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HomeMy WebLinkAbout08-08-11J 1505610143 EX (01-10 .' EV-7 500 ) ~ OFFICIAL USE ONLY PA Department of Revenue Pennsylvania County Code year File Number Bureau of Individual Taxes DEPARTLENT OF REVENUE PO 80X.280801 INHERITANCE TAX RETURN 21 10 1104 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 179 12 3955 10 24 2010 11 19 1921 Decedent's Last Name Suffix Decedent's First Name MI DAVIS DORIS I (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 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS O 1. Original Return ^ 2. Supplemental Return ^ 4. Limited Estate ^ qa. Future Interest Compromise (date of death after 12-12-82) g Decedent Died Testate (Attach Copy of W II) ^ ~ Decedenpt Maintained a Living Trust (Attach Copy of Trust) ^ 9. Litigation Proceeds Received ^ 1 p, Spousal Poverty Credit (date of death between 12-31- and i-1-95) ^ 3. Remainder Return (date of death prior to 12-13-82) ^ 5. Federal Estate Tax Return Required 1 8. Total Number of Safe Deposit Boxes ^ 11.Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number AARON C JACKSON ESQ 717 234 4121 First line of address 111 NORTH FRONT STREET Second line of address PO BOX 889 City or Post Office State ZIP Code HARRISBURG PA Correspondent's a-mail address: ajackson@tuckerlaw.com REGISTER 01=1~.LS USE.ONLY _. _: r r=~ ! , -~ - ~. < :..~ ; _ l~ 4' t DATE FILED 'n i ,, r - -r _J ., , -- ~ ~~ unaer penalties of per)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 orrect and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. S N RE OF RSON R ONSIBLE FOR FILING RETURN DATE Ronald A. Davis °l/~ 9 /.~ 1932 S rin Road Carlisle PA 17013 SIGNAT OF P PARER OTHER THAN REP ATIVE DATE r~ r Aaron C. Jackson Esq. ~~~ ~~ 111 North Front Street, Harrisburg, PA Side 1 L 1505610143 1505610143 J 1505610243 REV-1500 EX Decedent's Name: DaVIS~ DOrIS I. Decedent's Social Security Number 179 12 3955 RECAPITULATION 1. Real Estate (Schedule A) .................................................................................... ... 1. 2. Stocks and Bonds (Schedule B) .......................................................................... ... 2. 2 9 , 425.7 6 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)...... ... 3. 4. Mortgages & Notes Receivable (Schedule D) ..................................................... ... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............. .. 5. 93.98 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested.......... .. 6. 3 6 , 8 97.72 7. Inter-Vivos Transfers & Miscellaneous I~oq Probate Property (Schedule G) ~J Separate Billing Requested........... . 7. 8. Total Gross Assets (total Lines 1-7) .................................................................. ... 8. 6 6 , 417.4 6 9. Funeral Expenses & Administrative Costs (Schedule H) ..................................... .. 9. 8 , 4 63.65 10. Debts of Decedent, Mortgage Liabilities, 8~ Liens (Schedule I) ............................ .. 10. 3 62.97 11. Total Deductions (total Lines 9 8 10) ................................................................. .. 11. 8 , 82 6.62 12• Net Value of Estate (Line 8 minus Line 11) ........................................................ .. 12. 57 , 590.84 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .............................................. . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................. .. 14, 57 , 5 90.84 TAX COMPUTATION -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 .00 15. 16. Amount of Line 14 taxable at lineal rate X .045 57 , 590.84 16. 17. Amount of Line 14 taxable at sibling rate X .12 0 . 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 0.00 18. 19. Tax Due ................................................... .............................................................. . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505610243 1505610243 0.00 2,591.59 0.00 0.00 2,591.59 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-10-1104 DECEDENT'S NAME Davis, Doris I. STREET ADDRESS 2100 Bent Creek Boulevard Suite 228 CITY STATE ZIP Mechanicsburg PA 17050 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 2,200.00 115.79 (1) Total Credits (A + B) (2) 3. Interest (3) 4, If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2 Line 20 to request a refund 2,591:59 2,315.79 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 275.8 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 :.................................. ^ ^x 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? .................................................................................................................... x 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?....... ^ 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 QUESTIONSIS 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 is 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 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)]. 