HomeMy WebLinkAbout03-18-05
REV.15OC1EX ((;.OOJ
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
. '* COMMONWEALTH OF
PENNSYLVANIA
. DEPARTMENT OF REVENUE
DEPT 280601
. HARRISBURG, PA 17128-0601
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FILE NUMBER
21 05
D;:L 50S _
NUMBER
COUNTY CODE YEAR
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
FINK, CLAUDINE T.
SOCIAL SECURITY NUMBER
182-54-1011
DATE OF BIRTH (MM-DD-YEAR)
08/10/1916
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SDCIAL SECURITY NUMBER
DATE Of DEATH (MM-DD-YEAR)
12/30/2004
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
~ 1. Original Return
o 4. limited Estate
o 6. Decedent Died Testate (AlIad1copyofWlI)
o 9. litigation Proceeds Received
o 2. Supplemental Retum
o 4a. Future Interest Compromise (dale of death after 12-12-82)
o 7. Decedent Maintained a living Trust (AlIachcopyofTrusl)
o 10. Spousal Poverty Credit (date of death between 12.31-91 and 1-1-95)
o 3. Rema\m:ler Return (dale of dealh priorlO 12-1:),82)
D 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (AltachSch0)
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COMPLETE MAILING ADDRESS
2109 MARKET STREET
CAMP HILL, PA 17011
NAME
THOMAS E. FLOWER
FIRM NAME (If Appicable)
SAlOIS, SHUFF, FLOWER & LINDSAY
TELEPHONE NUMBER
(717) 737-3405
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
(1)
(2)
(3)
(4)
(5)
2,100.00
4. Mortgages & Notes Reoeivable (Schedule 0)
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5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule f)
D Separate Billing Requested
1. lnter-Yivos Transfers & Miscellaneous Non-Probate Property
(ScheduleG OI'L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Aclministrallve Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (Iotal Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for whid1 an election to tax has not been
made {Schedule J)
6,441.65
76,900.11
0.00
(6)
5,559.30
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(7)
75,682.46
83,341.76
(9)
(8)
3,565.00
2,876.65
(11)
(12)
(13)
(10)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(14)
76,900.11
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of line 14 taxable at the spousaJ tax.
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
76,900.11
17. AmouT'll. ofUne 14 taxable at sibling rate
18. Amount of Una 14 taxable at collateral rete
Decedent's Complete Address:
STREET ADDRESS
265 STONE HOUSE ROAD
CITY CARLISLE I STATEpA I ZIP
17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
3,460.50
"3 <I~C>' ....
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Total Credits (A+ B + C)
(2)
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3. InteresVPenalty if applicable
D.lnterest
E. Penalty
TotallnteresVPenalty (0 + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
0.00
',2. ~
Make Check
(5)
(5A)
(5B)
to: REGISTER OF WILLS, AGENT
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + SA. This is the BALANCE DUE.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;................................................................... ....................... 0 [Jg
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 [Jg
c. retain a reversionary interest; or........................ ............................................................n............. ..................... 0 [iJ
d. receive the promise for life of either payments, benefits or care? ...............,...................................................... 0 [i]
2. if death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ....................................."'..............."'.........................................,.......... 0 [Jg
3. Did decedent own an "in trust for" or payable upon death bank aocount or security at his or her death? .............. 0 [Jg
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .... ................................................................................................................... [Jg 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties. of perjury, I declare that I ha~e examined this rBtllm. ool.ldil'l9 acccmpar.ylng schedules and statements, and to the best of my knowledge and berlel, II IS true, correct
and complete.
Oeclarationofpreparerolherthanlhepersonalre resenlalive is based on all Informallonofwhich preparer has any knowledge.
SIG JURE OF PERSON R SPO SIBLE fOR G RETURN
DRESS
269 STONE HOUSE ROAD, CARLISLE, PA 17013
SIGN~R~ES~NTA~VE
ADDRESS
Saidis, Shuff, Flower & Lindsay, 2109 Market St., Camp Hill, PA 17011
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For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the sUNlving spouse is 3%
[72 P.S. 99116 (al (1.1) (i)].
DATE
1.;12.' 0:>'
For dates of death on or after January 1, 1995. the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)].
The statute does not exemot 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 sUlViving 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 twenty-one 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% [72 P.S. 99118(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%, except as noted In 72 P.S. 99116(1.2) 172 P.S. 99116(a)(I)].
Tile tax rate imposed on tile net value of transfers to or lor tile use of the decedent's sibiings is 12% [72 P.S. 99116(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.
REV-' 50. EX+ (6-98) ..
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
FINK, CLAUDINE T.
FILE NUMBER
21-05-_
ITEM
NUMBER
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property Jointly-owned wJth right of survivorship must be disclosed on Schedule F.
1 HOUSEHOLD GOODS AND PERSONAL EFFECTS
DESCRIPTION
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
VALUE AT DATE
OF DEATH
2,10D.00
2,100.00
REV-1509 EX+ 16-98.
COMMONI/oJEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY.OWNED PROPERTY
ESTATE OF
FINK, CLAUDINE T.
