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Home My WebLink About01-12-12 (2)REV-1500 EX (02-11) (FI) PA Department of Revenue Bureau of Individual Taxes PO BOX 260601 Harrisburg, PA 17128-0601 1505611185 OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN 21 11 0598 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY 156-12-3751 05142011 Decedent's Last Name Suffix LEITHEAD (tf Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Social Security Number Date of Birth MMDDYYYY 01201918 Decedent's First Name M I MARY C Spouse's First Name M I THIS RETURN MUST BE FILED IN DUPLICATE WITH THE - - REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW ® 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) 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 Schedule O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number DONNA M• MULLIN, CPA 717-761-721D First Line of Address BOYER & RITTER CPAS Second Line of Address 141 WEST HIGH STREET City or Post Office State ZIP Code CARLISLE PA 17013 REGISTER OF WILLS USE ONLY w.-~ C-1 _") _ :;.-', __ _,1 ry - ,~ ,~ -~, --, DATE-1; ILED "`~ -i ,.:; _,.; ,, { - Y~ L Correspondents e-mail address: D M U L L I N u1 C P A B R• C O M Under penalties of perjury, I declare that I have examined this return, inGuding 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~h all formation of which preparer has any knowledge. EDWARD C • LEITHEAD III, EXECUTOR / V.. T,~.c.cc.: 62 FAIRVIEW AVENUE C ATH M NJ 07928 SIGNATURE OF PREPARER OTHER THAN REPRESENTATNE DATE DONNA M • MULLIN, CPA C~/~-' )a ~ ~/ ADDRESS BOYER 8 RITTER, CPAS 141 WEST HIGH ST•, CARLISLE, PA 17 PLEASE USE ORIGINAL FORM ONLY Side 7 1505611185 OM46473.000 1505611185 J 1505611285 REV-1500 EX (FI) Decedent's Name: LEITHEAD MARY Decedent's Social Security Number 156-12-3751 C RECAPITULATION 1. Real Estate (Schedule A) 1 71 , 6 6 7.0 0 2. Stocks and Bonds (Schedule B) ......................... 2. 2 4 2 , 4 5 0.0 0 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) , g. 0 • 0 0 4. Mortgages and Notes Receivable (Schedule D) _ 4 0 • 0 0 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) 5. ], 6 , 3 4 2.0 0 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested 6. D . 0 0 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested 7. 5 2 ,12 6.0 0 8. Total Gross Assets (total Lines 1 through 7) 8 3 8 2 , 5 8 5.0 0 9. Funeral Expenses and Administrative Costs (Schedule H). g. ], 9 , 7 9 9.0 0 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) 10. 3 , 3 8 7.0 0 11. Total Deductions (total Lines 9 and 10) , 11. 2 3 ,18 6.0 0 12. Net Value of Estate (Line 8 minus Line 11) 1P 3 5 9 , 3 9 9.0 0 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) , , 1 g. D • D 0 14. Net Value Subject to Tax (Line 12 minus Line 13) , 14. 3 5 9 , 3 9 9.0 0 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 .o _ 0.0 0 15. 0.0 0 16. Amount of Line 14 xable 4~ at lineal rate x .0 0. 0 0 16. D- 0 0 17. Amount of Line 14 taxable at siblingrateX.12 359,400.00 17. 43,128.00 18. Amount of Line 14 taxable at collateral rate X .15 0 . 0 0 18. 0.O D 19. TAX DUE 19. 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 43,128.00 Side 2 1505611285 15D5611285 OM4648 3.000 REV-1500 EX (FI) Page 3 Decedent's Complete Address: ' File Number 21 11 ^598 DECEDENTS NAME LEITH AD MARY C STREET ADDRESS MBER A D CITY CARLISLE STATE PA ZIP 17013- Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments 0 • 0 0 B. Discount 0 • ~ 0 3. Interest (1> 43,128.00 Total Credits (A + B) (2) 0.00 (3) 0.0 0 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. (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 4 3 ,12 8 • O O 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 ^ ^X b. retain the right to designate who shall use the property transferred or its income ^ 0 c. retain a reversionary interest ^ d. receive the promise for life of either payments, benefits or care? ^ 2. If death occurred after Dec. 12, 1982, did decedent transfer 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 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(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. OM4671 2.000 REV-1502 EX+ (01-10) Pennsylvania DEPARndENTOF REVENUE INFERITANCE TAX RETURN RESIDENiDECEDENi SCHEDULE A REAL ESTATE ESTATE OF: FILE NUMBER: Marv C. Leithead 21 110598 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property that Is jointly-0wned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet'rfthe property has been sold. ITEM Include a copy of the deed showing decedent's interest'rfowned as tenant in common. NUMBER DESCRIP110N 1. 