HomeMy WebLinkAbout04-25-14 J 1505610105
REV-1500 EX(02-11)IFI)
Pennsylvania OFFICIAL USE ONLY
PA Department of Revenue oe>�smexroraevexue County Code Year File Number
Bureau of
2806vi1 Taxes INHERITANCE TAX RETURN
Ha 60X280601 `� I 13 `3iq
Harrisburg,PA 17128-0601 RESIDENT DECEDENT p��
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
09102013 10021921
Decedent's Last Name Suffix Decedent's First Name MI
LUDT BETTY J
(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 FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE BOXES BELOW
i. Original Return Q 2. Supplemental Return Q 3. Remainder Return(Date of Death
Prior to 12-13-82)
Q 4. Limited Estate Q 4a, Future Interest Compromise(date of Q 5. Federal Estate Tax Return Required
death after 12-12-82)
Q 6. Decedent Died Testate Q 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of WI) (Attach Copy of Trust.)
Q 9. Litigation Proceeds Received Q 10, Spousal Poverty Credit(Date of Death 0 11. Election to Tax under Sec.9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
ROBERT G . FREY 71724358
REGISTE10DR311ILLS USE ONLY m r*1
f1
CO O i
rTi = C_;, =0 Z;; M
First Line of Address T> r-- ry m
_ rn U'I
5 S . HANOVER ST . °'. � o
n O
tD Second Line of Address - C,> O C:, � �ry 'T
OC � `? n
s m !
City or Post Office -WATT ZIP Code FILED O I
J TI
CARLISLE PA 17013
Correspondent's e-mail address: RFREY@FREYTILEY . COM
Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true correct and complete.Declension of Preparsuother than the rsonal represontative based on all Information of which oreDarer has any knowled e.
SI URE F PE N R F NG RETU 1 ATE
AD P198
r
SIGNATURE OF PREPARER OTHER THAN REPRE N `rli DATE
ADDRESS
5 SOUTH HANOV_ER STREET, CARLISLE, PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 1505610105 1505610105
r
1505610205
REV-1500 EX(FI)
Decedent's Social Security Number
Decedent's Name: BETTY J LUDT
RECAPITULATION
1. Real Estate(Schedule A).. . . .. .. ... ... ... .. ... . ... .. ... . ... ... ..... 1. 1600 . 00
2. Stocks and Bonds(Schedule B).... .. ... ..... . .. .... . ... .... ... .... . 2. 0. 00
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C).. . 3. 0 . 00
4. Mortgages and Notes Receivable(Schedule D)...... ... .... ....... ... .. 4. 0 . 00
. 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E).. ... 5. 17911. 00
6. Jointly Owned Property(Schedule F) =Separate Billing Requested. .... .. 6. 0. 00
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) =Separate Billing Requested.. .... . 7. 0. 00
8. Total Gross Assets(total Lines 1 through 7) 8 19511. 00
9. Funeral Expenses and Administrative Costs(Schedule H).... ..... ... ... .. 9. 11756. 00
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)..... ........10. 30922. 00
11. Total Deductions(total Lines 9 and 10). ... .... ...... . ...... .... ... .. 11. 42678 . 00
12. Net Value of Estate(Line 8 minus Line 11). ... .... ... ................ .. 12. -23167. 00
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J)... ... .... ....... ......13. 0 . 110
14. Net Value Sublect to Tax(Line 12 minus Line 13) 14 -23167. 00
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable at
the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X.0 0 15. 0 . 00
16. Amount of Line 14 taxable
at lineal rate X.O 45 16. 0 . 00
17. Amount of Line 14
taxable at sibling rate X . 12 17. 11 . 0 0
18. Amount of Line 14 taxable
at collateral rate X . 15 18. 0. 00
19. TAX DUE... ... ...... .. .. .. .. .. ... ..... ... ... ... . .... .... ... ... .. 19. 0 . 00
20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0
Side 2
L 1505610205 1505610205 J
REV-1500 EX(FI) Page 3 File Number 178-16-5064
Decedent's Complete Address: 21-13-1319
DECEDENT'S NAME
BETTY J LUDT
STREETADDRESS
2123 RITNER HIGHWAY
CITY STATE ZIP
CARLISLE PA 17015
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (i) 0.00
2. Credits/Payments
A.Prior Payments
B,Discount
Total Credits(A+B) (2) 0.00
1 Interest
(3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT.
