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HomeMy WebLinkAbout10-31-12J 1505610105. REV-1500 ex(°2_""~' nnsylvenia OFFICIAL USE ONLY PA Department of Revenue Pe County Code Year Fb Numlter Bureau of Individual Taxes w.....~."~"""~` INHERITANCE TAX RETURN ~ °~ PO BOX 28o6oi ~/1 Harrisburg PA 1'7128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY _ _ ..~_ 492-26-2465 02/11/2012 ' ~ 08/15/1919 __ __. Decedent's Last Name Suffix Decedent's First Name MI FOX _ LUCILE = J __ _._. .. (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse s First Name MI i _ _ Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS O 2. Supplemental Retum O 3. Remainder Retum (Date of Death Prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of death after 12-12-82) OID 6. Decadent Died Testate O 7. Decedent Maintained a Living Trust (Attach Copy of Will) (Attach Copy of Trust.) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death Between 12-31-91 anii 1-1.95) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENT Name 'JOHN D. KILLIAN, ESQUIRE First Line of Address 218 PINE STREET Second Llne of Address City or Post Office State HARRISBURG ' PA O 5. Federal Estate Tax Retum Required ~ 8. Total Number of Safa Deposit Boxes O 11. Election to Tax under Sec. 9113(A) (Attach Schedule O) AL TAX INFORMATION SHOULD BE DIRECTED T0: Daytime Telephone Number (717) 232-1851 REGISTER OF WILLS USE ONLY rra Q r, O n -r1 _ C7C; , , ILI;D ~ i ' ZIP Code n - 17101 D --r r }~ rn C~ correspondenes e-mau address: jKillian(~DKlUangepnart.com Under penalties of perfury, I deGare that I have examined this return, including accompanying schedules and afatementa, end to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative Is based on all information of which preperer has any knowledge. SIGNATURE OF PE N RESPONSIByE FOg,Flll[+lG RETURN /DATE, 1217iGf~EENFIEL~ LANE, SKANEATELES, NY 13152 E STREET, HARRISBURG, PA 17101 Side 1 1505610105 ONLY 1505610105 J \~~p a~a ~~ 15056102175 REV-1500 EX (FI) Decedent's Name: LUCILE J. FOX Decedent's Social Securlt 492-26-2465 Number RECAPITULATION 1. Real Estate (Schedule A) ............................................. 1. ', 0.00 2. Stocks and Bonds (Schedule e) ....................................... 2 ' 4,825,877.72 ', 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 0.00 ', 4. Mort a es and Notes Receivable Schedule D 9 9 ( ) ........................ 4. ! ... 0.00 5. p party ( > Cash, Bank De osits and Miscellaneous Personal Pro Schedule E .... ... 5. J 27,369.55 '; 6. Jointly Owned Property (Schedule F) O Separate Billing Requested .... ... 6. ', 159,272.28 7. petty Inter-Vivos Transfers & Miscellaneous Non-Probate Pro -- _ _ 0 00 (Schedule G) O Separate Billing Requested..... ... 7. . B. Total Gross Assets (total Lines 1 through 7) .......................... ... 8. ', 5,012,519.55 ', 9. Funeral Expenses and AdminisVative Costs (Schedule H) ................ ... 9. E 45,474.78 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............ ... 10. 21,846.06 11. Total Deductions (total Lines 9 and 10) .............................. ... 11. ' 57,320.84 12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 12. ' 4,945,198.71 ', 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which °'°'°` ° °- ° °_ _.. _ __. __._„ .. , _. an election to tax has not been made (Schedule J) .................... .... 13. 365,000.00 ', 14. Net Value Subjeet to Tax (Line 12 minus Line 13) ..................... ... 14. ' 4,580,198.71 ', TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 ` ~~~~ ~ ~~~~ ~~ 4,350,476 26 ', (a)(1.2) X .0_ 16. Amount of Line 14 taxable ~ "~"' -'~~'~ ~ ~~ ~ ~ ~ ~ ~~~ ~ ~~~~ at lineal rate X .0 _ 17. Amount of Line 14 taxable ~~ ~~~ ~" ~ ~ ~ ~ -~ ~ ~! at sibling rate x .12 228,972.45 18. Amount of Line 14 taxable ~~ ~~ ~~~~ ~ ~~ ~~~~~~ at collateral rate X .15 19. TAX DUE ......................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 1505610205 155610205 195,771.43 '. 34,345.87 230,117.30 4~ REV-1500 EX (Fp Page 3 Decedent's Complete Address: File Number 2012-00217 DECEDENTS NAME LUCILE J. FOX STREETAODRESS 84 PLUM TREE CIRCLE CITY NEVWILLE STATE PA ZIP 17241 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. CreditslPayments A. Prior Payments 220,000.00 B. Diswunt 11,000.00 3. Interest 4. If Line 2 is greater than Line t + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval 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. (4) 882.70 (5) Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred .......................................................................................... ^ b. retain the right to designate who shall use the property transferred or Its income ............................................ ^ c. retain a reversionary interest .............................................................................................................................. ^ 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 "intrust 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 benefxtiaries is 4.5 percent, except as noted in [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 p2 P.S. §9118(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. (t) 230,117.30 Total Credits (A+ 6) (2) 231,000.00 (3) REV-i5o3 EX+ (e-u) Pennsylvania SCHEpYLE B DEPARTMENT OF REVENUE INHERITANCE TAX RETURN STOCKS & BONDS RESIDENT DECEDENT ESTATE OF FILE NUMBER LUCILE J. FOX 2012-00217 All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE 1' HSBC Holdings PLC 291 shares @ 44.25 12,877.00 2' 'IBM Corporation 4, 976 shares @192.50 957,980.00 3 International Paper Company 6,496 shares @ 32.44 210,730.00 4 McKesson Corporation 2,100 shares @ 81.50 171,150.00 5 PFIZER INC. 6,808 shares @21.18 144,193.00 g SARA LEE Corporation 71,548 shares @ 19.92 ' 1,425,236.00 7 TRI-Continental Corporation 22,336 shares @ 15.58 347,997.00 g Zimmer Holdings 211 shares @ 63.15 13,325.00 g Vanguard AD Treasury Fund 536,190.00 10 Vanguard TEMF 85,710.00 11 Vanguard PA Tax Free MM 6,581.00 12 Vanguard LTD Terre TX-EX 797.113 shares @ 11.21 8,936.00 13 Oppenheimer LTD Term NY Municpal A 22,001.881 shares @ 3.37 74,146.00 14 T. Rowe Price Tax Free Short-Interm 38,211.195 shares @ 5.71 218,186.00 15 AT8T INC. 2,979 shares @ 29.94 89,191.00 16 Bristol-Myers Squibb 2,112 shares @ 31.95 67,478.00 17 Cigna Corporation 157 shares @ 43.56 6,808.00 1 g Exxon Mobil Corporation 992 shares @84.11 83,437.00 19 Hanesbrand Inc. 12,818 shares 26.94 345,317.00 20 Oppenheimer Fund Dividend 126.43 21 Oppenheimer Fund Dividend 126.51 22 T. Rowe Price Dividend 196.64 23 T. Rowe Price Dividend 160.63 24 AT~TDividend 1,310.76 25 Bristol-Myers Squibb Dividend 718.00 TOTAL (Also enter on Line 2, Recapitulation) ; 4,825,877.72 If more space is needed, insert additional sheets of the same size Estate of LUCILE J. FOX File Number 1503 Schedule B (continued) 2012-00217 Item Number DESCRIPTION Date at Death Value 26 HSBC Dividend 130.95 27 McKesson Dividend 420.00 28 SARA LEE Dividend 8,228.02 29 Bristol-Myers Dividend 761.08 TOTAL $4,825,877.72 Page 2 REV-1508 IX+ (08-ix) pennsylvania DEPARTMENT OF REVENUE INHERrrANCE TAX RENRN RESIDENT DECEDENT SCFIEp1~LE E CASH, BANK DEPOSITS & MISC. PERSONAL PROPERTY ESTATE OF: FILE NUMBER: LUCILE J. FOX 2012-00217 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUt AI UAIt NUMBER DESCRIPTION OF DEATH 1. Adams Counly National Bank Account #9627103 1,325.10 2, F&M Trust Certificate of Deposit #015-29974008 17,886.00 3, Credit Card Settlement 18.04 4, Social Securiiy Check 01/2012 1,066.00 5, Social Security Check 01/2012 1,066.00 g, Auto Insurance Settlement 4,121.56 7. Residue from Philip E. Fox Estate 1,810.56 g, Travelers Check Refund 50.00 g. Carlisle Ear, Nose & Throat Refund 12.72 10. Sentinel Refund. 13.57 TOTAL (Also enter on Line 5, Recapitulation) ~ 27,369.55 If more space is needed, use additional sheets of paper of the same size. REV-i5og E)(+ (01->.0) ~ Pennsylvania SCNEpYLE F OEGARTMENT OF REVENUE INHERITANCE TAX RETURN JOINTLY-OWNED PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: LUCILE J. FOX 2012-00217 If an asset became jpindy owned within one year of the decedents date of death, it must bs reported on Schedule G. SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A. JUDITH A. FOX 1217 GREENFIELD LANE DAUGHTER SKANEATELES, NY 13152 8' PAUL J. FOX 1718 M STREET SON NW #A1 WASHINGTON, DC 20009 C. JOINTLY OWNED PROPERTY: ITEM NUMBER LERER FOR JOINT TENANT DATE MADE JOINT DESCRIPRON OF PROPERTY INrlUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMRAR [ NTIFYING NUMBER. ATTACH DEED R JOINTLY HELD REAL ESTATE. DATE OF DEATH VALUE OF ET % OF DECEDENTS INTERE DATE OF DEATH VALUE OF DECEDE INTEREST I. A. 05109/11 M&T BANK JOINT CHECKING ACCOUNT #1316400 42,629.63 50% 21,314.82 2. A. 05109/11 ; M8? BANK JOINT MONEY MARKET ACCOUNT #15004226663018 38,054.39 50% 19,027.20 3. A. 12102110 'ACNE BANK CERTIFICATE OF DEPOSIT #900043203051 118,180.26 " 50% 59,090.13 4. B. 12102110 'ACWB BANK CERTIFICATE OF DEPOSIT #900043203050 118,180.26 50% 59,090.13 5. A. -03101104 " '$500.00 SAVINGS BOND #D6574418HH 500.00 50°k 250.00 6. B. -08101104 $1000.00 SAVINGS BOND #M9736642HH 1,000.00 50%' 500.00 TOTAL (Also enter on Line 6, Recapitulation) I # 159,272.28 If more space is needed, use additional sheets of paper of lire same size. REV-1511 Ex+ (10-09) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INNERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER LUCILE J. FOX 2012-00217 Decedent's debts must be reported on Schedule I. ITEM A. 1. B. 1. FUNERAL EXPENSES;..... ADMINISTRATIVE CASTS: Personal Representative Commissions: Name(s) of Personal Representative(s) JUDITH A. FOX Street Address 1217 GREENFIELD LANE City SKANEATELES State NY ZIp 13152 Year(s) Commission Paid: N/A 2,556.28 0.00 40,000.00 2. Attamey Fees: 3. Family Exemption: (If decedent's address Is not the same as claimant's, attach exptanatlon.) 0.00 Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: 1,813.50 5. Accountant Fees: 6. Tax Retum Preparer Fees. 1,105.00 7. TOTAL (Also enter on Line 9, Recapitulation) # 45,474.78 If more space is needed, use additional sheetr of paper of the same size. REV-1512 EX+ (12-OB) SCHEDULE I ~ pennsylvania DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHEIII'TANCE TAX RETURN MORTGAGE LIABILITIES St LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER LUCILE J. FOX 2012-00217 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. QUANTUM IMAGING 1.75 2. GRAHAM MEDICAL CLINIC 110.72 3. PINKER & ASSOCIATES 40.13 4. HOLY SPIRIT HOSPITAL 144.03 ' 5. GREEN RIDGE VILLAGE 2,334.50 6. THE SENTINEL 157.68 7. CARLISLE MEDICAL GROUP 148.28 8. RVICES, INC. SPIRIT PHYSICIANS SE 49.07 9. PINNACLE HEALTH CARDIO INSTITUTE 38.49 10. WALNUT BOTTOM RADIOLOGY 5•~ 11. ALEXANDER SPRINGS EMERGENCY PHSC -.,... ..~,..~.. .~ 33.38 .VII: £ ku !: I 12. AT&T UNIVERSAL CARD 29.61 13. CENTURY LINKS 25.34 14. GREEN RIDGE VILLAGE 1,535.00 15. CENTURY LINKS 25.65 16. HOLY SPIRIT HOSPITAL 25.42 ' 17. CARLISLE MEDICAL GROUP 30.24 '. 18. AT&T UNIVERSAL CARD 30.52 19. CARD SERVICES 286.72 20. QUANTUM IMAGING 1.74 21. GREEN RIDGE VILLAGE 2,034.66 22. CARLISLE REGIONAL MEDICAL CENTER 72.46 23. CARLISLE REGIONAL MEDICAL CENTER 30.24 24. IBM PENSION REFUND 1,628.57 25. QUANTUM IMAGING 1.74 TOTAL (Also enter on Line 10, Recapitulation) ; 21 , 8 4 6.0 6 If more space is needed, Insert additional sheets of the same size. Estate of LUCILE J. FOX File Number 1512 Schedule I (continued) 2012-00217 Item Number DESCRIPTION Date at Death Value 26. CENTURY LINKS 27.39 27. POSTMASTER 65.79 28. SHREDDING SOLUTIONS 15.00 29. CARLISLE RENTAL SPACE 381.60 30. AT&T 21.22 31. RYAN MOVING COMPANY 10,732.50 32. POSTMASTER 9.90 33. U.S. AIRWAYS MASTERCARD 131.18 34. SKANEATELES MINI STORAGE 700.00 35. CENTURY LINKS 34.25 36. AT&T 1.42 37. AT&T UNIVERSAL CARD 16.33 38. GREEN RIDGE VILLAGE 757.48 39. CENTURY' LINKS 15.03 40. POSTMASTER 96.40 41. POSTMASTER 18.69 TOTAL $ 21,846.06 REV-1513 EX+ (OS-10) Pennsylvania DEVnRTMENT OF REVENUE INHERrrANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF: FILE NUMBER: LUCILE J. FOX 2012-00217 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Indude outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1• CHARLES BAYMILLER 91,588.97 2. KATHY JUNG 34,345.87 3. MARK JEFFREY 34,345.87 4. TERRI LINDSAY 34,345.87 5. KYLE JEFFREY 34,345.87 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II NON-TAXABLE DISTRI8Uh70N5 A. SPOUSAL DISTRIBU'~IONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. wA B. CHARITABLE AND GpVERNMENTAL DISTRIBUTIONS: L Guiding Ryes for the!Blind 40,000.00 2. National Parks ConsArvation Association 40,000.00 3. Smithsonian Instftutign 30,000.00 4. Green Ridge Village Fund 50,000.00 5. Heifer Project Intemaitional 50,000.00 TOTAL OF PART II'- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. ~ 365,000.00 If more spate is needed, use additional sheets of paper of the same size. Estate of LUCILE J. FOX File Number: REV 1513 Schedule J Beneficiaries 2012-00217 (continued) l;riAlil'1'AlfLL~ A1Vll liV VEKIVMEIV'1'AL llla'1'lilliUl'lU1V, 6. FIRST PRESBYTERIAN CHURCH 7. BIG SPRING PRESBYTERIAN CHURCH 8. PLANNED PARENTHOOD 9. AVALON CEMETERY ASSOCIATION TRUST 10. NORTHWEST MISSOURI STATE UNIVERSITY 11. MASSACHUSETTS INSTITUTE OF TECHNOLOGY llate at lleat6 Value 20,000.00 10,000.00 30,000.00 30,000.00 25,000.00 40.000.00 TOTAL $365,000.00 ' ~ ~~L L I~ 4/15/2012 Estate of Lucile J Fox Assets at Date of De ath Februa 11, 2012 Apply 50% for Cash Equivalents Joint Accounts Bank Accounts (see sep schedule) $367,228 $208,644.00 Vanguar Ad Treasury MF 536,190 536,190 Vanguard TEMF 85,710 85,710 Van PA Tax Free MM 5 1 6.581 995,709 837,125 Value # Shares Price/Sh Tax Exempt Bond Funds _ Vanguard Ltd-Term Tx-Ex 8,936 797.113 11.21 8,936 Oppenheimer Ltd Term NY Municipal A 74,146 22,001.881 _ __ 3.37 _ _ 74,146 T. Rowe Price Tax-Free Shrt=lnterm 12 8.186 38,211.195 5.71 218.186 [TRPrice includes PEF shares] 301,268 301,268 Stocks AT&T Inc. $89,191 2,979.000 $29.94 Bristol Myers Squibb Company 67,478 2,112.000 31.95 CIGNA Corporation 6,808 157.000 43.38 Exxon Mobil Corporation 83,437 992.000 84.11 Hanesbrands Inc. 345,317 12,818.000 26.94 - HSBC Holdings PLC. 12,877 291.000 ----- 44.25 - international Business Machines Corp. _ 957,980 4,976.000 182.52 International Paper Company ___ 210,730 6,496.000 32.44 McKesson Corporation 171,150_ 2,100.000 81.50 Pfizer Inc. 144,193 6,808.000 21.18 Sara Lee Corporation 1,425,236 ~,~ 19 92 ~j~"` ~ ' `;~: Tri Continental Corporation 7 97 22,336.141 15.58 3,862,394 3,862,394 Other Residual of Philip E Fox Estdte ?????? Excluding PEP TR Price sh. ?????? Lucile J Fox Personal Property 4,122 (see sep schedule) __ 4,122 Lucile J Fox Estate Expenses 0 _ (see sep schedule) 0 4,122 - -- - -- - -- 4,122 - Apply 5096 for __ SUMMARY Joint Accounts Other 4,122 _ _ Stocks 3,862,394 3,862,394 Tax-Exempt Bonds 301,268 _ ___ 301,268 Cash Equivalents 995.709 _ _ 7 1 Total of Cash Equivalents, Tax -Exempt _ Bonds and Stocks __ $5,163,493 _ 65,000,787 Charitable Bequests 385 0 (see sep schedule) 15365.0001 Total PA Estate Subject Total Taxable Federal Estate: x4,798,493 to PA Inheritance: x4 635,787 __. 