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HomeMy WebLinkAbout02-24-10+- t 15056051058 REV-1500 E>< (os-o5) o~„LL „sE oNLY PA oepaMrent of Re+rerltre Bureau of Individual Tortes Coady Code Yearr\ FNe Number ~Harn~scdmg~17t28-oeol 'N RESIDE TED EDE T~ ~' ( v (~~ ENTER DECEDENT INFORMATION BELOW Socal Security Number Date of Death Date of Birth 093-26-7277 12/03/2009 06/03/1915 Decedent's Last Name Suffix Decedent's First Name MI Cattuti Anna M (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Seauihr Number ails RETI>RN iiwsr ~ ~Ii~ ~ DuPUCATE wall THe REGISTER OF WILLS FILL IN APPROPRIATE OVAL8 BELOW ;~ 1. Original Retum ~-> 2. Supplemental Return ~•-m-^, 3. Remainder Retum (date of death prior to 12-13-82) ....._,_ ~°° 4. Limited Estate ~:::y 4a. Future Interest Compromise (date of ta.~::~ 5. Federal Estate Tax Retum Required death after 12-12-82) ._... 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust _.. 8. Total Number of Safe Deposit Boxes (Attach Copy of III) (Attach Copy of Trust) c ~~ 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTK)N MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTUIL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number Michael H. Cattuti (717) 497-8703 Fimr Name (If Applcable) _ _. ~ REGISTER OF~1111 ~7 LLS USE Oi~i- ~ First line of address f. O ~ ~ 106 Oak Drive r~•a second fine of address ~ ~~~ -~~` .t±- ~ ' City or Post Office State ZIP Code _ DA~ TuIfjED - , :_ r ~~~ Camp Hiii ~ PA 17011-8703 ~c± c,'7 Correspondent's e-mail address Under penalties of perjury, I declare that I have examMed this return, Including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaretion of p parer other than the personal representative is based on all iMonnation of which preparer has any knowledge. SIG OF RAN NSIBL R F G RETURN qTE f/ a i q7v r v ADDR S ~r Q n /U ~ UA/1 /~, 1. to y~ ~ c [, / /~• / / D / / SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE U8E ORIGINAL FORM ONLY Side 1 15056051058 15056051058 t. 1, J 15056052059 REV-1500 EX Decedent's Social Security Number oeoaaenrg Ne~~ Anna M Cattuti 093-26-7277 RECAPITULATION _ -~~`°°`-~~°y°' _.~ _____~_____~__.____ 1. Real estate (Sdredtrle A) ............................................. 1. 2. Stocks and Bonds (Schedule B) ....................................... 2. 3. Closely Flekl Corporation. Partnership or Sole-Propritr6OrsF~ (Sc~terhrle C) ..... 3. 4. Mortgages & Notes Receivable (Sr~adrale D) ............................. 4. 5. Cash. Bank Deposits 8 Misoetlaneous Pen~onal Property (Scxredt>te E) ........ 5. 6. Jointly Owned Property (Schedule F) t Separate Baling Requested ....... 8. 7. Inter-Vivos Transfers 8 Mneous Non-Pn~bate P-operiy (Schedule Gj ;-~ Separate Biting Requested........ 7. 8. Total Gross Assets (total Lkres 1-7) .................................... 8. 9. Funeral E~errses & Administrative Costs (Schedule H) ..................... 9. 10. Debts of Decedent, Mortgage Liabilities. 8 Liens (Schedule 1} ................ 10. 11. Total Deductions (total Lines 9 & 10} ................................... 11. 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. 13. Charitable and GoverrHrrental BequestslSec 9113 Tnists for which an election to tax has not been made (Schedule J) ........................ 13. 14. __ Net Value Subject to Tax (Line 12 minus Lkre 13) ........................ . 14. ~__ ___._.______.___n____a._._.._..~.____ _______._..._..__,._ TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICAt3LE RATES ___.._.______.._.~ ~....~_ 15. Amount of Lme 14 taxable at the spousal tax rate, or 280,062.15 280,062.15 3,181.62 1,648.60 4,830.22 275,231.93 275,231.93 transfers under Sec. 9116 (a)(12) X .0_ 15. 16. Amount of Line 14 taxable ~ /o at lirre~ rate X .0 4i5 12,385.44 16. 11,009.28 7 17. Amount of Line 14 taxable ._„7i5~ _ at sibling rate X .12 17. 18. Amount of line 14 taxable at cdleteral ra6e X .15 18, 19. TAX DUE ......................................................... 19. 