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HomeMy WebLinkAbout09-24-10 ENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES ~ ~~r AND FILE NO. 21'`''~°~~g4j Po BOX 280601 , ~-~~ C" r'f~YER RESPONSE ACN 10113101 HARRISBURG PA 17128-0601 f ~ ~1~ ~ ,- ~-~~-{ ,~,~~, ~,,, ,....~ DATE 03-08-2010 my-1543 EX nPP TYPE OF ACCOUNT 2010 SEP 24 PM 2.2~EST. OF EDWARD G SPIDEL ^ SAVINGS ~~~ ~` $SN 189-18-7477 ® CHECKING ~~,~ `OUR-~ DATE OF DEATH 11-21-2009 ^ TRUST ~y ~ pp n ~~,,,, (~ n COUNTY CUMBERLAND ^ CERTIF. ~j JMD~.I~t~.~~!i4=-` t~" r~~ REMIT PAYMENT AND FORMS T0: NANCY L SPIDEL REGISTER OF WILLS 923 W TRINDLE RD 1 COURTHOUSE SQUARE MECHANICSBURG PA 17055 CARLISLE PA 17013 WACHOVIA BK NA provided the Department with the information below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-named decedent, you were a joint owner/beneficiary of this account. If you feel the information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of Pennsylvania. Please call C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1010201011214 Date 07-01-2008 To ensure proper credit to the account, two Established copies of this notice must accomvam payment to the Register of Wills. Make check Account Balance $ 29, 098.33 payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to Tax $ 4,849.82 months of the decedent's date of death, Tax Rate ~( , ],Ij deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential Tax Due $ 727 • 47 nine months after the date of death. PART TAXPAYER RESPONSE 1 ;.,,. , T A. ^ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain a discount ar avoid interest, or check box "A" and return this notice to the Register of C H E C K Wills and an official assessment will be issued by the PA Department of Revenue. ONE C BLOCK B. ^ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y be filed by the estate representative. C. ~e above informs ion is ~ incorrect and/or debts and deductions were paid. 2 and/or Complete PART PART 3LJ below. PART If indicating a different tax~ate, please state ° relationship to decedent: ~~~ p.~~eySL TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 1 2. Account Balance 2 3. Percent Taxable 3 X F 4. Amount Subject to Tax 4 5. Debts and Deductions 5 - 6. Amount Taxable 6 7. Tax Rate 7 X 8. Tax Due 8 $ PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported a/b~ove~jare true, c/~orre~cJt and q q com~p'le~'te to the befit of my know/lf~edge and belief. HOME C /~/ ) ~~~ /~/~ ~~X°f~G _.~//~6!~~~`jF~~-'i'-~~ WORK C ) -_____.._ .-Z"~~l ,~ TCI CDL!llA1C NIIMACQ neTF TOTAL (Enter on Line 5 or lax t;ompuca a one a Wachovia Bank, N.A. Silver Spring Square Financial Center PA6664 6416 Carlisle Pike Suite 2100 Mechanicsburg, PA 17050 Tel 717 796-6585 Faz 717 610-9265 WACHOVIA To Whom It May Concern: September 22, 2010 Nancy Spidel was on a joint account with her husband Edward G. Spidel. Edward passed away on November 21s`, 2009. They opened the account here at Wachovia on july 7`h, 2008. Next her son Donald C. Lenk was added to the account on November 28`x', 2009 alter his fathers death. If you need anything else to removed Nancy Spidel and Donald Lenk for the inheritance tax please contact Nancy at (717)790-9970. Thank You Kindly, Josep M. Napoli Personal Banker Wachovia, a Wells Fargo Company n ~ -:~~ ~~ cn _ ~ ~ ~ ~~~ l ~: _ - 011 ~ . ~~ ACHQVIA Customer Access Agreement 0263076062 To help fpht the funding oT lerraism and money laundering 8CUv1Le5. Federal law regwes all finar+cral Insbtutiona to Obtain, verify and record rMOrmauon that rdentdres each person vrdfo opens an account Tars Agreemem (Sigreturc Card) rs designed to eliminate most subsequent signatue rAnls and autha+zations when Opemr+g Tuture accounts. Your signature on this Agretmen[ will give you the eonvemence of banking anywhere and anytime over life DhOne- Ths Agreemem, both now end as it Wray be amerxled from tune to lime by Wachovia. rs applrcabk 10 any deposit account that you open xrrth any Warhovre Bank erd,er now or m 0te futue for yourtrel! or jornlry with another person o< eudwnzed signer I taxiersund !tics agreerrrent does not apply to accounts on wroth my Warne may appear and I am not the auliwrrzed signer. However, d you open an account on behaN of another person (tor example, rf you open an account as antodran, grrardratr, trustee), you will need to complete a separate Agreemerri Tor that account I! you have any questions, please