HomeMy WebLinkAbout02-14-14 � ..
J 15056101�5
REV-1500°`{°�_u,�,
OFFICULL USE ONLY
PA Department of Revenue �Yt�
gureau of Individual Taxes Co�y Code Y�r File f��r�er
Po eox z8o6oi tNHERITi4NCE TAX RETURN s�� _. �_. .___ ..... _.._ $;._.__ .
Harr;stw pq 1 u8-o6o� RESIDENT DECEDENT �� � �
ENTER DECEDENT t�ITiON BELOW
Sociai Security Numt� Date of Death MMDDYYYY Date of Birth MMDDYYYY
�__._..._.___.__.,�.�____.__ _. , __........____. _. ._____. ._.___._.. .____. ,. ___,, _.._.. . _.____ ..___.___ _ ___ __
', 11 i23/2013 i 10/1511929
____._._.._�._..,...__. .--_. ._. � __ . ____ _ __.. _ ____ ___ _ . _._. _.---- _.. __._ ..__.__. __
Dec�denYs Last Name Suffix Decederrt's Frst Name MI
Armstrong ' Ellen ; L '
(if Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
, ____ _, . _._ ___ ----. ___..,_----- __ . ____.. __._ .__._--- � _________. ..__
Spouse's Social Secunty Number
__ __� ____. _ ____. ___ . . __ .__ THIS RETURN MUST BE FILED IN DUPUCATE 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)
Q 4.Limited Estate p 4a.Fu#ure Interest Compromise(date of p 5. Federal Estate Tax Retum Required
death after 12-12-82)
O 6.Decedent Died Testate O 7.Decedent Maintained a Living Trust 0 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 CONFIDENTWL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
;Carole A Armstrong (717)732-6247
REGISTER OF WILLS USE ONLY
�
First Line of Address �'
n__._._..�_..---___�...__...__ ,_.._ _ _._-----. __._. _.__ ____ _ __ __ ___,___ _____ -
�� �
'607 M2igaro Road � � "�
�. �`', ��� �
__.._.______..___._.._..._�._._�_...__._�.� .___.._ .. _ -�.,�� ___. ��,E. c,��7 "
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Sec�nd L�e of Address � -=
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City or Post Office State �!P Code � ! �Flt.ED � F���
.�-----------__.________ _ ,.._...___ �___,.. ___... _. . •
_.___ _ .___.... �
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Enola PA '17025 ` � � �-�"-� `��1
_ . ___. ____ ___ ____ _____
_...__._ _.____._. ._.___. _.. _ --_ ____ . ___ . __._ _ _____ _. _._ __ ,;
t,.�
Correspondent's e-mail address:carm83@verizon.net
Under penalties of perjury,l dedare that I have examined this retum,inciuding acoompanying schedules and statements,and to the best of my knowledge and belief,
it is true,aomect and oompiefie.Dedaration of prepar+er other than the personal r+ep�sentative is based on all information of which preparer has any knowledge.
SI ATURE F PERS RESPONSI FOR FILING RETURN DATE
�. � a�0/
DRESS
07 /�a a. o � a. A- 17D:Z�'
SIGNATURE OF P EPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1 i
� 1505610105 1505610105 J
� 1505610205
REV 1500 EX(FI)
DecedenYs Social Security Number
ueced��rs Na�: Ellen L Armstrong
�ca�ruu�►noN
1. Reai Estate(Schedule A). ............................................ 1. :
2. Stodcs and Bonds(Schedule B) •...................... ............. 2. ' 1,170.91
3. Closely Hefd Corporation,Partnership or Sole-P'�P�Schedule C) ..... 3. '
4. Mortgages and N�es Reoeivabfe(Schedule D�-••-•------...-•------..... 4.
5. Casfi.Bank[)eposits and Miscelianeotss Personal Property(Schedule E)....... 5. : 4,241.00
s. .Jantiy Owned Propeny(Sc�edule F) o Separate Bilting Reques�ed ....... s. ' 13,345.61 ':
,.._ . . :_..._.�..,..�_� .. ...... _ ,.,�.,..�. __..�.._.�. ..,..r...=..;
7. Inter-Ynros Tran,sfers S 11�sc�eltar�eous Non-Pnobate Property
(Sdtedule G) O Separate&8ing Requested........ 7. '.
s. Total Gross�►ssefis(t�t�es�mrougi,7)............................. s. 18,757.52
9. Funeral Expense.s ar�Administrative Costs(Schedule H)................... 9. 15,1 I 4.87
�o. c�bts of o�t,M«csage uabilities and uens(sc�lule q......-•--•--.. �o. . 4,677.24
�.,_, _ _�. � _. .,�r�.�ti W.�.��,_�...�.m�.����.,
11. Totai Deduct�ns(to�al Lines 9 and'!0)................................. 11. 19,852.11
12. MetNatueof�(L�e$mirwsLine11)• -•--•----.......-•-•---.... 12. � -1,094.59
13. Charitable and Govemment�Bequests/Sec 9113 Trusls f�which , .. ... ..._. .:..,. _..,:., .�,.,.. �_�,�._�,�. w.�_..o..;
�t��t�uc ttas not been rrtade(�uie J} ........................ 13.
14. INet 1/alue Subj�ct to Tax(Line 12 rninus Litte't3) ..-•--•-•............... 14. 0.0�
TAX�ALCULATiON-SEE INSTRUCTIONS FOR APPi.ICABLE RATES
15. Mmotmt af Line 14 taxab�e
�t ttte spousad tax r�e,or
tlransfers under Sec.9116 -__ �___ , _ __ . __.._
(�ax1.2)X A_ 15.