11,009.28 20. FILL IN THE OVAL IF YOU ARE REaIESTING A REFUND OF AN OVERPAYMENT c ~'w? 15056052059 Side 2 15056052059 REV 1509 E:X+ (6-88) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCI~IEptILE F JOINTLY-0WWED PROPERTY ESTATE OF FILE NUMBER Anna Marie Cattuti Man aaet was made JoMt whhin one year of tM decedent's dab of loth, K moat be nporbd on SchsduN G. SlA2VMNG JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT '°` Michael H. Cattuti 106 Oak Drive Son Camp Hill, PA 17011 8. C. JOINTLY-gNNED PROPERTY: TIEM NLYBER LETTER FOR ,IDiNr TENANT DATE MIADE JON1T DESCRIPTION OF PROPERTY wCLUDE NAME OF FINANCIAL prSiTTUitON AND aAleC ACCOIRIi NIR aR SIMILAR IOENnFYY10 NUi6ER. ATTACH DEED FOR ,K)INfLY~ELD REAL ESTATE. DATE OF DEATH VALIE OF ASSET % of [DECD'S ST DATE OF DEATH vALtE OF DECEDENT'S INTEREST t • a 12/01196 Wadlovia Bank dteddnglMMICD's -SEE ATTACHED LISTING 246,470.68 50 123 235.34 0 , 2 A 071'01108 ~+ C~artbalarld Federal Credit Union -SEE ATTACHED LISTING 86,883.51 50 48,441.75 a 3 A 12/01104 ~ Back -~ ATTACHED US11NG 102,749.31 50 51,374.66 ^ 4 A 10/31f90 US Treasury- H Bands 15 x;500 7,500.00 50 3,750.00 ~ 5 A O:i/01102 US Treasury- H Bonds 27 x;500 13,500.00 50 6,750.00 0 6 A 081r1810G Pa-a9alld National Bads Stock 320 Shares f11V 5290.69lshare 93,020.80 50 46,510.40 O TOTAL (Also enter on Iine 6, Recapittdation) I ; !, 280,082.15 (If more space is r-eeded, insert additional sheets of the same site) ~_ ~T { • I - _~ ,~ _ ~ .A Family Tradition Of Caring® PARTHEII~IORE Funeral Hame & Cremation Services, Inc. Mr. Michael x. catcnti 12n/20o9 106 Oak Drive Camp Bill, PA 17011 For the Service of Anna Marie Cattuti 1303 Bridge Street We sincerely appreciate the confidence. you have placed in us and will continue tb assist you in every way P.O. Box 431 we can. Please feel free to contact us if you have any questions in regard to this statement. The following New Cumberland, PA 17070. is an itemized statement of the services, facilities, automotive equipment and merchandise that you selected when making the funeral arrangements. (717)774-7721 (Fax) 774-5546 Terms Due Date Account # www.parthemore.com Net 30 1/6/2010 2009094.1 Gilbert W. Parthemore, Founder _ Gilbert J. Parthemore, Supervisor Stephen K. Parthemore, CFSP Bruce R. Parthemore, Pre-Need Coordinator, CPC Professional Memberships: NFDA • PFDA DCFDA • CCFDA G i~w,nm~wo~of,~, LE The Rule You Knox; The People You Trzes! Description Amount SERVICES & MERCHANDISE Direct Cremation 2,170.00 White Marbleite Urn 203.00 Total Services and Merchandise. _- _ -: - __ _ _ _ ___ _ __..3,373.00 CASH ADVANCE ITEMS - Death Notice, Harrisburg Patriot 271.10 Death Notice, New York 452.52 10 Certified Copies of Death Certificate 60.00 Cumberland County Coroner-Fee, Cremation Authorization. 25.00 Total Cash Advances 808.62 ,~ ~! L , l =~ --- TOtAi $3,181.62 Payments/Cred its $0.00 alance Due ~3,i81.62 ~.riuaw vas e B1ueSl~ield ' . , Federal Employee Program www.fepblue.or Camp Hill, Pennsylvania 17089 ANNA M CATTllTI 106 OAK DRIVE CAMP HILL PA 17011-8332 Explanation of Benefits416 THIS IS NOT A BILL FEDERAL EMPLOYEE PROGRAM PO BOX 890037 CAMP HILL PA 17089-0037 MEDICAL QUESTIONS CALL 1-800-779-6945, DENTAL QUESTIONS CALL 1-800-746-5687, TTY QUESTIONS CALL 1-800-345-3848 ~ EXPLANATION OF BENEFITS AT A GLANCE ~ ~ ID Number: 858422693 ~ ~ Claim Number: 10019512019 ~Pstient Name• ANNA ~ ~ ~ Claim Received On: 01/19/2010 ~n,.tes of Service• I2/02/2009 - 12/02/2009 ( Claim Processed On: 01/29/2010 Provider: WESTSHOREALS Dates of Service: 12/02/2009 - 12/02/2009 Type: NON-PARTICIPATING PROVIDER 165--BENEFITS ARE NOT PROVIDED FOR SERVICES/SUPPLIES LISTED IN THE GENERAL EXCLUSIONS SECTION OF THE BLUE CROSS BLUE SHIELD SERVICE BENEFIT PLAN BROCHURE. YOU ARE RESPONSIBLE FOR THESE CHARGES EVEN IF THE 5ERVICESJSUPPLIES WERE ORDERED BY A PROVIDER, EXCEPT WHEN ANOTHER CARRIER HAS PAID FOR THE SERVICE(S) IN FULL. If you have questions.; please call a customer service representative at your local H1ueCross B1ueShield Plan. If you disagree with the decision on your claims or request for services, and wish to have the decision reconsidered, you must notify your Plan in writing within 6 months from the date of this decisian, e.q. 07/29/2010. Your Plan will not accept unauthorized reconsiderations from providers. See the Disputed Claims Section of your Service Benefit Plan Brochure. oee414 D001 0007 EXPLANATION OF REMARK CODES " ~- ~ ' WEST SHORE EMS -BLS 205 GRANDVIEW AVE ~~ SUITE 211 -` ~~v CAMP HILL, PA 17011 '~~ Phone #: (800) 367-0512 Federal Tax ID: 23-2463002 `~ ~, ` `~' ~~ PATIENT NAME: ANNA CATTUTI PATIENT NUMBER: g32 WCS CALL NUMBER: 197586W W1 INSURANCE: DATE OF CALL: 12/02/2009 TIME OF CALL: 03:40 PM CALLER: HOLY SPIRIT HOSPITAL 197586W FROM: HOLY SPIRIT HOSPITAL TO: HEALTHSOUTH SPECIAL SVCS HOS ANNA CATTUTI 824 LISBURN RD APT 213 REASON(S) SHORTNESS OF BREATH CAMP HILL, PA 17011 FOR TRANSPORT INVOICE DESCRIPTION OF CHARGE QUANTITY UNIT PRICE AMOUNT Stretcher One Way Transport A0999 1.0 96.06 96.06 Transport Van Mileage A0999 5.0 3.74 18.70 OXYGEN ADMINSTRATION A0422 1.0 65.01 65.01 INF CONTROL GLOVES (PR) A0382 1.0 3.83 3.83 ANNa MaAiE caTTr>tTl 3-sas,o 15 5 8 ` MICHAEL H. _CATTUTi Iiil '~ / HI ~/i'%O C UNP 11, PA 17011-8332 DATE. ~: C S / J/~/7"~ ~ ~ OR ' ~ ~ ~ ` ~~ t DEROF f 7 ` v ~d [[`` ~' ~ ~ ~ b L uN I?/1:~ Cl ~~~~~ e1- ^ p ~' DOLLARS LI ~ 183.60 ~ I Charg@8 ~!1TAIfH~VIA ° Wechovie Bank, N:A. `AMOUNT ~n waehonvia.com /7 9/ ~ t0 /'>rllw<R 4 /q %'~/ %/ ~ ~ / 00f tvffi ~ 3`( G v r, r 0 ~, °~::0 3 100 50 3ti i~0 3~4 i Z 2..:3.33 3 LOII'- L 5 58 ~'"l Total Credits 0.00 PLEASE PAY THIS AMOUNT -INVOICE DUE UPON RECEIPT -r $18360 RETURNED CHECK FEE - $31.00 DETACH ALONG PERFORMATION AND RETURNSTUB Wrfl~ PAYMENT .AMOUNT DUE 183.60 CATTUTI, ANNA M PATIENT NAME: CALL NUMBER 197586W AMOUNT $ Q' ~ t7 PATIENT NUMBER: 932 BILLING DATE: 01104/2010.. ENCLOSED / u~ r THIS ACCOUNT IS PAST DUE! Send your payment now or contact VISA our ofFice to make payment an'angements. AND MASTER CARD ACCEPTED WEST SHORE EMS -BLS 205 GRANDVIEW AVE CAMP HILL, PA 17011 Consolidated Statement 07 1014122333310 752 30 0 115 21,549 WACHOVIA ATTENTION CUSTOMERS: THIS PAGE IS BEING PROVIDED AS PART OF YOUR MONTHLY STATEMENT BECAUSE WACHOVIA RECEIVED A CHECK IMAGE FROM ANOTHER FINANCIAL INSTITUTION IN PLACE OF AN ORIGINAL CANCELED CHECK(S). THE FRONT OF EACH CHECK IS DISPLAYED AS AN IMAGE. THIS'PAGE WILL APPEAR IN YOUR STATEMENT ANY MONTH WE RECEIVE A CHECK IMAGE. 11/21/2009 thru 12/23/2009 NNE 11ME GTVII EMJYEL M. GTM1 1ain1 1$ 48 W fOMl~ V'AI1xlM tgtlffi ~~~.~ ~ Mx ~~J=.1-,Q ~~.~~9e.s~1u ...n ~~J!/-N 1:0330005031: 303~i22333330r 358 REF#1152513580 PAID 12/11 16.71 uw w4pE G11Vf1 .'•'+u . '1550 wqu1EL K Gitlfll F CY~111LM I1N1lR wx / E f.,..,.. /~J~7 ~ial n. gt7i~r isf6.,S~._... _~ . ~'iy~~r ~tS a °9'-~ 0 ~ i 1 .~i ~C1Ct~oviw _y`~e9~~/.C ~r snt.w 5033000503~333330r 3550 REF#6657025070 PAID 12/23 65.00 Iwwt tuwE utnm NIC1111E1. k umm :x111 nV 1552 ~.~ ~IW_' M 1A11~i x .~-moo-oy a '. QN L ///o..1fi0 n .SE ~t._CP} ~~tc ~/`~~1wb B ' ~ WACHOVU wnwe.a 11.a ,,,,, os~•z~ • 927) • L. 1:0 3 3000 50 31:30 34 3 2 2 33 33 30+ 3552 X00 Oi9t. err REF#6654644330 PAID 12/23 1748.00 -~~YtME tt11n ~ - .__'__ ._...~..~:.~,y 1649 ' 8111. NLLM 11011ffi ~'~T~/ ...w„a/~,ye~/s.%G~ F.,~,s e N.:.•. i S 3//9~Y I N212 /tl le - Z ~ / lA ( 1 (~ } Js t :{ a.. ~ n , •~wr ,~ i ~ ~1•M,AOt'tA I 7~ r y .i4 n 1~^OLMp B ~a~ B ~ sw~ li4 ~NLt IERtS y1y S°Gf e6a/. v/ ' L/ ~L/ /~/~/]/ 7 1:033000503r.3U11.322333330r 3549 REF#1253222760 PAID 12/23 3117.99 •IEhI GMEE GTMt WC141E3 N G7TVi1 "^+ W 1551 F ciwnli M .rn.asv c~77 M ~ .z o I ' ~wo .OQ1SO .-~ ~ ~-~-+' B y/. / 7 ~i ~avts z.o y . --gowns 3;r ~a~uw/sq.ys of 11eo e?03.76-7.9~J ~~~ '1:0330009031:303432233333pr L95i REF#0958266360 PAID 12/22 200.00 C a WACHOVIA BANK, N.A. ,COLONIAL PARK page 7 of 7 ~~ Consolidated Statement ~~ 03 1014122333310 752 30 0 115 21,545 WACHOVIA 11 /21 !2009 th ru 12/23/2009 Crown Classic Banking Other W ithdrawals and Service Fees Date Amount Description 11/23 12.70 PURCHASE CVS 02882 02882--32nd & 11/20 Camp Hill PA 40591758769 11/23 13.18 PURCHASE WEIS MARKETS #125 11/21 CAMP HILL PA 40591058613 11!30 23.94 PURCHASE WEIS MARKETS #125 11!29 CAMP HILL PA 40591078414 12/04 28.41 PURCHASE CRACKER BARREL #550 12/04 MECHANICSBUR PA 40591491990 12/07 1.00 PURCHASE USPS CHANGE OF6610 12/06 4828621007901 800-2383150 TN 1049V244181 12!07 22.50 PURCHASE THE PATRIOT-NEWS E 12/04 4828621004944 717-255-8150 PA 40592290040 12/07 26.60 PURCHASE WETS MARKETS #125 12/06 CAMP HILL PA 40591885663 12/07 30.00 PURCHASE THE PATRIOT-NEWS E 12/04 4828621004944 717-255-8150 PA 40592270040 12107 33.01 PURCHASE ISAAC'S DELI #17 12/05 4828621004944 LEMOYNE PA 4059V242532 12/07 33.99 PURCHASE HEPFERS HOMECENTER 