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Home My WebLink About10-17-14 � REV 1505610143 —1500 Ex�oZ„> �: PA Department of Revenue pennsylvania OFFICIAL USE ONLY Bureau of individual Taxes oEPar+rMeNroFaeveNue County Code Year PO BOX.280601 Fite Number Harrisburg, Pq �7�28-oso� �NHERITANCE TAX RETURN 21 14 ENTER DECEDENT INFORMATION BELOW RESIDENT DECEDENT 0285 Sociai Security Number Date of Death 246 92 gg54 DateofBirth 01 27 2014 03 09 1955 ARTI S Suffix DecedenYs First Name DONNIE M� (�f Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name A.RTIS Suffix Spouse's First Name B.A.RBA� MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE FILL IN APPROPRIATE OVALS BELOW REGISTER OF WILLS LX� 1. Original Return �� 2. Supplemental Return �� 3. Remainder Retum(Date of Death �� 4. Limited Estate Prior to 12-13-82) �,) 4a. Future Inferest Compromise (date of death after 12-12-g2) r_1 5. Federal Estate Tax Return Required � 6 Decedent Died Testafe (Attach Copy of Wili) (_l 7. Decedent Maintained a Living Trust 0 (Attach Copy of rrusq —__ 8. Total Number of Safe Deposit Boxes � � 9. Litigation Proceeds Received �� p Spousal Povert Creait��ace of Dea�h - between 12-31-�91 and -1-g5) r� ��.Election to tax under Sec.9113(A) (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name �n7M D SCHRACK III ESQ Daytime Telephone Number 717 432 973,�, � �--, �� REGIST�2�WILLSQ�E O�O C:n r� First Line of Address ;1 �? ,,�. --.� .,J �.� T _ � . .f ;,_;,4 124 W HARRISBURG STREET '-� -� `� r'� _. , � `�� Second Line of Address ' _. ,�-, , r.._,; •-A-; ;'� `%"1 —3 'vI � � <� City or Post Office --�DATE FIIED � rn DILLSBURG State ZIP Code __ ' + PA 170191268 � � CorrespondenYs e-maii address: schracklaw@comcast.net Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowiedge 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 RESPONSIB^LE FOR FILING RETURN �/ r DAT ADDRESS � Barbara Artis �'� � 22 Bi Ho enue Mechanicsbur PA 17055 SIGNATURE PREPAR T �HAN EPRESEN ATE Wm. D. Schrack III Esq. ADDRE S / 124 W. Harrisburg Street, Dillsburg, PA 17019-1268 L Side 1 1505610143 � 1505610143 � � 1505610243 REV-1500 EX DecedenYs Social Security Number Decedent's Name: ACtIS� Donnie -- - ----- ----- --- -- RECAPITULATION -- - 1. Real Estate(Schedule A)............................. .......................................................... 1. 2. Stocks and Bonds(Schedule B)............................................................................. 2. 15, 150 . 82 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C)......... 3. 4. Mortgages&Notes Receivable(Schedule D)........................................................ 4. 5. Cash,Bank Deposits&Miscelianeous Personal Property(Schedule E)............... 5. 18, 686 . 65 Jointly Owned Property(Schedule F) I_� Separate Billing Requested............ 6. 7. Inter-Vivos Transfers&Miscelianeous oo-Probate Property 2�-2 . 50 (Schedule G) �� Separate Biliinq Requested............ 7. 8. Total Gross Assets (total Lines 1 through 7)............. ....................... 34 , 049 . 97 ------- -------- --- --- . Funeral Expenses and Administrative Costs(Schedule H).................................... g. 31 � g�1 52 10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule I)............................ 10. 69, 692 . 78 11. Total Deductions(totai Lines 9 and 10)................................................................ ��. 101 , 664 . 30 12. Net Value of Estate(Line 8 minus Line 11)............................. .... .. ...................... �2. -67 , 614 . 33 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. ---- ----------- -6 7 , 614 . 3 3 ---- TAX COMPUTATION-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 .00 � . 00 15. O . OO 16. Amount of Line 14 taxable at lineal rate X .045 0 . 0 0 16. 0 . 0 0 17. Amount of Line 14 taxable at sibiing rate X.12 Q . Q� 17. 0 . O O 18. Amount of Line 14 taxable at col�ateral rate X.15 � . �0 18. � . �0 19. TAX DUE................................................................................................................ 19. � . �� 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. � � Side 2 1505610243 15�561�243 � REV-1500 EX Page 3 Decedent's Complete Address: F��e Number 21-14-0285 DECEDENT'S NAME Artis, Donnie STREETADDRESS - -------------_—___ -------------------- 22 Big Horn Avenue -- CITY -- -------_----------- Mechanicsburg STATE z1P PA 17055 Tax Payments and Credits: 1. Tax Due(Page 2, Line 19) 2. Credits/Payments �� 0.00 A. Prior Payments B. Discount p,00 Total Credits(A +g� (2) 0.00 3. Interest (3) 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. Check box 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. �. . �� ,.�� ,� � , -. , ,., ,. � . 4F-�«�. ,.. . PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred:......................... ... . .. . . . Yes No i . . . . . . ....................................... �� [X 1 b. retain the right to designate who shall use the property transferred or its income:.................................. c. retain a reversionary interest;or.............................................................................._...................._......... uI �x� d. receive the promise for life of either payments,benefits or care?.......... . `—J rXl 2. If death occurred a f t e r D e c. 1 2, 1 9 8 2, di d dece dent transfer property within one year of death without I I ....................... ._ �X�I receiving adequate consideration?..................... . . . ............. . . . L_� �X� . . ................ .... ..... .. .... . . . . Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... �I 4. Did decedent own an individual retirement account, annuity,or other non-probate property which �J �X� contains a beneficiary designation?........... ... . . . �� C . . ... ... IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF TME RETURN. ---------_..T,._._.. For dates of�death o[o a . . < , - .. �, � � � � _, r 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 ercent 72 P.S. §9116(a)(1 1)(i)). 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)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.