-_.... ,...., -,,:, , r._ ,... ,.... . ..._,. .: ...... , �...,F ._
.,,,_.._..«.r.. �._Y rv�_n ,,.,a.r. ,._..�.._.�..,;
16. Mmourrt�Une 14 taxabte
�t Gn�i rate X.0'�� 16.
_ .,:. :.z......_., , , . ..:, . .... .. ..... . ........� ,. _,.. , . ,: . ....;a,..�,.,�.a, �R ti..�Q.� ..�..�,... x.w....:...
17. Arnour�t of Line 14 taxable
�t sibting rate X.12 17.
r.. ....... �..,,.,�..,.:... .,.�.... ..a._..,., .. .. . . .:.:...�. .. ,.r,. . .,.,.,,.�. ri. ...,. .,...�.,.,�_M_...,n�=x.�,_.,�..._.M......,.
,. ,:
18. �lmcwnt of Line 14 taxa�e
at ootlateral rate X.15 18.
19. TAX DUE ......-•................................................. 19. 0.00
20. I�ILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OYERPAYMENT O
Side 2
� 1505610205 1505610205 �
REV 1500 DC(Ft) Page 3 File Number
Decedent's Compiete Address:
oECEO�rs
Eilen L.Amhstrong
sr�nou�
607 Magaro Road
CI1Y STATE ZIP
Enola PA 17025
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 0.00
2. Credits/Payments
A.Prior Paymen�
B.Discount
Total Credits(A+B) (2) 0.00
3. Interest
(3)
4. ff Line 2 is greater than Line 1+Line 3,enter the difference. This is the OVERPAYMENT.
Fill in oval mn Page 2,Line 20 to request a refund. (4)
5. If Line 1+Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5)
;�.
Make check payable to: REGISTER OF WILLS, AGENT.
, � _,._. �° ��;�..�`'� .. ,.�-�"" ,�- .a�:�- � ��._�' �. � ,�.�5.�� .�" �-�-,��. �. sp 5•�. ���r�s� .
r �� :'�' � ^s � rr �'�r -s i� � :z .
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-... ';..,f-'�i�X'i'€3..'k�'� . <3;"HY.�'-� iT ..d' r-_,S..A s-sv��:_'�.�...-��-�""�: . .„ �
. . . .. . . . . . s���
PLE/#SE 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 oa;urred after Dec.12,1982,did dec�dent transfer property within one year of death
without rec:eiving adequate consideration?.............................................................................................................. ❑ �
3. Did decedent own an"in trust for"or payable-upon-death bank acxount 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 ANSIN�R TO AHY OF THE ABOVE QUESTIONS IS YES,YOU MUST COYPLETE 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 de�th on or aRer 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 disdosure of assets and
filing a tax retum are still appiicable even if the sunriving spouse is the only beneficiary.
For dates of death on or after July 1,Z000:
. 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 par�nt 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 benefiaaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)j.
. 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 Sectioh 9102,as an individual who has at least one parent in oommon with the decedent,whether by blood or adoption.
REV-i5o3 IX+(&i2)
� pennsylvania ���pV� B
����
I�qfER1fANCE TAX RETURN STOCKS & BONDS
RESII�ENT DECEDENT
ESTATE OF FILE NUMBER
Ellen L Arrr�strong
Ali property jointly owned with right of survivorship must be disclosed on Schedule F.
�� VALUE AT DATE
NUMBER DESCRIPTI�I pF pEqTH
1. 13 sha�e,s o#Pruden�F'�tnc,S�odc�90.07 p�sh�e as of 11/221'1012 1,'!70.91
TOTAi.(Atso errter on tine 2, Recapitulaaon) $ ' 1,170.91
If more space is needed,ins�t addidonal sheets of the same size
REV-15o8 D(+(o8-i2)
� �nns Lvania �NEOULE E
p�y R�UE CASH, BANK DEPOSITS 8c MISC.
INHBRiTANCE TAX RENRN pERSONAL PROPERTY
RESIbENT DECEDENT
ESTATE OF: FILE NUMBER:
Ellen L Arrr�strong
Include the proceeds of litigation and the date the proceeds were received by the estate.
AI!property jantly owned with right af sun�ivaship must be disdo�ed on Schedule F.
ITEM VALUE AT DATE
NUMBER DfSCRIP'TION OF DEATH
1. Au�orrx�bile-20Q0 Mercxiry Sa�e LS 3,041.00
2. Ctothing and P�na�Prr�erty 1,200.00
TOTAL(Aiso enter on Line 5,Recapitulation) � 4,241.00
If more space is needed,use additiaial sheets of paper of the same size.
REV-150J EX+(01-10)
� pennsylvan�a SC�1EpIr11.E �
DEPARTMENT OF REVENUE
INMERITANCE TAX[tETURN ����������'"R�
RESIDENT D�Et�BiT
E5Ti4TE OF: FILE NUh4BFR:
Ellen L Armstrong
If an asse�becarr�e jo�n#I�t awnexf wi�in one y�ar of the s�eceder�#'�dat�vf�t�,�t m��r�a�t a�a 5��f.
SURVMNG.IOINT THVAI�T(S�NAME(S) A�RESS RELATIONSHIP TO DECEDENT
A.Carole A Armsfio� fi07 Magaro Road _ Daugh#er
Enda,PA 1 7025-1 91 1
B.