FILE NUMBER
21-05-_
If an asset was made joint within ORe year Qf the decedent', date of death, It must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. LEWIS R. FINK
269 STONE HOUSE ROAD
CARLISLE, PA 17013
SON
6. THELMA R. FINK
269 STONE HOUSE ROAD
CARLISLE, PA 17013
DAUGHTER-IN-LAW
C.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT "ADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR S1MI~ DATE OF DEATH DECO'S VALUE Of
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE, VALue OF ASSET INTEREST DECEDENT'S INTEREST
1. A. Ifff, ~
1970 CHEVY IMPALA 1,500.00 50 750.00
2. AlB Iff! M&T BANK checking account #8892247159 14,427.90 33 4,809.30
I.
I
TOTAL (Also enter on line 6, Recapitulation) $ 5,559.30
(If more space is needed, insert additional sheets of the same size)
REV-'S10 EX+ (6-9..
COMMONVllEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
FINK, CLAUDINE T.
FILE NUMBER
21-05-_
This schedule must be completed and filed if the answer to any of questions 1lhrough 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECD'S
ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER. ATTACHACQPYOFTHEOEEDFQRREALESTATE VALUE OF ASSET INTEREST (IFAPPLlCABLEl VALUE
,. Western-Southern Life Assurance Co., single-premium deferred annuity, 75,682.46 100 75,682.46
contract number W 20732136
.
.
.' . --
TOTAL (Also enter on line 7 Recapitulation) $ 75,682.46
(If more space is needed, insert additional sheets of the same size)
REV.15" EX+112.991.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FINK, CLAUDINE T.
FILE NUMBER
21-05-_
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
EWING BROTHERS FUNERAL HOME, balance after prepayment applied
1,065.00
B. ADMINISTRATIVE COSTS:
1 . Personal Representative's Commissions
Name of Personal Represenlative(s)
Social SeClJrily Number(s}/EIN Number of Personal Representalive(s)
Street Address
City
,State
Zip
Year(s) Commission Paid:
2.
AllorneyFees
2,500.00
3. Family Exemption: (If decedent's address is nol the same as claimant's, attach explanation)
Claimant
Street Address
City
Slate
.Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
3,565.00
REV-1512 EX+ {12-03}
'*
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FINK, CLAUDINE T.
FILE NUMBER
21-05-_
ITEM
NUMBER
I.
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
VALUE AT DATE
OF DEATH
'.
DESCRIPTION
Pharmerica, bill for medications
-c
689.26
2.
Sara A. Toed Home, nursing home care
2,125.39
62.00
3.
Addus Health Care
2,876.65
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX+ (g..{)O)
.
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
FINK, CLAUDINE T.
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 ~nclude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.21J
1 SUSAN C. BEAR DAUGHTER 10,000.00
2 THELMA R. FINK DAUGHTER-IN-LAW 2,404.65
3 LEWIS R. FINK SON 100.00
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18. AS APPROPRIATE. ON REV-1S00 COVER SHEET
II NON-TAXABLE DlSTRI8UTlONS,
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
. .
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1SDO COVER SHEET $ 0.00
FILE NUMBER
21-04-_
(If more space is needed, insert additional sheets of the same size)
c:\wp5] \will~\fink.cl - J972-9~-Oj
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1kctg! 3JllIill ctub Wtg!ctuttut
OF
CLAUDINE T. FINK
I, CLAUDINE T. FINK, of 265 Stone House Road, Carlisle, Cumberland County,
Pennsylvania, declare this instrument to be my Last Will and Testament, in manner and
form following:
FIRST:
I hereby expressly revoke all Wills and Codicils heretofore made by
me.
SECOND: I hereby direct my Executor to pay all my just debts, funeral and
administrative expenses out of my estate, as soon as practicable after my death.
THIRD:
I direct that all taxes which may be assessed in consequence of my
death of whatever nature and by whatever jurisdiction imposed shall be paid out of my
estate as a part of the administration of my estate.
FOURTH: 1 hereby give and bequeath the sum of Ten Thousand ($10,000.00)
Dollars to my daughter, SUSAN C. BEAR. Should my daughter, SUSAN C. BEAR,
predecease me, then in that event, this bequest shall lapse and be distributed as a part
of the remainder of my estate and shall not be distributed to the issue of SUSAN C.
BEAR.
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c;\wp5I\wills\fink.ct - 3972-93-01
FIFTH:
I give, devise and bequeath the remainder of my estate, real, personal
or mixed, whatsoever and wheresoever situate, to my son, LEWIS R. FINK. I request
that my son, LEWIS R. FINK, be generous in sharing the enjoyment of the bequest he
has received with his daughters and grandchildren.
SIXTH: Should my son, LEWIS R. FINK, predecease me, or should not be
living on the thirty-first day following my death, I give, devise and bequeath the remainder
of my estate, in equal shares, share and share alike, to my following named grandchildren
and great-grandchildren: ROSEANN BARRICK, KAREN FINK, TAMMY FINK, LINDA
FINK, TENICIA WHITE, TYGER FINK, HOLLY WESTON, and WINTER R. FINK-
PEFFER, or the survivor or survivors of the grandchildren or great-grandchildren
aforenamed in this paragraph.