4/15/2012 Lucile J FOX Apply 50%for Total Apply 5096 for CalculatlOns Of Bank Balances at Death Total Amount Joint Holdings Amount Joint Holdings i Md~T Bank Checking Account with Judith j4 Fox (2/3/12 Statement) 42,778.45 21,389.23 less outstanding check Savings Account with Judith A Fox (11/8/12 Statement) 38,026.78 19,013.39 M&T CDs 17.280.82 17.280.82 -- 88,086 57,683 Adam County Natlonalj Bank Savings Account 1,325.10 1,325.10 CD 900043203050 with Paul J IFox 118,180.25 59,090.13 CD 900043203051 with Judith'A Fox 118.180.25 59.090.13 _ _ _ 237,686 119,505 FAM Trust --CDs 17,886 17,886 Und~oosit~d Chocks 1*sued Prior to Dsath Other Credit Card Settlement 18.04 18.04 January 55 1,066.00 1,066.00 February SS ___ 1,066.00 1,066.00 _ Mutual Funds Oppenheirmer 1/24/12 126.51 126.51 Oppenheirmer 12/29/11 _ _ _ _ 126.43 126.43 TR Price 12/30/11 198.64 _ 198.64 TR Price 1/31/12 160.63 160.63 _ Stock _ AT&T _ 1,310.76 1,310.76 Bristols-Meyers Squibb Co 2/1/12 _ _718.08 718.08 HSBC 1/18/12 _ 130.95 130.95 McKesson 1/3/12 420.00 420.00 Sara Lee 1/9/12 8.228.02 8,228.02 __ _ 13.570 1 570 Total Bank Accounts 5367,228 5208,644 Lucile J Fox Psrson>al Property Insurance Settlement for Car $4,121.56 77777 _ - -- 777777 _ 77777777 p 54,122 Lucile J Fox Estats expenses - __ Funeral Costs - __ --- ?777?7 - Professional Fees __ 777777 - Estate Expenses _ _ 777777 ?77777? 0 - so 4/3/2012 Estate of Lucile J Fox Computations of Average StocklBond Fund Prices COB values from New York Times Website on Friday before and Monday after death. Price(s) per Share Stocks Averaae 10-Feb-12 13-Feb-12 AT3~T Inc. $29.94 $29.84 $30.04 Bristol Myers Squibb Company 31.95 31.90 31.99 CIGNA Corporation 43.36 43.54 43.18 E~ocon Mobil Corporation 84.11 83.80 84.42 Hanesbrands Inc. 26.94 26.54 27.34 HSBC Holdings PLC. 44.25 43.94 44.55 International Business Machines Corp. 192.52 192.42 192.62 International Paper Company 32.44 31.85 33.02 McKesson Corporation 81.50 81.34 81.66 Pfizer Inc. 21.18 21.05 21.30 Sara Lee Corporation 19.92 19.80 20.04 Tri Continental Corporation 15.58 15.52 15.63 Bond Funds Averaae 10-Feb-12 7 -F -12 Vanguard LW-Term Tx-Fac $11.21 $11.21 $11.21 Oppenheimer Ltd Tenm NY Municipal A 3.37 3.37 3.37 T. Rowe Price Tax-Free Shrt-Interm 5.71 5.71 5.71 Bequests in Will 2/15/2012 Eyes for Blind $40,000 National Parks Conservation Assoc 40,000 Smithsonian Institutions 30,000 Green Ridge Village Fund 50,000 Heifer Project International 50,000 First Presbyterian Wappingers Falls 20,000 Big Spring Presbyterian Ch 10,000 Planned Parenthood 30,000 Avalon Cemeteru Assoc Tnust 30,000 NW MO State University 25,000 MIT 40.000 $365,000 Mom's Death: Early morning Saturday February 11, 2012 COB values from New York Times Website on Friday before and Monday after death. CoB Friday Feb 10th CoB Friday Feb 10th - 0 _ ~ Eal T T N ~ l x T: NYSE ~ ~ -0.1s uSD -0.50% 0.27% - - Ear Bristol Myers Squibb Company 39.90 r6 istol Mvers Comoanv R IGNA Corporation 3 54 E 31.9 -0.O9 usD -0.29% -7.89% Edk EElocon Mobil Corporation . 83.80 NA Corooratio " n Hanesbrands Inc. 28.54 CI: NYSE 43.s4 o.w usD o.oo% -4.ss% Eat HSBC Holdings PLC. 43.94 Exxon Mobil CorooraUo ~ Irttemational Business Machines 192.42 E e3.e -1.oe usD -1.z7% -2.24% Edx International Paper Company 31.85 H n ra n n . McKesson Corporation 81.34 E 28.54 -0.se use -z.14% 1z.o3% - Eau Pfizer Inc. 21.05 ll[~ ` in k ?~~. Sara Lee Corporation 19 80 E 43.94 -1.ot usD -2.25% 12.87% Ear Tri Continerrtal Corporation . 15.52 In rn fo ll;a1 Business Machines Corooratlo n E 792.42 -0.71 USD -0.37% 8.13% - Eat 10 nal Pacer R -- COmDanV IP: NYSE 3t.85 +0.37 USD +i.18% 1.69% - - Eat McKesson Corooratio ~ Vanguard Ltd-Terre Tx-E:x 11 21 E at.34 -0.85 use -1.03% 2.08% - Eau Oppenheimer Limited Tenn NY M . 3.37 Oooenhei mar limited Term NY Munkioal ~ T. Rowe Price Tax-Free Shrt-Iota 5 71 I.TNYX 3.37 0.00 USD 0.00% 0.80% Edk . Pflzerlnc. x E 27.05 -0.OB USD -0.13% ~.OB% - Er-t Sara Lee Corooratlo " !? E 19.8 -0.17 USD -0.B5% 4.71% - Edlt 7. Rowe Price Tax_ " Free Shrt_ Interm PRFSX 5.71 .0.01 USD +0.18% 0.53% Edit Tri Contlnent " Corooratio II TY: NYSE 15.52 -0.11 USD -0.70% 5.58% - Edk Van¢uard -T rm Tx- x VMLTX 11.21 .0.01 USD w.o9% 0.39% COB M onday Feb 1 Sth COB Monday Feb 1 S th AT&T lnc• M AT&T Inc. 530.04 T: NYSE ~,~ +0.20 usD +0.87% -0.10% -~ - Edn Bristol Myers Squibb Company 31.99 8ristoi Ayers Squibb m n k IGNA Corporator 3.18 NYSE 3196 +0.09 usD +0.29% -5.38% - Edn Epson Mobil Corporation 84.42 CIGNA k R Hanesbrends Inc. 27.34 CI: NYSE 43.19 -0.36 usD -d.83% -5.33% - Edn HSBC Holdings PLC. 44.55 Exxon Mobil r i ~ Intematlonal Business Machines 192.82 NYSE 84,44 +0.82 USD +0.74% -0.64% - Edn Intematlonal Paper Company 33.02 H n ra nds lnc• McKesson Corporation 81.66 NYSE 27.34 +0.80 USD +3.01% +19.08% - Edn Pfizer Inc. 21.30 HSBC Holdings k PLS. Sara Lee Corporation 20.04 NYSE 44,55 +0.81 USD +1.39% +15.a1% - Ean Tri Continental Corporation 15.83 Internatio in Machines Corooratlo NYSE 192.82 +0.20 USD +9.1096 +7.51% - Edn m o k n P r Comoanv IP: NYSE 33.02 +1,43 U3D +4.53% +4.98% - - Edn McKesson Corooratlo ~ % anguard Ltd-Term Tx-Ex 1 21 NYSE atee +0.32 usD +0.39% +5.72% - Edn Oppenheimer Limted Term NY M . 3.37 ~~ mar Limited Term NY " Municipal 9 T. Rowe Price Tax-Free Shrt-Iota 5 71 LTNYX 3.37 0.00 usD 0.0096 0.00% - Edn . PRzerlnc• M NYSE 21,3 +0.25 uSD +1.19% -2.47% Edn _ ___ .. bra lee Como atio n NYSE 20.09 +0.2~ USD +7.21% +a.20% Edit T• Rowe Pri x- M Free Shrt_ Interm PRFSX a,77 0.00 USD 0.00% +0.35% - Edl Trl Contlnent I K Corooratio II TY: NYSE 1a.ea +0.77 uSD +0.77% +6.6976 _ E~ VanQUard -T r Lx-.Ex_ ~~TX 11R7 O.aoUSD 0.00% +0.78% 09-20-'12 14:03 FROM- , ~ M&T Ban1c T-700 P0001/0002 F-133 4200 Derry Street Harrisburg, PA 17111 (PH) 717-237-6250 rFax~ 7t7_S~~t ~7n Killian & Gephart To: C/O: John Killian From: Tobin Rote Date: 9/20/2012 Phone Number: 717-766-2324 Fax: 717-238-0592 Total Number of Pages: 2 (Including Cover Shset~ Re: Fox Bond Values As Of 2/2012 Note: CONFIDENTIALITY NOTICE: The inlarmadon canlainetl in Ihis httalmlle maybe oonpdentlal. Thii infolmalion is intended only fa the we of the individwl or sntily to whom it is eddreued. N you are nd the Inlsnded recipient, or Ihs empbyse a agent reeponslble t0 deliver it to Ihs intended redpienl, you are hereby mlifiotl that any uee, dlSSen1N1a60n, dletnbVGon W aopyinp d Iles eomnanicalion to s1AeMy prolutbted. II you have received This taoeimik in error, please immedlaloy nolNy to by telephone, and raum the oAginal message to us al the atldross above via Ikal doss mail. 09-20-'12 14:03 FROM- / vul.rulMabu • u•uv va a vau a uNw vaviaa~ uvaau~o) J •• Calculated Value of Your Paper Savings Bond(s) Calculator Results for Redemption Date 02/Z012 T-700 P0002/0002 F-133 a ubv ~•• Total Price Total Value Total Interest YTD Interest $25,000.00 $96,500.00 $71,500.00 51,900.00 Bonds: 1-S of 5 Serial # Series Denom Issue Next Final Date Accrual Maturity Issue Price Interest Interest Value Rate X575608 EE .x108000 08/1986 08/2012.,08/,2016, „$5,000.00, ,,$14,300.00 4.OOWo 019,300.00 X575607 EE $10,000.08/1986; 08/2012.; 08/2016; $5,000.00 ,x14,300.00 4.OOW6 :19,300.00 X575606 EE $10,000.;08/1986.08%2012,08%2016. $5,000.00 $14,300.00. 4.00% $19,300.Q0 X575605; Ef; :$10,000 08/1986;08/2012:08/2016 x5,000,00 $14,300.00,; , 4.00°6;019,300.00 X575604; EE $10,000 08/1986:08%2012.08%2016 $5,000.00. $14,300.00 ,4.U09~6;019,800.00 Totals for 5 Bonds !25.000.00 f71.S00.00 596.500.00' Notes NI 'Not Issued NE . Not.eligible for payment PS Includes 3 month interest penalty MA Matured and not earnin interest http://www.treasurydirect.govBC/SBCI?rice 9/20/2012 SEP 1 ~ 2012 ' ~ M&T Bank 100 South Spring Garden Street, Carlisle, PA 17013 717 240 4525 vwc 717 240 +3526 September 1Q 2012 To whom it may concern, This letter is to confir-n the date of death values for Lucile Fox's accounts with M&T Bank. Her date of death was February 13, 2012. Her checking account was jointly held with Judith A. Fox. The balance as of 02/11/2012 was $42,29.63. Her savings account was jointly held with Judith A. Fox. The balance as of 02/11/2012 was $38,54.39. If there are any further questions, please contact the branch at (717) 240-4525~/'~ Sincerely, U "' ~_ Jennifer Rhodes Relationship Banker Ili M&T Bank 100 South Spring Garden Street Carlisle, PA 17013 _ _ `~~`,'~-1'T•Z012 16:55 KILLIAN & GEPHART 7172380592 P.002 1~ ~- ~J.7R~LiR~. r~yyp c;; ::::::r ::::::::.:.::. 2316400 P1011®2 CF26CKING 00 o Od344M 20?! 017 JUDITH A FpX LUCILB J FOX 84 PLt]NC T12E& CIR NEOPVILLE PA 17241-9324 iii::. i:iAf.i~i:i`..':: ~, ::::: iiii i~ F: .......,.:., .......Nisi:m~::A~~.~...vr:e~wiii~'r::. 16904 F89.Od-MAR, 05, 2012 1 OP 2 ^7_n5_:2fg~x~~.. naT.avrv $56,776.45 -:F'~ITZGARD 8AYMSNT CNSCK PYMT OOOOOOOOOOO3203 lde_ea 56,ti29.63 :2-:.5-:2'tnsCx MpT4$$R 3205 ~ 1a, 000.00 42,629_s3 02-17-12 CRSCK liS1ld3ER 3x17 ~ 33,000.00 9,629.63 02-21-12 CHSCk N[7H8HR 3216 ~ 1,813.SO 7,816.13 02-Sa-15 CFi6CK NUlIDHR 3208 522.96 ' , ,. -' ?~ ^'d!5CK MOYIBER 3218 100.00 -. -- i-::c HZLTi PYMT 000000000007211 55.36 7,167.83 -'CLa'y" C1~RJ CS CRffi3ITCARD 000000000003206 552.22 '~:Z •F3-71' CH3CK NOF0338R 3216 a0_la 02-23-12 CiIRCK NOFID8R 3209 20.12 6,575.35 ~ 02-24-12 CIffiCR AU!lD36R 3215 47,50 " .^,z-24-12~<Zi&CK liOD'18ER 3207 33.80 g,a9a.35 -.-. -_'..,-s-~~4~r,.,.gR~3Z:4 ._.. 100.00 u,39d.35 . ..' ....:,dc2x INVBSTM Pffid3ZOH 1,628.57 {~ 03-01-12~B~R OB Pi7II DTDT B/8fi. INTST - 3.7s 4,026.67 OI-OS-1?, II~1'BRKST PAYM8I~T1' 1.13 03-05+12 FPL EU 6LIIC SVC 317.x3 03.05-12 CFIIICK &LA038R 3219 50.00 7,660.57 _ .. __._ ._ _.:~.:-A . $7,660.57 fr.::::i,..;.::d:::::::n~iii~ `ii EE:;F~P?.;%%'i<j:::?i::::' a:]C::r: s:::.::~ :::::::::::::::~:::.;~.....::::::.::::::::::::.::...:..::................,......:........................................ .::.......::::::.:.:..:::::::::.:::;::: :::....;:..,,:::::. .. C1IN4SCS:.~nm..BY';E':.,t'.:r:;;~ asi;;""::.::..`::.~:.::::.......~.,..........' ::,::.,::.:;::::;;:. 3205 02-13-13 1d~000.00 3a07~ 02-24-12 33.8D 3208 OZ-22-1a 522.96 3209 02-2;-12 a0.la 3214• 02-23-1Z 20.12 3615 02-2d-12 47.2D ' ".! 02-2I-32 1,813.50 3217 Oa-17-12 33,000.00 3218 02-22-12 100.00 ' ~:.'. ~s-^s-12 50.00 32x0 07-27.12 100.00 ANDiOAL DBRCAl1TAGS Y1lII.D 8'A 0.04 1 .: -- ~~~:' -~ :;.,:aV~ 1-OR STATID.ffi0',P YSRIOD 1.12 9PRYMG GARp1Cli I2y:::l:E'~.';7' DAl'G"YRAR TO DAY"E.,. 7-a8' .. .. .........._.-.~...~ ...--. _.. .. ......_ STATEMENT PERIOD PAGE FEB.04-MAR.05,2012 2 OF 2 JUDITH A FOX LUCILE J FOX WARM UP WITH SPECIAL SAVINGS THIS SPRING AT POPULAR RfiTAILERS WHEN YOU USE YOUR M&T CHECK CARD OR M6T VISA CREDIT CARD IN STORES, ON THE WEB AND OVER THE PHONE. VISIT MTH.COM/SHOPPING TO TAKE ADVANTAGE OF GREAT DEALS ON SPRING SAVINGS TODAY! ~1V~I'B~tt~k ACCOUNT N0.`. ACCOUNT T7t2E 1316400 POWER CHECKING sTA~t ~~xoD aaGE FEB.04-MAR.05,2012 1 OF 2 00 0 04344M NM 017 JUDITH A FOX LUCILE J FOX 84 PLUM TREE CIR NEWVILLE PA 17241-9324 INTEREST EARNED FOR STATEMENT PERIOD 1.12 INTEREST PAID YEAR TO DATE 7.48 16904 T /'~!'