HomeMy WebLinkAbout07-24-14 J 15056101�5
REV-1500 EX�02_��,�FI, ;�
PA Department of Revenue pennsytvania OFFICIAL USE ONLY
Bureau of Individual Taxes "`"FT� ::`"°` Counry Code Year � File Numb
PO BOx 28o6oi INHERITANCE TAX RETURN />/ � ��
Harrisbur�,PA i'7128-o6oi RESIDENT DECEDENT �� '
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYWY Date of Birth MMDDYYYY
' ' 07/26/2013 ' 11/22/1925 '
Decedent's Last Name Suffix Decedent's First Name MI
'Wintermyer ' ' ' Melvin G
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
'Wintermyer ' ' 'Carol '
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
' �73-34-3533 REGISTER �F WILLS
FILL IN APPROPRIATE OVALS BELOW
� 1.Original Return p 2.Supplementai Return O 3. Remainder Return(Date of Death
Prior to 12-13-82)
p 4.Limited Estate O 4a.Future Interest Compromise(date of p 5. Federal Estate Tax Return Required
death after 12-12-82)
� 6. Decedent Died Testate O 7.Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Wiil) (Attach Copy of Trust.)
O 9.Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death O 11. Election to Tax under Sec.9113(A)
Between 12-31-9t and 1-1-95) (Attach Schedule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
',Paul D. Daggs ' (717) 884-4963
REGISTER OF WILLS USE ONLY
First Line of Address `:;�' �
130 W. Church Street _ �z G �!'�
Second Line of Address W"�' - +
f':�_`
T�Jy�__ N � . ,_
Suite 100 r-r_�_ r- ' '
City or Post Office State ZIP Code DA�f�C'�o _ , �,
_ C�;, � ,. ,�-
Dillsburg PA 17019 �� � �= i-�
: .z.k .. `n�
p t
CorrespondenYs e-mail address:pBUI@d8ggS18w.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.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNAT E OF PERSON RESPONSIDLE FOR FILING RETURN DATE
�,�/ 03/07/2014
ADDRESS
1 Mountain View Drive, Eno a, PA 17025
SIGN/ ✓i P�AR���R THAN REPRESENTATIVE DATE
� 03/07/2014
ADDRESS
130 W. Church Street, Suite 100, Dillsburg, PA 17019
PLEASE USE ORIGINAL FORM ONLY
Side 1
� 150561�105 1505610105 �
�
� 1505610205
REV-1500 EX(FI)
Decedent's Social Security Number
DecedenYs Name: Melvin G.Wintermyer '202- '
RECAPITULATION _
1. Real Estate(Schedule A). ...................... ............. ... ...... L ', _
' 3,316.50 '
2. Stocks and Bonds(Schedule B) .......... ............. . ........... .. .. 2. .
3. Cbsely Heid Corporation,Partnership or Sale-Proprietorship(Schedule C) .. ... 3.
4. Mortgages and Notes Receivable(Schedule D) .. .. ..... .. .. .. ... ......... 4. '
5. Cash,Bank Deposits and Misceilaneous Personal Property(Schedule E)..... .. 5.
6. Jointiy Owned Property(Schedule F) O Separate Biiling Requested ... .. .. 6. , 4,932.48 '
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property '
(Schedule G) O Separate Biiling Requested.. . .. ... 7. '
8. Total Gross Assets total Lines 1 throu h 7 .. ..... ... ... 8. ' 8,248.98 '
� 9 ).... . .. .. ... .. ..
9. Funeral Expenses and Administrative Costs(Schedule H).. .. ..... ... ....... 9. ', 1,258.50 '
10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule I). .... ...... .... 10. ,
11. Total Deductions(total Lines 9 and 10)........ ... ........... .. ...... ... 1L
12. Net Value of Estate(Line 8 minus Line 11) . .................. .. ......... 12. , 6,99�.48 '
13. Charitabie and Governmentai 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. ', 6,990.48
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousai tax rate,or _
transfers under Sec.9116 6,990.48 15 0.00 '
�a)�1.2)X.0 0 ,
16. Amount of Line 14 taxable
at lineal rate X.0_ 16. '
17. Amount of Line 14 taxable
at sibiing rate X.12 ' 17.
18. Amount of Line 14 taxable '
at coliateral rate X.15 18• _
0.00
19. TAX DUE .................................... ........... ........ .. 19. _
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0
Side 2
� 15�5610205 1505610205 �
. _ _ _ _ _ ___ __
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Melvin G. Wintermyer
STREETADDRESS
1 Mountain View Drive
��7y STATE ZIP
Enola PA 17025
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 0.00
2. CreditslPayments
A.Prior Payments _._................._..._..._
B.Discount
_.— _....._._......--- __._.