SEVENTH: If any beneficiary or remainderman under this Will in any manner,
directly or indirectly, contests or attacks this Will or any of its provisions, any share or
interest in my estate given to that contesting beneficiary or remainderman under this Will
is revoked and shall be disposed of in the manner provided herein as if that contesting
beneficiary or remainderman had predeceased me without issue.
EIGHTH: I hereby nominate, constitute and appoint my son, LEWIS R. FINK,
to be the executor of this my Last Will and Testament. In the event that my son, LEWIS
R. FINK, shall be unable to serve as executor for any reason, I then nominate, constitute
and appoint my granddaughter, ROSEANN BARRICK, as executrix. No personal
representative shall be required to file bond in this or any other jurisdiction.
2
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c:\wp5I\wills\fink.CI - 3972-93-UJ
NINTH:
I nominate and appoint my son, LEWIS R. FINK, as TRUSTEE of the
share of any beneficiary who may be a minor. In the event that my son, LEWIS R. FINK,
shall be unable to serve as TRUSTEE for any reason, I then nominate, constitute and
appoint my granddaughter, ROSEANN BARRICK, as TRUSTEE. The income and/or
principal of said Trust may be accumulated or expended for the maintenance, education
and support of such beneficiary as my TRUSTEE, in its sole discretion, may determine;
and my TRUSTEE, in the expenditure of income and/or principal for such purposes, may,
at its discretion, apply the same directly or pay the same to any person having the care
or control of said beneficiary or with whom the beneficiary resides, without duty on the
part of the TRUSTEE to supervise or inquire into the application of the funds by any
person to whom payment is so made. The balance of such income and/or principal shall
be paid to such beneficiary upon reaching majority, or to such beneficiary's estate in the
event of death prior thereto.
Should the principal of any trust herein provided for be or become too small in the
TRUSTEE's discretion so as to make establishment or continuance of the trust inadvisable
or impractical, my TRUSTEE or my executor may make immediate distribution of the then
remaining principal and any accumulated or undistributed income outright to the person
or persons and in the proportions they are then entitled to income. If any such person
is then a minor, distribution may be made to his or her guardian. Upon such termination,
the rights of all persons who might otherwise have an interest as succeeding income
beneficiary or in remainder shall cease.
3
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c:\wp5J\wills\fink.CI - 3972-93-01
TENTH:
In addition to the powers conferred by case law, by statute and by
other provisions of this Last Will and Testament, my personal representative, and any
successors in that capacity shall have the following discretionary powers applicable to all
real and personal property held by them, which powers shall be effective without Order
of any Court and which shall exist and continue until the time of actual distribution:
A. To retain any property of any nature received by them for
whatever period it shall be deemed advisable;
B. To invest and reinvest all or any part of the assets of my
Estate without regard to statutes limiting the property which a fiduciary may
purchase;
C. To sell, transfer, exchange or otherwise dispose of, any part
of the assets of my Estate, for cash or on terms, publicly or privately, or to
lease, without liability on the purchasers to see to the application of the
proceeds, and to give options for these purchases without the obligation to
repudiate them in favor of a higher offer;
D. To execute and deliver any deeds, leases, assignments or
other instruments as may be necessary to carry out the provisions of this
Will;
E. To borrow money, if necessary to facilitate the administration
and closing of my Estate, including the right to borrow money from any
bank, and to mortgage or pledge any asset of the estate as security;
F. To loan to, and to purchase assets from, my Estate, even if
it is also acting as Executor thereof.
G. To assume continuance of the status of any beneficiary with
regard to death, marriage, divorce, illness, incapacity and similar incidents
4
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c:\wp.'il\wills\fink.CI - 3972-93-0j
or matters in the absence of information deemed reliable without liability for
disbursements made on such assumption;
H. To make any distribution hereunder either in kind or in money,
or partially in kind and partially in money, considering of course the
reasonable wishes of the beneficiary. Distribution in kind shall be made at
the appraised value of the property distributed, as it is set forth in the
Inheritance Tax Return filed in my Estate;
I. To exercise any subscription right in connection with any
security held hereunder, to consent to or participate in any recapitalization,
reorganization, consolidation or merger of any corporation, company or
association, the securities of which may be held hereunder; and to delegate
authority with respect thereto, to deposit investments under agreements, to
pay assessments, and generally to exercise all rights of investors;
J. To continue in any partnership, joint venture, joint ownership
or other business enterprise of which I am a part at the time of my death;
K. To compromise claims;
L. To continue for whatever period of time my personal
representative shall deem necessary any ownership as a tenant in common
or as a partner, in real estate or other property and to act as I would have
done had I been living;
M. To do all other acts in his judgment necessary or desirable for
the proper management, investment and distribution of the assets of my
Estate;
N. I direct that my Executor shall be compensated for the
services it renders to my Estate in accordance with its prevailing schedule
of fees in effect during the time when said services are rendered.
5
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c:\wp51\wills\fink.d - 3972-93-()1
O. Should any changes occur in the Internal Revenue Code or
Pennsylvania Statutes after the date of the execution of this Will which affect
the tax liability of my estate, then to the extent possible and as may be
permitted by law, my personal representative shall have the power and
discretion to interpret this Will and to administer my Estate in a manner
which results in the lowest tax liability possible.