~I'IT TTTT C~TTMMTDV SPRING GARDEN 'BSGZNNING CE I7& IT3' & TtiER ET NS HE D OTSSR i CURRSN~! :INTEREST PD =FNDLNG >BALANCE N0. AMOUNT N0. AMOUNT NO. AMOUNT 56,778.45 2 1,632.32 11 49,707.70 4 1,043.63 1.13 7,660.57 nrrnrn.Im 21rTTVTTV POSTING DATEi.' -- - T T2 I]E - AS Q. ZT & ~~ C~I£CKS ;&: OT}i£R ~TRA~-~ DAILY 02-04-12 BEGINNING BALANCE $56,778.45 02-06-12 CITICARD PAYMENT CHECK PYMT 000000000003203 148.82 56,629.63 02-13-12 CHECK NUMBER 3205 14,000.00 42,629.63 02-17-12 CHECK NUMBER 3217 33,000.00 9,629.63 02-21-12 CHECK NUMBER 3216 1,813.50 7,816.13 02-22-12 CHECK NUMBER 3208 522.96 02-22-12 CHECK NUMBER 3218 100.00 02-22-12 CenturyLink BILL PYMT 000000000003211 25.36 7,167.81 02-23-12 BARCLAY CARD US CREDITCARD 000000000003206 552.22 02-23-12 CHECK NUMBER 3214 20.12 02-23-12 CHECK NUMBER 3209 20.12 6,575.35 02-24-12 CHECK NUMBER 3215 47.20 02-24-12 CHECK NUMBER 3207 33.80 6,494.35 02-27-12 CHECK NUMBER 3220 100.00 6,394.35 03-01-12 FIDELITY INVESTM PENSION 1,628.57 03-01-12 BUR OF PUB DEBT H/HH INTST 3.75 8,026.67 03-OS-12 INTEREST PAYMENT 1.13 03-OS-12 PPL EU ELEC SVC 317.23 03-OS-12 CHECK NUMBER 3219 50.00 7,660.57 ENDING BALANCE $7,660.57 CHECKS:'PATD 8UFm4ARY 3205 02-13-12 14,000.00 3207 02-24-12 33.80 3208 02-22-12 522.96 3209 02-23-12 20.12 3214" 02-23-12 20.12 3215 02-24-12 47.20 3216 02-21-12 1,813.50 3217 02-17-12 33,000.00 3218 02-22-12 100.00 3219 03-OS-12 50.00 3220 02-27-12 100.00 ANNUAL PERCENTAGE YIELD EARNED = 0.04 $ -®~ ,- ACCOUNT NO, -~.~ ACCOUNT TYPE 15004226663018 POWER MONEY MARKET STAT&FFENT PERIOD PAGE FEB.09-MAY.08,2012 1 OF 1 00 0 04344M NM 017 LUCILE J FOX JUDITH A FOX 84 PLUd7 TREE CIR NEWVILLE PA 17241-9324 INTEREST EARNED FOR STATEMENT PERIOD 2.08 INTEREST PAID YEAR TO DATE 18.76 20339 ~('C'C1TiTJT RTiMMaRV SPRING GARDEN ;.BEGNN ~.~ AE OSI.TS ~ s:WITHD WALS &sc3TliER ::CURRENT A ERDIftG E N0. 'i AMOUNT NO. AMOUNT 38,054.39 0 0.00 1 38 056.48 2.09 0.00 02-09-12I BEGINNING BALANCE 02-17-12 INTEREST PAYMENT 02-17-12 CLOSEOUT 2.09 $38,054.39 38,056.48 ~ 0.00 ANNUAL PERCENTAGE YIELD EARNED = 0.24 $ EFFECTIVE JULY 30, 2012, THE FEE FOR EACH DAY THAT THERE IS A TRANSFER FROM YOUR SAVINGS, MONEY MARKET, OR CHECKING ACCOUNT TO CpVER ONE OR MORE OVERDRAFTS IN YOUR CHECKING ACCOUNT WILL HE $12.50. THIS PEE WILL BE CHARGED TO THE ACCOUNT FROM WHICH THE FUNDS WERE TRANSFERRED. THIS FEE DOES NOT APPLY TO A POWER CHECKING OR MYCHOICE PREMIUM CHECKING ACCOUNT. OppenheimerFunds The Right Way to Invest AT 01 149270 636848484 A**3DCaT dIldl~fPIIHIIIIIIIIIIIIbIIII~~~IIfIIIIII~~rP~ll~til~lrll~ Ll1CILE J FOX 84 PLUM TREE CIR NEtNVILLE PA 17241-9324 Account Statement Statement Perlod: January h, 2e12 -Marsh S1, 2e12 Pape 1 Of 2 Maur Firmndal Adtdeor: JACK HIGBEE MERRNl LYNCH PIERCE FENNER 8 SMITH INC 4800 DEER LAKE DR E FL 3 JACK50NVILLE,FL 32246-6484 (845) 334-3874 Total AceottM Value Yarbt Yalue on Mardi 71, 2e12 573,lZe.32 ~ wan ua °°e"` ar'a,a"''°°P°"n°I"'°'+u„d..ao'" ® 24hourautomatedseMa: 1-000-CALL-OPP (ZZS-5677) Limited Term Nsw York Mu ia~al Fund Class A Value on March S1, Y012 Acoarrn Nundxr 00355 Bt w'wf 573,926.32 Account liya6atbn UICILE J FOX Steens 0"'~ 22.001.881 Wnd Symbol LTNYX Shan Prla 53.36 Fund arepory Manirdpal i,Band Year-To-Date Summary Coat stela Method Average Cost LNWdmds 5632.59 hear-tD-Data Traasastlelt Befall 7rasasetlaa paw ~, ~ Dees TraaascaoaOraplpUon ~ Aaawt Price orSaerss Sara8~slssos 01/24/12 Dividend Paid in Cash 5126.51 53.36 11 001 519 02/06/12 Transferred from Acct. ~ 7260050290 +10,962.853 , . 21 964 372 02/06/12 Transferred trap Acct. 55 7260050290 +37.509 , . 22 001 881 02/21/12 Dividend Paid in Cash 5253.05 53.37 , . 22 001 881 03/27/12 Dividend Paid in Cash 5253.03 53.36 , . 22,001.881 Year-tO-Date AeeOant Summary Orbs Nr1~tYalha Adelaaas Wlale)asa.IS Y sue" 11rca ~ P 01/01/12 536,525.D4 +537,071.22 -50.00 +5330.08 ~ 573,926.32 Does not include year-to-date dividends andfa capital gains paid in cash (nOt reinvested) taraNng: 563259 OppealtelmerFeMs News Global Tracker (5Nq is here. Explore the d's fastest growing markets, the companies that sell 4) thorn, and the funds positioned to benefit fran them. A . world of pk>bal knowledge, insights, ideas aid apportunNies All in one single app. Damload our free app at vwrw.globalizayourthinkingcom/app. Downkmd to fiBR Bock At Homer H you cah view your account onNne, you can downkrad your 1099 tax form information to H8di Bkrck At Home in addit~n to Turbo Tax, and Ouidcen. 149270/0000001 N ol..M1IO401~M,pf.,,,{1_........pippl tao]l,rt_ma_...a7~ow®0 OppenheimerFunds® The Right Way to Irnest FLOW ~ r.01111E1G~ ~S 1.e6II,wt.6PP awn 24-hour aurorrtated inkimnUai and trarrsactlons. Frr 1.308.76&1500 To Add to Your Aasount By Check To Add b Yar Aaarat M CMaalt Write a check nrede payable to you Lund ~~nves~hneM c~ fra~a r~ 00~ ~ion~ at ~Yfaty~p~jyarindudo c4edr to: OppenheimerFunds Distritxrta. Inc. Oppenheir 5 ~irihulCr, k~C. P.0. lbr 5270 12100 East Miff Avente, Denver, CO 80217-5270 Suite 300 Aurora, (~ 80014-1250 IIMwW rtorospan 1w rrar rgrt d year Mpllarp7s - Ftirrd performance, fund dacumenls, tmiy and historical fund prices and market camnerthary. i,oo b b - Review your balance,lfaasacUon hisYry, and accormt staterterits a to make a quxk purchase, elxharge a redemption. ~~ 0 ytwr sbemem includes a Contribution Summary, pease keep kr mind Uet Eris does rat represent a eau form. f1S Form 5498, nailed in May, contakrs final cordriddbris fix tax purposes. Please note, accatnt debts will natappear on this statement for prbr year cattrllutlorts lxbss the rArltribudon urea made between Jarnfary 1 and April 15 of the aayerlt yar. Fa details at mesa trar~ctia~, please refer to your lost Annual Account Statenem. ~j81eS hde1111ed011 You roe/ a allf~rMa ice' d+aslt:slrt aiaoarut)t read a 11M eta d far prudpsla, wrrsut YaM1ap er fitlltolrwus fro ais drrpa 1pu paid ttllr ~Ifr aft UsalrM. , „ t~lulasd rata dMir to ~respsefls ar al~etfar PLEASE IfDYE yar nrtltlal fund shares may be lrartdrred to 0fe appraprlate stath'rf ra activity axurs~ a rf staterrertts of your acceum Y prove undeliverable, wi[trin the bme period specified by state law. Ac~wnt S#satsm~nt Page 2 Of 2 ~OIICiO~ Tent R~orlin~ Me~ods Ste redeorred at the average cost of all covered shares in the aceolint at the time of the redemption. Average [bat is Ure derauft matlwd on yiour actaowr(~ wiM OpperrtN:bnerfierds, rmtess you ~!tY ,7Nerwtae. On each axoiad tied wfih us. you have urdfi the Urns Of the first redemption of Dovetail shares to charge your cost basis tax reporlYg method from average cost. S~re~s pu~se~.d redeemed first. the fdghe~ are redeemed first. Lart-Ice Rrot-0rt p.i~: Stares purt~rased last are redeemed first. I.ar pat Shares wfth the lowest cast are redeemed first. 13pselps tern IdaalMatloa: Shares era redeemed in the ceder specified ffi the Uma of Ue rederriplion, We can provide transacUatel reporting m this method but specific strata iderttlfica0ort cararorbe used as a standing method on your aaourd(s). CaaarM tMiroa: For Coveted shares purrdiesed on a after Jataary 1.2012, and stittsegiiently redeemed, OpperiheirrerFunds wall repot rte redemptlori trar~m(s) aril the gale a loss of 0iase shares to the IRS ar foorm 10!19.6. The gels a loss may vary based upon the cost bees method selecmd at the Uma of the transition. We are ialabte 10 change the cost t>dis tax repafirg method afiar your trade settles. For urrlro+rered std purchttaed prig to January 1,2012. and subsequetrtly redeemed. OppenheNrarFunds will report the proceeds hen the rederrlptlori lrans~fiargs) on the Form 1099-8; however, cost basis amt the Garin a loss of those shares rm7 nor ba cakUfalad a rtrpafed b the a~S OppenhelrnerWr~s wfil cananue to provide shareholders with the average cost of these strrarres as a cdgieay. We are rat stile to provide alternate cast teals tac repaUrg methods for Uwe shares. You away eMrwl~ cod rats in ~ s1slMedts) rY YNitrs aul ~a~dt~aatttattusrrutl)Rdtap 8/ItaMle rasYbrans ttlllsk year flawchl a Ent adMwr reyariiup four spalpo left oMrapaa. ~~ A dmsion of OpperireirtrerFurtd3, Inc. ~rfimrs transactions in your accourd as agent for the fund and far yen irnresbrrerd dueler. Fnr trans which are practfases of shares, OFS aces ore the agent for OppertreimerFiubs Distribrdor, Inc. (OF1>n, the dYtrilximr d the fund, in issuing this statarera.l'he distributor add the starves to yorx dealer. and your dealer sold them 1o you. Year dealer ailed as pdraipal in the trarrsartion end oval receive as oonipensetion that part d the sales dierge. it any. Uet is set forth in the Fund's carted prospecWs. fi you bWgtit shares dlrectlv, through an agency traraacdon a ttvou~ a txdcer, deals a Delver inarmedary, OFDI acted as apart in placirp the Trade. Addlllorcal Infamatim about yrna Fund account may be found h the f-und's cunem prrrspedus, includlrg kdonneaen shout how to redeem elnres. Please consuR yca proSpecWS, a write a call us at the add azid telephone numbers tided on this statement. 1!sis accord atatrraat dlYcb a frlrararr, radrg0a ar aMr firpeclsl trarweotlon. PYN review cep of Ms isrraraparr ordapf b ~b ~ aeaaacy d ttr raaoe0ra Yw slrWd praarfApl aoWf OpprdtdlrierFnrda dsErbaaur, Yrs. irrrrwardely p Mere Y a• error, traaoarrof ar iaaatpsay. You can aria rrdr wprt b ~, IpaltMrtr, Ina. d f.01p,7l6.t;A77. Aoy oral raprt Nraldd alto M rl-oNrAlrtW'Y aoltrp b O frilMal~rltdds plariadar, Ise P.a Gas 0170, paairar, 00 ppil7~fp, p Y rAarlMrl Mat fora rgwt arrdar Ms lrarrfras~ b Iharctla Aa1. 0 far b art~oolrfl~ r~ a rrar adpda ep irtayo d r.alpt d Mir atrtraat, fa a6I rs drraawd b Mr ra1Md aseti tartaaoperr, and rs ray wt Ye a01a b arruat fort aoasrt lYa atataared Y ~ a retard d UN r@pla d 0M aranrrldarQ-tread d Me data d p Yea 71Me adYarald Y aaOMr s nrpOarY Mrnrrd nor a ascraity. pantry d Mb abienmt aaMs a verb d Ma radlrYat O~rtararwFuMs pYYMrlor, rte. Y a aasrar d SlPO. Yea say otMaNr Yfraspa stioat 1N!'C, YdMiYO iti SpC Yradaa, rf eoabaps0 SFC at 2pL3T1.610p. a otrpao d arrraalpoar0. Far arty written correspondence, pease send to: OppeMeknerfrmds Senrices, P.D. Bar 5270. Demrer. CO 80217-5270. qP.!W1W..O11~glObllYV.Yf,i..........0~0\\mL1P10000aiT1.0YWM0.-.OOfa_..1L001Ym t7ppenheirner~unds® The Right Way to Invest AT 01 148268 6369464 4 A**3DGT 1,L~,I1~11~11,~ILJIy~y,1~~~11~1111111"~'I1I1~,,,"II111~~'1 PHILIP E FOX 84 PLUM TREE CIR NEINVILIJ: PA 17241-9324 Account Statement Statamallt Pealod: January 91, 1912 -March 31, 291! Page 1 of 2 Tour Fillandal Advleor. JACK HIGBEE MERRILL LYNCH PIERCE FENNER 8 SMITH INC 4800 DEER LAKE DR E FL 3 JACKSONVILLE, FL 32246-8484 (845) 334-3874 Total Account Value Martst Yalus on Marsh 31, 2912 69.N ~ "~ °$ °~^° at www•oppanhalrnart'un~.eom ® 24fiourautomatsdawla: 7-89g-CALL-OPP (ZZ6-6677) Limited Tsrm Now York Mu icipal Fund Class A Value on March 31, 2012 AcoouM Numbar 00355 72 50280 mat t/agn ~ • ~ AcxrouM Raastrsttan PHILIP E OX Slpn Prla ~•~ Pond Symbot LTNYX Year-TO-bate Summary Pond Lirt g ~ d DJvidsnda 5126 03 that Nrsla Nhthod g C . Tar-tO-Date Transaction Datall Tra~lon Oo1Far Slavs Dab 7wssactlonDpptptlos ralar6sr Aaraant Pllca WSharss SarsaNrrp 01/24/12 Dividend Reinvested 02/06/12 Transferred to Acct 5 7260050280 6126.03 63.36 +37.509 11,000.362 . Cost Basis Method - Av Cost -10.962.853 37.509 02/06/12 Transferred tD Acct. N003 5 7260050280 -37.509 0 000 Cost Basis Method - Av a Cost . Tsar-to-Date Aaottxt Summary Des WrkstYakrs Adaltloss Iwtl~apb V s ~ m t A lr t 01/01/12 636,396.67 +60.00 -637,071.22 +6674.55 .60,00 Op'aMtalmarFas~is News Gklbel Trader (SAA) is he% Explore the wglCs fastest growing markets, the companies that sell to them, and the funds positlarted to benefit from them A . world of global knowledge, insights, ideas afid opportunities. All inane single app. Downbad cur free app at www.globaAzeyourthinlang.com/apµ Downkled to HBiR Block At Home ff you ca0 view your account online, you can download your 1099 tax farm information to H81i Bkx* At Home in addition to Turbo Tax. and Ouidten. iaszes/ooooooi vr..ri,s~n+wnarwww.wax.........aooi,ms.a,os~~ow,~.yp,w._.ra~aam -_ _.. _ - QppenheimerFunds The Right Way to Irnest NOIW~VB l,aOa.GLLOPP ~~ 24-Hour atrtanatecl Irdonrratlon and trarrsactlons. rdrt 1.30a.76a.1:~0 To M!d ~n Your AacaMrt By Check To Add b Yeer AecarM iW (greck Witte a dreclc made payade to yow fund ~ imreshne~carpan fromorra recent 0onlirmadon of Fund Actlviry. Afiail lrour ~ cttedr to: RaAtdar Mtl l~eaarY OPpenhelmerFurrds Distributor, Inc. OpperthehrrerFunds Disirifndor, Inc. P.O. Baer 5270 12100 last Miff Avenue. Demrer, CO 80217-5270 Slrtte 300 Aurora, CO 80014-1250 M1~ itforreaYae yor rrorl rplrt ~ Your ~~ -Fund perfomrance, Lund docrrnrerlLS, dairy and historical turd pdCes and ntarkd arnrtrerrlary. LaA b b - Review your baknce, iransactbn history, ~ accorrrt staternerrrs a to make a quick purchase, excltarrge a redemption. Re~nle~ A ' ' CorM~lw~ilons Y your stelertterd krJutfoa a Coniibutbn Summary, please keep in mind that thk does rqf represent a tan form. yiS Farm 5498, maiNd in hby, radairrs final mrrMlxdbns for tax purpr>ses. Place oats, accorrtt details atilt not appear on ttrk SCatertlerrt fir prbr year conCbutlons unless the tonUibutlon was made between January 1 and April 15 d the curets year. For rielaik ar these transactions, please infe/r+i~nyour last~An~rn~ml.A,ccoau~m~S,tatement. a7~ Charge A~111~a0OWS~ Yoe tbq 60 ~r ierr ireelgoiln tiocorlrlo Hued ore its a4e d yar PrroMtab arr'ollt Mellya or •i11NIRiywdreots, TM alarr dl~ yoo P~ ~ t~Mr ~ titre file IyllillluidMnl t'ab o19 CMO~Mi. Fleero I~R b ~ R OrIllaCti Y~ ~adoloor flat 1Ya'rrK irlrlalatlclr. PtEA4E NO1E your mrtual fund shares may be Verrsfared to the appropriate stave rf no activity occurs, a ff slatemerds of your accarnt activity prove retddNorede, vdtiar the time period specified by state law. A~~t Statem®nt f3taNSINIt Pdrlo~ January M, 2h2 - MtNdl 31, 2fit2 Page 2 of 2 611 Coat 68SIS Tax RMoriin~ Ms~ds ~~ Shares are nldeerrred et die average oust of all covered shares in the aocormt at the time d` the redemption. Average Cast is the d~autt method on year account(s) nrttr ~peNrefinerFumt~ unless you sperxty otherwlae. On each accaert trdd with us, you have unttl tfre ~ of the first redtlrrrpdon d covered shares to ctraange your cast basis tax rePrxtln9 meilgd from average cost. HrelPae ylrci~Ytrt(ii0k Shares puttire.4ed tilt are r~eemed first. Hf~b Rrrk-art lllao}: Shares with the highest oust are redeemed first. 