HomeMy WebLinkAbout01-30-131505610105
REV-1500 a ~oz_ll> tom,
n tvarlta OFFICIAL USE ONLY
PA Department of Revenue P~ sY Coun Code Year File Number
Bureau of Individual Taxes OEP~NTNENTOFPEVENUE ty
Po Box s8o6oi INHERITANCE TAX RETURN n
Harrisburg, PA ~~iz8-o6o1 RESIDENT DECEDENT ~~ I c~ ~-7
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
07/07/2012 07/17/1926
Decedent's Last Name Suffix Decedent's First Name MI
Rosie Lieselotte
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Rosie Gerald ~
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
~ 1. Original Retum 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 O 5. Federal Estate Tax Retum Required
death after 12-12-82)
O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death O 11. Election to Tax under Sec. 9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
Kathleen Farrell (717) 418-1964
First Line of Address
5 Hilltop Circle
Second Line of Address
City or Post Office
CafllSle
State ZIP Code
PA 17015
Correspondent's e-mail address: cowboy00722Qcomcast.net
CBE~STER OF VWCL3 SLY
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unaer penalties of per)ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, con'ect and complete. Declaration of preparer other than the personal representative is based on atl information of which preparer has any knowledge.
SI~f T OF PERSO~SPONSIBLE FOR FILING RETURN DATE
ADDRESS \` ~ Zb~~
`~ ~\~'~-`'~ ,c~ ~..\ r```te ~.,r-~~5~ ~~ ~ ~ \-101~.~
SIGNATURE OF PREPARER THER THAN REPRESENTATIVE DATE
~UUKtSS
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610105 1505610105
J 1505610205
REV 1500 EX (FI)
Decedent's Name: Lieselotte ROSie
Decedent's Social Security Number
RECAPITULATION
1. Real Estate (Schedule A) ........................................ ..... 1. 0.00
2. Stocks and Bonds (Schedule B) .................................. ..... 2. 21,781.74
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 0.00
4. Mortgages and Notes Receivable (Schedule D) ...................... ..... 4. 0.00
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).. ..... 5. 18,007.43
6. Jointly Owned Property (Schedule F) O Separate Billing Requested .. ..... 6. 0.00
7. Inter-Vvos Transfers & Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested... ..... 7. 0.00
8. Total Gross Assets (total Lines 1 through 7) ........................ ..... 8. 39,789.17
9. Funeral Expenses and Administrative Costs (Schedule H) ................... 9. 0.00
10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) .......... ..... 10. 0.00
11. Total Deductions (total Lines 9 and 10) ............................ ..... 11. 0.00
12. Net Value of Estate (Line 8 minus Line 11) ......................... ..... 12. 39,789.17
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ................... ..... 13. 0.00
14. Net Value Subject to Tax (Line 12 minus Line 13) ................... ..... 14. 39,789.17
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) x .0 0 21,781.74 15.
16. Amount of Line 14 taxable
at lineal rate x .0 45 18,007.43 16.
17. Amount of Line 14 taxable
at sibling rate X .12 17
18. Amount of Line 14 taxable
at collateral rate X .15 18.
19. TAX DUE ...................................................... ...19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
1505610205 1505610205
0.00
810.33
810.33
O
J
REV-1500 EX (FI) Page 3
Decedent's Complete Address:
File Number
DECEDENTS NAME
Lieselotte Rosie
STREET ADDRESS - ---
Forest Park Health Center
700 Walnut Bottom Rd.
_ --
CITY
Carlisle STATE ZIP
PA 17013
Tax Payments and Credits:
2.
Tax Due (Page 2, Line 19)
Credits/Payments
A. Prior Payments
B. Discount
3. Interest
0.00
4. If Line 2 is greater than Line 1 + 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.
810.33
Total Credits (A + B) (2) 0.00
(3) 0.00
(4)
(5) 810.33
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 "in trust for" or payable-upon-death bank account or security at his or her death? .............. ^
4. Did decedent own an individual retirement account, annuity or other non-probate property, which
contains a beneficiary designation? ........................................................................................................................ ^
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an
adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)j.
