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Home My WebLink About05-28-1015056041114 X 06-05 OFFICIAL USE ONLY REV 1500 E c > PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN ~ j ~ ~O ~ ~~ 9~ PO BOX 280601 RESIDENT DECEDENT Harrisbur PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Date of Birth Social Security Number Date of Death 182-22-5362 12232009 09121924 Suffix Decedent's First Name MI Decedent's Last Name FRANCES E• HOCH (If Applicable) Enter Surviving Spouse's Information Below MI Spouse's First Name ff Spouse's Last Name ix Su Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~ 3. Remainder Return (date of death t 1. Original Return 0 urn 2. Supplemental Re prior to 12-13-82) ~ t 4a. Future Interest Compromise (date of [~ 5. Federal Estate Tax Return Required e 4. Limited Esta death after 12-12-82) t t T 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes e a es 0 6. Decedent Died (Attach Copy of Trust) (Attach Copy of Will) 9. Litigation Proceeds Received ~ 10. S ousal Poverty Credit (date of death 0 11. Election to tax under Sec. 9113(A) p Attach Sch. O) ( between 12-31-91 and 1-1-95) DIRECTED TO: ~Oe Me N THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TD I O l CORRESPONDENT - y t Number phone e Name 717-243-5838 STEPHEN D. TILEY Firm Name (If Applicable) REGISTER OF WILLS USE~LY ..~. ,~.~ ~,~ FREY & TILEY C7 r~ ~~i - ") ~_ _.} _ ~~ - First line of address c'~ ,:~ ~ ~ z 5 SOUTH HANOVER STREET ~~' "~"- ~ ~; Second line of address F.-y~..Y.~ '~ , ...j ' . DA~t.".... ED ~ 4 ; ~: ~ : t"~ ~.~'~ t City or Post Office State ZIP Code ...... CA PA 17013 CARLISLE Correspondent's a-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best o my knowledge and belief, it is true, co ct and corn lete. Declaration of re arer other than the ersonal re resentative is based on all information of which re aver has an k DATE e SI RE OF PERSOI~tESPONS~LE FQR FLING REn~ N ADD SS JU ITH A. HOCKENSMTH, 363 GREEN SPRING ROAD, NEWVILLE, PA 1.7AE1 SIG /¢R~EE6BER.OTH THAI~2EPRESENTATIVE ~ ~ ~ o~G~ _ _ _ ~ ADD ESS STEPHEN D . TILEY, 5 SOUTH HANOVER SiN L FORM ONLYLI SLE, PA 17 O 1 PLEASE USE ORIG Side 1 L 15056041114 15056041114 J REV-1500 EX Page 3 182-22-5362 Decedent's Complete Address: DECEDENT'S NAME 'RANGES E. HOCH STREET ADDRESS CITY DECEDENT'S SOCIAL SECURITY NUMBER 182-22-5362 STATE ZIP pA 17241 Tax Payments and Credits: 00 6871 (1) . 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments 6650.00 C. Discount 343.55 Total Credits (A + B + C) (2) 6993.55 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 0.00 If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. 4 55 122 . Fill in oval on Page 2, Line 20 to request a refund. (4) . 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A. Enter the interest on the tax due. (5A) (5B) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE AP PROPRIATE BLOCKS 1. Did decedent make a transfer and: .... Yes No a. retain the use or income of the property transferred : ................................... e i it ^ ^ : ................ ncom s b. retain the right to designate who shall use the property transferred or ^ ^ c. retain a reversionary interest; or ......... . ^ d. receive the promise for life of either payments, benefits or care? ............................. 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death ..... .. ^ ^ ~ without receiving adequate consideration? ........................................ ath d h hi ^ ^ .. . er e s or 3. Did decedent own an "in trust for" or payable upon death bank account or security at 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which ^ ^ containsabeneficiarydesignation? ................ .•.••••••~•••••••••••••••••• IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. File Number 21-10-00090 J 15056042115 REV-1500 EX Decedent's Social Security Number 182-22-5362 Decedent's Name: FRANCES E . HOCH RECAPITULATION 15 5 0 0 0. O O 1. 1. Real estate (Schedule A) .........................•••••••••••~•••••• 2. NONE 2. Stocks andBonds(ScheduleB)........••••••••••••~•••••••~~~~'~"" 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .... . 3. NONE 4. . Mortgages & Notes Receivable (Schedule D) ........................... . 4. NONE 5 Bank Deposits & Miscellaneous Personal Property (Schedule E) ........ Cash 5. 13710.00 . , 5188.00 6. Jointly Owned Property (Schedule F) OSeparate Billing Requested ........ 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property Separate Billing Requested ........ 7 9 81.0 0 (Schedule G) 8 174879.00 8. Total Gross Assets (total Lines 1-7) ................................. . 9 17131.00 9. Funeral Expenses & Administrative Costs (Schedule H) .................... . 10 Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............. . 10. 5050.00 . 22181.00 11. Total Deductions (total Lines 9 & 10) ................................. 11. 12 152698.00 12. . . ............... Net Value of Estate (Line 8 minus Line 11) ........... . . 13 Charitable and Governmental Bequests/Sec 9113 Trusts for which 0 . 0 O . an election to tax has not been made (Schedule J) ...................... • 13. 152698.00 ......•.. .. . 13 Li i ' 14. 14. ........... ne nus ect to Tax Line 12 m Net Value Sub TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 0 . 0 0 (a)(1.2) X .0 O 15. 