�
30INTLY OMYNEQ R�iOPERTY:
�rr� o� �S�TIt�N oF PttoPHtn �oF o�oF�n�
� FoR�on�rr � �[�oF�r+nNC.u�nrsn7UnoN�BMnc a�oc�ouHr n�x�tnt SrMn� oa�oF�7t� o�err5 v�OF
NuMee� �B�uwr .�rt' merrn-Yn��.Arniai o�t��rror r��at�sra�. va�.t�oF� n�sr o�a�s�sr
_
1. A. PSECU Regular Shazes 195229827 554.6fi 50 277.33
PSECU Cheddttg Aocamt 195229827 485.83 5Q 242.92
PSECU Mcxt�y M�1952'29827 19,339.58 50 ` 9,669.79
PSVIICU ftegular Shares 159�4�'�5453 1Q9.03 50 ' 54.52
PSECU Cheddng Aa�our�158445453 1,173.94 50 586.97
'`PSECU Mor�ey M�ke.t 159445453 5,028,15 50 2,514.08
T4TAL(Also enter�Une 6,Recapit�latian) $ 13,345.61
If mcue spaoe�needed,use ad�ianai shee�ts af paper af the sarrie size.
REV-1511 EX+(08-13)
� pennsylvan�a SCHEDULE H
��T"+�����E FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDEPIT DECEDEf�fT'
ESTATE Of FILE NUMBER
Ellen L Armstrong
Decedent's debts must be reported on Scfiedule I.
ITEM
NUMBER DESCRIP'TION AMOUNT
A. FUNERAL fXPENSES:
�. SuNivan Funerat Fiome 8,035.00
`Pameia Fbwers 148.03
Gaa�tt f�t��3723.�-481.�){�481.66 was paid by 2 0#the daug�tersj : 3,241.84
B. ADMINISTRATNf COSTS:
1. Personal Representative Commissions: - 0.00
Name(s)of�ersonai Representative(s) CaT'OIG Aft71StPOftg
Stree�t Address 607 Magaro Rd
�,�y Enola �te PA ZiP 17025
Year(s)Commission Paid: 0
2. Attorney�e.s:
250.00
3. Family Exem�ion:(If decedent's address is not the same as daimant's,attach exptanation.) 3,500.00
aaimar� Carole A Armstrong
Street Address 607 Magaro Road
City E�ola State PA up 17025
Relatia�ship of Claimant to Decedent Daughter
4. Probate Fees: 0.00
5. Accour�tant Fees: 0.00
6. Tax Retum Preparer Fees: 0.00
7.
TOTA��Atso enter on�ne 9,Recapitula�on) $ 15,174.87
If mc�re space is needed,use addidonal sheets of paper of the same size.
REV-1512 EX+(12-12)
� enns tvania SCHEDULE I
p y
�N°'���E DEBTS OF DECED�NT,
INHERITANCE TAX RETURN MORTGAGE LIABIL�TIE�8�LIEHS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Ellen L Armstrong
Report debts incurred by the decedent prior ta death that re�nained unpa�d at the date of death,indwding unreimbursed medk�tt exptnses.
�M VALUE AT DATE
NUMBER DESCRIP'TION OF DEATH
1. PSECU-ViSA 4,456.09
2. American Hc�ne Patient-CPAP S9 Autoset{ba�rx�e af��sur�x:e) 1.15
3. East Pennsbar�o Arr�ul�ce-transport from hospit�to t� 80.50
4. :Erie It�ut�x;e GroUp-Au�a tnsurance 139.50
TOTAL(Aiso enter on Une 10,Recapitulation) �' 4,677.24
If more space is needed,insert addfional sheets of the same size.
REV-1513 EX+(O1-10)
� pennsytvania S�CH EDU LE �
DEPARTMENT OF REVEMUE
I,�,.,�,,,�,,,,�� BENEFICIARIES
r�sto�rr o�rr
ESTATE OF: RLE RlIMBER:
Ellen L Armstrong
REtATIt�tSHIP TO DECEDENT AMOUNT OR SHARE
NUMBfR NJIME AND J�DRESS El�PERSOht(S)RECEMNG PR�tT1f Do Not list Tn�eejs) OF ESTATE
I TAXABLE DISTRIBUft�lS[Inc�de ouh�i�t spousal distribu�ons and transfers under
Sec.9i16(aj(1.2).]
i. Caro�A Arrnstrnng 6Q7 Magaro Rd.,Etmia,PA 17025 Daugh�er 1/3
2- Lit�ia M Wy�tt '12455 Moss Gro�e Rd.,Cen�lle,PA 16404 Daugi►� 1/3
3. 'Shir�y L C�ar�d 574 Gre�t Hi�Rd.,Pleasant»Ae,PA 16341 Daught� 1/3
ENTBi DOl1.AR AM0l1NTS F�t DISTRIBt1tI0N.S SHOWi�I ABOYE ON tiNES 15 THROUGH 18 OF REY-1500 COYER SHEfT,AS APPRt�R1ATE.
II I+�N TAXASlE DISfRIBUfIt�IS
A. SP'0liSAt DISTltIBUiTONS ttNt�R SECTION 9113 FOR WHICH 14N ELECTION TO TAX IS NOT TAKEI�:
1.
B. C'�iAiRITABI�AND GOVBt�lME�tTAL DIS1RIBtlTIONS:
i. _ _ _ _ _ __
T4TAL OF PART II—ENTER TOTAL N�i TAXABf.E DLSTitIBUTiQNS ON LINE 13 0�REV 15t�COVER SHEfT. #:'
if more space is needed,�e addi��onai s�#s�pape�a�the same size. _
- ��puts�h�r�
�,,�����
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_ ��,����
ELLEN L ARMSTRONG
607 MAGARO RD .
EN4LA Pd 17025-1911
�
_---- _-__.._ 38twary 16��0�4---- - -=---� ___ _ __ __ _ ___ _.__ __.V :__--_ - _- __ __ _._- _ _____.
