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HomeMy WebLinkAbout09-24-13 J EX(02-11)Fl) OFFICIAL USE PA Department of Revenue County Code Year ar File Number Bureau of Individual Taxes PO BOX 280601 INHERITANCE TAX RETURN 21 12 1107 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 09282012 09241937 Decedent's Last Name Suffix Decedent's First Name .ml NEWMAN JANICE B (ff Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M I Spouse's Social Security Number - THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW ® 1. Original Return ❑ 2. Supplemental Return ❑ 1 Remainder Return(Date of Death Prior to 12-13-82) ❑ 4. Limited Estate ❑ 4. Future Interest Compromise(dateof ❑ 5. Federal Estate Tax Return Required death after 12-12-82) © 6. Decedent Died Testate ❑ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) ❑ 9. Litigation Proceeds Received ❑ 10. Spousal Poverty Credit(Date of Death ❑ 11. Election to Tax under Sec.9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number VICKY ANN TRIMMER rn 1> R&91=R OF WILLS:USE ONEV Q rn n v r? z r ry First Line of Address h f1 -•� `-' - PERSUN & HEIM, PC Second Line of Address PO BOX 659 — City or Post Office State ZIP Code DATE FILED) s MECHANICSBURG PA 170550659 Correspondents e-mail address: VATRIMMEROIPERSUNHEIM• COM Under penalties of perjury,I declare that I have examined this retum,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and complete-Declaration of preparer other than the personal representative is based on all information of welch preparer has any knowledge. SIGI` i F P ON RF,S�ONS_IB�E FOR FILING RETURN ADDRESS BRADLEY R- NEWMAN 2135 SOUTHPOINT STREET SIG 7:U E OF P PAR ER THAN REPRESEMATIVE DATE ADD SS VICKY ANN TRIMMER PO BOX 659 MECHANICSBURG, PA 17055 PLEASE USE ORIGINAL FORM ONLY Side 1 1505611185 1505611185 pM4647 3.000 a y J 1505611285 REV-1500 EX(Fl) Decedent's Social Security Number Decedent's Name: NEWMAN I A10 Q RECAPITULATION 1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 230, 000 . 00 2. Stocks and Bonds(Schedule B). . . . . . . . . . . . . . . . . . . . . . . . . 2 0 . 00 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. 590,284 • 00 6. Jointly Owned Property(Schedule F) E Separate Billing Requested . . . . 6. 0 . 00 7, Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) ❑ Separate Billing Requested . . . . 7. 478, 5 4 7 • 00 8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . 8 1,298,831 . 00 9. Funeral Expenses and Administrative Costs(Schedule H). . . . . . . . . . . . . 9, 61936 . 00 10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule 1) . . , , , . . . . 10. 171 413 . 00 11. Total Deductions(total Lines 9 and 10). . . . . . . . . . . . . . . . . . . . . 11 24 ,349 . 00 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . 12 1,274 ,482 . 00 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. 1, 274 ,482 . 00 TAX CALCULATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers unfier Sec.9116 (a)(t2)...D_ 0 • 00 15. 0 . 00 16. Amount of Line 14 t xeble at lineal rate x.0 4� 1 ,274 ,482 . 00 16. 57,352 . 00 17. Amount of Line 14 taxable at sibling rate X 12 0 . 00 17. 0 . 00 18. Amount of Line 14 taxable at collateral rate X.15 0 . 00 18. 0 . 00 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 571352 . 00 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT X❑ Side 2 1505611285 1505611285 OM4648 3.000 REV-1500 EX(Fl) Page 3 File Number Dec dent's Complete Address: 21 12 1107 DECEDENTS NAME NEWMAN ^JANICE B STREET ADDRESS C LAND CITY STATE Z!P CARL LE PA 170 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) {1} 57,35200 2, Credits/Payments A. Prior Payments 5 4 ,7 4 4 . 00 B. Discount 2,868- 00 Total Credits(A+8) (2) 57,612 . 00 3. Interest (3) 0. 00 4, if Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT. Fill in box on Page 2,Line 20 to request a refund. (4) 260-00 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 1X:1 Nvo 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 . . . . . . . . . . ❑ I)1 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 f�I without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . r (©z? 3. Did decedent awn an in trust far"or payable-upon-death bank account or security at his or her death? ❑ i. 