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in [72 P.S. §9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)J. 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.
0.00
REV-i5o3 EX+ (8-u)
pennsylvania
ail DEPARTMENT DFREVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCNEpuLE B
STOCKS & BONDS
ESTATE OF FILE NUMBER
Lieselotte Rosie 2012-00898
All property jointly owned with right of survivorship must be disclosed on schedu~p F.
u more space is neeaed, insert additional sheets of the same size
REV-15o8 EX+ (08-12)
~ Pennsylvania SCFIEpVLE E
DEPARTMENT OF REVENUE CASH BANK DEPOSITS & MISC.
INHERITANCE TAX RENRN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Lieselotte Rosie 2012-00089
Include the proceeds of litigation and the date the proceeds were received by the estate.
Ail property jointly owned with right of survivorship must be discbsed on Schedule F
-~ inure space is neeaea, use aaamonai sheets of paper of the same size.
REV-1513 EX+ (01-10)
Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE ~
BENEFICIARIES
ESTATE OF: FILE NUMBER:
Lieselotte Rosie 2012-00898
NUMBER NAME AND ADDRESS OF PERSON(S) RECEMNG PROPERTY RE o~Not List T ustee(s)~ AMOOF ESTATE ARE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1 • Gerald Rosie, 911 W. Lowther St. Carlisle, PA 17015 spouse 21781.74
2 Linda Pelletier, 131 West Point Dr. Carlisle, PA 17015 daughter 4501.85
3 George Schwarz, 2522 Liberty Court, Modesto, CA 95355 son 4501.85
4 Kathy Farrell, 5 Hilltop Circle, Carlisle, PA 17015 daughter 4501.88
5 Chriselle Hernandez, 1952 Madrid Dr. Stockton, CA 95205 granddaughter 4501.85
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I~
If more space is needed, use additional sheets of paper of the same size.
~Caiculated Value of Yaur Paper Savings Band{s)
r
Calculated Yalue of Your Paper Savings Band{s)
Calculator Results for Redemption Date 06/2012
Total Value Total Interest YTD Interest
Total Price 418.18
$9,200.00 $21 781.74 $12 581.74 $
Bonds: 1-205 of 205
Issue Next Final Issue Interest
Interest Rate Value Note
Serial # series Denom
Date Accrual Maturity Price
00
0
56
$37
76%
0
$87•`.16
C545815526EE EE $100 12/1995 12/2012 12/2025
100 1011995 10/2012 10/2025 .
$5
$50.00 .
$39.44 .
1.12% $89.44
C540371007EE
C540371008EE EE
EE $
$100 10/1995 10/2012 10/2025 $50.00 $39.44 1.12%
12%
1 $89.44
44
$89
C532517715EE EE $100 08/1995 08/2012 08/2025
2025 $50.00
00
$50 $39.44
$39.44 .
1.12% .
$89.44
C532517716EE
E EE
EE $100 08/1995 0812012 08/
$100 06/1995 12/2012 06/2025 .
$50.00 $50.00 0.76% $100.00
C5222490$9E
C522249090EE EE $100 06/1995 12/2012 06/2025 $50.00 $50.00 0.76%
00%
4 $100.00
04
$99
C502096092EE EE $100 0311995 07/2012 03/2025
995 07/2012 0312025 $50.00
$50.00 $49.04
$49.04 .
4.00°l0 .
$99.04
C502096093EE
C483546279EE EE
EE $100 03/1
$100 0111995 07/2012 01/2025 $50.00 $49.68 4.00%
0% $99.6$
68
$99
C483546280EE EE $100 01/1995 0712012 01/2025
2024
1 $50.00
00
$50 $43.68
$50.36 4.0
4.00% '
$100.36
C483354303EE EE
EE /
$100 11/1994 07/2012 1
$100 1111994 07/2012 11/2024 .