call a Wachpvra Spaualrsl toll- Tree at t-gOG~WACHOVIA (800.922.4694). rrtswcUans: Hy s+grorrg This Agreement, i sulhonze any Wachovia Bank (ytrachovta') with wfUCh I open an account now or in me lutrae ro accept and act upon rnswctiats from me to do the fOllovnng • to open depo&l accounts vnlh Wachovia: • ro tran~f5~jr all or any poRbn of the balance of my accounts (rncludinq credit • ro use deposd accounts, process changes oT account infomrabon a oure+wrse service any oT my Wachovra accour>is, • ro obtain related services offered by Wachovra As used m Ihls Agreement, tiro terms 'DrOducts', 'services" and 'accounts" include various deposit products, services and accourns made evadable to you by Wachovia It more tltan one person is named rn the title for any account. such aCOOUM wdl be considered a pmt account Instructions vrhrch affect arty of my pint eccorrnts may be given by arty loin! account owner References ro me rn Ihrs IrrstruCbons section shall also refer to the prat account holder(s). I may give rmwctions orelry or rn writing, In person, by mad, messenger, telephone. facsimrte, computer terminal, vAre service, autorruted Seller maGxne, or by any other reasonabb me0od. Wachwla may adept and act upon such rnstrucuons which do not Contain my srgnaturo wnh the same eHeU as d Such inStruCUOns were slprred by me However, I xkrrowterlge that Wachovla may, at ds oplron, requrre my or+grrWt signature or any other documentation before aCCeplrng and acting upon eny inswurons. Your signature on This Agreement authorizes Wachovta to honor verbal stop payment orders up to six (6) months To extend stop payment orders WaChovia muss receive a v r (or such exlensron before the expretion oT !tics six month period I authorize WaChovra ro record and mortrtor arty teephone was for various purposes. rnclud+rrp to ensure accuracy, f0 provide a record of such conversatrore and to Improve the qualrly of service ro ma I agree to Idlow such security procedrues as Wachovia may requrre. The security prxadure agreed upon Tor venfyrrrp the aulhenticiry of mstrucuorts which are not delivered In person by me Tor any purpose (Including. but not limited to. the vnre vansler of money from eny oT my accounts) rs one or more of the (dknvrng at the option of Wachovia• (t } delivery ae s psraonal identification code by me or a person purporting to be me. (2) a callback, (3) a rrrGlalrpn by me or a person purporting to be me of one Or more Items of my personal intormauon which Wachowa has In its records about me. or (4) voice reeagrwrort of ma combined vnih the use of certain probing questions The telephone number(s) to which Callbacks shall be made shall be any telephone number(s) Wachovia may have for me rn rte records or any 1Nephone number assigned to rt+e by a telephone service prouder I agree shat This security procedure oonstriutes a wmmerualry reasonable method d provrdrrq security agarnft unauthorized mstrtrettons_ I agree ro matntan the coMrdenaalgy of eny personal rdentiflcaUOn code and will prevent the unauhonzed drsserturutron of such code 1 agree ro +rdemmty and hold Wachovia harmless Irom any losses. damages. sorts and expenses. of whatever land. rncludinp arty reasonable atrorrreys' tees, that WaChovia may incur as a resutl of relying upon rnStruCtiafri from me. or anyone purporting ro be me, provided that Waehovia has complied with the apptrcabie security proCedurea I acknowledge receipt of the WarJtovia rules and regulations governtng money vansfer requests and agree ro be hound by its terms as maybe amended from time ro lime. Acuptancs o! Terms and Conditions: I agree to be bound by the terms and conditions including, but nor Umltetl to wacttovw's Depose Agroemem and Disclosures. appbrable to each product or senrlce which I obtain from Waclwvis now or in the future. wrrth !amts end COndnrons wr0 t7e provided to me t also agree ro pay all fees associated wRh such products. aoraunts and services m accordance with ilia See schedules which wi0 tx9 provided to me by Wactrovia p you are claiming Foreign Exemption Status, the appropriate W-8 Foreign Certification Form must be completed for each account owner. 