§9116(a)(1.2)j. . The tax rate imposed on the net value of transfers to or for the use of the decedenYs lineal beneficiaries is 4.5 percent,except as noted in [72 P.S. §9116(a)(1)l, . The tax rate imposed on the net value of transfers to or for the use of the decedenYs 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 decedent,whether by blood or adoption. Rev-1503 EX+�6-98) " SCHEDULE B ,�: :- � "� ' STOCKS 8� BONDS COMMONWEALTHOFPENNSYLVANIA INHERITANCE TAX RFTURN RESIDENT DECEDFNT ESTATE OF Artis, Donnie FILE NUMBER 21-14-0285 All property join[ly-owned with right of survivorship must be disclosed on Schedule F. ITEM CUSIP NUMBER NUMBER DESCRIPTION VALUE AT DATE UNIT VALUE OF DEATH � Proceeds of liquidation of 100 Series E Savings Bonds of various denominations(see attached Redemption 15,150.82 Calculator Inventory) TOTAL(Also enter on Line 2, Recapitulation) 15,150.82 (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 B(Rev.6-98) Rev-1508 EX+(11-10� SCHEDULE E pennsylvania CASH, BANK DEPOSITS, 8� MISC. DEPARTMENT OFREVENUE INh{ERITANC[TAX RFTURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF Artis, Donnie IFILE NUMBER 21-14-0285 Include the pror.eeds of litigation and the dale lhe proceeds were received by the estate. All property jointlyowned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE � Chartway Federal Credit Union-Account 483136 -6M Share Certificate OF DEATH 3.911.34 2 Chartway Federal Credit Union-Account 483136-Legacy Checking 394.61 3 Chartway Federal Credit Union -Account 483136-Prime Share 7,168.41 4 First Bank-Checking Account#643006654 2.295.17 5 NCFCU -Account 82672 S1 (savings) 2,175.23 6 NCFCU -Account 82672 S4(checking) 2,077.64 7 NCFCU-Account 82672 S8 56.03 $ NCFCU -Account 82672 S9 52.29 9 NCFCU-Account 87675 S1 (savings) 5.00 10 Proceeds of a Branch Banking 8�Trust Co. checking account#4340000895970 titled to Donnie C.Artis 550.93 TOTAL(Also enter on Line 5, Recapitulation) 18,686.65 Copyright(c)2010 form software only The(L CknerPGroupn InCed,additional pages of the same size) Form PA-1500 Schedule E(Rev. 11-10) Rev-1509 EX+(Oi-10� pennsylvania SCHEDULE F DLPARTMENTOFREVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Artis, Donnie IFILE NUMBER if an asset was made joint wifhin one year of the decedenPs date of death,it must be reported on s2chedu�G028S SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT A. Barbara Artis 22 Big Horn Avenue Mechanicsburg, Pq 17055 Spouse B. DC Real Estate Investors C. JOINTLY OWNED PR�PERTY: ITEM LETTER DATE DESCRIPTION OF PROPERTY FOR JOINT MADE �NCLUDE NAME OF FINANCIqI INSTI iUTION AND BANK ACCOUNT %OF DATE OF DEATH NUMBER TENANT NUMBER OR SIMILAR IDENTIFYWG NUMBER.ATTACII DEED FOR DATE OF DEATH DECD�S JOINT VALUE OF ASSE VALUE OF JOINiLY-HELD REAL ESTATE. INTEREST �ECEDENT'S INTEREST � B 12/21/2012 NCFCU -Account 95720 S1 (savings) 5.00 50.000% 2.50 2 B 12/21/2012 NCFCU-Account 95720 S4(checking) 420.00 50.000% 210.00 TOTAL(Also enter on Line 6, Recapitulation) 212.50 Copyright(c)2010 form software only The(L CknerPG oupn Inced,additional pages of the same size) Form PA-1500 Schedule F(Rev.01-10) REV•1511 EX+(10•09) pennsylvania SCHEDULE H DEPARTMENTOFREVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN RESIDENTDECEDENT ADMINISTRATIVE COSTS ESTATE OF Artis, Donnie FILE NUMBER 21-14-0285 DecedenYs debts must be reported on Schedule I. ITEM N MBER DESCRIPTION A. FUNERAL EXPENSES: AMOUNT B• ADMINISTRATIVE COSTS: �. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio Year(s)Commission Paid 2. Attornev's Fees Wm. D. Schrack 111 Esq. 14,000.00 3. Family Exemption: (If decedenYs address is not the same as claimanYs,attach expianation) ciaimant Barbara Artis Street Address 22 Big Horn Avenue citv Mechanicsburg State PA Zin 17055 Relationshio of Claimant to Decedent �OUSe 4. Probate Fees 168.50 � AccountanYs Fees 6 Tax Return Preparer's Fees � OtherAdministrative Costs See continuation schedule(s) attached 17,803.02 TOTAL(Also enter on line 9, Recapitulation) 31 971.52 , Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev. 10-09) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF Artis, Donnie FILE NUMBER 21-14-0285 iTEM NUMBER DESCRIPTION AMOUNT 9t__ h�Adm�_ 'n_ ��trat�ve CoctS � AIIState Insurance-homeowners and auto policy coverages during period of administration 1,355.28 2 Cumberland Law Journal-estate advertisement 75.00 3 PP&P-electric utility costs during period of administration 3,418.28 4 Register of Wills -2 additional Short Certificates 10.00 5 Service of Mortgage debt on primary residence during period of administration-Bank of America, et al 12,387.49 6 The Patriot-News-estate advertisement 189.30 7 United States Postal Service-expense of mailing U. S.Savings Bonds to Parkersburg,WV 5.80 8 Verizon expenses during period of administration 361.87 H-B7 17.803.02 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev. 6-98) Rev-1512 EX+(�Z.08) SCIiEDULE i pennsylvania DEBTS OF DECEDENT, DEPARTMENT OFREVENUE INHERITANCETAXRETURN MORTGAGE LIABILITIES AND LIENS RESIDENT DECEDENT ESTATE OF IFILE NUMBER Artis, Donnie 21-14-0285 Report debts incurred by the decede�t prior to death that remained unpaid at the date of death,i�cluding unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 AscensionPoint Recovery Services, LLC, on behalf of Citibank, N.A-The Home Depot-filed 1,742.00 to Cumberland County, PA Estate No. 21-2014-0285 2 Chartway Federal Credit Union -Account 483136-Line of Credit 8,496.22 3 Chartway Federal Credit Union -Account 483136 -Signature Loan 7,616.66 4 DCM Services -on behalf of American Express Bank, FSB-filed to Cumberland County, PA 1,$41.67 Estate No. 21-2014-0285 5 NCFCU -Account 82672 Credit Card Balance 13,310.90 6 PenFed Credit Union VISA card ending in 8555 36,222.40 7 West Shore EMS-last illness (balance due) 462.93 TOTAL(Also enter on Line 10, Recapitulation) 69,692.78 (If more space is needed,additional pages of the same size) Copyright(c)2008 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-08) REV-1513 EX+(01•10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF Artis, Donnie FILE NUMBER 21-14-0285 NUMBER NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE PERSON(S1 RECEIVING PROPERTY DECEDENT I� TAXABLE DISTRIBUTIONS [include outright spousal o� oc � r. 5: e 5 (Words) �$�Cg� distributions,and transfers under Sec.9116 a 1.2 Barbara Artis Spouse 22 Big Horn Road Mechanicsburg, PA 17055 Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 ov�easheet,as a ro riate. 