$50.00 $50.36 4.00% $100.36
C483354304EE
C483145833EE EE $100 09/1994 07/2012 09/2024 $50.00 $51.00 4.00%
00%
4 $101.00
00
$101
C483145834EE EE $100 0911994 07/2012 0912024
2024 $50.00
00
$50 $51.00
$51.68 .
4.00% .
$101.68
C466202231EE EE
EE $100 07/1994 07/2012 07/
$100 07/1994 07/2012 07/2024 .
$50.00 $51.68 4.00% $101.68
C466202232EE
C465960900EE EE $100 05/1994 07/2012 05/2024 $50.00 $52.36 4.00%
00%
4 $102.36
36
$102
C465960901EE EE $100 05/1994 07/2012 05/2024
2024
3 $50.00
00
$50 $52.36
$53.04 .
4.00% .
$103.04
C451750125EE
E
6 EE
EE /
$100 03/1994 07/2012 0
$100 03/1994 0712012 03/2024 .
$50.00 $53.04 4.00% $103.04
E
C45175012
C451711205EE EE $100 01/1994 07/2012 01/2024 $50.00 $53.72 4.00%
00%
4 $103.72
72
$103
C451711206EE EE $100 01/1994 07/2012 01/2024
2023 $50.00
00
$50 $53.72
$54.40 .
4.00% .
$104.40
C437513421EE
2EE EE
EE $100 11/1993 07/2012 11/
$100 11/1993 07/2012 11/2023 .
$50.00 $54.40 4.00% $104.40
C43751342
C423533312EE EE $100 09/1993 07/2012 09/2023 $50.00 $55.08 4.00% $105.08
C423533313EE. EE $100 09/1993 07/2012 0912023 $50.00
00
50 $55.08
80
$55 4.00%
00%
4 $105.08
$105.80
C423490680EE:
E EE
EE $100 0711993 07/2012 07/2023
$100 07/1993 07/2012 07/2023 .
$
$50.00 .
$55.80 .
4.00% $105.80
C423490681E
C409843598EE EE $100 05/1993 07/2012 05/2023 $50.00 $56.48 4.00% $106.4$
C409843597EE EE $100 05/1993 07/2012 05/2023 $50.00
00
0 $56.48
96
$1 4.00%
30%
1 $106.48
$51.96
P5
C855789460EE
9EE EE
EE $100 02/2009 07/2012 0212039
$100 02/2009 07/2012 02/2039 .
$5
$50.00 .
$1.96 ,
1.30% $51.96 P5
C85578942
C762932269EE EE $100 12/2002 07/2012 12/2032 $50.00 $15.48 0.81%
$1%
0 $65.48
48
$65
C762932268EE EE $100 12/2002 07/2012 12/2032 $50.00
0
00 $15.48
08
$2 .
1
30% .
$52.08 P5
C854509853EE
E
2 EE
EE $100 12/2008 07/2012 12/2038
$100 12/2008 07/2012 12/2038 .
$5
$50.00 .
$2.08 ,
1.30% $52.08 P5
E
C85450985
C852418244EE EE $100 10/2008 07/2012 10/2038 $50.00 $2.48 1.40% $52.48 P5
C852418243EE EE $100 10/2008 07/2012 10/2038 $50.00
00
50 $2.48
60
$2 1.40%
40%
1 $52.48
$52.60 P5
P5
C85094?$71EE
C850947870EE EE
EE $100 0$/2008 07/2012 08/2038
$100 08/2008 07/2012 08/2038 .
$
$50.00 .
$2.60 .
1.40% $52.60 P5
C849629795EE EE $100 0612008 07/2012 06/2038 $50.00
00
0 $2.72
72
$2 1.40%
40%
1 $52.72
$52.72 P5
P5
C849629794EE
29EE EE
EE $100 06/2008 07/2012 06/2038
$100 0412008 07/2012 04/2038 $5
.
$50.00 .
$6.20 .