16. Amount of Line 14 taxable 15 2 6 9 8 0 0 1 s 6 8 71.0 0 . at lineal rate X .0 4 5 . 17. Amount of Line 14 taxable at sibling rate X • 12 17 O • 0 O 18. Amount of Line 14 taxable 18 0 . 0 0 at collateral rate X . 15 19. TAX DUE .......................................................19. 20• FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 15056042115 Side 2 15056042115 6871.00 0 J REV-1502 EX+ (11-08) Pennsylvania gCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT Dtc:tutrv i FILE NUMBER ESTATE OF 21-10-00090 Frances E. Hoch All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which grope would be exchanged between a willing buyer and a wiiln~g -soewned with nght off survivorsthipumust be d~sclosed on Schedule Fowledge of the relevant facts. Real property that Is jo y Attach a copy of the settlement sheet if the property has been sold. VALUE AT DATE ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. OF DEATH NUMBER DESCRIPTION ~ . 465 Shippensburg Road, Newville, PA 17241 Decedent's Former Personal Residence 155,000 Sold March 31, 2010 -Gross Sale Price See Settlement Sheet -Exhibit "A" See Copy of Deed -Exhibit "B" Tax Year 2010 Assessment $111,960 divided by CLR of 79.1 % _ $141,542.35 TOTAL (Also enter on Line 1, Recapitulation) ~ $ 155,000 If more space is needed, insert additional sheets of the same size. REV-1508 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONWEALTH OF PENNSYLVANIA PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF 21-10-00090 Frances E. Hoch I..,.I,,.Ie ~I,c ..rnr~caarlc r,f Iltiaation and the date the proceeds were received by the estate. (If more space is neeaea, Insert aaaltlonal sn~~~s VI LI IC .7QIIIG a~~c/ REV-1509 EX+ (01-10) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN ECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY RESIDENT D FILE NUMBER: ESTATE OF: 21-10-00090 Frances E. Hoch If an asset became jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. ADDRESS RELATIONSHIP TO DECEDENT SURVIVING JOINT TENANT(S) NAME(S) Daughter A. Judith A. Hockensmith 363 Green Spring Road, Nevwille, PA 17241 B C WNED PROPER TY: JOINTL Y O of R DATE OF DEATH DESCRIPTION OF PROPERTY io LETTER DATE UDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR T D REST ITEM FOR JOINT MADE T INCL ATTACH DEED FOR JOINTLY HELD REAL ESTATE. IDENTIFYING NUMBER ET VA UE OF ASS NTEREST DECEDENTS INTE NUMBER TENANT JOIN . Adams County National Bank Checking Acct. No. 135321, 1,208 50.00% 604 1. A. 2/5/85 See Exhibit "C" Accrued interest to Date of Death ($0.02) 0 50.00% 0 F&M Trust Compny Checking Acct. No. 35-22806, See Exhibit 3,351 100.00% 3,351 2, A 3/21/09 „D„ Accrued interest to Date of Death ($0.30) 0 100.00% 0 Citizens Bank Checking Acct. No. 622434-243-5, See Exhibit 1,210 50.00% 605 3. q 6/4/99 E 0 20 Shares McKesson Cor oration Common Stock, See Exhibit 1,256 50.00% 628 P 4. q 3/2/00 ..F ~~ price Per Share at Date of Death: $62.81 0 0 0 0 0 0 0 0 0 TOTAL (Also enter on Line 6, Recapitulation) ~ ~ 188 .00 If more space is needed, use additional sheets of paper of the same size. REV-1510 EX+ (08-09) SCHEDULE G Pennsylvania INTER-VIVOS TRANSFERS & DEPARTMENT OF REVENUE INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY pGCInFNT nFCEDENT r~~~ ~.v....,..._.. ESTATE OF 21-10-00090 Frances E. Hoch This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECD'S EXC LUSION TAXABLE THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST VALUE NUMBER 981 100.00% 0 981 1. IRA Account 0 Citizens Bank -See Exhibit "G" 0 Beneficiary: Daughter: Judith A. Hockensmith 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) $~ 981 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX + (10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS FILE NUMBER ESTATE OF 21-10-00090 Frances E. Hoch Decedent's debts must be reported on Schedule I. ITEM AMDUN I DUMBER DESCRIPTION A. FUNERAL EXPENSES: 3,904 1. Egger Funeral Home, Inc. (Paid by Adams County National Bank CD #900043201162) 125 2. Paster Phil Steele 300 3. Green Spring First Church of God -Funeral Service and Memorial B 1 ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City Year(s) Commission Paid: 2, Attorney Fees: FREY &TILEY 3. Family Exemption: (If decedents address is not the same as claimants, attach explanation.) 4. 5. 6. 7. V IQII I IQI It Street Address City State ZIP Relationship of Claimant to Decedent Probate Fees: Accountant Fees: FREY &TILEY Tax Return Preparer Fees: FREY &TILEY Addiional Administrative Expnses from Schedule H-1 State ZIP 6,000 308 0 0 6,494 TOTAL (Also enter on Line 9, Recapitulation) ~ $ 17,131 If more space is needed, use additional sheets of paper of the same size. ESTATE OF: Frances E. Hoch SCHEDULE H-1 1 Charles Smith -Trash Hauling 2 Register of Wills -Short Certificates 3 Charles Smith -Trash Hauling 4 Auctioneer's Commission -Advertising Personal Property Sale -See Exhibit "H" 5 Cumberland Law Journal -Advertising 6 The Sentinel -Advertising 7 Ace Chem-Dry - Capet Cleaning -Prepare House for Sale g Costs of Sale of Real Estate: (See Exhibit "A") 465 Shippensburg Road, Newville, PA 17241 Realty Transfer Tax Year 2010 County & Township Real Estate Tax Less Tax Pro-Ration for 2010 Cty. & Twp. Tax Less Tax Pro-Ration for 2009-10 School Tax 9 Payments to workers for help in disassembling house 10 