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HomeMy WebLinkAbout05-05-11 (3)w ~,,A 1505610140 ' REV-1500 EX (01-10) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN ~~ 1 1 1 0 2 5 8 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYW Date of Birth MMDDYYYY 1 8 9 0 3 1 1 D 1 0 2 1 7 2 0 1 1 0 9 1 1 1 9 1 4 Decedent's Last Name Suffix Decedent's First Name MI S T E V E N S J U N E E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW a 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) QX 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) GVKKC,F'VNUtN ~ - ~ t115 ,tG ~ wn mu5 ~ tst wmr~t i tu. A~~ curcrctarunutn~t Hnu wnriutn i u~~ ~ ~ ~nrvrcmA ~ inn ~nww tst uirct~ ~ cu ~ v: Name Daytime Telephone Number R O G E R B I R W I N '~ 1 7 ~_ 4 9 2 ~:B' 5 0 C7 -'"" ~ -~ R~''; REGISTER ~1,4LS US ~ ~ LY '_ ~ =; ;~-,'~ ~t ~~ ~° ~ r) ~w 4~ 7 I _:,7 ~~ First line of address ~ `•r :~ C:~ ~-~ - ,:-~ ~ ~ ~ -r, - 6 0 W E S T P O M F R E T S T R E E T `~~ ,~~ _} ~~' Second line of address -~ -~ h.1 .~== ~'~~'~ ~~ ~:%~ City or Post Office C A R L I S L E Correspondent's a-mail address: SIGNATURE PERSON RESPONSIBLE F R FILING RETURN DATE ~. ~~ ~ ~~~ ADDRE S 60 WEST P R T ST EET CARLISLE PA 17013 SIG E REPAR ER T REPRESENTATIVE DATE ADD SS 60 W ST POMFRET STREET CARLISLE PA 17013 Under penalties of pery'ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS C State ZIP Code DATE FILED P A 1 7 0 1 :3 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610140 1505610140 J 1505610240 REV-1500 EX Decedent's Social Security Number Decedent's Name: JUNE E• S T E V E N S 1 8 9 0 3 1 1 0 1 RECAPITULATION 1. ........................................... Real Estate (Schedule A) 1 • • 2. Stocks and Bonds (Schedule B) ...................................... 2. 9 4 4 0 9 7. 2 0 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. • 4. Mortgages and Notes Receivable (Schedule D) .......................... 4. • 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 6 4 7 5 . 9 5 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. • 7. Inter-Vivos Transfers & Miscellaneous N -Probate Property l Billi R t d S h d G ~ S t 7 ....... epara e ng eques e ( c e u e ) . 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 9 5 0 5 7 3 . 1 5 9. Funeral Ex enses and Administrative Costs Schedule H 9. 6 6 6 2 2 . 6 7 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ............. 10. 6 9 3 7 . 3 9 11. Total Deductions (total Lines 9 and 10) ......................... ...... 11. 7 3 5 6 0 . 0 6 12. Net Value of Estate (Line 8 minus Line 11) ..................... ....... 12. 8 7 7 0 1 3 . 0 9 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ............... ....... 13. 6 9 3 6 1 0 . 4 7 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... 14. 1 8 3 4 0 2 . 6 2 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x .0 0. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate X .0 0. 0 0 1 g. D. 0 0 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17. 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 1 8 3 4 0 2. 6 2 18. 2 7 5 1 0. 3 9 19. TAX DUE ............................................... ....... 19. 2 7 5 1 0. 3 9 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ ~. 1505610240 Side 2 1505610240 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 11 0258 DECEDENT'S NAME Ji.UNE ~. STEVENS STREET ADDRESS 210 BIG SPRING ROAD CITY NEVWI LLE STATE PA ZIP 17241 Tax Payments and Credits: 7. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 1,375.52 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (1) 27,510.39 Total Credits (A + B) (2) 1, 375.52 (3) (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 26,134.87 Make check payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred : ........................................ ........................ ...... ^ b. retain the right to designate who shall use the property transferred or its income; ......................... ...... ^ c. retain a reversionary interest; or .......................................................................................... ...... ^ d. receive the promise for life of either payments, benefits or care? ...................................... ........... ...... ^ 0 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? .....................................................................,,........... ...... ^ 0 3. Did decedent own an "intrust for" orpayable-upon-death bank account or security at his or her death? ... ...... ^ 0 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? ............................................................................................ ...... ^ ^X 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 Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or 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 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 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 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 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 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, undE Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1503 EX + (6-98) SCHEDULE B _ COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS • INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER JUNE E. STEVENS 21 11 0258 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. MERRILL LYNCH WEALTH MANAGEMENT 212,629.55 ACCOUNT #872-40583 DATE OF DEATH VALUATION ATTACHED 2. MERRILL LYNCH WEALTH MANAGEMENT 728,187,92 ACCOUNT #872-10534 DATE OF DEATH VALUATION ATTACHED 3. PRUDENTIAL -ACCOUNT #3408025351 3,279.73 PRU HIGH YIELD A FUND #: 0087 /NASDAQ: PBHAX 588.829 SHARES @ $5.57 PER SHARE _ $3,279.73 TOTAL (Also enter on line ~, Recapitulation) ~ $ 944,097.20 (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (6-98) _ COr1AMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER JUNE E. STEVENS 21 11 0258 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. WACHOVIA BANK -CHECKING ACCOUNT #8855 3,800.37 2. WACHOVIA BANK -CHECKING ACCOUNT #7422 1,835.86 3. JEWELRY -APPRAISAL ATTACHED 250.00 4. PERSONAL PROPERTY -APPRAISAL ATTACHED 508.00 5. CASH 81.72 TOTAL (Also enter on line 5, Recapitulation) I $ 6,475.95 (If more space is needed, insert additional sheets 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 ESTATE OF FILE NUMBER JUNE E. STEVENS 21 11 0258 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. HOFFMAN-ROTH FUNERAL HOME 254.25 B. 1. 2. 3. ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) ROGER B. (RWIN street Address 60 WEST POMFRET STREET City CARLISLE State PA ZIP 17013 Year(s) Commission Paid: Attorney Fees: (RWIN & McKNIGHT, P.C. Family Exemption: (If decedents address is not the same as claimant's, attach explanation.) Claimant 4. 5. 6. 7. 8. 9. 10. 11. 12. Street Address City State ZIP _ Relationship of Claimant to Decedent Probate Fees: REGISTER OF WILLS Accountant Fees: Tax Return Preparer Fees: PATRICIA A. ROSENDALE, CPA INCOME TAX RETURNS & FIDUCIARY RETURN REGISTER OF WILLS -FILING FEE CUMBERLAND LAW JOURNAL -ESTATE NOTICE THE SENTINEL -ESTATE NOTICE NOTARY FEES MELANIE RICHARDS -HOUSE CLEAN-UP ROY D. GOTTSHALL 31,500.00 32,300.00 711.50 495.00 30.00 75.00 176.92 25.00 1,000.00 55.00 TOTAL (Also enter on Line 9, Recapitulation) I ~ 66,622.67 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ (12-08) '- pennsylvania SCHEDULE ' DEPARTMENT OF REVENUE DEBTS OF DECEDENT, .- INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS RESIDENT DECEDENT ESTATE OF -FILE NUMBER JUNE E. STEVENS 21 11 0258 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. MILLENNIUM PHCY SYS -MEDICAL 165.82 2. DARRYL K. GUISTWITE -MEDICAL 70.00 3. HALE INDIAN RIVER GROVES -OUTSTANDING INVOICE 17.95 4. PENNSYLVANIA RETINA SPECIALISTS -MEDICAL 10.00 5. OUTSTANDING CHECK#2118 WITH WACHOVIA BANK 6,673.62 TOTAL (Also enter on Line 10, Recapitulation) I $ 6, 937.39 If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (01-10) ~. pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES ." INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: JUNE E. STEVENS 21 11 0258 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. ALBERT L. SAVIGNANO Collateral 10,000.00 117 GREEN STREET EDWARDSVILLE, PA 18704 5% REMAINDER DIVIDED BETWEEN: 2. ELOISE ACHHAMMER Collateral 14,450.22 3112 GRACEFIELD ROAD SILVER SPRING, MD 20904 3. JEANNE BEVIS Collateral 14,450.22 113 CHARLENE AVENUE SAVANNAH, GA 31410 4. DOROTHY TALIAFERRO Collateral 14,450.22 8737 INDIAN SPRINGS ROAD FREDERICKS, MD 21702 5. DONNA STRACHEN Collateral 43,350.65 9212 PINEHURST DRIVE 5% REMAINDER FORT WASHINGTON, MD 20744 6. NANCY J. STEVENS Collateral 86,701.31 659 WARREN AVENUE 10% REMAINDER KINGSTON, PA 18704 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. ji. NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN: B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. REDEEMER ORTHODOX PRESBYTERIAN CHURCH (10%) 86,701.31 10 BELVEDERE STREET CARLISLE, PA 17013 2. GRACE BAPTIST CHURCH OF CARLISLE (35%) 303,454.58 777 WEST NORTH STREET CARLISLE, PA 17013 3. THE CHRISTIAN SCHOOL OF GRACE BAPTIST CHURCH (35%) 303,454.58 777 WEST NORTH STREET CARLISLE, PA 17013 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 693 610.47 If more space is needed, use additional sheets of paper of the same size. ;~~ . ', ~!!i 'I . ~. .o J .; :, II 1 LAST T~VII,L AND TEST SENT I' '~E E• STEVENS, of West Pe nnsboro Township, Cumberland County, Pennsylvania, being of sound mind, dis osin P g memory and full legal age, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils heretofore made by me. 1 • I direct my Executor or Substitute Executor as the case may be, to pay all of my debts, funeral and administrative expenses as soon as convenient after my decease. Furthermore, I direct that all state, inheritance, succession and other death taxes unposed or payable by reason of my death and interest and penalties thereon with res e p ct to all property compos~g of my gross estate for death tax purposes, whether or not such ro e P P rty passes under this Will, shall be paid by the Executor or Substitute Executor of my estate. 2• My Executor or Substitute Executor ma at Y~ lus discretion, compromise claims, borrow money, retain property for such ten of g~ tune as he may deem proper; lease and s property for such prices, on such terms, at public or rivate ell P sales, as he may deem proper; acid invest estate properly and income without restricti on to legal investments unless otherwise provided hereunder. 