3.00% $56.20 P5
8482282
C848228228EE EE $100 04/2008 07/2012 04/2038 $50.00 $6.20 3.00% $56.20 P5
C846742037EE EE $100 02/2008 07/2012 02/2038 $50.00
50
00 $6.52
52
$6 3.00%
00%
3 $56.52
$56.52 P5
P5
C846742036EE EE $100 02/2008 07/2012 0212038 .
$ , .
file://C:1Documents and SettingslJudy\My Documents\Calculated Value of Your Paper S... 12/28/2012
,Calculated Value of Your Paper Savings Bond(s)
`'age ? o f ~.
C845316827EE EE $100 1012007 07/2012 10/2037 $50.00
00 $8.04
80
$6 3.40°l0
00%
3 $58,04 P5
$56.80 P5
C845316826EE
i45EE EE
EE $100 12/2007 07/2012
$100 1012007 0712012 12/2037
1012037 $50.
$50.00 .
$8.04 .
3,40°1`0 $58.04 P5
C843018
C843418144EE EE $100 1012007 07/2012 10/2037 $50.00 $8.04 3.40°~ $58.04 P5
C841212159EE EE $100 08/2007 07/2012 0812037 $50.00 $8.36 3.40% $58.36 P5
C841212158EE EE $100 08/2007 07/2012 08/2037 $50.00 $8.36 3.40% $58.36 P5
C839774854EE EE $100 06/2007 07/2012 06/2037 $50.00 $9.20 3.40% $59.20
C839774853EE EE $100 0612007 07/2012 06/2037 $50.00 $9.20 3.40°/a $59.20
C838177624EE EE $200 04/2007 07/2012 04/2037 $50.00 $10.16 3.60% $60.16
C$38177623EE EE $100 04/2007 07/2012 04/2037 $50.00 $10.16 3.60% $60.16
C836458584EE EE $100 02/2007 07/2012 02/2037 $50.00 $10.52 3.60% $50.52
C836458583EE EE $100 02/2007 07/2012 02/2037 $50.00 $10.52 3.60% $60.52
C834856391EE EE $100 12/2006 07/2012 12/2036 $50.00 $10,8$ 3.60% $60.88
C834856390EE EE $100 12/2006 0712012 12/2036 $50.00 $10.88 3.60% $60.88
C832284256EE EE $100 1012006 07/2012 10/2036 $50.00 $11.52 3.70% $61.52
C8322$4255EE EE $100 10/2006 07/2012 10/2036 $50.00 $11.52 3.70% $61.52
C830276857EE EE $100 0812006 07/2012 08/2036 $50.00 $11.92 3.70% $61.92
C830276856EE EE $100 08/2006 0712012 0$/2036 $50.00 $11.92 3.70% $61.92
C828392265EE EE $100 06/2006 07/2012 06/2036 $50.00 $12.28 3.70% $62.28
C858392264EE EE $100 06/2006 07/2012 06/2036 $50.00 $12.28 3.70% $62.28
C826564962EE EE $100 04/2006 07/2012 04/2036 $50.00 $10.80 3.20% $60.80
C856564961EE EE $100 04/2006 07/2012 04/2036 $50.00 $10.80 3.20% $60.80
C82471$951EE EE $100 02/2006 07/2012 02/2036 $50.00 $11.12 3.20% $61.12
C824718950EE EE $100 02/2006 07/2012 02/2036 $50.00 $11.12 3.20% $61.12
C815243025EE EE $100 12/2005 07/2012 12/2035 $50.00 $11.44 3.20% $61.44
C815243024EE EE $100 12/2005 07/2012 12/2035 $50.00 $11.44 3.20% $61.44
C81170$648EE EE $100 10/2005 07/2012 10/2035 $50.00 $13.00 3.50% $63.00
C811708647EE EE $100 10/2005 07/2012 10/2035 $50.00 $13.00 3.50% $63.00
C809759552EE EE $100 0512005 07/2012 08/2035 $50.00 $13.36 3.50% $63.36
C809759551EE EE $100 08/2005 07/2012 08/2035 $50.00 $13.36 3.50% $63.36
C807811644EE EE $100 06/2005 07/2012 06/2035 $50.00 $13.72 3.50°1° $63.72
