HomeMy WebLinkAbout01-30-131505610105
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PA Department d Revenue ~ OFFICIAL. uSE oNLr
BureaudlndivldualTaxes INHERRANCETAXRETURN ~~~ Y~ ~~~
PO BOX zBa6DS /.~ ~j J
Harrisburg, PA s7t28-o6oi RESIDENT DECEDENT pC. ( ~ O l ` /
ENTER DECEDENT INFORMATION BELOW
Sodel Security Number Date of Death MMDDYYYY Date of Bklh tkMDDYYYY
211-26-0042 01/13/2012 05/14/1933
DecedeM's Last Name Suffix Decedent's First Name MI
Snyder Caroline L
(H Applip6N) Enbr Surviving Spowe's InforrrLaNon Below
Spouse's lest Name Suffix Spouse's Flret Name MI
Spouse's Sodel Security Number
FN.L Ni APPROPRIATE OVALS BELOW
THIg a~~ Musr eE ~ a ourel.ICAtE wrrlf The
REGISTER OF WILLS
OlD /. Origiried Realm O 2. Supplemental Rewm O 3. RernatrWer Re1um (Dete.d Death
Prbrto 12-13-82)
O 4. Umked F-ataOa O 4a. Future interval t.ompromiae (dated Q 5. Federal Estate Tax RMum Required
death after 12-12.82)
Oti B. Decedent Died Testate O 7. Decedent Maintained a Living Trust ~ 8. Trial Number d Seta Deposit Boxes
(Attach Copy d WiIQ (Attach l:opy d Truk.)
O 9. Litigation Pnxxeds Received O 10. Spousal Poverty Credit (Date of Daalh O 11. Ebctlon b tax urMer Sec. 9113(A)
Between 12-31-91 and 1-1-95} (Attach Schedrile O)'
CORRE>iPONDBR - TFNt BEC710N Mt1sT SE COMPLETED. ALL CORRESPONDENCE AND CONFlDENTIAL TAX INFORMAtpN SlggLD BE DIRECTED TD:
Name Dayurrte Telephone Number
Jeffrey A. Snyder (717) 249-2045 ,.~
ca ,",O
~ ~ OF tN1u.StybE ~ t')
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Fsst LMIe d Address ~ _ ~ W --1
30 West Eppley Drive ~ z ~ ca :~~
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Second Line of Address :'
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Cit
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t Ohb State ZIP Code i
:RATE F . ~
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os
a ~"z7 .._ Get ~ ~
Carlisle PA 17015 c;.,0 ~
CorraaporrdsnCs eirrall address: 9uIlaler~pa.neT
Under pxrNtlss d perJlay, I dstlare Met 1 have examkted dtla renxn, indudlnp axompanyMq adledules arM atraemerds, and to Ina 6set d my MxM'Ndps and 6eYaf,
K k true. cones and oonKeele. Oadeason d prepuer atltar Man the peroonel repreesrdatlve k based on eN Irdorrltetlon d wMCh preparer has amt ploMladpe.
SIGMA R iF P &sLE FOR FlL,J,Np~G.yRETURN c~ DATE
ADDRESS g~ pZ~~-~i d 7 ~sT ~~ ~ ~/ 1/3 /,3
Ca.~-1.,51+ 0~ / tors GA~t es~ P . l 1 ~3e r
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PI.WE UsfE OIU@~INAL tTORSS OIY.Y
Side 1
1505610105 1505b10105 J
J 1505610205
REV-1500 EX (Fp
Decedents Social Securiyr Number
oeadenrs Name: Caroline L. Snyder 211-26-0042
RECAPRULATI~1
1. Real Estate (Schedule A) ........................................... .. 1. 0.00
2. Stocks and Bands (Schedule B) ..................................... .. 2. 0.00
3. Closely Held Corporation. Partrrership or Sole-ProprietasMp (Sq~edule C) ... .. 3. 0.00
4. Mortgages and Notes Receivable (Schedule D) ......................... .. 4. 0.00
5. Cash. Bank Deposits and Miscellerrears Personal Property (3c~edule E)..... .. 5. 28,150.16
6. Joirrlly Owned Properly (Schedule F) O Separate Biin9 Rorluested ..... .. 6. 0.00
7. Inter Vfvas Tre~ers & hlisaetaneous Non-Pr~oheta propeAy
(Schedule G) O Separate Billing Requested...... .. 7. 0.00
8. Total (irons Assets (total Lkres 1 through 7) ........................... .. 8. 28,150.16
9. Furtaral Experraes and Administratlve Casts (Sdredule H) ................. .. 9. 1,912.50
10. Debts of Decedent, Mortgage LiabikYdes and Dens (schedule q ............. .. 10. 3.759.34
11. Tetal Deduetlons (total Lines 9 and 10) ............................... .. 11. 5,871.84
12. Net Valor of Estab (Line 8 minus Line t1) ............................ .. 12. 22,478.32
13. Charitable and Governmental BequestelSec 9113 Trusts for which
err election to tax has not been made (Sdredule J) ...................... .. 13. 0.00
14. Nst Value SubJect b Tax (Line 12 minus Line 13) ...................... .. 74. 22,478.32
TAX CALCULATION -SEE INSTRUCTIONS FOR APPIJCABLE RATES
15. Amount of Line 14 taxable
at the spousal tau rate. or
transfers under Sec. 9116
(ax1.2) X .0_ 0.00 15 0,00
16. Amount of Line 14 taxable
at Ikraal rate x .0 4~5 16,534.32 16. 744.04
17. Amount of Line 14 taxable
at sibling rate x .12 5,944.00 t7. 713.28
18. AmarM of line 14 taxable
at cdleteral rate X .15 0.00 123 0.00
19. TAX DUE ........................................................ . 19. 1,487.32
20. FlLL IN THE OVAL IF YOU ARE REWJES7ING A REFUND ~ AN OVERPAYMENT
O
Side 2
L 1505610205 1505610205 J
nt11~7tp0 D((Fl) P•a~ 3
:
R~ rrnrbrar
Caroline L. Snyder
_ _.