1/3 Interest as Tenant in Common in Residence located at 221 South College Street, Carlisle, Cumberland County, Pennsylvania. See Court Order, attached, in lieu of deed, dated December 14, 2006. Valued at 1/3 of sale price. HUD-1 attached. VALUE AT DATE OF DEATH 71,667 TOTAL (Also enter on Line 1, Recapitulation.) I S 71 667 swass5 2.000 If more space is needed, use additional sheets of paper of the same size. ' REV-1503 EX+ (6.98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS ~ BONDS INHERITANCE TAX RETURN RESIDENT DECEDENlT' FILE NUMBER Mary C. Leithead 21 11 0598 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1.Orrestown Financial Services Investment Account No. 00010325508; See attached portfolio valuation. 46,706 2 Orrestown Financial Services Investment Account No. 00090116266; See attached portfolio valuation. TOTAL (Also enter on line 2, Recapitulation) ~ $ 195,744 242,450 3W4696 1.000 (If more space is needed, insert additional sheets of the same size) REV-1506 EX+ (11-10) Pennsylvania SCHEDULE E DEPARrIuENiOF REVENUE CASH, BANK DEPOSITS, ~ MISC. ~AN~I~T~~TURN PERSONAL PROPERTY ESTATE OF: FILE NUMBER: Marv C. Leithead 21 11 0598 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must t-e disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Checking Account #146000732 at Orrestown Bank, May 2011 statement attached. 10,410 2 Personal Property valued at gross proceeds from auction, Auction receipt attached. 3,218 3 Check payable to Decedent deposited after death 514 4 Auto - 1994 Toyota Sedan, valued at sale price 2,000 5 Personal Property distributed in kind to heir - resale value per executor 200 TOTAL (Also enter on line 5 Recapitulation) S ~ 16, 342 OW46AD 2.000 If more space is needed, use addRional sheets of paper of the same size. REV-1510 EX + (OS-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY Marv C. Leithead 21 11 0598 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 NUMBE DESCRIPTION OF PROPERTY IN(1lDETFEN~IAEOFTE7FW~SFEREE,TtFJRRELATIONSHPTODEGEDENTAPD TFE047EDF7RN`SFERATTPGHACOPYOFTFEDEFDFORRE{LLESTATE. DATE OF DEATH VALUE OF ASSET %OFDECD'S INTEREST IXCLUSION IFAPPUCABLE TAXABLE VALUE 1 DWS Trust Company Custodian for the IRA Rollover of Mary C Leithead, Account No. 00090163838, Estate of Mary C. Leithead, beneficiary; see Orrstown Financial Services Statement for value at date of death of holdings, 5,837.14 shares of DWS Strategic US Government Class A Bonds. 52,126 100.0000 0 I 52,126 TOTAL (Also enter on line 7, Recapitulation) $ 52,126 If more space is needed, use additional sheets of paper of the same size. 9W46AF 2.000 REV-1511 EX+~,aos, SCHEDULE H Pennsylvania DEPARTNENTOF REVENUE FUNERAL EXPENSES AN D INFERITANCETAXRETURN ADMINISTRATIVE COSTS RES~ENiDECEDENi -_- ESTATE OF FILE NUMBER Mary C Leithead 21 11 0598 Decedent's debts must be reported on Schedule I. ITEM NUMBER ~ DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~ Hoffman Funeral Home 1,975 2 George's Flowers 86 Total from continuation schedules 3,305 B. 1 2. 3. ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State ZIP Year(s) Commission Paid: Attorney Fees: 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: 424 5. Accountant Fees: 6. Tax Return Preparer Fees: 1 , 610 7. 1 Car Wash 18 2 Reserve for Final Income Tax Return Preparation 200 Total from continuation schedules ~ 12,181 TOTAL (Also enter on Line 9, Recapitulation) ~ $ 19 , 7 99 swasr,~ z o0o If more space is needed, use additional sheets of paper of the same size. Estate of: Mary C. Leithead Schedule H Part 1 (Page 2) 21 11 0598 Item No. Description Amount 3 Methodist Women's Association 25 4 Westminister Cemetery Interment & Vault Fee 2,185 5 Carlisle Memorial Service Stone Engraving 200 6 Organist Allison Methodist Church 200 7 Minister Allison Methodist Church 200 8 Church Secretary Allison Methodist Church 135 9 Church Custodian Allison Methodist Church 100 10 Funeral Programs 35 11 Edward Leithead II reimburse