C807811643EE EE $100 06/2005 07/2012 06/2035 $50.00 $13.72 3.50% $63.72
C805283183EE EE $100 04/2005 07/2012 04/2035 $50.00 $11.56 1.19% $61.56
C805283182EE EE $100 04/2005 07/2012 04/2035 $50.00 $11.56 1.19% $61.56
C804115669EE EE $100 02/2005 07/2012 02/2035 $50.00 $11.68 1.19% $61.68
CC804115668EE EE $100 02/2005 07/2012 02/2035 $50.00 $11.68 1.19% $61.68
C801793489EE EE $100 12/2004 07/2012 12/2034 $50.00 $11.80 0.81°!0 $61.$0
C801793488EE EE $100 12/2004 07/2012 12/2034 $50.00 $11.80 0.81°Jo $61.80
C797669795EE EE $100 10/2004 07/2012 1012034 $50.00 $12.56 1.19% $62.56
C797669794EE EE $100 10/2004 07/2012 10/2034 $50.00 $12.56 1.19% $62.56
C795386444EE EE $100 08/2004 07/2012 08/2034 $50.00 $12.68 1.19% $62.68
C795386443EE EE $100 08/2004 07/2012 08/2034 $50.00 $12.68 1.19% $62.68
C792004449EE EE $100 06/2004 07/2012 06/2034 $50.00 $12.80 0.81% $62.80
C792004448EE EE $100 06/2004 07/2012 06/2034 $50.00 $12.80 0.81% $62.80
j C395381398EE EE $100 02/1993 08/2012 02/2023 $50.00 $84.12 4.00% $134.12
C3953$1397EE EE $100 02/1993 08/2012 02/2023 $50.00 $84.12 4.00% $134.12
C395337131EE EE $100 12/1992 12/2012 12/2022 $50.00 $86.80 4.00% $136.80
C395337130EE EE $100 12/1992 12/2012 12/2022 $50.00 $86.80 4.00% $136.80
C388370296EE EE $100 10/1992 10/2012 10/2022 $50.00 $86.$0 4.00% $136.80
C388370295EE EE $100 1011992 10/2012 10/2022 $50.00 $86.80 4.00% $136.80
C365359415EE EE $100 0$/1992 08/2012 08/2022 $50.00 $86.80 4.00% $136.80
C365359414EE EE $100 08/1992 08/2012 08/2022 $50.00 $86.80 4.00% $136.80
C358584497EE EE $100 06/1992 12/2012 06/2022 $50.00 $89.56 4.00% $139.56
C358584496EE EE $100 06/1992 12/2012 06/2022 $50.00 $89.56 4.00% $139.56
C358442024EE EE $100 04/1992 10/2012 04/2022 $50.00 $89.56 4.00% $139.56
C358442023EE EE $100 04/1992 10/2012 04/2022 $50.00 $$9.56 4.00% $139.56
C344116261EE EE $100 02/1992 08/2012 02/2022 $50.00 $89.56 4.00% $139.56
C344116260EE EE $100 02/1992 08/2012 02/2022 $50.00 $89.56 4.00% $139.56
C332738867EE EE $100 12/1991 12/2012 12/2021 $50.00 $92.36 4.00% $142.36
C332738866EE EE $100 12/1991 12/2012 12/2021 $50.00 $92.36 4.00% $142.36
C332694217EE EE $100 10/1991 10/2012 10/2021 $50.00 $92.36 4.00% $142.36
C332694216EE EE $100 10/1991 10/2012 10/2021 $50.00 $92.36 4.00% $142.36
C312679343EE EE $100 08/1991 0512012 08/2021 $50.00 $92.36 4.00% $142.36
file://C:\Documents and Settings\Judy\My Documents\Calculated Value of Yvur Paper S.._ 12/28/2012
,Calculated Value of Your Paper Savings Bond(s)
Page 3 of ~
;312679342EE EE $100 08/1991 08/2012 08/2021 $50.00
00
50 $92.36
20
$95 4.00%
00°/a
4 $142.36
$145.20
2981g9765EE
4EE EE
EE $100 06/1991 12/2012 06/2021
$100 06/1991 12(2012 06/2021 .