Gomparty: PRUDENTIAL FINANCTAL INC
Reg�atiort: ELLEN L ARMSTR4IVG .
Holder A000unt Number: t�OQ1118838
Document I.D,: 14013WF00648231
�r Refenenoe: PRU/0120140113/46514997/
Dear Sir/Madam:
Thank you for c�ontad�ng Computershare, PrudentiaPs transf��nt.We appreciabe the oppo�tun�y b�be
�servioe tio yau.
As tt�e mark,et wz�s dosed on Navernb�23,2013,we hav�e pro�vicied the�000ur�t balanoe ir�fortnation fior
ttte previous bustness day. Below is the a000urtt balarx�e ittformat3on y�ou requesbed as t�f IVoMember 22,
2013 for the abonne a000unt
Shct�es I�Id by agent: 13
Sttares Held in Cerbficate Fonm by Hoider:0
T�al Shares: 13
C�osing Pr1oe P�er St�are: $90.07
_ _ __ __.
Sttouki y�ou_hav�e othe�'a000ur�relatied questions, pfease cap us a#1-800-305-�9404 be�.i�r�eett the ttours of
8:�AM and 6:00 PM Eashem US tjme, Monday through Fric�iy.Please no�e that arry available �
can assist y�ou.A t���aammun�t�io,rrs dev�ae f�,r tf�e fi�aring impairad('TTY/Tfl0)ts a�v
aval�fab,�ee at 1-�80I0�619�-2837. �
si�x�ene�y, q�,�1
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servioe Rep�entativ�e
Enclosur+e: None
___
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http:!/wvvwlcbb.comlmercury/sabie/2000,mercury-sableJls�-premium sedan-4d/?co�dition—... 1/15/2014
,� P�en�ri�►ania sta�,e Emp�oy�ees credit Union
-s P.O.Box b7�'13 tla�rtisbtrg,PA 171Q6-7013 �,N� ��.,t.,�.,.
800.237.7328
ps�-� Sta�emertt P�fod: 11/�01/131011/3Q/13
�r�4��9 P���� p�Nun�: Re�r 1 of 2
tr�t�.sfer ot a000u�t ennrs�o Uie abotie addness.
. Account Balances at a Glance
To�l Sha�: 520,354.51
Total C�S�ses: � i0.00
ELLEN L ARMSTRONG Total Laa�: 50.00
60T MAGARO RD
ENOLA,PA 17025-1911 .
,
_ $ � _ _ _ _ - _
� �1T� �UUT� :��f�JRE ��.,.�+:��w
F��y��ta,,���-�� �.��.,..�..�.�.,,�.
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a1rMs cw�l�/��s aMt ilws
t,pj in�o y«K acoo�.�t>sMy+Na�ey ,a.�.�"a..���+�.
YEAR TO DATE INFORMA710N � �
Descrip�iort /lnwunt
Total Dividends Year to Date $35.17
SHARES
Posting Eifectnre Transactla� New
Da�s t)abe Transar�ion Desaription Anaunt Balance
REGULAR SHARES tD 01
Additional.bint Owner(s):
CAROLE A ARMSTRONG
11f01 Beginni�g 6afanoe - 554.66
11/30 Payment Dhridend 0.15496 0.07 554.73
----- - ---- - - --A�uat Peroentage Ytetd Eamed 0.15�0%fiom 1 i/0111�thr!nugh 1113t)/13 ------
6ased on Average�y Balanoe of 554.66 - - - �----- _ .
------ - - - - -- __-- ---------- - _ _ _
- -
1 0 Ending Balanoe- --- - - -- - 554.73
Dividettd YTD: Year to Date U.76
CHECKING ID 04
Add�ionai.loint Owner(s}:
CAROLE A ARMSTRONG
11101 Bec,�'r�ing Balanc�e 307.26
11/01 Payment Ditect Deposit SSA TREAS 310 1,151.00 1,458.26
� 11/01 TYPE:XXSOC SEC ID:9031738026
11/01 CO:SSA TREAS 310
11/05 Withdrawat Di�ct Deposit COMBtNED tNS -7.90 1,450.36
f 1l05 TYPE:tWS PREM ID:9639995007
1110.5 DATA:ACCIDENT CO:COMBINEO!NS
11/05 Vl�tl�drawal Dir�ect Oepc�sit UNITED AMERlCAN 220.9.5 1,229.41
11105 TYPE:lNS.PREM ID: 1731128555
11/05 CO:UNiTED AMERICAN
11l08 Withdravr�POS#175�9263 28.58 1,200.83
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P.O.Bo�c b7013 Ha�risb�rg,PA i 7t t36-7013 �� 0,��,��
8t10.237.7328
p��-O0� Stabe�r�ent P�ivd: � 11I�M/13�o i 4/3QN3
Page l�rnbsr: Re�r 2 of 2
Po�tlny Etiectivo - Trmsachort t�w
D�� Dab Transaction Dsscrtption Airaunt BaVno�
11/09 POS GIANT 62fi3 310 EAST PENN DR ENOLA PA
11 N 2 1Al'�thdrawat via Flome B�g Tr�s#� -40Q.00 800.83
11/12 To ARMSTRONG,CAR�LE XX�UWCXXX Shane 04
11/20 Ct�e�lc 003828 �15.00 485.83
11f2? 1Mthdraw�Dir�ct Deposit NewYorkt.i#e-AARP 28.75 457.08
11l27 TYPE INSURANCE lD:1951985500 -
— - -— -- - -
- � 13�2-7 -- - -- DATA AAR�-CO:NewYaitt_ife-AARP _
- - - -
i 1/27 Paymen�Transfer From Shar+e 07 12.000.00 12�457.08
11/3� Paynten�Dividend 0.1�09f. 0.20 i 2,457.28
Artrwal Peroentage Y�eid Ea�ned 0.10096 from 11101113 ihnough'f 1130/'13
Based on Average D�y Batenae of 2,466.30
11/30 Ending Balariae 12,457.28
Dividerxl YTD: Ye�'�Ua�e 0.86
CLEARED DRAFT RECAP
Draft� Date /lrnount Draflt� Da�e Amount Drsit� D�e Arraunt
3828 11t20 315.00
� "Indicates a brea�c jn chedc s�c�e. .