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-1503 EX+~6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER Davis, Doris I. 21-10-1104 All property Jointly-owned with right of survivorship must bedisclosed on Schedule F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 U.S. Savings Bonds - U.S. Savings Bonds 29,425.76 TOTAL (Also enter on Line 2, Recapitulation) 29,425.76 ~~~ n~~~o space Is neeoeu, aaamonal pages Dt the same s¢e) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev-1509 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Davis, Doris I. 21-10-1104 If an asset was made joint wlthm one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Ronald A. Davis B. C. 1932 Spring Road Son Carlisle, PA 17013 JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSE % OF DECD'S INTEREST DATE OF DEATH DECEDENT'S NTEREST 1 A M&T Bank -Deposit Account #xxxx877, 53,427.78 50.000% 26,713.89 jointly held with son, Ronald Davis, per date of death valuation correspondence. 2 A M8~T Bank -Deposit Account 20,367.66 50.000% 10,183.83 #xxxxxxxxxx4371, jointly held with son, Ronald Davis, per date of death valuation correspondence. TOTAL (Also enter on Line 6, Recapitulation) (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. 36,897.72 Form PA-1500 Schedule F (Rev. 6-98) REV-1151 Ex+ (10-06) COM INHERITANCE T~ RETURNANIA RE IDEN DE EDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Davis, Doris I. 21-10-1104 ITEM DESCRIPTION N R AMOUNT A. FUNERAL EXPENSES: See continuation schedule(s) attached ~ 1,051.87 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Year(sl Commission paid 2. Attorney's Fees Tucker Arensberg, P.C. 6,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 273.50 5. Accountant's Fees 300.00 6. Tax Return Preparer's Fees 7. Other Administrative Costs 338.28 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 8,463.65 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Davis, Doris I. 21-10-1104 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Hetrick-Bitner Funeral Home -Funeral expenses. 651.87 2 Smith, Sherry -Reimbursement for funeral expenses. 400.00 H-A 1,051.87 Other Administrative Gosh 3 Cumberland Law Journal -Legal advertisement notice 75.00 4 Sentinel, The -Legal Advertisement 263.28 H-67 338.28 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) REV•1513 EX+(11-08) SCHEDULE J COMMORESIDE~NT DE~EDEEN~RNANIA BENEFICIARIES ESTATE OF D D FILE NUMBER avis, ores ~. 21-10-1 104 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 a 1.2 1 Ronald A. Davis Son one hundred 66,323.48 1932 Spring Road percent of net Carlisle, PA 17013 residue Total 66,323.48 Enter dollar amounts for distributions shown above on lines 1 5 throw h 18 on Rev 150 0 cover sheet, as a r o riate. II NON-TAXABLE DISTRIBUTIONS: . A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) Estate of Doris I. Davis, deceased Estate No. 21-10-1104 Re: PA Inheritance Tax Return List of Exhibits A. Death Certificate B. Letters Testamentary issued by Cumberland County Register of Wills on November 5, 2010, including Last Will & Testament of the Decedent dated December 16, 2008 C. Inheritance Tax Prepayment receipt D. Safe Deposit Box Inventory and Stocks/Bonds Inventory E. Savings Bond valuations F. M&T Bank account valuations H BGDB:121214-1 026476-148883 L~~AL R~~6STi~~1R'S ~E~f~~~~AT~QCV ~F ~E~.~'~ WAFi!`IING: It is illegal to duplicate this copy by photostat or photograph, . ~ee for this certificate, $6.00 ~- This is to certif}I that the information here Qiven is .II^~~,~.jK of p\ 1,,j1~~. /Y,~~_ correctly copied from as original Certificate of Death ,,o°o~ ~~~~ duly filed with me as Local Registrar. The original ~:~~~~ -~ ~~ ~1 certificate gill be for«rarded to the State Vital ~~°( y~y~l'~.;I Records Office for_pennanent film°. _ P 1632353 Certification Number r ,12(106 COMMON111MEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS .ENT" CERTIFICATE OF DEATH INK (See instructions and examples on reverse STATE FILE NUMBER Date Issued I. Nave d Decedent IFesl, made. lazt, zum+l 2. Sea 3. Saul Secumy NumNr +. Dan d DYm (Manm, day, rear) Doris I. Davis Female 179 - 12 - 3955 October 24, 2010 5. Age ltril emnaay) Under 1 Yeu UMw 1 day 6. Dale d &M IMmm, Ny. y!u) 7. Biitlrplace ICAy and dale w lw argn cwm6yl 6a. Place el Deam IOnaa ONy met Morn Dan ron eMarw Muglu: pMr 1921 19 N b PA Bloomsbur ^l t ^ER/W ^DDA a Moms ^Resrdwrca ^DNM~SOedly [~Nurse 88 Yrs. er , ovem g, npauen lpa enl g do. County d Deun &. Dory. 6oro. TwD. al Dsam fid. Facility Noma Id nd nwnrom, gw saeN and «+rbwl 9. Wu Dsudenl d Hispanic Orryn? ~-,iC ° ^ Yaz 10. Rau: Amennn 9r61n, Blfc7t, W61l, esc - III yes, sDedh Cuban. ISP•s'+M C'LUnberland Mechanicsburg Bridges at Bent Creek Assisted Liv Meixan. Pwd6 Rican. w~.) .White I t Decednfs Usual m Nnd of work dau au mASI d Yla. Do nd Wle rs6ed I z. Was Oacadere ever n me 13. Decedents Ed¢ason (Speedy mry ~w 9rau mmpleledj I+. Manlu Sulus: Monad. Nawr Mamed, 15. SwvNng Spouw III wile, 9^'e maiden name) Knd d Wad. KrC d &rswu / IMus6y U.S. Armed Fwcu7 Ekmenury / $%OrldafY 10-t 2) CalNge (I ~+ or 5.1 Widowed. ~C°d ISpauM Office Manager White Shield, I c. ^Yea ®N6 12 Widowed ; lawn, sole. ry a I6. CecedenYS Marlrlg Address ISVed. u pamul ' Oecedants Ud D•cedanl Decedere lived n TwD~ Yn 17c ^ Pennsylvania i 17 9 e ^ ~ - ., 11 00 Bent Creek Blvd. State 228 , . au AcWal Rae demi a m~hWV ov Mechanicsburg, PA 17050 n lro. cannJ ~,mhPrl anA 17° ~t ,,~"°YM~yive°Yntlen MecharLicsburcr Cryy6ap 76. famu'e None (Fast middle, east sd6a1 William H. ac n r 19. Mamw'1 Nams IFust nedW. maden surname) 20a. InlwnunYS Name IType / Pmq ZOb. mtmnanYS Madmq Address IStrew, Uy I lam, mu, up nde) Ronald A. Davis 1932 Spring Rd. Carlisle, PA 17013 21 a. Metlnd d Drsposi6m []jGemaeen ^ D«won 216. Dau a Qapnei6n (Haan. der, veal 21c Place a DispoMtion IName a cwnwery, wemalay «anw phial ltd. lensarl ICM y ~. eau. »o mde) ^ sww ^ Removal Imn $ala wu~tr.nywwnEaa~DO~wI~~A,~~ vas ^ o-w ^ QNU - $pePly: by Blt'Sler CrEYIIatOr~ LLC +' ~ Harrl SbUL' PA g a 12a. Sigrunrre d F l,~.n+e.,« per50n aCMN az eua,) zz6. (;<.ne< Nunmu zzc. Nam. asM Add.ea of FadiYy Hetrick-Bitner Funeral Home - 1 lnut t H isbur PA 171 Cwndeu nuns grey wlwn caulyrrq 23a. Tome 6esl d my Mwwkdge, dNm acuned u me mr,^M and DMU sluts. ISrguwn arq uNl 23D. Ucanse Nurturer 23c. Dau Sgned IMaKn. day. Yeu) pnyscun M not avaea6k u uma d deem to :lNY cause a Deem. ^ ~ (~ __ ~ as' lil~~l ~~7/r '(( /~/~~/v • s /-s Lt~' A V U~ fSC.w ~ ~ ~ d~G~ z+. rime a Dean 26. Dais Pronaared oya I . NY. Y~l 26. Waz Case Relerted to MetiW Examiner I Coroner la a Ranson Omu dun Crwna6m «Daeaml7 Ilene 2+2fi ne2l u rarrplwed M persm / O ::~ /1 C `I it d/ C3 7d ~ C ^ ra ~Qra wnp pr«rwncee Nam. M. i G1 rL . b CAUSE OF DEATH (Sw Inswctlons and eaunples) r Approsuwe nlervu: Pad II: Enlu dher ygnmonl rai6nms canbeaAnp m deem, 7B. Di0 Tdsaccp Use C«udM b Deam7 Item 27. Pan I: Enlar Ine UMin d even6 - dseuef. npunes. w nmpscabu - mu dveuY caused ma Nam. DO NOT weer lemeW avMle su[n u wbac ure51, r Dnsel to Deam WI nd nsu6erg n me unNdyrrq msse gvln n Pan I. ^ Yes ^ Prmady respualay arte51, a veancuMr 6«rWUOn aMal SMweg me elioY qy. li9 nay «M Huse m each ine. ~ (Np ^ LyyeVNi WMEDIATE CAUSE IFinu dseasew ~..(~/ ~/ ~~i /' '7 carrrmon rasunug n Naml -,~ a. ~ u r/) s' ~ r si 17 Q/~'s,' y A'1 ^ti-- L ~~G [ K cJ KCIC}"~~ / S P /~ 29. II Fwrule: tl t ^ Nd a Due a Iw u a once d): w en pas prequ yW ^ PrepWe u mw d deem $ewam6aay aM cmdrams, a arty. b. uadno la die nose tried m line a Enter Uw UNDERLYING CAUSE Due to Iw u a conseprw¢e op: ^ Nd pregua, bd Dre¢ure wCYll +t deY+ a deem IdiseASe «mlwy mu uuuated lu c wwns resuknq in Naml L16T. Du Ip for u a consequence oft: ^ Nd prgwK 6u prgw! e3 Nye b 1 Yaar Mae deem a. ^ unYmwn .t pr.gwa wanin tr De+l year 70a. Wu an Aulapsy 70b Wue Aukgsy Futlugs 71. Mama d Oeam 72a. Dau of Iryury IMonm, daY. yearl 326. DesrMe Mow Iryury Occurred 72c. Pun al 6MwY Name. Fame Street Fad«y, Oaice BuY0n9. ek. (Spwtl') Penwmed? Avaaada Pn« to Canpaam d Cause dDeath] / !] ~NaWnl ^ Haredde ^ Ye5 ~ ^ res ^/NOD /7 ^ '~nl ^ PanNp Mwesugauan 72a_ Tune d Iryury 72a. Inwry a Wwk? 721. II Transponaum Inury lSpenN! 329 ~mn d UM+Y 19rt1t rtly / wwn, sole) ^ $uode ^ Coda Na M Delerrrxrred ^ Yei ^ No ^ Dnvu I Operabr ^ Passergw ^Pedeslnan M Omar ~ SpwM: ]3a. CervFer Isreu Day are) r nose :r xam anu arolMr seaan Has garwr:ed Ham and campwed IMm 271 i n Ph n urul h C rut n u 776 Sgnawa)y1tl iiI(~e oI LeCe~ndur /' ~ ~ /~ A q I ysrcM p p y e ynq p y c a ~~ya. To die 6esldmy MnowlMge. Nam oce«rM eue to dre CWellsl and mumwueYN4________________________________ ld - ~/ l / (/ Y i ~. /, Pronouncing and urUlyng pryeicwe IPMMnan ran pral«erag deem and csmlyeg b Huse d Owml ^ 77c. Ucense Number 77d. Dale Sgrco (MOnm. nay. yeul To IM Gsl d mY Mnowledge, Nam oaurted w me Iimq Nb, arts plea, ane dw 1! Ur! tiuega) aM memo as sated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • Medical EaunmwY wonw G~ L ~ G' ' 7 0~ ~Z ( /' ~(/ I.