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 172 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 172 P.S.§9116 (a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent(72 P_S.§9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in 172 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)). A sibling is defined, under Section 9102,as,an individual who has at least one parent in common with the decedent,whether by Wood or adoption. OM4E71 2.000 REV 1502 EX (01-10) ' pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENTDECEDENT ESTATE OF: FILE NUMBER: Janice B. Newman 21 12 1107 All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 46 Wilson Street, Carlisle, PA 230,000 Valued per assessment and CLR TOTAL (Also enter on Line 1,Recapitulation.) E 230,000 9w4095 2 000 If more space is needed, use additional sheets of paper of the same size. REV-1508 EX+'TS-+2) pennsylvania SCHEDULE E DEPARTMENT TAX REVENUE RETURN INHERITANCE TAX CASH, BANK DEPOSITS K MISC. RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF: FILE NUMBER: Janice B. Newman 21 12 1107 Include the proceetls of litigation and the tlate the proceetls were received by the estate. All property'ointly owned with ri ht of survlvorshi must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH t. Valic 114,142 2 M 6 T Bank Checking #15004225781580 250 3 Patriot News refund 91 4 American Republic Long Term Care Insurance - payment due to decedent 6,876 5 Charles Schwab 2024-8333 Investent Account 433,424 6 PSECU Regular Shares 5 7 PSECU Vacation Shares 0 8 PSECU Checking Shares 6,752 9 PSECU Money Market Shares 0 10 Honda CRV - sale price 23,500 11 Household contents - 5,000 12 AAA Refund 19 13 Carlisle Sentinel Refund 25 14 Erie Insurance - house damage 200 TOTAL(Also enter on line 5, Recapitulation) $ 590,284 2W46AD 2.000 If more space is needed,use additional sheets of paper of the same size. REV-1510EXt(08 SCHEDULE G . pe nnsylvania DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Janice B. Newman 21 12 1107 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY ITEM it u]ETIEW EOFTIETRANSFEREE,THEla REUnOnswP TO DECEDENTAND DATE OF DEATH %OF DECO'S EXCLUSION TAXABLE NUMBEF TIE DATE Or TRAtEai ATTACnA COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST IF A PUCABLB VALUE 1_ Northwestern Mutual #14311370 93,167 100.0000 0 93,167 2 Northwestern Mutual #14595035 65,361 100.0000 0 65,361 3 Charles Schwab IRA 320,019 100.0000 0 320,019 Son is beneficiary TOTAL(Also enter on line 7,Recapitulation)$ 478,547 If more space is needed,use additional sheets of paper of the same size. 9W'46AF 2.DOC REV-1511 EX-VDf)9) pennsylvania SCHEDULE H DEPARTMENTOF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENTDECEDENT ESTATE OF FILE NUMBER Janice B. Newman 21 12 1107 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERALEXPENSES: 1. Hummelstown Flower Shop 101 2 Honorarium 250 Total from continuation schedules . . . . . . . . . 2,404 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Names)of Personal Representative(s) Street Address City State ZIP Year(s)Commission Paid: 2, Attorney Fees: 3,000 3, Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: 524 5. Accountant Fees: 6. Tax Return Preparer Fees: 7, 1 M&T Bank - lockbox key 10 2 Postage 18 3 Larry Gutshall Painting 300 Total from continuation schedules . . . . . . . . . 329 TOTAL(Also enter on Line 9,Recapitulation) S 6,936 9W46AG 2.000 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX«}12-M) pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE MORTGAGE LIABILITIES & LIENS ESTATE OF FILE NUMBER Janice B. Newman 21 12 1107 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,Including unreimbursed medical expenses. ITEM NUMBER VALUE AT DATE DESCRIPTION OF DEATH 1 CB Reifsteck Construction 300 2 Erie Insurance 640 3 Landscape Creations 745 4 Hospice of Central PA 10,360 5 Borough of Carlisle 1,295 6 Comcast 224 7 Lowes 67 8 PPL 487 9 Aero Energy 874 10 IRS - 2012 personal income tax 2,074 11 PA Dept of Revenue - 2012 personal income tax 397 TOTAL(Also enter on Line 10,Reca itulation $ 17 413 ew46AH 2.000 If more space is needed, insert additional sheets of the same size. REV-1513 DX (01-10) SCHEDULE J pennsylvania �+ DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF. FILE NUMBER: Janice B. Newman 21 12 1107 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)(12).) 