_ _
stt~reooraESS
442 Walnut Bottom Road
-- -
-
crtY
Carlisle swE -
PA ~ _.
17013
Tax Pam and Credits:
1. Ta Oue (Pees 2. lire t!t)
2. CreddslPayrtrerrts
A. Prior Payments
B. OtecgaR
3. iareet
0.00
4. X Lila 2's eiaeYr tlwn firs 1 + Lice 3, erierthe ~eraroa. Tlrs ie tre WeIP~IBR.
Fi M awl aw Pass>; Lira ~ b wgred a w4wrrd.
(t) 1,457.32
To~l(Xedtk(A+B) f21
0.00
(3T 13.14
(4) 0.00
5. ff Line 1 + Line 3 is greeter than Line 2, enbr the difierertoe. This is the TAX DUE (5) 1,470.46
Make check payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Old decedent make a transfer and: Yes Wo
a retain the use a imm~e of fhe property Uansfe~red ._._ .....................__..__.....:._.....__.__......._..._._.__~ ^ ^
b. ruin the ~ b dasgde rho slrel uee the property irarrlared a b iroarre ...~.....__.....~. ^ ^
e retain a rarareiorsy irlerest ..___.._....__.._._......._..__..___...~.~___....._._._._...~._._._...._. ^ ^
d. receive the pranise Ibr ib of etlhx paynrertts, 6enalRs a rxre? ...................................................................... ^ ^
2. M deatlr oocumed alter Dec. t2, 1981, did decedent transfer properly within one year of death
without receiving adequate corraideration7 .............................................................................................................. ^ ^
a Old deoedertt awn an Tn rrwt for a peyabbeporr~deerr bat aoou.t a seaaRy at Ins a her deaafi'~_ ^ ^
4. Old deoaiat own an irdwidtd aliewrenl eccoutt, army v other rtor-~pobeb PrePah. rhidr
carrlsirsatwruforaydsei~liarr2...._..___..~___._..._._.~.....__........_._.~.~........_._.~._ ^
F lit ANioi~t 1~0 ANY OF 11E ABOVE QUES'110NS IS YES, YOU MI4i CONPLEiE SCIEflU.E 6 AND Flt R AS PANT OF lit REMOL
Far defies d dedh m a aAer Juy 1,1994. and before Jar. t,1lt95, 9re tar nab irtPased m the rret vain drartsfas b a forthe use d fire sterivirg spgrsa
is 3 percent (72 P.S. X116 (a) (1.1) (ly.
Far darts d dean m a alien Jar. 1. 1985, the tax rate imposed m the rret vain of trardas b a for ttre use d the ttravivig spouse ie 0 percatt
[l2 P.S. X116 (a) (1.1) (~ The slatitb does not ezernpt a transfer b a survivig spouse tiom tax, and tare stablory regtienterrls fa diedoase d awels and
tllitg s tltar wren ens sw appice6le ererr rTthe srawwirg spouse is the aiy berreidsp.
Far dabs d deeMr an a atbr July 1,2000:
• The tmrr role iaQoaed an the wet rwtae d tansfESrs law a deceeewd did 2t freers d age o- ynu+9er of death b a for the use d a aaieal pararA ao
atbptiee pererrt a a steppersrt d the did is 0 percent [T2 P.S. ~116(ax1.2)].
The tact nab igroaed m Ilre riot value dttarefas b afxtre use of tfte daxrdat's steal bardoarias is 4.5 pemat, etmept as rrobde [l2 P.S. §9116(ax1)j.