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 II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev.01-10) r� � f �^'� i . �,i '+. ��t LAST WILL AND TESTAMENT OF DONNIE ARTIS I, DONNIE ARTIS, Social Security Number 246-92-8854, of the state of North Carolina, declare that I am a member of the United States Armed Forces and that I am currently living in Kaiserslautern, Germany pursuant to Military Orders. I declare that this is my LAST WYLL AND TESTAMENT and T revoke all other wills and codicils previously made by me. FIRST: I appoint my Wife, BARBARA ARTIS, as my Personal Representative concerning this Will. If she is unable or fails to serve, I then appoint my brother, CLAUDE ARTIS to serve as my Personal Representative. a• I request that my Personal Representative be permitted to serve without bond or surety thereon and without the intervention of any court, except as required by law. I direct that my Personal Representative act in unsupervised administration so as to administer my estate with a minimum of court supervision. If it becomes necessary to have ancillary administration of my estate in any jurisdiction where my Personal Representative is unable or does not desire to qualify as ancillary legal representative, I appoint as such ancillary legal representative such individual or corporation as my Personal Representative shall designate, in writing. b. I direct my Personal Representative to pay the expenses ot my last illness, the expenses of a funeral appropriate to my station in life and custom of living (including a suitable monument or marker for my grave) , and written charitable pledges which I have made. I grant my Personal Representative the power to extend or renew any deb� for such time as my Personal Representative shall deem appropriate. c. A11 estate, inheritance, succession and other death taxes with respect to all property passing under this my Will shall be paid from and borne by the principal of my residuary estate, without regard to reimbursement, as if such taxes were administration expenses . My Personal Representative may pay such taxes at any time deemed advisable, whether or not then due and payable. - P�GE 1 � OF 6 PAGES �/� , ,��.-�-- /�'l � d. My Personal Representative is requested to settle my estate as soon atter my death as may be practicable, and to pay or deliver every legacy or bequest to my beneficiaries without waiting any time that may be believed to be customary in probate matters. e. I have served in the Armed Forces of the United States. Therefore, I direct my Personal Representative to consult with a Legal Assistance Attorney at the nearest military installation and with the Department of Veterans Affairs and the Social Security Administration to ascertain i£ there are any benefits to which my family members are entitled by virtue of my military service. i f • I may leave a letter of intent with the executed copy of this Will for the purpose of giving guidance to my Personal Representative concerning the distribution or sale of certain items of my property. I request, but do not require, that my Personal Representative honor my wishes therein expressed. SECOND: I give, devise and bequeath, absolutely and forever, a11 � of my estate and property of which I may be seized or possessed, or to which I may be entitled, at the time of my death, wherever situated or of whatever nature, be it real, personal, or mixed, to my Wife, BARgARA ARTIS, as her sole and absolute property i� she shall survive me. THIRD: In the event that my Wife, BARBARA A.RTIS sha11 not survive me, I give, devise and bequeath, absolutely and forever, all of my estate and property of which I may be seized or possessed, or to which I may be entitled, at the time of my death, wherever situated or of whatever nature, be it real, personal, or mixed, to PATRICK A.RTIS, JASON ARTIS, and LAMAR ARTIS and to any child or children that may be born to or adopted by me, in shares of substantially equal value to be divided as they may agree. a• If any of my children shall not survive me, then 1 give the share of that deceased child to my surviving children in shares of substantially equal value to be divide� as they may agree. b. If none of m� children survive me, then I give, devise, and bequeath, absolutely and forever, all of my estate and property of which I may be seized or possessed, or to which I may be entitled, at the time of my death, wherever situated or of whatever nature, be it real, personal, or mixed, to the descendants of my child or children, who are to take per stirpes and not per capita, in shares of substantially equal value to be divided as they may agree. In order to receive a share of my estate under this paragraph, a descendant of any child of mine must survive me. � _. PAGE 2 OF 6 PAGES � / � �� j c• If they are unable to agree, the division among my children and the descendants of any of my children who fail to survive me shall be made by my Personal Representative, in that person's sole and absolute discretion. I empower my Personal Representative to sell any or all of such property, if such property is not distributed in kind hereunder, and to distribute the proceeds among my said children in substantially equal shares . Any determination of my Personal Representative as to what should pass or be sold under this paragraph and to whom it should pass or be delivered or at what price it should be sold shall be conclusive. FOURTH: If any beneficiary to any share of my estate which is not subject to the provisions of any trust which may be created by this will is at the time of distribution of his or her share, a minor under the laws of his or her domicile, I direct that the minor's share be converted into qualifying property and delivered_ to the minor�s Guardian as Custodian for the minor under the Uniform Gifts to Minors Act or the Unitorm Transfers to Minors Act as may then be in effect in either the state in which the beneficiary or the Custodian resides, or any other state of competent jurisdiction. a. The Uniform Gifts to Minors Act or The Uniform Transfers to Minors Act, as may then be in effect in the state concerned, is hereby incorporated by reference. The property affected by the Act shall be managed, held, and distributed in accordance with the provisions of the Act. b. The financial custodian will serve without bond or surety and without intervention ot any court, except as required by law. c. The receipt by the Custodian, for the minor, of any principal or income transferred pursuant to this paragraph shall be a full acquittance and discharge of my Personal Representative or Trustee, as applicable, from liability with respect to such transfer and from further accountability for the principal or income so transferred. FIFTH: Except as otherwise provided in this Will, I have intentionally failed to provide for any other relatives or other persons, whether claiming to be an heir of mine or