12/06 LEMOYNE PA 40591585871 12/08 62.50 PURCHASE PEPBOYS STORE # 21 12/07 MECHANICSBUR PA 40591958374 12/21 40.00 WITHDRAWAL CAMP HILL 12/19 1200 CAMP H{LL SH CAMP HILL PA 4059W003729 12/21 63.59 PURCHASE Staples, Inc. 12/19 CAMP HILL PA 40591795937 otal 391.42 WACHOVIA BANK, N.A. , COLONIAL PARK page 3 of 7 DEPHTI A896612 TF9GABEV Dep Acct History Transaction Inq BAHTD075 01/25/10. ~,® Page : 2 0 9: 3 4 Org: 075 Serv: DDA Acct: 1014122333310 C/W: Date: Stm: H MORE: - + Short Name: CATTUTI,ANNA MA Daily Bal: 3,566.50 Date Serial T/C Amount T/S Cap Rec Sequence Date/Desc 12/01/09 3121736156 725 1,649.66+ 018 004 752 3298648540 AUTO CREDIT AUTOMATED CREDIT US TREASURY 312 CIVIL SERV CO. ID. 3121736156 091201 PPD 3121736156 725 379.00+ 018 004 752 3298658325 AUTO CREDIT AUTOMATED CREDIT US TREASURY 312 CIVIL SERV CO. ID. 3121736156 091201 PPD 3111036002 725 376.00+ 018 004 752 3282789644 AUTO CREDIT AUTOMATED CREDIT US TREASURY 220 VA BENEFIT CO. ID. 3111036002 091201 PPD DAILY BAL: 5,971.16 12/03/09 3031036030 725 1,018.00+ 018 004 752 3348468485 AUTO CREDIT AUTOMATED CREDIT US TREASURY 303 SOC SEC CO. ID. 3031036030 091203 PPD Command: F1=Help F3=Exit F7=Bkwd F8=Fwd TDAHTI A896612 TF9GABEV TDA History Transaction Inquiry BATTI075 01/25/10 5 STAR 09:46 Org 075 Serv: CDA Acct: 24 7402063929064 State: PA Bank: 24 Date: MORE: - Short Name: CATTUTI ANNA MA BALANCE FORWARD: 87,068.42 Posting Effective T/C Amount Description Date Date 10/28/09 10/28/09 CP 187.69 + CAPITALIZED INTEREST CURRENT BAL: 87,256.11 11/27/09 11/28/09 CP 194.37 + CAPITALIZED INTEREST CURRENT BAL: 87,450.48 12/28/09 12/28/09 CP 188.52 + CAPITALIZED INTEREST CURRENT BAL: 87,639.00 Command: F1=Help F3=Exit F7=Bkwd F8=Fwd F9=APTDAI TDAHTI A896612 TF9GABEV TDA History Transaction Inquiry BATTI075 01/25/10 5 STAR 09:45. Org 075 Serv: CDA Acct: 247402053555434 State: PA Bank: 24 Date: MORE: - + Short Name: CATTUTI ANNA MA BALANCE FORWARD: 20,927.49 Posting Effective T/C Amount Description Date Date 10/09/09 10/11/09 CP 38.39 + CAPITALIZED INTEREST CURRENT BAL: 20,965.88 11/10/09 11/11/09 CP 12/11/09 12/11/09 CP 39.75 + CAPITALIZED INTEREST CURRENT BAL: 21,005.63 38.53 + CAPITALIZED INTEREST CURRENT BAL: 21,044.16 Command: F1=Help F3=Exit F7=Bkwd F8=Fwd F9=APTDAI I TDAHTI A896612 TF9GABEV TDA History Transaction Inquiry BATTI075 01/25/10. 5 STAR 09:49 Org 075 Serv: CDA Acct: 24 7402083394501 State: PA Bank: 24 Date: MORE: - Short Name: CATTUTI ANNA MA BALANCE FORWARD: 115,308.40 Posting Effective T/C Amount Description Date Date 10/30/09 10/31/09 CP 408.10 + CAPITALIZED INTEREST CURRENT BAL: 115,716.50 11/30/09 11/30/09 CP 396.31 + CAPITALIZED INTEREST CURRENT BAL: 116,112.81 12/31/09 12/31/09 CP 410.94 + CAPITALIZED INTEREST CURRENT BAL: 116,523.75 Command: F1=Help F3=Exit F7=Bkwd F8=Fwd F9=APTDAI NEW CUMBERLAND FEDERAL CREDIT UNION Four Community Credit Zlnion P.O. Boz 658. Ncw Cumbvland, PA 17070 . www acfcnonliae.org (717) 774-7700 • (800) 7162328 . Fu: (717) 774-7996 PAGE STATEMENT OF ACCOUNT 1 `IMPORraNT TAX RETURN DDCUMENT' fNCLpSED ACCOUNT NUMBER 257 2 AT 0 .482 Joint Owners 083658 ~n~~~~n~~~~nnn~~n~~~~n~~n~~n~~~n~~i~~,un~~n~n~~~ SOCIALSECURITY# ANNA M . CATTUTI MicHaeL H. cATruri 10 6 OAK D R STATEMENT PERIOD CAMP HILL PA 17011 FROM To 100109123109 TRANSACTION DATE FFFECTNE DATE DESCRI PT10N : AMOUNT FINANCE CHARGE FEES/ FINES :.BALANCE '. ~D~-1------ ----- ~~-1/It1US---BALANCE S1-PRIMARY SHARES 49 0 1231 NEW BALANCE ~ 49 0 1001 PREVIOUS BALANCE S3-MONEY MARKET 5381 4 1031 DIVIDEND 3 6 5385 0 THE ANNUAL PERCENTAGE YIELD EARNED IS 0.8 . 1130 DIVIDEND 3 10 5388 0 THE ANNUAL PERCENTAGE YIELD EARNED IS 0.7 . 1231 DIVIDEND 3 0 5391 0 THE ANNUAL PERCENTAGE YIELD EARNED IS 0.7 . 1231 NEW BALANCE DIVIDEND IS CALCULATE 5391 0 USING A DAILY BALANCE METHOD. 1001 PREVIOUS BALANCE CERTIFICATE 1 91111 3 1031 * CERTIFICATE EARNINGS 169.47 169 7 91281 10 THE ANNUAL PERCENTAGE YIELD EARNED IS 2.2 . 1130 CERTIFICATE EARNINGS 164.31 164 1 91445 1 THE ANNUAL PERCENTAGE YIELD EARNED IS 2.2 . 1231 CERTIFICATE EARNINGS 170.09 170 9 91615 0 THE ANNUAL PERCENTAGE YIELD EARNED IS 2.2 . 