• The tax rate imposed on the net valued 6ansfers to a for the use of the decedent's siblings ~ t2 percent (72 P.S. §9116(a)(1.3)]. Asibling is defined,
tinder Section 9102, as an individual who has at least are parent in common witlr the decedent, whether by blood or adopfon.
0.00
rev-~5os ac+ foe.-u~
Pennsylvania
oraarrr>NarraF~n~
INHEWTANCE TAX RETURN
RBIDEHT oECEOetr
scNSODU E
CASH, BANK DEPOSITS ~ MISC.
PERSONAL PROPERTY
R.SMTE OF: FAF NUMOER:
Caroline 1. Snyder 2012-00171
Include the proceeds of i~Ugatlon and the date the proceeds were rzcetved bN the estate.
All pnpMr jdntty owned with rlylrt d survivorship mwt be diadaaed on 8clndYla F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Members tat Federal Credit Union, 5000 Louise Drive, PO Box 40, Medchani~burg, PA 17055 (decking) 10,833.93
2, Members 1st Federal Credit Union, 5000 Louise Drive, PO Box 40, Medanicstwrg, PA 17055 (savktgs) 10.98
3, Members 1st Federal Credit Union, 5000 Louise Dr., PO Box 40, Mech., PA 17055 (cert. of deposit) i 0,000.00
4, 2004 Porttraac Mordana (good condition - ICeky Blue Book value) 5,744.00
5, Sylvania 32' N 200.00
6. Federal Income Tax reTund received after death 631.00
7. MiNertniwn Pham-ecy Systems Inc refund received afbx death 529.90
g, Century Link refund received after death 49.05
g, Refund from funeral home prepaid funeral account 151.30
TOTAL (Also enter on Line 5, Recapitulation) ~ 28,150.16
If more space Lt needed, use additlonal sheets of paper d the same size.
REV-1511 EX+ (10-09)
Pennsylvania
oEVamr~r aF aerie
o.aauowoE we s€nsw
wesnerr aa~an
FUNERAL EXPENSES:
Cumberland VaNey Memor~l Gardens (opening of grave)
I'STATE t1F FiQE 1NI1~
Caroline L. Snyder 2012-00171 ,
OeoetaslY Tails asrral k nprlaf w Stisisis L
li@i
A.
1.
B.
1.
z.
3.
0.00
a.oo
Street Address
City State ZIP _
Relationship of Claimant to Decedent _
4. probate Fees: 0.00
5. Accountant Fees: 0.00
6. Tax Return Pneparer Fees: 0.00
7• Cumberland County Regislter of Wfdls (Grant of Letters & Shat Certificates) 111.50
0.00
0.00
0.00
0.00
0.00
TQTAL (Also enter on lane 9, Recapitulation} ; 1,912.50
AOMIN[STRATNE COSTS:
Personal Representathn! Commissions:
Name(s) of Personal Representati+re(s)
Street Address
SCHEDULE H
FUNERAL EXPENSES AND
ADMIIiIISTRAT1vE COSTS
1,801.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
city _ __ State _~ ZIP
Year(s) Commission Paid: ___ __
Attorney Fees:
Family Exemption: (]f decedent's address is not the same as claimant's, attach explanation.)
C~imant
If more space Is needed, use addltlonal sheets of paper of the same sae.
REV-1512 EX+ (12-12)
Pennsylvania
om~urrr~roFRFVEnuE
INHERRANI~ TAY NFIURN
PFS[OENr OECEDRlI
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES 8t LIENS
ESTATE OF FILE NUMBER
Caroline L. Snyder 2012-00171 .
If more space Is needed, Insert additional sheets ~ the same site,
REV-1513 EX+ (O1-10)
pennsylvarda SCHEDULE ~
DEPARTMENT OF REVENUE
INHERITANCE rAx RETURN BENEFICIARIES
RESIDENT DECEDENT
wlw~c ur: FILE NUMlER:
Carotlne L. Sn der 2012-00171
NUMBER
NAME AND ADDRESS OF PERSON(S) RECEMNG PROPERTY RELATIONSHIP TO DECEDENT
Do Not Liat Tnratee(a) AMOUNT OR SHARE
OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers umler
Sec. 9116 (a) (1.2).J
1 • Linda J. Kuntz, 187 Frost Rd., Gardners, PA 17324 daughter 4,133.58
2. Robert L. Snyder, 3213 Briarddf Ave., Vestal, NY 13850 sat 4,133.58
3. Roger R Snyder,1906 EsUter Dr., CarYsle, PA 17013 son 4,133.58
4. Jet6ey A. Snyder, 30 W. Eppley Dr., Carlisle, PA 17015 son 4,133.88
5. Geraldine Kocher, 2827 Squirrel Hill Ln., Spntce Creels, PA 16683 sister 5,944.00
0.00
0.00
0.00
0.00
0.00
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE.
