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HomeMy WebLinkAbout07-21-14 (2) J 1505610105 REV-1500 EX(02-11)(FI) Pennsylvania OFFICIAL USE ONLY PA Department of Revenue 280601 1 Taxes DEPARmEmor REY Ns County Code Year File Number PO BOX 2806 Bureau vi INHERITANCE TAX RETURN u Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW 10272013 08021924 Decedent's Last Name Suffix Decedent's First Name MI STOVER HELEN P (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 Q 1. Original Return 0 2. Supplemental Return 0 3. Remainder Return(Date of Death Prior to 12-13-82) 0 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 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) - (Attach Copy of Trust.) 9. Litigation Proceeds Received Q 10. Spousal Poverty Credit(Date of Death [] 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 7175435838 REGIS®WILLS USFONLY First Line of Address %�: N r l- T 5 S . HANOVER ST. Second Line of Address y � ' C7) D ( Q City or Post Office State ZIP Code DATE FILED t 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.Declaration of Dreparer other than the personal representative is based on all Information of which preparer prep has any knowledge, SIGNATURE OF PERSON R,,.ESSPPgNSIBLE FOR FILING RETURN DATE ADDRESS V� 136 F STREE CARLISLE, PA 17013 SIGNATURE IA AR TH R T-RAW RE PR ENTATIVE DATE 1 % . ION ADDRESS 5 SOUTH HANOVER STREEYIARLISLE, PA 7013 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610105 1505610105 J J 1505610105 REV-1500 EX(02-11)(FI) OFFICIAL USE ONLY PA Department of Revenue Pennsylvania Count Code Year File Number P OEP/.RRAENi Of REVEXVE y Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW 10272013 08021924 Decedent's Last Name Suffix Decedent's First Name MI' STOVER HELEN P (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 Q 1. Original Return Q 2. Supplemental Return 0 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) 0 6. Decedent Died Testate 0 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) Q 9. Litigation Proceeds Received Q 10. Spousal Poverty Credit(Dale of Death Q 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 7175435838 REGISr5 OF WILLS USE:. NLY C ;z -' -JzJ' Y C_ First Line of Address M 5 S. HANOVER ST . C/-,=' ry :_8 _1 Second Line of Address City or Post Office State ZIP Code DATE FILED f— 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.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RE ONSIBLE FOR FILING RET DATE /�/ ADDRESS 136 F ST T CARL SLE PA 17013 SIGNAT PRE RE HE HAN RE ESENTATIVE DATE ADDRESS 5 SOUTH HANOVER STREET 0 ARLISLE PA 7013 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610105 1505610105 J 1505610205 REV-1500 EX(FI) RECAPITULATION 1. Real Estate(Schedule A). . . . . . . . . . . . .. . .. . . . . . . . . ... . . . . . .. . . .. . ... 1. 226600. 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. 26635 . 11 6. Jointly Owned Property(Schedule F) =Separate Billing Requested. . . .. .. 6. 11. 00 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) =Separate Billing Requested. ... . .. 7, 22892. 29 8. Total Gross Assets(total Lines 1 through 7). .. . .. . .... ... . .. . ... . ... . . 8. 276127. 40 9. Funeral Expenses and Administrative Costs(Schedule H). . . ... . . .. . .. . ... 9. 29279 . 91 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1).. . .. .. . .. . . .10. 1676. 13 11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . 11. 30956 . 04 12. Net Value of Estate(Line 8 minus Line 11). . . . . . .. . . . . . . . . . . . . . . . . .. . . 