Loading...
HomeMy WebLinkAbout11-30-11 (2)1505611180 J REV-1500 ~ I°2_,,, IFi> OFFICIAL USE ONLY PA Department of Revenue Pennsylvania oer~nn.Er,.oFr~veru,e County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN _ PO BOX 280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ~ - ~ U t~ Si ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 202-20-6417 05102011 08011928 Decedents Last Name Suffix Decedent's First Name MI STICKEL WILLIAM C (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW © 1. Original Return 0 2. Supplemental Return ~ 3. Remainder Return (Date of Death Prior to 12-13-62) Q 4. Limited Estate 0 4a. Future Interest Compromise (date of 0 5. Federal Estate Tax Return Required death after 12-12-62) ® 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 1 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) Q 9. Litigation Proceeds Received 0 10. Spousal Poverty Credit (Date of Death 0 11. Election to Tax under Sec. 9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number ROBERT G FREY 7172435838 First Line of Address 5 SOUTH HANOVER ST Second Line of Address Ciiy or Post Office CARLISLE State ZIP Code PA 17013 Correspondent's e-mail address: R F R E Y a1 F R E Y T I L E Y. C O M REGISTER O~,F WILLS USE QM~IdY ~: -~ `- O --- r, -,--n '-~ _ ~ . ~ ~;T ~.-~ r:. - ..., ~~ .-~~'- j' i:1 N EFfILED _. •'~ Under penalties of perjury, I declare that 1 have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and corn lete. Declaration of re aver other than the nonal re resentative is based on all information of which re aver has an knowled e. SIGNATURE mF P N RESP SIBL OR FILING RETURN BqATE 909 FO ES OAD C RLISLE PA 17013 SiGNATU E F REPA E O ERT N REP ESENTATIVE DATE ADDRESS 5 SOUTH HANOVER STREET, A LISLE_ PA 17013 PLEASE USE ORIGINAL FORM ONLY 1505611180 Side 1 150561118D J c,,' ~~ 1505611280 REV-1500 EX (FI) Decedent's Social Security Number Decedent's Name: WILLIAM C STICKEL 202-2D-6417 RECAPITULATION 1. Real Estate (Schedule A) ....................................... .. 1. N 0 N E 2. Stocks and Bonds (Schedule B) .................................. .. 2. N 0 N E 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . .. 3. N 0 N E 4. Mortgages and Notes Receivable (Schedule D) ...................... .. 4. N 0 N E 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) .. .. 5. 1$ O O . O 0 6. Jointly Owned Property (Schedule F) Separate Billing Requested ..... .. 6. $ 6 6 2 9 . 9 5 7. Inter-Vivos Transfers 8~ Miscellaneous Non-Probate Property (Schedule G) OSeparate Billing Requested ..... .. 7, 4 3 0 5 6. 0 0 8. Total Gross Assets (total Lines 1 through 7) ....................... ... 8. 10118 5 . 9 5 9. Funeral Expenses and Administrative Costs (Schedule H) .............. .. 9. 3891.00 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) .......... .. 10. 72.00 11. Total Deductions (total Lines 9 and 10) ........................... .. 11. 3 9 6 3 . 0 0 12. Net Value of Estate (Line 8 minus Line 11) ......................... .. 12. 9 7 2 2 2 . 9 5 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .................... .. 13. 0 . 0 O 14. Net Value Subject to Tax (Line 12 minus Line 13) .................... .. 14. 9 7 2 2 2 . 9 5 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 15. 