3. I authorize and empower my Executor or Substitute Executor to sell any realty and/or personalty owned by me at my death and not specificall Bevis Y ed or bequeathed herein, at public or private sale or sales and to give good and sufficient deed s and/or bills of sale therefore, in fee simple, as I could do if living. My Executor or Substitute Executor is authorized and empowered to engage in any business in which I may be engaged at m de Y ath, for such period of time after my death as seems expedient to said Executor or Substitute Ex ecutor. ~a.~o q 1 '+ ~ `~ 1 4. I give, devise and bequeath all of my estate of whatever nature and wherever situate as follows: a. Certain items of furniture according to a list left with my Will; b. The sum of $10,000.00 to ALBERT L. SAVIGNANO; c. Five percent (5%) to be divided between ELOISE ACHHAMMER, JEANNE BEVIS and DOROTHY TALIAFERRO, share and share alike; d. Five percent (5%) to DONNA STRACHEN; e. Ten percent (10%) to NANCY J. STEVENS; f. Ten percent (10%) to REDEEMER ORTHODOX PRESBYTERIAN CHURCH of Carlisle, Pennsylvania; g. Thirty-Five percent (35%) to GRACE BAPTIST CHI:JRCH of Carlisle, Pennsylvania; and h. Thirty-Five percent (35%) to THE CHRISTIAN SCHOOL OF GRACE BAPTIST CHURCH of Carlisle, Pennsylvania. 6. I nominate and appoint ROGER B. IRWIN to be the Executor of this my Last Will and Testament. In the event he has predeceased me, failed to qualify o:r is not able or does. not serve for whatever reason, I then appoint AARON W. BEARDMORE to be the Substitute Executor of this my Last Will and Testament, whereby the said Substitute Executor shall have the same powers as are given to the original Executor hereunder 2 7. No beneficiary shall benefit hereunder unless such beneficiary shall survive me by sixty (60) days. 8. No Executor or Substitute Executor acting hereunder shall be required to post bond or enter security in this or any other jurisdiction. 9. No beneficiary may assign, anticipate or pledge his, her or its interest in any income or principal held or distributable hereunder, and no beneficiary's creditors may levy, attach or otherwise reach any such interest. 10. I hereby suggest that my personal representative retain the services of Irvvin & McKnight, P.C. as attorneys in the settlement of my estate. IN WITNESS WI~REOF, I have hereunto set my hand and seal this 20~' day of April 2010. y, JUNE E. STEVENS Signed, sealed, published and declared by JUNE E. STEVENS, the above-named Testatrix, as and for her Last Will and Testament, in our presence, who, at her request, in her presence and in the presence of each other have hereunto set our names as sub~:c~ribing witnesses. ~~I~UYl ~ ~ ~~~~r~ 3 a ACKNOWLEDGMENT AND AFFIDAVIT WE, JUNE E. STEVENS, KAREN S. NOEL and SHARON L. SCHWA.LM, the Testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and that she had signed willingly, and that she executed it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as a witness and that to the best of their knowledge the Testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. COMMONWEALTH OF PENNSYLVANIA SS: COUNZ`Y OF CUMBERLAND Subscribed, sworn to and acknowledged before me by JUNE E. STEVENS, the Testatrix herein, and subscribed and sworn to before me by I~:AREN S. NOEL and SHARON L. SCHWALM, witnesses, this 20a' day of April 2010. ;~ otary Public CONrMONWEALTH OF PENNSYLVANIA Notarial Seal Roger B. Irwin, Notary Public Carlisle Boro, Cumberland County My Commission Expires Ocl 3, 2012 Member, Pennsylvania Aseodatlon of Notaries SHARON L. SCHWA,LM Merrill Lynch Wealth Management Bank of America Corporation s February 23, 2011 Irwin & McKnight, PC Attn: Roger B. Irwin 60 W Pomfret St Carlisle, PA 17013 RE: June E. Stevens accounts 872-10534 and 872-40583 Dear Mr. Irwin, Chrystal L. Woollett Registered Client Associate 214 Senate Avenue, Sth Floor Camp Hill, PA 17011-2344 Tel: 717.975.4619 Fax: 717.773.4446 ~~_ -, _. Please accept my condolences for the passing of June Stevens. To assist you with her estate, please reference the following information: 1. At the time of Ms. Steve's passing, accounts 872-10534 and 87:?