12. 245171. 36 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J). . .. . ... . .. . . .. . .. . . .. .13. O . 110 14. Net Value subject to Tax(Line 12 minus Line 13). . . . . . . ... . .. . . . .. . . . . 14. 245171, 36 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 atlinealratex.o 45 245171. 36 16. 11032 . 71 17. Amount of Line 14 taxable at sibling rate X .12 17. 0. 00 18. Amount of Line 14 taxable at collateral rate X .15 18. 0. 00 19. TAX DUE.. . .. . .. .. . .. .. . . . . . . . .. . .. . . . . .. .. . . .. . .. . . . .. . . .. . .. . . 19. 11032. 71 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0 Side 2 L 1505610205 1505610205 J uaaaaaaaa�i REV-1500 EX(FI) Page 3 File Number 201-16-4554 Decedent's Complete Address: 21-13-1193 DECEDENT'S NAME HELEN P STOVER STREETADDRESS 648 YORKSHIRE DRIVE CITY STATE ZIP CARLISLE PA 17013 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 11032.71 2. Credits/Payments A.Prior Payments B.Discount Total Credits(A+B) (2) 0.00 3. Interest (3) 4. if Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT. Fill 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) 11032.71 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......................................................................................... ❑ IK 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, 1962,did decedent transfer property within one year of death without receiving adequate consideration?............................. ...-..................................................... ❑ El 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)(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 P.S.§9116(a)(11)(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 PS.§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-1502 EX+(12-12) pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Helen P Stover 21-13-1193 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 facts. Real property that is jointly-owned 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 DESCRIPTION OF DEATH 1. 648 Yorkshire Drive, Carlisle, PA 17013; Assessed Value 226,600.00 TOTAL(Also enter on Line 1, Recapitulation.) $ 226,600.00 If more space is needed,use additional sheets of paper of the same size. REV-150a EX,(08-12) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT TAX REVENUE RETURN INHERITANCE TAX RET PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Helen P Stover 21-13-1193 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Santander Bank account no. 2891042549 1,787.02 2. 3. Wells Fargo checking account 6,578.55 4. Wells Fargo certificate of Deposit 5,001.90 5. Wells Fargo certficate of deposit 5,001.90 6. 1992 Buick Regal, sale price 1,200.00 7. Personal property sold at public sale 4,832.50 8. Personal property sold at yard sales 219.75 9. ING check payable at time of death 116.00 10. Franklin Templeton check payable at time of death 112.00 11. Deutsch Asset Management check payable at time of death 50.00 12, Refund: Sentinel 65.98 13. Cash on hand 1,486.27 14. Lottery ticket and cash 5.69 15. Medical Insurance refund 90.42 16. Comcast refund 87.13 TOTAL(Also enter on line 5, Recapitulation) $ 26,635.11 If more space is needed,use additional sheets of paper of the same size. REV-1510 EX+(08-09) SCHEDULE G pennsylvania INTER-VIVOS TRANSFERS AND DEPARTMENT OF REVENUE INHERITANCE TAX RETURN DECEDENT MISC. NON-PROBATE PROPERTY RESIDENT D ESTATE OF FILE NUMBER Helen P Stover 21-13-1193 This