6at1t-la FkM-0n[ alb Strares purclreasd last are redeemed first. lerr OooC Sfarres whh the Itrwest cost are redeemed first. SNaoifle tilrrre Idelra: Shares are redeerrrad in me txda specified at the time crf the redemption. We can provide lransaotional reperting on ibis medrod but apecffic share idenflficatim carmot be used as a starxNng method on your acmurdls). CevMOd tiioreo: For covered shares purcira5ed on a otter January 1,2012, and subsequerray redeemed, Oppenlteinretfvnds enll report the redempton trereacfiortls) and the gain a bas d those slreres to the IRS on Form 1099-8. The gain a loss may vary basod upon the cast basis trretlrod selecOad at the tlnre of the transactlon. We are orrable m change the Cost bask tax repating method attar your bade settles. For urtcouered shares purctresed Prior th January 1,2012. and subsequently redeemed, ODDsnhehrrerfurxk will repot the precesds from ttre redenrpllort hansactlorrls) orr the Form 1099-B: however, ~ basis and the pin a Iris of these shares will Trot da calctdaied ar mated tb the iRS. 0ppenheirtrerFunds wgl mntinlo to provide sirerehtNders with the average cost of these shares as a eorrlesY. Wa are Hat ode to provide alhemate mot brers tnc reportlng methods fa these shares. ~~A//d yRar t~ bane fret rtt~wllq Y~ lrorr IMukdN ar ta~c addaer reyarinp ~ Sarioer lops) A division d Oppedreimerf urtds, Inc. arrf~mts bansacUons in your accent as agent for the find artd br yar irwestment dealer. For bansarlions which are purchases of shares, OFS ads as the sgerd for OppertAetrterftrrds DistriMAOr, arc. (OFOq, the rSsbibuta d the Wnd, in issuing this statarrterr. The distrbutor odd the s-eares to yar dealer, and yax dealer sold them 1v you. Your deals ailed as pdndpal in the trereariiort end wgl receive as camperrsatien tltat pmt d the sties drerge, 'rf efry, that k set fear in the FuM's arrest provper;hus. tl ya bought shares dkeCtly, thrergh an agency trersaclbn a through a broker, dealer a otlrer irdrrmarkary, ~ acted as agerrt in pkcing the trade. Addtlbnal Infamatlon about you Hod accatm may be fend b the Find's cunem prospectus, including rdarntatlat shout how to redeem streres. Please corwr>t your pnx3pectus, a write a caa us at the addresses and telephone numbers listed on this statement. Tile aooaad etclcnreat reaoW a prreiea. reNrePtlan rx aOU aarr~el crarreWoe. Please reMow M d ire leldrareaorr errdlyr b eadfY are aecrrardr of tie frame. Ya Mrerdd prerapay rrrtlly Oppedekrerrtkarde de0raarlor, inc. itrredlaky if here k ore error, iracuece.7 K taro.p.r.'y. Yau tats realre arch relpwl b ~, flkldrrdor. hrs. rK tIJ00.ZZdi.•177. An arts report e110Wd alts lei rrt~oer8read b raarp b Uppcaiolawliarde al~krncr, Inc. P.O. aoe aZlO, 0oeeor, 00 la1:17.6Z70. tt k igrrhrt lied yor nprrt tailor tlra larullYa~ rb Pred~Yea Act N ynr ds eat ~ s ~ an omr trails tip dap of reocyrt of rile slabree~ yon rrla M doeerod b Mao rattNd ash trarraclla, and w ern eat be able b adJwt Yarn a0ard. Thb ctatcrrat k sly a record of ar ridlru of tie oiorelwikr~rt-record ~ fir dtrb of ~ kpa 71dc oYlceroln k rulrrtr a ocaareito 4irracrd aor a ooaefb. oeMvary d ark alrlwaerd Coates p rtOhb of the roelpleet OpperiairMrperlo lllailarlet, YrF k a reereber d SIPC. Ya sit obfaln k(resrce mart SA'G leeirdira the SRC iredeee, by eenteearra Sa'C at 2~9TI.a80a, ar Celina M trww.sipc.org. Far arty wriliBn caresportdence, please send to' OppedteimerFUnds Services, P.O. Bar 527(1. Dower, CO 8021 7-5270. OPP..g100t011MA001If10.Yfll....._..O®0111pLtP1 W 00061]I00001f0..00]16.....f100F0>!0 r- u Investor Number 521045420 March 2012 Mutual Fund Statement ~~~~~ INVEST WITH CONFIDENCE 1101381 01 AT 0.371 "AUTO TB 0 285413152-970417 C01-M7 -P01492 rllllll~hlll'II'I~IIII~IPIIIII'Illtll~4dtl'III~'~IIII~~" ~~II~ Judith A Fox Adm Est Philip E Fox 1217 Greenfield Ln Skaneateles NY 13152-9704 If you have questions, please visit troweprice.com or call T. Rowe Price Mutual Funds at 1-800-225-5132. Looking for an easy way to automatically maximize your IRA contributions each year? 51gn up today for our IRA AutoMax online service to begin fundingyour IRA for 2012. Visit troweprice.com/automax. Polrtfolia Ys1u~:. 1©7 064.br1 • This Month Year-to-Date' Beginning Value S0.00 50.00 Additions 106,895.04 106,895.04 Deductions 0.00 0.00 Income 169.60 169.60 Market Fluctuation= 0.00 0.00 Ending Value $107,064.64 $107,064.64 Net Change $107,064.64 $107,064.64 This Month Year-to-Date' Tax-Free $169.60 $169.60 lYear-to-date income may include closed accounts no longer shown on this statement ' The term "Market Fluctuation" reflects any increase or decrease in fund share prices since your last statement It does not reflect a fund's payment of dividends and interest or any reinvestment of dividends and interest into your account. If all ofyour holdings are money market funds, there should be no change in account value or principal due to market fluctuation. For other terms, please see "About Y°ur Account and Statement" T. Rowe Price Tax-Free Shott-Intermediate Account Number: 7150293397!-6 Tele*Access Code: 26 Ticker Symbol: PRFSX Covered Shares Cost Basis. Method; Average Cvst Judith A fox Adm Est Philip E Fox Date Activity This Month Shares Sha re Price Net Amount 3/1 Beginning Balance _ _ 0.000 $0.00 $0.00 3/28 Transfer From 650069371 +18,819.549 0.00 0.00 3/30 Dividend Reinv +29.859 5.68 169.60 3/31 Ending Balance _ 18,849.408 _ ... _ .. $5.68 $107,064.64 Covered Shares: 87.682 Noncovered Shares: ' 18,761.726 Covered Shares-Average Cost Aer Share: $5.71 Year•to-Date Information Noncovered Shares-Average Cpst Per Share: $5.33 Tax-Free Dividends $169.60 Annualized 30-day dividend yield: 1.89°~ Purchases $106,895.04 • This dividend is for 32 days vs', 29 days last month. Page 1 of 2 T.Ro~weAioe ~: About Your Account and Statement INVEST WITH CONFIDENCE Servicing Your Account CONTItCTT. RrDMIEtaRICE To view and update your account, select the Log In button to oursecure website at troweprice.com. Update your personal information, including enrollment in e•delivery programs and otherservices, in "Profile & Preferences:' To Websita activate your T. Rowe Price mutual fund and brokerage accounts online, visit troweprice.com/activate. For additional trowepice.com assistance, call 1-800-225-5132. E-rn~i info~troweprite,com Tat~Iphpni-ilundaKS lNutuef ftind~ i-Bff0.325.5332 Tefe'Access• 1-800-63&2587 for tfre,Neaein8 rmpwlred 1.800367-0763 iYgilin$1fddress T. Rowe Price P.O. Boz 17302 Baltimore, MD' 27247.1302 VISTT T. Rl}IIME PRICE Irrvecter Centers For directi4trs arid. hours, visit our website orcal)1-800-225-5132 California Century Ciry, CA Walnut Creek, CA Gatorade Colorado Springs, CO Olatrid of Columbia Washington, DC-Downtown Florida Boca Raton, FL Tampa, FL Hlirais Northbrook, IL Oak Brook Il Mazyland Baltimore, MD Owings Mitts, MD Massachusetts Wellesley, MA New Jersey Paramus, W Short Hills, N) Activity Summary This section summarizes the activity across all of your accounts for the statement period and year-to-date. "Additions" and "Deductions" comprise arty transactions to move money into or out of your account(s), including purchases or redemptions, exchanges into or from a fund, transfers to or from other accounts, or checkwriting activity. Any applicable redemption fees also are included in the deduction amount. Proceeds from arty income not reirnested in the same account (cash dividends paid to you and dividends invested into another account) also are reflected as a deduction. "Income" comprises arty proceeds (cash or reinvested dividends and short- and long-term capital gains distributions) earned from your accounts. Income that is not reinvested in the same account (cash dividends paid to you and dividends invested irno another account) also is reflected as a deduction. "Market Fluctuation" reflects any increase or decrease in fund share prices since your last statement. It does not reflect a fund's payment of dividends and interest or any reirnestment of dividends and interest into your account. If all of your holdings are money market funds, generally there should be no change in account value or principal due to market fluctuation. Income Summary: Taxable, Tax-Free, and Tax-Deferred Summary amounts are estimates provided as a cornenience fortax-planning purposes. To report taxable and tax-free income on your tax return, always wait to receive IRS Form 1099-INT, for interest income, and Form 1099-DIV, for taxable income, and Form 1099-B, for reporting the sale of securities and mutual fund shares, before completing your tax return. These forms are mailed in late )anuary with some exceptions. A fund's taxable income occasionally is reclassified, so amounts shown on yourstatement summaries may not match those on the official tax document. Cost Basis IrdormaUon Cost basis information forthe sale of taxable securities may have been added to this statement and may not be applicable to all accounts. New IRS regulations separate securities into covered securities and noncovered securities. "Covered" securities are subject to cost basis reporting on Forn 1099-B, including stocks purchased on or after January 1, 2011, and mutual fund shares purchased on or aker)anuary 1, 2012. "Noncovered" securities refers to securities purchased prior to the covered dates. When redeeming shares that are subject to cost basis reporting on Form 1099-B, T. Rowe Price will dispose of alt noncovered shares in a First In Frst Out order before disposing of covered shares, unless you choose to specify individual lots at the time of the redemption. The cost basis method applied to sate transactions is your account method or the method you have chosen for the transaction. Tax lots have been selected and disposed of in accordance with this method. This method will be used to report the cost basis information forthe sale of covered securities on Form 1099-B. For more information, visit troweprice.com/costbasis or contact T. Rowe Price oryour tax advisor. Averap Cost Per Share We use the average cost method as the default cos[ basis method for covered mutual fund shares. We also provide average cost information for noncovered mutual fund shares if the information is available. The average costs for covered shares and noncovered shares are calculated separately because IRS regulations require that covered and noncovered shares are treated as held in separate accounts. To calculate the average cost ofyourT. Rowe Price mutual fund shares, we include reinvested dividends (except for the month just closed) and capital gains distributions, purchases by exchange from another fund, and alt other purchases and prior sales. We also adjust for any wash sales, returns of capital, and stock splits. We may not show your average cost for the following reasons: 1. We may lack cost basis if: the account was opened prior to 1/1/93; noncovered shares were inherited or given to you; orshares were received via trensferfrom another T. Rowe Price account or another investment manager without the cost basis information. If you provide your cost basis for noncovered shares on our Cost Basis Change Form, we can report average cost per share to you in the future and also calculate your gains/losses on share redemptions for your convenience. 2. Average cost is provided only where applicable; it's not provided for money market ortax-deferred retirement accounts. About Your MMual Fund Account NewY~k T. Rawe Price Fund accounts are maintained and serviced by T. Rowe Price Services, Inc. The net asset value or share ' Garden City NY investment adviser price of each T. Rowe Price mutual fund is calculated by T. Rowe Price Associates, Inc., the funds , For more information, consult your T. Rowe Price Fund prospectus. The time of the transactions listed on this Vfrgirda statement will be furnished to you upon written request. The principal underwriterfor T. Rowe Price mutual funds is Tysons Comer, VA T. Rowe Price Investment Services, Inc. Request a prospectus or summary prospectus; each includes investment objectWes, risks, fees, expenses, and other informat)on that you should read and consider carefutiybefore investing. View Your Tax Forms and Statements Online -Now Avallable Up to Seven Years Did you know you may view yourT. Rowe Price tax forms and account statements online in the secure area of our Web site? The archive now holds up to seven years of your tax forms and statements. To access, log in to your account at troweprlce.com and visit the "Statements & Records" section. To manage your accounts quickly and easily, sign up for e-delivery at trmveprice.com/paperless. a T. Rowe Price Investment Services, Inc., Distributor. Pa e 2 of 2 05102-17.GB 1/12 g 111723 © One M~uftalo, N Spring Garden February 17, 2012 342 LUCILE J FOX PHILIP E FOX 84 PLUM TREE CIR NEWVILLE PA 17241-9324 Re: CD Account Closing Notice Account # 31003920484620 Dear Lucile J Fox, We are writing to confirm that on 02/17/12, your CD account was closed or transferred. At that time, the balance was $21,795.93. We'd like to remind you that M&T Bank is committed to providing you with solutions to all your financial needs. To find out more about the many ways we can help you with those needs, simply stop by any M&T Bank off-ice or call the M&T Telephone Banking Center at 716-626-1900 or 1-800-724-3222. Or if you'd like, visit the M&T website at www.mandtbank.com. Thank you for banking with M&T Bank. Sincerely, M.