FIII in box on Page 2,Line 20 to request a refund. (4) 0.00
5, If Line 1+Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 0.00
Make check payable to: REGISTER OF WILLS,AGENT.
7. _ a (,
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......................................................................................... El 13 b. retain the right to designate who shall use the property transferred or its income..........................._._.._........ ❑ ❑
c. retain a reversionary interest..................................................................................-......................................... ❑ ❑
d. receive the promise for life of either payments,benefits or care?..................................................................... ❑ ❑
2. if death occurred after Dec.12. 1982,did decedent transfer property within one year of death
without receiving adequate consideration?...........................................................:................................................ ❑ ❑
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?............. ❑ ❑
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
contains a beneficiary designation?........................................_..._................................................................
....... ❑ ❑
IF THE 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)(1)].
For dates of death on or after Jan.1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 RS.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of
assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary,
For dates of death on or after July 1,2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an
adoptive parent or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 PS.§9116(a)(1)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.§91t6(a){t3}].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-1502 EX+(12-12)
pennsytvania SCHEDULE A
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN REAL ESTATE
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Betty J Ludt 21-13-1319
All real property owned solely or as a tenant In common must be reported at fair market value. Fair market value is defined as the price at which property'
would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant fads.
Real property that is totntiy-ownod with right of survivorship must be disclosed on Schedule F.
Attach a copy of the settlement sheet if the property has been sold.
ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
1. Land locked property,West Pennsboro Township, Cumberland County 1,600.00
TOTAL(Also enter,on Line 1, Recapitulation.) Is 1,600.00
If more space is needed,use additional sheets of paper of the same size.
REV-1508 EX.(08-12) SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARENT OF
INHERITANCE TAX REVENUE PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Betty J Ludt 21-13-1319
Include the proceeds of litigation and the date the proceeds were received by the estate.
ITEM All property Jointly owned with right of survivorship must be disclosed on Schedule F.
VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Citizens Bank checking account 32.00
2. Citizens Bank savings account 3.00
3. Personal property sold at sale 17,876.00
TOTAL(Also enter on line 5, Recapitulation) $ 17,911.00
If more space is needed, use additional sheets of paper of the same size. -
REV-1511 EX+(W13)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX
RESIDENT DECEDENT RETURN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Betty J Ludt 21-13-1319 _
Decedent's debts must be reported on Schedule 1.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERALEXPENSES:
1. Ewing Brothers Funeral Home 8,470.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representatives)
Street Address
City State ZIP
Year(s)Commission Paid:
2. Attorney Fees: 2,500.00
3. Family Exemption:(If decedents address is not the same as claimant's,attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decadent
4. Partners Fees: 354.00
5. Accountant Fees:
6. Tax Return Preparer Fees:
7. Fiduciary bond 135.00
8. Advertising in Sentinel and Cumberland Law Journal 282.00
9. Bond fling fee 15.00
TOTAL(Also enter on Line 9, Recapitulation) $ 11,756.00
If more space is needed,use additional sheets of paper of the same size.
REV-1512 EX-(12-12)
pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN DEBTS OF DECEDENT,
RESIDENT DECEDENT MORTGAGE LIABILITIES & LIENS
ESTATE OF FILE NUMBER
Betty J Ludt 21-13-1319
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unrelmbursed medical expenses.
ITEM
NUMBER DESCRIPTION VALUE AT DATE
OF DEATH
1.
Citizens Bank Loan 30,922.00
TOTAL(Also enter on Line 10,Recapitulation) $ 30,922.00
If more space is needed,insert additional sheets of the same size.