Total Credits(A+B) (2)
3. Interest
(3}
4. if Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMEMT.
Fill in oval on Page 2,Line 20 to request a refund. (4} _
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5)
Make check payable to: REGISTER OF WILLS, AGENT.
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.......................................................................................... ❑ �
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
containsa 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)(i)].
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 P.S.§9116(a)(1.1)(ii)J.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 appiicable 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.§9'16(a)(1.2)],
. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineai 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 tlecedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)].A sibiing is defined,
under Section 9102,as an individual who has at least one parent in common with the tlecedent,whether by blood or adoption.
REV-i503 EX+(8-i�)
� pennsylvania SCI�IEDULE B
DEPARTMENTOFREVENUE STOCKS & BONDS
INHERRANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Melvin G. Wlntermyer
Ali property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
i' Met Life;CUSIP 59156R108;117 shares 3,316.50
TOTAL(Also enter on Line 2, Recapitulation) $ 5 � ��6. Sa
If more space is needed,insert additional sheets of the same size
REV-i5og EX+(oi-io)
` � . pennsylvania SCHEDULE F
� DEPAHTM[NT OFREVENUE
� INHER[TANCE TAX RETURN ]OINTLY—OWNED PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Melvin G.Wintermyer
If an asset became jointly owned within one year of the decedenYs date of death,it must be reported on Schedule G.
SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A•Carol Wintermyer 1 Mountain View Drive wife
Enola, PA 17025
B.
C.
JOINTLY OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR]OINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF
NUMBER TENANT 101NT IDENTIFYING NUMBER.ATTACH DEED FOR]OINTLY HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'SIPfTEREST
1• A' 168 H&R Block Common Stock Shares;CUSIP 093671105 4,932.48 50 2,466.24
TOTAL(Also enter on Line 6, Recapitulation) $ 2,466.24
If more space is needed,use additional sheets of paper of the same size.
�EV-�si� �x+ �os-zs�
� pennsylvania SCHEDULE H
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Melvin G. Wintermyer
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
g. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s}of Personal Representative(s) —
Street Address _.. __-- __. ____--- __- -....
City _... _ State ZIP__...._
Year(s)Commission Paid: ___ --.-- --- ..-
750.00
2, Attorney Fees;
3, family Exemption: (If decedenYs address is not the same as claimant's,attach expianation.)
Claimant — ---
Street Address __-- _ _- _
_ _ _... -
City - State ____.. ZIP _.._____.._____
Relationship of Claimant to Decedent..... _.....___ _____... _...___ ____....._ ____....._____..
____
4. Probate Fees: 358.50
5. Accountant Fees:
6, Tax Return Preparer Fees:
�• Estate publication fees
150.00
TOTAL(Also enter on Line 9, Recapitulation) $ 1,258.50
If more space is needed,use additional sheets of paper of the same size.
l.AST WI LL AND TESTAMENT
OF
P�IELVIN GLENN WINTERMYER
I, MELVIN GLENN WINTERMYER, of Enola, East Pennsboro
Township, Cumberiand County, Pennsylvania, being of sound and disposing
mind, memory and understanding, do hereby make, publish and declare this to be my ,
� �
Last Will and Testament, hereby revoking any and ai! Wills and Godicils previously � N
heretofore. z �
made by me at any time �
�
�
z
FIRST: i hereby direct that my personal representative(s), hereinafter named, � �
to pay ail of my just debts, not barred by any statute of limitations, as weil as my funeral �� ,
�
and testamentary expenses, including Pennsylvania inheritance Taxes, as soon after �
H
my demise as may be practicabie. �
� �
� �0
SECOND: To my wife, CAROL L. WINTERMYER, I hereby bequeath any ��
�
accounts held in my name oniy at the time of my demise, such as: � .
�
�
a. stodcs, �
�
b. checking accounts,
c. savings accounts, and
d. credit union accounts and/or shares.
i HIRD: To my wife, CAROL L. WINTERMYER, I hereby give any vehicles that
1 may own in my own name at the time of my demise.
