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HomeMy WebLinkAbout05-16-14 REV-1500 Ex(02-11) Z 1505610143 OFFICIAL USE ONLY PA Department of Revenue Pennsylvania county coda Year File Number Bureau of Individual Taxes °^°^RTMEA^or^^vo^^E PO 80x.280801 INHERITANCE TAX RETURN 21 13 1082 Harrisburg,PA 17128-0641 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 08 20 2013 04 25 1923 Decedent's Last Name Suffix Decedent's First Name MI MIDDLETON ROBERT M (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILE(}IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 0 1. Original Return ❑ 2. Supplemental Return ❑ 3, Remainder Return(Date of Death Prior to 12.13,82) ❑ 4. Limited Estate ❑ 4a.Future Interest Compromise ❑ 5. Federal Estate Tax Return Required (date of death after 12.12-52) B DoWent Died Testate 7 Decedent Maintained a Living Trust 0 B. Total Number of Safe Deposit Boxes (Attach Copy of will) ❑ (Atiac Copy Trust) ❑ 9. Litigation Proceeds Received ❑ 10.S etoweenPpvgr%Crne ait(Da�so f Death ❑ 11,Election to tax under Sec.9113(A) G f (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number GEORGE F DOUGLAS III ESQ 717 249 6333 REGISTER OF WILLS USE ONLY ry C7 �1 First Line of Address 354 ALEXANDER SPRING RO ❑ �; o r 7 1 c> c c; zI Second Line of Address r- r' �• m Fri ° DATE fk,LE City or Post Office State ZIP Code 4—� p T CARLISLE PA 17015 r � rn > o Cl) c Correspondent's e-mail address: adoualas(rDsalzmannhughos.com Under penalties of a'u I declare that I have examined this return,inGudi accam an m schedules and statements,and to the best of m knows and belief, ; it is true.00rcect and compiata.Declaration of preparer other than the personal representaytive is based on all Information of which preparer has any kr .edger. SIGNATURE PERSON RESPONSIBLE FOR FILINGRg�TURN DATE ADDRESS Aul $1 ��Jd.�,IAIi Bonnie J. Middleton dire rte_ _8384 Cypress Mill Road, Baltimore, MD 21236 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE 1 DATE Gearge F Douglas, !11 Esq. �t 1 C t ( L ADDRESS 354 Alexander Spring Road, Suite 1, Carlisle, PA Side 1 `� 1505610143 1505610143 J 1505610243 REV-1500 EX Decedent's Social Security Number D° denftN.M: .Middleton, Robert M. RECAPITULATION 1. Real Estate(Schedule A)..................................................................................... :. 1. 2. Stocks and Bonds(Schedule B).................................................. ..... 2. 13, 910 . 64 ...................... 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C)......... 3. 4. Mortgages&Notes Receivable(Schedule D)........................................................ 4. 5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 213, 612 . 22 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. - 17 , 778 . 14 7. Inter-Vivos Transfers&Miscellaneous too;Probate Property (Schedule G) u Separate Billing Requested............ 7, 34 , 860 . 40 8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 280 , 161 . 40 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 6,253 . 66 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 9, 872 . 17 11. Total Deductions(total Lines 9 and 10)................................................................ 11. 16, 125 . 83 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 264 , 035 . 57 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J)............................................... 13.: 14. Net Value Subject to Tax(Line 12 minus Line 13)............................................... 14. 264 , 035 . 57 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable - at the spousal tax rate,or transfers under Sec.9116 15. 0 . 00 (a)(1.2)X.00 . - 16. Amount ei 14 taxable - 264 035 . 57 16. 11 , 881 . 60 at lineal neal rate X X :045 r 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. 11 , 881 . 