schedule must be Completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % DECD'S EXCLUSION TAXABLE NUMBER THE DATE OFTFANSFER,ATTACHACOPVOF THE DEED FOR REALESTATE. VALUE OF ASSET INTEREST °`A"°°'°L`I VALUE 1. IRA with FSC Securities 22,892.29 100.00% 0.00 22,892.29 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 TOTAL Also enter on Line 7, Recapitulation)$1 22,892.29 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+(08-13) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND RESIDENT ED RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Helen P Stover 21-13-1193 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Cumberland Valley Memorial Gardens 1,906.00 2. Ewing Brothers Funeral Home 9,818.42 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State ZIP Veans)Commission Paid: 2. Attorney Fees: .. 7,500.00 3. Family Exemption:(If decedent's address is not the same as claimant's,attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: 366.50 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. Advertising costs in the Sentinel&Cumberland Law Journal 302.45 8. Expenses of Real Estate pending sale, see itemization attached 9,222.64 9, Kruger Rentals, public sale 121.90 10. Santander Bank fee 20.00 TOTAL(Also enter on Line 9, Recapitulation) $ 29,279.91 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 Helen P Stover 21-13-1193 Report debts Incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 2. 3. 4. Cumberland Crossings, final bill 1,380.00 5. Carlisle Digestive Disease Assoc. 37.28 6. Walnut Bottom Family Practice 20.54 7. Carlisle Regional Medical Center 238.31 TOTAL(Also enter on Line 10,Recapitulation) $ 1,676.13 If more space is needed,insert additional sheets of the same size. REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Helen P Stover 21-13-1193 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTR I BUTI ON S[include outright spousal distributions and transfers under Sec.9116(a)(1.2).] Louise S. Nicholson 1' 136 F Street, Carlisle, PA 17013 Daughter 1/3 Leslie C. Stover 2' 4 Springview Road, Carlisle, PA 17015 Son 1/3 Larry R. Stover 3' 404 Beetem Hollow Road, Newville, PA 17241 Son 1/3 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. Real estate expenses: Shipley Energy $ 483.00 Rynard Lawn Service,snow removal $ 33.92 Borough of Carlisle, water and sewer $ 83.82 PP&L $ 40.78 Encompass Insurance $ 149.75 Shipley Energy $ 39.00 Shipley Energy $ 523.86 PP&L $ 17.12 PP&L $ 20.65 Rynard Lawn Service, snow removal $ 216.24 Encompass Insurance $ 149.75 Shipley Energy $ 39.00 Shipley Energy $ 39.00 Shipley Energy $ 578.32 PP&L $ 36.82 Encompass Insurance $ 149.75 Shipley Energy $ 39.00 Borough of Carlisle,water and sewer $ 72.90 PP&L $ 35.87 Shipley Energy $ 39.00 Shipley Energy $ 498.79 Rynard Lawn Service, snow removal $ 42.40 PP&L $ 35.24 Encompass Insurance $ 89.50 Shipley Energy $ 66.25 Charles Holtry,Tax Collector $ 1,246.46 Shipley Energy $ 44.95 PP&L $ 40.83 Encompass Insurance $ 99.25 Shipley Energy $ 44.95 Rynard Lawn Service $ 33.92 Borough of Carlisle, water and sewer $ 74.82 American Modern Select Insurance $ 340.98 Encompass Insurance $ 11.25 PP&L $ 41.24 Rynard Lawn Service $ 135.68 Shipley Energy $ 44.95 Shipley Energy $ 274.10 PP&L $ 64.21 American Modern Select Insurance $ 197.56 Rynard Lawn Service $ 135.68 2014-15 School Real Estate Tax $ 2,872.08 Total $ 9,222.64 Property Mapper Cumberland County, PA A 648 YORKSHIRE DRrVE' )UNTY PTN: 04-22-0461-011 Owner. STOVER,HELEN P Land Use