FOURTH: i hereby devise my investment properties known as 27 iV. Humer
Street, Enola, Pennsyivania and 325 W. Dauphin and Givter Streets, Eno(a,
Pennsylvania, equaliy and per capita, to my five {5) chiidren:
�
A. to my daughter, BRENDA DARLENE MARZLOT; ''
� `�'
B. to my son, BARRY GLENN WINTERMYER; r �� ,
� f
H
C. to my son, DA�E AL�EN tNINTERMYER; ��-�._
� k�,,
D. to my son, RODNEY EUGENE WlNTERMYER; and � �
H'r:.a
E. to my son, BRtAN C.WINTERMYER � �---�..
� � .
F1FTH: i hereby devise my interest in the real estate at 152 S. Enola Drive,
�� y
�
Enola, Pennsytvania, to my wife, CAR�L L. W{NTERMYER. N �� '
� �. o --�
�t v� .-,
SIXTH : i hereby give, devise and bequeath all the rest, residue and v� �==��
�
�.
remainder of my estate to my belaved wif�, CAROL L. WlNTERMYER. �
_,
�
-•-;,,
�,
SEVENTH: i hereby nominate, constitute and appoint my beloved wife,
CARC7L L. WINTERMYER, as Executrix of this my, Last Wili and Testament. in the
event that my wife, CAROL, predeceases me, fails to qualify, ceases to act, or for some
reason is incapabfe of performir►g such task, I then nominate, constitute and appoint
my sons, BARRY ALLEN WINTERMYER and BRlAN C. WINTERMYER as alternate
Co-Executors of this my, Last Wil! and Testament.
EIGHTH: The above named person(s) sha11 not be required to post bond or
surety in this or any other jurisdicfion for faithful compiiance of the duties as
Executrix and/or Executor of my estate.
IN WITNESS WHEREOF, I hereby set my hand and seal and
declare this to be my, LAST WILL AND TESTAMENT, consisting of this and three (3)
other typewritten pages, identified by my signature, dated on this,
the�daY of �� ` --,19 �� .
t
�t�z`�,-,���-_ i��
MELVIN GLENN WINTER YER
(Testator)
The preceding instrument, consisting of this and two {2) other typewritten pages,
identified by the signature of the Testator, MEIVIN GLENN WiNTERMYER , as his
Last Wiii; who at his request, in his presence and in the presence of each other have
subscribed our names as WITNESSES hereto.
�.� �l•(�.�,�C2i Residing At t ���ur��a;n <<'��v �J�'�ve, E���,�4,
—�
�=� r ��5� ��..� }s�.. ...__�S-�• �s���� �.
� � .` �Residing At � -
�'(o�.5
COMM�NWEALTH OF PENNSYLVANIA )
)
COUNTY OF CUMBERLAND )
WE, '1YI��,L� :�.�+.►c. %r�,��'.t.. , �-`.t.� r�i, �L�.c..,c,�-�.rx.ttiz,4-- , AND
,�,,�,,.�� p���-; ,��Testator, and the witnes s, respectively,
whose names are signed to the attached and foregoing instrument, being first duly
sworn, do hereby declare to the undersigned authority that#he Testator, MELVIN
GLENN WINTERMYER, signed and executed the instrument as his Last Wili, and that
he signed and executed it wiliingiy, and that he executed it as his free and volurrtary
act for the purposes therein expressed, that each of the Witnesses, in the presence
and hearing of the Testator, MELViN GLENN WINTERMYER, signed the Wili as
witnesses, and that to the best of our knowledge and sight, MELVIN GLENN
WINTERMYER was at the time eighteen (18) or more years af age, of sound and
disposing mind, memory and under no constraint or undue influence.
�'�t,�v-� �-
� ,
MELVIN GLENN WINTER ER
(Testator)
ti
GGG�G� �,(it f l i�,--� d, ���.�
WITNESS WITNESS
Subscribed, sworn to and acknowiedged before me by MELViN GLENN
WINTERMYER, the Testator, who personaliy appeared before me, the undersigned
officer, and subscribed to and sworn to by the WITNESSES,
�a l l., i�nterm �er and i�ictne �. aµ`� , on this,
the 2 day of . �9�-•
�7y�, �c.��.�
NOT~�A�F�'Y PUBLIC
My Commission E ires: __�
,j l��.a�a�S=a•.
{:1QZ ivi.�ij`�Gi���'ei���f't'tii�f,v :
F$jjY�i?.�SU:i(J�'s4'�r. .�i�fil'�`.r�(�^:�is' 'Jt:.^.'f� i
?tf��:TF?:iSSt3f^.EXpIE25�lifit'Cf 1�,4�r��
�;`i6i7k.`Ef.��Ot i�}�Tf3a.