~chaeP N. Tncxdy¢.n Michael N. Tradyer SMACCL AZRCSI T T Date Tax Opened: 12/2/2010 Term: 33 Months ID: 492-26-2465 Number: 803 Certificate of Deposit Account Number: 900043203051 Amount of Depos&: One Hundred Sixteen Thousand Four Hundred Thirty-Three Dollars And Fifty Cents $ 116,433.50 This Tbne Deposit is Issued to: Issuer: ' LUCILE J FOX ' JUDITH A FOX 84 PLUMTREE CIR NEWVILLE PA 17241 :.... I Not Negotiable -Not Transferable + Additanal terms are below. , Additional Terms and Disclosures This form contains the terms for' your time deposit. It is also the Minimum Balance Requirement: You must make a minimum deposit to Truth-in-Savings disclosure for th a depositors entitled to one. There are additional terms and disclosures on pa a two of this form, some of open this acwunt of $ 5,000.00 ~ o explain or expand on those low. You should keep one wpy of ® you must maintain this minimum balance on a daily basis to earn the Meturhy Date: This account matures 9/2/2013 annual percentage yield disclosed. (See below for renewal information.) Withdrawals of Interest: Interest ^ accrued ® credited during a Rate Iaformetlon: The interest ra[e'i for this account is 1.490 % term can be withdrawn: at maturity with an annual percentage yield of '' 1.50 %, This rate will be paid until the maturity date specifiedl, above. Interest begins to accrue on Early Withdrawal Penalty: If we consent to a request for a withdrawal the business day you deposit any uotbcash item (for example, a check). that is otherwise not permitted you may have to pay a penalty. The Interest will be compounded monthly penalty will be an amoum equal to: six (61 months Interest will be credited i eve 012 Months and added beck to the account interest on the amount withdrawn. ® The annual percentage yield ass that interest remains on deposit Renewal Policy: until maturity. A withdrawal of i terest will reduce earnings. ^ Single Maturity: If checked, this account will not automatically ^ If you close your account befo#e interest is credited, you will not renew. Interest ^ will ^ will not accrue after maturity. receive the accrued interest. ® Automatic Renewal: If checked, this account will automatically The NUMBER OF ENDORSEMENTS needed for withdrawal or any renew on the maturity date. (see page two for terms) other purpose is: 1 Interest ^ will ®will not accrue after fatal maturity. ACCOUNT OWNERSHIP: You have requested and intend the type of account markedl below. ^ Individual ® Ioim Account -With Survivotshi~ io °~~oi`°'"° ^ JOIm ACCOUt[t - NO $uNIVOrShlp taa mrode in common) ^ Trust: Separate Agreement Dated! ^ Revocable Trust Designation as efined in this agreement (Beneficiaries' [tames and addresses) ACNB BANK 16 LINCOLN SQUARE PO BOX 3129 GETTYSB RG, PA 17325 By WITHHOLDING TIN: 492-26-2465 ® Taxpayer I.D. Number -The Taxpayer ^ Exempt Recipients - I am an exempt Identification Number shown above (TIN) is recipient under the Internal Revenue Service my correct taxpayer identification number. Regulations. ® Backup Withholding - I am not subject A provision for my signature, certifying to backup withholding either because I have under p~h~ of perjury Ute statements not been notified that I am subject to backup checked in thts section and that I am a U.S. person (including a U.S. resident alien), is withholding as a result of a failure to report contained on the first copy of this all interest or dividends, or the Internal certificate. Revenue Service has notified me that I am no longer subject to backup withholding. ENIIORSEMENTS - X X X i n ~ Fjr~; ©1893 lAnk~n Sy~tam~, Inn., St. Cbud, MN Form CD-AA-NPD (7~ 1/3/2001 READ PAGE TWO FOR ADDITIONAL TERMS (pegs ~ a/y~ DEFINITIONS: "We," "our," and "us" mean the issuer of this account and "you" and "your" mean the depositor(s). "Account" means the original certificate of deposit as well as the deposit it evidences. TRANSFER: "Transfer" means any change in ownership, withdrawal rights, or survivorship rights, including (but not limited to) any pledge or assignment of this account as collateral. You cannot transfer this account without our written consent. PRIMARY AGREEMENT: You agree to keep your funds with us in this account until the maturity date. (An automatically renewable account matures at regulaz intervals.) You may not transfer this account without first obtaining our written consent. You must present this certificate when you request a withdrawal or a transfer. This account is void if the deposit is made by any method requiring collection (such as a check) and the deposit is not immediately collected in full. If the deposit is made or payable in a foreign currency, the amount of the deposit will be adjusted to reflect final exchange into U.S. dollars. We may change any term of this agreement. Rules governing changes in interest rates have been provided. For other changes we will give you reasonable notice in writing or by any other method permitted by law. If any notice is necessary, you all agree that the notice will be sufficient if we mail it to the address listed on page one of this form. You must notify us of any change. W]ITIiDRAWALS AND TRANSFERS: Only those of you who sign the permanent signature card may withdraw funds from this account. (In appropriate cases, a court. appointed representative, a beneficiary of a trust account whose right of withdrawal has matured, or a newly appointed and authorized representative of a legal entity may also withdraw from this account.) The specific number of you who must agree to any withdrawal is written on page one in the section bearing the title " ...Number of Endorsements .... "This means, for example, that if two of you sign the signature card but only one endorsement is necessary for withdrawal then either of you tray request withdrawal of the entire account at any time. These same rules apply to define the dames and the number of you who can request our consent to a transfer. PLEDGES: Any pledge of this account (to which we have agreed), must fast be satisfied before the rights of any joint account survivor beneficiary or trnst account beneficiary become effective. For example, if one joint tenant pledges the account for payment of a debt and then dies, the surviving joint tenant's rights in this account are subject fits[ to the payment of the debt. OWNERSHIP OF ACCOUNT AND BENEFICIARY DESIGNATION: You intend these rules to apply to this account depending on the form of ownership and beneficiary designation, if any, specified on page 1. We make no representations as to the appropriateness or effect of the ownership acrd beneficiary designations, except as they determine to whom we pay the acwunt funds. Individual Account - Such an account is owned by one person. Joint Account With Survivorship (And Not As Tenants In Common) - Such an account is owned by two or more persons. Each of you intend that upon your death the balance in the acwunt (subject to any previous pledge to which we have consented) will belong to the survivor(s). If two or more of you survive, you will own the balance in the account ownership as joint tenants with survivorship and not as tenants in wnunon. Joint Account - No Survivorsbip (As Tenants In Common) -Such an account is owned by two or more persons but none of you intend (merely by opening this account) to create any right of survivorship in any other person. We encourage you to agree and tell us in writing of the percentage of the deposit contributed by each of you. This information will not, however, affect dre "number of endorsements" necessary for withdrawal. Revocable Trust Account (subject to this agreement) - If two or more of you create such an account, you own the accoum jointly with survivorship. Beneficiaries cannot withdraw unless: (1) all persons creating the account die, and (2) the beneficiary is then living. If two or more beneficiaries are named and survive the death df all persons creating the account, such beneficiaries will own this account in equal shares, without right of survivorship. Any such beneficiary may withdraw all or any. part of the account balance. The. person(s) creating this account type reserves the right to: (1) change beneficiaries; (2) change account types; and (3) withdraw all or part of the deposit at any time. Trust Account Subject to Separate Agreement - We will abide by the terms of any separate agreement which clearly pertains to this account and which you file with us. Any additional consistent terms stated on this form will also apply. SET-OFF: You each agree that we may (without prior notice and when permitted by law) set off the funds in this accoum against any due and payable debt owed to us now or in the future, by any of you having the right of withdrawal, to the extent of such person's or legal entity's right to withdraw. If the debt arises from a note, "any due and payable debt" includes the total amount of which we are entitled to demand payment under the terms of the note at the time we set off, including any balance the due date for which we properly accelerate under the note. This right of se[-off does not apply to this account if: (a) it is an Individual Retirement Account or other tax-deferred retirement account, or (b) the debt is created by a consumer credit transaction under a credit card plan, or (c) the debtor's right of withdrawal arises only in a representative capacity. You agree to hold us harmless from any claim arising. as a result of our exercise of our right of set-off. BALANCE COMPUTATION METHOD: We use the daily balance method to calculate the interest on this account. This method applies a daily periodic rate to the principal in the account each day. TRANSACTION LILVIITATIONS: You cannot make additional deposits to this account during a term (other than credited interest). You cannot withdraw principal from this account without our consent except on or after maturity. (For accounts that automatically renew, there is a ten. day grace period after each renewal date during which withdrawals are permitted without penalty.) In certain circumstances such as the death or incompetence of an owner of this account, law permits, or in some cases requires, the waiver of the early withdrawal penalty specified on page one. FOR ACCOUNTS THAT AUTOMATICALLY RENEW: Each renewal term will be the same as this original one, beginning on the maturity date (unless we notify you, in writing, before a maturity date, of a different term for renewal). You must notify us in writing before, or within a ten day grace period after, the maturity date if you do not want this account to automatically renew. Interest earned during one term that is not withdrawn during or immediately after that term is added to principal for the renewal term. The rate for each renewal term will be determined by us on of just before the renewal date. You may call us on or shortly before the maturity date and we can tell you what the imerest rate will be for the next renewal term. On accounts with terms of longer than one month we will remind you in advance of the renewal and tell you when the rate will be known for the renewal period. See your plan disclosure if this account is part of an IRA. (pege 2 a/ 2/ Ej(~; ®1993 Bankers SYStems, Inc., St. Cloud, MN Form CD-AA-NPD 7 /3!2001 ACNB BANK 16 LINCOLN SQUARE PO BOX 3129 GETTYSBURG, PA 17325 TRUTH IN SAVINGS DISCLOSURE FOR T/ME ACCOUNTS Terms following a ^ apply only if checked. Aoot: 33 Month Step UD'Soecial CD Aoct x: 900043203051 Date: 12/2/2010 ® The interest rate and annual percentage yield stated below are accurate as of the date pri(tted above. If you would like more current rate and yield information please call us at 888-3ki4-2262 This disclosure contains the 'rules which govern your deposit account. Unless it would be inconsistent to do so, words and phrases used in this disclosure should be construed so that the singular includes the plural. and the plural includes the singular. ^ FIXED RATE: ^ The interest rate for your account is % with an annual percentage yield of %. We will pay this rate ^ The interest rate and ',annual percentage yield for your account depend upon the applicable rate tier. We will pay these rates ® VARIABLE RATE: ® The interest rate for your account is 1.490 % with an annual percentage yield of 1.50 ",6. Your interest rate and annual percentage yield may change. ^ The interest rate and .annual percentage yield for your account depend upon the ,applicable rate tier.' The interest rate and annual percentage yield for these tiers may change. Daten»/nation of Rate: ^ At our discretion, we may change the interest rate on your account. ^ The interest rate for your account ^ The fixed initial rate is npt determined by this rule. ® The initial interest rate qn your account WIII apply until the one time rate ~Idiustment is reduested subsequent rates will epu~li the then current rate for 36 month certificate of ~feposit. Frequency of Rete Change: ® We may change the interest rate on your account at your request one time c~urinp the initial term ^ Your initial interest rate (will not change ^ The interest rate will not be less than or more than qr,, ^ The interest rate will not the interest rate