for flowers 15 12 Staples (guest book and copies for funeral) 10 13 Carlisle Sentinel - obituary publication fee 200 Total (Carry forward to main schedule) 3,305 Estate of: Mary C. Leithead 21 11 0598 Schedule H Part 7 (Page 2) 3 Reserve for Final Estate Income Tax Return Preparation 400 4 Real Estate Broker'Fees (1/3 From HUD-1) 4,025 5 UGI (1/3 of utility bill - tenant in common real estate) 22 6 Attorney Fees (1/3 from HUD-1) 167 7 Realty Transfer Taxes (1/3 from HUD-1) 717 8 Miscellaneous Settlement Fees (1/3 from HUD-1) 7 9 Seller Assistance (1/3 from HUD-1) 1,667 10 David Sheibley (1/3 fee for hauling and clean up tenant in common real estate) 28 11 Shane Bouder (1/3 of fee for unloading and clean up of tenant in common real estate) 133 12 Macruder Windows (1/3 if cleaning tenant in common real estate) 78 13 Andrea Kelly (1/3 of cleaning fee tenant in common real estate) 67 14 Chris & Robert Gilroy (packing and moving personal property of decedent) 40 15 Edward Leithead II (1/3 of reimbursement for cleaning supplies tenant in common real estate) 37 16 Mileage and toll reimbursement estate administrative travel 74 17 Rowe's Auction Service Commission on auction of personal property 1,126 18 Repairs to Real Estate (1/3 of amount escrowed per HUD-1 for buyer demanded repairs) 3,048 19 Expense of Sale of Auto 300 20 Eileen Powell (1/3 cleaning fee tenant in common real estate) 42 Total (Carry forward to main schedule) 11,978 Estate of: Mary C. Leithead 21 11 0598 Schedule H Part 7 (Page 3) 21 Century Link (1/3 utility expense tenant in common real estate) 11 22 PPL Electric (1/3 utlitiy expense tenant in common real estate) 40 23 Carlisle Borough Water (1/3 of utility expense tenant in common real estate) 24 24 Doug Glem (1/3 of painting and fix up expense tenant in common real estate) 128 Total (Carry forward to main schedule) 203 REV-1512 EX + (12-OB) Pennsylvania SCHEDULE I DEPARTNENiOF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES 8~ LIENS RESIOENr oECEOENr ESTATE OF FILE NUMBER Mary C. Leithead 21 11 0598 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• Dr. Harold Burkett 40 2 Martson Law Offices 41 3 Jim Potts (1/3 of payment for lawn care - tenant in common real estate) 83 4 Comcast (1/3 of utility bill tenant in common real estate) 7 5 Mark Renault (1/3 of plumbing services tenant in common real estate) 30 6 Edward Leithead II reimburse for purchases of items/supplies for decedent prior to death 650 7 Diakon Lutheran Social Ministry final prescription drug bill 15 8 Cumberland Crossing final nursing home bill 2,424 9 UGI (1/3 of utility bill - tenant in common real estate) 27 10 Carlisle Borough Sewer (1/3 of amount paid at settlement per HUD-1) 70 TOTAL (Also enter on Line 10 Recapitulation) ~ $ 3 387 8W46AH 2.000 If more space is needed, insert additional sheets of the same size. REV-1513 EX+(01-10) SCHEDULE J Pennsylvania oEPnRTrofNrOF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Ma C. Leithead 21 11 0598 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).] 1. Edward C. Leithead II 133 Fairmont Ave Chatham, NJ 07928 0$ of Residue: 179,700 Brother 179,700 2 Phyllis L. Martin 705 Wayne Avenue Reading, PA 19611 One Half of Residue: 179,700 Sister 179,700 1 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBU110NS ON LINE 13 OF REV-1500 COVER SHEET. ~ $ 0 swasAi z.ooo If more space is needed, use additional sheets of paper of the same size. ~ _~._ ~_~ F:1PR.E51CIidnsU2918MLeithe~dV29lB.l,will.3~11 ~ ~ ~- _r., I^ = ,7 - - - r._, -:~ =w .- - J _~ ---; ri 1' LAST WII.L AND TESTAMENT -.' ~~ , -' `'~ I, MARY C. LEITHEAD, of Carlisle Borough, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils made by me. 1. I direct that all my legally enforceable debts, funeral expenses, testamentary expenses and all death taxes (whether such taxes may be payable by my estate or by any recipient of any property) shall be paid from my residuary estate as soon as practicable after my decease and as part of the administration of my estate. My Executor shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other property not passing under this Will 2. I give, devise and bequeath all of my estate, both real and personal properly unto my brother, EDWARD C. LEITHEAD, JR. and my sister, PHYLLIS L. MARTIN, in equal shares, absolutely. In the event either of them shall predecease or fail to survive me by thirty (30) days, then his or her share shall be distributed to his or her issue, per stirpes. 