Filing Fee for Inheritance Tax Return 11 Reserve to File Account TOTAL SCHEDULE H-1: 21-10-0090 60.00 12.00 65.00 2,784.20 75.00 187.54 344.62 1,550.00 298.33 (225.58) (402.45) 1,550.00 15.00 180.00 6,493.66 Page 1 of 1 REV-1512 EX+ (12-08) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS FILE NUMBER ESTATE OF 21-10-00090 Frances E. Hoch Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. LUE AT DATE ITEM I NUMBER DESCRIPTION See Schedule 11 VA OF DEATH 5,050 TOTAL (Also enter on Line 10, Recapitulation) I $ 5,050 If more space is needed, insert additional sheets of the same size. ESTATE OF: Frances E. Hoch SCHEDULE I-1 1 Black's Water Conditioning -Water Softner Rental 2 PP&L 3 Big Spring Pharmacy - Deductable 4 Century Link -Telephone 5 PP&L 6 Century Link -Telephone 7 Millenniu Pharmacy g Erie Insurance Group (Homeowner's Insurance) 9 PP&L 10 Century Link -Telephone 11 Green Ridge Village -Nursing Home Care 12 PP&L 13 PP&L 14 Refund -Century Link 15 Refund -Erie Insurance 16 PA Department of Public Welfare Estate Recovery Program -Nursing Home Expenses TOTAL SCHEDULE I-1: 21-10-0090 22.26 32.43 205.64 33.11 38.45 33.11 3.89 137.00 45.10 33.11 1,176.14 27.11 12.40 (2.08) (109.00) 3 ,361.02 5,049.69 Page 1 of 1 REV-1513 EX+ (01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: Frances E. NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] Robert L. Hoch 1 ~ 5802 Bob Bullock Lp C1 Box 328C-116 Laredo, Texas 78041 Judith A. Hockensmith 2' 363 Green Spring Road Newville, Pennsylvania 17241 FILE NUMBER: 21-10-00090 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE Step-Son Daughter $25,000 Specifc Bequest Specific Bequest of real estate (personal residence) And 100% Residuary I ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I $ 0 If more space is needed, use additional sheets of paper of the same size. LAST WILL AND TESTAMENT OF FRANCES E. HOCH I, FRANCES E. HOCH, widow of North Newton Township, Cumberland County, Pennsylvania, (mailing address: 465 Shippensburg Road, Newville, Pennsylvania 17241),being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as , and for my Last Wil] and Testament hereby revoking and making void any and all Wills by me at any time heretofore made. 1. I direct my hereinafter named Executor or Executrices to pay all of my just debts and funeral expenses as soon after my death as may be found convenient to do so. I further direct that all inheritance, transfer, succession, estate and death taxes which may be payable on account of my death shall be payable from the residue of my estate regardless of whether the assets upon which such taxes are based are included in my probate estate. 2. I declare that I am the widow of W.Clair Hoch, deceased, and that we had no children by that mamage. I further declare that I have one child by a previous marriage, Judith A. Hoclcensmith of 363 Green Spring Road, Newville, Pennsylvania, and that my husband had one child by a previous marriage, Robert L. Hoch. 3. I give and bequeath the sum of $25,000.00 to my step son, Robert L. Hoch. 4. I give and bequeath all my tangible personal property to my daughter Judith Hockensmith, but should she predecease me or fail to survive my by a period of ninety (90) days, then in such event I direct my hereinafter named Executrix or Executor to sell said tangible personal property at public or private sale and the proceeds shall be'added to the remainder of my estate. 5. If at the time of my death I am the owner of my cun-ent home at 465 Shippensburg Road, Newville, Pennsylvania (North Newton Township), I direct my Executrix or Executor, as soon after my death as she or he deem appropriate to sell the said real estate and to pay the net proceeds from said sale, after paying all of the expenses associated with its sale in equal shares to my daughter, Judith A. Hockensmith. If I have sold my said house prior to my death, I give an bequeath to my daughter, Judith A. Hockensmith, a sum equal to the lesser of the net proceeds I received from the sale of said real estate or the balance of the funds held by me with financial institution at the time of my death. Should my daughter, Judith A. Hockensmith, predecease me or fail to survive me by a period of ninety (90) days, then the share which she would have otherwise received shall pass to her issue per stirpes. 6. All the rest residue and remainder of my estate, real, personal, or mixed and wheresoever the same shall be situate I give, devise and bequeath to my daughter, Judith A. Hockensmith, provided that she shall survive me by a period of ninety (90) days. In the event that my said daughter should predecease me or fail to survive me by the aforesaid period of ninety (90) days, then in such event 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 equal shares to such of her children as shall survive me by a period of ninety (90) days, share any deceased child would have received to pass to his or her issue per stirpes, and if there be no issue such shares shall lapse and be added to the remaining share or shares per stripes. 