not. Insofar as I have failed to provide in this Will for any of my issue now living or later born or adopted, such tailure is intentional and not occasioned by accident or mistake. SIXTH: Any beneficiary who fails to survive until one hundred twenty (120) hours after my death shall be deemed to have predeceased me, and the gift to that beneficiary shall be disposed of accordingly. c PAGE 3 n OF 6 PAGES � / b� � (ry`I 7 , - i I I � SEVENTH: Definitions: a. The term '�children" as used in this Will includes adopted and afterborn persons. The term "children" as used in this will shall also include step-children, the natural born or adopted children of a person's spouse. A relationship by or through legal adoption shall be treated the same as a relationship by or through blood for purpose of succession to property under this Will. b. The term ��descendants�� as used in this Will means the immediate and remote lawful, lineal descendants by blood or adoption of t the person referred to who are in being at the time they must be ascertained in order to give eftect to the reference to them. c. The term "issue" as used in this Will means all persons who are descended from the person referred to either by legitimate birth to or legal adoption by that person, or any of that descendant�s legitimately born or legally adopted descendants . d. The term ��Personal Representative�� as used i.n this Will means Executor, Executrix, Independent Executor, or any other title of like import which is used to describe such a fiduciary. e. The term "per stirpes" as used in this Will means that whenever a distribution is to be made to the descendants of any person, the property to be distributed shall be divided into as many shares as there are (1) living children of the person, and (2) deceased children, who lett descendants who are then living, of the person. Each living child (if any) shall take one share and the share of each deceased child shall be divided among his then living descendants in the same manner. ETGHTH: In the event that I shall die leaving a minor child or children surviving me, and my Wife, BARBARA ART2S shall not survive me, then I hereby appoint my brother, CLAUDE ARTIS as Guardian of each minor child of mine, during his or her minority. _ �he Guardi.an shall serve without bond or surety and without the intervention of any court or courts,. except as required by law. If the above named Guardian should predecease me or be unable or unwilling to act as Guardian, then I hereby appoint my sister, BERNICE ROYAL as Guardian of each minor child of mine, to serve without bond or surety and with the same powers and authority. PAGE 4 � �� OF 6 PAGES -'�t �(/ �=�---- �17 —� NINTH: In addition to any powers granted by the laws of the state in which this Will is probated, I hereby authorize and empower the fiduciaries named in this Will, to the extent of the discretion herein granted, to sell, exchange, convey, transfer, assign, mortgage, pledge, lease or rent the whole or any part of my real or invest, reinvest, or retain investments o� my estaperStoaperformeall� acts and to execute all documents which my fiduciaries may deem necessary or proper in regard to my property. If any of my fiduciaries elect to receive compensation for services, such compensation will be that allowed by law. TENTH: If any part of this Wi11 shall be invalid, illegal, or inoperative for any reason, it is my intention that the remaining parts, so far as possible and reasonable, shall be effective and fully operative. My Personal Representative may seek and obtain court instructions for the purpose of carrying out as �early as may be possible the intention of this Will as shown by the terms hereof, including any terms held invalid, illegal, or inoperative. IN WITNESS WHEREOF, I have at Kaiserslautern, Germany, on December 7, 1992, set my hand and seal to this my LAST WILL AND TESTAMENT, consisting of 6 typewritten pages, each page bearing my handwritten signature. DONNIE ARTTS (SEAL) ' PAGE 5 OF 6 PAGES �" � �� j _.�[.1+__. The foregoing instrument was, at Kaiserslautern, Germany, on December 7, 1992, signed, sealed, published and declared by DONNIE ARTIS, the testator, to be his LAST WILL AND TESTAMENT in the presence of all of us at one time, and at the same time we, at his request and in his presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses, and we do so verily believe that the said testator is of sound and disposing mind and memory at the date hereof. �."�-`_ �q� .'�7 f /fffyyy1/��n ' . f � ��(/�-_-�/{�)��! - '� '� G, �V� Soc.Sec.No.�,�p,f� , �'79 Soc.Sec.No. � ' '� �d y�'.s 2- 3�x� Soc.Sec.No. < < - �� 3 -O/ 7Ln3o oF _p Fl 6� �K 1§�I oF ��/�E F��P�r ��-r C� oF � I�� 1 v.�,�.�P� !c� �r.� � ��-r 1 . �� ? �� o�-�_D v�a 22,5� �i,z �� e, � a�% ,v- c � ` PAGE 6 OF 6 PAGES ��i� �� 'p� -�=�(-- SERVING WITH THE UNITED STATES ARMED FORCES AT KAISERSLAUTERN, GERMANy Before me, the undersigned authority, on this day personally ap�eared DONNIE ARTIS, known to me to be the testator, and / 1 ` —��_��_cn Q'Q�� t'� ' , and � ,�izv,;� ��,.,,�� ,� ��, known to me to be the witnesses, whose names are signed to the attached or foregoing instrument and, a11 of these persons being by me first duly sworn, the testator declared to me and to the witnesses in my presence: that said instrument is his last will; that he had willingly signed or directed another to sign the same for him, and executed it in the presence of said witnesses as his free and voluntary act for the purposes therein expressed; or, that the testator signified that the instrument was his ihstrument by acknowledging to them his signature previously affixed thereto. The said witnesses stated be�ore me that the foregoing will was executed and acknowledged by the testator as his last will in the presence of said witnesses, who, in his presence and at his request, subscribed their names thereto as attesting witnesses and that the testator, at the time of the execution of sai.d will, was over the age of 18 years and of sound and disposing mind and memory. ONNIE ARTIS � ' � 'tness Witness �-�^ �i%�j��-- Witness Subscribed, sworn to and acknowledged before me by DONNIE ARTIS, the testator, who is known to me to be a member of the Arn�ed Forces of the United States serving on Active Duty, and subscribed and sworn to before me by 9. - _ `�7`�iiJ71j �J�/2/�f'1 ' , and ��.