REV-1513 EX-(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Betty J Ludt 21-13-1319
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Ttuatse(s) OF ESTATE
TAXABLE DISTRIBUTIONS(Include outright spousal distOutions and transfers under
Sec.9118(a)(1.2).]
John F. Ludt, IV
1. 82 Sleepy Hollow Road, Staunton,VA 24441 Son 113 of the remainder
William Ludt
2. 3 School Street, , New Hampshire 03031 Son 1/3 of the remainder
MaryJane Ludt
3. 2230 Middle Range Road, Newport, PA 17074 Daughter 1/3 of the remainder
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II—ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 0.00
If more space is needed,use additional sheets of paper of the same size.
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1
0
:::.':ksi.'vgzv..'.o":r•..n ;rs:`a'.:''r'.'%¢i.,'�iio:wr'/.�ai:1.,+..w:r"i.':yG.'v 372.00
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.F:::y9'•,O°d'':.v,`,�?N'J Y�rv.�."u': 'u;Y'..%Fnrn'bl,Gv'.': inrsi$'6�%:' ::%'yf L'.:
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v ?S>. ..�.ic.:••;rv,2,';'�wvn2'."n':�rn�"r'd'ny�:o°:G„C..r uro.b°61u
f \ S �'''°G,u�'u',f''i�rr`s'y{:':iJ'.iSs%.'::i':::i.%,.u...�...ur..:.nou..�a/i�::[.:i:'./9:':n:(.sc�r�:�.k::. Q•
r��':y':i;���%%'v°:.i'.a ii:°v:�u".r..0 ,..h.n:n.rsC..q✓.
y::g:'%�tLju��'a.:•...:r:....r7,.�<:.:f:�o-w.�..:»��.°:.'�`�:�.<5.s:.ry�<���s:.>,�Cl�':+�',+',..u'�.`'..
\\\ $ ..:.
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:, VX
IA"Ok Citizens Bank -
Account Number 6203268295
Account Title Betty I Ludt
Date Opened 10/12/2004
Account Type Checking
Principal Balance as of DOD $242.31
Interest from Last Posting to DOD $ .00
Account Balance as of DOD $242.31
YTD Interest to DOD $ .00
Citizens Bank -
Account Number 6244692883
Account Title Betty J. Ludt
Date Opened 8/6/2004
Account Type Savings
Principal Balance as of DOD $2.84
Interest from Last Posting to DOD $ .O1
Account Balance as of DOD $2.85
YTD Interest to DOD $ ,15
ROWE'S AUCTION SERVICE (RH 79L)
2505 Ritner Highway • Carlisle, PA 17015
Bill Rowe (AU 1538L) 249-1978 215-1044 574-1008 Dave Rowe (AU 2295L)
Auction Is Action Call "Rowe" For Satisfaction
SELLERS NAME S!� nC � L �4 V /}6vLt nJ DATE L�P/L f�
ADDRESS a l '>-23 'i i NyE ri N w 1 PHONE SY0'L14
OTHER -�5�� �/� 1--) ,0L5 AUCTIONEER %
AUCTION DATE/LOCATION CLERK % 2 5
DESCRIPTION OF MERCHANDISE
5en, hae, as y. yo
dC� ' e- V41Z — ea, sv
wide. — / � • oo
y,2s
I Commission the Auctioneers to sell the merchandise to the highest bidder by Public Auction. Merchandise
to be sold as is & grouped as necessary to obtain bids. I certify that I am the owner or authorized represen-
tative of the merchandise,goods and or property and have good title and the right to sell and that they are free
from all incumbrances. I agree to accept all responsibility for providing merchantable title and for delivery of
title to the purchaser. kagree to hold harmless the Auctioneers against any claims of the nature referred in
this agreement. .—
AUCTION SIGNATURE SELLERS SIGNATURE '^
Total Sales (Clerking Tickets Attached) $ o 9 D 9� •a) r//1133����11 M i V `
Less Sale Expense:
• Commission Auctioneer $ �,> O 90. 00
% Co/mmission Clerks $/3,25 00 r
OTHER: ��4 (lo S/ �� 30
` f
TOTAL SALE EXPENSE DEDUCTED $ 3x733.• 3a ��
SELLERS NET $ 1 '7
r ��
Ewing Brothers Funeral Home, Inc.