1231 NEW BALANCE (MATURES 112710)2.190% 91615 0 Your c rrent Member Rewards level is DIAMOND which entitl s you to a 0.4 incre se over and above our base rate on fut re CD u chas es . TOTAL DIVIDEND YEAR-TO-DATE TOTAL FINANCE CHARGE YEAR-TO-DATE to °"'°'~"°` IRA "`~. DMden~s ehowm, ff over s~o, ~~ be reported 3 0 51.8 9 ~,~ psne 0 . 0 0 m use Internet Revenue Service ror ttris • MDICATES ~FECTIVE DATE NOTICE: See reverse side for important information 0850769 ^! a: i Ea or x ~, Q ~~ ~~ ~a ~ rytl ~? ~-; ,i~,~ ',J... 1.; ~''I ~' ~, ~:- ~, ' - _rr. -' ~; ~ "- i'a v~ V~ I- I H `,, x . • w °A C' ~ ~ N .' ~ V H r, ~ ~ 4 ? ~ ~ ' i W a , I ~. o ;~ aiDO o ~ ..... o c°~~mo moo ea c ~° o~ mNO! ~.~ ~ ~ o ~ m~ ~~n °cv' o•' ooom o° moo ac ~ O G O .m. N N~ .-. p N N .~. ~ } ti p N ~ ~? i~ Q ~ _ F~ ~ d '-' ~ 4 y ~ {[ p _ C r1- Q +~ ~ v ~ °' a ~ ~ ~ ¢_ ~ ~ i.. ~ ~ ~ a~ ~ ~ ai n'~i J V j ? .ai c> ~ is m o y api io °~ g ~ y ar W~ ~ v~ m eC',V UOIUU~ ~_~OO~i aJZ~ i1C,~"JJ 4i ~ Q~ ~ O V O 0 ~ ` J ~ ~ ~ ar ~ m ~' lCl G •\• l17 Q~ ~ ~.+ a ^~ ~ z~nnnnoiDO~ a OD C~ ~m ~ aomn ~ " a~ ~ ~ ~ U O N~ D „ rr ~ ~ v v 1 f. N o '~o~ ~ ` ~ Q '~Fy ~"_' d N ~ _y ~-.= {} Q c d ~ ~ J~ . ~ a m C ~~' p~~ ~ 7 m Q °p d~ s ~ -. N Q i~=Eaoc~ N ` ~ fX0 ~ tvt ~ O 7 UI-U m= I~ u ~ } F- m « N c c $ ~~ ¢ m ~~ ~a E Certificate of Deposit Receipt This receipt is issued to: 'ANNA MARIE CATTUTI ' MICHAEL H CATTUTI 824 LISBURN ROAD APT 613 CAMP HILL, PA 17011 O1 - Susquehanna Bank Blue Ball Office 1060 Main Street Blue Ball, PA 17506 Account Number: 15 6 818 3 3 0 IRA Number: Amount $ 100.000.00 Date Opened 02/03/2004 Term 13 Month(s) Maturity Date 02/03/2010 Interest Rate 2. 7 2 0 0 0 0 °6 Annual Percentage Yield 2 .75°hi The account evidenced by this receipt is subject to and further explained in the terms and conditions contained in the account agreement and account disclosures. The account is Not Negotiable and Not Transferable. Only the items checked apply. ® fixed Interest Rate ^ Variable Interest Rate ^ Additions Permitted ® Automatically Renewable ^ Single Maturity (not automatically renewable) ^ Callable ^ Notice Account Interest will be: ^ mailed to the owner(s). ® added to principal (compounded). ^ paid to account No. ® to be paid every 1 Month(s) ®1994 Bankers Systems, Inc., St. Cloud, MN Form CDREC-BK-LAZ 8/7!2002 (Psy~ 1 0! 1J m H ~ ~p1 M (gyp V' `7 ~I N ~ p..,p fig ~' ~ .~,,, o d o .-, ~ o~ .~ ;; o y ~ ~ ~ A ~ o ~ ~ w~' ~~ ~~k~~,~.~ n N --- s ~ y yl bl IlillliulNl r O C ~ ~' O . `4 ~ a ~ " ~~ „ills. ~ ''I ~. ~' o. o 0 o C7 ti n G ~ b ~- n ~ o ~ ~ h. ~ c ~ ~~ IY~Ii411A!Illl~lllill~!I ~~ ~ A a o I w_ I° ~ ~~ I1lln~hl~illnil ~ b ~+ ~ ~ ~ ~ •, ~ 5' 5' o a ~ ~ ti INlllplli~i~l!IIIIi~~I ~ ~ ,,, ~ ~I~IIIIg1 ~, ~.{~ Ill o~pp C; ~ ~ ~ ~IIUIN~@IU~IIN~Illnli plll~~ N o ~ luull ,I ~. p '~~ ~ Il~f~. , ~ ~ ~iINV91~li81liillil~IHiI~ ~ ~~ ~r .~ C e M ._ p ~ ~ x I~ ~ ~' ~~ ~ - 00 ~"'.. °~ a a` ~ ~. k ~ ~ ~v rr ~ n o H ~: M ~' tip~l~~lll~~i~l'~fllliliitlllll~a'~, Ij~~~~i~' E ~ ^ ~~q-il~ ~ o ~~ a ~i' p oa a' n G ~' ~ g ~o ~. ~ ~ M '~ ~ ~ ~' ti ~ ;~ ~ c •, ~ ~ ~ ;: ~ o a. ° o ~°»~ _.~ ¢ ^ ~~ I App .~~:, ' p~"~L I~~u `~~I:•I ' ti:; ;. r.,'d'~r, 11 1 L _-- --__ __ _- __ __ __ ,~ J '~~~~' ~~?~.x`~~3~i~ ~?~~1~~~~ ~ 1 ~~~~ E~~~ T=fit ~~~ '1'~'Y~~~:yj>~tlrCTl~i~d]i~t;1.~~~~~~~1~~1` ~~f ISSUE DATE F 4~i 4~3-~T6='~~'t` 551024 wnlE«,5,«fFRS.~ ANNA M CATTUTI IND EiCC _ $EP_ 1 '~ 8 RED MILL RD _I"~~ ~_ ~~' PEEK SKILL NY IOSbb FRB'N•Y• ' OCT 31 1990 OR MICHAEi. H CATTUTI D-~~bb~b36~ F S ._ __ 3OZbvMd ~DND$/SAYINGS MOTES IS PFPDPTABLE R FEOEROL INCOME TA% PUPPOSES. fOR iMf vEAR OF PFOEYPTION. DISPOSRIDN OR Flx.l MATURITY DF T«IS BOND.` WnICn~VER M15 EARLIEP. I.4 n' SERIES HH i:00009000 7~: 14 ~ 0/LO^0 2466 136u' ~A~~Ij~ N'~'1Y~~I U,Y~~~3 ISSUE DATE / 09 1~6 2 ~llvv 551024 w«~LN Is IIIE FIR:T DAY of ' ANNA M CATTUTI INO E7(C SEP 1 $ RE0 MILE RD -LAa~-----_---.., PEEKSKZiL NX lOSbb FR8'.N.X. FSIS~C-~,A.6T ~ US OGT 3i 1990 OR lIICNAEL H CATTUGTI INTEPEST OF S ~SRVp~ ~NDS/SAVINGS NOTES IS PEIORTARLF lOP IfDERAI INCOME TAX PURro5E5. FOR THE YEAR Oi REDEMPTION. DISPOSITION OR FINAL MATURITY OF THIS pONDq wNICNE VfR 15 Ew PLIEP. /E _ SERIES HH roooo9000~~~~:14 ~ 000 2466 i 3 711' ~f ~~ T~~TI~~~Y ~~ ~~~~w~Tii~~ S 51 0 2 4 wN c5 S U E D A o E D ANNA-M'CATTUTI IND FXC SEP 1 $ RED MItL` RO `"°" - '"' PFEKSKZLL NX 305bb FRB~.N.Y. FpIS~A,EAl6 T', U S ', OCT 31 1990 OR MICHAEL'H CATTTU`TI' NTERFST OF 3 -0F~ wN0$/SAVINGS ROTES IS REroRTMLF OR fEOEPAI INCOME TA% PUPro5E5. FOR THE YEAR OE PEOEYPTION. DISPOSETION OR l1NAL MATURITY Of THIS BOND. WHICHEVER 15 EARLIEP. . ~== ~`= SERIES HH ~:00009000'7: 14 ~ 000 2 4 6 6 1 3811' °~~c~~b4~~~~ E 'ill ~~~~ ~.