��._„�„� /�'l- /�/�rl.s✓J�thC witnesses, on December 7, 1992. This acknowledgment is executed in my official capacity under the authority granted by Title 10, United State,�Section 044a, which also states that no seal is required on this acknowled gment. (Sign) - � . OFFICIAL CAPACITY ��f��e af f�e �±�s�{ ��SE �d�'atat@ (Print)M11F� W. HA1l�E1�' HQ Z�Sf ��t@'- _ ¢ RANKJCOMPONENT � ut�i' ,'rmy �i:�a Command MAJ, JA 4,avrv Center Judge Advoca'te • APO WITH G�NEl�Af. �"C1WER3 �F NdT�-��?'Y f'I.iQE�lC Articte 13�, UCMJ 10 USC Section 1044a �aicuiated Value of Your Paper Savings Bond(s) http://www.treasurydi rect.gov/BC/SBC Price Calculated Value of Your Paper Savings Bond(s) Calculator Results for Redemption Date 05/2014 Total Price Total Value Total Interest $562..50 $3,471.89 YTD Interest $2,.909..39 $0..00 Bonds: 1-30 of 30 Serial # Series Denom Issue Next Final Issue Date Accrual Maturity. Price Interest Interest .mQ6290253458Ed__�En�_�, _, Rate Value Note $25�06/1979�._�. .,,, � _Q6360476671E��__Ea_.„e_,_ � ._06/2009�.,.. $18J5�. ..�__,$90.84: , _ $109.59, MA_ $25u01/1980,�0,,, ., . :',01/2010..., .,$18.75�,,., ._:$91.87: _Q6360376748E,�..�E..o;.__�$z5�12/1979w .�,,, _ • $110.62 MA. _Q6343276330E„--�E-- " � �a ;_12/2009;,s,.$18 75�wm._.�.$g1 87.;,_. : $110.62;,..MA, -._.__$25U11/1979;._______ y ' .Q6343183770E�__�E---�-- ,M � _11/2009;__.$18.75�___..$91.87.:;._,..,. __ ..$25� 10/1979�,�_,. � 10/2009;n:,$18.75:..._�_.$90.84.;;r._ . ` ._$110.62,, .MA_ _Q6338817293E,---E---„--�_$25�,;09/1979�.�__ T__ E = �. -''._..$109.59i;.,.MA:. .Q6338701215E;---E-..:... --09�2009:--.$18J5 w-----$90.84�_________ _$25:08/1979�,�_�,:a. y 08/2009�.__, 18.75� � , - �._._$109.59.;,...MA_ .Q6290364366E:_._E.--_---- ° F '�07/2009:__. 18.75:�Tm� `�90.84�.a�_ ,., f $25�,07/1979;��______ :_ � . . $109.59: MA,: .,Q6284492243E�,�nE�,zw,Pe,$25�05/1979 � •----.$90.84:__.. ..._ _. :: ... $109.59:_MA. _.,,_ �, nQ6284391392E;,>>>E�_��,�r_ ' O5/2009 .,,$18 75::_, >-,$90 58;:... $25;,04/1979 . � $109.33 ..MA�. ,=Q6273978424E�, E _ _�25;03/1979 J-' ;�03/2009 ,,.�18 75R, ,_ $89.53 - �108.28._MA_ Q6248275356E�,,,�E�,> >>, $89 53 -�, , $25�;.02/1979_ _,_, .. � - $108.28: ..MA_ ,,Q3273872905E»a�E>>,:,,, ' �-,02/2009:.__$18.75�-----$89.53 __. $25��01/1979.,,� ___ � O1/2009;,.,, $18.75�� .- $108.28:...MA .�Q6273751717E,_�,E�__:,,�,$25°12/1978v_ ___ : $89 53,;,. $108.28::�MA., ,.,12/2008._..$18.75:.:.- $89.52. _ . ,�Q6250879386E�,>>E,�,a, $25°11/1978:. ... ...... :.11/2008�._ $18.75:. : $89.23: $108.27::_MA. $107.98. :MA .�Q6250644256E�„�E�>>y>>>,$25�,09/1978;.. .,.,, , ;,:,09/2008�,., $18.75_ :._, . $88.22. ,, ,�Q6242426771E�>»E�=,u� . ,$25�08/1978,�,,.,, ,_.-, ;,08/2008;._., 18.75A :.. -: �106.97 ,MA .Q6242186212W>=_,,E>>>„, , $ $88.22� , $106.97 MA $25d06/1978,�� ,,: ,,.r ;_,06/2008°„_.:$18.75„ , : ,,$88.19:._ .Q6236196653E�.__E--.:.___$25:,05/1978;�___.__T � - -$106.94 MA Q6236081878E. E ._OS/2008;__.$18 75;.,...__.$87.92:,,.._, ._. " "--- -. �--..$25�04/1978�a.�_. -- � _.. $106.67:,._MA ' ..04/2008;_..$18.75�..,,,�,,.$89.79:��e ,....� .,: ,..... $108.54:.MA._ -Q6229510139E,:---E---,---_�25:,03/1978M1.___ __ ' _. '_03/2008:__,$18.75;.._.,_...$89.79�__..,... . . . ; ..Q6220135151E�_.-E---_,_,_$25�,02/1978,._.,..__ � -_$108.54._.MA -Q6220017186E____E.._;�_._ ° - ;�02/2008:_.,.$18J5�. .,..,$109.70.,_,..,_. _ . ;.._ $128.45 MA.. $25:,01/1978.:.____�_._ :.01/2008:....,$18J5._......$109.70..... .._. .... . . „Q6214121814Em, E :n ..12/1977�.,_ ,. ,_, � _ $128.45 MA _Q6200372476E;_ E � --12/2007�,.,.. $18J5°..,.._$109.70� _. . $128.45 MA ,,n$25. � l^�$25�.; ""_ .--. '..11/2007._.,$18.75_ , $109.34: .eQ6188273218E;�_,Eeayu V0�25:;11/1977� $128.09 _MA.. 08/1977��,_,�_� '.,OS/2007; .� $18.75�.�,..$120.92 .. . --Q6125133688E,_n_E�__.�._�_$25�.;12/1976�,,.___._.. ;,12/2006:._.� $18.75:. . $139.67, .MA_ ._ Q6052830214EYs_�E_��:�.__$2,5�12/1975:.� _,,.. :..12/2005;.., 18.75� . - �116.00 $138.04._MA.. .�Q5215205400E:__�E_._:_ ::12/1974.._ � � $134.75.._.MA. __a 25� • , ..�Q 208596905E�RE�,.� " � ;- - -.$18.75.- , $112.84 .. $25�.11/1974.:.., , ._ ,=11/2004�..� $1$.75,� ._$112.51 _ _ $131.59 MA Tota.ls for 30 Bonds�.$562.50�$2,909..39 ' $131.26 .MA. $3,471.89_ Notes .NI.�Not, Issued..__.__, .NE.�Not.eligible ,for,payment__ '� '_�T"T�-� .P5_�Inc,ludes 3 mont,h ,int,erest penalty._y�__ ._ MA.�Ma�ured a.nd .not.earning ,int.e.rest Page 1 of 1 �aicuiatect value of Your Paper Savings Bond(s) Page 1 of 2 Calculated Value of Your Paper Savings Bond(s) Calculator Results for Redemption Date 05/2014 . Total Price Total Value Total Interest YTD Interest 2 175.00 9 840.81 $7 665.81 69.24 Bonds: 1-58 of 58 Serial # Series Denom Issue Next Final Issue Interest Interest Value Note Date Accrual Maturity Price Rate j ; 10/2014 04/20181 $37.50 $95.25. 4.00% $132J5 K77598120EEi EE $75 04/1988 _ _ K90904117EE:--.EE ... ....�75=_08/1990_: 08/2014; 08/2020..__. ..$37 50 $82 74:_ 4.00%i $120.24 __ K90880339EE; EE _i $75_ 06%1990 06%2014! 06%2020 $37,50 $82J4i 4.00%i �120.24 K86502442EEi_ EE _,; . �75_, 04/1990„_10/2014 04/2020___..,._�37.50� $85.14; _ 4.00%, $122.64 I K86475357EE, EE . .. . �75, 02/1990. 08/2014 02/2020, ___�37.50f $85 14: 4.00% $122.64 � 12/2019 $37.50 i $85.14 4.00%: $122.64 _ - • - - K82599362EE; EE..:,.. $75, 1%1989�.O%2014 y 10/2019 _ _.$37 50! $87 60_ 4 00%; $125.10 - - " 06/2019, $37 50. �87 60; _4 00% $125.10 _ ?' ; $87.60 4.00%:, �125.10 K82550673EE; EE $75: 08/1989 08 1 : K86448309EE EE _: $75. 04/1989 �10/2014 ' ? � _ - t -- 04/2019 �37 50; $90 09 4.00%E �130.14' _ _ 12/1988 06/2014, 12/2018 _ __ . �, K77638350EE _ EE.. .... �75_ 06/1988. 06/2014.-- 06/2018. __ $37.50;_ $92.64,_ _ $. .. _ K81499279EE EE _ 75 � 02/2018 $37 50: $95 25 4 00% $132J5 K73275?47EE. EE�--+ $75 O10/19887 �10/2014� 12/2017; __$37 50: $95 25: 4 00%: $132J5 _ _ __ ---�--- . - -- �" " 10/2017 $37 50. $97 89; __ 4 00% $135.39 K7 - _-• . . _. : --- K73228723EE: EE , -_$75;.08/1987 08/2014: 08/2017 _ _$37.50; $97.89 4.00% $135.39 K73179913EE_ EE , $75_ 06/1987 06/2014; 06/2017 $37 50 $97 89. 4.00% $135.39. _._ _ K73130997EE EE $75 04/1987 10/2014; 04%2017 $37 50 $100 59 4.00% $138.09 _ i. .. 08/2014 i 02/2017' $37 50, $100 59 _ 4.00%, �138.09: __ K58461�731EE; EE $75 �12/1986! 06/2014 12/2016 $37.50: $100.59 4.00%: $138.09. K58301372EE EE . $75, 10/1986_ 10/2014; 10/2016 $37.50 $119.16' 4.00%: $156.66 _...---.• . 08/2016 _$37 50: $119 16,_. 4.00% _$156.66 _ K564�17058EE. EE � $75_ 06/1986__06/2014' 06/2016 $37 50 $119 16 4,00%. $156.66 - -- -- . - y _ .. _10/2014. 04/2016: _..._$37.50 1 _$122.31; __4.00% .$159.81 . __ . $75 .04/1986_ K56285057EE.._ EE _ K58089618EE EE _,. _$75_ 02/1986 .08/2014 02/2016 $37.50 $122.31' 4.00%. $159.81 K57805503EE . EE . ,.._...