NOIM-TAXABLE DISTRIBUTION$
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECRON TO 7AX IS NOT TAKEN:
1.
0.00
0.00
0.00
0.00
0.00
I B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
0.00
0.00
0.00
0.00
0.00
TOTAL OF PART II -ENTER TOTAL NON TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I!i
22,478.32
If more space is needed, use additional sheets of paper of the same size.
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LAST WILL AND TESTAbIENT .:. >b r
~_ ~'~ ~
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C~ ~ 7
CAROLINE L. SNYDER ~ ~ ~ `"
c.~.
I, CAROLINE L. SNYDER, a resident of the Commonwealth of Pennsylvania, make,
publish and declare this to be my Last Will and Testament, revoking all wills and codicils at any titter
heretofore made by me.
FIRST: I direct that the expenses of my last illness and funeral, the expenses of the
administration of my estate, and all estate, inheritance and similar taxes payable with respect to property
included in my estate, whether or not passing under this will, and any interest or penalties thereon, shall
be paid out of my residuary estate, without apportionment and with no right of reimbursement from any
recipientof any such property.
SECOND: It is my desire that, upon my death, my body be cremated, and interred
beside my husband at the Cumberland Valley Cemetery.
THIRD: I give to my sister GERALDINE KOCHER her choice of any of, and as much
of my tangible personal property as she wants.
All other tangible personal property is given as hereafter provided with respect to my
residuary estate.
FOURTH: I give all the rest, residue and remainder of my property and estate, both real
and personal, of whatever kind and wherever located, that I own or to which I shall be in any manner
entitled at the time of my death (collectively referred to as my "residuary estate"), as follows:
(a) To those of my children (my daughter LINDA SNYDER KUNTZ, my son ROBERT
L. SNYDER, my son ROGER R. SNYDER and my son JEFFREY A. SNYDER) who
survive me ,per capita.
(b) If no child of mine survives me, my residuary estate shall be paid and distributed to
my sister GERALDINE KOCHER if she shall survive me. If none of the aforesaid
beneficiaries of my residuary estate shall survive me, my residuary estate shall be paid
and distributed to those of my grandchildren who survive me, in equal shares.
(c) If none of the beneficiaries described in clauses (a) and (b) above shall survive me,
then I give my residuary estate to those who would take from me as if I were then to die
. ~ •. J 7
/ ~~
J
~_
without a will, unmarried and the absolute owner of my residuary estate, and a resident of
the Commonwealth of Pennsylvania.
FIFTH: If any property of my estate vests in absolute ownership in a minor or
incompetent, my Executors, at any time and without court authorization, may: distribute the whole or any
part of such property to the beneficiary; or .use the whole or any part for the health, education,
maintenance and support of the beneficiary; or distribute the whole or any part to a guardian, committee
or other legal representative of the beneficiary, or to a custodian for the beneficiary under any gifts to
minors or transfers to minors act, or to the person or persons with whom the beneficiary resides.
Evidence of any such distribution or the receipt therefor executed by the person to whom the distribution
is made shall be a full discharge of my Executors from any liability with respect thereto, even though my
Executors may be such person. If such beneficiary is a minor, my Executors may defer the distribution of
the whole or any part of such property until the beneficiary attains the age of eighteen (18) years, and may
hold the same as a separate fund for the beneficiary with all of the powers described in Article SEVENTH
hereof. If the beneficiary dies before attaining said age, any balance shall be paid and distributed to the
estate of the beneficiary.
SIXTH: I appoint my daughter LINDA SNYDER KUNTZ and my son JEFFREY A.
SNYDER as co-Executors of this will. If either of my Executors shall fail to qualify for any reason as
Executor or, having qualified shall die, resign or cease to act for any reason as Executor, the other
Executor may act alone as my Executor. I direct that no Executor shall be required to file or furnish any
bond, surety or other security in any jurisdiction.
SEVENTH: I grant to my Executors all powers conferred on executors under the
Pennsylvania Probate, Estates and Fiduciaries Code, as amended, or any successor thereto, and a1I powers
conferred upon executors wherever my Executors may act. I also grant to my Executors power to retain,
sell at public or private sale, exchange, grant options on, invest and reinvest, and otherwise deal with any
kind of property, real or personal, for cash or on credit; to borrow money and encumber or pledge any
property to secure loans; to exercise all powers of an absolute owner of property; to compromise and
release claims with or without consideration; and to employ attorneys, accountants and other persons for
services or advice. The term "Executors" wherever used herein shall mean the executors, executor,
executrix or administrator in office from time to time.
EIGHTH: I direct that for purposes of this will a beneficiary shall be deemed to
predecease me unless such beneficiary. survives me by more than thirty days.