Page 1 of 2
• �omputershare
�� ' � Computershare
� PO Box 43006
= Providence,RI 02940-3006
� Within USA,US territories fr Canada 800 649 3593
� Outside USA,US territories 6 Canada 201 680 6578
_ �2 0 6 31 Hearing Impaired(TDD) 201 680 6611
= vwuw.computershare.com�nvestor
� ���'I�'����'I'�����i�l�ll'll�ll'�'��"����'�I����II�I"'I�'����'I MetL'rfe,lnc.isincorporatedunderthelawsofthe
= MELVIN G WINTERMYER State of DE.
= 1 MOUNTAIN VIEW DR
� ENOLA PA 17025-1532 Holder Account Number
=
= C0059568582
=
Ticker Symbol MET
CUSIP 59156R108
Transaction(s)
I Trust Interests CUSIP I Class
Date Transaction Description I (Shares) I Description
07 Apr 2000 Opening Balance 28.000000 59156R108 Trust Interests
Account Information: Date:07 Aug 2013(Excludes transactions pending settlement)
Trust Interest I Price Value($)
(Share)Balance Per Share I
49.50 1,386.00
28.000000
This Transaction Advice is your record of lhe indicated Trust Interests being credited to an account on the books of the referenced transfer agent.The Transaction Advice should be kept with your
important documents as a record of your ownership of these securities.These Trust Interests are transferable only as permitted under the MetL'rfe Policyholder Trust Program.Please read the
important information on the back of this form and in the MetL'rfe Purchase and Sale Program Brochure.
� ^` 01JEJA
IMPORTANT:Carefully cut along the dotted line and retum the form BELOW to the address provided. „ ' �
---- -
---�-,-.-_--_-__-_-_ -----
_ , __—_ _ -
__. . _.
—._.._.
Purchase Instructions Hoider Name:MELVIN G WINTERMY
(See reverse side to SELL) Holder Account Number
If you wish to request a purchase,detach,complete and retum this form.
Make check in U.S.dollars payable to the MetLife Purchase Program. COO'rJ9'rJ6�'rJHZ I N D
Attached is a check in the amourd of:
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• No third party checks,money orders or credit card payments witl be accepted. IIIII�II�II�I���I�III�III�IIII���IIII���I���III�IIII�'����IIIIII�
• Please write your holder account number and the company name on your check.
• This form should ONLY be used for MetL'rfe,i��. Computershare
• The enclosed amount will ONLY be applied to the account referenced to the right. PQ BOX 6��6
Minimum investment$250(except as described in the Purchase and Sales Carol Stream, IL 60197-6006
brochure).
OOOOOOOOMETL SPP3 C 0059568582
Please detach this portion and mail it to the address provided on the right. ,
001 CS0003.d.mix.0A4938_4 1 69/02063 1/0305 87fi3
_ __ _ . _
Page 1 of 2
� �omputershare
= et ' e Computershare
— PO Box 43006
Providence,RI 02940-3006
= Within USA,US territories 6 Canada 800 649 3593
� Outside USA,US territories 8 Canada 201 680 6578
- �2 0 6 3 2 Hearing Impaired(TDD) 201 680 6611
— www.computershare.co�nvestor
MetL'rfe,Inc.is incorporated under the laws of the
= MELVIN G WINTERMYER State of DE.
� 1 MT VIEW DR
— ENOLA PA 17025 Hoider Account Number
=
= C0059568591
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Uncertified accounts are subject to withholding taxes Ticker Symbol MET
on dividend payments and sales proceeds. CUSIP 59156R1os
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Transaction(s)
Date I Transaction Description Trust Interests I CUSIP I Class
(Shares} Description
07 Apr 2000 Opening Balance 39.000000 59156R108 Trust Interests
Account Information: Date: 07 Aug 2013(Excludes transactions pending settlement)
Trust Interest Price I Value($)
(Share)Balance Per Share
39.000000 49.50 1,930.50
This Transaction Advice is your record of the indicated Trust Interests being credited to an account on the books of the referenced transfer agent.The Transaction Advice should be kept with your
important documents as a record of your ownership of these securi6es.These Trust Interests are transferable only as permitted under the MetL'rfe Policyholder Trust Program.Please read the
important iniormation on the back of this form and in the MetLife Purchase and Sale Program Brochure.