0.0 0 16. Amount of Line 14 taxable at lineal rate x .0 4 5 16. 0. 0 0 17. Amount of Line 14 taxable at sibling rate x .12 6 4 815.3 0 17. 7 7 7 7. 8 4 18. Amount of Line 14 taxable at collateral rate x .15 3 2 4 0 7.6 5 18. 4 8 61.15 1s. Tax DUE ..................................................... .. 1s. 12638.99 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0 Side 2 L 1505611280 1505611280 J REV-1500 EX (FI) Page 3 Decedent's Complete Address: 2111-0578 File Number 202-20-6417 DECEDENTS NAME WILLIAM C STICKEL STREET ADDRESS 923 NORTH WEST ST CITY CARLISLE STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 11750.00 587.50 Total Credits (A + B ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in box on Page 2, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (1) 12638.99 (2) 12337.50 (3) (4) 0.00 (5) 301.49 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 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 ................................................................................................................... ....... ^ i'fal d. receive the promise for life of either payments, benefds or care? ............................................................ ...... ^ 2. If death occurred after Dec. 12, 1982, did decedent Vansfer property within one year of death without receiving adequate consideration? .................................................................................................... ...... ^ 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? .............................................................................................................. ...... ~ ^ 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 is 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 disGosure 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(ax1.2)]. • 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(a)(1)j. • 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, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1508 Ex+(11-10) SCHEDULE E Pennsylvania CASH, BANK DEPOSITS, ~ MISC. NHER N ETDnx~URN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: William C Stickel 2111-0578 Include the proceeds of litigation and the date the proceeds were received by the estate. If more space is needed, use additional sheets of paper of the same size. REV-1509 EX+ (01-10) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF: FIt.E numet:K: William C Stickel 2111-0578 If an asset became jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A. DONALD C. STICKEL (923 NORTH WEST STREET (BROTHER CARLISLE, PA 17013 B. BETTY ANDREWS 1909 Forbes Road (SISTER CARLISLE, PA 17013 C. 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 ASSET % OF DECEDENT INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST SERIES EE SAVINGS BONDS ~ A 95,833.90 50.00% 47,916.95 ORRSTOWN BANK ACCOUNT 10601999 2. B 319/01 17,426.00 50.00% 8,713.00 TOTAL (Also enter on Line 6, Recapitulation) I S 56,629.95 If more space is needed, use additional sheets of paper of the same size. REV-1510 Ex+(08-os> SCHEDULE G Pennsylvania INTER-VIVOS TRANSFERS & DEPARTMENT OF REVENUE INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER William C Stickel 2111-0578 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR REUITIONSHIP TO DECEDENT AND