Code: 101 10�0 O y , / �r J�.yf— it ` Clean&C�Status: Squam Feet Qj Copyright 2011 Esri. All rights reserved. Tue Oct 29 2013 09:38:21 AM. 648 YORKSHIRE DRIVE PIN: 04-22-0481-011 Deedbook: 0022U-00727 Owner: STOVER, HELEN P Land Use Code: 101 Property Type: R Acreage: 0.42 Square Feet: 2156 Taxable Status: T Clean &Green Status: Land Assessed Value $: 54000 Building Assessed Value $: 172600 Total Assessed Value $: 226600 Sale Price $: Sale Date: Year Built: 1968 Municipality: CARLISLE BORO 3RD WRD Height in Stories: 2 Type of Dwelling: DETACH Primary Exterior: Aluminum Basement Percentage: Air Conditioning: NO Total Rooms: 8 Bedrooms: 3 Full Bath: 1 Half Bath: 2 DAVWSON, VELENCIA & BENKOVIC, INC. 6018 LINGLESTOWN ROAD, HAMUSSURG, Pty 17112 Cr PHONE: (717) 652-6901 FAg ( '�71 540-4280 To: r Fro n. C Lire C/AA ` Fax Number: ( ) Pages (incl. Cover) Date: Time: t 1 ao63 a %�`L M• Re: 1. E leik 54ot Jcai CC: ❑ Originals to Follow ❑ Urgent ❑ For Review ❑ Please Reply ❑ Please Acknowledge Rece'ip't by Phone, Fax or Email COM1MENTS: Seaari#cs and ianvesianent advisoiT son>icas offered arough TSCSa=ri.iics Corporation, M&nt cr FZU%'.A/,5r'C a registuved inve.Ttnsant advisor: Xnsurance services offered through Davidson, Velenaia,&Bo?zhovtc,Inc. is not of Uatad with FSC Securities Corporation or register•ad as a broksrJdealar or invemncnt gdvisor: i00 'd OHI`0b9t [L '°N Xy3 ti( ink WN N :90 HI 6tH-ZI-AO Holdings by Investor Helen P Stover Bill Davidson - Combined Account Portfolio 648 Yorkshire Dr FSC Securities Corporation Date: 10/27/2013 Carlisle, PA 17013 6018 Linglestown Rd Created: 11/072013 Harrisburg, PA 17112 717-662-6901 Helen P Stover Acct Name:BNYM I S TRUST CO CUST FOR THE IRA OF HELEN P STOVER 648 YORKSHIRE DR CARLISLE PA 17013- 3550 Acct No:00011112763 AcctType:IRA Rep.No:75T ;/Csset Name, Ticker Asset Type Mgt Name Quari t Price(S) Value(f); VAIRTUS STRATEGIC GROWTH FUND PSTAX US STOCKS VIRTU$MENT 160.50 12.07 1,816.52 PARTNERS Amount7otal: $1,816.52 Acd Name:DWS TRUST COMPANY CUST FOR THE IRA ROLLOVER OF HELEN P STOVER 648YORKSHIRE DR CARLISLE PA 17013-3550 Acct No:00900372075 Acct Type:IRA Rollover Account Rep.No:75T .Asset Namf --- -Ycker ✓ASSetTypeT Mgt Name -.Quantity wPrice(S)"�^.--�Valor(f)� DWS U-S.GOVT SECURITIES A KUSAX BONDS DWS 25623 8.22 2.106.17 SDER INCVUESDTMENTS . Account Total: $2,106.17 Acct Name:FTB&T CUST FOR THE ROLLOVER IRA OF HELEN P STOVER 648 YORKSHIRE DRIVE CARLISLE PA 170133550 Acct No:000002970215120 AcctType:IRA RolloverA000unt Rep.'No:75T ,Asset Name .x. Ticker Asset Type .-,✓.�.-Mgt Name ^-- Quantify Price(S) _ Value(f) WX TEMPLETON WORLD FUND- TEM NON-US STOCKS FRANKLIkr EM 395.3] 19.95 7,887.55 CLASS A PLETON FUNDS Awount Yotal: $7,887.55 Acct Name:HELEN P STOVER 648 Yorkshire Or Carlisle,PA 17013 Acct No:C031836LM AcetType:IRA Individually Established Asset Name Tit:ker AssatType. Mgt.name -.Quantity -_ Price(S)--- -Value(i) .ING RETIREMENT MODERATE BONDS 'INGVARINBLE 890.06 1245 11,082.05 ANNUITIES Account Total $11,082.05 InvestorTutal: $22,89229 IncongAete if pmserftd wfvmt aocompanyln9 dlsdmura pages Page 1 of 2 d00 Id )HZ DSLlL '0N XVd WV ZZ :90 101 MI -dI-AON Santander Bank ESTATE OF Helen P Stover SOCIAL SECURITY#: DATE OF DEATH: October 27, 2013 Account#: 2891042549 Type: Checking Open date: 5/30/2002 In the name of: Helen P Stover(Louise S Nicholson POA added 10/17/13 Date of Death Balance: $1,787.02 Int.(YTD) from 1/1/2013 to 10/27/2013 $0.00 Accrued interest to date of death: $0.00 Otherinfo: Page 1 of 1