihy20, 2010 last WUf and Tntmnmt ofRolrcn L 7M1unma pis 3 ~3 Exhibit "I"