THE DATE OF TRANSFER.ATTACHACOPVOFTHEDEEDFDRREALESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION °`~P1~I TAXABLE VALUE 1. MetLife Annuity 41,556 100.00% 41,556 2. Prudential Annuity 1,500 100.00% 1,500 TOTAL (Also enter on Line 7, Recapitulation) S~ 43,056 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX + (10-09) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER William C Stickel 2111-0578 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Westminister Cemetery, Foundation 273 2. Carlisle Memorial Service, Veteran Marker 190 B. 1 ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City Year(s) Commission Paid: 2. Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant 4. 5. 6. 7. 8. SVeet Address City State Relationship of Claimant to Decedent Probate Fees: Accountant Fees: Tax Return Preparer Fees: Liberty Mutual, automobile insurance Advertising expenses to the Sentinel and Cumberland Law Journal TOTAL (Also enter on Line 9, Re If more space is needed, use additional sheets of paper of the same size. State ZIP ZIP 2,750 157 267 254 S 3.891 REV-1512 EX+ (12-08) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF FILE NUMBER William C Stickel 2111-0578 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. REV-1513 EX+ (01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: William r: Ctirkal 2111-0578 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] Donald Stickel 1 ~ 923 North West Street, Carlisle, PA 17013 Brother 1 /3 of Residue 2. Betty S. Andrews 909 Forbes Road, Carlisle, PA 17013 Sister 1/3 of Residue Krista Upplinger 3. 146 F Street, Carlisle, PA 17013 Niece 1/3 of Residue ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUG H 18 OF REV-1500 COVER SH EET, AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. If more space is needed, use additional sheets of paper of the same size. June 10, 2011 Robert G. Frey Frey & Tiley Attorneys-At-Law 5 South Hanover Street Carlisle, PA 17013 Fax: 243-6441 Re: Estate of William C. Stickel Social Security Number 202-20-6417 Date of Death 5/10/11 IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD THE FOLLOWING ACCOUNT WITH ORRSTOWN BANK: CHECKING ACCOUNT Account No.- Account Type- Date Opened- Joint Account (name/date)- n_,.. Accrued Interest- 106001999 50+ Interest Checking 3/09101. Betty S. Andrews-3/09/01 $0.03 Best Regards, w ~ ~ , Ji 1 R. Worthington Deposit Processing Clerk 2695 Philadelphia Avenue Chambersburg, PA 17201 1.888.ORRSTOWN www a~rrst~w-n.cosa~ Vl{K~'1'UWN BANK A Tradition of Excellence MetLife Investors USA P.O. Box 14593 Des Moines IA 50306-3593 MetLife July 20, 2011 BETTY ANDREWS 909 FpRBES ROAD CARLISLE PA i 7013 __ RE-. OWNER WILLIAM STICKEL Dear Ms. Andrews: We processed a lump-sum distribt~ion representin the r . you under the above-referenced annuity. We are sending a check in the amount of $12,466,80 5 o you unbder Sepa~e The taxable portion of p ~ cover. withheld for federal tax~ur roceeds is $13,1352:Ipg. Due to your request for withholdin An IRS Form 1099-R will be mailed to you by Jan g' $13'21 was The Internal Revenue Service requires we furnish the date of death value ford 31 ~ 2012. Annuities (IRA) on which a death claim has been filed in case this value is needed for in purposes. In most cases, the