initially disclosed to you. COMPOUNDING AND CREDITING: ® Frequency -Interest Wlii be compounded monthly Interest will be credited every 012 Months and added back to the account ® Withdraws! of /ntereat Before Msturity. The annual percentage yield assumes that interest remains on deposit until maturity. A withdrawal of interest will reduce earnings. ^ Required /nterest Distribution. This account requires the distribution of interest and does not allow interest to remain in the account. ® Effect on Closing en Account. If you close your account before interest is credited, you Will receive the accrued interest. MINIMUM BALANCE REQUIREMENTS: ® To Open the Account. You must deposit at least 6 5.000.00 to open this account. ® To Obtain the Annual Percentage Yiehf D/sclosed. ® You must maintain a minimum balance of S 5,000.00 in the account each day to obtain the disclosed annual percentage yield. ^ You must maintain a minimum average daily balance of S to obtain the disclosed annual percentage yield. The average daily balance is calculated by adding the principal in the account for each day of the period and dividing that figure by the number of days in the period. The period we use is BALANCE COMPUTATION METHOD: ® Deily 8s/ance Method. We use the daily balance method to calculate the interest on your account. This method applies a daily periodic rate to the principal in the account each day. ^ Average Deily Bence Method. We use the average daily balance method to calculate interest on your account. This method applies a periodic rate to the average daily balance in the account for the period. The average daily balance is calculated by adding the principal in the account for each day of the period and dividing that figure by the number of days in the period. The period we use is ACCRUAL OF INTEREST ON NONCASH DEPOSITS: ^ Interest begins to accrue no later than the business day we receive credit for the deposit of noncash items (for example, checksl. ® Interest begins to accrue on the same day you deposit noncash items (for example, checksl. MATURITY DATE: ® Your account will mature on 9/2/2013 ^ Your account will mature in ^ We may accelerate the maturity or call this account, at our We may change the interest rate on your account at that time and thereafter. Limitations on Rare Chsngest ^ The interest rate for your account will not by more than each ®1982 Bankers 3yatams, Inc., St. Cloud, MN Form TSD-TIME 8/172005 option, (papa 1 of 2/ ^ Your account has no definite maturity date. To withdraw any or part of this deposit without penalty, we must receive at least written notice from you of your intention to make a withdrawal. The notice must specify the exact amount and date of the intended withdrawal. Interest will no longer accrue after the withdrawal. date specified in your notice on the amount specified in your notice. We may terminate this account by mailing a notice to you of our intention to terminate at least ten days before the termination date. The date of intended withdrawal of the last funds in the account, or the termination date, is considered to be the maturity date. TIME DEPOSIT WITHDRAWAL LIMITATIONS: ® prirrcipat You cannot withdraw pllncipal from this account without our consent except on the maturity date or during the ten (10) day Grace period follawintl the maturity date. ^ lnterest: ® /nrerest rming: You can withdraw interest at maturity EARLY WITHDRAWAL PENALTY: A penalty ® may ^ will be imposed for withdrawals before maturity. The penalty will be an amount equal to: ^ Seven days' interest on the amount withdrawn if the .withdrawal is made within the first six days after the deposit. ^ 180 days' interest on the amount withdrawn ^ 90 days' interest on the amount withdrawn ^ 30 days' interest on the amount withdrawn f& Six (6) months of interest ® The interest rate we will use to calculate the interest forfeiture will be: The rate of the cergficate of deposit We will charge the penalty first against any interest then in the account, and any excess will be deducted from the amount you withdraw. ® If you withdraw some of your funds before maturity, the interest rate for the remaining funds in your account will be 1.490 % with an annual percentage yield of 1.49 °k. ® Minimum Bs/snce Accounts. We reserve the right to-treat any withdrawal which would reduce the balance remaining in the account below the required minimum initial deposit or minimum balance as a withdrawal of the entire account balance and calculate the amount of the penalty accordingly. In certain circumstances, such as the death or incompetence of an account owner, the law permits, or in some cases requires, the waiver of the early withdrawal penalty. Other exceptions may also apply,- for example, If this is part of en IRA or other tax-deferred savings plan. ADDITIONS TO ACCOUNT: ^ You may make nc more than deposits into your account each ® You may only make deposits into your account In the amount of $5 000 00 or more during the initial term. ® ©1992 Bankers Systems, Inc., St. Cloud, MN Form TSO-TIME 6/17/2005 ^ You may make unlimited deposits into your account. ^ You may not make any deposits into your account until maturity. ^ The minimum amount you can deposit is $ ^ The maximum amount you can deposit is S RENEWAL POLICY: ^ Single Maturity: This account will not renew automatically at maturity. If you do not renew the account, ® Automatic Renewe% This account will automatically renew at maturity. ® You will have ~.-.~ O) calendar days after the maturity date to withdraw funds without penalty. ® Exceptions to Automatic Renewe% This account will not renew if you withdraw the funds on the maturity date or if we receive written notice from you on or before the maturity date of your intention not to renew. ^ There is no grace period following the maturity of this account to withdraw funds without penalty. RENEWAL TERMS: ^ Same Term As Originsl: Each renewal term will be the same as tha original term, beginning on the maturity date. ® Dif/erent Term: Each renewal term will be thirty-Six (36) months ,beginning on the maturity date. RENEWAL INTEREST CALCULATION: ® Same lnterest Calcu/soon: Interest will be calculated on the same basis as during the -original term. ^ Different /merest Ce%u/ation: The interest rate will BONUSES: ^ You will as a bonus ^ You must maintain a minimum of S to obtain the bonus. ^ To earn the bonus, ^ PRE-MATURITY NOTICE: Your account will mature on . If the account renews, the new maturity date will be ^ The interest rate for the renewed account will be % with an annual percentage yield of °k. ^ The interest rate and annual percentage yield have not yet been determined. They will 6e available on Please call to learn the interest rate and annual percentage yield for your new account. ^ ADDITIONAL TERMS: (page 2 of 21 ~ I, ~ ~ ~ Date Tax Opened: 12/2/2010 Term: 33 Months ID: 492-26-2465 Number: 803 Certificate of Deposit Account Number: 900043203050 Amount of Deposit: One Hundred Sixteen Thousand Four Hundred Thirty-Three Dollars And Fifty Cents $ 116,433.50 This Time Deposit is Issued to: Issuer: LUCILE J FOX PAUL J FOX 84 PLUMTREE CIR NEWVILLE PA 17241 Not Negotiable -Not Transferable » Additional terms are below. ' ACNB BANK 16 LINCOLN SQUARE PO BOX 3129 GETTYSBUR , PA 17325 BY Additional Terms and Disclosures This form contains the terms for your time deposit. It is also the Minimum Balance Requirement: You must make a minimum deposit to Truth-in-Savings disclosure for 'thosje depositors entitled to one. There are additional terms and disclosures ! on pa a two of this form, some of open this account of $ 5,000.00 this f nenxplatn or expand on those bClow. You should keep one copy of ®You must maintain this minimum balance on a daily basis to earn the Maturity Date: This acwunt matut~ 9/2/2013 annual petcentage yield disclosed. ($ee below for renewal information.) Withdrawals of Interest: Interest ^ accrued ®credited during a Rate Information: The interest rate!for this account is 1.490 % term can be withdrawn: at maturity with an annual percentage yield of 1.50 %. This rate will be paid until the maturity date specified above. Interest begins to accrue on Eazly Withdrawal Penalty: If we consent to a request for a withdrawal the business day you deposit any non~ash item (for example, a check). that is otherwise not permitted you may have to pay a penalty. The Interest will be compounded monthly .penalty will be an amount equal to: six (6) months Imerest will be credited ~ every 012 Months and added back to the account interest on the amount withdrawn. ® The annual percentage yiekl ass that interest remains on deposit Renewal Policy: until maturity. A withdrawal of itterest will reduce earnings. ^ Single Maturity: If checked, this account will not automatically ^ If you close your account befo¢e interest is credited, you will not renew. Interest ^ will ^ will not accrue after maturity. receive the accrued interest. ® Automatic Renewal: [f checked, this account will automatically The NUMBER OF ENDORSEMEIFITS needed for withdrawal or any renew on the maturity date. (see page two for terms) other purpose is: 1 Interest ^ will ® will not accrue after Erna! maturity. ACCOUNT OWNERSHIP: You live requested and intend the type of account mark below. ^ I~ividual ® Joint Account -With Survivotshi}~ on°~~i`°'"' ^ Joint Account - NO SurviVOtship Q~t umne io mo~mw) ^ Trust: Separate Agreement Dated. ^ Revocable Trust Designation as defined in this agreement (Beneficiaries' natnes and addresses) BACKUP WITHHOLD] TIN: 492-26-2465 ® Taxpayer I.D. Number -The Taxpayer Identification Number shown above (TIN) is my correct taxpayer identification number. ® Backup Withholding - I am not subject to backup withholding either because I have not been notified that I am subject to backup withholding as a result of a failure to report all interest or dividends, or the Internal Revenue Service has notified me that I am no longer subject [o backup withholding. ^ Exempt Recipients - I am an exempt recipient under the Internal Revenue Service Regulations. A provision for my signature, certifying order penalty of perjury the statements checked in this section and that I am a U.S. person (including a U.S. resident alien), is contained on the first copy of this certificate. ENDORSEMENTS -SIGN ONLY WHEN YOU REQUEST WITHDRAWAL X X X i ®1993 Bunion SYtUTt, Inc., St. CIoW, MN Form CD-AA-NPD 111 1/3!2001 READ PAGE TWO FOR ADDITIONAL TERMS (psye 1 oI zl a- DEFINITIONS: "We," "our," and "us" mean the issuer of this account and "you" and "your" mean the depositor(s). "Account" means the original certificate of deposit as well as the deposit it evidences. TRANSFER: "Transfer" means any change in ownership, withdrawal rights, or survivorship rights, including (but not limited to) any pledge or assignment of this account as collateral. You cannot transfer this account without our written consent. PRIMARY AGREEMENT: You agree to keep your funds with us in this account until dte maturity date. (An automatically renewable account matures at regulaz intervals.) You may not transfer this account without first obtaining our written consent. You must present [his certificate when you request a withdrawal or a transfer. This account is void if the deposit is made by any method requiring collection (such as a check) and the deposit is not. immediately collected in full. If the deposit is made or payable in a foreign currency, the amount of the deposit will be adjusted to reflect final exchange into U.S. dollars. We may change any term of this agreement. Rules governing changes in interest rates have been provided. For other changes we will give you reasonable notice in writing or by any other method permitted by law. If any notice is necessary, you all agree that the notice will be sufficient if we mail it to the address listed on page one of this form. You must notify us of any change. WITHDRAWALS AND TRANSFERS: Only those of you who sign dte permanent signature card may withdraw funds from this account. (In appropriate cases, a court appointed represeptative, a beneficiary of a trust account whose right of withdrawal has matured, or a newly appointed and authorized representative of a legal entity may also withdraw from this account..) The specific number of you who must agree to any withdrawal is written on page one in the section bearing the title " ...Number of Endorsements .... "This means, for example, that if two of you sign the signature card but only one endorsement is necessary for withdrawal then either of you may request withdrawal of the entire account at any time. These same rules apply to define the names and the number of you who can request our consent to a transfer. PLEDGES: Any pledge of this acwunt (to which we have agreed), must fast be satisfied before the rights of any joint account survivor beneficiary or trust account beneficiary become effective. For example, if one joint tenant pledges the account for payment of a debt and then dies, the surviving joint tenant's rights in this account are subject first to the payment of the debt. OWNERSHIP OF ACCOUNT AND BENEFICIARY DESIGNATION: You intend these rules to apply to this account depending on the form of ownership and beneficiary designation, if any, specified on page 1. We make no representations as to the appropriateness or effect of the ownership and beneficiary designations, except as they determine to whom we pay the