$
$50.00 .
$95.20 .
4.00% $145.20
~29819976
~289615661EE EE $100 04/1991 10/2012 04/2021 $50.00 $95.20 4.00% $145.20
~289615660EE EE $100 04/1991 10/2012 04/2021 $50.00
50
00 $95.20
20
$95 4.00%
4
00% $145.20
$145.20
~289588020EE
019EE EE
EE $100 02/1991 08/2012 02/2021
$100 02/1991 08/2012 02/2021 .
$
$50.00 .
$95.20 .
4.00% $145.20
C289588
C276990652EE EE $100 12/1990 12/2012 12/2020 $50.00 $98.08 4.00°/a $148.0$
C276990651EE EE $100 12/1990 12/2012 12/2020 $50.00 $98.08 4.00% $148.08
C276950943EE EE $100 10/1990 10/2012 10/2020 $50.00 $98.08 4.00%
4
00°1 $148.08
08
$148
C276950942EE EE $100 10/1990 10/2012 10/2020
2020
09 $50.00
50
$37 $98.08
56
$73 .
0
4.00% .
$111.06
K94995759EE
K95992458EE EE
EE $75 09/1990 09/2012
$75 06/1990 12(2012 /
06/2020 .
$37,50 .
$75.7$ 4,00°l0 $113,28
K95992457EE EE $75 06/1990 12(2012 06/2020 $37.50 $75.78 4.00% $113.2$
K95731140EE EE $75 05(1990 11/2012 05/2020 $37.50 $75.78 4.00% $113.2$
K95731139EE EE $75 05/1990 11/2012 05/2020 $37.50 $75.78 4.00% $113.28
K95971708EE EE $75 04/1990 10/2012 04/2020 $37.50 $75.78 4.00% $113.28
K95971707EE EE $75 04/1990 10/2012 04/2020 $37.50 $75.78 4.00% $113.28
K94869050EE EE $75 03/1990 09/2012 03/2020 $37.50 $75.7$ 4.00% $113.28
K94869049EE EE $75 03(1990 09/2012 03/2020 $37.50 $75.78 4.00% $113.28
1C93946961EE EE $75 02/1990 08/2012 02/2020 $37.50 $75.78 4.00% $113.28
K93946960EE EE $75 02/1990 08/2012 02/2020 $37.50 $75.78 4.00% $113.28
K93934878EE EE $75 01/1990 07/2012 01/2020 $37.50 $75.78 4.00% $113.28
K93934877EE EE $75 01/1990 07/2012 01/2020 $37.50 $75.7$ 4.00% $113.28
K93430155EE EE $75 12/19$9 12/2012 12/2019 $37.50 $78.06 4.00% $115.56
K93430154EE EE $75 12/1989 12/2012 12/2019 $37.50 $78.06 4.00% $115.56
K93418093EE EE $75 11/19$9 11/2012 11(2019 $37.50 $78.06 4.00% $115.56
K93418092EE EE $75 11/1989 11/2012 11/2019 $37.50 $78.06 4.00% $115.56
K93401340EE EE $75 10/1989 10/2012 10/2019 $37.50 $78.06 4.00% $115.56
K93401339EE EE $75 10/1989 10/2012 10/2019 $37.50 $78.06 4.00% $115.56
K93389318EE EE $75 09/1989 09/2012 09(2019 $37.50 $78.06 4.00% $115.56
K93389317EE EE $75 09/1989 09/2012 09/2019 $37.50 $78.06 4.00% $115.56
K83741830EE EE $75 08/1989 08/2012 08/2019 $37.50 $78.06 4.00% $115.56
K83701829EE EE $75 08/1989 08/2012 08/2019 $37.50 $78.06 4.00% $115.56
K93372319EE EE $75 07(1989 07/2012 07/2019 $37.50 $78.06 4.00% $115.56
K93372318EE EE $75 07(1989 07/2012 07/2019 $37.50 $78.06 4.00% $115.56
K93355731EE EE $75 06/1989 12(2012 06/2019 $37.50 $80.37 4.00°!0 $117.$7
K93355730EE EE $75 06/1989 12/2012 06/2019 $37.50 $80.37 4.00% $117.87
K$8942650EE EE $75 05/1989 11/2012 05/2019 $37.50 $80.37 4.00% $117.$7
K88942649EE EE $75 05/1989 11/2012 05/2019 $37.50 $80.37 4.00% $117.87
K84911713EE EE $75 04(1989 10/2012 04/2019 $37.50 $80.37 4.00°/a $117.87
K84911712EE EE $75 04/1989 10/2012 04/2019 $37.50 $80.37 4.00% $117.87
K84899885EE EE $75 03/1989 09/2012 03/2019 $37.50 $80.37 4.00% $117.87
K84899884EE EE $75 03/1989 09/2012 03/2019 $37.50 $$0.37 4.00°/a $117.87
K84883254EE EE $75 02/1989 08!2012 02/2019 $37.50 $80.37 4.00% $117.57
K84883253EE EE $75 02/1989 08/2012 02/2019 $37.50 $80.37 4.00°Jo $117.87
K84881522EE EE $75 01/1989 07/2012 01/2019 $37.50 $80.37 4.00% $117.87
K84871428EE EE $75 01/1989 07/2012 O1/20I9 $37.50 $80.37 4.00% $117.87
K84854846EE EE $75 12/1988 12/2012 12/2018 $37.50 $82.74 4.00% $120.24
K84854845EE EE $75 12/1988 12/2012 12/2018 $37.50 $$2.74 4.00% $120.24
K8484313$EE EE $75 11/1988 11/2012 11/2018 $37.50 $82.74 4.00% $120.24
K84843139EE EE $75 11/1988 11/2012 11/2018 $37.50 $82.74 4.00% $120.24
k83094777EE EE $75 06/1988 12/2012 06/2018 $37.50 $85.14 4.00% $122.64
K83067039EE EE $75 04/1988 10/2012 04/2018 $37.50 $85.14 4.00% $122.64
K83067038EE EE $75 04/1988 10/2012 04/2018 $37.50 $85.14 4.00% $122.64
K88443604EE EE $75 03/1988 09/2012 03/2018 $37.50 $85.14 4.00% $122.64
K88443603EE EE $75 03/1988 09/2012 03/2018 $37.50 $85.14 4.00% $122.64
K88443602EE EE $75 02(1988 08/2012 02/2018 $37.50 $85.14 4.00% $122.64
K88443601EE EE $75 02/1988 08/2012 02/2018 $37.50 $85.14 4.00% $122.64
K88443599EE EE $75 01/1988 07/2012 01/2018 $37.50 $85.14 4.00% $122.64
K88443600EE EE $75 01/1988 07/2012 01/2018 $37.50 $85.14 4.00% $122.64
K88444096EE EE $75 11/1986 11/2012 11/2016 $37.50 $92.64 4.00% $130.14
K88444095EE EE $75 11/1986 11/2012 11/2016 $37.50 $92.64 4.00% $130.14
file://C:\Documents and SettingslJudy\My DocumentslCalculated Value of Your Paper 5... 1 212 8/2 0 1 2
Calculated Value of Your Paper Savings Bond(s)
"age ~ o r G-
K88444094EE EE $75 10/1986 10/2012 10/2016 $37.50
7
50 $107.25
25
$107 4.00%
4
00% $144.75
$144.75
K88444093EE
2EE EE
EE $75
$75 10/1986
09J1986 10/2012 10/2016
09/2012 09/2016 .