3. I nominate, constitute and appoint my nephew, EDWARD C. LEITHEAD, III, as Executor of my estate. 4. I direct that all fiduciaries acting under this Will, whether or not named herein, shall not be required to give bond for the faithful performance of their duties in any jurisdiction. 5. I authorize and empower my Executor, in his sole and absolute discretion, to purchase or otherwise acquire and retain any investments of which I die seized or any real or personal property of any nature; to sell, lease, pledge, mortgage, transfer, exchange, dispose of or grant options in regard to any or all property of any kind forming a part of my estate for such terms and such prices [Iniiials] Page 1 of 3 Pages COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ) We, Mary C. Leithead, ` e }~. Ct I r€i and ~ VJz ~~ ~ C . ~ ~r~~ , the Testatrix and the witnesses, respectively, whose es are signed to the foregoing instrument, being first duly sworn, do hereby declaze to the undersigned authority that the Testatrix signed and executed the instrument as her last Will and that the Testatrix has signed willingly, and that the Testatrix executed it as her free and voluntary act for the purposes therein 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 his/her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. r Subscribed, sworn to and acknowledged before me by Mary C. Leithead, the Testatrix, and subscribedandsworntobeforemeby +-~w~r'~j~„~~ y and Cc(w~~~ ~, ~ei1a~~.~ j~ , the witnesses, this ~ ~ day of f~~ n t , s-p ~ I ~ ~~ ~~ o ubhc ~J C0"~rfr of ~NnrsnvnNU~ s~ ~c s ~a honolN Page 3 of 3 Pages ~y . ~ .~ ~~ N Hubert X. Gilroy, Esquire rtlt_ 2 ~ 200' ~`~ MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES ~ ' ~o `=~ =-=~~ --~ --- --; I.D. 29943 ~ '~ ~ ~ cam- ' = ` ~ =~~ ;,- :; 10 East High Street -`- ~ --~ :~ r-- '- - - .' ~ -' Carlisle, PA 17013 _ , -~' ~~:. ~ ~-~' ~ ~ - - -~ - (717) 243-3341 -., - ---- ~ ' =,' Attorneys for - ' `-y - ',- RE: ESTATE OF IlV THE COURT OF COMMON PLEAS mF - ' ' . LEITHEAD CUMBERLAND COUNTY, VERONICA M _ ' PENNSYLVANIA NO. 1964-2093 ORPHAN'S COURT DIVISION (Prior Filings at Register of Wills File #2093 and at Tax Book No. 7, Page 54-36) ORDER AND NOW, this~3 day of 2007, upon review of the attached Petition and exhibits, and after cazeful consideration of the allegations in the attached Petition and in the original Petition for Determination of Title of Real Estate, it is ordered as follows: 1. This Court's Decree Nisi dated December 14, 2006 is hereby confirmed. Title to the Real Estate located at 221 South College Street, Cazlisle, Cumberland County, Pennsylvania, more particulazly described in Exhibit "1" attached to this Order, is and shall be jointly held by Edwazd C. Leithead, Mary C. Leithead and Phyllis L. Martin, each owning aone-third interest in said Real Estate. 2. The Recorder of Deeds of Cumberland County is directed to index this Order in the records of the Recorder of Deeds, listing as Grantor Veronica M. Leithead and the Estate of Veronica M. Leithead and listing as Grantees Edward C. Leithead, Mary C. A TRUE COPY FRO In Testimony twh ; set my hand and the ~ of said Court ~ CarNsl~. PA ` . r~~r -, This~!fs~day ~ .a •^.~.,~ r r• R •~('- Clerk of the ilsrw - ~ :~' Cumberland 0o~u~i .: ~• cc: Hubert X. Gilroy, E.: - ~ T e ~~ } ~ ~ot~ : atz i~ rr1, : 7! ~as~= r~.s. as z~ ~:..+~~ a~ ~ I 4 ~G.~~,.%~.~c K~s,r9~~4 :MaR.4~R/~4M~~1siLiltL6A~r.O~i R.L(2iw~l.MCsi,'pJdwLd-f/`~C4raCaL'Y..'J~l'ra+r'~ ~.4a~6f~E1/~ ~~ ^ l~•~1~.{CC[d1~h~.rac3- 1rry.~d !' •~!'CI~+eL,rvctl • a ~ ~e.s~~l .. /.+lf~~i..-,elL~.ie2r~.~r./~ G.I~:L:rr:~~ 1 '.n QhL4~•L. C4Y~~f^1/wK./.IGGJ~4Yi.(l. -,-,-r _, ,- ~ . ~~ 1(f-~;aw.o%-~ caztc~,''..~ies~r~or.Zi' ~~~°~~jaa•~.~..c„.-e.<<.,:~:-,~G•r:.~~x~~./ : •~6-uGt ny~%# r+fvr~•SS: w~svl-ffX.Ld(~ic~~/Jt~~ac+l.ue.aTiJ.~~.ese.~ll7ae.+fiP~eea..~~~M. ;ci.,~r~e.t••C. !..•t~.,~i«G~ar~rsl~i rr•~:s~,~t~r~•lcean/ ~~.Y64RV~a«,Fle+ti~cl~ai%G~,fl.~~:.GCG . Lirud f ,. 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EXHIBIT • ~ ' FPp't :,'itII~.Rlr~C, ~ F-xc rn. .7.'~-5?5b: i-a.a. r.