1. Bradley R. Newman 2135 Southpoint Drive Humnelstown, PA 17036 100% of Residue: 1,274,482 Son 1,274,482 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. S.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ONLINE 13 OF REV-1500 COVER SHEET. E _ 0 9W4EAi 2,000 If more space is needed, use additional sheets of paper of the same size. ([� COPY List Will and Test .meitt = �, N OF � N _ JANICE B. NEWMAN a, CO — n D N �•�Q I, JANICE B. NEWMAN, of Carlisle, Cumberland County, Cn Pennsylvania, do make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils by me at any time made. ITEM 1: I direct that all inheritance and estate taxes becoming due by reason of my death, whether payable by my estate or by any recipient of any property, shall be paid by the Executor out of the residue of my estate, as an expense and cost of administration of my estate. The Executor shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. ITEM 11: I direct the Executor to pay the expenses of my last illness and funeral expenses from the residue of my estate as an expense and cost of administration of my estate. I prefer cremation with no viewing. A small memorial service may be held if desired by my son. ITEM III: I give the residue of my estate, not disposed of in the preceding portions of this Will, to son, BRADLEY R. NEWMAN. If he is not living at the time of my death, his share shall be paid to his then living issue, per stirpes. If, however, any issue of a deceased child has not attained the age of thirty (30) years at the time of my death, his share shall be held in trust by SUSAN W. NEWMAN, as Trustee, IN TRUST NEVERTHELESS, and shall be administered and distributed as follows: Page 1 (a) The Trustee shall pay to or for his or her benefit, in convenient, at least annual, installments, all of the net income. The Trustee shall also pay to or for the benefit of that issue (the "Beneficiary") so much of the principal of this Trust as the Trustee, in the sole discretion of the Trustee, considers necessary to maintain the Beneficiary in the proper station in life, including proper support, maintenance, medical care and college or higher education. (b) Upon the attainment of the age of thirty (30) years by the Beneficiary, the Trust shall terminate, and the Trustee shall distribute to the Beneficiary all the assets of the Trust. (c) If the Beneficiary dies before final distribution of the assets of the Trust, but is survived by then living issue, the Trustee shall quarterly pay the net income from this Trust to or for the benefit of the Beneficiary's issue, per stirpes, living at each time of quarterly distribution. As soon as any one of the Beneficiary's issue attains the age of thirty (30) years, the Trustee shall pay over all of the assets in the Trust to the then living issue of the Beneficiary, per stirpes. Should such Beneficiary die before final distribution of this Trust and not be survived by issue, the provisions of subparagraph (d) shall apply. (d) If, before final distribution of the assets of any Trust established for issue of a deceased child, there is no living beneficiary of that Trust, it shall terminate. The principal of the Trust shall be added to the other Trusts created under this Will for the benefit of my children's issue, in the same proportions in which the Trusts were originally funded pursuant to the provisions of this Item. If any Trust created for issue of deceased children had previously been terminated, Page 2 r the beneficiaries who received the principal of that Trust shall collectively be considered a "Trust" for the purpose of this paragraph, and one share shall be paid directly to each beneficiary in the same proportion by which each received the principal of the Trust. If any beneficiary is deceased, the share of the deceased beneficiary