-40583 were titled in the name of "June E. Stevens". 2. Account 872-10534 was established on February 1, 2010. Account 872-40583 was established on January 24, 1989. 3. No ownership or registration changes were completed during the year prior to Ms. Steven's death. 4. Ms. Stevens did not close any accounts with our office during the year prior to her passing. 5. Please reference the attached statement and date of death valuation for details concerning accrued interest and death of death values. To establish an estate account for Ms. Stevens, please return an original death certificate and short certificate in addition to the enclosed documents provided. Best regards, Chrystal L. Woollett Registered Client Associate Encl: Code 0088 (Affidavit of Domicle) and Code 100296RR (CRA) We are providing the above information as you requested. The information is provided as a service to you and is obtained from data we believe is accurate. However, Merrill Lynch considers your monthly account statements to be the official record of all transactions. Merrill Lynch Wealth Management makes available products and services offered by Merrill Lynch, Pierce, Fenner & Smith Incorporated and other subsidiaries of Hank of America Corporation. Banking products are provided by Bank of America, N.A. and affiliated banks. Members FDIC and wholly owned subsidiaries of Bank of America Corporation. Investment products offered through Merrill Lynch, Pierce, Fenner & Smith Incorporated and insurance and annuity products offered through Merrill Lynch Life Agency Inc.: Are Not FDIC Insured Are Not Bank Guaranteed May Lose Value Are Not Deposits Are Not Insured by Any Federal Government Agency Are Not a Condition to Any Banking Service or Activity Merrill Lynch, Pierce, Fenner & Smith Incorporated is a registered broker-dealer, member Securities Investor Protection Corporation (SIPC), and a wholly owned subsidiary of Bank of America Corporation. 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'~i °`° co ? m ~ ~ a vo- ~~ ~~~ ~ ~ ~ °-a~. ~ (A O .~- (~I ' ~ ~ y N O C ~ Ot 0 •.' n C "` mm ~ c ~ ~ E v. ~ __ ~ ~ =~ cn n v o, ~ ~ o ~ ~ i ~v c~ d m ~ c~ x ~ ~ ~ c F ~ ~~ y~ ~ N ~ 7C d , fl1 ~ pl n C ~ M < ~ N j N 3 o a• c o C o d N m m ~ ~ .o c ~ ~~ ~o; a ~ d eo~ o : ~• ~ r. 3 sU ; ~ 3 r ~G ~ Ct .~ .C `: ep ( ~ ~ ~n ~p n ~ 01 3 ~ ~ O ~ ID ~~ n ~ O+.O ~ ~~ ~• ~ a ~ ~1 y~ 7 ~ N ~ 11 !D G. _ ~ ~ ~ z ~ ~ p ~ r ~ y H ~. m ~ ~ , = a~ O ~ fig < 'r~,a. `<r a o ' ? 17 ~ ~ y ^ fD ~ •* O ,~ Oa '"' ~ a e~ O ~ y N O ~ ~ O ~ y N ~ O• (A O Q cu C 1 0 C "~-- .M N d ~ m m c d N c~ 0 oAi ~v c N a D 01 n 0 C N Prudential i 00003316 MISS JUNE E STEVENS Your Representative FIRST CLEARING LLC MUTUAL FUNDS UNKNOWN REP Your SSN/Tin#: ON FILE Page 1 of 4 GILLILAND MANOR Your Account 210 BIG SPRING RD 3408025351 Non-Retirement NEWVILLE PA 17241 Mutual Fund Statement -January 1, 2011 to March 31, 2011 1st Qtr Year-to-Date Jan 01, 2011 to Mar 31, 2011 Jan 01, 2011 to .Mar 31, 2011 Opening Balance $3,244.40 $3,244.40 Additions $0.00 $0.00 Subtractions $0.00 $0.00 Investment Results +$52.99 +$52.99 Closing Balance $3,297.39 $3,297.39 Dividends $54.15 $54.15 Capital Gains $0.00 $0.00 Personal Performance* +3.33 % +3.33 Taxable Bond 100% ~~~~~~ APB 1 ]. ~ ~ ~'i i ,, , ~ McKNIGH s EAW OFFICES * Calculated using adollar-weighted rate of return method for the period(s) listed. Results are based on your speoific activity and may not reflect overall fund performance. Standardized fund performance is available by speaking with your financial professional or by visiting www.prudential.com. Note: There are other personal performance formulas that may yield different figures, and past performance is not indicative of future results. Save. Paper,. Save T~m~, :Enroll.;: ~n .et~I~Ve~'y,' .:~f~ro+~~h: Prudetial Online A!ccolu~f Access , Why, VVaiit ~t~r the mail;.lt: you can; get Xot~r 4>~IUltu~l fund alEbpem±~ttts f~~#~r by ~~gh~"hg up for eDii~tl~-er;-? Tt~ e~tirpll,..> ~~. +o, www.prudentiat:co.t»r/to~acce$s <: ? : ,, .. .;Mile . we make. every at#pn~pt to . ensure ~t~a#. your stat±~ment is acclurate, ~rxArs :'may <1nad~ertentty. ocour. Ple~sa review yaur statement tf~orougrly and eontacf us If' >'y0~t tihd eny t~forrriatlon ;you b~lleve to be. inaccurate. If rare ~a hothear. frotr~ you iir>t 3Q d~lys; we will assume that all i1lfoatlorli is correct. Investment Allocation e J r ~~~ Aeferenoo ID: 3310822 Wachovia Bank Balance Cotlfirmation Services P O Box 40028 Roanoke, VA 24022 March 15, 2011 IRWIN & MCI~NIGHT PC ** SUBJECT: Verlfic~tion / Con~mation of Account and Bala>~e Information pravidod for: C>.attmncr: JIINE E STEVENS (S'SN# ~ RX 1101) Date of Deatb: February 17, 2011 Denoat Accon~nt Information Acoonct Acoourtt Dam of Dettth Average Balance Date Maturity Ltter+ett Accrued YTD Date Type Numbtr Balance Opened Date Rage Irterest Ittereat Paid Closed t~CKING XaXX8833 $3,800.37 4/3/2004 $0.06 50.07 LEGAL TITLE: ]LINE E STEirENS CHECKWG 422 $1,835.86 10128/1994 $030 $0.37 LEGAL TITLE: ]L]NE E 9TE@ENS ~' Gate of death balance does not include accued interest. * if date of death omens on a weekend or a hdiday, date of death balance does not inchrde any transactions that were made durieg the time period ~~ At~rey TIOUtt Servicenter Associate Phonc:(540)563-7323 at; at By atxeptittg this irrEortmtiott, the recipieai thereof repraeerrra aid warrants m Webs FarIIo Bank N A ("1,4ella Fa~'~, that the recipient is artharized by t5e tststormr m reoei~e IawGtily this information The recipient agroea that it will mt disdasc this in~mariart bo any third pally, ualoas eonopnl]ed fo do so by legal pmcma, and that it wr7l ]awfully use this infonnstioa The recipient acknowledges that WeW lar®n does net represent asd rAmraat that the iniomsation is complete cad accurate. •1'he recipient further aotmowladges tlrot the irdorrustion>'>~ nd disclose the entire relationship betm+aen aimto<ner cad Wel]s Fargn. The informatioa is subject to change without rntiee fo the recipdent The recipient agees fo indemnify, deii:nd, and bald Weds Fargo hamalasa from and against nary claim resulting from the dise]asure and use of the irtforrnatiart by the recipient or $nm the breach by the recipient of arty agreement, representation, or warranty contained berate WaaFwvia Baokand K'aahcvia i3anlc of Aelawae aro divisions of Walls Nateo rank, N.A Ptage 1 of 1 .~ ~ ~° i ~~ ~, v ~ ~- j l~ ~` Z~ ~~ ~~ 7-s ~____ s ~ ~ ~.~. v3 ~i ~~ ~~ ~~r ~ . w ~ ~~~ ~ :~~ -~ - ~ Z-- ~ ~~ ,` ~ ~l.E ,~ ~ ~ S2? ~. r ~u~iQ~c ~d~ ~~j4- • 1 . ~ - c~ ~~~ ~~~ ,~ ~ . i i~ ~~.. 'r . % ~ .. C r ~~~} ._ ,~ r`/ ~~ ~,~ :. ,! _ . t _. , ~,: ,.- ~.. ~~ _. ~ ~ ,P. ~ r a ~„ Y E ~ r ~ ~ . ~, ,,: -.- ~0 ~r i ,. . , ~. ~ .. ~ -- '~~ ~ ---- - ---- -~~--- - ----~~------...