7. Should any person less than 21 years of age be entitled to distribution from my estate in such event the share that person would otherwise have received shall be paid to my hereinafter named Executrix or Executor in Trust. I authorize the herein named Trustee to receive and invest the same, and to pay the income arising there from, together with so much of the principle there of as in his or her opinion is necessary or desirable to be expended for the proper maintenance, support, and education of such person, to or for the benefit of such person, and upon such person obtaining 21 years of age to pay to him or her the then remaining principle together with any undistributed income. 8. In addition to the powers conferred by law, my herein named Executrix or Executor and Trustees are empowered: a. To invest any part of the trust corpus in such securities, investments, or other Page 1 of 3 E ~ F~ property as may be deemed advisable and proper, irrespective of whether the same are authorized for the investment of trust funds under the laws of any governing jurisdiction. b. With respect to any corporation, the stocks, bonds, or other securities of which may be held, to vote in person or by proxy on any shares of stock; to consent to the merger, consolidation or reorganization of such corporations; to consent to the leasing, mortgaging or sale of the property of any such corporations; to make any surrender, exchange or substitution of such stocks, bonds or other securities as an incident to the merger, consolidation or reorganization of such corporations; to pay all assessments, subscriptions and other sums of money which may be deemed wise and expedient for the protection and maintenance of the proportionate interest of the investment in such corporations; to exercise any option or privilege which may be conferred upon the holders of such stocks, bonds, or other securities of such corporations either for the conversion of the same into other securities or for the purchase of additional securities, and to make any and all necessary payments which may be required in connection therewith; and generally to have and exercise as to all such stocks, bonds and other securities, the powers of an individual owner who is not under trust obligation. c. To hold the trust corpus in one or more consolidated funds in which separate shares shall have undivided interests. d. To sell at public or private sale for cash or upon credit, or partly for cash and partly on credit, and upon such terms and conditions as shall be deemed proper, any part or parts of the trust estate, and no purchaser at any such sale shall be bound to inquire into the expediency or propriety of any such sale or to see to the application of the purchase moneys arising therefrom. e. To keep on hand and uninvested such money as may be deemed proper and for• such period as may be found expedient. f. To compromise, settle or arbitrate any claim or demand in favor of or against the trust estate. g. And authorized in the discharge of fiduciary duties, to employ counsel and to determine and to pay such counsel reasonable compensation which shall be charged against the principal or income of the trust fund, and shall further be entitled to charge against the principal or- rncome such other reasonable expenses and charges as may be necessary and proper to incur for the proper discharge of fiduciary duties and for the proper management and administration of the trust estate. h. In making any division of property into shares for the purpose of any distribution thereof directed by the provisions of the trust, to make such division or distribution, either in cash or in kind, or partly in cash and partly in kind, as shall be deemed most expedient, and in making any division or distribution in kind may allot any specific security or property or any undivided interest therein to any one or more of such shares, and to that end may appraise any or all of the property so to be allotted and the judgment as to the propriety of such allotment and as to the relative value for purposes of distribution of the securities or property so allotted shall be final and conclusive upon all persons interested in the trust or in the division or distribution thereof. i. And authorized to register any shares of stock or other assets of any trust in their own names or in the name of a nominee. To retain and invest in shares of stock of my Trustee. k. To retain any investments including mutual funds which I may own at the time of my death and in addition to invest any part of the Trust corpus in such mutual fund or mutual funds as may be deemed advisable or proper, irrespective of whether the same are authorized for the investment of trust funds under the laws of any governing jurisdiction. 1. To determine from time to time whether all or some portion of realized capital gains shall be treated as ordinary income for distribution to a beneficiary or treated as principal to be retained as part of the corpus, and such designation need not be consistent from one year to another. Page 2 of 3 ~ . ~ i~ I hereby nominate, constitute and appoint my daughter, Judith L. Hockensmith, as Executrix of this my Last Will and Testament, but should she predecease me or fail to qualify or cease serving as such, then in such event I nominate, constitute and appoint my grandson, Thomas L. Shaffer and Lorie Shaffer Stum, or either of them, as Executors and I further direct that none of them shall be required to post any bond to secure the faithful performance of his or her duties in the Commonwealth of Pennsylvania or in any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament written on one (1) page, this Est day of~~ 2006. z ~ ~ ,~~ ~r~~s7 ..