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
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> 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
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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.
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i Very truly yours,
9
s Ashley Nobrega/
[COP Specialist III]
617-514-5189
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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
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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
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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
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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.
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