~..~~'~`' ~ <~.i~'~j ~ ~ ri ''~;~ ~ ~ ~J1E~y y -5 i~lsf ~. T1~~~~1~1,~~f~-~~~f~~~~l~~fit',`~ ISSUE DATE ~: 51025 Wn:EH s rHE FIPfT D.Y D ~ ANNA M CATTUTI IND EXC SEP 14 8 RED'NILI RD -"A'"--- __- - `": PEEKSKiLL Nr i056b FRB•,N.r. ;~ F,j,,~,D~T` US DC7 31 .1990 OR MICHAEL M CAI2TULpTI HTEREST OF S _ ~V~. '^~ FOR FFDFRAI INCOME TAA PURPOSES FOP THE TEAq OF 0.EDE DF THIS oHD wHl<NEVER a EARUEq. OOMOS/SAVINGS NOTf9 IS REPOPTAYI.E MPTION. OlSPO51TION OR FINAL MATORITV f .. ~~- ,w - r SERIES HH ~~: i4 ~'' 000 2,66 ti3311' ~:000O9oo o D246b1~3~HH Lr9~~,~,HF7e i~~~R~`I..~...,,~.~.. NF o.~~ .,. ~ ~ 1 S S UHE DATE / J rMMi~~, 51024 WH:EH s E . sl D.. ~F ANNA M CATTUTI IND'EXC 5EP 1 8-RED MILL'RD -'`'°`'----_- - `^,- PEEKSKILL Nr 10566 FRB',N.r. F.LI~.G.oalfiT'~ US DCT 31 1990 OR MIL„AEL`M"CATTUTI 3~ INTEREST Of f SA`~1~ IONDS/SAVIN45 IgTES IS REPoRTARIE fOR iEDERAI INCOYF TA% PURPOSEA FOR THE MEAN OF REDEMPTION. DISPOSITION OR FINAL MATVRIIY Of THIS EONO. WNICX[VER 15 FARLIER. ru~ r o~ lf R ~.~ nn~ u ~ ol a L ~ Iw^N~IyAr Tis~.P SERIES HH ~:00009000 7i: i4 ~` 000 2466 13+11' 7 fT>F ~c(~ TI~Y~~\1.3i~~~lFi~~17.Lt~ ISSUE DATE 1 ~7 Z SI O2; WHICH IS TnC FIRST OAr OF ANNA h`CATTUTI IND EXC SEP 19 8 RED MILL RD ,"~--- _ ~ ~NI PEEK SKILL Nr 10566 FRS~,N.~. F3SL„~,6T'~ US ~, DCT 31 1990 OR MICHAEL' H CATT#!TI' INTEREST OF f ~~~ RDNDS/SAVINGS NOiF3 IS AFPORTAALL FOq FEDERAL INCOME TA% PURPOSES, FOR THE YEAR OF REDEMPTION. DISPOSITN)N OR FINAL MATURITY OF THIS BOND, WHICNCVER IS EARLIER. r.~r er ~ ~ ~~ ~~~ ~rT.w~.y SERIES HH i:0000900~0'7~: L~, ~ 000 2466 L 3 2ii' D-~~`~~b~~~ 'y~llfl~ LE r.~titil~I• It) 7jlt rii~l `7)11H11 c1~ds(/'1"7~f lllld~lV "'~'" ~'~~ ) II~'~'~ FII['.1'~l)~I,iJI:;rI~)1 I~>(C)',I YL<~I~~:~ ISSUE DATE ~~_ t793=Z5 T2~T7 ~ 551024 w,,,_„,5T R~,~> ~ ,,r~, ANN4 M CATTUTI INJ >_XG SEP i9 3 42fD MILL RO ~"°" - _ - .", P¢cKSKILL NT 10166 FRSS'•N.Y. fe~S~.DF~aT'~ U S DGT 31 1990 =~ OR MICHAEL H tATT77UTI77 a ~~~.. mob! ~A.r ~ND e INTEREST of s sis.v ncs noTE+ s NEPORTABLE ~ iON rEOERAI OMF TAX PUN VO5E5 fOR THE Or REDkMVT UN SvDS,T ON ON FINAL MATUR FY ~A M,ITON OF TNIS BOND. NN,c'REVFR IS EAPITEq. SERIES I-~H ~;~~~~~~~~ ~~:1-, ,< •~• 24CC i4~ll' ~~2~~b~~+~H~i :I~'l~l~'l~k FI6l~7~d~)1Rar~:~Y) liY~`I.I:r1~y'i'SI ~ TF1[ ~~+yy~ d . ~>_-=yp~ewyu~ „~ .. ,,,~,~ ~ . r..¢ k.... ~,. ti , ~ 15 S U E DATE ~'1y~'~ t/~.7-~ b- / L I I ~ rj102~/ w«IC« ~s T«c riNST DAY O~ ~''~~~~~+ ANNA M CATTUTI IND fXC SEP 19* PffKSKILL NY 10565 FRB ,N. Y. ' Fsi,SL.DTA,GT ~ U S OLT 31 1990 DR MICHAEL H CAT~}T~U`TI EREBT of s ___ _ ~+oIF ~11~~ ~NDS/sAV,nGS nor[s ,s REPORTABLE FOR iEDERAI ,n<OME TA%PU OPR SES FOP THE Yf AR OF REDEMPTION. DISPDSIT,On OR FINAL MATURITY DF Tnl, BDnD. wN,DnEVER .G EARLIER. ~T~ / yy~~r " W'~~ SERIES Hll ~:00009000~17~:.i4 `~ 0D0w2466 L 301I` o-$2`~~b4~~3~~~ FE~'GI~'tClc 'IUIIt~LkU 7)fr)',~6I.E?l~I` ~i ~ y~,~ ,,4-_ ~ ~~~ ISSUE DATE ~`9`~3-L6=T ~ $51024 w«:<«IST«EF~RSTD ~ , ANNA M CATTUTI IND EXG SEP i 8 RFD MILL RD -,MOB--, __ - .a,- PE:K$KILL NY 10556 FRd N. y. ' FE3..SL.<.FA,GT U S OCT 31 1990 DR MFC4iAfL H CATTU`T~IE ,NTEPfST OF S ~SNw~ ~NDS/SAVINGS HOLES IS REPORTABLE FOR FEDERAL INCOME TA% URPOSEB. FOR T«E YEAR OF REDEMPTION. DISPOSITION OR FINAL MATURITY OF TNIS BOND. WRICNEVEA IS EARLIER. ~~~-~ P,...,..~w~.~:~. ,.,~.. s:.~.,,M.,-.~..T SERIES HH x:00009000 ~~: i-, s+W 000 2466 i 3 lli` ° ~~ ~ 64~~3 ~ ~'H DR MICHAEL H CAT]]TUTI77 INTEREST OF 3 ~b~fMlllfl5•AbNDSis AV,NGS NOifS ,S REPORTABLE R FEDERAL InEOME TA%PURVO5E5. FOR THE YEAP OF REDEMPTIOn. POS,TIOH OR FINAL NATUA,iY jjj777 OF Tn15 BOx0., WNI.N3 .age.S EARLIEA. ~~~ ~F~ SERIESHH ~:000090007~: 14 ~ 0002466 L39i1' ~I r~I~~ ;~_t~~k II~r)~I~'Z~I,I)C~)'I~i~1_:ls~s IssuE DnTE ~ iT 2b 551024 wNgN s T«r F.RtT DAY or ~y' ~3 ANNA M CA77UTI IND EXG SEP 13, A RFD-MILL RD L.a~ --. - -:A, P[EKSKILL'NT 105b6 FRB' N.Y. F,l„~~.a~T US OGT 31 1990 ~ ~2~~64~~3~ I E 51D2 ANNA'N`CATTUTI IND B RED NILL'RD Pf£KSKiLL NV 1056b ~- - ~ -~ ~. WNISSUE DATE -.I s THE F RsT DAr or .i':' ExC SEP 1 FRB'~N.Y. ' F.