__._ - r ~~~ _.~_.-- - ---_`~- .._ _~~ _ - -.~ ,~ ~' ~ ~ w ~ ~ Yom' _~_~_ ~~~`. - -- r~ y -, ` ~. ~'' ___.__. __ __..._.._ ..._... __ _.______ .. __ _~___._ _ _ ~r ~, f l _ . _._ ._ _.._ _ __ __ :.- : __ _ ... ~ ; _.,~. ... ~' r ,~~ ~- ~y _ :. .~_._ ~ ~ L * i r J t ~ ~- --~. _'- `. ... _Q _. .--- - ~~ ~~~~ ll II ~ ~ ~ ~ ~ ~ .~~~ . , _.._ . ~ :' I r ~t .. .. _._.___..._______..._.._._._ ,_~..._p.___.__...- ,1 _ _ _.._ ._._ _. _ _ ___...____._.__...._-T_. ____....__ _____ a r- '~ j, . _. .. ,T- /~/ , F• ,. ~ ~ _,~ LNG SpR - ,.~? -o?/- // r • ' ~ 219 North Hanover Street Carlisle, Pennsylvania 17013 t 7 717.243.4511 ~ /'~' toll free 1.866.451.4511 .~ C fax 717.243.3723 vvww.hoffmanroth.com FUNERAL HOME ~ CREMATORY, INC. infoC~hoffmanroth.com ~~~~~~ ~~~ ~ 2 `~ ~01~ March 25, 2011 Attorney Roger B. Irwin 60 West Pomfret Street ~~WIN ~ ~IcKNIGH b Carlisle, PA 17013 ~ I.AW OFFICE Statement of Funeral Expenses for: June E. Stevens Date of Death: February 17, 20.11 Account Id: 16170-047 PACKAGE: Traditional Funeral Service TRADITIONAL FUNERAL SERVICE PACKAGE ~ $ 4,550.00 Sub Total: $ 4,550.00 MERCHANDISE: Casket: Covington $ 5,500.00 Sub Total: $ 5,500.00 TOTAL FUNERAL HOME.CHARGES: ~ ~ $ 10,050.00 CASH ADVANCES: 3 Certified Death Certificates at $ 6.00 .each $ 18.00 Newspaper Notice -Sentinel. $ 77,25 Newspaper Notice -Wilkes-Barre $ 60.00 Flowers $ 159.00 Sub Total: $ 314.25 Total Funeral Expense: $ 10,364.25 Total Payments Made: $ 10,010.00 Payments Made: Disc On PreNeed Discount ~ Mar 10, 2011 .2,695.95 Madison National Life Check .375676 Mar 10, 2011 . 7,314.05 Balance: ~ 354.25 ---------------------------------------- `... ------ ~ ------ ~-- ----- ~oG GU ---• Please return this portion with your Remittance. ~ (~ ~ ~ S`~a~ $ Amount Enclosed June E. Stevens Service ID#: 16170-047 SERVING OUR COMMUNITY SINCE 1 907 OVERDRAFT NOTICE i Our records show there were insufficient funds in your account 1********7422 to cover all of the following items received on 02/23/2011. ITEM DESCRIPTION ITEM AMOUNT FEE Check # 2118 # 6,673.62 #22.00 Because we have paid these items and may have charged applicable fees, your account is overdrawn. Please make a deposit to bring your account back to a positive balance as soon as possible. Your current available balance can be obtained 24 hours a day, 7 days a week through Online • Banking, any Wachovia/Wells Fargo ATM, or by calling 800-WACHOVIA C800-922-4684). Thank you for banking with Wachovia, a division of Wells Fargo Bank, N.A. PLACE .. ~ ~ STAMP ' HERE WACHOVIA BANK _ ~ CORRESPONDENCE TEAM D1118-02D P.O. BOX 563966 CHARLOTTE, NC 28256-3966 ~~il~~~~ll~~liili~~~i~l~iliillili~~ll~~~~l~i~ill~~i~~li~~i~~i,i,i Wachovia Bank, N.A. Dept. VA7300 PO Box 40031 Roanoke, VA 24022-0031 JUNE E STEVENS 210 BIG SPRING RD NEWVILLE PA 17241-9497 OVERDRAFT NOTICE Our records show there were insufficient funds in your account 1000590427422 to cover all of the following items received on 02/23/2011. Item description: CHECK #00000002118 Item amount; $6673.62 Available balance before items were presented; E2012.30 We have paid these items and caused an overdraft on your account, and a deposit is required as soon as possible. You can obtain statement information at most Wachovia ATMs, or contact your financial center, Commercial Relationship Manager, or Wachovia Wealth Management. For further Page 1 r assistance, or for information about overdraft protection, please call us at 1-800-922-4684. Please deduct from your account records the insufficient funds fee of $22.00 for each item listed. Page 2