executor/administrator of the decedent's estate ndividual Retirement death fair market value for income tax purposes. The date of death valuation will onl b Come tax income tax u wrtl not need the date of p rposes if one or more of the decedents IRAs contain nondeductible contributions and in addition, the decedent received an IRA distribution in the year of death. Y e necessary for This is to inform you that the value of the IRA contract as of the date of death, Ma 10 $41, 321.25. Y , 2011, waS If you have any questions, please contact your representative or call our Cus ___1_800-284-4.536 Monday th_gh Friday between 8:30 a.m. and 6:30 m. tourer Service Center at Sincerely, ----- p~ ' ~' ____ Elizabeth Theisen Sr. Annuity Representative -Post issue Processing MetLife Annuity Operations and Services 06/14/2011 Orrstown Bank Page: 1 Branch: 8 Savings Bond List Teller: 281 Serial Number Denomination Issue Date Value Interest C12721111EE $100 08/1980 $ 334.80 $284.80 C 12721112EE $100 08/1980 $ 334.80 $284.80 C 12721113EE $100 08/1980 $ 334.80 $284.80 C 12532076EE $100 08/1980 $ 334.80 $284.80 C1414962EE $100 06/1980 $ 334.80 $284.80 C 12640208EE $100 06/1980 $ 334.80 $284.80 C 12640212EE $100 06/ 1980 $ 334.80 $284.80 C 12640211 EE $100 06/ 1980 $ 334.80 $284.80 C 12640213EE $100 06/1980 $ 334.80 $284.80 C 142745014EE $100 08/ 1988 $ 154.08 $104.08 R54233065EE $200 10/1989 $ 296.16 $196.16 C 142745024EE $100 07/ 1988 $ 154.08 $104.08 C 142745031 EE $100 07/ 1988 $ 154.08 $104.08 R40021222EE $200 11/1987 $ 320.64 $220.64 R40965339EE $200 03/1988 $ 314.32 $214.32 C220650646EE $100 02/ 1990 $ 145.20 $95.20 C200144757EE $100 06/ 1989 $ 151.04 $101.04 C220650653EE $100 03/ 1990 $ 145.20 $95.20 C 106482834EE $ 100 03/ 1986 $ 189.20 $139.20 C 106482833EE $ 100 03/1986 $ 189.20 $139.20 C105441483EE $ 100 01/1986 $ 189.20 $139.20 C 106482829EE $ 100 02/ 1986 $ 189.20 $139.20 C 106482831 EE $ 100 02/ 1986 $ 189.20 $139.20 C219635123EE $ 100 08/1989 $ 148.08 $98.08 R54233066EE $ 200 10/1989 $ 296.16 $196.16 R041736555EE $ 200 12/1988 $ 308.16 $208.16 C 12532110EE $ 100 10/ 1980 $ 334.80 $284.80 C 106482835EE $ 100 03/ 1986 $ 189.20 $139.20 R029190535EE $ 200 04/1986 $ 378.40 $278.40 R029190539EE $ 200 07/1986 $ 370.96 $270.96 C 117847380EE $ 100 07/1986 $ 185.48 $ 135.48 C 117847381 EE $ 100 08/1986 $ 185.48 $135.48 R029190537EE $ 200 06/1986 $ 378.40 $278.40 R029190540EE $ 200 03/1986 $ 378.40 $278.40 C 142745019EE $ 100 06/ 1988 $ 157.16 $ 107.16 C 136292433EE $ 100 04/1988 $ 157.16 $ 107.16 C 136292448EE $ 100 06/ 1988 $ 157.16 $ 107.16 R40965343EE $ 200 04/1988 $ 314.32 $ 214.32 C 106482836EE $ 100 03/1986 $ 189.20 $ 139.20 R40021223EE $ 200 11/1987 $ 320.64 $ 220.64 R40021215EE $ 200 10/1987 $ 320.64 $ 220.64 C 133519309EE $ 100 12/ 1987 $ 160.32 $ 110.32 C 136292420EE $ 100 O 1 / 1988 $ 157.16 $ 107.16 C 136292430EE $ 100 O 1 / 1988 $ 157.16 $ 107.16 R40021220EE $ 200 10/1987 $ 320.64 $ 220.64 R40965341EE $ 200 04/1986 $ 378.40 $ 278.40 C 133519285EE $ 100 08/ 1987 $ 160.32 $ 110.32 C 133519291 EE $ 100 09/1987 $ 160.32 $ 110.32 C133519287EE $ 100 08/1987 $ 160.32 $ 110.32 N/E =Not yet eligible for redemption 06/14/2011 Orrstown Bank Page: 2 Branch: 8 Savings Bond List Teller: 281 Serial Number Denomination Issue Date Value Interest R40021224EE $200 