'RIGHTOF SURVfVORSHTP (NC and TN ACCOUNTS ONLY}: I understarxt that by signing below and establ~stxrg a joint account under the provlsrons of North CarolMa General Statute 51146.1 and Tennessee Coda 42-2-703 that: t Wachona may pay ilia money in the account to, or on the order ol. 8ny person earned +n Ne atcouM unless we have Agreed vnlh the bank that wrOtdrawals requrre more than one signature; and 2 Upon d+s death of ono joint owner the money remaining in the account wl9 belong to the surviving joint ownea and will not pass by InMrltarrce ro the hairs of ttra deceased Joint owner or ba conlrolNd by the deceased jotm owner's will. 1 DO elect to create the Right o} Survivorship for eny Joint account ,Signature ~ . - FORM yY9 SOCIAL SECURITY NUMBER OR EMPLOYER IDENTIFICATION NUMBER CERTIfICAT'ION (Not applicable for Non-Resident Aliens): (The Social Security Mumber or Employer Idenuficatron Number should notch Ilia firs) name bsietl an the account and will be used for tax repatirp purposes.) I, Soclat Security Number or Employer Identification Number: __ __ _ If If exempt tram backup withholding check d+rs box ~ EXEMPT III CertitiCaUOn -Under penalties of pequry. I uNfy that t The number set forth above a my coned social security number or employer derttitication number (pr I have applied tar and 1 am waiting for a number ro be +ssued to rne), and 2. I am riot sub)at ro backup withholdingg because: (a) I am exempt from backup wrthholding, a {b) I have not been notified by d+e Internal Revenue Servix (II2S} that 1 am stbjCC1 to backup wtihhoidrng as a result of failure to report all rnltrest or drvdends. or {c) the IRS lies notified me that t em rw longer subsea ro backup vnthhoWrng 3 1 am a U S person prxarrding a U S. resident alien. CeN(leasion Inswclfona -You nwst cross out +tem 2. above +f you have been notified by the IRS that you are currently subiect to backup wrilthokitrtg because a! caviar repomrg imerest or dmdends on your tax realm. ^ By checking tins box I am regwsbng issuance of an ATM Card ar CheckCaro. The IrrternsF Revenue SsrWcs does calf requke your tonseM to arty provision o1 -- ~ C= cu•Wm•r Slanatun {,bov tiny Ony one s gnature per agreement Prim Name DONALD C LENK Address 924 W TRINDLE RD MECHANICSBURG PA 17055 11 /28/2009 DOCUMENT STORAGE CO?Y 562279 Scow 02) SEND TO NC8538 ACHOVIA Customer Access Agreement 0224207909 To help fight the funding d terrorism and money laundering aCtrvities, Federel law rpwres au financial tnsbh7lions to abtaln, verlry and record information that identifies Bath person who opens an account This Agreement (Signature Card) is designed to eliminate most subsequent signature cards and aulhorizalions when opening future accounts Your signature on tMs Agreement will give you the convenience or banking anywhere and ariyllme over the phone This Agreement, both now and as d may be amended from time to time by Wachovia, ii appkroble to any deposit account chat you open with any Wachovia Bank either now or in the future }or yourself or jointly with another person or authorized signer I understand flue agreement does not apply t0 accoums on whlth my name may appear and I am rid the euthonzed signer However, d you open an atxount on behalf of another person (for example. it you open an account as custodian, guardian, trustee). you will need to complete a separate Agreement for that account II you lave arty questions, please roll a Wachova Specialist ld>- hoe at 1-B00-WACHOVIA (ao0~22~684). fnstrucdons: By signing this Agreement, t authorize any Wachowa Sank ('Wachowa') with wfuch open an atxount now or m the future to accept and act upon instructions from ma b do the following: • to open deposit accounts vent Wachovia; • to~rn~`@r all or any poison d the balance of my aocaunts (including eredd • to close eposil accounts, process changes of account rnfonnation or dherwlse service any 01 my Wachovia accounts; • to obtain related srrvlces offered by Wachowa As used in this Agreement, the farms 'products'. 'services' and "accounts" include various deposit products, services and accounts made available to you by Wachovia. If more than one person is named in the tide far any acwunl, such account will 4e considered a pint account. Institutions which affect any of my pmt accounts may be given by any pint account owner Reierencec to me In this instructions section shall also refer to the pail account folder(s) I may vyiva instructions orally o- In writing, rn person, by mad, messenger, telephone, fataimile, terminal, wiro serwtte, automated teller methane, or by any other reasonable method Wachovia may accept and act upon such instructions which do not contain my sgnature wrath the same effect