MONEY MARKET ID O7 -
Additional Jan#C�vner(s).
CAROLE A ARMSTRONG
11/01 8e�nrw�g Balanoe 19,339.58
11J27 i�thdraw�Tr�a�sfer To Shar�e 04 -iZ.000.Q0 7,339.58
� 11/30 Payn�er�Dividend 0.200'!G 292 7,342.50
Aruural Peroentage Yteid Earr►ed 0.200'X.ft+om 11/�01/13�11/3Qi't3
91f30 Ert�ng B�anoe 7,342.50
Dividerxi Y7'D: Ye�ar�o D�a�e 33.55
"*The b�anoe used io oompu�e�tterest�the unpaid balarx�e each da�►af�'p�yrnen�s�d credit�s to that ba�oe ha�te
been SubUac�ed�d ar�I adc�or�s io the beianoe hav�e beert made. - - -
*��.'FEES�'�..'.�' _ ---
TOTAL FEES F4R THIS PERIOD �0.00
''�*"�'*'INTEREST CHARGEO*'�'*"'"* •
TOTAL lNTEREST FOR THiS PERIOD $0.00
2013 Tofieis Year To Da�e
Fees Ci�arged YTD 50.00
1� �IMI5�11a11��S��O�S��
P.O.Bwc b70i 3 Harrisberg.PA 17106-7U13 �N� �5�.
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. t�inect inqtiies t�ga�9 P�d�tronic pa�Nt�mber: Reguiar'1 af 4
�a a�oount emo�s b�e abw�e addi+ess-
Account 6alances at a Giance
Tata!Shar�ss: 58,398.08
Tot�ii C�e�rtifica�es: $0.00
To�ai L�o�ns: �'t 0.543.88
CAROLE A ARMSTRONG
g07 MAGARO RD .
ENOLA,PA 17025-1911
� N � '! noo�a.��.wr se awwes s�or
� ��� � i�I'�� �1��+.�+w��b d a�e
F��a,�y��s t,� Flca c�t sco�e �,a"`"'""'.`.�...`.�''�,.�°"`
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al�ult a�r�M!�MMiws�t h�e
(��111p�011�i0001/�»� serlo��t�Owes�d1�IMe. �
YEAR T� DATE 1NFOR�AATION
��� Amount
Totai D�vidsnds Y�r�o�#e $11.20
SHARES
Pvstlrty Ctf�sc�ti�re TFansa�tto�t New
Da� D�e Ts��t�saction Desaciptia► Atnou�rt 8atanos
REGULAR SHARES ID 01
Additionat Joint Owner(s}:
ELLEN L ARMSTRONG
11I�1 Be�u�in9 Ba�c�e 109.03
11/30 Payrt�nt Div�dend�.15096 0.01 1Q9.04
Annual Penoenfage Y�eid Earned 0.11096 from'!1/01/13 thrott�11r30/13
Based on Average Daily Bal�oe of 109.03 ---�--
11/30 ------ -- Er�g gai�oe - - -_�__,_ ___ -- __...._� ___.—_.. _ �09:04-
Dividend YTD: Year�Da�a 0.15
CHECKING 1D 04
A�ditional Joint Owne�(s):
EILEN L ARMSTR�IG
11/01 Beginnin9 Ba�rx�e �g�.`�
11/01 ELECTRONIC BILL 0009 FOR�574.2g
11/01 W/�S SENT TO WELLS FARGO HOME
11101 Withdrawal at ATM#00006436/PE0439 -100.00 2.793.44
11/01 ATM P.S.E.C.U.�!E CREDIT UNION P
11/01 HARRISBURG PA
11�1 Cttet�c 102806 -138.00 2,655.44
��ro� wu,d�r�,�c� -26.ao 2,s2a.c�t
1QI312316808SC�OOSRHOF9 b642 BJ'S WHQLESALE C 460 S CAMP HtLL PA
11I01 Withdranv�Chedc Card -35.49 2,594.05
10J3123198389G0060X4AS 5943 Staples,!nc CA141P HILL PA
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P�er�sytvania�Stat�Ernployee�s Cc�dit lJ��ion� CA�R�OI.E A ARMSTRO�K3
P.O.8c►�c 67013 Harrisbung,PA 17t06-7�'13 ��� �5�*
840.237.7328
�-� S�snt Prriod: #1Ib1/13 io 11/30/13
Page Number: Re�r 2 of 4
Pos�ing 'Etfective Transsc:tiort New
Dste Da�e Transactfon Description Aenount Balance
11/02 1N[thdreMtal POS#1 fiB27663 �8.64 2,555.41
11/02 P4S GfANT 6263 310 EAST PENN�R ENOLA PA �
11/OS Wifhdrawal Dined Depo�it WEL1S FARGO HOME ,574.26 1,981.15
11�05 TYPE:E�-BILL CO:iNE�LS FARGO H011AE
11I�D5 Ct�ec�c 004006 -400.00 1,581.15
11/06 Withdrawai D�ect Deposit COMBINED INS -15.17 1.565.98
11/06 IYPE:iNS PREM iD:9638986002
11l'06 t�ATA:L70 HEALTH CARE CO:C�IBINED I�+IS
_ ___._ __
- -- - 11/t2 � Wfthdrawai Dinect t5epo�it PROFESSiONp►L INS _ - � -38.57 1,527.41
!1/t2 TYPE:PARSEQ2IO:1231674479