11/1987 $320.64 $220.64 C 112132972EE $100 06/ 1986 $189.20 $139.20 C 117847376EE $100 07/ 1986 $185.48 $135.48 84002 1 2 1 1 EE $200 10/1987 $320.64 $ 220.64 C 133519268EE $100 06/ 1987 $163.52 $ 113.52 C 136292411 EE $100 OS/ 1987 $163.52 $ 113.52 C 136292412EE $100 OS/ 1987 $163.52 $ 113.52 C 133519320EE $100 07/1987 $160.32 $ 110.32 R40021213EE $200 10/1987 $320.64 $ 220.64 R40021212EE $200 10/1987 $320.64 $ 220.64 C 133519292EE $100 09/ 1987 $160.32 $ 110.32 R052509384EE $200 12/1988 $308.16 $ 208.16 R052509382EE $200 12/1988 $308.16 $ 208.16 R40965342EE $200 04/1988 $314.32 $ 214.32 R041736542EE $200 09/1988 $308.16 $ 208.16 L362174702EE $50 05/1988 $78.58 $53.58 L362174701EE $50 05/1988 $78.58 $53.58 R046517676EE $200 12/1988 $308.16 $208.16 R046517677EE $ 200 01/1989 $302.08 $202.08 R041736556EE $ 200 12/1988 $308.16 $208.16 R40965336EE $ 200 01/1988 $314.32 $214.32 R40965340EE $ 200 03/1988 $314.32 $214.32 C 136292437EE $ 100 04/ 1988 $157.16 $107.16 C 136292441 EE $ 100 OS/ 1988 $157.16 $107.16 C 136292445EE $ 100 06/1988 $157.16 $107.16 C 136292439EE $ 100 05/1988 $157.16 $107.16 840021221 EE $ 200 10/1987 $ 320.64 $220.64 C219635132EE $ 100 08/1989 $ 148.08 $98.08 R054233068EE $ 200 10/1989 $ 296.16 $196.16 8057587481 EE $ 200 O 1 / 1990 $ 290.40 $190.40 R041736545EE $ 200 10/1987 $ 320.64 $220.64 R052509383EE $ 200 12/1988 $ 308.16 $208.16 R041736543EE $ 200 10/1988 $ 308.16 $208.16 R041736536EE $ 200 07/1988 $ 308.16 $208.16 R40021216EE $ 200 10/1987 $ 320.64 $220.64 R054233067EE $ 200 10/1989 $ 296.16 $196.16 C219635106EE $ 100 09/1989 $ 148.08 $98.08 C219635118EE $ 100 09/1989 $ 148.08 $98.08 C219635104EE $ 100 09/ 1989 $ 148.08 $98.08 0200144781 EE $ 100 07/ 1989 $ 148.08 $98 08 R054233086EE $ 200 07/ 1989 $ 296.16 . $196 16 R054233087EE $ 200 07/1989 $ 296.16 . $196 16 C174781419EE $ 100 11/1988 $ 154.08 . $104 08 R041736554EE $ 200 ].0/1988 $ 308.16 . $208 16 C 142745043EE $ 100 10/ 1988 $ 154.08 . $104 08 R041736553EE $ 200 10/1988 $ 308.16 . $208 16 C 186944207EE $ 100 12/1988 $ 154.08 . $104 08 C 174781416EE $ 100 10/1988 $ 154.08 . $104 08 R40021214EE $ 200 10/1987 $ 320.64 . $220.64 N/E =Not yet eligible for redemption 06/14/2811 Orrstown Bank Pa e: 3 Branch: 8 Savings Bond List Tel~er: 281 Serial Number Denomi nation Issue Date Value I nterest C 171270855EE $ 100 03/ 1989 $ 151.04 $ 101.04 R40965344EE $ 200 04/1988 $ 314.32 $ 214.32 065173041 EE $ 100 04/1984 $ 204.80 $ 154.80 R14878624EE $ 200 04/1984 $ 409.60 $ 309.60 R041736549EE $ 200 09/1988 $ 308.16 $ 208.16 C 171270857EE $ 100 03/ 1989 $ 151.04 $ 101.04 C65257249EE $ 100 06/ 1984 $ 204.80 $ 154.80 R14878626EE $ 200 04/1984 $ 409.60 $ 309.60 065101031 EE $ 100 O 1 / 1984 $ 204.80 $ 154.80 R14878618EE $ 200 04/1984 $ 409.60 $ 309.60 C65010045EE $ 100 02/1984 $ 204.80 $ 154.80 R14878620EE $ 200 02/1984 $ 409.60 $ 309.60 R18063577EE $ 200 06/1984 $ 409.60 $ 309.60 R18063580EE $ 200 09/1984 $ 401.60 $ 301.60 C65257267EE $ 100 09/1984 $ 200.80 $ 150.80 R14878619EE $ 200 02/1984 $ 409.60 $ 309.60 R14878623EE $ 200 04/1984 $ 409.60 $ 309.60 C65173040EE $ 100 04/ 1984 $ 204.80 $ 154.80 R14878622EE $ 200 04/1984 $ 409.60 $ 309.60 C65173036EE $ 100 04/ 1984 $ 204.80 $154.80 R14878621EE $ 200 03/1984 $409.60 $309.60 C72082246EE $ 100 10/1984 $200.80 $150.80 