~ f - puce. and d W to IM rausys) and mamx as flaled_ ^ On tn! fiafie d esamuulipn errs / « InvllUgeeon. i y Nam ocwrtM at lne nme, rlue, a nd , ~. Name am Ad«ess d Parson Who CunpM~l° Guse d Deam ulem 211 Typ I Pml Neer+rr - ewe D l ^ ~ ~ ~ ~ ~ Feed IMOnm, mr. vean . /y G ~C ~ ~~ G l ~ ~ / C~ l /O- D V ~ O SS /Co /~_ t~ ~ tin , r, t _ PSIMUr6m Perms No. / >d ~ J . -:•t ~. REGISTER OF WILLS CUMBERLAND COUNTY PENNSYLVANIA No . 2010- 01 104 Estate Of: DORIS l DAVIS CERTIFICATE OF GRANT OF LETTERS PA No . 21- 10- 1 104 (First, Midd/e, Lastl Late Of : MECHANICSBURG BOROUGH CUMBERLAND COUNTY Deceased Social Securi ty No : 179-12-3955 WHEREAS, on the 5th day of November 2010 an instrument dated December 16th 2008 was admitted to probate as the last will of DORIS l DA VlS (First, Middle, Lastl late of MECHAN/CSBURG BOROUGH, CUMBERLAND County, who died on the 24th day of October 2010 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wi 11 s in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: RONALD A DA VlS who has duly qualified as EXECUTOR(R/Xl and has agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed thE= seal of my office on the 5th day of November 2010. Register of Wi! s ~~~~ Deputy **NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) ~~ ~ Q ~ i~ 0 LAST WILL AND TESTAMENT ~'s ~' ~ _ =~ti-m = = i OF _ -n - = c~, : ~:~,~~ DORIS I. DAMS ~-' ~~= ~J --,t_~-~~ ~. ~~ : ~ _ .~ .. o I, DORIS I. DAMS, of Cumberland County, Pennsylvania, declare this to be rny`~ Last Will, hereby revoking all prior wills and codicils. FUNERAL EXPENSES FIRST: I direct the payment of my funeral expenses, including my gravemarker, as soon as may be convenient after my death. PAYMENT OF DEATH TAXES SECOND: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of administration of my estate. PERSONAL PROPERTY THIRD: I bequeath those items of my household furnishings, personal effects, and personal property as I may set forth in a separate signed memorandum to the persons named in that memorandum. DISTRIBUTION OF RESIDUE FOURTH: I give the entire residue of my estate to my son, Ronald A. Davis, provided that if Ronald A. Davis predeceases ine or dies on or before the thirtieth day following my death, the entire residue of my estate shall be distributed to Raymond H. Davis, if living on the thirty-first day following my death. I specifically disinherit my other children. PROTECTION OF BENEFICIARIES (Spendthrift Provision) -:, -~ ; - ,`- _~ - . --, __ _, `_ ~<_; FIFTH: No interest in income or principal shall be assignable by a beneficiary or available to anyone having a claim against a beneficiary before actual payment to the beneficiary. TRUSTEE OF ESTATE OF MINORS AND INCAPACITATED BENEFICIARIES SIXTH: If any income or principal shall be payable to any person who shall be a minor I appoint my Executor, as trustee to hold such income and principal during minority and shall be entitled to apply such income and principal to the health, maintenance, support and education of such person during minority without the appointment of any committee or any authority of court My trustee shall be entitled to make direct application hereunder or to make application by payment of income and principal to the parent or other person in charge of such minor or to his or her guardian or to a custodian under the Uniform Transfers to Minors Act. Trustee may, in discharge of all the Trustee's duties, pay any minor's share deemed impractical of administration to the parent or other person in charge of the minor or to his or her guardian or to a custodian for the minor under the Uniform Transfers to Minors Act. Any remaining income and principal to which such person shall be entitled shall be distributed to such person upon such person reaching the age of 18. My Trustee shall have the same powers as my executor and shall serve without bond. If any income or principal shall be payable to any person who shall be incapacitated for any reason, my executor, as trustee shall hold such income and principal during incapacity and shall be entitled to apply such income and principal to the health, maintenance, support and education of such person during incapacity without the appointment of any committee or any authority of court. My Trustee shall have the same powers as my executor and shall serve without bond. POWERS OF EXECUTOR SEVENTH: I confer upon my executor the right to sell or otherwise convert any real or personal property at public or private sale, at such time or times, in such manner, and for such price or prices, and upon such terms and conditions as my executor shall determine, and to execute and deliver good and sufficient conveyances, assignments and transfers thereof, without liability of any purchaser for the application of any consideration; to borrow money and to secure its payment by mortgage of real or personal property, pledge of investments or otherwise, without liability on the part of the lenders to see to the application thereof; to retain any investments at discretion; to invest and reinvest at discretion, without restriction to so-called "legal investments;" to make distribution in cash or in kind; and to do all other acts and things necessary or appropriate in the management, administration and distribution of my estate. APPOINTMENT OF EXECUTOR EIGHTH: I appoint RONALD A. DAMS executor of my will. If RONALD A. DAMS is unable or unwilling to qualify as executor or having qualified is unable or unwilling to act, I then appoint RAYMOND H. DAMS as executor hereof. I direct that my executor shall not be required to furnish security in any jurisdiction. INTERCHANGEABILITY OF LANGUAGE NINTH: Words used in the singular may be read to include the plural or the plural may be read as the singular. Similarly, the masculine form may be read to include the feminine and neuter; the feminine may be read to include the masculine and neuter; and the neuter may be read to include the masculine and feminine. HEADINGS TENTH: The headings used on the various paragraphs of this will are included for convenience only and shall have no legal significance. I have signed this Will on December 16, 2008. ;/~J~;~ DORIS I. DAVI(S Witness ACKNOWLEDGEMENT and AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND SS. I, DORIS I. DAVIS, the testatrix/or in, and /'UI~12h'U ~- J~~~J ~~ and ~~' D ~~?~r~.] , f /~i~~~~w ~ ,the witnesses to the last will, the attached or foregoing instrument, who Have signed the instrument, having been duly qualified according to law do depose and say: (a) that I, the testatrix/or, do hereby acknowledge that I signed and executed the instrument as my last will, that I signed it willingly and as my free and voluntary act for the purposes therein expressed; and (b) that we, the witnesses, were present and saw the testatrix/or sign and execute the instrument as her last will, that she signed it willingly and executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix/or signed the will as a witness and that to the best of our knowledge the testatrix/or was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL JUDD M. AHRENS, Notary Public Mechanicsburg Boro., Cumberiand County My.Commission Expires May 23, 2009 DORIS I. DA S ' ,~~ _ ~~ ~ No~ary Public COMMONWEALTH OF PENNSYLVANIA REV-1 162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 013926 DAVIS RONALD A 1932 SPRING ROAD CARLISLE, PA 17013 ACN ASSESSMENT AMOUNT CONTROL NUMBER fold ESTATE INFORMATION: SSN: i7s-7z-3955 FILE NUMBER: 2110-1 104 DECEDENT NAME: DAVIS DORIS I DATE OF PAYMENT: 01 / 21 / 201 1 POSTMARK DATE: 01 /20/201 1 couNTY: CUMBERLAND DATE OF DEATH: 10/24/2010 REMARKS: REC TO ATTY CHECK#1004 SEAL 101 ~ $2,200.00 TOTAL AMOUNT PAID: INITIALS: DB RECEIVED BY: $2,200.00 GLENDA EARNER STRASBAUGH REGISTER OF WILLS TAXPAYER ~~~ ~ I I 4850D041046 .~.1 REV-485 EX (1-07) SAFE DEPOSIT BOX INVENTORY PA Department of Revenue PLEASE .USE ORIGINAL FORM ONLY Social Security or Death Certficate Number Date of Death County Code Year File Number Decedent's Last Name Suffix First Name MI ~/ ~ ~ ' y _ ® ADDRESS OF DECEDENT STREET. a. ~ o y (~ enjr C2 rs K 63~ v r~ S u ;~ ~ _... - _- - CITY: STATE: ZIP CODE: ~~ /11 ~t- ~ ~ ~ ~ , . c - ~~ n ~i ~ ~~~-~ ~ - ~ 7~ , 6 ®NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX NAME: STREET ADDRESS: CITY: ~ a ~ a t~rz,(N~ ~ ~ ~'r~-Q,~, I~ NAME, ADDRESS AND RELATIONSHIP (IF ANY) TO DECEDENT, OF PERSON(S) PRESENT AT THE BOX OPENING a. NAME: RELATIONSHIP: R~~ ~~n 1~- Jests ~~ STREET ADDRESS: ~ 4 3a- SP2-~n~c~ lZo,4-~ CITY: CA-+~-Lr ~ ~~ STATE: ZIP CODE: ~ f~- r~vr b. NAME://~~ p Q ~ ~ RELATIONSHIP: - _ /T r- D N . A Ll~.~IT!'l/ l~7 7~"O fL-/V c~ STREET ADDRESS: ~ ~ S CITY: STATE: ~ ZIP CODE: . l l ( i . w2~ ~r T h~A-~.r2 r~~t ~h fF-- ! [ ? (U I c. NAM ~ f-f- RELATIONSHIP: _ ~ (gym ~N STREET ADDRESS: ~ S l a N CITY: ~f STATE: ZIP CODE: ; , . ~~T l t i~--2~~~ uQc-~ P~ ~~~~ I NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED NAME: ~ ¢ ~ l3 ~k STREET ADDRESS: CITY: STATE: ZIP CODE: (16(pU CpriC-LtS - L CSv ~C_t-~H~vICS 2 l7d 0 N E OF PER O MAKING LAST ENTRY DATE AND TIME OF LAST ENTRY ~ , ~ o : a-d D!{TE OF ONTRACT TO RENT BOX ' NUMBER OF BOX 1 TITLE UNDER, HIC OX IS REGISTERED NAME AND ADDRESS OF PERSON(S) HAVING ACCESS TO BOX a. N S EET ADDRESS: '1 ~~-~. r~f~ rc~( .ice CITY: , STATE: ZIP CODE: 71P ~ ~~ ~ c S ~.~'~ -('~} NAME AND TITLE OF EMPLOYEE AKIN THE INVENTORY 1'x'1-. WAS A WILL IN~THE BOX? ^ YES ~f NO 'If yes, a. Date of will: b. Name and address of personal representative, if named in the will NAME: c. Name and address of attorney, if any NAME: STREET ADDRESS: L 48500041046 CITY STATE: ZIP CODE: 48500041046 J b. ME: STREET A~~DD~R._E~~ i~ I ~ f~C.:l CITY':lY ~~ Y STATE: ZIP CODE: STATE: ZIP CODE ~1~-- (1 or ~ REV-485 EX a7E'1f-"G ®E~Oa7~ 1 ®®~ ~Itl ~/ Ci~~®~ i Page ~ of_ ~ INSTRUCTIONS (1) Cash: Report total only. (2) Stocks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are to be designated by name of company, certificate number, date of certificate, name in which stock is registered, and number of shares and class of stock. (3) Obligations of U.S. Government: Number of items, date of issue, face value, names in which registered and type of ownership, i.e., jointly held, payable on death, etc. (4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds) (5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book, name of bank and branch, and balance. (6) Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible. (7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as fully as possible. (8) All other contents. (9) Return completed form to: DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG, PA-17128-0601 ITEM - ITEM DESCRIPTION +LJ' ft's-cG,a~'~ •"i of , T1v.`r'.'~i L ~y n ~~ ~' • ~ f ~ G r~C Ss s- - ~-` i 7~Y Lstr~ I L.~e.v-ter- Cep,. ,8~ ~ r•,~ r-l y ~'~~i~m~'f L~.,•~t~;C ~a~, ~S,-,`s ~d T 9~la.r-r 1 ~`.- f/1 ~.r-t~ ~ c~2 ~~-~ ~ t~ b, s~~~ ~ I CERTIFY.UNDER PENALTY OF PERJURY-THAT THE ABOVE RECORD IS--PERSON-RECEIVING-COPY-OF--- - --- -- - CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. SAFE OSIT BOX INVE ORY: SIG SIGN U P IN NAME ~R~a J,~~,~ RI A E AN K A PRIATE BOX BELOW: ~A~ ~. ~p,~,s PRINT TITLE /~'f"'~m r ~"~ Y DATE / /~¢3/,~ !!!!!! CHECK APPROPRIATE BOX: dExecutor(trix) ~ Administrator(trix) ~ Estate Representative ~ Joint owner of safe deposit boz NOTE: Attach additional 8'(~" x 11" sheet(s) if necessary or use duplicates of this page of form. The Department is authorized by law, 42 U.S.C. §405 (c)(2)(C)(i), to require disclosure of Social Security numbers in connection with administering state tax laws. The Department uses the Social Security number to identify the decedent and personal representatives of the estate. The Commonwealth may also use the information in exchange of tax information agreements with Federal and local taxing authorities. The state law prohibits the Commonwealth's personnel from disclosing confidential tax information except for official purposes 0 0 ~ p 0 ~ o g ~b ~ 0 0 0 0 m n Ifi I~' d. ° 0 d~ ° ''' u ~ °a '~ ° p z ^~ 3 3A z~ x M Orn Z~ m m m ~ ~ ~ ~~ ~ m ' ` ~ '` ~~ ~ Rt ~ `~ A m N N ~ ~ ~ G N N~ A N N / ~. p• y 7 n ,F fR ~ 3 ~ ~ ail ~ ~ Z ~ e~ ~ a ~ m ~ ~ ~ ~ L° 1° ~ ~ P ~ ~ n n n ~ ~ ~ ~ ~ ~' ~ ~ ~ W z ~ ~` ~ ~ N ~ -~ m i- ~ w m xv D O ~ W O m X p o m ~ o v ~ ~ ~ N C m s o ~ ~ m z ~,. D V o~ - N 00 o rn o n D m ~ m z C m ~~ V/ H O Zn rn~ Z~ --I ~ ~~ ~Z ~v ~' w ~ ~ ~ ~ ~ ` J ~ W W ~ ~ W ~ ~ ~ ~ ' 1 ~ ~ vi ~ ~ ~ m rn -~ D -~ O (V 'Lf ~' .. 1' ^ ~ •~O ~ ~ ~ b _ ~ ~ _ ~ ~ 1N v w 0- _ ~ C m rD- cn z 3 i - m C ~ ~p \ [~ \ y~~ \ ~ °~ ~ ~ ~ h 1R >~ ~ ~ h ° ~ ~ ~Q "~ ~ w a1 ~ ~ D rn n ~ m ~ O T t n O ~ yr w z z ~ o ° z °~ ~ ~ d ~ w ~ Q ~ ~ c ~ ~ ~ , ; - --- - a _ ~ J o -- ~ ~ _ ~ ~ ~ '~ •~ n T_ ~ V ~ ~ O ~ -0 1 I- m d ~ ~ ~ - c1 ~ ~ ~ ~ ~ ~ r• ~ z W ~ _ 4. ~-~ `" j ! ~ ~• ~. ~ ~ ~ ~ ~ ~ ~ Yr , „' •nZ. 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VI H O Z e ~~ rn~ Z~ -~ GO OO ~v ~ ~ rn -~ 00 rn D w D Z rn m c ~ cn 3 O in n rn ~' m C v O p d z n ~ U ~ z 3 •, c ,~ ~ ~ ~ o J ~ ~ 4 _ ,..