account funds. Individual Account - Such an account is owned by one person. Joint Account With Survivorship (And Not As Tenants itn Common) -Such an account is owned by two or more persons. Each of you intend that upon your death the balance in the account (subject to any previous pledge to which we have consented) will belong to the survivor(s). If two or more of you survive, you will own the balance in the account ownership as joint tenants with survivorship and not as tenants in common. Joint Account - No Survivorship (As Tenants In Common) -Such an account is owned by two or more persons but none of you intend (merely by opening this account) [o create any right of survivorship in any other person. We encourage you to agree and tell us in writing of the percentage of the deposit contributed by each of you. This information will not, however, affect the "number of endorsements" necessary for withdrawal. E~,~ ®1983 9ankan Syateme, Inc., St. Cloud, MN Form CD-AA-NPD 1 /3/2001 Revocable Trust Account (subject to this agreement) - If two or more of you create such an account, you own the aceoum jointly with survivorship. Beneficiazies cannot withdraw unless: (1) all persons creating the account die, and (2) the beneficiary is then living. If two or more beneficiaries are named and survive the death of all persons creating the account, such beneficiaries will own this account in equal shares, without right of survivorship. Any such beneficiary may withdraw all or any part of the account balance. The person(s) creating this account type reserves the right to: (1) change benefielazies; (2) change account types; and (3) withdraw all or part of the deposit at any time. Trust Accotmt Subject to Separate Agreement - We will abide by the terms of any separate agreement which clearly pertains to this account and which you file with us. Any additional consistent terms stated on this form will also apply. SET-OFF: You each agree that we may (without prior notice and when permitted by law) set off the funds in this account against. any due and payable debt owed to us now or in the future, by any of you having the right of withdrawal, to the extent of such person's or legal entity's right to withdraw. If the debt aiises from a note, "any due and payable debt" includes the total amount of which we aze entitled to demand payment under the terms of the note at the time we set off, including any balance the due date for which we properly accelerate under the note. This right of set-off does not apply [o this account if: (a) it is an Individual Retirement Account or other tax-deferred retirement account, or (b) the debt is created by a consumer credit transaction under a credit card plan, or (c) the debtor's right of withdrawal arises only in a representative capacity. You agree [o hold us harmless from any claim arising as a result of our exercise of our right of set-off. BALANCE COMPUTATION METHOD: We use the daily balance method to calculate the interest on this account. This method applies a daily periodic rate to the principal in the account each day. TRANSACTION LIIvIITATIONS: You cannot make additional deposits to this accoum during a term (other than credited interest). You cannot withdraw principal from this account without our consent except on or after maturity. (For accounts that automatically renew, there is a ten day grace period after each renewal date during which withdrawals are permitted without penalty.) In certain circumstances such as the death or incompetence of an owner of this account, law permits, or in some cases requires, the waiver of the eazly withdrawal penalty specified on page one. FOR ACCOUNTS THAT AUTOMATICALLY RENEW: Each renewal term will be the same as this original one, beginning on the maturity date (unless we notify you, in writing, before a maturity date, of a different term for renewal). You must notify us in writing before, or within a ten day grace period afteq the maturity date if you do not want this account to automatically renew. Interest earned during one term that is not withdrawn during or immediately after that term is added to principal far the renewal term. The rate for each renewal term will be determined by us on or just before the renewal date. You may call us on or shortly before the maturity date and we can tell you what the interest rate will be for the next renewal term. On accounts with terms of longer than one month we will remind you in advance of the renewal and tell you when Ute rate will be known for the renewal period. See your plan disclosure if this account is part of an IRA. rpega ~ or zl r ~. r ~ ~ V ACNB BANK 16 LINCOLN SQUARE PO BOX 3129 GETTYSBURG, PA 17325 Terms following a ^ apply olhly if check A~~t: _ ~ 33 Month Step UD Special CD Acctas~ 900043203050 Date: 12/2/2010 a ® The interest rate and annual percentage yield stated below are accurate as of the date printed above. If you would like more current rate and yield informal on please call us at 888-3~-2262 This disclosure contains the .rules -which govern your deposit account. Unlesa it would be inconsistent to do so, words and phrases used in this disclosur should be construed so that the singular includes the plural an~the plural includes the singular. ^ FIXED RATE: ^ The interest rate for yolur account is % with en annual percentage yield'lof %. We wilF pay this rate ^ The interest rate and ',annual percentage yield for your account depend upon the applicable rate tier. We will pay these rates ® VARIABLE RATE: ® The interest rate for yoWr account is 1.490 % with an annual percentage yield of 1.50 %. Your interest rate and annual percentage yield may change. ^ The interest rate and 'annual percentage yield for your account depend upon theiapplicable rate tier. The interest rate and annual percentage yield for these tiers may change. Determinstlon of Rate: ^ At our discretion, we 'may change the interest rate on your account. ^ The interest rate for your account ^ The fixed initial rate is ryot determined by this rule. ® The initial interest rate ~n your account WIII apply until the one time rate ~dlustment is requested Subsequent rates will e u I the then current rate for 36 month certificate of eposit. Frequency o/ Rste Change: ® We may change the interest rate on your account at Your request one time luring the initial term ^ Your initial interest rate juvill not change We may change the interest!, rate on your account at that time and thereafter. Limitet/ons on Rote Chengeal: ^ The interest rate for your account will not by more than each r-~1-~ 4 ®1992 6en4ers Systama, Ino., St. Cloud, MN Form TSD-TIME 8!17!2005 TRUTH IN SAVINGS DISCLOSURE FOR T/ME ACCOUNTS ed. ^ The interest rate will not be less than % or more than %. ^ The interest rate will not the interest rate initially disclosed to you. COMPOUNDING AND CREDITING: ® Frequency -Interest WIII be compounded monthly Interest will be credited every 012 Months and added back to the account ® Withdraws/ of /merest Before Maturity. The annual percentage yield assumes that interest remains on deposit until maturity. A withdrawal of interest will reduce earnings. ^ Required Interest Dsstribution. This account requires the distribution of interest and does not allow interest to remain in the account. ® Effect an Clos/ng an Account. If you close your account before interest is credited, you WIII receive the accrued interest. MINIMUM BALANCE REQUIREMENTS: ® To Open the Account. You must deposit at least s_5,000.00 to open this account. ® To Obtain the AnnueJ Percentage Yie/d Disc/Deed. ® You must maintain a minimum balance of S 5,000.00 in the account each day to obtain the disclosed annual percentage yield. ^ You must maintain a minimum average daily balance of S to obtain the disclosed annual percentage yield. The average daily balance is calculated by adding the principal in the account for each day of the period and dividing that figure by the number of days in the period. The period we use is BALANCE COMPUTATION METHOD: ® Daily Be/ante Method. We use the daily balance method to calculate the interest on your account. This method applies a daily periodic rate to the principal in the account each day. ^ Average Dai/y Bs/ante Method. We use the average daily balance method to calculate interest on your account. This method applies a periodic rate to the average daily balance in the account ffor the period. The average daily balance is calculated by adding the principal in the account for each day of the period and dividing that figure by the number of days in the period. The period we use is ACCRUAL OF INTEREST ON NONCASH DEPOSITS: ^ Interest begins to accrue no later than the business day we receive credit for the deposit of noncash items (for example, checksl. I~ Interest begins to accrue on the same day you deposit noncash items (for example, checksl. MATURITY DATE: ® Your account will mature on 9/2/2013 ^ Your account will mature in ^ We may accelerate the maturity or call this account, at our option, /page 1 of 2/ i. - ^ Your account has no definite maturity date. To withdraw any or part of this deposit without penalty, we must receive at least written notice from you of your intention to make a withdrawal. The notice must specify the exact amount and date of the intended withdrawal. Interest will no longer accrue after the withdrawal date specified in your notice on the amount specified in your notice. We may terminate this account by mailing a notice to you of our intention to terminate at least ten days before the termination date. The date of intended withdrawal of the last funds in the account, or the termination date, is considered to be the maturity date. TIME DEPOSIT WITHDRAWAL LIMITATIONS: ® Principal: You cannot withdraw principal from this account without our consent except.on the maturity date or during the ten (10) day grace period following the maturity date. ^ /merest: ® /ntereat Timing: You can withdraw interest at maturity EARLY WITHDRAWAL PENALTY: A penalty ® may ^ will be imposed for withdrawals before maturity. The penalty will be an amount equal to: ^ Seven days' interest on the amount withdrawn if the withdrawal is made within the first six days after the deposit. ^ 180 days' interest on the amount withdrawn ^ 90 days' interest on the amount withdrawn ^ 30 days' interest on the amount withdrawn ® Six (6) months of interest ® The interest rate we will use to calculate the interest forfeiture will be: The rate Of the CertlflCate Of depOSlt We will charge the penalty first against any interest then in the account, and any excess will be deducted from the amount you withdraw. ® If you withdraw some of your funds before maturity, the interest rate for the remaining funds in your account will be 1.490 % with an annual percentage yield of 1.49 %. ® Minimum Bderrce Accounts. We reserve the right to treat any withdrawal which would reduce the balance remaining in the account below the required minimum initial deposit or minimum balance as a withdrawal of the entire account balance and calculate the amount of the penalty accordingly. In certain circumstances, such as the death or Incompetence of an account owner, the law permits, or in some cases regwres, the waiver of the early withdrawal penalty. Other exceptions may also apply,. for example, if this is part of an IRA or other tax-deferred savings plan. ADDITIONS TO ACCOUNT: ^ You may make no more than deposits into your account each ® You may only make deposits into your account In the amount of $5 000 00 or more durino the initial term. ® ©1992 Bankers Systems, Inc., St. Cloud, MN Form TSD-TIME 8/17/2005 ^ You may make unlimited deposits into your account. ^ You may not make any deposits into your account until maturity. ^ The minimum amount you can deposit is S ^ The maximum amount you can deposit is S RENEWAL POLICY: ^ Sing/e Maturity: This account will not renew automatically at maturity. If you do not renew the account, ® Automatic Rerreweh. This account will automatically renew at maturity. ® You will have ten (101 calendar _ days after the maturity date to^ w thaw funds without penalty. ® Exceptions fo Automatic Renewah This account will not renew if you withdraw the funds on the maturity date or if we receive written notice from you on or before the maturity date of your intention not to renew. ^ There is no grace period following the maturity of this account to withdraw funds without penalty. RENEWAL TERMS: ^ Same Term Aa Original: Each renewal term will be the same as the original term, beginning on the maturity date. ® Different Term: Each renewal term will be thlrtV-SIX ($6) mOnthS ,beginning on the maturity date. RENEWAL INTEREST CALCULATION: ® Seine /merest Celcu/anon: Interest will be calculated on the same basis as during the original term. ^ DiNerent /merest Ce/culetion: The interest rate will BONUSES: ^ You will as a bonus ^ You must maintain a minimum of S to obtain the bonus. ^ To earn the bonus. ^ PRE-MATURITY NOTICE: Vour account will mature on . If the account renews, the new maturity date will be ^ The interest rate for the renewed account will be % with an annual percentage yield of %. ^ The interest rate and annual percentage yield have not yet bean determined. They will be available on Please call to learn the interest rate and annual percentage yield for your new account. ^ ADDITIONAL TERMS: IPa9e 2 of 2/ 20 South Maitt Street PO Box 6010 Chambersbutg PA 17201 Last staltement: December 31, 2011 This statement: March 23, 2012 Total days in statement period: 83 •~~aa~~~~~~M~».f ~..a».