R18550436EE $ 200 10/1984 $401.60 $301.60 C65257277EE $100 10/ 1984 $200.80 $150.80 C65257264EE $100 08/ 1984 $200.80 $150.80 R18063578EE $200 07/1984 $401.60 $301.60 065257251 EE $100 06/ 1984 $204.80 $154.80 R11004403EE $200 06/1988 $314.32 $214.32 R11004401EE $200 04/1983 $440.96 $340.96 C65257265EE $100 08/1984 $200.80 $150.80 R18063579EE $200 07/1984 $401.60 $301.60 R14878617EE $200 12/1983 $417.76 $317.76 C48904777EE $100 06/ 1983 $213.08 $163.08 C48826023EE $100 06/1983 $213.08 $163.08 C48826017EE $100 05/1983 $213.08 $163.08 R11004406EE $200 08/1983 $417.76 $317.76 C50206725EE $100 10/1983 $208.88 $158.88 811004411 EE $200 10/1983 $417.76 $317.76 C52575146EE $100 10/1983 $208.88 $158.88 R14878615EE $200 11/1983 $417.76 $317.76 R11004410EE $200 10/1983 $417.76 $317.76 C50206720EE $100 09/1983 $208.88 $158.88 R11004408EE $200 09/1983 $417.76 $317.76 C50206714EE $100 09/1983 $208.88 $158.88 R1738296EE $200 04/1980 $662.96 $562.96 C5573625EE $100 04/1980 $331.48 $281.48 C5573622EE $100 04/1980 $331.48 $281.48 C5573620EE $100 04/1980 $331.48 $281.48 R11004405EE $200 08/1983 $417.76 $317.76 N/E =Not yet eligible for redemption 06/14/2011 Orrstown Bank Pa e: 4 Branch: 8 Savings Bond List Tel~er: 281 Serial Number Denomi nation Issue Date Value I nterest C48904782EE $ 100 07/ 1983 $ 208.88 $ 158.88 C48904781EE $ 100 07/1983 $ 208.88 $ 158.88 C48904778EE $ 100 07/1983 $ 208.88 $ 158.88 R11004404EE $ 200 07/1983 $ 417.76 $ 317.76 R18892493EE $ 200 11/1984 $ 401.60 $ 301.60 C 125733369EE $ 100 03/ 1987 $ 163.52 $ 113.52 C 117847437EE $ 100 02/ 1987 $ 163.52 $ 113.52 C 133519265EE $ 100 04/1987 $ 163.52 $ 113.52 C 136292407EE $ 100 04/ 1987 $ 1.63.52 $ 113.52 R37825679EE $ 200 01/1987 $ 327.04 $ 227.04 C 17414756EE $ 100 04/ 1981 $ 306.88 $ 256.88 C23039257EE $ 100 07/1981 $ 288.04 $ 238.04 C23039249EE $ 100 06/1981 $ 293.80 $ 243.80 C42039932EE $ 100 03/1983 $ 220.48 $ 170.48 C42039928EE $ 100 03/1983 $ 220.48 $ 170.48 C42039926EE $ 100 03/ 1983 $ 220.48 $ 170.48 R11004399EE $ 200 02/1983 $ 518.00 $ 418.00 C75273235EE $ 100 12/1984 $ 200.80 $ 150.80 C75273234EE $ 100 12/ 1984 $ 200.80 $ 150.80 C75273233EE $ 100 12/1984 $ 200.80 $ 150.80 C75273228EE $ 100 11/1984 $ 200.80 $ 150.80 C17414753EE $ 100 03/1981 $ 306.88 $ 256.88 C 17414749EE $ 100 03/1981 $306.88 $ 256.88 C 17414748EE $ 100 02/1981 $306.88 $ 256.88 C 14701976EE $100 02/1981 $306.88 $ 256.88 R1738298EE $200 04/1981 $613.76 $513.76 C 18974212EE $100 05/1981 $293.80 $243.80 C18974204EE $100 04/1981 $306.88 $256.88 C18974202EE $100 04/1981 $306.88 $256.88 R6122532EE $200 12/1981 $576.08 $476.08 C24392282EE $100 1.2/1981 $288.04 $238.04 C24392277EE $100 10/1981 $288.04 $238.04 C23039272EE $100 10/1981 $288.04 $238.04 C23039270EE $100 09/1981 $288.04 $238.04 C23039268EE $100 09/1981 $288.04 $238.04 R6122526EE $200 09/1981 $576.08 $476.08 C17414755EE $100 03/1981 $306.88 $256.88 C24392286EE $100 01/1982 $282.36 $232.36 R6122533EE $200 01/1982 $564.72 $464.72 C24392285EE $100 01/1982 $282.36 $232.36 R11004398EE $200 02/1983 $518.00 $418.00 R10171633EE $200 06/1982 $564.72 $464.72 028 1 1 043 1 EE $100 05/1982 $282.36 $232.36 R8862677EE $200 05/1982 $564.72 $464.72 C28110433EE $100 06/1982 $282.36 $232.36 R8862678EE $200 05/1982 $564.72 $464.72 R10171634EE $200 06/1982 $564.72 $464.72 