$75;..12�1985,__06/2014; 12/2015„ ,__$37.50.; __$122.31! . 4.00%. $159.81' K57154144EE,_.EE.._„ . $75, 10/1985, .10/2014; 10%2015, $37.501 __$12549; 4.00%' $162.99 08/2015 $37 50: $125 49 4.00% $162.99 K56123917EE EE $75 08/1985 08 2014; - K50831180EE,__.EE .. . .�75.; 06/1985: 06/2014 06/2015.. . __�37.50, $125 49� „ 4.00%, �162.99. K51991598EE EE . $75 04/1985; 10/2014 i 04/2015 $37.50 $128J6: 4.00% $166.26 . K51929513EE;. EE _, ____�75 ,02/1985 _08/2014; 02/2015, ___,$37..50, $128.76; 4.00°/a: $166.26, K50169798EE _.EE .____�75 12/1984,_06/2014: 12%2014, $37.50 _$128 76; 4.00% $166.26, K50107256EE: EE , $75 10/1984; 10/2014 i 10/2014 $37.50, $132.09; 4.00% $169.59 K47720079EE, EE ; $75. 08/1984, 08/2014; 08/2014, _$37.50, $132.09 4.00% $169.59, $75, 06/1984; 06/2014 06/2014 $37.50 $132 09' 4.00%, $169.59 K45688194EE EE _ - K45082233EE. ._EE_ r __ .�75 04/1984 . .._. , ; 04/2014, $37.50 $13548; , $172.98 MA K44526916EE_ _.EE __$75 02/1984 _ 02/2014 $37.50 $135 48 $172.98 MA K42217231EE EE _; $75, _12/1983:_ _ _ . '; 12/2013, $37.50 _ $135.48; $172.98 MA - 1 .. ... ..; _ � - . .. _. . $172.98. .MA.. K42146966EE'. .EE 75 __10/1983, 10/2013 37.50 $135 48; .. _. ... �. K31953931EE, EE ; $75, 08�1983; _ , 08/2013 $37.50, $135 48; $172.98 MA K31880324EE:._ EE . ..$75. 06/1983.___ .. ._.; 06/2013;_ _ . $37,50A $13548;_ ._ LL $172.98 _MA - 04/1983, _ __ 04/2013 _ �37.50: $135.48 y172.98 MA K31794681EE_ EE ; ____$75 _ -- , K31717351EE EE , $75, 02/1983! , 02/2013; $37.50 $172.74' $210.24 MA - - - � K31637658EE: EE __$75, 12/1982; - _- , 12/2012;_ _ $37,50 $172.74._ _ $210.24 MA K31555680EE, EE .$75 10/1982! 10%2012 $37.50 $182.85; $220.35 MA K31471333EE.--.EE_. .. _..�75, 08/1982; . .. _._,.. 08/2012, $37.50 $182.85 _ _ ; $220.35 MA K31384351EE i EE __$75 06%1982 ___ __--.. 06/2012 _ $37.50 $182.85_ _ _ . . $220.35 MA ' ...�. . _. . � _ _ ; $220 35 .MA. K31094301EE; EE_ 75 04/1982 . 04/2012 �37 50 $182 85 _, K31000964EE. EE-_--•-_---.-�75, 02%1982.. ... , 02/2012 37_50. . .$182 85: $220.35 MA K30904948EE: - EE _-$75 12/1981: _ - ---- -.- 12/2011: _ $37.50 _ __$182 85: _ __ $220.35 MA - - K30806188EE EE � . $75; 10/1981 _ ---_-_., .10/2011; -. $37.50 $182 85: _ _-_ �220.35 MA http:Uwww.treasurydirect.govBC/SBCPrice 5/2/2�14 �a��u�a�Gu v a�ue oi Y our raper �avings Bond(s) Page 2 of 2 ---• - ----�� - - _ $182.85 ..._._ ' $220.35 _MA.. K30698641EE. ._EE , 75 08/1981. ......... ...„ .08/2011 .�37 50„ �182.85 $220.35 MA ... K30592554EE EE _ _ $75; 06/1981 ;__ 06/2011 37 50 K30481802EE; EE__; $75; 04/1981_ . 04/2011 $37.50'_ $192.66 $230.16 MA K29305869EEt...EE . . ._$75 02/1981 -_ --_ 02/2011y $37 50: $192.66 __ _.;___�230.16 MA. K25915339EE i EE ! $75' 12/1980'•: -_ _- ....j 12/2010 $37.50 i $192.66 ' $230.16' MA - - - - ._ _ -- - K24078964EE ._EE. .._. $75: 10%1980 t _ _.;--.10/2010 ___$37.50, _ $213.60:_.._.. __.; ._$251.10 MA K23946013EEi_ EE __i_ $75_! 08(1980 _ _08�2010 __..,_,__$37 50;_. $213.60 ' $251.10 MA Totals for 58 Bonds 2 175.00! 7 665.81 : 9 840.81' Notes NI f Not Issued _--.---_..____..-- -- -------�--�----- ---- -- ----- - --- NE !Not eligible for payment •- ---- P5__.;Includes 3 month interest penalty__ ,_, . -��-�-- ' -•- -•---�---�- --... . MA 'Matured and not earnin interest http://www.treasurydirect.gov/BC/SBCPrice 5/2/2014 �aicwatea value of Your Paper Savings Bond(s) http://www.treasurydirect.gov/BC/SBCPrice Calculated Value of Your Paper Savings Bond(s) Calculator Results for Redemption Date 05/2014 Tota) Price Total Value Total Interest YTD Interest $700.00 $1,838..12 $1,138..12 $32.24 Bonds: 1-14 of 14 Issue Next Final Issue Interest Serial # Series Denom Interest Rate Value Note Date Accrual.Maturity Price C458555364EE:.__EE__��__.$100�.07/1995;;07/2014�:_07/2025��:__.$50.00:.__.�_.$51.00:�.._1.12%:__..$101.00:,._ __. ,C502204600EE�»EE�,'��,$100'_03/1995;,06/2014:.03/2025�'�_.,$50 00:...,,,.-$56.84_ 4.00% ., $106.84 . C463495096EE�e�EE,a:�n, � � �=11/2024'�'..,..$50 00�' _..__-$58.28: __4.00%. _ $108.28 _.. _�. $100:,11/1994;.06/2014. C483123157EEy»EE»;.n�=$100m07/1994n06/2014:.07/2024;..:,:$50 00;,,:,,.,::$59 72>,:,:,4.00%:....$109.72 C465885964EE.._EE..:...$100:03/1994:06/2014 L.03/Z024:m„,$50.00°„,.._,..$61.,16:.__4.00%,.,.a m$111.16 .._. ' " ' �06/2014:',.11/2023°-.,,.$50.00:.,._,=,$62.64:..__4.00%:. .. $112.64 .. _ C445004763EE�,�EE._�,:�_,$100�l i/1993 , C388249787EE;e_EE__'�_.$100:,03/1993:.06/2014;_03/2023'_..-..$50.00;,..>>_.$65.64,;. ,.4.00%._ _$115.64.. . ,... ,C387976195EE:__EE__.�,.$100:,11/1992w11/2014;'_11/2022°_,�.$50 00:._...,_.$98 08:_ 4.00%.. .$148.08. _ C359240059EE'___EE__�__.$100:07/1992�.07/2014;,07/2022°,...$50 00_�___.$98 08�:...,.4.00%... ..$148.08 . C346327518EE�__EE__._..$100',03/1992w09/2014°,03/2022°__.$50 00°__..$101 04..,._4.00% ._..$151.04 C329156563EEa�a EE�=;,,,,$100�11/1991;,11/2014u_11/2021°_-.$50 00; _�-$104 08:.:. ,4.00% . _$154.08 _ ,C295197157EE>>aEE�,U>>,$100:,07/1991;,07/2014,'=07/2021�,_.$50.00:__,._$104.08.:.._4.00%,. _$154.08_ . _.. .C294545968EE>>>EE>>:=�,$100;�03/1991;.09/2014°.03/2021 ,_„$50.00;,., ,..$107.16,,,. ,4.00% . , ,$157.16 C264586617EE.__,EE__w_,._$100.11/1990,:.11/2014",,,11/2020:�_,$50 00:.._r$110.32..r,.4.00%.,..,..$160.32� Totals,for 14 Bonds.�$700 00°�$1,.138 12 $1,.838.12_ Notes _NI_�No.k Issued.................................. , _NE.�Not eligible ,for,pay,ment____________________ ,P5�pIncludes 3 month ,interest penalty,.,=,.,_, MA;Matured and .no�earning .int,e.rest Page 1 of 1 � 963136 � Corporate Cerner A R T WA Y 16U Newlown Road 1 ,^ Virginia Beach.VA 23462 r �_ �"' _ (757)552-1000•(BOG)678-8765 RdI CRIiDTT C:�TO\� �� wwv:_cPr�rlw2y.com •� �ROM ' 01/01l2014 70 01l31/2014 ii��ii�IPld�ill��i�iil�ril�i�il�l�lii��ini�n�ni��n��ri �••••^•"AUTO"MIXED MDC 230 C 62 P 1 712-2153F3 . DONNIE C ARTIS pp BOX 184 NEW CUMBERLAND PA 17070-0184 .. ,._ �` '� �; i �1LIf�� Y��R TAXES: �`�3 � � ^ - Lookinq foryour� routinc�, transit, and account nurpbers? �_; � �'� Visit us online for more information. �;, x{' ` h I J 1 , . . . . . �*�;:ry �`�� . . . AS OF Oi/31l2014 • SHARES $7,168.41 � PRIME SHARE $394.61 ;� LEGACY'CHECKING � �t]L,3 $3,911.34 i,, 6M SHARE CERTIFICATE ' : $g 49622 �. LOANS $7,616.66 L LINE OF CREDIT:' � � «• _�.,.. SIGNATURE LOAN: T-62�; PGGG6!ULi2 r F-CL'J=� t��-1�-`14 15:25 FhOC�- FiR�T �ANK _Date of Death Bal�nce Acc.otrtzt Titl� DQTtNTE(: A�:l YS -- �.J Accc:iiint# C7��OU�654 .�ccotint'I',ype CHECkINC7 `1'he L��l��ncc? af the account listed above is$?,?`��•17 as of 1/27/1�wit.h tl�e�3cer��ci interest bertlg�0.00 and the YTJ� interest beirig "�0.0�. 