IN WITNESS WHEREOF, I hereunto set my hand and seal this
~3;uf
day of
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,1996.
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CLAUDINE T. FINK
SIGNED, SEALED, PUBLISHED and
DECLARED in the presence of:
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c:\wp5I\wills\futk.ct - 3972-93-0l
COMMONWEALTH OF PENNSYLVANIA
55.
COUNTY OF CUMBERLAND
I, CLAUDINE T. FINK, 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; that 1 signed it
willingly; and that 1 signed it as my free and voluntary act for the purposes therein
expressed.
Sworn or
Testatrix, this
affirmed to and acknowl~dged before me,
73/uf day of .Auf~;{
by CLAUDINE T. FINK,
,1996.
_ ~A (
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L- .. ./'~( A'"f,,"'l/ -:Yl (! ~,i' \./.--c~
CLAUDINE T. FINK, Testatrix
~lU'~~h)C,y~
\ Notary Publi . '--
N01ARlALSEAL P1l>1i:
I,\ERLENEI,\~= pa
ealisle,CU E. 6.i196
My Commission ~ll'8S
7
c:\wp51\willslfink.cl - 3472-4.1-01
COMMONWEALTH OF PENNSYLVANIA
55.
COUNTY OF CUMBERLAND
We, Susan 11. Ramsey and Roqer 11. l10rqenthal
the witnesses 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, CLAUDINE T. FINK, sign and execute the instrument as her Last Will; that she
signed willingly and that she executed it 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 18 or
more years of age, of sound mind and under no constraint or undue influence.
Sworn or affirmed to and subscribed to before me by Susan 11.
and Roqer 11. l10rqenthal
;!.,'9;'2.d day of .J:1.tA/0 ' 1996.
Ramsey
, witnesses
this
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Witness
~d~aV;;/~~,
Notary%blic
00l'-1'w..SEAL
MERLENE MARHEVK.O, Not'<y Poo'"
carlisle. CUmberland County, ?e.
My COmmesion Expires SIP",!.:"
8
APPRAISAL REPORT
OF
PERSONAL PROPERTY
OF
Claudine T. Fink, deceased
date of death (d.o.d.) December 30, 2004
265 Stonehouse Rd.
Carlisle, PA 17013
for:
Lewis & Thelma Fink
269 Stonehouse Rd.
Carlisle, PA 17013
AS OF:
d.o.d. December 30, 2004
Reported on February 9,2005
BY:
IBIS APPRAISAL
SERVICES
14.5 N Hanover St.
P'Q Box ~4
Carlisle, FA 1701J
(717) ~4J-J474
lax 2.58-Q.5fY2
lbisas@eartlJinlc.net
TABLE OF CONTENTS
Table of Contents
Appraisal Certificate
Appraisal Summary
Photograph & CD-ROM Instructions
Personal Property Listing
Appraisal Summary (Copy)
References
Statement of Qualifications
Assumptions and Limiting Conditions
2
3
4
5
6
9
10
11
12
2
APPRAISAL CERTIFICATE
I hereby certify that, upon the request for the estate appraisal of the personal property of
Claudine T. Fink, deceased, 265 Stonehouse Rd. Carlisle, P A 17013, I have personally
and physically inspected the listed personal property. The personal property was
appraised to determine the FAIR MARKET VALUE, AS OF d.o.d. December 30, 2004
& reported on February 9, 2005. The date of inspection was February 6, 2005.
The information and values contained in this report are based upon my experience as an
appraiser and other reliable sources. The personal property was found to be in GOOD to
EXCELLENT condition, unless otherwise noted. Values are reported piece-by-piece,
and/or as a whole. All values reported have been determined with consideration to the
condition of the item, market conditions, and salability factors.
IBIS APPRAISAL
SERVICES
3
APPRAISAL SUMMARY
It is in my opinion, that as of d.o.d. December 30, 2004, the Fair Market Value of the
personal property of Claudine T. Fink, deceased:
(Three Thousand Six Hundred Dollars and Zero Cents)
($3,600.00)
IBIS APPRAISAL
SERVICES
//
"~ /
;c.
-: c~>-~--^
I
The report must be read in its entiretv. The Appraisal Summarv ONLY is
not the appraisal report.
4
Photograph and CD-ROM Instructions
Ibis Appraisal Services has provided you with a CD-ROM that houses all of the digital
photographs of all of the items appraised. The CD-ROM also contains a saved copy of
the appraisal report. This CD-ROM may be kept with the paper copy of the appraisal
report or kept off-site, such as a safety deposit box.
The photographs are saved in the JPEG picture format, meaning that all of the file names
end with a ".JPG".
The file names correspond to the written appraisal report's Corresponding Photograph
File that is included at the end of each item appraised.
Getting started with your CD-ROM
I. Insert the CD-ROM into your computer's CD-ROM Drive. If you do not have a
computer or access to a CD-ROM Drive--a copy store, office supply store, or public
library will be able to help you view and/or print your pictures.
2. Your computer may contain one or several different software programs that will
allow you to view your pictures. Examples of these programs are Draw, Photo Editor,
Picture It! Express, Photo Suite, My Photo Center, Photo Studio Lite, Photo Shop
Pro, Picture CD, or Photo Deluxe. The program that is included with a digital camera
is another wav to view vour pictures.