as it such instructions wero signed by me However, I atlcnowledge Ihat Wachova may, at ds aptron, require my ongmal signature or any other documentation before accepting and acting upon any instructions. Your signature on this Agreement eudwrizes Wachovia to honor verbal slop payment orders up to sIx (6) months. To extend stop payment orders, Wachowa must receive a verbal order for such extension before tfie expirolion of this su month period I authorize Wadgvip b record and monitor any telephone calls for vanoua purposes, including to ensure accuracy, to provide a ra~rd of such conversations and to improve the qualify of service to me 1 agree to follow such 8etunty procedures as Wachovia may require. The security proCSduro agreed upon for ventying tfie authentiGty d insttugions which era rid delivered In person by me IOr any purpose (including. but not hmibd to, the wire transfer of money from arty d my aowunts) rs one or more of the fdlowing at the option of Wachovia. (1) delivery of a personal identification code by me or a person purpontrig to be me. (2) a rollback, (3) a rentatiar by me or a person purporting to De me of one or more Items of my personal information which Wachovia has In its records about ma, or (1) velce recognilon Of me oombined xrdh die use of cenaln probing questions. The talephorie number(s) b which callbacks shall be made shall be any telephone number(s) Wachovia may have for me in its records or any telephone number assigned to me by a telephone service provider I agree that Ihis setunry procedure coristitules a Commercially reasonable method of providing security against unauthorized Instructions I agree to mainbin the confidentiality of any personal rdentifiealion code and will prevent the unauthorized dissemination of such code. i agree to indemnify and hold Wachovia harmless from any bases, damages, suits end expenses, d whatever kind, including any reasonabb attorneys' fees, that Wachovia may incur as a result of retying upon instructions from me, or anyone purporting to be me. provided that Wachovia has oompUed wrath the applicable security procedures, I acknowledge reteept of the WaGowa rotes and regulaliona governing money Iansfer requests and agree to be bound by its lerins as may De emende0 from tune to time H you are claiming Foreign Exemption Status, the appropriate W-8 Foreign Certification Form must be completed for each account owner. RIGHT OF SURYNORSMIP (NC and TN ACCOUNTS ONLY): I understand Ihat by signing below and establishing a joint account under the provisions of. North Csrollna General Slatuts 53.118.1 and Tennessee Code 12.2-7031hat 1 Wachovia may pay tt» money in the account to. or an the order of, any person named in ttxr account unless we have agreed with the bank that withdrawals rtgwro more than one sgnature, and 2 Upon the death of one jdnt owner the money romalning In the account w111 Mlong to the surviving Jalnt owners and will not pass by InherRance to the heirs of the deceased Joint owner or be controlled by the deceased Joint owner's will. 100 elect to croaq the Right o1 Survivorship for any Joint account, FORM YYY SOCIAL SECURITY NUMBER OR EMPLOYER IDENTIFICATION NUMBER CERTIFICATION (Not applicable for Non-Rwldant Allans-: (The Social Seventy Number or Employer Iden6firotion Number should match the first name listed tNt the account and wdl be used for tax reporting purpasea ) 1, Soclaf Security Number or Employer IderiUflcatlon Number: II If exempt from bactrup Nnthhotding check this bax~ I] EXEMPT III. CeAifirotion • Under penalties of penury, I certify that. t. The number set brth atxwe is my correct social security number or employer idenlifiCelx>n number (or I have applied for and I am waiting for a number to be Issued to me), antl 2. I am rid subject to txadwp withholdingp because: (a) I am exempt from backup wilhtioiding, or {b) I have not been nddied by the Internal Revenue Service (IRS) that I am sub)ecl to backup vritttholdlr-g as a result of failure m report all interest or dividends, or (c) the IRS has nobfietl rive that I am no bnger sublact to backup withholding 3 I am a U S. parson (including e U S resident alien) CarUfleatlon Instruetlons -You must cross out item 2 above tf you lave Ixsen notdied by fife IRS that you are currently subJect to backup withholding because d under reporting interest or dividends on your tax return. Atcepfance of Terms and Condltlons: ~ ey checlung