~ ~a~ c~::~~Y. P:~ Y • .~Y, 2Z • 1 r / ~ rJ.s•. Ylw~:d4~. =%fRlM/~p +7.ryM~,.~ilr'~rrP iaNsw~ `i.cQ~..R/~'~ ~uw.r:Jw~M..:r:~! .! • J( •I}~I~ %.i.4~ yLA'~LYG AJ~ff MIt(ffl . . t ~~ / ~ :I• j ~~Iwt./' NXl~4YaA ~Ly.~.iC2Yf~~.ii ~.KiMM.I+YF/.r.rrifAN ~' L...~....nwlFU GV4~ ~w~^~f~Y~M~~l /L~Y.WYJII.}~i .f{I/~~~r/• ~Q //..t.TI ~~4i .~N'. .~«.,.yr•r,•E..:..1~L.1/ 1 w.~.f~rrs..,,i..Y,.N/~,.MUI.r~..~/ltd.,./.w:./~' ~ i~.+.e~`i~..K«....w~.A-.~"pia(i.~r:...1C~yr4f~'.t:6.~...•,:..tcs..-fgaw! 1:,...1~ ~vfS~/+K~+.~.y~6tA.l1.Itci'~t,i~saE~w.l,'fit.~a,..laG+ewf.~iw.io~i.t~st+.u,4v.• ~,. , M.7d•?1'A 6i TIC ~f~IArrN . - (al.riq CT-l[~AIflf,'/h. f C ~ . S'`/1%+4 ~ s~~ " IM...~L. ~.w t~~f.. lA~Rii~~/~/Q-f~i~/wM~ (i~(•.el FEl ~iwrwa.r~} riFlwR/~r•W./ii:wMM:d'r. ~5~~".~-~ - !~r.,~ ..,,r ~ .;. Rwl4.•..L.r.~w.0 Owdw•~~ , ~ y, t a.~~~ ...`l+«6 .1+4 es...~Mrpr.....~ ~~'",,~.,.~/.~~ '~ ..;. .ti~~.e.~:rlL../ ~~..v~.IG.~2:~.rla..~, t .es..; Sri ~r..a.lw.+..IG.f~...l•Eerr~t~s .I~f.-14H~...., ; m W m ~_ ~. r r ILLEGIBL>= QRIGIN~L A. Settlement Statement (HUD-1) OMB Approval No. 2502-0265 FINAL ®Conv. Unins. Q FHA 2 ^ RHS 3 1 8 umber. ~ ~ 11 mbar: B. Mortgage Insurance Case Number. . . . 7 5701283100 4. Q VA 5. Q Conv. Ins. C. Note: Thy form rumislred m glue you a statemerR of atlas[ settlement costs. Amourks paid W and by the sel8erir~rtagents are shown. hams marked "(p.o.cp were paid outside the dosing; they are shown here for irrrormatlonal purposes and an: not Included In the totals. D. Name 8 Address of Borrower. E. Name 8 Address of Seller. F. Name & Address of Lender: George E. Teague, Deborah R. Teague Edward C. Leithead, The Estate of Mary C. Leithead, Fulton Bank, N.A. 50 Conifer Ridge Orive, Carksle, PA 17013 Phyllis L Martin One Penn Square, Sulte 304, Lancaster, PA 17502 G. Property Location: H. SettlementAgertt I. Settlement Date: 10!24/2011 221 S. Cottage Street PA Reel Estate Setllemerd Services, LLC Distwrsement Date: 10/24/2011 Carlisle, PA 17013 354 Aknrander Spdng Road, Cadlsle, PA 17015 Carlisle Borough Telephone: 717-Z49~333 Fax: 717249-7334 Place of Settlement TitieExpress 354 Alexander Spring Road, Cadisle, PA 17015 Printedd 10/24/2011 at 12:52 pm by KSC 100. GropAmomdDuefromt3orrotaer 400. GrossAmourttDuetaSaBar price 215,OOD,00 401, t 2f5,000.00 142, Personal 402. Personal .103. Settlement charges to borrower (8ne 1400) 7,537.03 403. 104. 404. 105. 405. asbeanls for items seller In advamx usfinetds for itafns as0er M advance 106. GtyMwn lazes to 406. GlyRawn tteces to 107. County taxes 10242011 to 12/312011 202.69 407. County taxes 10124120'11 l012131121111 202.69 106. Assessments 1024/2011 to p6I3p12012 1,714.50 406. Assessments 10242011 to 061302012 1,714.50 1os. 409. 110. .410. 111. 411. 112. 412. 120• Gross Amaurt Dua from 8orroarer 224,45412 420. Grote Amount Dua to Sella 216,917.19 200. Amou-rts Pa1d or in Bshdf dBorrower 500. Redrrctloru h Amount Due to Boller t a eanrest money 5, s eposd see inalmcliatsj 202. Prindpal amount of new ban(s) 172,000.011 502. Settlement charges to salter (line 1400) 15,790.06 203. s taken t to 503. E>asli s) taken su to 204. 504. of first ban 205. 505. P d secartd loan 206. 506. 207. 507. Escrow per Addendum 9,145.00 208. SellerAssistance 5,000.00 506, SeBerAssistance 5,000.00 209. 509. Inheritance Tax Escrow of 1/3 7,790.92 ants forNarm d- seller _ for items un b seller 2 ry hexes b 5 ty taxes to 211. County taxes to 511. Caunly taxes tb 212. Assessments to 512. Assessmerds to 21_3. 513. 214. 514. 215. 515. 216. 516. 217. 517. 21$. 518. 219. 519. 220• Total Paid Bortoerer 182,0110.00 520. Tdat Reductlort Amount Due SsOer 37,725.98 300. Cash at Ssltlerrterrt iromito Borrower 800. Cash at Seltlemard toJfram Salver 301, Grces amarert due from btxrower (Ilse 120) 302. Less artaurds paid bylfor borrower (line 22D) 224, 182,1x70.00 601, mss amount due to'seller (line 420) 602 Less ntducfians in amount due seller (Brre 520) 2i6,91T.19 37,725.98 303. Cash QX Fran ~ To Borrower vw: uMr^ ~mMf wilOWaM+W 4wp,r, Me a~rl~,a+Mrr~ 42.45422 4~~diw..isn.d~sr.7 N. 803. Cash ®To ^ From Salter 4awk~++baww.ll.sr4.a.11F~A mvr.ebw,lan.t'i ~ 179,19127 e,. Previous editions are atuolete Page L ot`4 HUo-I 700. Toby RaarF~ble~t3iotaur~s ;12,075 Paid From Pald-Frorn Dlvisiort.dfoormuutOn asfollosrs Borrower's Seller's ZOt. 56700.00 to pnrderrYalHanessleServioasGroitp Funds at Funds at 702 Sr.