This document was prepared under the authority of 10 U.S.C. §1044 and implementing
military regulations and instructions, by .Captain Joseph Krill, United States Army, who is licensed to
practice law in the State of Pennsylvania.
IN WITNESS WHEREOF, I, CAROLINE,~SNYD ,sign my name and publish and
declare this instrument as my last will and testament this ~ ~ day of ~~, 2007.
..
,.
CAROLINE L. SNYDER
The foregoing instrument was signed, published and declared by CAROLINE L.
SNYDER, the above-named Testatrix, to be her last will and testament in our presence, all being present
'1
.i ,
at the same time, and we, at her request and in her presence and in the presence of each other, have
subscribed our names as witnesses on the date above written.
~1 C1..
`~"~'~
having an address at
~ "~ S.-~: --r---~-'
/?D/3.
having an address at
l~013
L-~
3
ACKN WLEDGNiENT AND AFFIDAVIT
CO~IVIONWEALTH OF PEN~tSYLVANIA, COUNTY OF CUivIBERLAi~iD, ss.
We, the Testatrix and the witnesses, whose names are signed to the attached or foregoing
instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix,
CAROLINE L. SNYDER, signed and executed said instrument as her last will and testament in the
presence aad hearing of the witnesses, and that she had signed willingly, and that she executed it as her
free and voluntary act and deed for the purposes therein expressed, and that each of the witnesses at the
request of the Testatrix, in the presence and heazing of the Testatrix and each other, signed the will as
witness, and that to the best of his or her knowledge the Testatrix was at the time at least eighteen years of
age or emancipated, of sound mind and under no constraint, duress, fraud or undue influence.
~ ~ -~ ~,
CAROLINE L. SNYD~ .
Testatrix
z~~..?~
print: ~3ie~c. ~."~~'~
Witness
print: ~ •~ ~, S!',
Witness
Subscribed, sworn to and acknowledged before rtie by the said CAROLINE L. S~ER,
Testatrix, d subscribed and sworn to before me by the above-named witnesses, this ~ day of
2007.
N tary Public
My commission expires on ~ !~ Z~'
c:oa~~,io~ryv~;>=t;_vt' F~rt~vsvs:vartia
tValadal Arai
~'aY s. i0stler. t~k~ry Pubec
as~e eor~, 4~.~rr~iana c«buy
; _ ~ Comrrtiesbn 5~irt~ play 14, 2006
'+ta.nber. !'ar.+tay!•~r.,y!v Asno^i!rticr+ a! h7o!erlsr
REGISTER OF WILLS
CUMBERLAND COUNTY
PENNSYLVANIA
CERTIFICATE OF
GRANT OF LETTERS
No . 2012- 00171 PA No . 21- 12- 0171
Estate Of : CAROL/NE L SNYDER
fF6st, MMRS, Lash
Late Of: CARLISLE BOROUGH
CUMBERLAND COUNTY
Deceased
Social Security No: 21.1-26-0042
WHEREAS, on the 8th day of February 2012 an instrument dated
March 21st 2007 was admitted to probate as the last will of
CAROLINE L SNYDER
(Fist, Mlddle, Cestl
late of CARL/SLEBOROUGH, CUMBERLAND County,
who died on the 13th day of January 2012 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wi11s in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters TESTAMENTARY to:
JEFFREY A SNYDER and LINDA KUNTZ
who have duly qualified as EXECUTOR(R/Xl
and have agreed to administer the estate according to law, all of which
fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYLVAN/A.
IN TESTIMONY WHEREOF,.I have hereunto set my hand and affixed the seal
of my office on the 8th day of February 2012.
egtisYer o ' r s
~ ~ ~ ~ ,
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**NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
St
MEMBERS 1't
FriDfiRAL CRfiDCr i)NION
SerM Inquires to:
5000 Louise Drtw
PO Box 40
Macbankaburq,PA 17056
www.mambenisl.org
Main 9wkch6osrd: (717)697-1161 or (800) 283-2328
EZ Call: (717) 897.4372 or (800) T83~4372
TDD: (717)891-5312 or (800) 283-2328 ext. 5312
T~IeBranch: (717) T95~8049 or (800) 237-7288
~~~ E
CAROLINE L 3NYDER
Statement of Accounts 1
Dec 25, 2011 thru Jan 24, 2012
Account Number:
Balances at a Glance:
Checking:
Savings:
Certificates:
Loans:
162063
10,633.93
10.98
10,000.00
_0.00
o.oo
0.05
THORNWOOD HOME - ~~~ ~_ Money Management:
CARLISLE PA 1 OBS TTOM RD ~ Swipe 5 YTD Reward:
~/l-e C;!/LC~P-Ct! Page: 1 of 2
Your current Member Loyalty Rewards level is Gold.
