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Home My WebLink About08-05-13 ' � 1505610101 REV-1500 EX�°i_1°> � OFFICIAL USE ONLY PA Department of Revenue pennsylvania Bureau of Individual Taxes '`P"p M`"`� County Code Year File Number POBOX28o6oi �INHERITANCE TAX RETURN �� i 3 D!."g� Harrisburg PA i�1z8-o6oi RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 127-20-2034 05/03/2013 06/09/1926 DecedenYs Last Name Suffix Decedent's First Name MI ENGLUND JARL E (If Applicable)Enter Surviving Spouse's Information Below Spouse's�ast Name Suffix Spouse's First Name MI Spouse's Sociai Security Number -- THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW (� 1.Original Return O 2.Supplementai Return O 3. Remainder Return(date of death prior to 12-13-82) p 4.Limited Estate O 4a. Future Interest Compromise(date of O 5. Federal Estate Tax Return Required death after 12-12-82) � 6.Decedent Died Testate O 7. Decedent Maintained a Living Trust _ 8. Totai 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 Sch.O) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMA�N SHOULD BE DIRECTED TO:r,� Name Daytimec.F�lep�one Nu� �°� �'� . c'� THOMAS E FLOWER (717) �'43=5�513 <~ � � �'�' � . � � . , C,. : ... � P;�`� . R�GIS7E12 O WILI��;JSE ONLY�:t " �:. . , , t;- "7 First line of address ` � '' �� ., , __ _. 9 ,. . ..., --� � . .,... ' FLOWER LAW, LLC ; c.� ;",:� ._ .. Second line of address a ' �-� ti:y c.� . - � 10 W. HIGH STREET �— City or Post Office State ZIP Code DATE FIIED CARLISLE PA 17013 CorrespondenYs e-maii address: TOM@FLOWER-LAW.COM Under penalties of perjury,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,correc[and complete. clarat' f preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATU F PERSON R ON E FO ILING RE RN DAT • �� 3 ADD ESS DONNA E. ENGLUND, 225 W. LOUTHER ST., APT. #2, CARLISLE, PA 17013 SIG UR PREPA�iC-R�ht AN REPRESENTATlVE DATE - `U 08/05/13 ADORESS FLOWER LAW, LLC, 10 W. HIGH STREET, CARLISLE, PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610101 1505610101 J " � 1505610105 REV-1500 EX DecedenYs Social Security Number �ecedent•s Name: JARL E. ENGLUND 127-20-2034 RECAPITULATION 1. Reai Estate(Schedule A). .. . .. . . . .... . . .. ... . . . .. . . . . .. . .. .. . .. . . . . . . 1. 113,296.00 2. Stocks and Bonds(Schedule B) . . . ... . .. .. . .. . .. ... . .. ... .. .. . .. . . . . . . 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) ... . . 3. 4. Mortgages and Notes Receivabie(Schedule D) .. . .. . . .. . . . . . . . . . .. . .. . .. . 4. 5. Cash,Bank Deposits and Misceilaneous Personal Property(Schedule E).. . . . . . 5. 17,055.24 6. Jointly Owned Property(Schedule F) � Separate Biliing Requested . . . . . . . 6. 7. Inter-Vivos Transfers&Miscelianeous Non-Probate Property (Schedule G) O Separate Billing Requested.. .. . . . . 7. 62,632.58 8. Total Gross Assets(total Lines 1 through 7).. .. . .. .... ... .. . ... . .. .. . .. . 8. 192,983.82 9. Funeral Expenses and Administrative Costs(Schedule H). ... .. . ... ... ... .. . 9. 18,204.72 10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule I) ... . .. .. . .... . 10. 