60 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 1505610243, 1505610243 J REV-1500 EX Page 3 File Number 21-13-1082 Decedent's Complete Address: DECEDENT'S NAME Middleton, Robert M. STREETADDRESS 1700 Market Street CITY STATE ZIP Camp Hill PA 17011 Tax Payments and Credits: 1, Tax Due(Page 2,Line 19) (1) 11,881.60 2. Credits/Payments A, Prior Payments 10,900.00 B. Discount 573.68 Total Credits(A +B) (2) 11,473.68 3. Interest (3) 4, If Line 2 is greater than Line I+Line 3,enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2,Line 20 to request a refund 5, If Line 1 +Una 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 407,92 Make Check Payable to: REGISTER OF WILLS AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X"IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or Income of the property transferred:...........____....... ....... x b. retain the right to designate who shall use the property transferred or its income;...................... c. retain a reversionary interest,or...........-.................................................................................................. z d. receive the promise for life of either payments,benefits or care?............................................................ 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?............................................................_........................................ .............. ❑ 34 Did decedent own an 1n trust for" or payable upon death bank account or security at his or her death?....... ❑ Q 4. Did decedent own an individual retirement account,annuity,or other non-probate property which contains a beneficiary designation?...............................................................................................__..._.......... ® ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1,1994 and before Jan.1,1995,the tax rate Imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(ill. 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 percent [72 P.S.§9116(a)(1.1)(ii)). The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and firing 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[72 P.S.§9116(a)(1)). • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings Is 12 percent[72 P.S.§9116(a)(1.3)). 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-1503 EX+(6-90) SCHEDULE B STOCKS & BONDS coMenorm6a.TMOF aFnnsnvAnu a+�mravice TAZasnunn RE510fnrC�CEDENr ESTATE OF FILE NUMBER Middleton, Robert M. 21-13-1082 All property)olmlyowned with right of survivorship must be disclosed on Schedule F. ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH Comoutershare Account Holdinos 1 78 shares of Prudential Financial,Inc. 77.82 6,069.96 PNC Investments Account No.097038397 2 100.28 shares of Blackrock Large Cap Growth Fund Class A 12.3905066 1,242.52 3 98.87 shares of MFS Mass Investor Growth Stock A 20.5498129 2,031.76 4 224.17 shares of MFS Utilities Class A 20,3702547 4,566.40 t TOTAL(Also enter on Line 2.Recapitulation) 13,910.64 (If more space Is needed,additional pages of the same size) Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule 6(Rev.6-98) Rav4508 EX-(1140) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Middleton, Robert M. 21-13.1082 tndude the Proceeds Mlitigatlw she the date the proceeds v alm received by the estate, All property)omfly-cnmetl m the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 PA Treasury Department-monthly annuity payment 334.81 2 Cash held in PNC Investments Account No.097038397 27,613.02 3 M&T Bank,Checking Account No.60116897 7,918.79 Accrued interest on Item 3 through date of death 0.05 4 Santander Bank,Certificate of Deposit Account No.2335253403 1,554.73 Accrued interest on Item 4 through date of death 0.19 5 Santander Bank,Checking Account No.0571121446 58,825.44 Accrued interest on Item 5 through date of death 0.13 6 Santander Bank, Money Market Account No.1054168261 104,46936 Accrued interest on Item 6 through date of death 25.76 7 Santander Bank,Savings Account No.0574116802 10,642.65 Accrued interest on Item 7 through date of death 0,29 8 Aetna-refund unused medical insurance premium 90.00 9 Musseiman Funeral Home&Cremation Services Inc.