11h2 CO:PROFESSI�IAL INS
11/12 Paynrien�via Home B�Transfer 400.00 1,927.41
11/12 From ARMSTRONG,ELLEN XXXXXXX�(X S'�+a 04
11/15 Withdrawa{D"aed Deposit COMBINED INS -�f7.60 1,909.81
41/15 TYPE:INS PREM ID:96;i9995001
11I15 DATA HEALTH CARE CO:COMBINED INS
11i16 Wifhdrawai Tt�sfer To L�o�t 50 -60.00 1,849.89
� 11118 VYithdrawai Chedc Cand 26.5D 1�823.31
11/15 2472193A1966DR6VK 4812 THE CELLULAR CONNECTiO ENOLA PA
11/18 Withdr�wet Ctteck C�d 211.98 - 1.611.33
11/15 2472193A1 S66DR6VQ 4812 THE CELLUU4R CONNECTtO ENOLA PA
11/19 ELECTRONIC BILL 0001 FOR 5137.66
»MS was s�To�
11M9 ELECTRONIC 81LL 0002 FOR 544.42
11h9 WAS SENT TO PENNSYLVANIA-�AME
11N9 Withdrawal Chedc Cand� -14.38 1,596.95
11h7 243990QA240GPNJSV 5812 RED LOBSTER US00001958 MECHANICSBURG PA
11/21 V�thdrawal Dired Deposit PENNSYLVANIA AME -44.42 1,552.53
11/'21 TYPE:E BILL CO:PENNSYLVANIA-AME
t 1t21 1Mfi�al Dired Deposit PPL -137.66 1.414.87
11/21 TYPE:E-BILL CO:PPL
11121 Withdrawai P�.S�If�00;i8282 � _ __-�0.00 ___ �,3S4.S�.-_____._
�-----------�-�------- - - �--- _
11/21 P4S C1iS 0232102321-720 V!lertzvi - - -- --- -_ _ _ -- - - -- - --.- _ _ _ _
11/21 Hanisburg PA
11122 VViU�draw�Dir+�ct Depo�it COMBINEDSAVE800 -10.95 1.343.92
11/22 TYPE:882Q621 ID:0000145045
11J22 DATA:800-6.5.3-dA33 C4:COMBINED�AVESQp
11/22 Vlrfhdrawai Dinec�Deposit COMBINED INS -19.98 1.323.94
11122 TYPE:!NS PREM iD:96:i9995007
11/22 DATA-ACCIDENT CO:COMBINED iN�
11/23 Withdrawai via Home Ba�ang Tr�sfer To L�oan 49 -450.00 1,173.94
11/24 Vl�ft�drawai POS#013689T8 -�0.26 1,143.68
11/2�4 POS DOLLAR TREE#0 417 NORTH ENOLA RD
11l24 ENQLA PA
11124 Withd�POS#18628490 � � -86.37 1,t�7.31
11/24 POS L3tANT 6Z63 31 U EAST PENN DR ENOLA PA
11124 Withdrewsl Pt�S#136558fi6 � -30.28 1,027.02
i 4J24 P03 GlANT 8263 3'10 E PENN DR ENOLA PA
11/26 VY�thdravrai POS#d9004005 �S.OQ 992.02
1 fl26 POS THE NEW YOU 70 E SHADY lANE ENOLA PA
,� Pcrosytvar�ia St�e En�ioyees Credit i)� Cl1ROLE A NG _
P.O.8a�t 67013 Harrisbfsg.PA 1 T106-70t 3
�.237.732a Me�nbar Nwnber: 0'159'*"�**
��•� S�abement Period: 11/01M3 tio 11/30/13
Page Numbec: Reg�3 of 4
Posting E#fect�e Transaction New
Date Date Transaction Description � Amount B�anoe
11/26 Withdravral POS#12566787 ' -40.65 961.37
11/26 P4S GtANT 6263 310 E PENN DR EN�A PA
11/26 Chedc 004007 -200.00 751.37
�,1/27 Paymen�Oir�act Deposit PA TREASURY DEPT 2,770.22 3,521.59
'!1/27 TYPE:ANNUITANT ID:12360�i133
11/27 DATiA:A�0'!i 121337U15014
11/27 CO:PA TREASURY DERT
11/27 Withdrawal P4S#�Oai2102 23.64 3.497.95
11/27 POS CVS 0232102321 720 Wertz�►i
11l27 H�stwrg-PA - - - -
11/27 Vl�fhdtaMral Cttec�c Cand -54.58 3,443.37
11�26 2316808AA005XBL14 530U B.!'S WHO�ESALE C 3805 Catttp F�dN PA
11/29 Ct�dc 004008 -148.03 3,295.34
11/29 Wiihdrav�rai Chedc Card -35.45 3,259.89
11/28 2319482A(�0059BGEB 5542 COUNTRY FA1R'#36 SHIPPEM/ILLE PA
11 J30 Paytnen�Divider�d 0:10096 0.16 3.260.05
Annuat Peroentage Y�eid Earned 0.10096 from 11�1h3 through i 1�30Vt3
Based on Average Daiiy Balanoe of 1,91g.63
11/30 En�ng 6alanoe 3,260.05
Dividend YTD: Year to Date 1.63
CI.EAREO DRAF�RECAP
Draft� Dats- Amount _Draft� Date Amount .Draft� Dste /Arnount
r
4006 11/05 400.00 4008 1 i/29 948.03 �
4007 11/26 2�.00 102806"` 11�t11 136.�
"Indit�tes a break in d�eck sequenoe.