this box I am requesting issuance d an ATM Card or CheckCard t agree to he bound by the terms and conditions including, but rid Ths Internal Rwsnue Service does not require your consent to airy provlslon of limited to Wechovla'a Deposit Agreement and Distbsures. this document other than the certlflcatlona ro utred b avoid backu withholding. applicable t0 each product ar service which I obtain from Wachovia now Or in the future, which taints and conditions will be provided to me I also agree b pay all fees associated with such /' ~ products. aeoouMa and services in aotordarx:e with the fee A ~~~~ 07~01~20~8 schedules wfiich wrµ be provided to me by Wachowa. -~/ cu^tom^r sfaruwr^ ptrov^ tr^^) Only one slgnaturo per agreement gate PnntName NANCY L SPIDEL Address 923 W TRINDLE RD MECHANICSBURG PA 17055 DOCUMENT STORAGE COPY 582279 (Rev 02) SENp TO' NC8538 ACHOVIA Customer Access Agreement 0224207894 To help ilgM the funding of terrorism and money laundering activities, Federal law requires all finandal institutions to obtain, verily and record mlomtabon That kienGBes each person wrro opens an account. This Agreement (Signature Card) is dasegned to elaninate nicer wbsequem signature cards and authonzalwns when opening future arxounis Your srgnalure on this Agreement veto gwe you the COnvemence of banking anywhere and anytime over the phone This Agroement, both now and as rl may be amended from time to Urns by Wathovla. Is appfirabte to arty deposit aGWUM That you open with any Wachowa Bank either now or m the luturo for yoursell or (only with another person or authorized signer I understand tins agroenwnt does not apply to accounts on which my name may appear and 1 am not the autttonzed 6igner However, it you open en aCCOUnt on behalf o! another person (for example, rf you open an account as Custodian, guardian, trustee), yeti wdl need to complete a separate Agreement for that 8f:00um. If you have any questions, please cats a Washouts Speclaltst toll- free at 100-WACHOVU (lOOdi22.481ir). lnstructlons: ey signing this Agreement, 1 authonze any Washouts Bank ('YVachovia') with which t open an aocounl raw or In the luturo to srxept and act upon lnatructlans from me to do the fo0avrng • to open deposit accounts Mnlh WAChovia; • to ttrDan~ all or any portion of the balance of my accounts (rrtduding credit • to ewse~postt accounts, process changes o1 account information w othenJisa service any of my Wachovia accounts, • to obtain rotated services offered by Waettovta As used in this Agreement, the tgrrts 'products', -services' and -aaounts' Include various deposit products. services and accounts made evadable to you by Wachovla. If nrore than one person Is named in the title fa any account, such aooouM will be considered a joint account Instructions which affect any of my Jant accounts may be given by any IorM account owner Referortus to ma m grin Inalnlcti0ns sectwn shall also rater b the Joint arxouM rtok)q(c). I may giro InclrtrAfons orally or in wnGng, In pe serMce, automated teller machine. G by 8ny Other reasonable method. Washouts may accept and ac- upon such mstnrcbons which do not oontam my srgnaturo with the same effect es d sudr instrudwns wero signed by me However. I acknowledge that Wachowa may, at its option, require my original stgrtature or any other documentatlon before accepbrtg and scoop upon any inatrUdlona. Your aignaturo an this Agreement authorizes Washouts Io honor verbal slop payment orders up to six (8) months To extend stop payment orders. Wachovia must receive a verbal order for wch extension before die expiration of this six month period 1 auUtorize WaCftpvW tO record arM monaor qty telephone calls for venous purposes, inruding to ensure accuracy. to provide a record of ouch conversabons and to improve the quality d service to me I agree to follow such securlly procedures as Wacrtovia may require The secunty procedure agroad upon for verifying the autetantyaty of Irstructions which are not delivered in parson by rtre for any purpose (including, but not timlted lo. the Mitre transfer 01 overlay from any or my accounts) is one or more of the following at the option at Wachovia (1) delivery of a peroonal idenbficauon oode by ma or a pennon purpartrrtg W be me. (2) a callback, (3} a recitation by me or a person purporting to be me of onto or ogre items of my personal iniprmpbon whxXt Wachovla has in its records about me, or (4) voice reeognltron