'rhi5 ini��rr��:�tion w:�s pr�,vicl�d by: �a.�,(a,�.ia , .t-�x� �'atricia T�ery�c�ns RGS��TC}l A��iSt�il7t D<ite 411.�/1� 21'l I3urnetts Str�st•Tray, NC�7371-08��•�1�-572-3934• 91U-5/2-3262 FAX � New Ctunberland I'ederal Credit Union Yorcr•C�ntnzuizity Credit Unio�z P.O.T3ox 658,Ne�� Cumberla»d,PA 17070-065� Phone: �717) 774-7706• 1-800-716-2328• Pax: (717) 774-799C•Web: w�v�v.ncfcuonline.or� April 3, 2014 � ��; �� VV��. D. Schrack, IjI Attorney at L��w 124 West Harrisburg Street llillsburg, PA 17019-2368 Dear Mr. Schrack: Pursuant to your letter dated March 30, 2014, in regards to Estate of Donnie Artis the infonnation is as follows: Account Number: 826�2 - Ovimer(s)on Account: Donnie-Artis �' Date acct opened: 3/10/2004 � Date of Death Balances: S1 (Savings) $ 2,175.23 ✓ S4 (Checking)$ 2,077.64 ✓ Sg $ 56.03 �'` S9 $ 52.29 tf C�edit Card Balance as of llOD: $13;310.90 �✓ , ,�., �Y Account Number 82950. � � ,� ,, � n,ari:�=_•��>.��, .A��n,��zt> T��nnie Ai�*is '� _ � � � Barbara H� Artis �!% Date Acct opened: 5/26/2004 Date of Death Balances: S 1 (Savings) $ I21•�S �� S4 (Checking)$ 81.48 '� Account Number: 87675 Owner(s) on Account: Donnie Artis '� Date acct opened: 8/22/2007 Date of Deaih Buiances: S 1 (Savin�;s) $ 5.00 � � �� Account Number: 95720 Y `�� r�'�� ,, Owner(s) on Account: DC Real Estate Investors � � Donnie Artis Date acct opened: 12/21/2012 i`��` Date of Death Balanccs: S 1 (Savings) $ 5.00 � �-- S4 (Checking}$ 420.00 � If you need anything additional in regards to this infonnation,please feel free to eontact me directly. Sincerely, ,--_—�j ; v/ '�� - ! l3arbra Wright Branch Manager Enclosures Branch Banking &Trust Co. � P.O.Box 1088 Fayetteville,NC 28302 (910)860-7320 , ax(910)486-3223 May 29,2014 Mr.William D.Schrack III 124 West Harrisburg Street DiNsburg, PA 17019 1268 Subject: Estate of Donnie C.A�tis Dear Mr.Schrack: Below is the informa tion requested relative to the Estate of Donnie C.Artis,Sociaf Security#ending 8854. s one account,4340000895970,listing Mr. Donnie Artis as the sole individua owner 1 . BB&T ha � without any joint owners. • The account Balance as of January 27,2014 Was$550.93. Should you have any further questions, please let me know. Sincerely, . ��~ D.T. McMillan Asst:Vice President NOTICL OF CLAIM (Filed Pursuant to 20 Pa.C.S. 5 3532) COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA pRPHANS' COURT DIVISION ESTATE OF DONNIE C ARTIS , DECEASED No. 21-2014-0285 7'o the Clerk of the Orphans' Court Division: Enter the claim of AscensionPoint Recoverv Services LLC on bel�alf of Citibank.N.A. -THE HOME DEPOT �XXXXXXXXXXX7605 �CIQZT72QT11� in the amount of� $1 742.00 ,a�ainst the above entitled Lstate. The Decedent,who resided at 22 BIG HORN AVE.MECHf1NTCSBURG,PA (Sh-eet Address) 17055-5515.died on Ol/24/2014. Written notice of said clainz«ras given to (Date af Deatll) BATZi3ARA ARTIS. (Persorial Represe�itative or liis/her coznzsel) at �2 BIG HOKN AVE.MECHANICBURG PA 17055. (Address) � on 5/I3/2014. f � ��y, j � } i �I�nl�� ;L,�1'`�; �rv�,�r�--APP.S Representative (Gaimant) �;�� , �, i ' ZCO Coon Ra ids f31vd. Suite 200 �i'!��°�E -' -�"1''� �"" (Street AddressJ Coon Raoids. MN 55433-5876 (City,State,Zip) Robin LeDonne-�L Bar# 52947cs (Ciaimant's Counsel) 200 Coon Rapid�61vd. Suite 200 (Address) Coon Raoids MN 55433-5876 � g88-420-2510 (Te(ephone) CLMFRMPA_v1.1_20121120 � 483136 � Gomorate Cente� Y60 Newivwn Road �[:R T WA Y/^ Virginia L�each.VA 23462 ,�_ (757)552-1000•(800)67II•8765 7UlL CRlil)(T C.'�'ION �� www.G�artway.com •! ' �ROM; 01l01/2014 Y� 01/31/2014 ni��i�ll�lilhlli�i�ii�,��il�i�ii�l�lit�iim�iuni,��n��i •�^"""AUiO"��IXED MDC 230 C 62 P"I 712-2 1 5 36 �� DdNNIE C ARTIS PO BOX 184 NEW CUMBERI.AND PA 17070-0184 � �. ��k 1F1LiN� ��'�R TAXES: . � ,,: � �tF' - Lookinc� for your routing, transit, and ;�c�=ount numh�rs"? ..�,., __ . _ • � _ ` : -,, � ;`' , ` Visit us online for more information. �.� . r, ' t, /F`r, y , . . . ^4'��i:'-� 't AS OF 01/31?2014 • $7,168 41 �� SHARES $394.61 i,, PRIME SHARE : � �1 L,5�' ,n3,911.34 � LEGACY'CHECKING ' 6M SHARE CERTIFICATE : �8 49622 L LOANS - �7,616.66 L LINE OF CREDIT: � ! �Z--' ... SiGNATURE LOAN: __.� NOTICE OF CLAIM � (Filed Pursuant to 20 Pa.C.S. § 3532) COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE OF DONNIE ARTIS , DECEASED No. 2014-00285 To the Clerk of the Orphans' Court Division: Enter the claim of (Claimant) in the amount of$ 1,841.67 , against the above entitled Estate. Th�r�P��P�lt, whn rFsic�ed 2t 2.2 I3Tr, I�ORN AvF : . . (Street Address) MECHANICSBURG PA 17055 , died on 1/27/2014 . Written notice of (Date of Death) said claim was given to WILLIAM D SCHRACK II (Personal Representative or his/her counsel) at 124 W HARRISBURG ST DILLSBURG PA 17019 (Add,-ess) ' Christie M. Berry on �F� '� "' (�� thorized hepresentative (Date) AMERICAN EXPRFSS ,FSB NIA N/A C/O DCM S�RVICES 7601 PENN AVE S SUITE Su reme Cour(LD.No.) A600 (Claimant's Counsel) � � (Street Address) N/A MINNEAPOLIS,MN 55423-5004 (Address) (Citv,State,Zip) N/A N/A (Telephone) Form OG07 rev.10.13.06 PA DeCanit R20140129 f� �� Nev�� Cuinbex'laiid Federal Ci-edit Unio�� Yo�cr Conr.nxic�r,ily C�•edit Unio�i P.O. Box (i58,Ne�v Cumberlanci.PA 17070-065� Ph�ne: (717) 774-7706• 1-800-716-232g • 1=ax: (717) 774-7996 •Web: w�v�v.ncfcuonline.�r� April 3, 2014 i%l�, i�.Y: V�%rn. D. Schrac�, 1II :Attorney at L��w l24 West Harrisburg Strect Dillsburg, I'A 17019-2368 Dear Mr. Schracic: Pursuant to your leiter dated March 30, 2014, in xegards ta Estate of Donnie Artis the informat�ion is as follows: Account Number: g2672 Owner(s)-dn Account:`' � ';Donnie-Artis "� Date acct opened: 3/10/2004 ' Datc of Death Balances: Sl (Savings) $ 2,175.23 ✓ S4 (Claecking)$ 2,077.64 � Sg $ 56.03 �" .�..�..y._.,._�,_„,.��__ rS�._�,.._ $ 52.29 i.l. : -- �..�.,.��..�..,..,�•rt m.�.�.._°-.-.- $13�-.-- 3--i�-�-� ...� �Credrt Card Balance as af DOD: _ ��,._...,...w.:.�..A�,.-......�„a., ._...�—��,.�..._,.,,n.,.„,.. .,=A�,..�..�,�. � .�..-..- ..,, - � Account NumUer. 82950 � �� ; � n;.��:��.i�� ., _�,:�nti��,t� D�nnie 1?i�is ''' , ' -.