~~„t- ~--~ ~ ~ ~ ' ~ - ° (SEAL) FRANCES- E. HOCH . Signed, sealed, published, and declared by Frances E. Hoch, the Testatrix above named, as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other; have hereunto subscribed our names as attesting witnesses. !orrn "'UD-' ';+is~~ rar Hancnocr n~u~.~ previous editions are obsolete ,o.;-settlement Statement U.S. Department of Housing and Urban Development ~ OMB A royal No. 2502-0265 B. T e of Loan 7. Loan Number S. Mortgage Insurance Case Number 1. GFHA 2. ^FmHA 3. ^Conv. Unins. 6. File Number TitleEx ress Settlement System 4. nVA 5. Conv.lns. 102172YOST i is rorm is rumis ee o give you a s a[emen[ o ac ua se ement cos[s. moun s poi o an y e se ement agen are snown. C. Note: Items marked "(p.o.c.)" were paid outside the closing; they are shown here for information purposes and are not included in the totals. Pflntetj O3IJOI2O~ O at ~ 6:34 ASF onRction can~snc ude a finenand Impr sonmenL Foar details see: Title 18 USS.tCode Sew on 1001 and Section tOtpenalties upon D. NAMEOF BORROWER: Kevin E. Yost and Aimee J. Yost - -- ADDRESS: 450 Bi S rin Road. Newvifle PA 172471 E. NAME OF SELLER: The Estate of Frances E. Hoch ADDRESS: 363 Green S rin Road Newville PA 17241 F: NAME OF LENDER: Frank J. Yost and Rose Ann Yost ADDRESS: G. PROPERTY ADDRESS: 465 Shippensburg Road, Newville, PA 17241 North Newton Townshi H. SETTLEMENT AGENT: South Central Home Settlements, Inc., Telephone: 717-532-7387 Fax: 717-532-6552 3UJ. I.HJI'1 rRVIYI Gvf~nvn ~~. a neBgSfgence penalty ar other sanct on wnAll be imposed on you fath~s itemt s~rrequieed to be reportedtand he IRS detenn nes ithat' has not been retported. The Contrail Sale Price descri ~ a~ le a return. line 401 above constltutes the Gross Proceeds of this transactlon. `: ' ' You are required bylaw to provide the settlement agent (Fed. Tax ID No: with your correct taxpayer idenliflcatlon number. If you dd not provide your correct taxpayer identification number, you may be subject to civil or criminal penalbes imposed bylaw. n er penalt es o perjury, I certify that the number shown on this statement is my correct taxpayer identification number. TIN:.. / - SELLER(S) SIGNATURE(S): SELLER(S) NEW MAILING ADDRESS: (W) SELLER(S) PHONE NUMBERS: (H) ~° wnn nw-i t~~oof iei nmwu~un ~o~a.c "°"""""°--.- --.,..,,,,,.,,. ~.,r, ~ ~r,o~~~ n=trot npnni=nlT File Number 1O2172YOST ~ PAGE 2 The Estate of Frances E. Hoch / , Sy:uu i ocKensmi ecutnx i WARN G: IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE The HUD-1 Settlement Statement which I have prepared is a true and accurate account of this transaction. UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON CONVICTION I have caused or will cause the funds to be disbursed in accordance vaith this statement- CAN INCLUDE A FINEAND IMPRISONMENT. FOR DETAILS SEE TITLE 18: U.S. CODE SECTION 1001 AND SECTION 1010. 1.. ~ C~ ~ ~/~/~ sy. HUD CERTIFICATION OF BUYER AND SELLER I have carefully reviewed the HUO-1 Settlement Statement and to the best of my knowledge and belief, It is a true and accurate statement of all receipts and disbu ements made on my account or by me in this tibn. I further c ity that I have received a copy of the HUD-1 Settlement Statement. ` imee os awn o Tax Parcel No.: 30-08-0593-084 THIS INDENTURE a~ MADE THE ~~ '~ day of March in the year of our Lord two thousand ten (2010) BETWEEN JUDITH A. HOCKENSMITH, Executrix of the Last Will and Testament of FRANCES E HOCH, deceased, late of West Pennsboro Township, Cumberland County, Pennsylvania, and JUDITH A. HOCKENSMITH, married woman, of 363 Green Spring Road, Newville, Cumberland County, Pennsylvania 17241, in her individual capacity, parties of the first part, GRANTORS, AND KEVIN E. YOST, and AIMEE J. YOST, husband and wife, of 450 Big Spring Road, Newville, Cumberland County, Pennsylvania 17241, parties of the second part, GRANTEES, WHEREAS, Frances E. Hoch, died on December 23, .2009, seized in fee of the hereinafter described real estate, WHEREAS, by her Last Will and Testament dated February 2, 2006, she provided, in part, as follows: "5. If at the time of my death I am the owner of my current home at 465 Shippensburg Road, Newville, Pennsylvania (North Newton Township), I direct my Executrix or Executor, as soon after my death as she or he deem appropriate to sell the said real estate and to pay the net proceeds from said sale, after paying all of the expenses associated with its sale in equal shares to my daughter, Judith A. Hockensmith. If I have sold my said house prior to my death..." "6. All the rest residue and remainder of my estate, real, personal, or mixed and wheresoever the same shall be situate I give, devise and bequeath to my daughter, Judith A. Hockensmith, provided that she shall survive me by a period of ninety (90) days." "[9] I hereby nominate, constitute and appoint my daughter, Judith L. (sic] Hockensmith, as Executrix of this my Last Will and Testament, but should she predecease me..." WHEREAS, Letters Testamentary in the Estate of Frances E. Hoch were issued by the Cumberland County Register of Wills to Judith A. Hockensmith on January 27, 2010, without