. Select the program for viewing photographs and open the program.
3. Click FILE, and Click OPEN.
4. Use the Pull-Down, "Look in" Menu and select the D Drive (D:) or whichever drive
is designated as your CD-ROM (sometimes this may be the E Drive (E:) on your
computer).
. NOTE
· Your CD-ROM Drive is designated with a small CD-ROM graphic Icon or a
cartoon representing the drive.
· The drives of your computer can be found under My Computer section of the Pull-
Down "Look in" Menu. Common Drives are: A Drive (floppy disc drive), the C
Drive (hard disc drive), the D Drive (CD-ROM Drive), and the E Drive (sometimes
CD-ROM Drive; sometimes an external drive, like a CD-ROM Writer, Zip, or Jazz
Drive).
5. Double-click on the photograph you wish to view.
5
7
8
9
10
11
12
1
2
3
4
5
6
Personal Property Listing
Furniture. Miscellaneous pieces of furniture. Pioe table, desk,
magllZine s1aDd, two plush chairs, plush couch, coffee table.
Location: Livin Room.
Television. Zenith television.
Location: Livin Room.
Milk GI.... Miscellaneous selection of milk glass.
Location: L.. Room.
~. Pair of glass crystal lamps.
Location: Li. Room and Bedroom.
Table & Chair. Oak kitchen table and four chairs.
Location: Kitchen.
Television. Zenith Space Command television.
Location: Kitchen.
Q!imj. Homer Laughlin china service for 8. Dinner plates, salad
plates, soup bowls, dessert plates, cups & saucers. Pattern: Majestic.
Location: Kitchen.
Corresponding Digital Photograph File: r0305826jpg
Corning Ware. Miscellaneous selection of Corning Ware.
Location: Kitchen.
Kilehenwares. Miscellaneous selection of kilehenwares including
Fire King, one Jadeite mug, plates, cup, utensil, pols, pans, ele.
Location: Kitchen.
Freezer. Gibson freezer.
Location: Rear Porch.
Bedroom Suite. Waterfall Depression Era four piece bedroom suite.
Suite includes armoire, double bed, vanity and dresser with mirror.
Location: Bedroom and Master Bedroom.
Corresponding Digital Photograph File: r0305827jpg
~ Twentieth century chest with mirror.
Location: Bedroom.
$300.00
$40.00
$20.00
$30.00
$75.00
$15.00
$300.00
$20.00
$50.00
$40.00
$425.00
$55.00
6
13
14
15
Side Table. Half circle mahogany side table.
Location: Bedroom.
$35.00
16
Blanket Chest. Lane cedar blanket cbest. 23" tall, 46" wide, 20"
deep.
Location: Master Bedroom.
Corresponding Digital Photograph File: r0305830jpg
$95.00
Bedroom Suite. Two piece bedroom suite. Suite includes double bed
and dresser. Maker: Mengel.
Location: Master Bedroom.
Corresponding Digital Photograph File: r0305828.jpg
$100.00
Flower Hanger. Atomic period flower pole hanger.
Location: Master Bedroom.
Corresponding Digital Photograph File: r0305829jpg
$20.00
17 Armoire. Cedar armoire. $40.00
Location: Master Bedroom.
18 Kitchen Table. Enamel top kitchen table in green. $65.00
Location: Master Bedroom.
19 Linens. Miscellaneous selection of linens. $30.00
Location: Master Bedroom.
20 ~. Signature Freezer. $40.00
Location: Front Porch.
21 Work Cabinet. Enamel top work cabinet/table. $15.00
Location: Front Porch.
22 Refrigerator. Gibson refrigerator. $40.00
Location: Front Porch.
23 Freezer. Older model Admira1 freezer. $20.00
Location: Front Porch.
24 Barrel. Vintage barrel. $15.00
Location: Basement.
25 Dinin T Ie. Victorian waInnt dinin room table. D cd. $65.00
7
Location: Basement.
26 Table. Enamel top table. $30.00
Location: Basement.
27 Table. Primitive table. Damaged. $35.00
Location: Basement.
28 Jars. Selection of canning jars. $15.00
Location: Basement.
29 Trunk. Twentieth century trunk. $25.00
Location: Basement.
30 Washing Machine. Older model wringer washing machine. $45.00
Location: Basement.
31 Vehicle. 1970 Chevv Imnala. $1,500.00
Total $3,600.00
8
APPRAISAL SUMMARY (COPY)
It is in my opinion, that as of d.o.d. December 30, 2004, the Fair Market Value of the
personal property of Claudine T. Fink, deceased:
(Three Thousand Six Hundred Dollars and Zero Cents)
($3,600.00)
IBIS APPRAISAL
SER VICES
" /%'
~-~~~----------
Alyssa i'\#{-~T.l).P.
The report must he read in its entiretv. The Appraisal Summarv ONLY is
not the appraisal report.
9
.
.