+:3f5.00 to HdokeHooke~Ealenarr Settlement Settlement '703. CamiisalonpaudattaBletrrenl 12, :00 BOO. ~ Con~fiamvr~ Lo>tr ~1. Our origigoGoo [barge ( O[i~ir~aliort POint0.t10074 or $0.00} S&95.00 (from ) 802. Your treat a charga'(po1MS) br theaPedBe Ggarest rate dween 5 (tn7m GFEd2} Your aigiriaHdti dfalges GF_ E } b95.00 804. Appraisal tee W SduOons (from tt3} 425.00 805. Credit capon to Credstar (LTOm GFf1R3} 10.24 806. Tax service !o kom GFE B3 [107. Flood cedlflca8an to Flood Servkes (from GFE tp} 11.50 808. to 9~. Mems red lender to tisPaid to Advance 901. Dally illerist(il8igesirtm 1012241!011 bo 11N11201t ~ day ((rbm GFEY1 i79.W 902 irurvance monlhato GFE~f 903. Homeowners inwrranoe for 1 Io,USAA (trap GFE S11} 823.26 904. madhs to ham GFESt1 10~. asenrea der 1001.Ini8aldeposdforyceresrrovoaccount (fromGFEtt9} 1,161.33 1002. FlOraefMillers 6isurante 3 S 68,fi11rranth 5205.83 1003. Insurance monBu: S lmontlr 1004. axes months: S hnonlh 1005. Cotmly taxes 9 ~~ S 89.35hnarrBr $804.15 1006. SchooiTmres 5 ,~„B„ 5 22917hranlh $1,145.85 1007. Aggreg~[• AdJusbnent $-OfYl.50 1100. Title § e insurance Iran GFE#4 1;559.25 1102. Settlement a rinsing fee in $ 1103. O+~ste¢s tllle inwrance from GFE. 358.38 1104. LenderslAlelnsurance $1,443.75 1105. Lenders title pdicy limit 5172,000.00 Lenders Pdicy 1106. Owners title poOC.y ~ 5215;000.00 Owners Paicy 1107. Agent's potion of the local the Insurance premian 51,490.56 1108. Underwriters portlon of the total Otle irisuratce premium $311.57 1109. Altomay Fees to Mmison Law Office 500.00 1200. GovaronreriYRax and Transfer es 1201. Government recvrrfing charges 5 (from GFE #7) 164.00 lzoz t>~d sbzoo 5102.00 Raease S 1 z03. transfer taxes 5 (from GFE 88) 2,150.00 1204. Clty/Cowty tax/stamps Deed 52,150.00 .Mat $ 1205. StateTax/slerrtps t)eed52,1S0.00 S 2,150.00 1206. Aced 5 5 1207. Power of Attorney 21.00 1]00. AddiOonaLSNtNm~t es 301. Regured services at you can shop a (from GFE ~ 1301.3ttlil~etlmenlofBle2li11a2SdwDtoCar~e Tax Account 633.51 mat Bill t0 Catlsle Baou 2i0. 1304. to 1305. ~ 7,537.03 1S,T80.06 'Paid aul~de of dosing by (8)orraver, (S)eller, ((.}ender, (1}nvesta, Bro(K~r. "Grad[ by lender shown on page 1. "'Credit by setler stxrwn on page 1. Previous editions are obsolete page 4 HUD-1 -- Ca b[Good=EellhiEe Q ~alifitlM;1'. - .: -. _. ~ ~C ` - `' 'HOD~f;lJite'.Number YaMj'!xe.~+x-iP~1tGerspei~k'.Mr1it>~dioten; . . ~„~: Yourartlnrlpitrellonagas' ° =¢:'8Q3' T~ -. - ~ , . -# .~. C es•Tlgtiiii~ai`Citpwl;Mic[eassYorsTfw~llMl:. . t3nvermrten6temn6ng,~dwrges ' ~ -, - _ ' - _ _ ~ 12Dt ,APPralsal fee ~ 8Q4. c10dR•TepOrt - - ~,~ . F1ood~oertlBcMlatr ~ 807 >k fF . •_ . ~ :$ .' G ~:TfutCan ~ a _ _ n bat- t _ :~!orrescrow~account - ._ 8,.'1001-- in - #901 $22.389674 xmxallce #903 T' and dens tlue insurance # 1101 Owner's 8tle~:xrsurance # 1103 # Loan Terms (iood'Fidtt F_stlnwte 'HbQ1 . 695,00 695.00 D.00 0.00 695.OD 695.00 2,i5T1.00 2,150.00 Good+FaNh:EdihiaOs HUD-1" _ 150.00 164.00 6'OQ,On 425.00- 20.00 10.24 11.50 11.50 781.50 610.74 $ -170.76 or •21.8543% Good:Faithstlma<e HG~1 2,919.98 T16'1.33 671.51 .07 600.00- 823.26 T,803.75 1,559.25 250. 350.36 Yaurklitlal:ban.amounl.~ ~ - ~ $172,000.00 ,.. ,. ., , Youraoantenmisr - - 30, years _ - ; , - .-- Yoilrlnltlal Irrterestrate is 4.750096 Your-initlal monthy amamt owed for pdncipsl,: interest,.ar~d.any. mortgage $897.23 includes Insurance is ~ ~~~ ^X Interest ^ Mortgage Insurance Can yaur,ihlerestl>3larise? ^X No. ^ Yes, it can rtes to a maximum of X. The first change will be on / I and can change again every years after 1 / .Every change . dale, your interest race can increase or decrease by %. Over the 8fe of the loan, your interest rate is guaranteed to never be lower Than % or higher than %. Even:iF'you make:paymenis•an"Ume;:cai your Bari balani~.rise?' _ ^X No. ^ Yes, it can rise to a maximum of $ Even 'rf you~make~aymenis on time, prl yarrmrxdhly amowrt awed for ^X No. ^ Yes, the first increase can tx; on ! ! and the monthly principal, interest, and mortgage hrsurance rise? amount owed can rise 10 $ The maximum Il can ever dse to is $ Does.your loan have:a pr~ayment penalty? 