R10171635EE $200 07/1982 $553.68 $453.68 R10171636EE $200 07/1982 $553.68 $453.68 N/E =Not yet eligible for redemption 06/14/2011 Orrstown Bank Page: 5 Branch: 8 Savings Bond List Teller: 281 Serial Number Denomination Issue Date Value I nterest R10171637EE $200 08/1982 $553.68 $453.68 810171641 EE $200 08/1982 $553.68 $453.68 C24392288EE $100 02/1982 $282.36 $232.36 88862671 EE $200 02/1982 $564.72 $464.72 R8862674EE $200 03/1982 $564.72 $464.72 R8862672EE $200 02/1982 $564.72 $464.72 C24392290EE $100 03/1.982 $282.36 $232.36 R10171645EE $200 10/1982 $553.68 $453.68 R10171646EE $200 11/1982 $528.32 $428.32 R10171647EE $200 12/1982 $528.32 $428.32 C28452924EE $100 01/1983 $259.00 $209.00 R11004397EE $200 01/1983 $518.00 $418.00 C28452920EE $100 01/1983 $259.00 $209.00 093027431 EE $100 12/ 1985 $193.00 $143.00 C28110430EE $100 04/1982 $282.36 $232.36 R8862676EE $200 04/1982 $564.72 $464.72 R8862675EE $200 04/1982 $564.72 $464.72 C24392296EE $100 04/1982 $282.36 $232.36 R10171642EE $200 09/1982 $553.68 $453.68 R10171644EE $200 10/1982 $553.68 $453.68 R10171643EE $200 09/1982 $ 553.68 $453.68 C80225626EE $100 03/1985 $ 196.84 $146.84 R24039333EE $200 12/1985 $ 386.00 $286.00 C89675512EE $100 09/1985 $ 193.00 $143.00 089675511 EE $100 09/ 1984 $ 200.80 $ 150.80 C93027425EE $100 11 / 1985 $ 1.93.00 $ 143.00 C 105441473EE $100 12/1985 $ 193.00 $ 143.00 C89675514EE $100 10/ 1985 $ 193.00 $ 143.00 C89675495EE $100 08/ 1985 $ 193.00 $ 143 00 C 112132956EE $100 OS/ 1986 $ 189.20 $ . 139.20 C 112132953EE $100 05/1986 $ 189.20 $ 139.20 R8862673EE $200 03/1982 $ 564.72 $ 464.72 R19227809EE $200 12/1984 $ 401.60 $ 301.60 C72082259EE $100 11 /1984 $ 200.80 $ 150.80 C77354634EE $100 12/1984 $ 200.80 $ 150.80 K3177470EE $75 01/1985 $ 147.63 $ 110.13 K3177469EE $75 01/1985 $ 147.63 $ 110.13 R22209393EE $200 06/1985 $ 393.68 $ 293 68 C80225620EE $100 02/1985 $ 196.84 $ . 146 84 C80225623EE $100 02/1985 $ 196.84 $ . 146 84 089643031 EE $100 OS/ 1985 $ 196.84 $ . 146 84 C 106482828EE $100 O 1 / 1986 $ 189.20 $ . 139 20 R22209394EE $200 06/1985 $ 393.68 $ . 293 68 C80225627EE $100 03/1985 $ 196.84 $ . 146 84 C80225637EE $100 04/ 1985 $ 196.84 $ . 146 84 C89643045EE $100 07/ 1985 $ 193.00 $ . 143 00 C89675510EE $100 09/1985 $ 193.00 $ . 143 00 R22209396EE $200 07/1.985 $ 386.00 $ . 286 00 D8882286EE $500 12/1985 $ 965.00 $ . 715.00 N/E =Not yet eligible for redemption 06/14/2011 Branch: 8 Serial Number Denomi Orrstown Bank Savings Bond List nation Issue Date Pa Tel Value I e: 6 ler: 281 nterest C 105441474EE $ 100 12/ 1985 $ 193.00 $ 143.00 C 105441477EE $ 100 12/ 1985 $ 193.00 $ 143.00 C89675497EE $ 100 08/1985 $ 193.00 $ 143.00 D8882285EE $ 500 12/1985 $ 965.00 $ 715.00 C8967551 SEE $ 100 10/1985 $ 193.00 $ 143.00 C93027422EE $ 100 10/ 1985 $ 193.00 $ 143.00 C93027424EE $ 100 11 / 1985 $ 193.00 $ 143.00 C 105441470EE $ 100 12/ 1985 $ 193.00 $ 143.00 R22209395EE $ 200 07/1985 $ 386.00 $ 286.00 C89675496EE $ 100 07/ 1985 $ 193.00 $ 143.00 C 106482840EE $ 100 02/1986 $ 189.20 $ 139.20 C 105441486EE $ 100 O 1 / 1986 $ 189.20 $ 139.20 C 105441484EE $ 100 01/1986 $ 189.20 $ 139.20 C105441485EE $ 100 01/1986 $ 189.20 $ 139.20 R029190536EE $200 04/1986 $ 378.40 $ 278.40 C 117847379EE $100 07/1986 $ 185.48 $135.48 C 112132961 EE $100 06/ 1986 $189.20 $139.20 