$3
$37.50 .
$107.25 .
4.00% $144.75
K8844409
K88444091EE EE $75 09/1986 09/2012 09/2016 $37.50 $107.25 4.00% $144.75
K88444090EE EE $75 08/1986 08/2012 08/2016 $37.50
50
37 $107.25
25
$107 4.00%
4
00% $144.75
$144.75
K88444089EE
E EE
EE $75
$75 08/1986
07/!986 08/2012 08/2016
07/2012 07/2016 .
$
$37.50 .
$107.25 ,
4.00% $144.75
K88444088E
K88444087EE EE $75 07/1986 07/2012 07/2016 $37.50 $107.25 4.00°/a $144.75
K88444086EE EE $75 06/1986 12/2012 06/2016
2016 $37.50
50
$37 $110.13
13
$110 4.00%
4.00% $147.63
$147.63
K88444085EE
K88444084EE EE
EE $75
$75 06J1986
05/1986 12/2012 06/
11/2012 05/2016 .
$37.50 .
$110.13 4.00% $147.63
K88444083EE EE $75 05/1986 11/2012 05J2016 $37.50 $110.13 4.00% $147.63
K88444082EE EE $75 04/1986 10/2012 04/2016 $37.50 $110.13 4.00% $147.63
K88444081EE EE $75 04/1986 10/2012 04/2016 $37.50 $110.13 4.00% $147.63
K88444080EE EE $75 03/1986 09/2012 03/2016 $37.50 $110.13 4.00% $147.63
K88444079EE EE $75 03/1986 09/2012 03/2016 $37.50 $110.13 4.00% $147.63
K88444078EE EE $75 02/1986 08/2012 02/2016 $37.50 $110.13 4,00% $147.63
K88444077EE EE $75 02/1986 08/2012 02/2016 $37.50 $110.13 4.00% $147.63
K88444076EE EE $75 01/1986 07/2012 01/2016 $37.50 $110.13 4.00% $147.63
K88444075EE EE $75 01/1986 07/2012 01/2016 $37.50 $110.13 4.00% $147.63
K88444074EE EE $75 12J1985 12/2012 12/2015 $37.50 $113.10 4.00% $150.60
K88444073EE EE $75 12/1985 12/2012 12/2015 $37.50 $113.10 4.00% $150.60
K88444072EE EE $75 11/1985 11/2012 11/2015 $37.50 $113.10 4.00% $150.60
K88444071EE EE $75 11/1985 11/2012 11/2015 $37.50 $113.10 4.00% $150.60
K$8444070EE EE $75 10/1985 10/2012 10/2015 $37.50 $113.10 4.00% $150.60
K88444069EE EE $75 10/1985 1OJ2012 10/2015 $37.50 $113.10 4.00% $150.60
K88444068EE EE $75 09/1985 09/2012 09/2015 $37.50 $113.10 4.00% $150.60
K88444067EE EE $75 09/1985 09/2012 09/2015 $37.50 $113.10 4.00% $150.60
K88444066EE EE $75 08/1985 08/2012 08/2015 $37.50 $113.10 4.00% $150.60
K88444065EE EE $75 08/1985 08/2012 08/2015 $37.50 $113.10 4.00% $150.60
K88444064EE EE $75 07/1985 07/2012 07/2015 $37.50 $113.10 4.00% $150.60
K88444063EE EE $75 07/1985 07/Z012 07/2015 $37.50 $113.10 4.00% $150.60
Totals for 205 Bonds $9,200.00 $12,581.74 $21,781.74
Notes
NI Not Issued
NE Not eligible for payment
P5 Includes 3 mont h interest penalty
MA Matured and not earnin interest
file://C:\Documents and Settings\Judy\My Documents\Calculated Value of Your Paper 5... 12/28/2012