11. Total Deductions(total Lines 9 and 10). .. .. . .. ..... .. ... .. . .. ... . .. . .. . 11. 18,204.72 12. Net Value of Estate(Line 8 minus Line 11) . ... .. ... .. .. . .. . . .. . . . .. . .. . . 12. 174,779.10 13. Charitable and Govemmentai 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. 174,779.10 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxabie at the spousal tax rate,or transfers under Sec.9116 (a)(1.2)X.0_ 15. 16. Amount of Line 14 taxabie at lineal rate X.0 45 174,779.10 1g. 7,865.06 17. Amount of Line 14 taxabie at sibling rate X.12 17. 18. Amount of Line 14 taxable at collateral rate X.15 18. 19. TAX DUE ........ .. .. . .. .. . .. .. ... .. . ...... .. . .. .. . .. .. . ... ... .. . . 19. 7,865.06 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p Side 2 L 1505610105 1505610105 J REV-1500 EX Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME JARL E. ENGLUND STREETADDRESS • __.__ _ . _ 1139 PHEASANT DRIVE NORTH STArEPA ziP17013 C�CARLISLE Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) i�) 7,865.06 2. CreditslPayments A.Prior Payments 7,500.00 __ __ _ B.Discount 393.25 Total Credits(A+B� �2j 7,893.25 3. Interest �3f 0.00 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. Pill in oval on Page 2,Line 20 to request a refund. (4) 28•19 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 0.00 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;or.......................................................................................................................... ❑ � 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 tleath 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 retum are still applicable even if the surviving spouse is the only beneficiary. For dates of tleath on or after July 1,2000: . The tax rate imposed on the net value of transfers from a deceased chiltl 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 decedenYs lineal beneficiaries is 4.5 percent, except as noted in 72 P.S.§9116(1.2)[72 P.S.§9116(a)(1)]. . The tax rate imposed on the net value of transfers to or for the use of the decedenfs siblings is 12 percent[72 P.S. §9116(a)(1.3)).A sibling is defined,under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. aev-i,oz ex+t�i-oa� - ��` pennsylvania SCHEDU�E A DEPARTMENT OF REVENUE IPlHERITAPICE TAx RET'URN RfAL ESTATE RESIDENT DECEDENT ESTATE OF FILE NUMBER JAR�E. ENGLUND 21-13-0597 All real property owned solely or as a tenant in commam m�s#be repnrted at fair market value.Fair market value is�efined as the price at which property would be exchanged between a willing buyer and a willing seller,neither being compelled to buy ar se(I,both having reasonable knowledge oP#he relevant facts. Real property that is jointly-owned with right of survivorship must be disciased on 5chedule F. Attach a copy of the setkl�ment sheek if the property has been soid, ITEM Inciude a copy of the deed showing decedenk's interest if owned as tenant in common. VALUE AT DA7E NUMBER OF DEATH DfSCRIPTI4N 1' TOWNHOUSE STYLE DWELLING, 1139 PHEASANT DRIVE NORTH,NORTH MIDDLETON TOWNSHfP,CUMBERLAND COUNTY,PA;PARCEL NQ.29-17-1583-060,ASSESSED VALUE$116,$00 X.97 C.I..R.