C93027428EE $100 11 / 1985 $193.00 $143.00 C 105441471 EE $100 12/ 1985 $193.00 $143.00 C 105441472EE $100 12/ 1985 $193.00 $143.00 C 117847383EE $100 08/1986 $185.48 $135.48 R37825676EE $200 12/1986 $333.60 $233.60 C 117847384EE $100 08/1986 $185.48 $135.48 C l 17847391 EE $100 10/1986 $185.48 $135.48 C 117847393EE $100 10/ 1986 $185.48 $135.48 C 117847389EE $100 09/1986 $185.48 $135.48 C 117847414EE $100 12/ 1986 $166.80 $116.80 Pre-January 1990 Bonds: 269 $78784.94 $59859.94 January 1990 and Later Bonds: 3 $580.80 $380.80 ---------- ---------- Total Bonds: 272 $79365.74 $60240.74 N/E =Not yet eligible for redemption LAST WILL AND TESTAMENT OF WILLIAM C. STICKEL I, WILLIAM C. STICKEL, single man, of 923 North West Sheet in the Borough of Carlisle. Cttmberland County, Penasylvattia, being of sound and disposing mind. mettx~ry, and wtderstauding, do hereby make. publish, and declare this as and for my Last Win and Tesament hereby tevokiag and making void any and all wt71s by me at any time heretofore mane. I. I direct my hereinafter named Executrix to pay all of mY just debts and funeral expenses as soon after ttry death as may be found convenient to do so. I funkier direct that all iaheritattce, trrttsfet and succession taxes which maybe paid on account of lay death shall be paid from the residue of my estate regardless of whether the nasals upon which such taxes are based are included io my pmbau estates I fuNur direct that my funeral services be conducted by Ewing Bmdtets Fungal Home. 630 South Hanover Stree4 Carlisle, Pennsylvania, gad that my body be interred on the burial kx in Wesrmtaam Cemetery on which the bodies of trty patetus, Harlan Stickel and Haul Stickel, ore interred. 2. All of the rest. residue, stet remainder of ttry estate. teal. personal and mixed, and wheresoever the same maybe situau, I give, devise, and bequeath in equal shares to my sister, brother and niece, provided each of them shall survive me by a period of ninety (90) days. but should any of them fall m w su:,rive rite then the shoe such deceased person wouhi have received shall htpae and be added to die share ~ shares of tbe remaining persons. per stirpes, my sister being Berry S. Andrews. my brother being Donald L Stickel, and my Hies being Itrista Lee Uplinger, who is the daughter of John and Betty Andrews. 3. I hereby nominate. constitute, and appoint my sister, Berry S. Andrews, as Executrix of this my Last Will and Testament, but should she pttxtecease tae of fail to qualify or cease serving as such, then in such event I nominate, oonstimte, and appoint my niece, ICrista Lee Uplinger, as attetttate or successor Executrix, and I further direct that neither of them shall be requited to post any bond to secure the faithful perfotmaace of her duties in the Commonwealth of Pennsylvania or in nay ocher jurisdiction. IN R-ITNESS WHEREOF. I have hereunto net my hand and seal to this toy Last Will and Testament written on one (1) page, this t3th day of December .1993. stn nc Signed, sealed, gnblished and declared by W,.II.LL+M C. STICKEL, the Testator above- i ttaaned, as and for his Last Will gad Testatrxrtt, in ottr gresena, who, in his presence, at his request, and in the presence of each other. have hereunto subscribed our names as attesting witnesses.