Your aggregate balance as of January 1st is;18,755.66.
An aggregate balance of;35,000 and having 3 products
will move you to the Platinum level.
Want to earn some extra cash? Take advantage of our CASH4U referral
program.. Ask an associate for details.
CHECKING ACCOUNTS:
0011- .CHECKING
Date: Transaetian DesCrintion Additions> Subtractions Balance
Diic:25 Balance Forward 3,713.70
Dec 31 ..Deposit Dividend 0.100% 0.89 3,714: 39
Annual Perocer-gge YINd Earned 0. 100% from f2/C1/2011 through 12/31/2011
Bassd on Average Lally Balance oI B, 084.91
Dec 31 ' Deposh Transfer From Share 0043 t5. S4 3,729:: 93
Jan 03 Deposit Transfer from Share 0000 987, 7T - ;
4,897.70
Jan 03 Deposit Transfer from Share 0000 1,022.00 „
3,719'. 70 -
Jan OS Deposit Metrtbers 1st OnNne Transfer From Share 000 `!54.87 5,874.31
Jan 05 Deposit by Check
~ ~ 23.49 5,887.80
Jan 05 ~ Deposit Transfer From Share°0045 ' ~ ~
, . ~
Jan 05 Withdrawal ACH STATE FARM RO 27 ~ ~ 5,014.75 ~ - ~ 9
28.82- 10,83 3
TYWE: SFPPID: 9(107001 CO~ST/~1TP FARM`RO 27 ~ ~`
Jan 19 Check 000521 Tracer 0001501738 ~. ~ 200.00- - 10;833.83
J,an24 Endlny~Balance ~ ~•
~
~ ~ 10,833.93
2011 Dlvldenda Pafd
10.10
~~
CHEININARY ~
e
Check # Amount Date ~
tChllck 0 ~ Amaunt Dat
~
000521 200..00 Jan 19 ~'
SAVINGS ACCO~INTS
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GOOD- REGULAR-SAVINGS :
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.~~i.3 T~~.5 e':~P i.. k~}~:~~Y}k ~I~SSl4
Date Transaction Dss*crintion Additions Sultraetione Balance
Dec-25 Ba/itnce Forward
~ 10:.88
Jan 03 E~posiEACH.DFAS~CLEVELIWD ~ ~ ~ 982.77- 978:'75
TYPE: AR ANN PAY ID: 3041036004 DATA: b0 SYM90L 8522-APS
COtDFA& CLEVELAND
Jan'03 Withdrawal Transfer,To Share 0011 987.77- 10:98
Jart 03 Depoaft ACH=XXSOC SAC 1,022.00. 1,033:98
ID; 3031038030 CO; XXSOC SPC
--- Continued on following page--
~~St end Inpu'ues to: Main 8wltchtroard: (71 T) 697-1181 or (890) 283-2326
5000 loulsa Drive ~ Ca9: (717) 697-4372 or (800) 283.4372
PO Box 40 TOD: (717) 697.5312 or 800) 283-2328 ex[. 5372 Dec 25, 2011 thrU Jan 24, 2012.
Mechanicabur0, PA 170SS ( Account Number: 182083
MEMBERSI~° TeiaBraneh: (717)795-6049 w (800)237-7288
www.msmbermtst.org Page: 2 Of 2
Date Transaction Description Additions Subtractions Balance
Jan 03 ~thdrewal Transfer To Share 0011 1,022.00- 10.98
Jan 03 Deposit ACH AETNA INC 1 ~ • 81 1ti5. ~
TYPE: BENFT PYMT ID: 9949371001 CO: AETNA INC
Jan 03 Withdrawal Transfer To Share 0005 154.61-
Jan 24 Ending Balance 0.9
2011 Dividends Pald 0.24
0005 - MONEY MANAGEMENT
Dec 25 Balance Forward 0.00
Jan 03 Deposit Transfer From Share 0000 154.61 154.61
Jan 05 Withdrawal Members lst Online Transfer To Share 00 154..61-
0
Jan 24 Er-d/ng Balance 0
0.
2011 Dividends Pald' 1.87
CERTIFICATE -ACCOUNTS
0043 - 30 MONTH CERT Maturity Date - Jun'20, 2012
~acticn Description Additions
Date Tra Subtractions Balance
„
Dec 25 Balance Forward 10,000.00
Dec 31 Dt3posit DlVidend 1.830% 1b. 54 10,015.54
Annual Percentage Yield Earned 1.850% from 1TlIU1/2011 through 12/31/2011.
Dec 31 Withdrawal Transfer To Share 0011 15.54- 1
Jan 24 Ending Balance ,
2011 Dividends Pa/d 182.98.
0045= 9 MONTH NO PENALTY CERT.
Date Transaction Description Additions SubtrnlrsUons Balance.