the requirement that any bond be posted by her, which Letters are of record at estate file no. 21-10- 0090, and-which remain in full force and effect, and, Page 1 of 3 ~~ WHEREAS, Section 3351 of the Frobate Estate and Fiduciaries Code (20 Pa. C:S.A. §3351) gives personal representatives the power to sell at public or private sale any real property that is specifically devised, with the joinder of the specific Devisee, and, WHEREAS, Judith A. Hockensmith, the specific Devisee of the hereinafter described real estate, joins in this deed. NOW THIS INDENTURE, WITNESSETH, that the said Grantors for and in consideration of the Burn of One Hundred Fifty eve Thousand and nollOOdredths-- ($155,000.00)-- Dollars lawful money of the United States, to them in hand paid by the said Grantees, their heirs and assigns, at and before the sealing and deliver hereof, the receipt whereof is hereby acknowledged have granted, bargained, sold, aliened, released and conformed, and by these presents, do grant, bargain sell, alien, release and confirm unto the said Grantees, their heirs and assigns, as tenants by the entirety, ALL THAT CERTAIN tract of land together with the improvements thereon erected situate in the Township of North Newton, County of Cumberland, and State of Pennsylvania, bounded and described as follows, to wit: BEGINNING at a point in the Newville-Shippensburg Road (Route No. 533), at corner of lands now or formerly of Harvey N. Keck, and wife; thence North 41 1/a degrees East, 186.00 feet to an iron pin in the center of the aforesaid public road at corner of lands now or formerly of Charles L. Bear, and wife; thence by said Bear land, North 88 degrees East, 247.00 feet to an iron pin; thence by lands now or formerly of Paul Mackey, South 30 Ski degrees East, 61.00 feet to an iron pin; thence by lands now or formerly of Harvey N. Keck, and wife, by a line parallel with the aforesaid public road, South 41 1/a degrees West, 356.00 feet to an iron pin; thence by the same, North 42 degrees West, 238.00 feet to the Point and Place of BEGINNING. HAVING thereon erected a single family dwelling with attached garage. KNOWN as and numbered 465 Shippensburg Road, Newville, Pennsylvania 17241. ALSO KNOWN as UPI No. 30-08-0593-084. BEING the same premises which Martha R. Cocklin, widow, by deed dated December 14, 1979 and recorded December 14, 1979 in the Office of the Recorder of Deeds, in and for Cumberland County, at Carlisle, Pennsylvania, in Deed Book "U," Volume 28, Page 246, granted and conveyed to W. Clair Hoch and Frances Hoch, husband and wife. THE SAID W. Clair Hoch died on June 4, 1999, thereby vesting title to the above-described premises solely in his surviving spouse, Frances E. Hoch, also known as Frances Hoch, Deceased,- whose estate is one of the Grantors herein. THE UNDERSIGNED Wayne L. Hockensmith, Sr. joins in this conveyance as the spouse of Judith A. Hockensmith, solely for the purpose of quitclaiming whatever interest in the above described real estate he may have as such spouse, and does not join in any of the warranties that inay be expressed, or implied, in this transaction. TOGETHER with all and singular ways, waters, water-courses, rights, liberties, privileges, hereditaments and appurtenances whatsoever thereunto belonging, or in anywise appertaining, and the reversions and remainders, rents, issues and profits thereof; and also all the estate, right, title, interest, use, trust, property, possession, claim and demand whatsoever of Page 2 of 3 the said Frances E. Hoch at and immediately before the time of -her death, in law, equity or otherwise howsoever, of, in, to or out of the same: TO HAVE AND TO HOLD, the said. buildings, hereditaments and premises hereby granted and released, or mentioned and intended so to be, with the appurtenances, unto the said, Grantees their heirs and assigns, to and for the only proper use and behoof of the said Grantees, their heirs and assigns, forever. AND the said Grantors do covenant, promise and agree, to and with the said Grantees their heirs and assigns, by these presents, that. they the said Grantors, have not done, committed, or knowingly or willingly suffered to be done or committed, any act, matter or thing whatsoever whereby the premises hereby granted, or any part thereof, is, are,, shall or may be impeached, charged or encumbered, in title, charge, estate, or otherwise howsoever. WITNESS the due execution hereof the day month and year first above written. WITNESS: ,. _ C.__-_ ~ . ~ , " - ~ (SEAL) JU ITH A. HOCKENSMITH, Executrix of the Last Will and Testament of FRANCES E. HOCH, Deceased. ,,< '~ ~ ~ + ~ ~~. (SEAL) JU ITH A. HOCKENSMITH, Individually, as Specific Devisee. C- -.. WAYNI-~L. HOCKENSMITH, SR. Commonwealth of Pennsylvania } ss. County of C ...., ~ ~ ~~ - /j' On this, the 3 t Sr day of March, 2010, before me, the undersigned officer, personally appeared JUDITH A. HOCKENSMITH, Executrix of the Last Will and Testament of FRANCES E. HOCH, late of West Perinsboro Township, Cumberland County, Pennsylvania, Deceased, and JUDITH A. HOCKENSMITH, Individually, as specific Devisee, and WAYNE L. HOCKENSMITH, SR., known to me (or satisfactorily proven) to be the persons whose names are subscribed to the within instrument, and ,acknowledged that they executed the same in