~,RS~NOEAFbT'~ i3S DGT 31 1990 DR MICHAEL H CATTUTIyy INnp[sT of s _ ~ ~DNDS/SAVINGS Norfs Ia R[rogr[nE EOEMI INCOME TAA PURPOSES FOP THE YEAR OF REDEMPTION. OISroSIT10N OR FINAL MRTDNITY OF. THIS ROND~WNICHEVER IS fAREIER. SERIES HH ~:00009000.7: 14 :'~z 000 2466 1 2611' ~~'2~6 b~~~ b ~~i wl~~a~~~~,~...' ~.~a.~ ~~~a~ ISSUE D A 7 E 4 51fl24 wNlcN .s rNF FINST DAr of ANNA N"CATTttTI IND EXC SEP 1 S RfD=MILL` RD -I~~--= -__ -A^I- PEEKSK.ILL:NT Ifl56b FR9'N.T. F,j„S~WfA.GT'~ US DCT 31 1990 DR `MICHAEL"H"GA3T~TLpUT2Ii INifRE3T OF f '9TSRVIIWT WN03IEAVINGS WTES IF RfPORTARIE FOR FEDERAL INCOME fA% PURPOSES. FOR iNE YEAR Oi REDEMPTION. DISPOSITION OR FINAL MATURITY OF TNIS RONOw WNICNfYCP IS EARLfEA. /I SERIESHH ~:00009000.7: i4 ~ I///0/%~0' 246612711' D-~2°~ ~ 64~~ ~ E'~'S`~(~`T~~ ~ i~~~~~'~~r~~' /E L ISSUE GATE V l.l~'~~~~I~~S1 V21 wNICN 5 F F RSTDAY OF~ ANNA N CATTUTI IND EXC SEP 1TTT'"„µ,y, 8 RED•MILL">RD -IMa.., ____=--_R, 9~ PEEK SKILL' Ny: "105bb FRB~~,N~Y. E.IS~.Dd11GT' US i Dt7 31 -1990 OR NZCHAEL':H`CATTUTi °"$~~b INTEREST OF S -0f. SWYAIO~~NOS/SAYINGS NOTES IS RErogiARLE FOR FEDERAL IHCOMETA% PURrosE3. FOP THE YGR OF REDEMPTION. DISPOSITON OR FINAL MATURITY OF TNIS RDN0. WnICNFV[R IS EARLIER. ~~ ~~ SERIES HH i:00009000,7: 14 '~ 000 2466 i 2811' o~~~b-~E~i~.~~"~4~SiF~ ~ w ISSUNE DATE / S51flj4 RICH 5 ErIR3iD+.aF j ANNA`Mi CATTUTI IND EYC____SEP __ 1 8 RED°MiLL; RD '"°" - --_ •"' PEEK SKILL NT 1fl566 fRB~~.N.~. F+•L~iLoRAICT~; US '~ OCT 31` X990 Oit> `NICHAEL~ H' CATTUTT~R INTEREST Oi f ;"7 bWY0i~NDSISAVING3 NOTES IS REroRTAE1E FOR FEOEpAI INCOME TAp PURFOSEi F011 THE YEMW REDFYITNIN, pISPOSITION OR fIMAL MATURITY Oi Tn15 ROnD. WnICNEY[q IS fAllllEq. //{/y()~~~~ ~. 4 - '- sERIES HH ~:000090D0~7i: i4 ~*a 000 2466 i 29i~' Y ~ ~ ~T9=7b- EIf$~~~1'iY ~~t`1,r`F '~ ~ W IssuE oATE I .t - 51024 NICN s rNE F sr o•r of _ To ANNA.'1~i CATTUTI IND EXL SEP 1 $ RED MILL` RD -~.a--- =-- _ --..I PEEK3KILL' NT:' 1O56b FR$••,N.T. F31S•GuFJ1,GT•: U5 ~ OGT 31 .1994 .IN^ .T..» ~:,. ~° OR 'FIICHAEL' f1-"CATTUtTI~"[ __ _ TEREST DF s ~7}~ bNOi/SAVING NOTES Is REroqusLE ` FOR FEDERAL INEOYE TA% vUPVOSCi FOR THE YUR Of R[OEYPTION. DISPOLITNIN OR FINAL NATURITY Z T 6 Of TNIE PONO~ WNICN."[.KVEPo-S EAPlIE0. ~ ~ ~~ 6 L~I~ SERIES HH x:00009000 7~: i4 000 2466 i 2 2ii' y o ~T~b~«L+.II~1N~~~~/«~~ W ISSU«E GATE Iyl02i NICN s E FIRST D.r of tE ANNA ' h+ LAT7UTI IMO EXG ----5£P_-- 1 $ REO' MILL` RO I~ _._ .. PEEKSKYLL NY lOSbb FR8••.N.CT. FZSCAOdkIGT~~; ilS ', OCT. 31 1990 OR° MICHAEL?H CATTUTI'' INTEREST OF S p~EM~ 17NDb~SAVINw NOTEb IL REPORTMLE FOR FFDERAI INOpYE TAY PUgP03[S FOR TML YFAR OE R[DFYPTION. OIEPOSITION OR iINAL YATURRY OF TNIE POND. WNICNEYEP Ib GRLIER. ///~y//,,~,^~~,'.~.'~ AA !' ~T'/y~ SERIES HH ~:00009000•~~: i4 r~ 000 2466 i 2 3~i' °' ~b`Y~ ~ RIN ~~ ~~L~~i'IIl ~~1IID«~~E"~~it ~~S10I4 - W ISSUE DATE NI[N 5 E FIRST OAT OF ~~ ~~,,~,,ppC ANNA- M 'CA7TtITI INO EXC SEP lY~ ---------------- 8 REd•MZLL?RO IM --- "I PEEKSKILL NY 10566 FRB'~,M.Y. F.I,St.oAGT~~ US ~I DCT 31 1990 OR MICHAEL<H`GATTU~TI _ NTEREST OE f ~UL~i VAI~MRITDS/SAVIIW$ MOTEE Ib REPORTABLE fOR FEDERAL INCOME TAIL PURPOEES FOR TXE YEAR Of REDCYPTION. OISPObITIONYAIURITY ^-~~ ~ ~~~~ Of TNt4 [ONO. WNION[VER IS EARLIEP. B!~ SERIES HH roooo900~0~~~:.i~. ~' o00 2466 i 24~~' ~.T Tr~. o.~~ Nun. w<o• ..~;~,I~+• ISSUE DATE / b- ~}'~~+~_•~` :11024 wN C s E FIRST OAT OF aNN~ M tATT13TI IMO ExC SEP i ----------------- $ REO'MILI=RO I ____ _ .EAR, PEEKSiCILL NT 10566 FR$~•,N~Y. ~, DCT`31 .1990 flR • NZCHAELaHCATTUTI`' INTEREST a s 3e7~NIR1 ~eNDSFS.vINw nmo Is REroqunE DISPOPITION 011 FINAL YATURRY FOR fEOERAI INCOME TAY WRPOSES FOR THE YEAR Oi REDEMITNNV . DE TNIS wnD~WwcNEVER n EAgLIEa. n_ . ( ,,, 0 2466 i 2 5i~' 0 SERIES HH r,00009000•?~: i4 ~ 00 °~$ 2"~ 6 b 5102 = Tu AHNA:M':CATTUTI INfl 8 RED'MIlC'R0 PEEKSKILI NY:'1056b ;' , ISSUE DATE WNICH IS THE iIRSi DAV OF EXC 5fP 1 FRS'. N. Y. ~3D~~.aEA,GT`; US ~, OGT 31 1990 C: OR NICHAEI'H CATTUTI` INTGFST OF { ~~~ RONOS/SAVINGS MOTET I! NfPoRTMLE }L~ fOR l[DCR.L ,N:OM.~A~•i~RPOSES i0A THE YEAH OF REDEYPTIOM. DISPoF I~ONY.TURITY y-$ 2~ ~ b`. OF TNI! BOND. wNICNEYG IS EARLIEa `//(/,M^(_... SERIES HH ~:000090007~: i4 ~ 000 2466 i i8u' 0 dR MICHAEL H CATTUTI: TEREST pF f - ~~V1ROS ~NDlIfAVlnpf NOTE9 IS AEPORTAELE FOP FEDERAL INEOYE T.