MONEY MARKET ID O7
Ardditionai Joint Ch�mer(s):
ELLEN L ARMSTRONG
11/01 Beginning Baiarx�e 5,028.16
11130 Payrnen�Dividend 0.2009f. 0.83 5,028.99
Armtr�Pernertfiage Y+eld Eamed 0.20096 tr�nm 11/01113 thnaagh 11/3W13
- - __. _ __'�1r�o --- - -Er�g Ba�ar,c;e--
- -: --- - _ - - _ _ _ __ - -----5,-t�2f�9'9-----
- Dividet�d YTD: Year�o Da�e 9.42
LOANS
Trans Post Paymer�s,t�edi�s Flnsnce Fess or Tranaaction - New
Dats Date Transaction Des�xiption or Debits Ch�go Changss AnwuM Balance
iD 01 PSL LOAN(Open End}
t**ANNUAL PERCENTAGE RATE 12.90096'"�'` Periodic Rate(Daily) -035342%
��ro� ee��
o.00
11/30 • Erbing B�anoe 0.00
Credit Limi��7,dOb.00 Avaii�le Credit�1,574.57
Intenest Ctwr�ed YTD 0_�
ID 50 HOME EQUITY LINE OF CREDlT(Opert End)
'`'"'ANNUAL PERCENTAGE RATE 3.2509b*** Periodic Rate tDaily) .00894496
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PBn�syha�a State Employ�ees Cred�i�on CA�kOLE A ARMSTRt)NG
P.O.8oac 670t 3 HanisbtN�,PA i 7106-7t1�t3 ��� p159'"�"�`*
' 6�0,237.732ffi
�'� St��ement Period: 1 i101M3 Ao 11/30/13
R�Mermbei': R+�4 of 4
Tr�ns Po�t Pa�n�ents,� � F�ws or T�at�n Hew
Dafie Dstie Trsnsaction Dss�eiptlon or Dabits Ch�+ge Ct�arges AnwuM Balance
11/01 Be�r�Balanoet 10,575.10
11J16 Paymartts Transfer Frem Share 04 �1.22 28.78 -6►0.00 10,543.88
1 i/30 Ending Balartoe 10,543.B8
Cre�it L&ni�515,000.00 Available Cre�t�4,456.12
As of 12/1612013:
t�rr�ertt Amo�utt Due: �60.00
Totai Arraunt Due: �60.00
int�rest Charged YTD 2$�-�
**Ttte ba�noe useci io cornpute interest is the unpaid balanc�e e�Fi day after payments and cx�dits to�at�anoe�have � � - ----
been st�trac�d and�ty addifbns fo the baianoe have been made.
*""'�'*FEES...�.*
TOTAL FEES FOR THIS PERIOD �p,pp
*"'*'*'"'INTEREST CHARGED'�***t'*'�
inte�rest(�arge on Laan 0001-PSL LOAN �p.pp
Interest(�an8e an L�oan 0050-HOME EQUITY UNE OF s2g.7g
TOTAL tNTEREST FOR THIS PERIt� $Zg,7g �
2013 Toials Ye�To Daie
Fees Charged YTD $0.00
'� VtSA Page 1 of 2
Pen�sylva�State Empto�ees cre�t i&�on
P.Q.�wc 67013 Harrisb�rg,PA 17106-7013
800.237.7328
_ Pse�w•com
0195*'*�`''* 11/3af13 58.800.00 $4,343.9'1_ �0.00 �4,456.09
ShareYour Credit UnionWithYour Far�nily and F'riends. »psecu.com/join
. • • . • . • . • • • • •
tn�oar w�r a�sra��eo-
CaM ar bueine�as r�rnb�s�sied at the top of�ch statennent p�ge trom BJWi-9PM Monday to F�iday�d 9AM-5PM Sadxday,o�enrise caN 800.5.5�6.5678.
SUM�iIARY OF ACCCjUNT ACT1V[TY - -PAYMENT-N�iFORMAi'iON- -
Pre�►ious Balarwe S4,�_78 d�llt�ti�g P�Ol�na��Due D�e
P� �t1.00 54,�56�19 12IZ5J2@13
Otl'�et C�+ecl�s 50.00 Bm�tL'��t�1� � _ ldi0imN0�tm�
� is323 is7.00 ie�.00 if7s.o�
Cash Advar�oes 50.00 LATE PAYMENT WARN�NG:If we do�tot r+ec�eive your mi�in�tm payn��t by the d�e
Fsss Chirqed �.1lA ���'�•Y°���nwe�o pey a S20 la�e#ee.
�'�t� �- MIN�AUM PAY#IIENT WARNtNG:if y�oti nrake aMy the n�ntm peyment e�cit period,
New Balanoe 54.456.09 ��in ir�est and�wi�iae�►+ou btger ict pay dt your befenoe.