the capacities therein stated and for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. NOTARIAL SEAk ~~~/~ RICHARD L. WEBBER JR., NOTARY PUBLIC `---ti (SEAL) SHIPPENSBURG BORO, CUMBERLAND COUNTY MY COMMISSION EXPIRES JULY 15,2010 I do hereby certify that the precise residence and complete post office address of the within named Grantees is 465 Shippensburg Road, Newville, PA 17241. - Richard L.Webber, Jr. Esquire Attorney for Grantee Page 3 of 3 ~~ "~ CO NATIONAL BANK February 11, 2010 Frey & Tiley Attn: Stephen D Tiley 5 S Hanover St Carlisle PA 17013 RE: Estate of Frances E Hoch Dear Mr. Tiley: The following information is being provided as per your request: Acct. Type Account No. Account Accrued Principal on Interest to D.O.D. D.O.D. Esteem 135321 $1,207.70 $0.02 Checking Account Certificate of 900043201162 $3,904.00 $0.41 Deposit Ownership Date Opened Jt w/ Judith A Hockensmith 2/5/85 Burial Fund 12/17/09 Inquiries concerning ACNB Corporation stock information should be directed to the Registrar and Transfer Company at 1-800-368-5948. If you need any additional information, please contact me at (717)339-5122. Sin erely, ,~ Q. .. ,' Barbara J Warn Adams County a onal Bank Deposit Servic epresentative II ~~~ PO Box 3129, GETTYSBURG, PA 17325 I rxoNE 717.334.3161 I TOLL FReE 888.334.2262 I wwwacnb.com www.fmtrustonline.com -rR~T February 22, 2010 Frey & Tiley Attorneys-At-Law 5 South Hanover Street Carlisle, PA 17013 RE: Frances E. Hoch To Whom It May Concern: In reference to the above customer, our records show the enclosed information to be accurate of today's date. If I may be of any further assistance, please contact me. Sincerely, Tricia Ganoe Deposit Operations Manager 717-261-3624 ~.~, yl ~ 717-264-6116 888-264-6116 P.0. Box 6010 Chambersburg, PA 17201-6010 FINANCIAL SOLUTIONS... FROM PEOPLE Y.OU KNOW ~ ~ n ~ ~ ~ ~ c N r~ O C °' 3 a o p ~ ~ v d o o n e~ N ~ o p; o ~° w d ~ ~ o ~ ~ A o ~ is o ~ c a .. 00000ooooow o cooooooooow 0000000000 ~ m 3 W ~;a a~~ ~: 0 D~ ~ ~m~ ~ ~ ~ ~~ ~ ~ ~- 0 w ~ O O 3 O ~+ co m Q w s A a ~~'~ ~_ s ~: - r ` _. _... _.. ...i ~. _ .. 1-888-910-4100 Call Citizens Phone Bank anytime for account information, current rates and answers to your questions. US102 BR 289 FRANCES E HOCH 363 GREENSPRING RD NEWVILLE PA 17241-9608 Circle Account Statement ® OF 3 Beginning December 04, 2009 through January OG, 2010 COnt@1115 Summary Page 1 Checking Page 2 Circle Summary Account Account Number Balance Balance FRANCES E HQCH Last statement This statement JUDITH A HOCKENSMITH DEPOSIT BALANCE Circle Checking with Interest Checking 622434-243-5 Circle Checking with Interest 622434-243-5 1,209.77 1,194.88 t D sit Balance Monthly combined balance to waive monthly fee is Your monthly combined balance this statement period is n Tote epo 1,194.88 7 , 500.00 n Total Relationship Balance 1,209.77 1,194.88 ~' ~" iVlember 1-CIC L=_i [qu[;l hcusirg Landar .;, ,„ ~...~ ~; . ~:a ~° 1-888-910-4100 Call Citizens' PlioneBank anytime for account information, current rates and answers to your questions. Circle Account Statement Q of 3 Beginning December 04, 2009 through January O6, 2010 Checking SUMMARY FRANCES E HOCH JUDITH A HOCKENSMITH Balance Calculation Balance Circle Checking with Interest Previous Balance 1,209.77 Average Daily Balance 1~Z09•7 622434-243-5 Checks .00 - Interest Withdrawals 15.00 - Deposits & Additions .00 + Current Interest Rate • 1~% Annual Percentage Yield Earned .10% Interest Paid .11 + Number of Days Interest Earned 34 Current Balance 1,194 , 88 = Interest Earned .11 Interest Paid this Year .11 Previous Balance TRANSACTION DETAILS Withdrawals Other Withdrawals Date Amount Description 01/06 15.00 Monthly Maintenance Fee Interest Date Amount Description 01/06 .11 Interest Daily Balance Date Balance Date Balance Date Balance 01/06 1,194.88 1,209.77 /'~ Total Withdrawals lv~-- 15.00 n Total Interest Paid .11 n Current Balance 1,194.88 ~ NEWS FROM CITIZENS --We are making an improvement to your account statement. Beginning in Januarv, if you have paid Overdraft/Insufficient Available Funds Fees, your statement wilt include a table that shows the total amount of these fees, net of any rebates, that you have paid both for the statement period and for the calendar year to date. This table will then continue to appear on future statements for the remainder of the calendar year. If you have not incurred these fees during the calendar year, the table will not appear. --A message for all Citizens Bank MasterCard Debit Card customers, you should have received your new Visa Debit Card which replaced your MasterCard Debit Card. If you have not received your new Visa Debit Card, please call us at 1-888-850-4070. To activate your new Visa Debit Card call 1-800-527-1800. Or simply use your card at any ATM or merchant and make aPIN-based purchase. IMPORTANT: Your card number and expiration date have changed. If you use your current debit card for recurring payments, we'll make every reasonable effort to ensure your payments are not impacted. To ensure there is no interruption in service, we recommend that you contact your billers to update your information. --Introducing the Big Savings Sale. See all of the savings offers waiting for you at citizensbank.com/bigoffers. But hurry, these offers won't last long! --Looking for high yields and easy access to your cash savings? Look no further! Citizens Bank offers savings and money market accounts with great rates and the peace of mind of FDIC insurance. Whether you are just starting out or looking to preserve your liquid cash deposits, we have an account to suit your needs. We'also have new products that reward you for saving for college or a new fiome! For more information, to open an account, or add to your existing balance, visit your local branch today or call 1-8GG-600-0008. Member FDIC. See a banker for FDIC coverage amounts and transaction limitations. Iviemuar I=DIC 'C-t-t Equal Housing Lender ~C~~ O~d7~~ }yew User? Sign Up Sign !n He!p Trending; i far Yahoo! 