630 South Hanover Street,Carlisle,PA 17013(717)243-2421
Steven A.Ewing,FD,Supervisor,Owner Email: admin @sincel853.cem www.Since1853.com Fax: (717)243-7553
DATE 911112013 SERVICE NO. Ludt,Betty Jane
DECEASED NAME Betty Jane Ludt
DATE OF DEATH1 9/10/2013 nn tl� PLACE OF DEATH
holes ainre.¢qnl99 d eith.jGt'reuaselecte$uasglnereyQrt that are u4uiretl If we,secgeaulnedfu%l1w,9FbV a. emeterymaY�aerioorya triusemEvitems,l-oedolln e�Claid
Pay r em�'eYmP,g You Eid n approve R you se�ec{ea armXgeraedasic¢,ea a�vect c re�wn or�wm2tlafe PJ.1.9Ywe charged foQ a balming,we�itl exp�a,n y�eYow.
STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED,AGREEMENT&PROMISSORY NOTE
A. SERVICES,STAFF,FACILITIES, Special Charges
EQUIPMENT AND MOTOR EQUIPMENT Forwarding of Remains to
Basic Services of PA L.F.D. $ 1,295.00 $ -0_
Bathing and Embalming $ 895000 - Receiving of Remains from
Other Preparation of Deceased $ 295.00 $ -0-
Basic Use of Facility $ 250.00 $ -g-
Documentation Prep/Recording $ 375.00 -g-
FD/Staff Supervision VewNisit/Seriice $ -0- $
E -0-
Facility/Equip ViewNient/Service $ -0- $
FD/Staff Supervision ViewNisif/Service $ -0- $ -0-
Facility/Equip ViewNisit/Service $ -0- $ 0
FD/Staff for Interment Service $
Extended FD/Staff Usage $ -0-
Extended Facility Usage $ -0- D. ITEMS INVOLVING CASH -
Transfer Deceased to Funeral Home $ 295.00 Grave OpenBClose $ 1.595.00
Hearse Usage $ 295.00 Rock breaking charge????? $ -0-
SafetylLead Vehicle $ 140.00 The Sentinel Obituary(Est) $ 250.00
Utility Vehicle $ -0- The Patriot Obituary $ -0- -
Family Vehicle $ -0- Clergy Honorarium (Family) $ -0-
$ -0- Organist at Church(Family) S -0-
$ -0- Soloist/Cantor $ -0-
$ -0- Altar Servers $ -0-
$ -0- Death Certificates $ 30.00
S -0- Flowers $ 75.00
$ -0- Other Newspaper Obituary $ -0-
$ -0- Professional Hair Styling $ -0-
$ -0- Saturday charge for Grave Closing $ 100.00
$ -0- Vault Saturday charge $ 75.00
$ -0- $ 0
$ -0- $ -0-
B. CHARGES-FOR $ 3.980.00 $ -0-
Casket $ 875.00 $ _0
20G NG Earthtone Casket $ -0-
Outer container $ 1,395.00 $ -0 -
#12 guardian OBC $ 2.125.00 -
Vault $ -0- We charge you for our services in obtaining(specify cash advance items).