~ ~ 1 D ~ ~ ~ ~ ti ~ L.' m ll~ ~ h~ 1 calculated Value of Your Paper Savings Bonds} Calculated Value of Your Paper Savings Bond(s) Page 1 of 2 Calculator Results for Redemption Date 10/2010 Total Price Total Value Total Interest YTD Interest 7 825.00 29 425.76 21 600.76 924.38 Bonds: 1-86 of 86 Serial # 'Series Denom Issue Next Final Issue Interest Interest Value Date Accrual Maturity Price Rate 815951752' EE $200 : 04/1984 04/2011_ : 04/2014: $.100.001 $301 60', 4.00%: $401.60; 814885029. EE $200 .11/1983 11/2010 : 11/2013 $100 00 ~ $301 60 ~ _ 4.00%_ $401.60: 814885030 _ EE $200 ;11/1983 11/2010 ,_11/2013 $100 00! $301 60 4.00%. $401.60; 814885032. " ". ~ EE _ ' $200 ;12/1983 12/2010 _ 12/2013 $100 00 $301 60: 4 00% ,_ $401 60 R15140062 " "." EE $200 : 12/1983 :_12/2010 12/2013 $100 00 . $301 60 4 00%_ ~ $401 60_ 815140068: EE _ $200 :12/1983 12/2010 12/2013 $100 00 $301 60 o 4.00 /o: ~ ~~-~ ~ " $401.60: 815140069. EE $200 01/1984 01/2011 01/2014 $100 00 $301.60: 4.0 0% $401.60:' 815147221 EE $200 01/1984 01/2011 :01/2014. $100.00; $301.60 . ~ ~o "~ 4.00 /o "" $401.60: 815147224. EE $200 ; 02/1984 02/2011 02/2014 $100.00! $301 60 4 00% :$401.60_ 815951734. EE $200 02/1984 , 02/2011 i 02/2014 $100 00 $301.60 _ 4.00% $401.60 815951738 EE $200 03/1984 .03/2011 03/2014 $100 00," $301 60: 4 00% $401.60. 815951743 __ EE _.. $200 03/1984 :03/2011: 03/2014 $,100 00^ " $301 60 _ 4 00% $401 60; 815951747 EE $200. ;04/1984 :04/2011 : 04/2014 $_100 00_ $301 60 4 00% . $401.60: L155253552 EE $50 j 04/1984 ,04/2011: 04/2014 $25 00 $75 40_ , 4 00% $100 40; 837843120,_ EE $200 .03/1987 :03/2011 03/2017 $100 00", $220 64 4 00% $320.64' 837842110 EE $200 :03/1987 03/2011; 03/2017 $100.00; $220.64 4 00% _ $320.64; 837843100' EE $200 02/1987 02/2011' .02/2017 $100.00 $220.64 4.00% $320.64 ; 837843095 EE $200 02/1987 02/2011 02/2017. $100 00 $220.64: 4 00% _ $320.64: 837843091 EE $200: 01/1987 01/2011. 01/2017 $100.00, $220.64 4.00% "' $320 64,: 837280689 EE $200: 12/1986 12/2010. 12/2016 $100 00 $220 64 4 00% $320 64r 837280676_ EE $200, 12/1986 12/2010; 12/2016 $100 00, $220 64 4 00% " $320 64 837280671 EE $200: 11/1986; 11/2010: 11/2016, $100 00, $220 64 4 00% $320 64 834427986 EE $200 11/1986. 11/2010. 11/2016 $100.00' $220.64' 4.00% ~ "" $320.64: 834427968; EE $200 10/1986, 04/2011. 10/20,16 $100.00_ .$263.76 _ 4.00% $363.76! 834402656 EE $200. 10/1986; 04/2011; 10/2016 $100.00_ $263.76 4.00% $363J6: 834402653 EE „ $2fl0 lOf 1986. 04/2011 10/2016 $100 00 _ $263 76' . 4 00% $363 76 834402643; _EE $200'. 09/1986 03/2011. 09/2016_ $100 00 $263 76 4 00% $363 76 831842976: EE $200. 09/1986, 03/2011. 09/2016 $100 00_ $263.76' _ 4 00% $363 76: 831842968 EE $200' 08/1986 02/2011: 08/2016 $100.00 $263.76. 4 00% $363 76. 830780143 EE $200 08/1986 02/2Q11 08/2016_ $,1,00.00: $263.76: 4 00% $363 76 830780137. EE $200. 07/1986 01/2011: 07/2016 $100.00 $263.76: " 4.00% $3 63.76 830529286' EE $200, 07/1986. 01/2011: 07/2016 - 100.00 $ $263.76: ° 4 00% __ $363J6 830529279 EE $200 06/1986.., 12/2010. 06/2016: $100.00! _ $263.76; __ _ 4 00%; $363 76_ 830529272 EE $200 06/1986, 12/2010 06/2016, $100.00 $263.76 4.00% $363.76' 0130759362 EE $100 01/1987; 01/2011 01/2017 $50.00; _ $110.32: . 4 00% .. "__. $160.32 0130759361 EE $100: 01/1987 01/2011 01/2017 $50.00. $110.32: 4.00% $160.32 L260970879 ' EE $50. 04/1986 04/2011: 04/2016•. $25.00: $67,74: _ _ 4.00% , $92 74 L260970877 EE $50. 04/1986 04/2011 04/2016 $25.00. $67.74' 4.00% $92J4' L260970878 EE $50' 04/1986, 04/2011. 04/2016 ~ $25.00 $67.74 4.00% $92J4: L260970876 EE $50._ 04/1986: 04/2011. 04/2016_ $25.00 $67.74 4.00% $92 74, 111605586- -" _ EE $100; 04/1986 04/2011" 04/2016; $50.00_ $135.48_ 4 00% $185.48: 111605585 EE $100: 04/1986; 04/2011 04/2016_ $50.00; . $135 48 _ 4 00% $185 48 830529255: EE $200 05/1986 11/2010 05/2016: $100.00 $263.76_ 4 00% $363J6 830529259 EE $200' 05/1986 11/2010. 05/2016: $100 00 $263.76: "4 00% $363 76 830529266- EE $200 05/1986 11/2010: 05/2016 $100.00._ $263.76' " 4.00% $363.76: http://www.treasurydirect.govBC/SBCPrice 12/27/2010 calculated Value of Your Paper Savings Bond(s) Page 2 of 2 8029190176: EE --- -- - 8028782788 EE $200.03/1986 03/2011;03/2016: 100.00- $200 03/1986 03/2011 0 ' "- -" - - `--- "~-$270 96 4.00%_ 70 96; 8028782783 EE 8028782775 - EE_ . 3/2016: $200 02/1986.02/2011; 02 2016 ~__ /- -,$100 00, $100 00 $270 96 $270 96 4 00% - --o "_ " ,_ . $370.96: 8028782758 EE .- - ----. $200 02/1986.02/2011: 02/2016: - __ ;_...$200 01/1986 01/2011 01 $100 00 _ .__.,_$270.96 4 00 /o 4 00% $370.96_ $370.96 R027432290 EE , /2016, -, $200.01/1986.:01 2011.01 2016: / 100 00', -_,$270.96 - ,_„ 4 00%: _.. $370.96; _821994872 EE 821994882. EE ~ • , ~- $200: 06/1985. 12/2010: 06/2015: 20 $100 00:- $100.00: " ..-$270 96_ $278 40; --- 4.00%_ - a 4 O _ _ „$370.96.;. 