~f.SNG LP 0199.9 0.7675 SP 00.450131 10 lalu..L~,ul}u~PPr~llh~,gl~rl9hUmr.~ll..i.l~.~q. LUCILE J SOX 84 PLUM ~IRCLE NEWVILL PA 17241 "" Cloyed Account -Final Statement Certificate Of Deposit Account number 0152997408 Total principal 50.00 Total current balance 50.00 Total interest year to date 565.13 DAILY Page 1 of 1 0152997408 (0) Direct inquiries to: 717 776-2240 F&M Trust 9 West Big Spring Avenue Nevwille, PA t 7241 DISBURSEMENT TYPE MANUAL PAYEE Thank you 1br banking with F&M Trust #1 03-23 I Avait Int Wd -447.52 17,438.43 DISBURSEMENT TYPE MANUAL PAYEE CHECKING ACCOUNT STATEMENT RECONCILIATION HOW TO BALANCE YOUR CHECKING STATEMENT 1. Add to your check register any interest earned shown on this statement. 2. Subtract from your check register any service charges shown on this .statement that you have not already recorded. 3. Enter outstanding balance from $ front of statement. 4 it th dit E t d . n er s or o er cre epos s •~~- recorded in your register but not $ shown on this statement $ 5:'Add the totals of lines 3 and 4 $' above. 6. Enter the total of checks, with- drawals, service charges (if any), $ and automatic payments entered in your check register but not shown on this or previous statements. 7. Subtract item 6 from 5 above. This should be the balance shown $ in your checkbook register. OUTSTANDING CHECKS OR WITHDRAWALS NOT YET CHARGED TO YOUR ACCOUNT CHECK NUMBER AMOUNT E TOTAL H this balance does not agree with the balance in your checkbook register I F YOUR Make sure an amounts recorded to checks and other payments are correct. Make sure the amounts recoMed for deposits are correct. ACCOUNT • Make sure you have deducted ell checks from your balance. DOES Make sure you have deducted all drarges from your balance. NOT Check for errors in addition or subtraction. BALANCE N You need additional help in balandng your account, please contact a customer service representative at the office nearest you. PROCEDURES FOR CORRECTING ERRORS IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR ELECTRONIC TRANSFER OR YOUR LINE OF CREDIT ACCOUNT . Notify us promptly if you think your statement a receipt is wrong or if you need more information about a transfer listed on the statement or receipt You must notify us no Later than 60 days after the first statement on which the problemor error appeared. 1. Tell us your name and account number. 2. Describe the error or the transfer you are unsure about and explain as cleariy as you can why you believe it is an error or why you need more information. 3. Tell us the dollar amount of the suspected ertor K you tell us orally, we may require that you send us your complaint or question in writing within 10 business days. We will tell you the results of our investigation within 10 business days after we hear from you, and we will correct any eroor promptly. If we need more time, however, we may take up to 45 days to investigate your complaint or question. H this action is deemed necessary, we will recredit your account within 10 business days for the amount you think is in ertor, so that you will have the use of the money during the fime it takes us to com- pleteour investigation. If we ask you to put your complaint or question in writing and we do not receive it within 10 business days, we may not recredit your account. tt we decide that there was no error, we will send you a written explanation within 3 business days after we finish our investigation. You may ask for copies of the documents that we used in our investigation. DIRECT INQUIRIES TO: PLEASE EXAMINE STATEMENT AT ONCE. IF NO ERRORS ARE REPORTED WITHIN 10 DAYS, THE ACCOUNT WILL BE CONSIDERED CORRECT. LINE OF CREDIT ACCOUNT INFORMATION ABOUT YOUR ACCOt1NTCHARGES__.. __.._ We compute fhe FINANCE CHARGE on your account by applying the periodic rate to the "average daily balance'.of your account _ . (including curtem transactions). To get the "average daily balance," we take the beginning balance of your account each day, add any new loans, and subtracf any payments, bredils,unpaid finance charges, and unpaid insurance premiums. This gives us the daily balance: Then, we add up all the daily balances for the billing cyGe and divide the total by the number of days in the billing cycle. This gives us the "average daily balance.' tl a "finance charge adjustment" is shown on this statement, we wmputed this porton of the FINANCE CHARGE by mutfiplying the principal amount to which the adjustment applies by the periodic rate which applied in the bllling cycle for which the adjustment was made and by the number of tlays for which the adjustment was made. F&M TRUST, 20 South Main Sheet, Chambersburg, PA 17201 • 717-264-6116 LAST WILL AND TESTAMENT OF LUCILE J. FOX I, LUCILE ~T. FOX, declare this to be my Last Will and Testament and hereby revolke all prior wills and codicils made by me. FIRST: M~ Executor shall pay from the residue of my estate all my debts, funeral a~hd administration expenses and all estate, inheritance, succession and tnansfer taxes imposed by the United States or any state, territory or possession which shall become payable by reason of my death. It shall nbt be necessary to f ile any claims therefor, nor to have them allowed by iany court. SECOND: !I give such of my tangible personal property as is set forth in a separate, dated and unsigned letter of instruction, which I shall place with My Will, to the persons therein designated. If I have not LAST WILL AND TESTAMENT OF LUCILE J. FOX left a letter of instruction or for those articles not distributed under this letter of instruction, I direct that such items be distributed as equally as possibly to my son, PAUL A. FOX, amu ,my daughter, JUDITH A. FOX, If there is any disagreement as to distribution, I direct my Executrix to ma~'e such distribution. The decision of my Executrix shall be final and binding. THIRp: (a)~ I hereby make the following bequests to the listed charitable institutions: (1) The surrh of Forty Thousand ($40,000.00) Dollars to 6VIDIN6 EYES FOR THE', BLIND, INC., P.O. Box 709, Yorktown Heights, NY 10598-0709. -2- LAST WILL AND TESTAMENT OF LUCILE J. FOX (2) The sumof Forty Thousand ($40,000.00) Dollars to NATIONAL PARKS CONSER~/ATION ASSOCIATION, 777 6T" Street , NW, Suite 700, Washington DC 20001-3723. (3) The sjum of Thirty Thousand ($30,000.00) Dollars to SMITHSONIAN INSTITUTION, Washington, DC. (4) The surh of Fifty Thousand ($50,000.00) Dollars to GREEN RIDGE VILLA6~' FUND, Green Ridge Village, 210 Big Spring Road, Newville, PA 1741-9486. (5) The surd of Fifty Thousand ($50,000.00) Dollars to HEIFER ' PROJECT INTEt~NATIONAL, P.O. Box 6021, Albert Lea, MD 56007. (6) The sunk of Twenty Thousand ($20,000.00) Dollars to FIRST PRESBYTERIAN CHURCH, Elm Street, Wappinters Falls, NY 12590. -3- LAST WILL AND TESTAMENT OF LUCILE J. FOX (7) The sun+ of Ten Thousand ($10,000.00) Dollars to BI6 SPRING CHURCH, Corporation Street, Newville, PA 17241. (8) The surr~ of Thirty Thousand ($30,000.00) Dollars to PLANNED PARENTHOOD, 434 33"d Street ,New York, NY 10001. (9) The surd of Thirty Thousand ($30,000.00) Dollars to AVALON CEMETERY ASSOCIATION TRUST, Citizens Bank & Trust Company, P.O. Box 50, ChilNicothe, MO 64601. (10) The sun of Twenty-five Thousand ($25,000.00) Dollars to NW MISSOURI ST~ITE UNIVERSITY, 800 University Drive, Maryville, MO 64468. (11) The sum of Forty Thousand ($40,000.00) Dollars to INSTITUTE OF TECHNOLOGY, Cambridge, MA. -4- LAST WILL AND TESTAMENT OF LUCILE J. FOX (b) I may make inter vivos gifts to one or more of the above named charities during ~ny lifetime. To the extent I make such inter vivos gifts durin m lifeti a the sum thereof shall be deducted from the total 9 Y ~ - bequest made herein to that particular charity. FOURTH: ~ ive and devise the residue of my estate, real, personal 9 and mixed, of whatever kind and nature, and wherever situate at the time of my death, inc~uding any property over which I now have or hereafter acquire a power bf appointment, as follows: (a) Two (2~°) percent to my cousin, CHARLES E. BAYMILLER, his heirs and assign forever, per stirpes. (b) Three ~3%) percent to my brother, LARRY Q. JEFFREY, his heirs and assign forever, per stirpes. -5- LAST WILL AND TESTAMENT OF LUCILE J. Fox © The reminder of my estate to my son, PAUL J. FOX, and my daughter, JUDI~'H A. FOX, in equal shares, or to the survivor if one of my children predeceases me. If both of my children predecease me, I give twenty (20°r~) percent of the remainder to my brother, LARRY Q. JEFFREY, his h'leirs and assigns forever, per stirpes, twenty (20%) percent of the remainder to my cousin, CHARLES E. BAYMILLER, his i heirs and assign forever, per stirpes, and the remainder of my estate to the charities named in Paragraph THIRD (a) hereof in proportion to the bequests made herein, the principal to be held in perpetuity and the interest therefrom applied annually for the use of the charities.. ~I -6- LAST WILL AND TESTAMENT OF LUCILE J. FOX FIFTH: I'~ nominate, constitute and appoint JUDITH A. FOX, Executrix of thi$ my Lnst Will and Testament, to serve without bond or security, and to I~ make distribution of my estate in cash or in kind, or partly in cash anc~ partly in kind, and in such manner as he may determine. I authorize, empjower and direct her to sell and convey, by good and sufficient deed, in fee simple estate, any and all of my real estate, at public or privat~ sale, for such price or prices, upon such terms and conditions, as in Iher judgment is best for my estate, and to that end to sign, seal, execute, acknowledge and deliver all deeds or other instruments necessary therefor, as effectively as I could do if I were personally present. -~- LAST WILL AND TESTAMENT OF LUCILE J. FOX In the eve~-t that JUDITH A. FOX does not survive me, or refuses to act as Executor or does not complete the duties of Executrix, then I nominate, constitute and appoint JOHN D. KILLIAN, as the alternate Executor, to serve without bond or security. My alternate Executor shall ~~ have all of the ~owers, privileges, duties and immunities granted to my Executrix as provided herein. In the ev~nt that JOHN D. KILLIAN does not survive me, or refuses to act a Executor or does not com (ete the duties of Executor, s P then I nominat constitute and a oint LINDA J. OLSEN as the le, pp , alternate Executrix, to serve without bond or security. My alternate Executrix shall (have all of the powers, privileges, duties and immunities i granted to my ~xecutrix as provided herein. -a- LAST WILL AND TESTAMENT OF LUCILE J. FOX SIXTH: I No beneficiary shall have the power to anticipate, encumber or transfer his or her interest in my estate or any trust created herein iln any manner other than by the valid exercise of a Power of Appointment{ No part of any trust or my estate shall be liable for or charged with and debts, contracts, liabilities or torts of a beneficiary or subject to seizure or other process by any creditor of a benef iciary. IN WITN~55 WHEREOF, I, LUCILE J. FOX, the Testatrix, hove `fc'~ to this my Last ~VI/ill and Testament, set my hand and seal this (O' day of ~~^~~ , 2011. ~ ~ <: ~-~- ~ " ~ (SEAL) LUCILE J. F -9- Signed, sealed, published and declared by the above named Testatrix, as and for her Last Will and Testament, in the presence of us, who have hereunto subscribed our names at her request, as witnesses hereto, in the presence of the said Testatrix, and of each other. The preceding document consists of this and nine (9) other consecutively numbered typewritten residing at <(,' '~~ residing at ~~~ ~ ~~ t~~ v' • ~~: ,. . ~ COMMONWEA~.TH OF PENNSYLVANIA) ss. COUNTY OF D~IUPHIN ) I, LUCIL J. FOX, the Testatrix whose name is signed to the attached or for going instrument, having been duly qualified according to law, do hereby cknowledge that I signed and executed the instrument as my Last Will;~and that I signed it willingly and as my free and voluntary act for the pur ores therein expressed. Sworn to for affirmed a acknowledged before me by LUCILE J. FOX, the Testatrix, this iay of J U!~`~" , 2011. ~. ~c ~ , Test rix ~, __~ ~ . (SEAL) Notary Public~MONwEALTH of PENNSYLVANIA Notarial Seal Vkkl L HopMne, Notary Punic 10 tMsst PennsborO 1Mip., Curribellend Couity My Commtasfon E~Iroa Jan.15, 2012 Member. Pennsylvania .Association of Notaries ~_ r LAST WILL AND TESTAMENT OF LUCILE J. FOX COMMONWEALTH OF PENNSYLVANIA) ss.: COUNTY OF DIAUPHIN ) ~_. We, ~/~ , _ a and C V~ a ~ . ,the witnesses who a names are signed to the attached or foregoing instrument, berg duly qualif ied according to law, do depose and say that we were prese t and saw the Testatrix sign and execute the instrument ns her Last Wi I; that the Testatrix signed willingly and executed it as her free and vo~untary act for the purposes therein expressed; that each subscribing wit ess in the hearing and sight of the Testatrix signed the Will as a witne s; and that to the best of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind, and under no constraint or u~hdue influence. Swo~^n to or affirmed and subscribed to before me by E~1,~_~~'r1 Inc (-~z~;~ and ~< < ~,; IF,,e~, W'1. i~a n ~~ y , witnesses, this' day of -~ , 2011. Witness Witness AL) /Notary Public COMMONWEALTH OFpENNSYLVANIA Notarial Seal -11- west Pennabo-o~Twp~ cu ~,,d ~,~, MY Comml~ion tires Jan. 15, 2012 Member, Pennsvlvenia Asanrietip~ ~ Notaries