Register Book $ -0-
Thank You Notes $ 85.00
0.00 ZoI%UMMARY OF CHARGES:
Thank You Notes
$ -0- , -I���/I A. CHARGES FOR SERVICES $ 398000
$ -0- �I n,➢Y(p CHARGES FOR MERCHANDISE $ 2.365 00
$ -0- WWW�j 91�lt//..IfNN'°'C OTHER CHARGES $ -0-
$ -0- A D. CASH ADVANCES $ 2.125.00
$ -0. 0� E. SALES TAX,IF APPLICABLE $ -0-
$ -0- &&(.'1 TOTAL FUNERAL HOME CHARGES $ 8,470.00
$ -0- da - SS CREDIT AND PREPAYMENTS: a
$ 6
$ -0- $ -6-
$ -0- $ -0-
$ -g- TOTAL CREDIT $ -0-
$ 2.365.00 BALANCE DUE $ 8.470.00 -
Theonly wormnryonthehasket and f or outer burial container sold in If any law,cemele or crematory requirements have required the purchase of
connection with Nis service is the expel written warranty, If any, granted any IN the items lis,d above the law or requirement is explained below. -
Zino enorma This funeral home makes no warranty, express or Implied, OBC by cemetery
urer.h respect to the casket and/or outer burial container. OBC by cemetery
Billing To Mary Jane Ludt
Reason for Emviewin gRequested for viewing
3230 Middle Ridge Rd.Newport,PA 1]0]4 Requested Pon viewing
Newport PA 17074
hereby a ree Nat I have exommed the above stated items and found them to be correct and aereminpp to the w angemenb requested and I hereby acknowledge revel t of a copy of m s
memorandum and agreement I hereby represent that l have sufficient funds and assets legally available for payment of cash once and hereby agree and covenant loinPry and severally to
be eke YYaymen,tayy ggCC]0 DD thin 30 di Alate charge of Intel per month amounting to 12. per rar is applied to th unPad balance beginning 30 days from
reOPotetl on the this foment t acknowledge that I have eveavea the yeneml price list and have been offers Mr review the casket once at
3nC the ester banal container pace Irst
Me date IN this agreement Any additional services or merchandise orders or-requested after the date of IDis agreement will be considered pan of this agreement and the cost thereof will
ned Q �� Oated Relat�hiyJ�d
.grad
Steven A. Ewing Dated Relationship to Deceased
Name of Nneml home representative IOIIIeB
Fax Server 3/512014 8 : 18 :20 AM PAGE 1/001 Fax Server
AK
Citizens Bark
Loan Account No: 6057033918
Date: 3/5/2014
Requestor Name:
Attention To: ROBERT G FREY
Fax:'- (717) 243-6441
Customer Name: BETTY JANE LUDT
Collateral Description: 2123 RITNER HIGHWAY CARLISLE PA
You are receiving this notification as a result of your recent request for a fax payoff confirmation. To pay your
account in full, you need to remit the balance owed of$30,921.85.
The amount reflected above is your outstanding loan balance of$30,921.85 inclusive of a recording fee of
555.50 and/or an early termination fee of 50.00.This amount also includes the Fax Fee of$0.00 which was
disclosed to you at the time of the fax confirmation request.
The payoff is valid through:9/10/2013.The Per-diem is 52.53 per day if payment is received after the valid-
through date.
Payment can be made at any Citizens Bank branch or mailed to:
Consumer Finance
Attn:Payoff-RJ W230
443 Jefferson Blvd.
Warwick, RI 02886
Please check one of the following selections and sign where indicated below:
❑ By signing below, I/We request that this account be permanently closed to further advances and a
discharge of mortgage be Issued.
❑ By signing below, INVe acknowledge thatthis account is to remain open and available for future
advances and that the payoff amount is requested only for the purpose of paying down the account
balance.
r
BETTY JANE LUDT
PLEASE READ THE DISCLAIMER BELOW
Any outstanding checks or charges that are not Included In the above payoff amount are the responsibility of the customer.
The customer Is also responsible for the entire balance on the account regardless of the quoted payoff amount. H this account
`
Is secured by a mortgage, the mortgage will not be released until the above conditions are met.
The customer Mtormation contained In this fax Is only for the use as requested or authorized by the customer whose name Is
listed above. This information may not be reused for any purpose or re-disclosed to any affiliated or nonaffiliated third party
unless authorized by the customer or by Citizens Bank of Pennsylvanla, If this fax has been received In error, please destroy
this document Immediately.