of me combsted Meth the use of pertain probing questions. The telephone number(s) to which catlgacks stroll be made shell be any telephone number(s) Wachovia may have fix rite in its rocords or any telephone number assigned to me b1r a telephone 6ervioa provider I a~ee that this security procedure constitutes a eorrrrrerdely reasonable method of pro,ndmg security against unauthorized irawctrats I agree to maintain the oon60entiality of arty personal identification code arW MnA prevent ltte unautltorired dissemrnaoon of such code. I agree to indemnify and hold Wacttnvla harmless horn any bases. damages, wds and expenses, of whatever lurid, inqudmg any roasbnable attorneys' tees. that Wachovia may Incur as a resort of retying upon instructions from me, Or anyone purporting to be me, Provided that Waehovla has complied with the appbcable seventy procedures I ackraMnedge receipt r» the W2Criovia rules and reputations governing money transfer requests and agnoe ro be bound by its terms as may be amended from dine to time If you are claiming foreign Exemption Statusr the appropriate W-8 Foreign Certification Form must be completed for each account owner. OF SURVIVORSHIP (NC and TN ACCOUNTS ONLY): I understand that by signing below and establishing a Ioint aecoum under the provisions of North Carolina General Statute S~-18.1 and 7ennessea Code 62-2•TOS that f. Washouts may pay the money In the account to, or on ute order at, arty person narrwd in the account unless we have agreed with the Wok that wlthdrawale requiro move than one slpnature, and 2. Upon ilia death of one joint owner tM money remalning in the account will belong to tM survivlny Joint owners and will not pass by Inharltance W the halo of ilia deceased Joint owner or be controtlsd by rite deceased Joint owner's will. I DO slept to create the Right of SurvNonhip for arty Jdnt account rol- (FORM YY9 SOCUIL SECURITY HUMBER OR EMPLOYER IDENTIFICATION NUMBER CERTIFICATION (Not applicable for Non~tesldenl Aliens}: (The Soaat Security Number or Employer Identifitatan Number should match the first name fisted on me account and will fro used IM tax roponing purposes ) 11, If exempt tram backup MnlhrtOlding check this box ~ EXEMPT Ill Certification -Under penatbes of penury, I certdy that: 1, Ttte number set forth above is my correct social secunty number or employer identlficatbn number (or I have applied for and I am wading for a number to be issued to meJ, and 2 I am riot wbJed to backup vnUtttoldrng because- (a} 1 am exempt frorri backup withh0ldirtg, or (b) I have not been notrfled by the Internal Revenue Service (IRS) that I am cutgect to backup witMotdlnp as a rewlt of failure to report all interest or dividends. or (e) the !RS has nobted me that I am no longer subteet Io backup wilhhoWitg 3 I am a U.S person (indudrng a U.S restdem alien} CeRlflcatlon Instructions -You mull cross out item 2. above if you have risen notified try ilia IRS drat you are currently subject to backup withholdnp beause Of under roprxting interosl or drvidsnds on your tax rotum. Acceptance of Terms and f:ondldons: 0 By checking This box I am requesting lssuarrca of an ATM Card or CheekCard 1 agree to rte bound by Vie terms and condtlions including, tart not Tha Internal Revenue Sarvlce does not requtrs your conssnl to arty prowl Nmded to Wadtowa's Deposit Agreement end Discbsurea, thle document other than the ceNflcattons ro ufrsd to avoid 6acku wlthhol applicable to each product or service whk9r 1 obtain Iron ! ;~(~~(/~~J,J/ Wacttovra now or m Itte tuWro. wroth terms and condNans wdl he C%^6~~ ~• ~!/ provided W me. I aLw agree W PaY ell fees esaociated with such products. atxouMs and servkes in eocordartce with the fee sbtadulss wtxch will be pcavided to ma by Waeewvta. Customer egnaeun (above I ) Only one slgnaturo per agreement PrintNama EDWARD G SPIDEL „~re~ 923 W TRINDLE RD MECHANICSBURG PA 17055 o7~a1i2oo8 Daa DOCUMENT STORAGE COPY 582279 (Rev 02) SEND TO: NC8538 K'rT '~'oS oRas3 stteM 3o aoteu~tp s '~ugg stnot~gM Consolidated Statement O1 1010201011214 752 30 EDWARD G SPIDEL NANCY L SPIDEL 923 W TRINDLE.RD MECHANICSBURG PA 17055 Summary of Accounts Checking & Savings Account number 1010201011214 247402053493261 Total WACNOVIA BANK, N.A. SEP 2 2 2010 02360 TEL~.ER N0. 