shall be paid to his or her then living issue, per stirpes. ITEM IV: In the event I am not survived by my son or any issue, or in the event there are no issue of mine surviving upon the termination of any Trust, the principal shall be paid to JUNIATA COLLEGE, Huntingdon, Pennsylvania, to be used in its library. ITEM V: No part of the income or principal of any Trust created by this Will shall be subject to attachment, levy or seizure by any creditor, spouse, assignee or trustee or receiver in bankruptcy of any beneficiary prior to his or her actual receipt of income or principal distributed. The Trustee shall pay the net income and the principal to the beneficiaries specified by me, as their interests may appear, without regard to any attempted anticipation, pledging or assignment, and without regard to any claim or attempted levy, attachment, seizure or other process against the beneficiary. ITEM VI: The Executor and the Trustee shall each possess the following powers, each of which may be exercised without court approval and in a fiduciary capacity only: (a) To retain any investments I have at my death. (b) To vary investments, and to invest in bonds, stocks, notes, real estate mortgages or other securities or in other property, real or personal, without being restricted to so-called "legal investments," and Page 3 �' without being limited by any statute or rule of law regarding investments by fiduciaries. (c) In order to divide the principal of a Trust or for any other purpose, including final distributions, the Executor and Trustee are authorized to divide and distribute personal property and real property, partly or wholly in kind, and to allocate specific assets among beneficiaries and Trusts so long as the total market value of each share is not affected by the division, distribution or allocation in kind. (d) To sell either at public or private sale real and personal property severally or in conjunction with other persons, and to consummate sale(s) by deed(s) or other instrument(s) to the purchaser(s), conveying a fee simple title. Provided, however, that no sale shall take place at my residence. (e) To mortgage real estate, and to make leases of real estate. (f) To pay all costs, taxes, expenses and charges in connection with the administration of my estate or any Trust established under this Will. (g) To make distributions of income and of principal to the proper beneficiaries, during the administration of my estate, with or without court order, in such manner and in such amounts as the Executor deems prudent and appropriate. (h) To vote shares of stock which form a part of my estate or any Trust established under this Will, and to exercise all the powers incident to the ownership of stock. Page 4 �� I (i) To unite with other owners of property similar to property in my estate to carry out plans for the reorganization of any company whose securities form a part of my estate. (j) To disclaim any interest in property which would devolve to me or my estate by whatever means, including but not limited to the following means: as beneficiary under a will, as an appointee under the exercise of a power of appointment, as a person entitled to take by intestacy, as a donee of an inter vivos transfer, and as a donee under a third-party beneficiary contract. (k) To prepare, execute and file tax returns of any type required by applicable law, and to make all tax elections authorized by law. (1) To employ custodians of property, investment or business advisors, accountants and attorneys as the Executor or Trustee deems appropriate, and to compensate these persons from assets of my estate or trust, without affecting the compensation to which the Executor and Trustee are entitled. (m) To allocate administrative expenses to income or to principal, as the Executor or Trustee deems appropriate. However, no allocation to income shall be made if the effect of the allocation is to cause a reduction in the amount of any estate tax marital deduction or estate tax charitable deduction. (n) To do all other acts in their judgment necessary or desirable for the proper and advantageous management, investment and distribution of the estate and Trusts established under this Will. Page 5 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA ) SS COUNTY OF C .