1~1ai1 R°V iedys .T. .~ eaa~errx<.revaorm>. - .Ya-.~ac~re~ :mc.... :x~au~ Web Search Search ~ ~, .a~.~ ^i«uva:xx::ww::vaM~.uaxvxxtcx xn.~M.wn+x..x .x.. .. ~ Saturday, January 30, 2010, 12:47PM ET - U.S. Markets Closed. Dow ~ 0.52% Nasdaq ~ 1.45D/o ADVERTISEMENT CFT I1oTF RANf:F vr• rr.•. s~r~. ~vr ~. ~ Daily Start Date: -DeF c , 23 2009 ` Eg. ]an 1, 2003 ~~/eekly ;Monthly ~ End Date ~ ~ ` 23 2009 ~ Dec - ~ Dividends Only Get Prices ~. ~, F ~,. 4~ ). First ~ Prev ~ Ne xt ~ Last x PRICES ~ - Date Open High Low Close Volume C ose* 23-Dec-09 63.24 63.50 62.75 62.81 1,096,800 62.81 '` Close price adjusted for dividends and splits. First ~ Prev ~ Next ~ Last W~~~~"~ ~~ ~'~~~'~~~ ~ Download To Spreadsheet ~~~~ ~~~~ I~~ ~~' Ul . RI ~ ~~~~!~'~~I .;R • ~ f R ~ i t ~; ~` ~ f ~~~i~ _ _ ~,~ t { - ~..,- , ~,.,,~.> ~,cZ i - y - ~ ,~ ~ r f ti ~ ~ .~ ,~~ ~,,~ t s ~ 4r #~~,~ ' a. Mu p2~ ''~ ji~L ~. `r < a .".~' Vii;, .i r'~ .,~ ` ,r' A' ~.`. ~ ' ~: fir" M1~ Tf '~itT~,_; ~I^~,~ u~ ~ 9 ~.\ , v''./`, ~ ~'~ ,'4/"~r/F%'+~ali~l.t~ tik:."`t'.~y` %~+~a~ n.."t 1 3 n o ~ T m O 1 y ~ H S r~e n Z s S ^' as m C Y ~ O N T ' Z 3 'b A z ~-Zio s a TZ -~ ~ o s c~ T , ti $ _ 9 y C H ~ y n m y O O ~ 3 9 ~ i''~ ~~ , a a < ,~ S o "o, s ~ ~`, z ami a~ °s o ~ ~_ c = ~n > T ~ o~ N = m m ~ o~ X ~ ~ ~ ~ ~ ~ o . c~ ..~ - ._.._ m S r1 's ~ ~ ~ c C a ~ ~- -„ a ~~ R n1 r ~ ~ ~ ~ ~ a. a ~ ~ ~ a 2 ~ ~ v ~~ ~ ~ a ~^ o n ~ 4 ~ Z ~i~ ~Q ~ z ~~ Q ~ ~ ~ N a O y R ~ Q ~ ~ y ~~ ~ ~ ::~ y a.` ~'" ~ a ~~. ~; ~~': ~ m ~•O-Dar ly O ai"~1 f ~+, m r' ~ ~., r.. Q ~ ~~~ _: ~ ~ 3 __ ~-- ~ ~ Z a Qom, o C7 ~a~T~ ~ h ^~ F ~~ ~; ~ ~A-~' ~~` ~. r ~ 1 ~: rti~ ri. 4 . ~A V~ ~ c.• a c~ ~ . ";~ ~'•~ ~~~ ~ „r,. a~ €~~ ~ ~a°. ~ c ~, a :o ,`"' R ~,.~ ~~`C,. ~ c a. ~. ~ ~' ~ o ~ ~, s 3 a ~ ~° 0' O ~~ ~ ~ ~~ R O ~ A o ~e G ~ ~ '~~ a. Z v v /~ o \i 9 u ->i !rte,' o~ ~~ Z o~ m 9 O m ~ u 0 m N O 0 °m m ~~ IT q ~~ I~ a n ~ c R n sn +~n C s ~ z Z R m ~ Z= =' a y R ~~ "~' n w 0 O Z C/~ 0 c~ 7C ''~ Citizens Bank CITIZEI~IS BANK 060 20 CABOT RD MMF 430 MEDFORD, MA 02155-9934 FRANCES E HOCH 363 GREENSPRING RD NEWVILLE PA 17241-9608 12/31/09 PAYERS EIN # 23-3097422 1-800-948-7200 PARTICIPANTS ID # XXX-XX-5362 THIS IS THE STATEMENT OF CONDITION OF YOUR INDIVIDUAL RETIREMENT PLAN 0-XXX-XX-5362 FOR THIS YEAR. IRA STATEMENT OF CONDITION 2009 --~ -- TYPE ------ -----AMOUNT _ BEGINNING BALANCE 1,013.0.3 - (DISTRIBUTIONS} NORMAL 68.46 +EARNINGS FOR YEAR 36.54 =ENDING BALANCE 981.11 +EARNED INT NOT PD 0.10 FAIR MARKET VALUE 981.21 FAIR MARKET VALUE* 981.21 *THIS INFORMATION IS BEING FURNISHED TO THE INTERNAL REVENUE SERVICE TAX YEAR 2009 LISTED BELOW ARE THE INDIVIDUAL ACCOUNTS THAT ARE INCLUDED IN YOUR RETIREMENT PLAN TOTALS ABOVE. ACCOUNT NUMBER TERM/INCR TYPE RATE MATURITY BALANCE XXXX-XX-7992 60-MONTH CD 3.69 12/31/2010 981.11 IRS regulations require that IR.A holders age 70 '~ or older must take a distribution from their Retirement Plan each year by December 31. Citizens Bank is required to notify the IRS that you are subject to these regulations for calendar year 2010. Citizens Bank is pleased to offer assistance in calculating your required minimum distribution. To take advantage of this free service, please contact our Retirement Services Department at (800) 948-7200 weekdays between the hours of 8:00 AM and 6:00 PM Eastern Standard Time. ~R «~~ ~~~ ~~~~ ~~~~ _ f, Date ~; ;~ - ~ . ;. Address k ,r,,~ :yf~, ;r'°f,J'`J ,;' }i~ ~', ~~~ -Sale Location ._ _ ,~.,: , Date of Sal , - . f ~t ,~,-" /,r j ~' - ,,`~~-2'- • ~ -,,~_' ~ ~'"~ -t' j'- c , - t-~'=~~; r .,. ..y ~'`i"` "~-- c` Cashier `-- - '- Clerk Auctioneer _ Other PROCEEDS OE SALE: Cash.--•----------------------- -- Checks---- ------- ~- -- --- ~. ----- ------------- c Other- -- -•- - ' / .-•;,~~~ J ..~", Miscellaneous {see attached {ist}----------------------------•----- , TOTAL PROCEEDS C)F SALE----------------------------- LESS SELLER'S SALE EXPENSE: ~, .7i : '~- •---- Auctioneers Eee -------•-------------- Other Seder's Expenses Advanced by Auctioneer: - ~:- = _.. `~ ,Miscellaneous {see at#ached lis#; ----------•------------- ' r ~' ~~;, . ~:%- ,_, - DEDUCT TOTAL SELLER`S SALE EXPENSE--.-.---~--- -~ .-- TOTAL i~IET PROCEEDS Tt3 SEt-LER..._._..~ ~ _ r f° 1, (or V+se), the seller of goods merchandise, and/or prcpertx sold a# public auction ors- abover t a#~ .~` .. location, acknowledge and accept this settlement of proceeds ohand'ssel and/or} pgopert~ fl d p a~ scar sponsibiiity for providing merchantable title to ail goods, mart , delivery of-title to the purchaser. .~- ... (Seller`s Signature} (Date) r. . (Seller`s Signature3 Auctian.eer or Cashier's Signature ;' - , ~~~~