= ��(3,�gg.pp TOTAL(Also enter on Line f, Recapitulation.) $ 113,296.00 If more space is needed,insert additional sheets oE the same size. � ��e:�� Property M� pp�r ��:�-�� Cw-nberland Cc�unty, PA ^ � a � � V �. . Parcel Search ��' ti�' � � � ' � , }�� Features seleeted ; 1 � _ _ _ _ ' 1139 PHEASANT DRIVE Nt�RTH - PIN : Z9-1�-1583-060 - Deedbook: 0032L-00971 Owner. ENG�UND, JARL E La nd Use Code : 101 _ Property Type : R - Acreage : 0.08 - Square Feet. 1242 - � Taxable Status : T � Clean & Green Status : �� La nd Assessed Va lue $ : 200D0 Building Assessed Value $ : 9�r8QQ To�a I Assessed Va lue $ : �. 16800 �` Sa le Price $ : 59000 Sale Date : Thu Jan 29 1987 {�7.QQ .QQ P�i �.� Ye� r Built: 1985 Municipali�y: NQRTH MIDDLET{�I� TWP Height in Stories: 2 Type of Dweiiing : TOW N Primary Exterior. Aluminum Ba�ement Percenfiage : 100 Air Conditioning : HP Total Rooms; 6 Bedrooms : 2 Full Ba�h : 2 Ha If Ba th : 1 REV-igq8 EX+(�1-io} � ` � pennsylvania ��NEDULE E �� oEPA�TMENr p�RE��N�c CASH, BANK DEPdSITS & MI5C. INHERI7ANCE TAX RETURN PERSOWAL PRQPERTY RESIDENT DECEpENT ESTATE OF: FILE NUMBER: JARL E. ENGLUND 21-13-0597 Include the proceeds of litigation and the date khe proceeds were received by the estate. All RropertY laintly owned wi#h right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBfR DESCRIP7ION OF DEATH 1. US EE SAVINGS BONDS,SEE ATTACHED INVENTQRY 1,749.78 �. ORRSTOWN BANK CKG.ACCI'.Nt}.10$00711d 15,305.46 TOTAL(Also enter on Line 5, Recapikulation) $ 17,055.24 If more space is needed,use additior�al sheets oP paper af the same size, . Calculated Value of Your Paper Savings Bond(s) Page 1 of 1 Calculated Value of Your Paper Savings Bond(s) Calculator Results for Redemption Date 05/2013 Total Price Tatat Value Ta#al I�nterest YTD Interest 575.00 1 749.78 $1 174.78 28.34 Bonds: 1-16 of 16 Issue tVext Final Issue Interesfi Serial # Series Denom Date Accrual Maturity Price Interest Rate Vaiue Note L432962308EE EE $50 11/1989 11/2013 li/2019 $25.00 $55.16 4.00% $80.16 L436952585EE EE $50 12/1989 06/2013 12/2019 $25.00 $53.58 4.00% $78.58 L449892185EE EE $50 02/1990 08/2013 02/2020 $25.00 $53.58 4.00% $78.58 � L450679121EE EE $50 03/1990 09/2013 03/2020 $25.00 $53.58 4.00% $78.58 � L4557142151EE EE $50 04/1990 10/2013 04/2020 $25.00 $53.58 4.00% $78.58 � L458936621EE EE $50 05/1990 11/2013 05/2020 $25.00 $53.58 4.00% $78.58 � L461163720EE EE $50 06/1990 06/2013 06/2020 $25.00 $52.04 4.00% $77.04 � L473649612EE EE $50 07/1990 07/2013 07/2020 $25.00 $52.04 4.00% $77.04 L476353652EE EE $50 09/1990 09/2013 09/2020 $25.00 $52.04 4.00% $77.04' C266822736EE EE $100 11/1990 11/2013 11/2020 $50.00 $104.08 4.00% $154.08 C277138435EE EE $100 O1/1991 07/2013 01/2021 $50.00 $101.04 4.00% $151.04 C308596666EE EE $100 04/1991 10/2013 04/2021 $50.00 $101.04 4.00% $151.04 � C308755540EE EE $100 06/1991 06/2013 06/2021 $50.00 $98.08 4.00% $148.08 � C309320908EE EE $100 08/1991 08/2013 08/2021 $50.00 $98.08 4.00% $148.08 I C309334034EE EE $100 10/1991 10/2013 10/2021 $50.00 $98.08 4.00% $148.08 I C332801071EE EE $100 O1/1992 07/2013 01/2022 $50.00 $95.20 4.00% $145.20 � Totais for 16 Bonds 575.00 1 174.78 1 749.78 Nates NI Not Issued NE Not eligible for payment I P5 Includes 3 month interest penalty MA Matured and not earnin interest http://www.treasurydirect.gov/BC/SBCPrice 8/4/2013 � - QRRSTOWNBANK � ,4 Traduion of Excellence ^ ORRS P�O. Box 250 ° Shippensburg,PA 17257 Temp-Return Service Requested Date 5/31/13 Page 1 Primary Account 108007110 Enclosures �o rt. -T'uw. FL v w E2 ��I�I�I��III�I�I�I��II�I'��I��'�I��II'll�lll�l�lll��l�i��l��i) � 000788 0.6500 AV 0.360 TR00003 Jarl E Englund � PO Box 1913 Carlisle PA 17013-6413 � C H E C K I N G A C C O U N T Account Title', Jarl E Englund > 50+ Interest Checking Image Number of Enclosures: 0 Account Number: 108007110 Statement Dates: 5/01/13 thru 6/02/13 Previous Balance � 13, 966.46 Days In The Statement PeriodJ 33 1 Deposits/Credits 1, 339.00 Average Ledger : 15, 214.89 ..�;_, 1 Checks/Debits 12. 95 Average Collected � 15, 219.89 �:;: Service Fee' 3.00 Interest Earned : .68 Int . 68 Annual Percentage Yield Earned: 0.05"� Current Balance, 15,290. 1 2013 Interest Paid, 1.90 Service Charge Disc e Date Total Service Fee Amount 0 5/31 ** Image Fee ** �— 3.00 N � � n O °o De oeits and Additions o Date_— Deacri�ption _ Amoun � �� j 5/03 XXSOC SEC SSA TREAS 310 1, 339.00 �-+ '� P PD 0 6/02 Interest Deposit .gg � 0 0 � � o Electronic Debits and Withdrawa s O M �� Date Description Amount o� 5 10 CASH TRANS ECCO --� 12 .95- � PPD N.-1 o° 5/31 Total Service Fee 3.00- :; �EV rsio Ex+-(a8-ogi � � a ��"��'p�nnsylvania SCHEDUI.E C� ' pEPAPTMENT OF REVENUE INTER-VIV05 TRANSFERS AND ir�H��a,r�cE TAX R��uR� MISC. N4N-PRC}BATE PROPERTY RESIDENT DECEDENT ESTATE QP FILE NUMBER JARL E. ENGLUND 21-13-0597 This schedule must be completed and filed if the answer ka any of questions 1 through G o�page three of the REV•1500 is yes. DE$CRIPTION OF PROPERTY DATE OF DEATH °/a OF DECD'S EXCLUSION TAXABLE ITEM iNCLUDE TNE NAh1E Of'TNE TRANSfEREE,iF!EIH RElA1iDM5HIP 70 DKEL�ENT ANO (�(J(w��R Tt#pq'TE OF 3RAEJSFER,A17ACH A CQPY Of 7ttf DEED FOR REAt ESTATE. VAI.UE OF ASSE� INTEREST t1F AFPtIC,ABLE' VAI�UE 1. ME7LIFE IRA ANNUITY CONTRACT#A2053159, DESIGNATED 2,gg4,48 100 2,884.48 BENEFlCiARY:DONNA E.ENGLUND,DAUGHTER 2 SOVEREIGN BANK ITF MONEY MARKET ACCOUNT, FBO DONNA E. 4,541.69 100 4,541.69 ENGLUND,DAk1GHTER 3 SOVEREIGN BANK ITF CHECKING ACCOUNT,FBO DONNA E. 3,045.83 100 3,045.83 ENGLUND,DAUGNTER 4 AMERICAN GENERAL LIFE INS.C0.ANNUITY CONTRAC7#XP226462, 52,160.58 100 52,160.58 DESIGNATED BENEFIGIARY:DONNA E.ENG�UND,DAUGHTER TOTAL(Also enter on i.ine 7, Recapitulation) $ ��2•�$ If mare space is needed,use additianal sheets af paper of the same size. y ._ ��., .�,�.,��.a,a.��,�� , .�. f` !�. ,,o � i �,� j - ,`_ -� .�,, t +J ��, - MetLife / '? '��; ��r / � dj P.O. Box 1459 !� �� '�� Des Moines, IA 030 3593 � 1 _� _ � — January 25, 2013 . � 001-0483 ;`'� ;�,'` ' �w�\ , U�� J\!`� = JARL E ENGLUND � � = 1139 PHEASANT DR N �(� .,.� \\� � �- _ `1 i ` t �,L., = CARLISLE, PA 17013-1252 \ �k "��-w._ -�i o� �'I I�x.,,�':.�',a�� (R-J�,( -�1, �,�vV � u J RE: METLIFE INVESTORS USA INSURANCE COMPANY CONTRACT A2053159 OWNER JARL E ENGLUND REQUIRED MINIMUM DISTRIBUTION > Dear JARL E ENGLUND: This letter is being sent to comply with Internal Revenue Code (IRC) requirements.You are currently enrolled in an automated program which calculates and pays your Required Minimum Distrbution (RMD); therefore,this letter is being sent foryour information and you do not need to take �y action. The Irrtemal Revenue Service(IRS) reauires us to reoort your name,current address, ��ial Security number and the fair market value of your contract(s) as of December 31,2012 on IRS Form 5498. We are providing you with your RMD Amount for 2013 as well as the RMD Base that was used to calculate your 2013 RMD Amount. Please retain this information as a part of your tax files. . Contract Value as of 12l31�2012: $2,884.48 RM D Base: $2,884.48 RM D Amount fo r 2013: $215.26 ' Enrolled in Automated Program: Enrolled Frequency of Automated Program: ANNUAL This letter is being provided to you in lieu of a copy of IRS Form 5498 for tax and informational purposes; therefore, you do not need to respond. However, if you have any questions,please contact your representative or call Annuity Operations and Services at 1-800-284-4536 Monday through Friday between 8:30 a.m. and 6:30 p.m., ET. S ince re ly, MetLife Annuity Operationsand Services � � �� 1�,�'i" � Ph� ��c,c\ vL�.� , � ( IIIIII IIIII IIIII IIIII IIIII 1111111 III 1111111111 IIII IIIIII IIIII IIIII IIII IIIII�11111 IIIII IIIII IIII IIII 1Z�� / L� ��Y t w''� ��C,t�(� `��e,�,G�! (�k�/(� ��C• �--_ �� • . - . �- .. � � � DONNA ELAINE ENGLUND BENEF Account#1674061765 JARL E ENGLUND TRUSTEE Balances .. : .� �. .: �. � �� ' ,�.�,�s�'�'�''r�x�� a'�sr�s a3.�<��:T.� �,.�`�'. �K...� -.��,��.E��....- . �.^. ....��"�2`^,£��'�u�`.::�c?Y��#S��w�k�,��r,_8��k� a z ,�`z. De sits/Credits +$0.75 Avera e Dail Balance $4,541„76 s?�y�� `� *:� `x� s�"��.su�� '�' ��"� av,a.« - aa r�'� .'a � �t.3t ,� _.- �h.�..��;. a�3: � .: �e�:z ., ,. .. .. �. . �':. , .�. . ,: -,, �',... ,:. T.. .; >,:.. ...;s s.�. .�-�€ •.;.;�`=s�'�,.'�.'�..�.:."�? r°l;�-i,..i�:.:�u.. 'a�.r. t,�,%x�:¢.,��>_?� x.,..3t:t.�`" '� Interest � . , �-. � . �� a.,r .��;�,�';(x� � �,. ��i> :k��tF �� e � s� �:=x�x�t. ..�� u� �� x� �z . s:_, r�, . .�..�.,� . x,?.x . .a,, �.M� ,a�� ' . I�� :?�: �S �<�'� � n�'� ��t _ ,.. ,. . . . ,.��. , Farned this Period $0]8 Paid Last Year $9 00 . . ...�. ._ .�. y, r r a`��.,r,��'s. �x,` ,.��,�'. ., xx �,, . ,. .. �,�...�,�, , . .i�„�r �a��a,r � .:s� �r � - . '" � . � .�.:.;:...��i�3""�'¢'A�',. : . r;..,�`a,g�w _ ..!.;a, �^K`�:�. -s°f 3 .>:3.^� rD r r`e..,.: � �s: 'The interest eamed and fhe interest paid may differ depending on when interest is credited to your account. Accoun c �vi � Date De_s_c_ri_�ti-o�-n Additions Subtractions ce 05�1 Beginning$alance '�"� $q:sq� gg va . .� � �. : s �; ��.-��.�`� �.� _ ; rrr� �� . y„��s� m �` , ��'S,,�� .�. �� .:a�ca> ,� s�.,�. . �7��3s�: � � �c� .„��..�s °�`"`�� ,"��.� .€a 0 05-31 Ending Balance ; $4,542.44 V � Whet You Nccd to Kn��w about Overdrafts and Ovcrdraft Fccs 0 o � ^' Overvicw 0 � An overdrali occurs whcn you io nol have enough moncy in your accouul to cover a Ir�nsaction,hut we pay ii anyway.Wc can cnvec your ovcrdral�s in °o hvo diffc�cnl wavs: o - o -� �° I. Wc havc slandard ovcrdrafl pracliccs th�1 comc with your accounl 'o0 2. Wc also offcr an ovcrdrafl protcclion plan which allows you lo link mhcr accounts such ns a�.�vinRs accounl or an l3:+sy Acccss Linc of o C'rcdit to covcr avcrdrafls in yow chccking nccounl.'fhis plan may hc Icss cxpcnsivc Ihan our tilandard ovccdrali pracliccs.7 o Icnrn morc,ask W us aboW Ihis plan. � � m Chis nolicc cxpl�ins our slanJard ovcrdrafl praclices. � � Whal arc the slandard ovcrJrafl pracliccs Ihal comc wilh my accounl? o Sove�ci€n curretdly aulh�rizcs nnd pays ovcrdrafls lor�hc Collowing lypcs of hansaclions: rn ° • Checks mid olhcr Iran�.�clions mndc using'your checkin�account number 0 -' • Auiouiatic hill paymcnis r- � • Onlinc 13ankin�paymcnis and tr�nsfcrs � • Rccurring dcbif cmJ Iransaclions Sovcrei�,n�vill nol autliorizc�nd pay ovcrdca0s on Ihc IOIIO\VIII��V}1CS OI(fAll&'1CU0115,UNi:I?SS you a�uho�izc us io do s�: • nl'M wiihdr�wals and irnnsfcrs • Onc-timc dcbi�card lransaciions Wc pay ovcrdr�tts al our discrclion,which means wc do noI�,t�arantce Ihal wc will�Iways aulhorize and pay any type of�ransaction.ICwc do no1 aulhorirc and pay an ovcrdr�ft,you�Iranv�ciion will bc dcclincd. What fees will(be charRcd if tiovcrci�n paV�an ovcrdrafl caused by my,�TM or one-lime debil transaction? I Jnder om s�andard overdraft pracliccs: • We will chargc you�lce of up t��S3S cach lime wc p�y an overdra0.l�herc is a limil oC6 lces per day we can char�,e you foc averdrawing yoia accounL • An addi[ion�l onc-Iimc lcc of T�35 will bc charged on tlie Gtli consccutive busincss day your accounl is ovcrdrawn.'I'his charge applies io checking accounls(othc�than any Premicr Checkin�,/�ccowus),savin�s and moncy market savin�s accounts. Whal if I�vanl SovcrciRn to authnr'•v.c and pay overdrafls on my,1'fM and onc-limc dcbil card transactions? [(you waiv us 10 atdhorize anA pay ovcrd�alts on n'fM�nd onc-linu dcbit cacd Iran�ctions,Ihc casicst way lo do so is to cnroll onlinc in tiovcrcign necoum Protcctor by visiling www.sovere_i�ank.conti�ccounl��otector.You can�Iso call us at I-X77-7G8-4721,visit your ncaiest hranch or opl-in al any tiovcrcign n'1'M. (':�n I changc nrv mind lalcr? 11 you�cll us ihal wc arc pcnnitred tu pay any ovcrdra(ts causcd ha,��M or onc-iimc dchi�transaciions,yon can al�v�ys changc your nund and Icll us you no long,c�w�ni us to do Ihi�.You c�n visit nnv hranch or c�ll us at I-R77-76R-4721 and Icll us you no lon�cr w�nl ris io pa��Ihcsc Iapcs of ovc�drafts. pu�r 1 u�3 167.Jp6176.5 _ PGs�p,� S�3d��,3 o�E2EisN�t��tc . �rT�,K �w,er- - - - .. �� • � JARL E ENGLUND Account#1481138669 DONNA ELAINE ENGLUNO ATTY IFF Balances �, . De osits/Credits +$638.71 Avera e Dail Balance� $2,g7g.pg �•. Interest y. Earned this Period $0.02 Paid Last Year $0.19 � € 'The interest earned and the interest paid may differ depending on when interest is credited to your account. Account Ac#iv't pate Description Additions Subtractions Balance 04-24 Beginning Bala�ce 2�2 ,_. . .,. ,�,.. . , :. , � 04-30 PA TREASURY DEPT ANNUITANT 130430 > $542.66 $3,249.80 o ",,,'••'048115 o •� � ..`;.:.... � .:.. > �. . . .. 0 04-30 WITHDRAWAL , < s ,r .� >r..::,� . . . . . , , .. . �. $300 00 $3 045 83 o . ;,'�� . z '., ^ �`� �`� �� : o � ��.: �� .�. � ;' ° � x ,��'� � r�a�� ;� . p . :.e�::� �1 ...a�.i.4,�>. 3.a.>, �...a�;: �,. ... :; ;;.: ., ... � : z'�v?t.� �. ,>„ :..�x, �i, '�.�� •,�-�� w� a� �.:s � ° OS-23 Ending Balance $3,0�15.85 0 0 0 N O O O A � � W � W V V � O G� N O r n � W pa�e 7 oj4 148//38669 �2rt car-�'�tx.r4.� L� Corr�paw�,ax� 'Pos�rn.a�,.c� Sl�i/��,3 ( �.i��"�` c�'" � WESTERN _• ��,� $�� _ �� NATIONAL �n 1 t�, —C"� �-q c o s . .�� ANNUAL T IVERSARY S TEMENT JARL E ENGLUND I P4 BqX 1413 ;� I CARLISLE PA 17013-1252 ' Palicy Number: XP22b462 Annuitant: JARL E ENGLUND Policy Date: 05/14/2009 Important Messages We are going green! Go on-line today at www.aannuityaccess.�c,am ta find out haw ta sign up for electronic delivery ofyaur annuai statement Report af your Annuity for the Contract Year ending 0511412013 0511412012 0511412013 Accnmulated AccumuMated Value Ueposit(s) Withdrawai{s) Interest Va(ue $59,768.25 $0.00 $$,992.73 $1,385.06 $52,160.58 Yaur cash surrender value for 05/14/2012 was $SC,389.04. Your cash surrender value for 05/14/2p13 is $49,208.60. As of 05/14/20I3 the coznposite annual yield is 2.04�"0. This is your annual report and is provided for your information. NO ACTION IS REQUIRED ON YOUFt PART. Thank you far your continued confidence in American General Life Insuz�ance Campany. We knaw that your American Generai Life Insurance Ct�mpany contract is an importar�t gart of yaur financial plan. We are dedicated to providing you with safety, liquidity, and a competitive return on your annuity. I£ we can be of service regarding any of your current Arnerican General Life Insurance Ccrmpany contracts, please contact aur customer service center at 1-$OQ-424-4990. • American Generai Life insurance Company Annufty Service Center•P.O.Box 871•Amarillo,TX 79105-0871 The Western tJational series of annuities is issued and underwritten in(Vew York by The United States life insurance Company in the City of New York and in a(I other s#ates by American General Life Insurance Company. REV-1a11 EX+(1U-09) � ��'pennsylvania ��HEQU�E H �� DEPARTMENT OF REVENUE pU N E RAL EXPE N SES AN D TNHERITAtVCE TAX RETURN ADMINISTRATIVE CUSTS RESIDENT DECEDENF ESTATE OF FILE NUMBER JAR�E. ENGLUND 21-13-0597 Decedent's debts must be reported on Schedule i. ITEM NUMBER bESCRIPTION AMqUNT A. FUNERAL EXPEhISES: i' EWING BROS.FUNERAL HOME,PROFESSIONAL SERVICES 2,490.00 2 EQUIPMENT&FACII.ITY USE 1,404.Ot1 3 AUTOMOTIVE TRANSPORT 860.00 a MERCHANDISE 2,530.00 5 GRAVE QPENlNG 'I,395.OQ s OBITUARY,DEATH GERTIFICATES,FLOWERS,CLERGY HONORARIUM,HONOR GUARD, MEAL 913.68 7 STONE FOUNDATION AND ENGRAVING 4g$.00 B. ADMINISTRATiVE COSTS: I. Personei Representative Commissions: Name(s}af Persana��epresentative{s� 5kreet Address City— ----- — _ _ _._.--- _ _ _ _ State . ZIP Year{s)Commission Paid: __ _ _ _. 2. Attorney Fees; 7,500.00 3. Family Exemption:{If decedent's eddress is not khe same as ciaimant's,attach explanation.) Claimank Street Address _ _ _ City State ZIP Relationship of Claimant to Decedenk �. Probate Fees: �� 5. Accountant Fees: 6. Tax Return Preparer Fees: �� PUBLISH ESTATE NOTICES, 189.54(the Sentinel)+75.00(Law Journal) 264.54 TOTAL(Aiso enter on Line 9, Recapitulakion) $ 1$,204.