„l �:o ✓ ) 1, JANICE B. NEWMAN, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that 1 signed it willingly; and that I signed it as my free and vohuntary act for the purposes therein expressed. (SEAL) JANICE B, NEWMAN Sworn to and subscribed before me this 13 ” day of f"I'_ 2010. I I Notary Public COMMONWEALTH OF PENNSYLVANIA NoUAal Seal MN Commission Expires: Vicky Ann mmmer,Wt-a' +o k Silver Spring Twp.,CumbePam County (SEAL) My Commlzon Expires Marcl,11,2014 ^smher,Pennsylvania of No,anes AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) SS: COUNTYOF I We, 1,,41-1 c,a A. eJ ba c 'lu H, n i and %L/'c- . the Witnesse whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testatrix, JANICE B. NEWMAN , sign and execute the instrument as her Last Will and Testament. that Testatrix signed willingly and that she executed said Will as her free and voluntary act for the purposes therein expressed. that each of us in the hearing and sight of the Testatrix signed the Will as Witnesses; and that to the best of our knowledge the Testatrix was at that time eighteen (13) or more years of age, of sound mind and under no constraint or undue influence. ') n Witness Witness Witness - Sworn to and suhscrihed before me this I l ril drty Of ��'ia 2010. /Notary Public COMMONWEALTM OF PENNSYLVAN4 NWrfel Seal W,5 Mn T"., Notary I'ublIc Sliver 5pnn TWp.,CUmbem,' �1P Commission Expires: MyCem Is31 SICounty,4 SLA1 ) Member.Penn ISM:11,2ta, 0.55od'Lor:of Notades Tax' dapper Cumberland County, PA y.- ' T I /i T rr+ ,, c �^s @I . ''tCCat`S ''rC} . •�^�.—.� �f�}�' S RF.,s KFA` 'Yrl —�T / ks. P rriA•� R s" (r #' }'6L7 e r-•ya a� t D�.7 N �� ''� 8 a^ n—w`�. s"'� _ _g'�dYf (3EIIG•.y £.'i.l;•: }'1'Si. �4e• wwjy �,� r. ,41 r# I . I' {�iu� `'fir''$': q Lw i M1t" O J : y .a14r,. �cT.ro a- ]Ve>• Y �� .•- as x140 gip' °' .fix a6 �F� `^ � //'' 1 rvCf i 8.4' ,t` •��.L_� �C C� .,has` iL Yp w ♦ '-6 iy('e lr'V �N� Imo.vi ty � `)'C' A ro L1. 5 1 f.18•'al�rirPngr„i!-n nR vy d -.�2�3 ' ♦ - .__ a Tf I I 'oI�yE I:' r . 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DIN:04-21-0322-045 Decd000y:0015900661 :.ot Description:LAND LESS THAN 1 ACRE Owner:NEWMAN,JANICE B Land Use Code: 101 Rioperty Type:R Acreage:0.1 square Feet: 1120 1 Tara0le Status:T Clean B Green Status: ASSessed Land Value S:50000 1 VV .J Assessed Building Value L.98 48 L 1 As3e5sed Total Vdlpe S 200 \ Sale Prim S: 1 Sale Dale:Tue Jun 17 1997 08:00:00 PM Y",Built: 1930 Municioalily:CARLISLE BORO 3RO WAD r�• Height in SladeS:2 Type of Dwelling:DETACH '1 Rdmary Exterior:Aluminum Basement pementage: 100 Air Conditioning:AC Total Rooms:] Bedrooms:I Full Bath: I V n Half gath: U 1 r Account Statement VALIC, Y For the Period 07/01/2012-09/30/2012 JEFFREYA HOFMANN (800)M2-5558 x88418 you,Alan,ial"'reo, MOO)49-2542 Stroak will,a CLurn.Smmca Yrolessmnal VALIC by Phone auton,aled account access 700 ado.W 800p,m.rCS7),Monday through inday #BWNKDDB wrvw.VALlCcam VALICOnline,internetaccountaceess >00597 7783589 001 008120 A ....................................... ........... ....... . _ NEWMAN,WILSON STREET B. Can$3 a day Flake a dibin-ence in)roar fmuro?Say you make$411 flfiLl n 46 WILSON STREET year and save 2%in oureirldo ce retirement Ian-ahoul.830 a check. • CARLISLE PA 170132842 )' I >"' p �r u111m 11�nun11 u�1 ua1r�1u1n1rr�n�rlolu�,�lnnlrll Increase that to 5%-roughly$3 a(Iay nave-and over 30 year s;it an 8%. average annual return,you could increase your a'clirclnenl savings by as much x`.$140.000.](you eel an employer match.the dill'erence is even bigger. Illustration,only.Assru..p(ionx:Hi-aeelc/n Pq1'Period,to c-rltf Bred _� occunuJn(inn:firs and cbnrgev,ifapplicahle,ore runt reflected and — u rind reduce rew/as short ► Portfolio Snapshot Ending value 09/30/12: $114,142.19 Activity.0 a Glance Personal Performance Beginning value 07/01/12 $112.886.27 Portfolio Value Net chan'g"' "e in va'let' $1,75$.92 For lhr lrtalind vital In date for lj naenlh;; 01101/1209/30/12 I11/01/17-09/30/12 0n/90/11 09/w/17 Ending value 09/30/12 $114,192.19 - . .. ............... ... . 