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HomeMy WebLinkAbout12-11-14 (2) . ' J 15056Z014❑ REV-15�0 EX (02-11)(Fl) OFFICIAL USE ONLY PA Departmeni of Revenue Bureau of Individual Taxes County Code Year File Number Po Box 2soso� INHERITANCE TAX RETEIRN � 1 1 3 1 0 9 6 Harrisburv,PA 17128-0601 RESIDEIVT DECEDEPIT ENTER DECEDENT INFORMATION BELOW Social Security Number Da#e of Death MMDOYYYY Date of Birth MMpDYYYY 1 0 0 9 2 D 1 3 ❑ 5 0 7 1 9 2 � 17ecedent's Last Name Suff'ix Decedent's First Narne MI t 0 L E M A N G 0 R D 0 N lil (lf Applicable)Enter Sunirving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN AAUST BE�ILED IN DUPLICATE WITM 7ME REGISTER �F WILLS fELL IN APPROPRIA7E OVALS BELOW � 1.Original Retum � 2.Supplemental Return � 3.Remainder Return{Date of Death Prior to 12-13-82) � 4. Limited Estate � 4a.Future Interest Compromise(date of � 5_Federal Estate Tax Retum 12equired daath after 12-12-82) QX 6.�ecedent Died Testate � 7.Decedent Maintained a Living Trust 1 8_Total Number of Safe Depasit Boxes (Attach Copy of Wil� (Attach Copy of Trust.} � 9.Litigation Proceeds Received � 10.Spousal Poverty CredR(Date of Death � 11.Election to Tax under Sec.9113(A) Between 12-31-99 and 1-1-95) (Attach Scfiedule O) CORF2ESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SNOULD BE DIRECTEp T0: Name baytime Telephone Number P U R C E L L , K R 11 G & H A L L E R � � � � � rn REC�6�OF lMLL�C�E O � fTi � C'� � � t� First Line of Address %� D � ► '� � f71, !"' ;� CTt F.-+ � p i 1 7 Z 9 N • F R 0 N T S T R E E T �� �.' �� c:a q �,� � Second Line ofAddress �``"� � �� � `Tl c:r � 'ft � ^�:::� � F—+ t"? C"' CZ'I 'L�ATE FI M � p City or Post Office State ZIP Code T „n y' V! H A R R I S B U R G P A 171 � 2 CorrespondenYs e-ma'rl address: hkruACa?_pkh.Com Under penalties of perjury,[deGare that I have examined ihis retum,inGuding accanpanying schedufes and statements,and to the best of my knowledge and belief, it is true,correct and oomplebe.Deciaration of preparer other than the personal representative is based oa all information of which preparer has any knowledge. �SIGNAT RE OF R$QI�J�RES ON 18LE FOR FILfNG RETURN p(��[E / � �; � >����t�,� ___ ------ - ADDRESS 402 Andre C' c Indiana PA 15701 S{ RE PA R TFiAPI REPRESEN3ATNE TE , L �� ADDF2 17 N • ront Street Narrisbur PA 7102 FLEASE USE ORIGINAL FORNf ONLY Side 1 � 15�5b107,40 150561QZ4� � � f e } � 1505610240 REV-1500 EX(FI) DecedenYs Social Security Number �ecedent'sName: GORDON W • COLEMAN RECAPITULATION 1. Real Estate(Schedule A) �. 2 6 9 0 0 � . � 0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Stocks and Bonds(Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2• 1 1 6 9 6 4 8 . 0 9 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . . . . . 3. ' 4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . 4. ' 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . 5. 2 � 2 5 � 3 . 2 2 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. • 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property 3 1 � � � . 0 0 (Schedule G) � Separate Billing Requested . . . . . . . 7. 8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 1 6 7 2 1 5 1 . 3 1 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9• 1 5 1 6 5 6 . 1 8 10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule 1) . . . . . . . . . . . . . 10. 5 8 3 . 1 5 ��. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 1 5 2 2 3 9 . 3 3 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12• 1 5 1 9 9 1 1 . 9 8 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) . . . . . . . . . . . . . . . . . . . . . . �3� 5 � � � . � 0 14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . 14. 1 5 1 4 9 1 1 . 9 8 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 _ � . � � 15. � . 0 � 16. Amount of Line 14 taxable at�inea�rate X.045 1 5 1 4 9 1 1 . 9 8 �6. 6 8 1 7 1 . 0 4 17. Amount of Line 14 taxable at sibling rate x.i z D . 0 0 ��. 0 . � 0 18. Amount of Line 14 taxable at collateral rate X.15 0 • � 0 18. � • � � 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 6 8 1 7 1 • � 4 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Q Side 2 � 1505610240 1505610240 J REV-1500 EX(Flj'Page 3 File Number Decedent's Complete Address: 2� 13 1096 DECEDENT'S NAME GORDON W. COLEMAN STREET ADDRESS 1000 Ciaremont Road CITY STATE Z�P Carlisle PA 17013 Tax Payments and Credits: ��� 68,171.04 1. Tax Due(Page 2,Line 19) 2. CreditslPayments A.Prior Payments 70,750.00 B.Discount 3,408.55 Total Credits(A+B) (2) 74,158.55 3. I nterest (3) 4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT. Fill in oval on Page 2,Line 20 to request a refund. (4) 5,987.51 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 0.00 Make check payable to: REGISTER OF WILLS, AGENT 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 ...................................................................... Q � b. retain the right to designate who shall use the property transferred or its income ............................... X c. retain a reversionary interest ..........................................�......................................................... ❑ 0 d. receive the promise for life of either payments,benefits or care. ....................................................... 2. If death occurred after December 12,1982,did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... 0 � 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death? ......... ❑ ❑X 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation?.................................................................................................. ❑ � IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 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)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an adoptive parent or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in p2 P.s.§st�s(a)(���. • 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-1'S02 EX+('i2-12) pennsylvania SCHEDULE A DEPARTMENT OF REVENUE REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: GORDON W. COLEMAN 21 13 1096 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 decedenYs interest if owned as tenant in common. VALUE AT DATE NUMBER OFDEATH DESCRIPTION 1. 621 Stoney Run Road, Monaghan Township, Dillsburg, PA 269,000.00 (See attached HUD-1.) TOTAL(Also enter on Line 1,Recapitulation.) $ 269 000.00 If more space is needed,use additional sheets of paper of the same size. REV-f503 EX+($-12) pennsylvania SCHEDULE B DEPARTMENT OF REVENUE INHERITANCETAXRETURN STOCKS & BONDS RESIDENT DECEDENT ESTATE OF FILE NUMBER GORDON W. COLEMAN 21 13 1096 All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 1,350 shares of Gratz National Bank stock(GNBF) 78,300.00 $58 per share on 10/9/2013 (See stock certificates and Date of Death value attached hereto.) 2. PNC Investment Acct. #001-281182 659,879.97 $655,485.57 + $4,394.40 (accrued interest) (See attached PNC Investments Date of Death statement.) 3. Woodbury Financial Services, Inc. Acct. #7F1-181439 431,468.12 (See attached combined account portfolio showing date of death balance of account and holdings.) TOTAL(Also enter on Line 2,Recapitulation) $ 1 169 648.09 If more space is needed, insert additional sheets of the same size REV-1508 EX+((J$-12) pennsylvania SCHEDULE E DEPARTMENTOFREVENUE CASH, BANK DEPOSITS 8� MISC. INHERITANCETAXRETURN pERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: GORDON W. COLEMAN 21 13 1096 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. Woodbury Financial Services, Inc. (cash account) 24,304.10 Acct. #7F1-181439 (See attached account portfolio showing date of death value of cash held in account.) 2. PNC Bank Checking Account#5004882592 396.16 (See attached date of death statement.) 3. PNC Bank Savings Account#5004882592 98,414.55 (See attached date of death statement.) 4. