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HomeMy WebLinkAbout07-19-101505610101 QC\/_i CAA Ex(o~•io~ ~' ~ OFRICW. US€ ONLY PA Department of Revenue p~e~~anh-Ivania County Code Year File Number Bureau of IndfvidualTaxes "`~""TM~"`""`"°` ~ ~ -~-- Po eox Zt;o6oi INHERITANCE TAX RETURN ~' 0 ~ ~ / / ~~ l PA s us-o~soi RESIDENT DECEDENT ~ `''1 ....~ a.a,.r;ar.. ....~... wrls^ ..... Sodas Security Number Date of Death MMDDYYYY 356-03-5197 ~ ~~~ 04/2612009~~ ~. Decedent's Last Marne ,~... ~ ~ Suffix Egeberg ~ __..~........._~.~..._,__.__..m____._.__._.__....~.._~.._~....__...._m_~__..._.~~..~.~..~....._.~...~.._.~... ~..__._.~.._.___.._~~.~.__.~ (M Appitcaible) Enbr Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Soda) Security Number Date of Birth MMDDYYYY 08/16/1919 ~~ Decedent's First Name MI ..................... ~ Mary J _..._._._.~_..__.~.._w..~._._~..__._.~.._.~..~.._..,..~.~.._._._.._.___...__._._.~_..._.__.~...._._ ~_.___~. Spouse's First Name __ MI ` ~~~ ~-~ _ THIS RETURN MUST 8E FILED IN DUPLICATE Wi'TH THE R~~~~T~a aF ~~.~s FILL iN APPRtlPRi/~l-TE OVALS BELOW ~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) ~ 6. Decedent Di~sd Testate O 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes (Attach Copy of 1111111) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A} between 12-31-91 and 1-1-95) (Attach Sch. O) COtiRESP'OND~IT - THIS SECTI~1 MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFlDf NTIAL TAX NlFORMATiON SHOUf.D t3E DIRtCTED T0: Name Daytime Telephone Number „._.~__.~~....~......._.~..~.~....~.~.....w........~..~.....~......~..~._..~..~..~..V....~.~..._._._.~..._w..~....~...~......~......~...~~._._.~..~..._.~._~..._.~.. ~...~.....~~...._..~..~~.~,.._._.,~...... F i Nathan C. Wolf, Esquire ~ ~ (717) 241-4436 REGISTER OF WR.LS USE ONLY ~. ~ ; First line of address t... ~ ................................._...._.....................................,......................................:.........................._......._....._._............................................................................................................................................................................ ~ r- ~ 10 West.H~.. h...Street ......................._.............._......._._.._._........................._............_..........................................................................................................................._......................... ~ ~ ~: ~ cry Second line of address ~ ~ ~.:~ ~,~._ ~~- IL D _ ....,:: City, or .Post. Office State ZIP Code ~, ,,,, ~"'v`t ....... ................................................................................................................................................................................., .............................. ._._...~M..~...~... ~ Carlisle ~ PA 17013-2922 _~ ~ `' correspondent's a-n~aii adanass: nath®ncwotf~embargmaif.com Under penaltfea of perjury, l dsdane that I Dave ex~nined this n31um, inducting axompanying sd~edules and atatsmsr~#s, and b the test of my knowledge and belb#, it is true, corned and oortie. Dedsr+stiorr of pr+sparer o#rer than the personal represerNative ~ teased on sN ~formatbn of which proparer has any knowledge. SIGNATURE d~PERSO~i RES IS E FOB FILING RETURN DATE T s-~:-..