Pas#Due Atnotnt 387.00 ,
Cre�it Limit 58.800-00 If you e�ak�e no addM�on�l Yau wiN pa�d'1 tla And ou w�a�d
Ava�ade Credit 54,343.91 ���qb - 6a�noe shown an U�is payii p an e�d
Statemet�t Clocing Oate 11I30V13 - ��
����� � ���p� 3� ��
�SavinYs�'1.o32-00)
For i�if�nabon abot�txec�t aoer�ig seivioes,caM 1-8T7�47 2'156
DETAGH t�
0195�**'"� 87.00 89.00 17G.00 12i25J13 11f3Q/13
4,456.09
AMOUNT E�Pl1Y#ENT ENCl.OSED
�t _� , ;�... . < �
36620 1 AV 0.360 O�_90t 00 OTO T181 P1 63 �E� -- �.. _`
P.o.eo�c s7o�o
� ELLEN L ARMSTRONG
607 MAGJttRO RD
EN4LA.PA 17425-1911 10009U1952DD2029827
1�l1�����11��i1,t��1'1�'�•�•�f���l����ill'��'�llill�f��lllllljili
... 0009801 t 004074 001 D S3 SAP:1.2,4,5
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p�o.,��4�
F.�o1q Pd 17025 D�ATE �CE�
(717) 732 SSS2 F�lX(717)7Zl�95�1 _
Fe�deral Tax Nr�Ler 23-24G4S43 1112�11013 i3-2619
BILL TO P�►TIEHT NA�AE: Etkn Ano�
�S� AD� b0?�R�o�d
G07 Megmv Ro�d
Et�o�,PA 17025 �: Eaola,PA 17025
PICK U�: Hply Sp�t
TAK�i TO: R+�sdm�x
DE9CRpTiOl�k St�+eldrr
_------ FUP NtA1A - --- - -- - . ..------ ------ _--- - - _- _- -- -------___ __ _ _
�i3-OOfi9a
QATE OF SEI7V... DESCRlPTI�N !�T RATE A#AOIA�(T
21�??JZ013 �Ti�a�t-1�Viy(I�e.�aber Rs�t)- 73A0 73.00
A0130
I 1t71/2013 �V�INi�'les�e-Me�ber Ra�e 3 2Sti 7S0
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����n�������.�a�� TOTAL DUE
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C�e� Y�pry�e■�t is i�e�ae�+eceipt M�ia�a��t i�ors ilo Mt a�'tii�set�►ieR If�
ee�d b etiee�t w��wc i�w�oe c��ieate�Ic�'�pL ew�es�s tr�peel�w aie A�L�. �$Q.JrQ
Ple�ue N� II�ii aca�ls�be sart 1r a�a�e�c�r a�ar�ia�s.
F������g Account No.: 06572117474
� � AMERf CAN HQMEPATIENT�' ���, ca��: B��� o�: 11l'l412013
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877-214-7913 C�pfion 4
P.O.BOX 827161
PHILADELPHIA PA 19182-7161
�i� Days
Pas� D�e'. .
�i��l,i��.�i��.1��111II�III�1'Ih�l�i•��•��•�ltt�lr�l������h��t
ELLEN ARMSTRONG
607 MAGARO RD
ENOLA PA 17025 � � Pay oniine with your credit card!
Visit www.ahom.com anytime.
Patient Name: ELLEN ARMSTRONG Statement of Account a� of 11f'i4�'201�
08/05/2013 L156367 CPAP S9 AUTOSET $1.15
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We have not received payment required on your accoun#.
To avoid forwarding o#your account to a collection • ��.�cJ
agency, please send paymen#immediatetv.
_Yt��r-�►�t��#-a��:�tior t��-��ii� r�c�►ti���ne�de�:___ _ ____�.__ __--..� -- —_ _ -----__ -.
��t�SUtdt'i0e ��y
�XCrk�l'� Mail Date:'11/18/2013
1�lember•Etie kKUrance G�oup
100 Erie hts.Pf.•Erie.P/l.16630
Premium Invoice
Nan�ed Insured
MRS ELLEN l ARMSTRONG Poiicyhotder. MRS ELLEN L ARMSTRONG
607 MAGARO RD pa��y N��� t�6070193fi
ENOLA PA 17025-1911
Policy Type: Private Passenger Auto
Policy Period: 06/07/2013-06/07/2014
sa�a5ss
_
��s4s Previous Minimum Due: $139.50
Paymen�Thank You! $139.50 CR
Net Adjustments: $0.00. �
Past 0►t�Atnou� �O.Qp
_ - �_ – --- - . __.- – -- — - _----- - ----- ---= -- -_ _--�------_-_
Curren#Instaltmen� $134.50.
ERiE A�ger�# Bi�ling Fees Due: �5.00
To in fuil-
Agent Number AA7646 P�i • . �'� �274.00
FETR - .. : � � -�
ow�NSU�►rvcE Assoc�TES�c _Minimum Due. �� �� $139.50
5299 E TRINDLE RD �Due Da#e: '��-�� 1�109/2013
MECHANICSBURG,PA 17050-3511 ` : ,: _
(717)766-32� Thank you for choosing Erie lnsurance for your
insurance r�eeds!
See Summary Page for important policy messages. �
--Want to pay#Mis�bill onl�ne?-Go to www.erieinsuraRes:com;-�ay h►iy Bi#i aneFinake a-convenient, secnre oNttr�paymErrt.---�—�- -
Othec biil payir�options are also available on our Web site. Contact your Agent with questions or coverage changes.
Fe�s will be added for any retumed payments and included on future invoices.
K�P�P P��for y�our recads/Retum bdtom P��Y'�P�t
Detach here Pc�oo4 Detsch t�ene