0015 Y~~ 1~-~ 0 9 SAFEKEPT Replacement Statement 075 PB 7/01/2008 thru 7/16/2008 Account Balance As of Interest Maturity rate date CROWN CLASSIC BKG 10,000.20 7/16 TIME DEPOSIT 12 MONTHS 20,000.00 7/16 4.16$ 7/01/2009 $30,000.20 WACHOVIA BANK, N.A. MECHANICSBURG page 1 of 4 achovia Bank, a division of Wells Fargo Bank, NA. Consolidated Statement 02 1010201011214 752 30 Crown Classic Banking Account number: 1010201011214 Account owner(s): EDWARD G SPIDEL NANCY L SPIDEL 0 9 SAFEKEPT Replacement Statement 075 7/01/2008 thru 7/16/2008 Account Summary Opening balance 7/01 $0.00 Deposits and other credits 10,000.00 + Interest paid 0.20 + Closing balance 7/16 $10,000.20 Deposits and Other Credits Date Amount Description 7/01 10,000.00 DEPOSIT 7/16 0.20 INTEREST FROM 07/01/2008 THROUGH 07/16/2008 Total $10,000.20 Interest Number of days this statement period Annual percentage yield earned Average interest balance Interest earned this statement period Interest paid this statement period Interest paid this year Daily Balance Summary Dates Amount Dates 07/01 10,000.00 07/16 16 0.05 $ $9,375.00 $0.20 $0.20 $0.20 Amount Amount Dates 10,000.20 1MACHQIIIA BAN-K, R~~ A SEP ~ 2 2010 ~,~~~ 'TELLER N(3. ~JO1S 000000120893046 000425000400001 UUV~ WACHOVIA BANK, N.A. MECHANICSBURG page 2 of 4 /achovia Bank, a division of Wells Fargo Bank, NA Consolidated Statement 03 1010201011214 752 30 0 9 SAFEKEPT Replacement Statement 075 7/01/2008 thru 7/16/2008 Let a Wachovia Mortgage Specialist help you buy or refinance. Call 866-416-6076 and we'll provide you with the stellar service that helped Wachovia earn the "Highest In Customer Satisfaction With Primary Mortgage Sales" award for 2007 from J.D. Power and Associates. Loans subject to credit approval and originated by Wachovia Mortgage, FS B, an Equal Housing Lender. Visit www.jdpower.com for award information. Earn $25 or more with Wachovia! with our Customer Referral Program, when you refer someone to us, you can both earn $26! It's that easy. Don't your friends and family members deserve the convenience, value, and customer satisfaction that you get with Wachovia? Visit a financial center or wachovia.com/referral for more details. Make A Statement by enrolling in Online Statements. You could win your choice of 2 Hybrids Cars or 1 Luxury Hybrid when you sign up for free Online Statements or eBills! Online Statements and eBills are a convenient and secure way to help reduce your paper statement clutter. Sign up today! To learn more, visit us at wachovia.com/makeastatement. Sweepstakes ends September 30, 2008. See official rules at wachovia.com/makeastatement/rules. SEP 2 2 2010 02360 TELLER N0. 0015 I~~l~ WACHOVIA BANK, N.A. MECHANICSBURG page 3 of 4 achovia Bank, a division of Wells Fargo Bank, N.A. Consolidated Statement 04 1010201011214 752 30 0 9 SAFEKEPT Replacement Statement 075 7/01/2008 thru 7/16/2008 Customer Service Information Phone number Address Checking & Savings Accounts, 800-WACHOVIA WACHOVIA BANK, NATIONAL ASSOCIATION Check Card & ATM Card 800-922-4684 NC8502 P O BOX 563966 TDD (For the Hearing Impaired) 800-835-7721 CHARLOTTE NC 28256-3966 En esparlol para cuentas Corrientes 800-326-8977 y de ahorros Bank By Mail (Deposits Only) WACHOVIA BANK, NATIONAL ASSOCIATION VA3289 P O BOX 26090 RICHMOND VA 23260-6090 Consumer Loan Accounts. 800-347-1131 WACHOVIA BANK, NATIONAL ASSOCIATION VA0343 P 0 BOX 13327 ROANOKE VA 24040-0343 In Case of Errors or Questions About Your Electronic Transfers: Telephone us at 800-WACHOVIA, 800-922-4684, or write to us at WACHOVIA BANK, NATIONAL ASSOCIATION, NC8502, P O BOX 563966, CHARLOTTE NC 28256-3966, as soon as you can, if you think your statement or receipt is wrong or if you need more information about a transfer on the statement or receipt. We must hear from you no later than 60 days after we sent you the FIRST statement on which the error or problem appeared. 1. Tell us your name and account number (if any). 2. Describe the error or the transfer you are unsure about, and explain as clearly as you can why you believe there is an error or why you need more information. 