Appraisal References
Brickers, Chuck E. Auction. 93 Texaco Rd. Mechanicsburg, P A 17050
Conestoga Auction Company, Inc. 768 Graystone Rd. Manheim, PA 17545
DeHart's Auction Services & Used Furniture. 1554 Holly Pike Carlisle, PA 17013
eBav. http://www.ebay.com
Gottshall. Jr.. Rov Auctions. 113 Forge Rd. Boiling Springs, P A 17007
Hershev, Dan Auctioneering Service. 3 Brown Rd. Shippensburg, PA 17257
F. Lonev, C.A.P.P., L.P.I. 2005. Personal Communication
Ocker, Carl E. Auction. 4401 Philadelphia Ave. Chambersburg, PA 17201
Replacements. http://www.replacements.com
Rowe's Auction Service. 2505 Ritner Hwy. Carlisle, P A 17013
York Town Auction. Inc. 1625 Haviland Rd. York, PA 17404
10
Statement of Qualifications
Alyssa L. Loney, C.A.P.P.
Professional Designations and Certifications
C.A.P.P. - Certified Appraiser of Personal Propertv designation earned through course work
and classes provided by the Institute of Appraisal of Personal Property.
Archaeological Resources Protection Act - Certified to conduct investigations and damage
assessment that pertains to violations ofthe United States federal, state, and local laws
pertaining to archaeological sites and cultural properties. Including by not limited to the
Archaeological Resources Protection Act of 1979, National Historic Preservation Act of
1966, the Native American Graves Protection and Repatriation Act and the American
Antiquities Act of 1906.
Professional Accomplishments
. State Historical and Underwater Archaeologist for the State of Louisiana.
. Attended the Conservation of Indian Artifacts Symposium sponsored by the Smithsonian
Institution and the Tunica-Biloxi Indian Reservation, Marksville, Louisiana.
. Director of the West Virginia University Historical Costume Museum.
. Research Archaeologist! Artifact Instructor for CADW (Welsh Historic Monuments)/
University of York, England.
. Research and Preservation Specialist for the Maryland Historical Trust.
. Presented and published works for national and international organizations including the
Society for Historical Archaeology, Middle-Atlantic Archaeology Conference, Southeastern
Archaeological Conference, Louisiana Archaeological Society, and the Maryland Historical
Trust.
Education
B.Sc.
S.B.D.C.
Historical Textiles and Clothing, 1992, West Virginia University, Morgantown,
West Virginia, United States.
Medieval Archaeology, 1995, University of York, York, England.
Certified Appraiser of Personal Property, 2001, Institute of Appraisal of Personal
Property, York, Pennsylvania, United States.
Certified to conduct investigations and damage assessment that pertains to
violations of the United States federal, state, and local laws pertaining to
archaeological sites and cultural properties.
First Step Entrepreneurial Series, 200 I, Kutztown University of Pennsylvania,
Small Business Development Center.
M.A.
C.A.P.P.
A.R.P.A.
Presently
Director and Founder ofIbis Appraisal Services. Member ofInstitute of Appraisal of Personal
Property, American Society of Appraisers, Appraisers Association of America, International
Society of Appraisers, and Professional Coin Grading Service.
Conducts extensive on-site appraisals, assessments, analyses, and authentication of personal and
cultural property. Operates on local, national, and international levels. Conducts research on all
objects considered personal and cultural property.
11
,
Assumptions and Limiting Conditions
The term "Fair Market Value", as used in this report, is defined as follows: The highest price an
item would bring if the sale occurred under normal market conditions providing
1. neither the buyer or seller is acting under duress,
2. the property has been exposed on the open market for a reasonable length of time,
3. both the buyer and the seller are aware of the potential assets and defects,
4. no unusual circumstances are present.
This appraisal was based upon the following assumptions, limitations, and conditions:
]. The information contained in this report was gathered from sources considered reliable,
personal examination, research of authenticity and comparable sales and/or auction prices.
2. No responsibility is assumed for matters that are legal in nature, including, but not limited to:
the representation of others concerning the value, authenticity, condition, origin, or
provenance of an item appraised.
3. The appraiser assumed that a normal and careful examination of the property was sufficient
to determine its quality and condition and that no extraordinary examination procedures were
to be utilized, unless these were specially requested and the expenditure of funds therefore
authorized.
4. The appraiser's court attendance and expert testimony report, if required, are not included as
part of this report. The appraiser does have the right to refuse testimony.
THE UNDERSIGNED HEREBY CERTIFIES;
1. That] have no interest now, nor have I had an interest in the past, nor shall I
contemplate an interest in the future, in the property covered by this appraisal.
2. That to the best of my knowledge and belief, all statements and information included
in this appraisal are true and based upon objective findings and that no pertinent
information has been knowingly withheld or deleted in this report.
3. That neither the employment to make this appraisal or compensation for doing so is
contingent upon the value of the property.
It is the firm belief of the appraiser that the information furnished in this appraisal report and the
conclusions drawn from this information are true and correct, but they are not guaranteed.
IBIS APPRAISAL
/ SEf ~.ICES
/j. ln
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Aly'" itLonc ctX.I"I'.\
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-
,
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E_CCOUNT NO.