-refund 111.00 10 United State Treasury-2013, 1040 income tax refund 2,026.00 TOTAL(Also enter on Line 5,Recapitulation) 213,61222 (If more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group, Inc, Form PA-1500 Schedule E(Rev. 11-10) Rev-16"EX.(01.10) pennsytvania SCHEDULE F DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Middleton, Robert M. 21.13-1082 H an asset was made)ohm within one year of the decodont's data of death,It must be reloaded on schedule 0. SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT A. Bonnie J. Middleton 8384 Cypress Mill Road Daughter Baltimore, MD 21238 B. C. JOINTLY OWNED PROPERTY: DESCRIPTION OF PROPERTY_ DATE OF DEATH ITEM LETTER DATE INCLUDE NU`MBER OR SIMILAR IDENTIFYING NUMBER.ATTACH DEED FOR DATE OF DEATH DECDFS DECEDENT'S INTEREST VALUE OF NUMBER FOR JOIN MADE ALUE OF ASS INTEREST TENANT JOINT JOINTLY-HEIR REAL ESTATE. 1 A 11/10/2008 PNC Bank,Checking Account No. 35,085.75 50.000% 17,532.88 5140043128 2 A 111/1012008 PNC Bank, Savings Account No. 5000938093 0.09 50.000% 0.05 3 A 11/1012008 PNC Bank,Savings Account No.500800705 490.41 60.000% 245.21 i TOTAL(Also enter on Line 8.Recapitulation) 17,778.14 (If more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group,Inc. Farm PA-1500 Schedule F(Rev.01-10) Rev4510 FX-(09-00) SCHEDULE G pennsyivania INTER-VIVOS TRANSFERS AND DEPARTMENT OF REVENUE INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Middleton, Robert M. 21-13-1082 This sshedale most be completed and filed If the answer to any of Rucsaons 1 through 4 on page threeaf the REV-1500 Is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECDS EXCLUSION TAXABLE NUMBER THE DATE OF TROANSFERSATTACH A COPY of THE DEED FOR REAL STATE. VALUE OF ASSET INTEREST (IF APPLICABLE} VALUE 1 PNC Investments,IRA No.097038442-Beneficiary if 34,860.40 100.000% 34,860.40 decedent's daughter, Bonnie J. Middleton i i TOTAL(Also enter on Line 7,Recapitulation) 34,860.40 (if more space is needed,additional pages of the some size) Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule G(Rev.08-09) REV-1611 EX.(10-04) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND ID RTU RESNTT DECEDENT ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Middleton, Robert M. 21-13.1082 _ Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representa6ve(s) Street Address City State Zio Year(s)Commission Paid 2. Attorney's Fees Salzmann Hughes, P.C. 5,000.00 3, Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) Claimant Street Address city state Zio Relationship of Claimant to Decedent 4. Probate Fees 358.50 5. Accountant's Fees 6. Tax Return Preparees Fees 7. Other Administrative Costs 885.16 See continuation schedule(s)attached TOTAL(Also enter on line 4,Recapitulation) 6,253.66 Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-l1500 Schedule H(Rev. 10-09) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Middleton, Robert M. 21-13-1082 ITEM NUMBER DESCRIPTION AMOUNT Other Administrative Costs 1 Salzmann Hughes,P.C.-reimbursement for payment to Cumberland Law Journal for legal 75.00 advertising 2 Salzmann Hughes,P.C.-closing costs and final fees for income tax preparation,postage 600.00 and miscellaneous contingencies in order to administer the estate 3 Santander Bank-service fee to provide date of death information on accounts required in 20.00 order to administer the estate 4 The Sentinel-Legal advertising 200.16 H-B7 696A6 Copyright(c)2002 fomr software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98) Ree-0512 EX•(12-08) SCHEDULE I pennsylvania DEBTS OF DECEDENT DEPARTMENT OF REVENUE t INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Middleton Robert M. 21-13-1082 Report debt Incurred by the decedent pdor to death that remalned unpaid at the date of death,Including unmimbureed medical expenses, ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Bonnie J. Middleton -reimbursement for debts owed by decedent-medical 450.00 2 Bonnie J.Middleton-reimbursement for 2013,PA40 income tax due paid to the PA 235.00 Department of Revenue 3 NCR Manor Care Services,LLC-check written prior to death cleared after death 8,881.25 4 Heartland Pharmacy of Pennsylvania-check written prior to death cleared after death 305.92 TOTAL(Also enter on Line 10,Recapitulation) 9,872.17 (if more space is needed,additional pages of the same size) Copyright(c)2008 form software only The Lackner Group,Inc, Fom PA-1500 Schedule I(Rev. 12-08) REV-1513 EX.