�2 If mare space is needed,use add3tionai sheets of paper aP the same size. REV-1513 EX+(01-10) � � �,� pennsylvania SCHEDULE � ��t� DEPAPTMENT Of REYENUE INHERITANCE TAX RENRN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: JARL E. ENGLUND 21-13-0597 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[Include outright spousal distributions and transfers under Sec.9116(a)(1.2).] 1. DONNA E.ENGLUND,225 W.LOUTHER ST.,APT.#2,CARLISLE,PA DAUGHTER 100% ENTER DOLIAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. II NON-TAXABIE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OP PART II—ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed,use additional sheets of paper of the same size. LASfi WILL �.N'D fiEST`AMEN� � � � �— c� r� �, a� �`' �> c�' �; —�' —�- rr, :z�, 0�' � "`" �`' .`� _� ;*,x. C'- �j ' _,.,� � "'�TM � G".� :.� �:.f . .�.`r �,� �3 .�.. .. JARL E. ENGLUND �=� :� " -� �=� `�p� �: �. -t ,,� , _ :_ �-:;� _.,� _ ,.. . . �,� ,_ a. �. � ' . , ; i tr:: °�n v� ..,:� I, JARL E. ENGLUND, of 1139 Pheasant Drive Nort}�, Carlisle, Cumberfand County, Pennsylvania, being of sound and dispos�ng mind, memory and understanding, do make, �aubiisn ana deciare this as and #or my Last Wili anc# Testament, hereby revoking and making vaid any and all former Wills, �adicils, or writings in the nature thereof, by me at any time here#ofore made. > FIRST: ! hereby order and direct my Executrix or Executor, hereinafter named, to pay all rny just debts, funera! expenses, #estamentary expenses and all Inheritance, Estate, Transfer and Suecessian Taxes, as soon as may be . conveniently done after my death, aut of my residuary estate. - SECQND: 1 give my entire estate ta my daughter, DONNA EL.AINE ENG�UND, of 1139 Pheasant Drive Nor�h, Carlisle; Pennsylvania '11013. THtRD: Should I no# be survived by my daugh#er; Dt?NNA ELAINE ENGL.UND, I give rny estate in equaE shares, to the fallowing: A. To my goddaughter, LENDA F10R11Va, of 8fi1'1 249th Street, Bellerese Manor, New York, per stirpes; B. To GI�LIAN TURNER, af 30 Sefsey Raad, Dar�ningtan, Chict�ester, West 5ussex, Er�glar�d PO'1925N; C, Ta the F1RST EVANGELICAL �UTNERAN CHURCH, of Garlisle, Pennsylvania; �n_ , ,� _., _., . .___ - - �� > , z�.�h - _ _ _ ._ _ D. To the CARLISLE LIONS CLUB, of Cariisie, Pennsylvania, for their Eye Program; and . E. To the ST. JOHN'S LODGE 260 F & AM, Holly Pike, Carlisle, Pennsyivania 17013, for Dual Membership. r LASTLY: 1 nominate, constitute and appoint my daughter, D4NNA E. ENGLUND, to be the Executrix of this my Last Will and Testament. No Executor or Executrix shaii be required to file bond in this or any ather jurisdiction. IN WITNESS WHEREOF, I have hereunta set my hand and seal this � �`"� day of , 2006. jI ! r ! J f � I / � ,,/''J �,; ;�� Jarl ,glund � t; ;� � J + � SlGNED, SEALED, PiJBLfSHED and DECLARED irr the presence of: r. � �.......,.,.r � 4��.4y` . �,.. � ,.._,� � . (,. �� / 2 __._ ____ �_ _ _,__. .._ ___ _ _ . _. -- --- -_- - -.4.�.r. . _.__ __ .v._.. __-��___.__�- _ ...._ _ �._�LL_„�....._� ..,__