1.11% 3,35% 4511% 'VALIC is pleased io provitic you with yoaar invesuncm'.a pennant parinnnance.All,active accounts at end,title cutlet wen:inchaJed in the calculation,using the acluul number of days your lirnds wore invested. "]'list Perronnance is not a guarantee orlidure perinnu:mee. 'Individual limit perfnnnance is available political VA1.IC.com. Asset Allocation .. Contributions and Balances - 09/. Lane Ca Conmhulions for the frond rodinq onav, J P Plan typo 0710 1/1 2-09;40/17 :IN12 0000 ._ ..._........ �. ...09/0413. 0% Mid Cap EMPLOYER 0% Small Cap SCRANTON STATE SCHOOL FOR THE 0% Global&Intl Equity DEAF 0% Specialty Tax Sheltered 403(6) 50.00 $11414719 0% Hybrid _ 100°5 Fixed Irrcorne At Your Service You.say you're 2s ycnrs old and you're pat young In worn obpul Our wchaile has been n nslinnned!Vasil VALIC.amr ood'cc for'eureclt yotn'retire nelp?/orerr,v l0pem's.volt artrit to rmnsaring.you the steps wc've taken to enhance your online cxpericna.Yuaa'll lied mote I'll"/roe(n Sort J.c as vnmh to repel,dm Same gaaL Start now. personalization and more inleraclkc vechnnioey.1VC xhu inrpruved have has more to spend on other things Inter.and still retire ou your navigation and added convent(hat helps explain Complex liourcisl lopics. Iemts.Ask your VALIC'financial advisor about it free financial ('heck it nut today, analvsis. ' Sour..:(!oiled Stnlex I tellerNmnt e f/(Ihtll-. 11 ..oaoh'IO,rcau. Quick Facts nn.Vora,$for Reli........ 00597 7783589 001194 002374 00001100002 cA /' q n, lG1Z� ( 11 N!J+�..� TBank ACCOUNT NO. ACCOUNT TYPE STATEMENT PERIOD PAGE 15004225781580 RELATIONSHIP SAVINGS MAY.09-AUG.08,2012 T I1 OF 1 00 0 04345M NM 017 -P 11U !M k- 000005372 FIDS1549DO1708081208 02 000000 14478 JANICE B NEWMAN 46 WILSON ST CARLISLE PA 17013 INTEREST EARNED FOR STATEMENT PERIOD 0.01 STONEHEDGE INTEREST PAID YEAR TO DATE 0.02 - - " ACCOUNTSUMMARY BEGINNING::', DEPOSITS.4 .-WITHORAWALS 4::OTHER - CURRENT -°::ENDING OTHER ADDITIONS:- SUBTRACTIONS INTEREST PAID:: BALANCE '- NO. 1 AMOUNT - NO: I AMOUNT 250.01 0 0.00 ol 0:00 - 0.01 1 250.02 ACCOUNT ACTIVITY -.:.POSTING.:: '° - - DEPOSITS,INTEREST. .M/DRAWALS.B-OTHER DAILY :DATE TRANSACTION DESCRIPTION - - S OTHER ADDITIONS ;SUBTRACTIONS � BALANCE 05-09-12 BEGINNING BALANCE 0250.01 07-06-12 INTEREST PAYMENT 0.01 250.02 ENDING BALANCE $250.02 ANNUAL PERCENTAGE YIELD EARNED = 0.01 7. n LIUJ-.AA;- WITH A VARIETY OF LOANS AND LINES OF CREDIT, WE HAVE ONE THAT'S RIGHT FOR YOU. TO HELP YOU CHOOSE,TRY THE NEW MST LOAN FINDER - OUR NEW ONLINE TOOL THAT LETS YOU CUSTOMIZE ABSOLUTION. VISIT WWW.MTB.COM/.LOANFINDER AND TRY IT TODAY! YOU'LL BE ASKED A FEW SIMPLE QUESTIONS ABOUT YOUR.GOALS AND PERSONAL FINANCES. THE MST LOAN FINDER WILL THEN MAKE A PRODUCT RECOMMENDATION TO SUIT YOUR NEEDS AND YOUR BUDGET. THE MST LOAN FINDER IS FREE, READY TO USE, AND IS JUST ONE MORE WAY MST IS MAKING YOUR LIFE EASIER. EQUAL HOUSING LENDER. MEMBER FDIC. L008 IWl2) Pennsylvania State Employees Credit Union P.O. Box 67013 Harrisburg, PA 17106-7013 Member Number: 8009""'" PSE@U 800.237.7328 psecu.com Statement Period: 09/01/12 to 09130/12 Direct inquiries regarding preaulhorized electronic transfer or account errors to the above address. Page Number: Regular 1 of 3 Account Balances at a Glance Total Shares: $6,756.94 Total Certificates: 50.00 Total Loans: SD.00 JANICE B NEWMAN 46 WILSON ST. CARLISLE, PA 17013-2842 Ct - r . r r IT'S THE PLASTIC CARD WITH REAL VALUE ANNUAL PERCENTAGE RATE psecu.com/vio for complete program details. YEAR TO DATE INFORMATION Description - Amount Total Dividends Year to Date $23.38 SHARES Posting Effective Transaction New Date Date Transaction Description Amount Balance REGULAR SHARES ID 01 09/01 Beginning Balance 565.83 09/20 Withdrawal Transfer To Share 04 -560.83 5.00 09/30 Payment: Dividend 0.150;6 0.04 5.04 Annual Percentage Yield Earned 0.140% from 09/01/12 through 09/30/12 Based on Average Daily Balance of 360.19 09/30 Ending Balance 5.04 Dividend YTD: Year to Date 1.09 VACATION SHARES ID 02 09/01 Beginning Balance 211.22 09/20 Withdrawal Transfer To Share 04 -211.22 0.00 09/30 Payment: Dividend 0.150°/ 0.02 0.02 Annual Percentage Yield Earned 0.180%from 09/01/12 through 09/30/12 Based on Average Daily Balance of 133.77 09130 Ending Balance 0.02 Dividend YTD: Year to Date 0.30 CHECKING ID 04 09/01 Beginning Balance 5,777.71 09/01 Withdrawal Transfer To Share 07 -828.00 4,949.71 09/01 Automatic Share Transfer 09/05 Withdrawal Direct Deposit PPL EU -48.04 4,901.67 09/05 TYPE. ELEC SVC ID 1230959590 CO: PPL EU Y� 3 Cn, Pennsylvania State Employees Credit Union Member Name: JANICE B NEWMAN P.O. Box 67013 Harrisburg, PA 1 71 06-701 3 Member Number: 8009"'* 800.237.7328 psecu.com Statement Period: 09/01/12 to 09/30112 Page Number: Regular 2 of 3 Posting Effective Transaction New Date Date Transaction Description _ Amount _ Balance 09/12 Check 004546 -740.00 4,161.67 09/18 Check 004544 -1,990.00 2,171.67 09/20 Payment: By Check 22.50 2,194.17 09/20 Payment:Transfer From Share 01 560.83 2,755.00 09/20 Payment: Transfer From Share 02 211.22 2,966.22 09120 Payment:Transfer From Share 07 829.86 3,796.08 09120 Check 004545 -57.00 3,739.08 09125 Withdrawal Transfer To Loan 09 -130.29 3,608.79 09126 Payment: Direct Deposit US TREASURY 303 1,337.00 4,945.79 09126 TYPE:XXSOC SEC ID: 3031036030 09/26 CO: US TREASURY 303 09/27 Check 004548 -208.33 4,737.46 09/27 Processed Check- ERIE INSURANCE 09127 TYPE: 1256038677 ID: 1256038677 09127 Check 004547 -104.00 4,633.46 09128 Payment: Direct Deposit FRONTIER COMMUNI 0.30 4,633.76 09/28 TYPE: DV01 DF1209 ID:2431912740 09/28 DATA: FRON D CO: FRONTIER COMMUNI 09128 Payment: Direct Deposit PA TREASURY DEPT 2,117.66 6,751.42 09/28 TYPE:ANNUITANT ID, 1236003133 09/28 DATA:A7009131227015009 09/28 CO: PA TREASURY DEPT 09130 Payment: Dividend 0.1000 0.37 6,751.79 Annual Percentage Yield Earned 0.100%from 09101/12 through 09/30/12 _ Based on Average Daily Balance of 4,518.72 09/30 Ending Balance 6,751.79 Dividend YTD: Year to Date 3.37 CLEARED DRAFT RECAP Draft# Date Amount Draft# Date Amount Draft# Date Amount 4544 09/18 1,990.00 __-- - 4546 09/12 740.00-- 4548 09/27 _--208.33 4545 09120 57.00 4547 09127 104.00 'Indicates a break in check sequence. MONEY MARKET SHARES ID 07 09101 Beginning Balance 1.86 09/01 Payment: Transfer From Share 04 828.00 829.86 09/01 Automatic Share Transfer - 09/20 Withdrawal Transfer To Share 04 -82986 0.00 09/30 Payment: Dividend 0.200% 0,09 0.09 Annual Percentage Yield Earned 0.210%from 09/01/12 through 09/30112 09/30 Ending Balance 0.09 Dividend YTD: Year to Date 18.62 LOANS Trans Post Payments, Credits Finance Fees or Transaction New Date Date Transaction Description .or Debits Charge Charges_ _ Amount Balance ID 01 PSL LOAN (Open End) "" ANNUAL PERCENTAGE RATE 12.900% "` Periodic Rate (Daily) .035342% Pennsylvania State Employees PSE@Uli Credit Union Member Name: JANICE B NEWMAN P.O. Box 67013 Harrisburg, PA 17106-7013 Member Number: 8009""" 800.237.7328 psecu.com Statement Period: 09/01/12 to 09130/12 Page Number: Regular 3 of 3 Trans Post Payments, Credits Finance Fees or Transaction New Date Date Transaction Description or Debits Charge Charges Amount Balance ---- - --... -- -_ - 0.00 09101 Beginning Balance 0.00 09/30 Ending Balance Credit Limit: $10,000.00 Available Credit: 59,869.62 0.00 Interest Charged YTD "The balance used to compute interest is the unpaid balance each day after payments and credits to that balance have been subtracted and any additions to the balance have been made. ,........ FEES.. .... $0.00 TOTAL FEES FOR THIS PERIOD . """"' INTEREST CHARGED""" Interest Charge on Loan 0001 -PSL LOAN 0.00 $O.00 TOTAL INTEREST FOR THIS PERIOD 2012 Totals Year To Date $0.00 Fees Charged YTD it TRW / Fr 100 74D -imoo - n ® 9 / 0 cl(D § \$ CL a; (D � 2 , \ z» ° k /}ƒ) \ ƒ /\ } }± j ( E �n E, _ , n < , § / � E ® ( | C < � P. CD e } � 9k < ; J g \ } } ° / \ ± \ \ ; E \§ e \ k ° / a2 2 E f a < k ; 7i k � ) / � , @ : \ [ §[ . _ \ \t 7-j gy !