(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Middleton, Robert M. 21-13-1082 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(SI RECEIVING PROPERTY DECEDENT (Words) ($$$} I TAXABLE DISTRIBUTIONS (include outright spousal distributions,and transfers under Sec.9116(a)(1.2)) 1 Bonnie J.Middleton Daughter Entire Estate 264,035.57 8384 Cypress Mill Road Baltimore, MD 21236 Total 264,035.57 Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate. NON-TAXABLE DISTRIBUTIONS: II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 0-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-150D COVER SHEET Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10) / 1 LAST WILL AND TESTAMENT OF ROBERT M. MIDDLETON I, ROBERT M. MIDDLETON, of 824 Lisburn Road, Apartment 315, Camp Hill, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all former Wills, Codicils, or writings in the nature thereof, by me at any time heretofore made. FIRST: I hereby order and direct my Executrix or Executor, hereinafter named, to pay all my just debts, funeral expenses, testamentary expenses and all Inheritance, Estate, Transfer and Succession Taxes, as soon as may be conveniently done after my death, out of my residuary estate. SECOND: I own three remaining burial plots in the Rolling Green Cemetery, Camp Hill, Pennsylvania. I will be buried in one plot next to my late wife, Pauline M. Middleton. I give the remaining two plots to my daughter, cv'ivnilc 116.1". _,CIm. THIRD: I give my entire estate to my daughter, BONNIE J. MIDDLETON. In the event that my daughter, BONNIE J. MIDDLETON, should predecease me, then I devise and bequeath all the rest and remainder of my estate, both real and personal, to my sister, FRANCES JOHNSON and my brother-in-law, EUGENE HULL, in equal shares, per stirpes. LASTLY: I nominate, constitute and appoint my daughter, BONNIE J. MIDDLETON, to be the Executrix of this my Last Will and Testament. In the event that my said daughter, BONNIE J. MIDDLETON, shall be unable to serve as Executrix for any reason, I appoint my sister, FRANCES JOHNSON, as Executrix. No Executor or Executrix shall be required to file bond in this or any other jurisdiction. 3o�ra IN WITNESS WHEREOF, I have hereunto set my hand and seal this day day of 2008. Rob rt M. Middleton SIGNED, SEALED, PUBLISHED and DECLARED in the presence of: 1kt 2 COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF CUMBERLAND I, ROBERT M. MIDDLETON, Testator, 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 I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me, by ROBERT M. MIDDLETON, the Testator, this_ �61rt= day of 2008. j VV Robert M. Middleton, Testator Notary P�u is COMMONWEALTH OF PENNSYLVANIA Notanal Seal Jo Ann Seker,Notary Pubiic Camp Hill Eoro,Cumberland Courtly My Commission Expires June 30,2011 Member,Pennsylvania ASSCSIavon of Notarles 3 COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF CUMBERLAND I We,GEORCcc F• Q) �GCAS r and baai � L, a jaiya e 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 Robert M. Middleton, Testator, sign and execute the instrument as his Last Will; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our knowledge the Testator 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 GcyzC£ r. Do'A W S land id nr'P I L Sc�l%i Van this 315 Tl' day of n , 2008. Witness ']ess 'P lic COMMONWEALTH OF PENNSYLVANIA Notarial Seal Jo Ann Seker,Notary Public Camp Hill Boro,Cumberland County My Commission Etpires June 30,2011 Member,Pennsylvanla Association of Notarlell 4 alNIFIS I'I'+iE. :ri art�a;:e1 aM S,nc October 28, 2013 Marian Kinter marian.ki nterp pn c.com RE: 097038397/Robert M Middleton (Individual) Dear Marian The value of the above-referenced account on August 20,2013 is as follows: —r—Symbol/ -; Adcrued .I Amount Description - - 1 Cusip .' DOD Price DOD Value -_ Interest. r 224.171MFS UTILITIES CLASS A U_ _ FXI $ —20.37 I_4566.40405 100.28 BLACKROCK LARGE CAP_ GROWTH FD CL A MDLHX 1242.51876 IG ! — 98.87IMFS MASS INVESTOR GROWTH STOCK A MFXI 1.00;UNINVESTED CASH UNIESTED CASH N/A' $27,613.02 27613.02 NV CA — -- - — $35,453.70 $ — — - - -- _ Grand Total(Market Value+Accrued Interest) _ $35,453.70 I Date of Death price is calculated using that days closing value. If you have any questions, please contact our Estate Resolution Desk at 800-622-7086. Sincerely, PNC Investments, LLC. Estate Resolution Desk AH The summaries, prices, quotes and/or statistics contained herein have been obtained from sources believed to be reliable but are not necessarily complete and cannot be guaranteed.They are provided for informational purposes only. Past performance does not guarantee future results. NI C 30ves!menc5 LLC Meif;bor eP-1 lie Pigi f'irancL.;Scrvia:e Cruuo 4242 Carlisle Pike Camp 1-111 Pennsylvania 17011 ovww rrnccom trn?o;tint lovestneuts Ird:rrnY.on:R:c::eraye and insurance products are: P:c!PGl�lns;retl•fb,lOm!;h rarS^odfiay l.or lztee j 4/151014 Prudential Financial Ir>c.,PRU Historical Quote-(NYSE)PRU,Prudential Financial Inc.Stack Price-fNgGtwts=m � ! 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Ater 4. ra an 16.1mOs,fe, a Need".a mtl no e.fa[hvmcbidXmpa Imrodq S&PJDmyed esmanule reIborder,. AmhlNea rpae.C+eecMrge. S&P4 rorXed Im6Ce ISM Inen D.J.8 Compeast lrie. SEHK ImhedeY don b PbYa}etl q SIX am in k Information 0"b g keel WmMae daleyrd. M aaOea em M bees ncherge lama trigsJbechwts.rTaa k*atcKcmMstonc.1/ieWLasp7sy rib=pruWosedat-8%2F20%2F13$x=40&x28 1J1 p M&Tsank 499 Mitchell Road,Millsboro,DE 19966 Adjustment Services Phone 888-502-4349 F ax (302)934-2955 October 22,2013 Salzmann Hughes, P.C. Attorney at Law 354 Alexander Spring Road, Suite 1 Carlisle, PA 17015 Re: Estate of Robert M.Middleton Social Security: 196-12-6968 Date of Death: August 20, 2013 Dear Sir or Madam: Per your inquiry on October 15, 2013, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. TypeofAeeount Checking Account Account Number 60116897 Ownership(Names ofJ Bonnie J Middleton(POA) Robert M Middleton Opening Date 0212811981 Balance on Date of Death $ 7,918.79 Accruedhiterest $ .05 Total $7,918.84 For any additional information on the above accounts,including ownership and any changes,closures and/or reimbursement of funds, please call the West Shore Plaza at 717-731-1730. We were unable to locate any safe deposit box for the above-mentioned decedent. This letter does not include any accounts in which the deceased may have been listed as Power of Attorney,Custodian of Uniform Transfers, Representative Payee,or Trustee under a Written Agreement. Sincerely, Valarie Mercer Adjustment Services CZ= Court Order Processing\Decedents- MA I-MB3-02-1 0 - P. O. Box 841005 - Boston,MA 02284 October 29, 2013 a 3 George F. Douglas III, Esq Salzmann Hughes, P.C. 354 Alexander Spring Rd Suite 1 Carlisle, PA 17015 RE: Estate of Robert M Middleton A 82 Date of Death: 08/20/2013 Dear George F. Douglas III, Esq: S � Per your request, enclosed please find the account information as of the date of death g for the above-named decedent. For your information, accrued interest is not included in the date of death balance. 5 5 Please feel free to contact me if I can be of any further assistance. b a i Very truly yours, 9 s Ashley Nobrega/ [COP Specialist III] 617-514-5189 s 4 s u gE f r z yb 3g a E .2 Q' Santander Bank ESTATE OF Robert M Middleton SOCIAL SECURITY #: 196-12-6968 DATE OF DEATH: August 20, 2013 Account #: 0571121446 Type: Checking Open date: 1/5/1987 In the name of: Robert M Middleton or Pauline M Middleton (Bonnie J Middleton POA) Date of Death Balance: $58,825.44 Int.