822206467 EE -_. $ 0.07/1985 01/2011 07/2015 -- -~ - - .:.-- $200;07/1985 01/2011 07 100.00: ~--.. _ _ -$278.40: Ooo: ___ 4.00 /0 $378.40 378 40 : X 822206473 EE 82 ; /2015 $200108/1985 02/2011 08/20 15 _ 100.00; $100 00 _2.7.8 40: $ 4.00% . - 378 4 0; ~•- 2206479 EE 824025881 EE . . _ $200; 08/1985 02/2011' 08/2015 : . .: __ $100.00_ $?78.40 $278 40 ° 4 00 /o . _.$378 40 __. .. _ _. .824025884 _ EE ---- _ $2.00; 09/19.85: 03/2011.09 2015 •-----/~ -~- --._ , $200:09/1985 03/2011 0 .,,._ .... $-100 00... _.,_ .. $278 40 _ 4 00% 4.00% $378 40 $378 40 824392989: EE 824392995 EE / , : 9 2015 $200: 10/1985 04/2011' 10/2015; 100.00; $- - $100 00 _ $278.40 $278 40 -. "" ., _ 4.OD%, . . . . - $378.40._ - ' ,. ; - ..824393004,_ "" EE ,___$200; 10/1985 04/20.11. 10/2015 $200:10/1985 04/2011 10 5 _ 100.00 $~ -' -_ . . -$278:40: 4.00% --- ~_ 4.00% __$.378 40 $378 40 8027081444' EE 802708144 E ; /201 $200111/198511/2010: 11/2015' -.$100.00: $100 00: $27,8 40 _ 4.00%: . , $378 40 9 E 8027081462: EE ----. __. -. $200:11/1985 11/201011/2015: ' . ... ,_ $100.00: $270 96 _ $270 96 4.00%: %' $370 96: 818555407 EE $200 12/1985: 12/2010. 12/2015' $200; 10/1984 04/2011 10 - _ $100.00; . ~ _ $270 96 _4 00 4 00%? $370.96' ~~ $370 96 818555411 EE R18555415' EE . /2014_ $200. 11/1984 11/2010 11/2014: $100.00, 100 00 ~ - ~ $293 68_ $286 00: - 4.00%' ...- - 4 ° _. $393 68: 818555418 . EE ..$200'11/1984 11/2010.11/2014 $200 11/1984 11/2010 11 . ..... ... ...... $100 00 $286 00~ 00 /o_ 4.00% 3. 86 00. -- -- $ - $386 00 _ 8185554.26 EE ;. : /2014 _ - $200 12/1984 12/2010 12/2014 $10.0 00 ~~ $286 00 - 4 00%:' , $386 00' 818889140 EE 818889148 EE : $200: 12/1984' 12/2010: 12 2014 - -/ 100 0 $ ~- $100.00_ $286.00 $286 00 4 00% _ ,,.$3.86.00: ~ : 818889155 EE --- ,_ $200 01/1985.01/2011'01/20151 $200: 01/1985 01/2011 _ .. $100 00 $?86 00 f 4 00%; 4 00% $386 00_ $386 00 _-818889160 EE . ._.- 81922763 , 01/20151 - _.,$200; 02/1985, 02/2011 02/2015. 100 00. $_ . - - -.-- $100 00 - $286.00 ` -- - 4 00%: - • -- .-- $386 00: ~" '" ._ 2 EE - - - R19664272 EE - -- - $200.02/1985; 02/2011. 02/2015: _ $200 03/1985;03/2011 03/2015: . $100.00 - $286.00 $286.00 4.00% 4.00%: 386.00 $386.00 819227639 EE 819664279 EE . _ .- _ - _$200 03/1985;03/2011:03/2015' $100.00 -- __ $100.00 . $286.00 4 00%, --- $286 0 ` °--• - --~- $386 00 -- 819664282 EE _ $200 04/1985 04/2011. 04/2015 - - $200:04/1985 04/2011 0 ;. $100.00 _ .. . 0 4.00% - - $286.00_ 4.00 /o ° _$386 00' ' $386 00: ,822007039 EE .--._... _ -_ 822007037 - .. 4/2015; __$200.05/1985.11/2010 05/2015 $1.00.00.. 100 00 . $286.00 4.00%- - - . - $386.00: EE .822007034, EE _ -_. 200'_0.5/1985:11/2010 05/2015.' $200 05/1985 11/2010 05/2015 . ;.._- $100.00: $278.40_ 4.00% _ $278.40: 4.00% $378 40 ` $378.40' 819664290 EE 038024532 - EE , - $200 06/1985; 12/2010 06/2015 $100.,00 $100.00- $278.40 4 40 $278 .00% ~ ~"--- "~•-•~"" $378,40' 038024538 EE $100 01/1983 01/2011 01/2013: $100 01/1983.01/20 11 0 - - - $50.00' : 4.00%: $203.92 4.00% $378 40 $253 92I 038024549: EE : , 1/2013. $100 02/1983! 02/2011 02/2013 - .$50.00; _ _ $203.92 4.00% $253.92 038024557 EE - . $100 02/1983; 02/2011 02/2013 ~ $50.00. _ _ 50 00 $203.92 4 - 20 _ .00% __ - _ _ $253 92, .--~ Totals for 86 Bonds: 7 . ,; - ..- 825.00' 21 3.92,- 4 $ 600 76' ._0.0%- - - $253 92'. -- . 29,425.76: Notes NI -Not Issued NE Not eligible for payment P5 Includes 3 month interest penalty _ MA Matured and not earnin interest ~ ~tP ~ //~'ww. treasury direct. govB C/SB CPrice Heilman, Dawn From: DATE OF DEATH REQUESTS [ERNABX4@mtb.com] Sent: Monday, December 13, 2010 9:56 AM To: MARCIE MCCARDELL Subject: Re: prod -Date of Death Request Per you request, please find below the date of death values for Ronald Davis, SS#177-424-865. ACCOUNT NUMBER BALANCE ACCRUED INTEREST TOTAL 1 1345877 53,427.30 .48 53,427.78 2 15004201994371 20 367 16 50 20 36 , . . , 7.66 Let me know if there's anything else you need :-) Thanks, Tammy Spencer Records Management /DOD Unit M&T Bank- "Understanding what's important." »> <MMCCARDELLCa~,mtb.com> 11/26/2010 3:07 PM »> Account Information Date of death: 10/24/2010 Account Number: 1345877 Product Type: Deposit Account Account Number: 15004201994371 Product Type: Deposit Account A1~tl -1~r~~~ Ron ~ c Additional Information These accounts were in joint name with Doris I Davis and need a dod balance. thank you i Request Details Deliver to: Other Delivery Options: Mail Mailing Address Name: Tucker Arensberg P.C. c/o Aaron Jackson Address: 111 N Front Street Address: PO Box 889 City: Harrisburg State: PA Zip: 17108 z