5,012.61
Dec 25 Balance Forward
Dec 31 Deposit Dividend 4.50096 2.13 ' 5,OtA. 75
Annual Percentage Yield Earned 0.50096 from 12/01/2011 through f?J31/2011
Jan 05" Withdrawal Transfer To.Share 0011 5,Ot4.75- 0, 00
9 MONTH°fY0 PENALTY CERT Closed
"""This is the final statarrferit presenting Information on th/s duct"`
`"" Please retain this final statement for tax report/ng purposes '*"'
2011 Dividends Pald 14.75`
YTD SUMII~ARIES ' ~ ``
TOTAL DIVIDENDS,PAID
0000 REGULAR SAVINGS 0:00
'
0005 MONEY MANAGEMENT 0.00. °
0011 GH!?GK(NG ~ ~ 0.0(1, <~`
C6RT~ r 0.00
A043 30 MONTH
~
,
0045 9 MONTH NO PENALTY'CERT 0. Q
;
}
..;
Total YearT a i rtdr ~~ 0.00
~edEiar~r
NOTE: Tota~~
` ~
~
225.24
~
Total 2011 b ds std '
Ron't forget about our, new ,Melmber Loyalty Rewards; Pro ram.
"
the more bereHts you'ill
ou have with us
ts~
d receive.
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yy
uc
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~~~-t -~+-- sue, E
Kelley Blue Book the trusted Reso~rte"
Your Blue Book® Value
2004 Pontiac Montana
r Sty4: Mptlwn 4D
Ml4ape:75000
FYfvate Putt' Value
ExOal4nt
56.194
Very Good '.
55.894
Good
53,744
Fafr
$5,019
Vahkle tliphOghts
'. MPG: Chy 17Mwy 24 MalcSeaHnp: 8
i
Daors: 4 Engine: V6, 3.4 Liter
Orivehdn: FWD 'M1anemiasbn: Automatk
'i EPA 0436: Vans. Pageetgar T11Pe Bod1f Style: Vert
Country oiOdpln: UnkW Stabs Country of Arembty. Unibd Stags
Yow CtxtBptaed Options
Otrc P ORIIOns, based q1 typi[el eglYpmeK for this tar.
~Optlprta that you added rAWe mi6yurNq thi6 tar.
P.npale
V6, 3.4 Uher S6aaAtly
Power Steerhg
rr«tpMwlat nR Nnleel
Ausanetk lttEerbNlauetR aae itrttrtrtterltatlott
AMlFM Stereo
m (sxgie oxta
FWD
~e1Y aa~s.stetlt;
Cornlbs! and C.ertveetutoe Dual AM Baps
Air CantAlbMrg
Pbwar Window
EtcSeAw
s
Power Door L.Odts
Cndee GOnbd Two-TOnC Paint
Ceryo aed Towaq
ROOF Refit
tNAeals ena nta
Smd wheels
Glossary of Terms
turey Bate balt~ Tsrda-In whr - Ttss B tAe anaunt wu can etrnalt m tetelve wlen
.,, _ why ati:7
you trade M yar car m a dealer. ltd value is detenmrretl basetl on the style, mrdKbn,
mNeage acrd options indkxted.
Kelkey Blue BooNQp Prfvabs tarty Vatue - This is the starorrg point for rrepadatbn d a
used-qr 5~e bebxeerr a pdvaee brryer and seller. This 1s an "as is" value the does not krcNrde
arty warrardks. The flrol price depends an the car's ardtrel corrUtlort and bray market fach:xs.
lxaeNwK Carrdidan: 3% d aN cars we vabe meet this crtherW. Th(s car Woks crew and is b
ewcegeM nredrankal oondipar. R has never bed f~ a 7RftdM an ktea'lor and
tlOdy tree d wear and visible defetds. 7hecx B rustfia~fiae add dogC tldt deed neoord~onkg. Its
clren engine aomperbrrent k tree d fluid bNcs. It also has a deerr tltlehk+tbry, has oompkte
and verifiable service recon6 aro wdl pes apMY and smop krrpectton.