8892247159
ACCOUNT TYPE
STATEHENT PERIOD
PAGE
M&T SELECT WITH INTEREST
DEC.30-JAN.28,2005
1 OF 1
00 7 04345M M 021
4871
CLAUDINE T FINK
LEWIS R FINK
265 STONEHOUSE RD
CARLISLE PA 17013
INTEREST PAID YEAR TO DATE
1.14
STONE HEDGE
BEGINNING DEPOSITS I OTHER CURRENT ENDING
BALANCE DTHER ADDITIONS CHECKS PAID SUBTRACTIONS INTEREST PD BALANCE
NO. I AMOUNT NO. AMOUNT NO. AMOUNT
14,427.90 1 586.00 7 3,830.49 1 202.95 1.14 10,981. 60
ACCOUNT SUMMARY
POSTING DEPOSITS~INTEREST CHECKS I OTHER DAILY
DATE TRANSACTION DESCRIPTION I OTHER ADDITIONS SUBTRACTIONS BALANCE
12-30-04 BEGINNING BALANCE $14,427.90
01-03..05 US TREASURY 303 SOC SEC 586.00 15,013.90
01-04-05 CHECK NUMBER 1259 48.43
OI-D4-aS CHECK NUMBER 1260 42.41 14,923.06
01- 05.. 05 CHECK NUMBER 1258 63.00 14,860.06
aI-Io-as UNITED AMERICAN INS. PREM 202.95 14,657.11
OI-lq- 05 CHECK NUMBER 1261 2,125.39 12,531.72
01-20-'5 CHECK NUMBER 1263 62.00 12,469.72
01-25-'5 CHECK NUMBER 1264 800.00
01-25-05 CHECK NUMBER 1262 689.26 10,980.46
01-28-05 INTEREST PAYMENT 1.14 10,9&1. 60
lENDING BALANCE $lu,961.60
ACCOUNT ACTIVITY
CHECKS PAID SUMMARY
1258
1261
1264
01-05-05
01-19-05
01-25-05
63.00
2,125.39
800.00
1259 01-04-05
1262 01-25-05
48.43
689.26
1260
1263
01-04-05
01-20-05
42.41
62.00
ANNUAL PERCENTAGE YIELD EARNED
0.10 %
FOR QUESTIONS ABOUT YOUR ACCOUNT CALL 1-800-724-2440.
DO YOU HAVE "LESS-THAN-PERFECT" CREDIT OR ARE YOU SELF-EMPLOYED?
MIT'S ALTERNATIVE LENDING MORTGAGES ARE DESIGNED FOR THOSE,
- WITH HIGH MONTHLY BILLS.
- WHO HAVE DIFFICULTY DOCUMENTING THEIR INCOME.
NOW AVAILABLE IN NEW YORK, PENNSYLVANIA, MARYLAND, VIRGINIA AND WASHINGTON DC.
TO FIND OUT MORE, CALL US AT 1-800-436-0798. MIT IS AN EQUAL HOUSING LENDER.
LOC ~ II l)
I, J() Balance Your M&T Bank C'!.~ck!mLAc...f?..'!..L}!'t
J-:L'e steps to bring your checkbook balance into agreement i.1'I'th iN;;; statement.
Beqlnning with tt18 first Item on this statement pi,)(:e ;:; ':: ',:0<>\'-(;-, ~'\ .~":T;C- c?(-]Cl'l I:em that has a corresponding entry In
your checkbook register. (Place the checkmark next to f]8Ch itR'-'," \;(i:Jr I:: +:ckbook register and on this statement.)
TO DETERMINE YOUR CURRENT CHECK50(W; BAL'':.iCE
,:'..Dr: 10 the balance shown in your checkbook register IJy writln(j 'r~ ;:->:~ ;]r;i( -l,nt 0'-
""I; .Any deposits and other additions shown on this state:r:el~ti\il~iC:'; V()' ll\'e not already added: and
f\ny Interest this statement shows as creditecl [0 YULt ;--,CC:,)u!ll ",'1 !i*-H8St oarnlng account.
Irorn that total by wnting In your checkbook register ;jlt" aITiOUi:~
,_] Arl\, checks or other subtractions shown on Ulis c;t,~~E;~,fJ,l "'itl 'u :1(A enter Into your register; and
Any automatic VISA or loan payments or other el',:ct~mli(; '~r('n~,ters h)\I\~\ ,'r) this statement which you have not already
subtracted: and
:'l.,;1\, service charges shown on thiS statement which yeu ~Ia\/e nUl a!((;ady subtractf;d.
't:' ::; rEPS 3 through 8 to determine the current balance in your checking account.