0 No. ^ Yes, your maximum prepayment penally is; , Does yaucban havere balloon paymentT- ^X No. ^ Yes, you have a balloon payment of $ due in years on r Total. mouthy amount owed: irxduding esrrow.acwtrM paymerrts ^ You do not have a rtan8dy escrow payment for items, such as ProP~y ~~ = and homeowner's insurance. You must pay these items dkeclly yours~f. 0 You have an addAionai narlthty escrow payment of X987.13 Ihat results in a total initial m«,u,ly amount owed of $1,284.36. This includes pdrxipat Interest, err mor~age Insurance and any items chedred bekrw: , ^X Properly taxes X^ Homeowner's insurance ^ Flood insurance ^ ^ ~ School Taxes note: 0 you have any questions about the Settlement Charges and Loan Terms listed on this form, please contact your lender. Previous itlons are obsolete Page 3 0 4 HUD-1 HUD CERTIFICATION OF BUYER AND SELLER f have carefirlly revievied the HUD-1 Settlernerd Statement and lb the beat of my IcwvAedge and beGet, it is a hue and accauate statement of all receipts and dlstxusemenls made on my account or by me in this transadlon I turCter certify that I have received a copy of the kUD-7 SettiementSlatament George E. T Teagrte Edwad C. Le (head The Esta~ary C. L~Ihe or wIA cause tire / ~~ T~ / DATE WARNING IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM PENALTIES UPON CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE TiTIF 18: U.S. CODE SECTION 1001 AND SECTION 1010. Prevlotu editions are obsolete Page 4 4 HUM i ne huu-i semement statement vMich I have orecared is a true Name d Borrower. George E. Teague Deborah R. Teague Name of Seller Edward C. Leithead The Estate of Mary C. Leithead Phyllis L. Martin File Number 2011-178 TitleExpress Prepared 10/24!2011 at 12:52 pm Note: This page is furnished to give you an itemization of the amounts shown on Lines 110'1, 1103 and 1104 of the Settlement Statement (HUD-i). This page accompanies but is not a part of the settlement statement if a discrepancy exists, the information shown on the Settlement Statement (HUD-1) applies. ~=PafdS~Frogri `~Bpe}',g ~ , $~t#~gmCRf ! ~ ,~ ~S~_ .; "j'~~ ~'~g~l'e~i~i;. _.: .._ _. :, ; 19110:_ 6fia(y~ ' ' ,, ` . , ,: ~!J.4ji'1~d1 - _ - v3. t- _ 1101. TTtle services and lender's the Insurance 1,559.25 a. Ovem' ht Mail b 20.50 b. Wire Fee 12.00 c. Processhq Fee 49.00 d.14o Fee 34.00 S 115,50 1102. Settlement or dosin fee 1103. Owner's tltle Insurance (policy) ; 358.38 358.38 1104. Lender's title insurance 1,218.75 S 1,443.75 a. Endorsement 900 EPL-Residential 50.00 b. Endorsement 100 fNo Vblatlon 50.00 a Endorsement 300 Surv 50.00 d. Clos Service Letter 75.00 (Tota11103+1104} s 18n91a 4a+!~':, ^,~niw 1109. 1110. 1111. 1112. • • r - 4.F.J1~ ,??_ "~`n°l-~.~i ~a 1100._1 cMNli; . ~ _ - - P0'C~urEndk: 4G I~O{rNr ~ ~rr1101 .~}el`.. .,P.tlrrC 1101. Title services and lenders Ode insurance $ a. Ovemi l Mail to Salmnam Hu has, P.C. 20.50 20,50 b. Wire Fee to Salunann Hughes, P.C. 12.00 1200 c. Fee to Salunam Hu has, P.C. 49.00 49.00 d. Not _Fee to N Clerk 34.00 34.00 1104_ Lenders title Insurance to Stewart Title Guarani IPA RE SS 1,443.75 1,443.75 .- ,_-..,.+ , . ' . - , 'S ' 1.55925? ` ~.. _ . '..1,55925''' ' . , . Date 10124/11 Edward C. LeitheadTHE ESTI/AfTE~OF MARY C. LEITHEAD By ` ~ Date 10!24!11 Date 10/24/11 Phyllis L Mara Date 10/24/11 Date 10/24/11 ' ~ ORRSTOWNB.ANK A Tradition of Excellence ORRS P.O. Box 250 o Shippensburg,PA 17257 Temp-Return Service Requested Date aes'rf~-3; Page 1 Primary Account 146000732 Enclosures '~,Ac,Anr,~ ~ b~~-c~+ III~~~I~~~II~I~~~~I~II~~I~~~~III~~I~~~II~~I~I~~~II~~~II~~~~III .~ 004715 0.6500 MB 0.390 TR00021 Mary C Leithead !~ $ Edward C Leithead ~ 133 Fairmount Ave Chatham NJ 07928-1835 C H E C K I N G A C C O U N T S Account Title Mary C Leithead 'k Edward C Leithead 50+ Interest Checking Check Safekeeping Account Number 146000732 Statement Dates 4/26/11 thru 5/25/11 Previous Balance 12,108.71 Days In The Statement Period 30 2 Deposits/Credits 6,472.00 Average Ledger 9,581.07 11 Checks/Debits 18,580.71 Average Collected 9,581.07 Service Fee .00 Interest Earned .39 Interest Paid .39 Annual Percentage Yield Earned 0.05 Current Balance .39 2011 Interest Paid .63 Deposits sad Additioas ~ Date Descraptioa Bmouat '^ 4/27 INVESTMENT 466: MGD MUNI A 5,000.00 ~r, P PD 5/03 XXSOC SEC US TREASBRY 303 1,472.00 o PPD N 5/25 Interest Deposit .39 u~ 0 'r 0 ~lectroa3c Debits aad i~ithdra9-aIs o° Date Description Amouat 5/20 Miscellaneous Debit 9,886.40 °o ~i o o .