% rURPoSE3. iOR THE YGR OF REDEMITION. OISIOSITION OR FINAL MATURITY Oi TNIS fOND. WHIONEV[R I! [ARLIER. //~`2-w_ j '• .4 SERIES HH i:D0009000•?~: i4 ~' 000 2466 L L91~' ~r~~. N~~H,f.E~. ISSUE DATE 5102 WHICH s rHE FIasT DAE OF- ~-. -. ~ 1 ANNA li=CAT7U7I IYD fXC SPP 1 8:RE0 MIEt°Rfl -rMal„iN,-_-~=,n~.l- PEEKSKILE"N1` '10566 FRB`, ti. y. F,;L~.;ap;GT'~ US ~, OCT 31 1990 RnY LDr ~' ~~eDnl~~"ii 1R8 ~~~Z' "'~."55102- ANNA M CATTUTI iM0 8 RED MILL R0 PEEKSiKILl NY: lOSbb OR MICHAEL H CATTUTZ" °~$ ~~ b`~`r~~i / ~i c ISSUE DATE • WNICH IS iNE FIasT D.Y OF EXC SEP 1 .; FRB'• N. Y. F.,a1,CrT'~ US i OCT ` 31 .1990 °~$2°~~b~~~~ INTGEST OF S 3~~L~~N05/SAYINGS NOTES IS REPORTA{LE OR FEDERAL INCOME TA%rURPoSEl. i0A THE YGR Ol RCDEMTTMDN. DISIOSIIION OR FINAL Y.TURITY OF THIS NOND. wNICNEVER IF GALICR. _ u ~rr n.r~.r SERIES HH ~:0000900017: ~4 ~ 000 2466 1 201I' OR MICiiAEt' M CATTUTI INnAESr or ! -b~~?NII~ ~IIYD!/SAYING! NOES! I! AENRTMIf F011 F[D[RAL INCOME TAL IVRPOSEL FOR THE YEM OF REDEYITN)N. DISROS?ION OR FINAL MATURITY 21 Or TNIf aOND, wNICN[YLR K GRLIG. H ru~wn• r I A^M'Iww~ArM SERIES HH ~:000o9ooo17l: 14 ~ o00 2466 i 2 ill' ~~.,.1~~ pwa~l «~~.RRF,~ ISSUE DATE GC OO ~1 OI~ WNICH S IHC FIRST DAV OF _ ! 1 ANNA M CATTUTI IMD'EXC' SfP 1 8`REO MILi.`RD -'----:-----`"I- PEEKSKILL NT> 10566 FRB'~N.Y. FjSC;~T'~ US OCT 3i 1990 D2Q~661~2~ ~ ~ ~_ OR l4ICHAEL` H-£ ATTUTI' INTEREST OF S ~~WMI~ ~N03ISAV1xGt MOTfi IS R URPOSft. FOR fOP iEOERALO N; OY i T OF THIS BONG. WHICHEVER IS EARLIER. ~ITIONYATUPITY THE YEAR Of R[DFYRTIO 76 o-~ ~ ~ b~ ~ ~ ~ ~ SERIES HH ~:000090007~: 14 ~ ~ sus 000 2466 i i411' 1 J~ ~ Jul, •T.7f~L~-`„."'T„_",~'."",R ~R~l'ja^~ • wH c5 5 U E DATE / A. r j A,~ ~FilJH~"FrEl l/11 51 ~2~' - s rHE F RsT oAr of To ANNA K £ATTtITI INQ fX£ SEP 1 ,. $ RED~MILL RD -r..o~--==_ --- ..I ,~~' ' PfEKSKILLr NY! ..10568 PR8'~li.Y. ~' ~~r ~ F~,S,CAO~,feT ~~, U S ~, DGT 31 1990 ~~T~~T~N~E CY~x~al r.~~n~T~r f f~~ I ~ ~~ ~i D24 wH1E55UE DATE x'17 Jfl 5 LNE fIRST D.Y Of ANNAc M' £ATTUTT IND EX£ SEP 1 ----------------- 8 RED-NiLL' RD. I..o.. -- .x, REfKSKILL NY; 10566 FR8's,N.~. FWLSL.o,A,&T'~ US 0£T 31 1990 OR 'MI£HAEL--H'CATTUTI EPfST OF S ~~ ~ND$/SAVINGS NOTES IS DEPORTABLE FOR FEDERAL INCOY[ TA% IURPOSES. fOR THE TEAR Of REOEYPTION, OISPOSRUIH QA FINAL MATURITY OF THIS BONG. WHICHEVER IS EARLI[P. }/JnWy~' SERIES HH C0000900o'7i: L4 ~ !!!///000 2466 ~ L511' .. ice. ~~'~~y~~.~~~#~~a '~~~~..~ L~."~ / ,7~~yly.~; ~~,I•i ~ ~~ 7;i i.4• d~Vr ~r`~r•Y~~ ISSUHE DATE ~, V 7~~6~~ S f~1424 wH~cH s E F HsT o.r of ANNA tls£ATTUTI IND EX£ SEP 1 8"RED°l1ILL"RD -~ ----~~~-- :~,- PfEKSKILL NT 1O5b6 fR8•~,N.Y. ;" F.Z,~oRAIGT ~ U S DCT 31 X990 DR MI£HAEL'H CATTUTZ- NTCREST OF f ..__ 3,2 ViI~ iNDSIEAVIN65 NOTCS IS R[POPTARLF FOR FEDERAL IHCDNE TAX PURPoSES. FOR 1NE YEAP OF REDEMPTION, DISPOSITION OR FINAL MATURITY OF THIS FOND, WNICNEYfP IS GRLIER. /n{~ ~~/ ~. SERIES HH ~;00009000.7: 14 ~ f~/o00 2466 1 i6~~' ~AT~ ~~~„~,~A"E~„~2~7 ISSUE DATE ~~6~~ S 5102 wHiE S ,Hf FIRST DAY DF ~~,, ~,~~~~p' ANNA N'-£ATTUTI IND EXG____SEP_-_ 19~ $ R+ED MILL' RD I"L`:. -__-- .a PEEKSKILL HT 10566 FRB`.N.Y. F~odST~•; US DGT' 31 X990 OR NI£HAEL~H'-GATTUTI° INTEREST Of 3 3D2br«2 ~ND OT[S IS R[PoRTAFLC iOR FEDERAL INCOME TAY PURPOSES. FOR THE YEM OF REOEYPTN)N."DISPOfITIOY 011 fINAL MATURITY OF THIS FOND." WXICHEVFP IS EAPLIER. SERIES HH ~:00009000"~~: i4 a~ 000 2466 L L 711' o-~2`~ ~ b`~`~ ~~I'N s~RY~ Iii . .. --- ~,.~...R.~~,,~.o ... .. ,`, - _ i~',. ~ 0 ~~ _ _ _ - f RLiM I56UE-0hT£ Oi-~ _~= __ `.. `093-2b-7277 _. - _- ', 03 - 200 ~_ _ ~' fN Ta AN~F~-'~~4T~TI ~~~~ ' _ GAM~.1F1Il~Lri"Pb°17d~I1 -~ ~ ~~ ~ x~ _ _ w r. r;;.. a ; # z.- q ~ -_ _ - OR MICHAEL H' CATUTTI _ -_ 0583-871=F ____=; i_ 00314102-067069 11, ~ 300D 58-38 ? i 2~~' SERIES I~H _ -~,~, - _.. ..__...._- ... ..... ...~~ U RAJ O-f 1. J- _- - -0EfERRE6_MIFER E3T S __ 8__e_~ _- _. _ , ~ /~~ n _... _.:..aa~I4lo2ob7o~9 ~ 4 _:~~ -,OQD 58 ~8'~ ~ 3~~' -_ ~ = -= SFIRIE~ HH --- - ~a~i - ~~ ~ ~ .~ f ~ a._ ~. =-i ~ Ear-eersf so-verws-.~ FROM KSU E-O FrE DF- - - 093-Zb-7277= - ~63 2002 --!_ - ~' ~b ~ - ~ - - _- - __ _ ~~a ~ w I l 170 ~~~A~ 1 _ _ M ~ ~, ~~ 1 ~ I~ ~ . - - = - _ =0R MLCHAEL H- CATUTTI 05838X4 =_ _ -f~1iR-E~FtFTFTERES#- - -_ _ S i3 .. r - ~ ~rr,..~.,. 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