Vary Good Conditlon: 23% d all cars wa value meet the aiterta. This car has minor wear a
visile defects on the body and intarbr twt is in omeNent merirardcal rnrdltlon, regrwing only
minimal reaordkiortWg. It has Nttle m m pakk and bodywork and is free d rust. Its cban
errgkre mmparbnent b bee d fltAd leak. The flees mahtt and bare 75% a mae d trued. It
aHD has a dmn tltle hkmry, wkh most Service remNs avaMable, and wAl pas safely and smog
InsPectlon•
Gaud forrdltionn: 54% d all cars we value meet ttas aiteria. TMs car a free d
meclraNcal problems but may need some recardkbMng. Its pakrt and trodyvrak may require
mkgr mrrclrups, wah repakable oosmeuc defeats, and ks anpire may have
mina kinks. There are mirar lrodY saa6cire6 a dogs and moor kderbr Wenttdra, trot no rust
The fires match aM have 50% a more d tread. It also has a dean tkk hkaory, wkh some
servbe records avaUaf7le, and wIU pass satiety and smog irt5pedlon.
lair CaWNbn: i8% d ae cars we value meet tMc criteria. This car has some rrreclrarrkal a
cdinrretlc detects and needs seriddng, 6rR k: afUl in safe runrYrg corrdldorr and has a ebmr tN1e
h~Y• The Pam. ~Y and/or ineerlor may need proAessloriel servkirrg. The tltes may need
replacing and tlrete may be some repakalrle rust damage.
® 1995-2012 KeNey Blue Book Co.®, inc. All fights reserved.
® 2012 Kegey Blue Book Co., Inc. Ali rights reserved. 12/Zl/IOIZ-IZ/27/Z012 Edltlon for Aennsylvdn/a
17013. The specl8c informatlon required m determine [he vakre !nr this particular vehkie was suppled
by the person gerleratlng th/s repoK. Vehkle vahratkars are oplnkrns arM may vary darn veAk7e ro
vehkle. Actual va/ua[bns w1ll vary based upon market cotrdttlons, specNkatfons, veYrkie mndklon or
other partkular circumstances pertinent to this parttctrlar vehkJe or Me trsnsattlon or the parties m the
lranraMtnn 'Fl.in ..nnn.v~ tr fnMnrlnil Fnn H.n tn.iA.t.l. ref r..-.. ..F!/.n nnTnn nunoro~(nn 1A1.- rnnnM nnF. ani/
W ~ r J .
_._ _ .___.__ __~..,,..._.. , - ,,_.._..._..__ ,.. _ ._ .. ._~-..._ _-___ _ _ _ ... --_~. /1C
!4/12 NYDER, JEFFREY A -'
12/12 Medical Supplies 54 .1 66.
IS/12 Personal Supplies 1 1.01 1.
16/12 ical Equipment Rental 2 24.5 49.
tl/12 Personal Laundry Services 1 25.0 25.
- 01/31/1 Room & Board -Private 31 291.00 -9,021.
- 01/12/1 Room & Board -Private 12 291.00 3,492.
ii/12 ble Television 1 24.75 24.
-° ~`~1" orfi -fir S~G~ T
Current
31-fi0 Days
61-90 Days .
Over 90 Days
Amount Due
166.03
A-~[~J~... .00 .00 .00 ~ ~~
~ ~ rS ~ ~ ~~
"~ F.a1...°.u u...Clr xl UFr IG0.11 4Y1
Otl`'MR BY the 25th of each month. Thank you.
Caroline LSnyder -Account #: 1300
Thornwald Home
442 Walnut Bottom Road
Carlisle, PA 17013
Telephone: (717) 249-4118
~~~
Statement Date: 02/01/2012
.Due Date: 02/25/2012
~~
~ ~, p R~
-f ~`- P Sg3.31
3,
I (n ~. 03
.~ 3~
~/
M
__.
r
r . .. i n
.
~ e, ...o-
rc. t.
. '.~.
y
.tneo-L._
.
'i.
v
Balance B/F 9,207.32 4,207.32
12/15/11 NYDER, CAROLINE L 9,207.32 .00
12/02/11 edical Suppiles 29 3.S1) 54.53 54.53
12/03/11 rsonalSuppHes 3 .9 2.03 56.56
12/31/11 Personal Laundry Services 1 20.00 20.00 76.56
12/31/11 ble Television 1 24.75 24.75 101.31
01/01/12 - 01/31/1 oom & Board -Private 31 291:00 9,021.00 4,122.31
Current 1-30 Days 31-60 Days 61-90 Days Over 90 Daya Amount Due
9,021.00 101.31 .00 .00 .00 9,123.31
rceimnaer: Haase Sena new mwrance taro copies w our uustr~
Office to ensure we have your current information.
Please be sure to label any new dothing or gifts that our residerrts
may receive crier the hoiday.
**Warmest wishes for a joyous, blessed holiday season**
Caroline LSnyder -Account #: 1300
ThorrlwaW Florae
442 Walnut Bottom Road
Carlisle, PA 17013
Telephone: (717) 249-4118
Statement Date: 01/01/2012
Due Date: 01/25(2012
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https://www.doreservices.state.pa.us/pitservices/Default.aspx
Penalty and Interest Calculations
CALCULATION DATES-
10/13/2012 TO 1/31/2013
TAX DEFICIENCY $ 1,457.32
CALCULATED INTEREST $ 13.14
BALANCE AS OF 1/31/2013 $ 1,470.46
1 ~'