�, Barbara`H� �rtis '�'='� �` Date Acct opened: 5/26/2004 Datc of Death }3alances: S1 (Savings) $ 121.78 r�~ S4 (Cllecicing) $ g�•4� $✓'� Accoui�t Nunzber: 87675 COwner(s) on Account: Donnie �lrtis '� Date acct opened: 8/22/2007 Date of Death B�iances: S1 (Savin�s) $ 5.00 � 6486 U001 JAII 1 7 18 140318 0 C D PAGE 1 of 2 1 0 3888 0000 IAX1 OlAI6486 4962 Account Number '�"i/'�� page 1 of 2 Cardholder Name � , , ��D DONNIE C ARTIS )(�(X_)Q(XX-XXXX-8555 PENTAGON FEDEftAL CNE�IT UNION ' You are a valued member! Thank you tor allowing us the opportunity to serve you. � _ ;,.,,. .Aacount 5ummary_ ' < Account Infotmatlon ' '' -_ _ $35,707.67 03/18/2014 Previous Dalance $0.00 Statement Closing Date $40,000.00 - Payments Credit Limit - Other Credits $0.00 Available Credit NONE + Purciiases $151.75 Cash Credit Limit $40,000.00 + Cash Advances $0,00 Available Cash $0.00 + Other Debits $0.00 Past Due Amount $1,418.00 + Fees Charged $26.00 + Interest Charged $336.98 ' =New Balance $36,222.40 ;i�aymont lntormation ." , Payment Due�ate:04/15/2014 Late Payment Date:04l30/2014 Mfnimum Payment Due:$2,142.00 ,. Late Payment Warning: if we do not receive your minimum payment by the date iisted above,you may have to pay a late tee ot up to 525.00 and your H APR may be increased up to the Pena�ty APR of 17.99%. Minimum Payment Warning: If you make only the minlmum payment each perlod,you will pay more in interest and it wiil take you ionger to pay off your balance.The table is based on your standard min(mum payment and does not inciude any past due and overlimit amounts.P Pry x9mple: ,If you make no edditional charges using this >You wiil pay off the balance shovrn; And Yest mlated�totai'of.,�n an>: _Y � y,,, ; on this statement fn about... ' card and each month ou a 39 Years $73,495.00 Onl the minimum a ment 3 Yea�s $43,612.00 $1,211.00 Savin s=$29,883.00 If you wouid like information about credit counse�ing aervicea,call 1-866-685-6322. -Transactions ': _�-�--- Descrlptlon Amount Post Date Trans Date RA(atence $151.75 03/07 03/05 2498894EHLDTRFZSQ UNIVERSAL 18882332302 816-233-2299 MO ; Paes ' '. PAPER STATEMENT FEE $1.00 03/18 03/18 , $25.00 03118 03/18 DELINQUENT CHARGE 5Z6.00 TOTAL FEES FOR THIS PERIOD . _ , Intereat Charges . = interest Charge on Purchases $336.98 03/18 03/18 _� Matl Inqulrtes To: '� LluestlonsT � Remlt Payment to: Call Cusiomer Servlce:800-247-5G26 PENFED CREDIT UNION PENFED CARD SERVICES P.O.EiOX 456 Lost or Slolen Card: 800-556-5678 PO BOX 247080 OMAHA,N[68124-7080 AIEXANDRIA,VA 223130456 We appreciate your membership! �etech the bottom porllon end retum payment using enclosed envelope to be recelyed no leter tnen by s:oo p.m.on tha due data.Please use blue or black Ink. Payment Due Date Aprll PENFED CREDIT UNION , s M T w r F s PO BOX 456 ^� Account Number XXXX-XXXX-XXXX-8555 � 2 3 a s ALEXANDRIA VA 22313-0456 / e 7 s to i� iz LNew Balance $36,222.40 13 � �g;e » ta �s 20 21 22 23 24 25 28 Minimum Payment Due $2,142.�0 27 28 29 30 Make Payment Payable lo PENFED AMQUNT '. ENCLOSED� • ' _. __ � New address,phone number or e�nai�9 C�eck the box to the lefl end print changes on back, DONNIE C ARTIS 4962 22 BIG HORN AVE PENFED CREDI7 UNION MECHANICSBURG PA 17055-5515 E2oi PO f30X 247080 OMAHA,NE 68124-7080 Il"�11��1�11��111'�I'I'��1��1��1��1��11��1�1��11111"�I�' IIII�I�ii��l�li�'�II11�1�'I�l��l'�i"I��1"'1"��i�'I"�"I�� 002142�00362224040715400455985552 r' ' i �*"a^'rT - WEST SHORE EMS - EMS �°`,�' � je` `��-�° ' '�� - �,�---��-� ', ��: � . � 205 GRANDVIEW AVE STE 211 oN REVERSE sioE � � CAMP HILL, PA 17011-1708 ��F�T�i-t��Rt'rM5 Phone #: (800) 367-0512 Federal Tax ID: 23-2463002 n Hl l\'�fIRIT HF\I.TI I:1"�TF.Tt INSURANCE: TRtCARE CLAIMS ESTATE PATIENT NAME: DONNIE ARTIS DEFENSE DISTRIBUTION RI NONE DATE OF CALL: 01/27/2014 cA�`"uMBER' 1401686E FROM: 22 BIG HORN AVE To: HARRISBURG HOSPITAL ACCOUNT SUMMARY DONNIE ARTIS TOTAL CHARGES: 1�87'6$ WILLIAM D SCHRACK Iil pqYMENTS/ADJUSTMENTS: 1324.75 124 W HARRISBURG ST pLEASE PAY THIS AMOUNT: 462.93 DILLSBURG, PA 17019-1268 pETACH ALONG PERFORATION AND RETURN STUB WlTH PAYMENT — QUANTITY UNIT PRICE AMOUN7 DESCRIPTION OF CHARGE 1.0 1545.32 1545.32 MICU EMERGENCY ALS LEVEL 1 A0427 13.73 134.55 ALS MILEAGE A0425 9•8 1.0 6.72 6.72 ANGIOCATH (14-24) A0394 8.00 EKG ELECTRODES (1) A0398 10.0 0.£30 1.0 12.52 12.52 EXTENSION SET 8" NEEDLELESS A0394 1.00 4.00 INF CONTROL GLOVES (PR) A0382 4•0 7.0�3 A0394 �•� 7'08 GLUCOSE BLOOD � 92 1.92 OP SITE A0394 �•� 65.01 OXYGEN ADMINSTRATION A0422 1.0 65.01 2.56 SALINE PREFILLED SYRINGE A0394 1.0 2.56 Total Char es 1787.68 * DESCRIPTION OF PAYMENT REGEIPT PAYMENT DATE AMOUNT 04/0712014 1324.75 Champus/Champva Adjustment Total Credits 1324.75 ��_k.��_ :'f�Y T�-iiS r'Rkti+�i:1,�_7f�T—�s'�t1«t�C� �l.4� ��E'C?�9 lt��iF�a �—'""' � $462.93 M`�LTi��91l,€=� Z.��".��. e��-;��€.�?� cn,��NUMSER: 1401686E AMOUNT PAID: — PATIEN7 NAME: ARTIS, DONNIE 04/17/2014 If��P��f-+�� Ae°�� WE ARE AWARE THAT THE PATIENT IS DECEASED AND YOUR OFFICE IS HANDLING THE ESTATE. PLEASE FORWARD PAYMENT TO ABOVE ADDRESS AS SOON AS POSSIBLE. WEST SHORE EMS - EMS 205 GRANDVIEW AVE STE 211 CAMP HILL, PA 17011-1708 .� _ , ��,t�' '�1.��-� ': `7 �� a -� �� , ��- �� .�� c�-' - � � ` �� ; ��,�`` �.Y� ��, � \�' LAW OFFICE OF WM. D. Scxx�cx III 124 WEST HARRISBURG STREET DILLSBURG, PA 17019-1268 Telephone 717-432-9733 E-mail: Schracklaw@comcast.net Telefax 717-432-1053 Website: Schracklaw.net October 13,2014 r-.� � � r � � o --� � rn � .� � � ,� � �, � _ �-;-� � n -�-� ,-.�� _.� ,� �-... ., t:�-� Register of Wills � � � ° �� r�� ' �. � —�.y e,,.z Cumberland Countv Court House ` ' , ; .:_, One Courthouse Square � �� `P �'� Carlisle,PA 17013 - ` � ~� '=.= c-� w ;— � Re: The Estate of Donnie Artis ,.', � crt � � D/D: Januaty 27,2014 a File#: 21-14-0285 Dear Register: You will find enclosed herewith the original and one copy of"Inheritance Tax Return - Resident Decedent",Form REV-1500, submitted on behalf of the Executor of the above-noted Estate. Also enclosed is a third signature I�age stamped"COPY",which I ask that you time stamp and return to me in the envelope provided. Please include the Official Revenue Receipt when returning the time stamped"face page". Thank you for your attention to this request. Sincerely, � , . D. SCHRACK III WDS/jsg � �+� �e _ 1 c��,� ` � N — Fs A � — � � � � — �. �, � 9 �. � _ — r-+ N � � � � _ -_ : � �� °°° ___ e`-.,� �\; N � — r � �� ` � - �� -_ �� _ � - = � - � � < ,.. , ; b . ..., � `,._...., . . . . . ,. . .. . : �; . '.a-, ,.i�- . � � � .. .,.<. . . . . . . . . . . . . '�� . :�--� � . . - ' � � � ! . ` `� �d' . . .. . . � �.. , �� . .I��. ,".:.,2'V . . . . . . . . � . 'T'.-: . . . .. . . . :. . . , . . 3z '..' ' � ' � . . .-� -,�. . . � . ' ' ,�. . . � r w. .: � . . . . . . . . � . -vv.; e . . . "_� . . ';(�_r.,, ,�"^' .. . � . . ., . . . - � . . yF, �� .. . � � � � � , � . _ - � . y� �, . ' . . . � - � . {' . , .� . . . . . �:. � � � . , " , .�rF � . . � . . . � .. . �:-=/ .t..� . . 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