--~ N --- CHECK SUMMARY --- c Date Check No Amount Date Check No Amount 5/18 1762 90.00 5/06 1766 323.63 5/02 1764* 7,515.90 5/12 1767 253.17 4/28 1765 78.36 5/17 1768 80.70 * Denotes missing check numbers _ URRSTOWNBANK A Tiiate~tion of~,~cdlatce Date 5./25/11 Page 2 Primary Account 146000732 ~ Enclosures Mary C Leithead ~ $ Edward C Leithead ~' 133 Faizmouat Ave Chatham NJ 07928 0 N cn °o ~o 0 .~ 0 a 0 0 ~tf n et 0 0 N a 0 50+ Interest Checking 146000732 (Continued) --- c~cx s rn~,xx --- Date Check No Amount Date Check No Amount 5/18 1769 41.14 5/'23 1771 40.00 5/23 1'770 25U.OQ 5/20 1772 21..41 * Denotes missing cheek numbers Daily Balance Iafvrmation Date Balance Date Balance Date Balance 4/26 12,108.71 5/03 1D, 986.45 5/18 10,197.81 4/27 17,108.71 5/06 10,662.82 5/20 290.00 4/28 17,030.35 5/12 10,409. 5/23 .00 5/02 9,514.45 5/17 10,- :95 5/25 .39 Iatarast Rati S~sy 4/2.5 0.050000$ 5/02 0.010000$ 5/03 0.050000$ 5/20 0.000000$ THANK -YOU FOR BANKINIG WITI3 QRRSTOAN BANK H~oldin4s by Investor Mary C Leithead Lisa Riggleman Combined Account Portfolio 221 S College Street Orrstown Financial Services Date: 05N3/2011 Carlisle, PA 17013 427 Village Drive Created: 05/1712011 Carlisle, PA 17015 717-249-3737 -- - Mary C Leithead Acct Name: DWS TRUST COMPANY COST FOR THE IRA ROLLOVER OF MARY C LEITHEAD 221 S COLLEGE ST CARLISLE PA 17013-3706 Acct No:00090163838 Acct Type:IRA Rollover Accflunt Rep. No:19130 Asset Name Ticker Asset Type Mgt. Name Quantity Price (;) Value (S) DWS STRATEGIC US GOVT FD KUSAX BONDS DWS 5,837.14 8.93 52,125.64 CLASS A SCUDDER INVESTMENTS Account Total: $52,125.64 Acct Name: MARY C LEITHEAD 221 S COLLEGE ST CARLISLE PA 17013-3706 Acct No:00010325508 Acct Type: General Rep. No:19130 Asset Name Ticker Asset Type Mgt. Name Quantity Price (S) Value (S) DWS BALANCED FUND A KTRAX US 5TDCKS DWS 4,549.89 9.41 42,814.49 SCUDDER INVESTMENTS DWS MM PRIME SERIES-DW5 KMMXX CASH DWS 3,891.96 1.00 3,891.96 MONEY MRKTFD SCUDDER INVESTMENTS Account Total: $46,706.45 Acct Name:MARY C LEITHEAD 221 S COLLEGE ST CARLISLE PA 17013-3706 Acct No:00090116266 Acct Type: General Rep. No:19130 Asset Name Ticker Asset Type Mgt. Name Quantity Price {s) Value (;) DWS MANAGED MUNICIPAL SMLAX BONDS DWS 22,268.89 8.79 195,743.53 BOND FUND #466 SCUDDER INVESTMENTS Account Total: $195,743.53 IrwestorTotal: 5294,575.83 Incomplete If pnasented without accompartying discbsure pages Pegs 1 of 2 Holdings by Investor Mary C Leithead 221 S College Street Carlisle, PA 17013 Lisa Riggleman Om3town Financial Services 427 Village Drive Carlisle, PA 17015 717-249-3737 Combined Account Portfolio Date: 05!13/2011 Created: 05!17/2011 Disclosure: Registered Represeniative of and securities offered through Financlai Network Investment Corporetlon, member SIPC. Onstown Financial Services is not afiliated with Finandal Network Investment Corporation. Values are as of 05/13/2011 unless otherwise noted. We believe the sources to be reliable, however, the accuracy and completeness of the infomtation is not guaranteed, as it is a compilation of information from various flnandal sources (mutual funds, direct partidpatlon programs, correspondent brokers, etc.). 1n the event of any discrepancy, the sponsor's valuation shall prevail. Performance data quoted represents past performance and does not guarantee future results. The investment return and principal of an investr~nt will fluctuate so that an investor's shares when redeemed may be worth more or less than the original cost. The values represented in this report may not reflect the true original cost of the diem's Initial investment Forfee-based accounts only: the figures may or may not reflect the deduction of investment advisory fees. If the investment 1s being managed through afee-based account or agreement, the returns may be reduced by those applicable advisory fees. Refer to your Advisor's Form ADV, Part II. The information contained in these reports is collected from sources believed to be reliable. However, you should always rely on your statements received directly from product sponsors. If you have any questions regarding your report, please Dell your representative. Page 2 of 2