� ®{/ \ k j � j\j O2 � / f7 b§2 § 6K)iw & Z {G - w � � m � �� oo = �{ \ \ } \\ §$ rl}/ \ (\ k: § . f 3 � 3 } \ ( � ( } :! E ( ƒ ( [ ( ; & Nm \ ) { E 03 , ) - /y 3 ' ) \ } - ng G m \ | } � � ` ^ ° Northwestern ` ~ Variable Annuity Summary Statement For the Period: V7YV1/2O12 through V9/3V/2O12 M000n22730008754 Contract No: 1459*035 Janico8 Newman 46 Wilson Sit Annuitant: Janice nNewman Carlisle PA1TV13 Contract Date: 0312611998 Account: o 'mu Series back end design Market: Personal Annuity Page 1o,u --- X. == �£22��|l��y ==` Beginning Contract Value $6o:oocc �000r^o1 --- � � � Annual Dividend ww +442.41 Investment Return +2080.67 +45*387 Ending Contract Value $65,360�89 $65.360x9 ~--' Mason Street Advisors, LLC(MSA)is the principal investment adviser for all the Portfolios in the Northwestern Mutual Series Fund(Series pv:d). (Portfolios io the Series Fund are identified h'the parenthetical next m the portfolio oamo.) MS»has engaged and ovn,snoosoh-advisonw^vpmvidoda'-m-duymaoaoemeo/h/cevaioo/moCoriospundponf000s. sac^ sub-adviser may be replaced without the approval of shareholders. Please see the prospectus for more information. Additional fund options are advised by Russell Investments,Fidelity Investments(D and Neuberger Berman Management,Inc. Variable Funds Percent of Units Unit Value Contract Value Current Period Contract Value Investment Return aa|uncod (w5A) 100% 6J7431 $10u5 $65.360u8 *2,080a7 gn Cash surrender value at the beginning v/the current period ononn1/201uwas$63,280.uu. Tho cash surrender value m the end o|the current period ono9/om2o1u was$6s,36o.80. Total Contributions Since Inception: Total Withdrawals Since inception: Mo Total Death Benefit on 09/30/2012: $65360.8 Your contract can be converted into guaranteed lifetime income. Assuming the current contract value and current rates,and an age of 75,you could receive$408.51/month in lifetime income.with a 10 year minimum guarantee. Other income plans are also available. Withdrawals may be limited with some plans and withdrawal charges may apply. Contact your financial � The wort^m,,um Mutual Life/*mw^wCwn o' r ,�vouo^ " ��*woo�*/o� ��nn o m 1444 .xo^y, u*nmo/oo/ zom � ,no z,,nm,n^v^mm' m � � � t � Northwestern Mutual- Variable Annuity Summary Statement For the Period: 07/01/2012 through 09/30/2012 30088522730008750 Contract No: 14311370 Janice 8 Newman 46 Wilson St Annuitant: Janice B Newman —_ Carlisle PA 17013 Contract Date: 07/21/1997 Account: B -Oo Series back end design Market: Individual Retirement Annuity(IRA) Page 1 of 2 Beginning Contract Value $89,517.17 $89,890.94 Withdrawals 0.00 -3,925.37 =_ Annual Dividend +-681.67 +681.67 Investment Return +2,968.25 +6,519.85 _ Ending Contract Value $93,167.09 - $93,167.09 Yattable Ftlnd,tnformatlori Mason Street Advisors, LLC(MSA)is the principal investment adviser for all the Portfolios in the Northwestern Mutual Series Fund(Series Fund).(Portfolios in the Series Fund are identified by the parenthetical next to the portfolio name.) MSA has engaged and oversees sub-advisers who provide day-lo-day management for certain of the Series Fund Portfolios.Each sub-adviser may be replaced without the approval of shareholders. Please see the prospectus for more information. Additional fund options are advised by Russell Investments, Fidelity Investments®and Neuberger Berman Management. Inc. Contract Yalue;by Fund- ,_ K °As x Variable Funds Percent of Units Unit Value Contract Value Current Period Contract Value Investment Return Balanced (MSA) 100% 9,086.11 $10.25 $93,167.09 $2,968.25 Other Contract Info nrl' n Cash surrender value at the beginning of the current period on 07/01/2012 was$89,517.17. The cash surrender,value at the end of the current period on 09/30/2012 was$93,167.09. Total Contributions Since Inception: $72,897.93 Total Withdrawals Since Inception: $-1- 716 Total Death Benefit on 0913012012: $93,167.09 Your contract can be converted into guaranteed lifetime income. Asssniin current contract value and current rates,and an age of 75,you could receive$582.29/month in lifetime income,with a 10 year minimum guarantee. Other income plans are also available. Withdrawals may be limited with some plans and withdrawal charges may apply. Contact your financial representative to learn more. The Nonwestern Mutual Life Insurance Company 720 East Wisconsin Avenue,Milwaukee,WI 532024797 414271 tut www.northwestemmutuatcom 22721 '27300097502e0n0,' 1,2