List any outstanding checks (written but not yet paid by M8.T B"F1K' dnC1 oti-:8r subtractions not appearing on your
statement in the spaces provided below
I' ;;y~' is:r!'r:-!DIN~;iJ\~D OTHER SUBTRACTION?_.~
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LJ?TEP ~~~~~~~~~;~~ t~e Ending Balance
I showll onthe ~:nt of tI"Sslat:m.'e._nt____ n __-+' $
~ STEP ~_~_J u<(', -':ota~} "3ny depOSits or
Olhe!- w:il:iliions ':;11(''11''1 In yuur cnC'ckbook register !
which are rlO~ SrKi'fJri on th, J S~..:~~~len1_ _ ___ _ ~ S
STEP 6 ] {",cd the; ! nOllnts In STEPS 4 and 5, I
entu Ole loin! t ' 1 I
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.$
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~be ,{?L!_~~~l!.f:~r2~ acc:u.:!t_?~~nce- $ I
d.~ (71C~ 621::j-1QOG
local brar:cX: ,)f ~,h
~liea~'-C' contact the M&T Telephone Banking Center
3C c.", 7:.~4-?4,JO oLltside of the Buffalo area or contact your
[){'T:( .v'T',,' '.';
HAVE 'IOU IvIO\;F' n
",::1 \',/I._>,;r',
"1 m !J.J 1F,-cPHONE BANKING CENTER
P.O BOX 767
8UF':I'IL() N"r' 14240-0767
r.i5-1900 OR (800) 724-2440 OUTSIDE OF THE BUFFALO AREA TO lJETEIOlvIlNE IF ANY SCHEDULED DIRECT DEPOSIT
-0RIZED TRANSFER TO YOUR ACCOUNT HAS OCCURRFD
of Errors or Questions About Your Electronic Transfers
716) 626-1900 or (80m 724-2440 outside of the Buf1aio ctH:'c, ",',"!h' t, i;S cj'
i\1:(f BANK
'IHI": IvI&T TELEPHONE BANKING CENTEil
p,a BOX 767
0GFFAl.O. ~~y 14240-0767
'('if if 'IOU think your statement or receipt is wrong 'Jr if you r'.ec'J ,YI':;:'e information about a transfer on the statement or
"c:'r from you no later than 60 days after we sent you ihc FiFL;~ '::tterrLf:i on whictl the error or problem appeared.
'LP na.me and account number (if any)_
,)(' Ule error or the transfer you are unsure about. ana eXpla!:l ;ciS cl(;sriy as you can why you believe there is an error or why
,j :nore information
, (jo:;ar aiTlount of the suspected error.
.;i:<, \":)w complaint and wi)1 correct any error p!'Of'IDt\' ~f \'-.,(-;~ Ke'
"Y'('Lint you tnlnk is in error so that you will i10'W "C' ,-)C ~";' ~:;Ylr'
md Traders Trust Company
+, l' U'_;:3inf!ss days to do this, we will recredit your
l'loj,!n;8 ;1wkes ilS to complete our investigation.
m1 M&rBank
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2000 2001 2002
JANUARY FEBRUARY MARCH JANUARY FEBRUARY MARCH JANUARY FEBRUARY MARCH
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'USE THESE CODES WHEN RECORDING YOUR NON-CHECK TRANSACTIONS
D-DEPOSIT DP-DEBITCARDPURCHASE ATM.CASHWITHDRAWAL AP.AUTDMATICPAYMENT FT.FUNDSTRANSFER TO.TAXDEDUCTIBLE
CLAUDINE T. FINK
LEWIS R. FINK DR THELMA R FINK
265 STONEHOUSE RD
CARLISLE, PA 17013
1267
Date
50-295/313
4345
Pay to the
Order of
$
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Western-Southern Life
Assurance Company
980
Single Premium Deferred Annuity
Annual Report
Prepared on 02/01/2005
Owner CLAUDINE T FINK
265 Stonehouse RD
Carlisle FA 17013
Page 1 of 1
Western-Southern Ute appredales
your business.
Annuitant
Contract Number
Contract Date
Contract Type
CLAUDINE T FINK
W 207J21.16
Ol/28/200..~
NON (ltJALIFIED
iiiiiIii
-
iiiIi
..
.........
;;;;;;;;
~
-
E!iEi
~
IiIIII!
!!i!!!!!!Illl
... INFORMATION ABOUT YOUR CONTRACT'"
= > Total interest earned during any contract year will be impacted by any w~hdrawals, including systematic
w~hdrawals, from the contract during that year. For example, if you select the systematic withdrawal plan,
the interest you receive will be less than the amount indicated by the effective annual interest rate because
interest is being paid out rather than accumulated.
= > Effective December 13, 2004, if a withdrawal or surrender is processed on the day before your Contract
Anniversary, we will deduct the surrender charge that would apply on that Contract Anniversary, if any.
SUMMARY OF ACTIVITY
01/28/2004 through 01/2712005
Bf'grnmno Contra.ct Valup
plus
Interest Credited'
less
Systematic W~hdrawals
Partial Withdrawals
Surrender Charges
Ending Contract Value
Surrender Value-
$
75,682.46
2,762.39
.00
.00
.00
78,444.85
73,502.82
The effective annual interest rate for the contract year indicated above was 3.65% and is 3.65% for the current
year. The guaranteed minimum effective interest rate for the life of the contract is 3.00%.
- Amount available after deducting any applicable charges if you cancel your contract.
For further information about your MultiRate annuity
contract. including interest rates, contact your sales
representative or call Annuity Operations.
ANNUITY OPERATIONS
Western-Southern Life Assurance Company
PO Box 2918
Cincinnati, Ohio 45201.2918
1-800-926-1702
Customer Service Hours:
Monday - Thursday, 8 a.m. to 6 p.m., Eastern Time
Friday, 8 a.m. to 5 p.m., Eastern Time