~ _ f "~ _ ~-g- ~ e D 07/19/10 1304 White Birch lane, Ca>rriisle, PA 17013 SIGNATURE THAN EPRESENTATIVE DATE 07/19/10 10 W~f HiDl~tt Carlisle; PA 17013-2922 1505610101 Side 1 1505610301 J ~~ J REV 1500 EX Decedents N$me: iW~Sfy ~8ne 1505610105 1. Real Estate (Schedule A) ............................................. 1 2. Stocks and fonds (Schedule B) ....................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages and Notes Receivable (Schedule D) ........................... 4. 5. Cash, Bank beposits and Miscellaneous Personal Property (Schedule E)....... 5. 6. Jantly Own~-d Property (Schedule F) O Separate Billing Requested ....... 6. 7. {nter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested........ 7. 8. Totat Goss'Assets (total Lines 1 through 7) ............................. 8. 9. Funeral Expenses and Administrative Costs (Schedule H) ................... 9. 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) .............. 10. 11. Total Deduckions (total Lines 9 and 10) ....................... ........ 11. 12. Net Value ofi Estate (Line 8 minus Line 11) .............................. 12. 13. Charitable arld t;,ovemmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ........................ 13. 14. Nat Value S~bJect to Tax (Line 12 minus Line 13) ........................ 14. TAX CALCULAT~IN -SEE {NSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Une 14 taxable at tt~e spousal tax rate, or transfers under Sec. 9116 ~~--_.~____._~.~~~.~.__~.__~..~__~~.~.w.._~~.~_______~.~_ (ax1.2) X .0.,+ 15. 1 fi. Amount of Lute 14 taxable at lineal rate ',X .0 4~r' 254.07 16. 17. Amount of Line 14 taxable at sibling rate X .12 ~ 17. 18. Amount of Line 14 taxable at collateral rite X .15 18. 19. TAX DUE ......................................................... 19. Decedent's Social Security Number ..................................................................................................................................... 358-03-5197 5,285.36 3,786.75 8,072.11 3,404.40 21.50 3,425.90 5,646.21 5,6146.21 254.07 254.07 'l 20. FILL IN THE OPAL IF YOU ARE RE4UESTINQ~ A REFUND OF AN OVERPAYMENT O Slde 2 L 15Q5610105 1505610105 REV 1500 EX Page 3 Decedent's Complete Address: File Number s Mary Jane Egeberg STREET ADDRESS 770 South Hanover Street C Carlisle sTATEPA ziP17013 Tax Payments and Credlltss: 1. Tax Due (Page 2, Lme 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAY[YiENT. Fib in oval aM Page 2, LMe ZO to request a refimd. (1) Total Credits (A + B) (2) (3) (~) 5. If Line 1 + Une 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) Make check payab{e to: REG{STER 4F W{LLS, AGENT. 25a.o7 250.00 2.39 6.46 PLEASE ANGER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROi~tIATE BLOCKS 1. Did decedent rrucke a transfer and; Yes No a. retain the use or income of the property transferred :.......................................................................................... ^ b. retain tt-e right to designate who shall use the property transferred or its income : ............................................ ^ c. retain a rteversionary interest; or .......................................................................................................................... ^ 0 d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ 0 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. ^ 0 3. Did decedent own an "in trust tor" or payable-upon-death bank account or security at his or her death? .............. ^ 0 4. Did decedent own an individual retirement acxount, annuity or other non-probate property, which contains a beneficiary designation? ........................................................................................................................ 0 ^ ~ THE AHR TO ANY 0~ THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND I~~.E IT AS PART OF TIC RETURN. For dates of death on a' after Juiy 1,1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent (72 P.S: §9116 (a) (1.1) (i)]. For dates of death on ar after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 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 nequinements for disclosure of assets and filing a tax return are still apptica~ even if the surviving spouse is the only beneficiary. For dates of death on or attar July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 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 0 peroent [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 beneficlaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2} [72 P.S. §g116(a)(1)]. 250.00 • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3}]. A sibling 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-is~g EX+ (DS-~o) pennsylv~nia M~~ ~ DEPARTMENT OF REVENUE ~OINTLY_OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ~raTE oF: ~ NuR: Mary Jane Egeberg 2110-0421 It sn ssret bee~ms f oint~h owned vW tldn ane yruar of #ha deoedant's of dasRh, ft Kraut be ngwtr ~l on 9cb~edul+a ®. SURVMNG ]DINT T'ENAIVT(S} NAME(S) ADDRESS RELATIONSHIP TO DECEDENT ~.w.. A• Kathryn Gatrell ~ ~ 1304 White Birch Lane ».., .£ ..:~....... ~.~ ;Daughter ~£ Carlisle, PA 17013 yChristine L. Pearson ;325 W. Washington St. Suite 2 #110 Daughter ,San Diego, CA 29103-1946 B.. i x , 3 i 4 A ~o=~nY ovln~v rr: LETtER DATE DESCRIPTION OF PROPERTY % OF DAZE OF DEATH ITEM Fqt DINT MADE INCWDE NAME DF FINANCIAL INSTITUTION AND BANK ACODIN~IT NUMBER OR SIMILAR DATE OF DEATH ~ YALUE OF 1. A, f02/28J02' Metro Bank 0513417352 15,856 07 ~ 33~ 5,285 36 -~ _ ~ a ;....:. .:»,,,. r < :. .:..:,, 0 y ... ........:.:..».~::..::._.:.....:.:.., ..:.,.., : ,:: ,:.,.:,.~ 5 a r ,;.k~~;o~. .r y-'~;!if%i'.Q...'r"tz; ~i.3'2{$a/&`F',~"-'3EkS~. ~„:., ~ ti; ~.b'i4.:,.., .. . . ~,~.a:tairs 2;%4 i . r < . ..................... : 3: f ,..mow ,».:: ...., :: .... ».. .:. .:: ~. .,.,. „. o ..k _. z~... {{ :i; ~i ~.%?~ S~`9,~1i:£'.:~Y:~v.,g~F'~xa ~~: -.. : h$ :,..,..:.» :.v,: Y .. :„ .. ... ..:...n.:.. ~.:....v ... .:...:. .:.~..... .....:..,. ... :. :.., ..:.., ,....:..:.:... ..., ,..... .. .:.. ::.:. qz .... .„, vn... - ?;~~ 1.~~' dN, ,..,9E ~ ~ s ?.:.,.~ :.,.,:. , ,.: ,.. .:...:..:. , ~ F ~. F : : : . ' ,.: t ~ .. ~Yfidi9'3~/a~r.5>:u'a`v'~'~tts,"w'wa <,ria Y i z ..,::.,.... ...,;., .::....~ :.:,. ,.,..:.. s ..R. . n ~ T©TAL (Also enter on line 6, Recapitulation) $ .....:.. .... .. 5,285.36 If more space is needed, use additional sheets of paper ~ the same size. y REV-15~Q EX+ (OS-09} pennsylvani~a DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEQULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY ESTATE OF ~~ ~~ Mary Jane Egebesg 2110-0421 This schedule must be compMeted and filed if the answer to any of questions 1 through 4 on page three of the REV-1540 is yes. DESCRIP'TiON OF PROPERTY DATE Of: DEATH ~'0 0~ DECD'S EXCLUSION TAXABLE TTEM INCLUDE THE NAME OF THE 1>sAN~'EREE, THEpt REIATidNSHiP TO DECEDENT AND NUMBER 'THE DATE ~ TRANSfEft. ATTACH A GDPY GF THE DEED FOR REAL ESTATE. VALU__E OF ASSET INTEREST IF APPlICA9tE VALUE 1. ~.. I ~ .,,, ~.. i ~. S: ~: t 3 i- 9 i ~.. nv 2 , ~.... 6 i i :: 2 :...............:.»Mf 3,786.75 xes .. a: a Ate:. ~... _ .... : y, :. :. ';: b fl9.. 6: TOTAL (Aiso enter on Line 7, Recapitulation) ~ 3,786.75 ~ 140; O.OC s, S; ` 3, 78fi.75 - _- If more space is needed, use additional sheets of paper of the same size. + REV-15.1 EX+ (10-09) SCHEDULE H ns~rlvania DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE C43TS RESIDENT DECEDENT ESTATE OF FILE MI~IMdER Mary .lane Egeberg 2110-0421 DeaaAent's dew mwE be o~ 5chaduie i, ITEM NUMBER DESCRIPTION AMOUNT _ .. ~ °~ 1. ~Hoffm~ moth Funeral Herne ~ 0 41 23 . .; K, ~~; z.. } ~:.. ~ .. : W .. ~.: ~. .., x . .., r_.. ...~m.._ ~m._. ~' B. ADMINISTRATIVE COSTS: 1. Personal t~epresentative Commissions: ~~~~ ~ s~ Name(s) of Personal Representative(s) Street Address City State ZIP Year(s) Commission Paid: ~~ ~ :~ 1 560 00 2. Attorney Flees: , . :,~. 3 lanation ) atta h ex i t th cl i t' dd If d i d t' l ~~:~~ . . p a man s, c s a ress s no e same as ece en Fami y Exeimpt on: ( ~;~,,~p~~~~~s~~;~~a~ Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: 133.50 5. Accountant Fees: 6. Tax Return Pre arer Fees: P ~ ~" , <,. „.:. ; ~. _7, ~Cumt~tand Law Journal Legal Advertising ``~;~¢ , 75.00 . z s 8 t _.........:~..... ~_ ...............~M.......~............m~....~~..~..~..ro_..rw~.... ~~..:.....~....~......~......~..~.. ~ ..... ,...........~:.....,.. ~....: ~..... ... .... ,.~........:_...:.~......,...~.:....~:.~.....:......,...~...~.. ;r he Sentinel - Leggy Advertising F ~~ '~ Y.` 176.92 . :.;. , ~ :3 ~ .> ...~~ ................_ .~......~~..~.,._.~~.._.~w..~~x.~n~~~.~..._~~..~..~._.._H.~...._..~......~~......_......~~...~~..._.._ ......~~~....~ ~. _....,M._.., ..~....~..~.._........,......... ~ ,.... ~Funera~ Relatied Costs (Pennsylvania and Indiana) ,, ,.~..,. ..... .... .,.v~..v.,. .~._ ....~..... ..,. . ... ,......... .... ...... .. .,.._. _... . . .. ~. . . .: .. ... .. ~. .. .. :. ,. ~ ~ ~~ 1 , ^ 1,128.57 . .., ,: , to : :k f :-i '. .~........., ..5 .. ... . . .. .. . . . .. .. . ,,.. Reserve fcx outstanding expenses £ i:.:. a.:'.n ...~.. ....t. r.... c~' .. .n..'-v. .. .n ..::c.~'~- '....::n. Fwx ,tt+n. .u>.:aia+u<>.ttv/aw'..w':ii...w...:v: a.~~an.r.armn.i. art >n i.. .~ rt. .R i.... v. ....n+ c .. ~ ..e. .. ~ ..:.... .. .. .....:.... . .. .:.::.... ...: ...: ..:... ... ...:.. :.. ..:. ... .......... ........ ....... ... ~...... .i.. .. .... ..:..... .. .. ... .. .. v.. .. .......... ~. .... .~.. ....... ..... .. ....v. ....,.. ... :.:... v.. ..::... .... 100.00 i .i .. y~. TOTAL (Also enter on Line 9, Recapitulation) 3,404.40 If more space is needed, use additlonai sheets of paper of the same size. REV-1512 EX-F (12-08) pennsytvan~a DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT scHEDU~E i DEBTS OF DECEDENT, MQRTGAGE LIABILITIES 8E LIENS ESTATE OF FILE NI~IiER Mary Jane Egeberg 2110-0421 Report dsbtsr incvrted by tl~e decedent prior to deeMi that remained unpaid at the date of death, including unreiimbur~ed medkai expen~. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. ;£:.:. 2 $yp. 8 t. t Fine! pharmacy bill 21.50 ~~~~Z~ $Y.g fi~.~~:i'. ~w::~e ce ,i .. ::...„ .:.....::.....:: .. : :: :..::... ,. ..:...::: :::-- ,:: :....v. .. .. ::.. :. ,: «,: 9Y w,R3t,~ 9R~`A.~w'4a,i,aw..n,~ d, .t~'.~am TOTAL (Also enter on Une 10, Recapitulation) ~ $ 21.50 If more space is needed, insert additional sheets of the same size. LAST ~VZLL AND TESTAII-ZENT aF A~ARY JA-~~TE EGEBERG I, Macy Jane Egeberg, County of Ma~chison, State of Indianay hereby do make, publish and declare this to be m}r Last V~ill and Testament hereby revoking any and all former Wills by me heretofore made and intending to dispose of all property over which I shatll, at my decease, leave the right of disposition by appointx~ent, V~ill or otherwise. ITEM I I direct that expenses for the administration of xny estate, memorial expenses, all my lawful debts and expenses of my last illness shall be paid by my personal re~prese~ativ~e from the residuary of my estate as soon after my death as may be practical. I direct that the personal representative of my estate pay all estate, inheritance, transfer and succession taxes which may be imposed or assessed on my property or estate upon any devise by operation ot~ law, contract or otherwise. Such taxes shall be paid out of and charge! generally against my residuary estate without reinabur~mexrt. from. any person. I declare that I was married to Lansing E. Egeberg, deceased, and we had two (2) children by our marriage: Kathryn E. Gatrell and Christine L. Wallace. References in this my Last W ill and. Testament to "my children" are to them. 1 ~- of eyed mature •,~ue of mY ~ e~ ~ eat •ve, ,~en~ie and I }~reby ~ a~ fohows• f ~a wb~~,°e"'~ a~ i~ ~,~ ~'-~ A..f ~ p~,~pe~y~ su'~ table ale p~~ may, a +~, all ~y ~ such ~il of sv-~ ~o ~,u~ve ~• , ~ X11 ~ ~,y ~' ve ~ my ebil ue, ~~ .~ dive ,ate e+qu~i1 val a fp9r v~i1 ~~~ b~ bey, app ~1~' as they P'~Q~ sari sac ~~ ~r,~i lei" • e ~~~"~ •d a?pap'~ f bl P~ ~{ler ~ ~ de' $;~ty {,~1'~`~ • . i~ of ~ ~'ch oy~w~s', ~f, v~ ~ ~ lee ~'~ fa~• 13 t~lVeS ~,~-;~ t° ash seen at ~a"'ca~ •~~,, 1 ~~ a~ ve , a~ b •~~ sole d~.~ sly ~ ~Xe~tot' ~i~tch p~'~ ~~~'` ~ my be+~ ~ ~ t1a~ theme n~y'E of ~,ch ~ ~°t' ~bu~ u an i~ ~ v~,ue of any ~ to all ` ~~t~e. The of t1~ b"e'a~' of my ~iiaty b~Ye ~ as the ~'~'iye be mot, off ~' visit w~11 p~ .. ~,Ch are •vi~sic~s v b f~eSau~' ~"O • . Cif a d~ of Y B ~ ~ Div ~- ~!~~'~ t A11 of ~,y ~. ~"~t° ~`~ 1 be . 2 ITEM III If ariy such child shall predecease me without leaving children, then I give her share undeyr any prowaion of this Will to my surviving child. If arty duld shall p~~ed+ecease me leaving children, then I give her share to her children, per sltirpes• ITEM IV I hereby nomnate and appoint Kermeth Watkins as full Executor of this my Last Will and Testament. If I am not survived by Ke~rn~th Watkins or in the event lze is unable to serve, I herby narninate and appoint Christixie L. Wallace as Sucxsrssor Executrix. In the event Chrine L. Wallace is unable to serve, I hereby nominate aril appc3int I~-athryn E. ~atrell to serve as Znd Successor Executrix. I direct that in the event Kenneth Wad serves as personal representative of my esxate, that he be permitted to serve without band or with the b~-d reduced to the lowest amouat permitted by the Court having ' 'c~ion of my estate. _ '~. .' .a '~~a. ~r- 3 IN WITNESS WHEREOF, I have hereu~o subscribed my name to my bast Will and Testam c~sisting of three (3) rrpevv~Ytten pages, ic~rtification I have sighed each page this day. of Anderson, Mladison County, Indiana. 1996, at Mary Jane T ' x ~- T'he f~megoing instYUme~rt, consisting of three (3) typewritten pages, was signed, sealed, puhli~hed anr! declar®d by Mary Jane Egeberg to be her Last Will and Testamerrt in our presence aid we at her request in her presence acrd in the presence of each other have hereunto subBCnribad our Haines as witnesses. ~ ~ 1 ~~~ "~~ ~ 9 i Witness ~ \ T. ~~~ e~ r~/ ~ ~ - W~sss` E. Iwo Ir AtOonraSr-~Lsr~- xa s~-4s ~~ Andaoroo, IIV 46416 (3l~643~9987 ~ f}` Ads for the propose of 4 LAST ~~ILL A-ND TESTAII~IE1~1'T QF A~AIL~Y JANE EGEBERG STATE OF Il'~TDIANA ) COUNTY OF MADISlJN ) Under the Penalties for perjury, we, Mary Jane Egg the Testatrix and witnesses, resp~Ctively whose names are signed to the attached or foregoing ia~~ument declare: 1. That the Testatrix executed the iY>~1r<ument as her Will; 2. .That in the presence of both witnesses, she signed or acknowledged her signature already made ~ directed another to sign for her in her presence; 3. That she executed the Will as her free and volurrtary act for the purposes expx+e.~,sed in it;. 4. 'That each of the witnesses, in the presence of the Testatrix and of each other, signed the Will as witness; S. the Tes~rix was of sound mind; 6. 1'ha~tt to the best of their knowledge the Testatrix was at the fame ei~ (18) or more years of age. Dazed: ~ ' `~ ~~ , Mary Jane ~gelberg: '~estalri ,.~:. ~ y, --,.. f,. r ~~ Wens Piepe~iodby. E. Lee Y {~ , ~.,,r AtOomiay-oit Lear, ~. 8b12~4-~8 940 MeeoidiertPfeee„ Alnciaraity ITT 46016 (3I7) b43~787 f' .. Wetness S Commence Bank/Harrisburg N.A. P.O BOX 4888 Harrisburg, Pennsylvania 17111-0899 1.888-837-0004 o~ee~t~nr~MOOO®~ses MARY JAINE EGRG KATHR'11~1!li E tATRELL CHRISTI L PEARSON 1304 VIVI~ BIRCH LANE CARLISLE: PA 17013 We're here 7 days a week, 24 hours a day at 1-888-937-40E~4. PLUS CHECKING Q513417352 Tra~saction>~ By Date 041221109 CHE 8 821 ;113.00 ;18,$86.07 04/281n9 CHEC~G' P 234 x,000.00 :14,574.07 081011b9 AC-• L.N NAT LIF-EFTPY'MNT ~,TB ;i2,6~f8.83 08/01/09 CHECK''~8 816 ;x.00 ;14,505.82 08i~041'08 CHECK',8 832 ;4„000.00 ;10,?~tA2 08/07/08 CKCD gEBR 06108 COURIER ;87.80 ;8,177.22 PUHINt3GRANT3 PA88 OR 06M2109 PO8 DEBIT 08112 HOBBY ;4.27 ;5,082.53 LOBBY 8TOR HOBE3Y ANDERSON IN :,t ~- 08/12/08 POS. DEBT OEi112 CN8 JOANN ST+ORES,16313ANDERSON IN 05J14fQ9 CKCD DEBIT 06112 FTD'TOLES FLQ'WERS ANDERSON IN 006 Cycle ;12.78 _ x,027.34 ;24.34 ;7,741.67 Page 1 of 3