3. Tell us the dollar amount of the suspected error. we will investigate your complaint and will correct any error promptly. If we take more than 10 business days to do this, we will credit your account for the amount you think is in error. You will have use of the money during the time it takes us to complete our investigation. WACHOVIA BANK, N.A. AND WACHOVIA BANK OF DELAWARE, N.A. ARE MEMBERS FDIC 'N©VIA 6ANK. AI.A. sEP 2 2 zolo i72~6t TELLER NO. C~01S `Nl~~f -, WACHOVIA BANK, N.A. MECHANICSBURG page 4 of 4 Vachovia Bank, a division of Wells Fargo Bank, N.A. Consolidated Statement O1 1010201011214 752 30 EDWARD G SPIDEL NANCY L SPIDEL 923 W TRINDLE RD MECHANICSBURG PA 17055 Summary of Accounts Checking & Savings Account number 1010201011214 247402053493281 Total CH01~A BAN1t "".,. SEP 2 ~ 2[i~~~~ 02361E A TELLER NO. JU:s ? V uV 0 9 SAFEKEPT Replacement Statement 075 PB 7/17/2008 thru 8/14/2008 Account Balance As of Interest Maturity rate date CROWN CLASSIC BKG 13,091.11 8/14 TIME DEPOSIT 12 MONTHS 20,068.31 8/14 4.16$ 7/01/2009 $33,159.42 WACHOVIA BANK, N.A. MECHANICSBURG page 1 of 3 achovia Bank, a division of Wells Fargo Bank, NA. Consolidated Statement 02 1010201011214 752 30 Crown Classic Banking Account number: 1010201011214 Account owner(s): EDWARD G SPIDEL NANCY L SPIDEL 0 9 SAFEKEPT Replacement Statement 075 7/17/2008 thru 8/14/2008 ACCOUnt Sllmmdry Opening balance 7/17 $10,000.20 Deposits and other credits 3,090.45 + Interest paid 0.46 + Closing balance 8/14 $13,091.11 Deposits and Other Credits Date Amount Description 8/O1 1,185.82 AUTOMATED CREDIT US TREASURY 303 RR RET 420082110425916 CO. ID. 3031736071 080801 PPD 8/01 1,904.63 AUTOMATED CREDIT US TREASURY 303 RR RET 420082110425915 CO. ID. 3031736071 080801 PPD 8/14 0.46 INTEREST FROM 07/17/2008 THROUGH 08/14/2008 000425000400001 TOtdl $3,090.91 Interest Number of days this statement period 29 Annual percentage yield earned 0.05 g Average interest balance $11,492.14 Interest earned this statement period $0.46 Interest paid this statement period $0.46 Interest paid this year $0.66 Interest Rate Summary Dates Rate & Dates Rate 8 Dates Rate ~ 7/17 - 8/14 0.05 Daily Balance Summary Dates Amount Dates Amount Dates Amount 08/01 13,090.65 08/14 13,091.11 WACHOVIA BANK, N,A. s~ 2 2 Zo~0 02360 'YEti..ER NOS--., WACHOVIA BANK, N.A. MECHANICSBURG page 2 Of 3 1,~1//l' `/ `-" yachovia Bank, a division of Wells Fargo Bank, N.A. Consolidated Statement 03 1010201011214 752 30 0 9 SAFEKE PT Replacement Statement 075 7/17/2008 thru 8/14/2008 Make A Statement by enrolling in Online Statements. You could win your choice of 2 Hybrid Cars or 1 Luxury Hybrid when you sign up for free Online Statements or eBills! Online Statements and eBills are a convenient and secure way to help reduce your paper statement clutter. Sign up today! To learn more, visit us at wachovia.com/makeastatement. Sweepstakes ends September 30, 2008. See official rules at wachovia.com/makeastatement/rules. Customer Service Information Phone number Address Checking & Savings Accounts, 800-WACHOVZA WACHOVIA BANK, NATIONAL ASSOCIATION Check Card & ATM Card 800-922-4684 NC8502 P 0 BOX 563966 TDD (For the Hearing Impaired) 800-835-7721 CHARLOTTE NC 28256-3966 En espafiol para cuentas Corrientes 800-326-8977 y de ahorros Bank By Mail (Deposits Only) WACHOVIA BANK, NATIONAL ASSOCIATION VA3289 P 0 BOX 26090 RICHMOND VA 23260-6090 Consumer Loan Accounts 800-347-1131 WACHOVIA BANK, NATIONAL ASSOCIATION VA0343 P O BOX 13327 ROANOKE VA 24040-0343 In Case of Errors or Questions About Your Electronic Transfers: Telephone us at 800-WACHOVIA, 800-922-4684, or write to us at WACHOVIA BANK, NATIONAL ASSOCIATION, NC8502, P O BOX 563966, CHARLOTTE NC 28256-3966, as soon as you can, if you think your statement or receipt is wrong or if you need more information about a transfer on the statement or receipt. We must hear from you no later than 60 days after we sent you the FIRST statement on which the error or problem appeared. 1. Tell us your name and account number (if any). 2. Describe the error or the transfer you are unsure about, and explain as clearly as you can why you believe there is an error or why you need more information. 3. Tell us the dollar amount of the suspected error. We will investigate your complaint and will correct any error promptly. If we take more than 10 business days to do this, we will credit your account for the amount you think is in error. You will have use of the money during the time it takes us to complete our investigation. ~2~6~ TELLER N0. 001 SEP 2 2 2010 WACHOVIA BANK, N.A. AND WACHOVIA BANK OF DELAWARE, N.A. ARE MEMBERS FDIC WACHOVIA BANK, N.A. MECHANICSBURG W1lOHOVIA BANK. N.A• page 3 of 3 ',~/~ y~/p ~`. ~ ~ 1/ ~ (~ ll~~ IISA FIRST-CLASS FOREVER FI T-CLASS FOREVER J ~ I i I - zq~ 1 ~ 11111 11 '~,?Yr.> i' ~ ~'- `!~adr ;, Y O N IO .~. 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