°dG IMPORTANT:Carefully cut along the dotted line and return the form BELOW to the address provided. ; ;c,��,-. '�+r' o��E�A
------------------------------------------------------------------------------------------------,-5 --------------
PUI'ChBSe InStt'UCtiOns Holder Name:MELVIN G WINTERMYER
{See reverse side to SELL)
If you wish to request a purchase,detach,complete and retum this form. Holder Account Number
Make check in U.S.dollars payable to the MetLrfe Purchase Program. COO'rJ9'rJGH'rJ9� I N D
Attached is a check in the amou►�t of;
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• Nothird party checks,money orders orcreditcard payments will be accepted. IIIII�II�I�I�II��I�II'I���III�"����I��'I�"���1����'�'�'�����I��
• Please write your holder account number and the company name on your check.
• This form should ONLY be used for MetLife,i��. Computershare
• The enclosed amount will ONLY be applied to the acwunt referenced to the right. PQ BOX 6��6
Minimum investment$250(except as desaibed in the Purchase and Sales Carol Stream, IL 60197-6006
brochure).
OOOOOOOOMETL SPP3 C 0059568591
Please detach this portion and mail it to the address provided on the right.
OO1CS0003.d.mix.044938_4169/02063?1030i88/i3
55321120
Direct Registration Transaction Request visit shareowneroNine.com or see reverse side for
Mail to: Wens Fargo Shareowner Services HRB1 4003659436 additional transaction requests. ,�,
� H&R Blodc,Inc.
PO Box 64874 Deposit shares in my
St Paul MN 55164-0874
Direct Registration ❑ Ptan ❑
� Please change mY address as indicated.
A(!registered owners MUST sign on the back of this form. You must submit your stodc certificate(s).
Do not erulorse your certlfica�es-
CAROL L WINTERMYER 5end the unsigned certificates and�mpleted Transadion Request
1 MOUNTAIN VIEW DR Fomi to Shareowner Services.1110 Centre Pointe Curve,Suite 101,
ENOLA PA 17025-1532 Mendota Heights,MN 55120�100.We recommend that you use
traceable mail and insure the padcage for 2°k of the current market
value.
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Direct Registration Account Statement
H&R BLOCK� IMP4RTANT�Re#ain this s�ateme�rt�`or�tour investment,taQC and cost-ba�is c�scorc�. '
Vsit shareowneroe��ne-com a�ime to acxess acoount i�ormation,obtain fortns,and complete
transactions.U.S.telephone number:888-213-0968 Local and Outside U.S_:651-450-4064
Account Summary H8R Block,Inc.Common Stock Account# 4003659436
February 6,2014
CAROL L WINTERtiAYER CUSIP Number. 093671105
1 MOUNTAIN VIEW DR
ENOLA PA 17o25-1S32 Account Value 02/06/14
Market Value Date
Market Value Price $29.3600
Totai Market Value $4,932.48
Year to-Date Amounts g0.00
Service Charges Paid by You $0.00
Share Balanaes Commissions Paid by You $o�
Direct Registration 168.000 Federai Tax Withheld
Divide�d Reinvestment Plan 0.000 Nonresident Alien Tax Withheld $O.�
Totat Shares 168.000 State Tax Wdhheld
Trstls�ction or TransacUon Price p�r Gross Ssrvios Brokerape N�t AmourK Number of Diroct Rsp�°n
�t � ghare Amount Charpe Commission
Sharos Balanca
-- ___. .a.boo--
Bq{J�i�1C��ORWARD �
O2/O6%2014' 7ransfer - ±. $��_--- $0.00 �_ :&0.00 $0.00 `$0.00 168.000 168.000
The transaction(s)has beer�pr�cessed as instructed.
':qs reqrjiced by.Federal tax regulations,111/e(is Fargo Shareowner Servic�s nses FtE(3(Frst In.Frst Out)as the defaWt method of disposing of shares.T�select
' crtlter meU�od of di.s 'tion� - ta�t lots.--. must rovide ; in�rsidion in writi �and indutle the a Uisition'date and shar+�amouM.
Sale F6e�: Bah:h-515.Market-525.LlmidSboP•i30.Mua i0.10 P�;share commission.An addiHonal i5 fee w111 be clarged fordhect dePosR of sale proceeds.
The sha►es represented bY th�statement are fuly Paid aMl iwn-assessable.This statement is a record of addcessee rights at the time o�fSissue�S�n�De ae�ry°f��whichtmay be�
conveys no righfis to W@�P�rd.This stalement is neither a negotiabie instrument nor a security.A fuil copy of any rights.privite9
attached to fhe securities aovered bY�S sta�e�t can be obtained bY writm9 to the Secretary of tt�e Company.
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