(YTD) from 1/1/2013 to 8/20/2013 $2.86 Accrued interest to date of death: $0.13 Other Info: Account#: 0574116802 Type: Savings Open date: 4/20/1995 In the name of: Robert M Middleton or Pauline M Middleton (Bonnie J Middleton POA) Date of Death Balance: $10,642.65 Int.(YTD) from 1/1/2013 to 8/20/2013 $3.09 Accrued interest to date of death: $0.29 Other Info: Account #: 1054168261 Type: Money Market Open date: 9/21/2006 In the name of: Robert M Middleton or Pauline M Middleton (Bonnie J Middleton POA) Date of Death Balance: $104,469.36 Int.(YTD) from 1/1/2013 to 8/20/2013 $187.88 Accrued interest to date of death: $25.76 Other Info: Account #: 2335253403 Type: CD Open date: 3/10/1999 In the name of. Robert M Middleton or Pauline M Middleton (Bonnie J Middleton POA) Date of Death Balance: $1,554.73 Int.(YTD) from 1/1/2013 to 8/20/2013 $4.15 Accrued interest to date of death: $0.19 Other Info: Page 1 of 1 v . JV• LV I J U. JJ�un nv Uunn nV• VJVJ I I f PN October 30, 2013 George F Douglas, III, Esq Salzmann Hughes, P C 354 Alexander Spring Rd Ste I Carlisle, PA 17015 RE: Name: Robert M Middleton SSN: 196-12-6968 DOD: 08-20-2013 Dear Sir/Madam: In response to your request for Date of Death(DOD)balances for the customer noted above,our records show the following: Checking Account Account# 5140043128 Established: 11-10-2008 ROBERT M MIDDLETON BONNIE J MIDDELTON DOD balance: $ 35,065.61 +0.14 accrued interest Interest paid 01-01-2013 thru 08-20-2013 $2.35 YTD Savings Account Account# 5000800705 Established: 11-10-2008 ROBERT M MIDDLETON BONNIE J MIDDELTON DOD balance: $490.41 +0.00 accrued interest Interest paid 01-01-2013 thru 08-20-2013 $ 0.00 YTD Account# 5000938093 Established: 11-10-2008 ROBERT M MIDDLETON BONNIE J MIDDELTON DOD balance: $ 0.09+0.00 accrued interest Interest paid 01-01-2013 thru 09-20-2013 $ 0.00 'YTD Investment Account The decedent maintained Investment Account# 97038397& 97038442. For further information, you may call the Brokerage Department at 1-800-762-6111. Page 1 of 2 V, t, ". LV I V, JIInO I 'IV vuun nV. VJUJ L Please note that this office provides date of death balances for deposit accounts(IRAs, CDs,Checking and Savings). We do not proeess any financial transactions or provide statements. If you need assistance with any of these items,please call 1-888-PNC-BANK.(1-888-762-2255)or stop by your local PNC Bank branch office_ Sincerely, National Financial Services Center PNC Bank,N.A.. Member FDIC This message is intended for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applieable law. If the reader of this message is not the intended recipient or the employee or agent responsible for delivering this message to the intended recipient you are hereby notified that any dissemination, distribution or copying of this communications is strictly prohibited If you have received this communication in error,please notify me immediately by reply or by telephone at 800-762-1775 and immediately destroy this feed document. Page 2 oft .mkern:fAm'ISRC October 28, 2013 Marian Kinter maria n.kinterta')pnc.co m RE: 097038442/Robert M Middleton(Premiere Select IRA) Dear Marian: The value of the above-referenced account on August 20, 2013 is as follows: Symbol _I' DOD Accrued Amount s Descnption Cusfp # Price i DOD Value. Interest - — -.. 510.3 AMERICAN CAPITAL INCOME BUILDER CL C I CIBCX€_$ M_j 28232.72796 I_ 6627 67 PNC BANK DEPOSIT_ SWEEP PROGRAM i OPNCO $ 1,00 6627,67 $ 34,860,40 i $ I_.__J __ i ._ Grand Total(Market Value+Accrued Interestly $ 34,860.40 ; _ i * Date of Death price is calculated using that days closing value. Beneficiary is Bonnie J. Middleton daughter If you have any questions, please contact our Estate Resolution Desk at 800-622-7086. Sincerely, PNC Investments, I.L.C. Estate Resolution Desk AH The summaries, prices,quotes and/or statistics contained herein have been obtained from sources believed to be reliable but are not necessarily complete and cannot be guaranteed.They are provided for informational purposes only. Past performance does not guarantee future results. Pic ircrostments LLr. 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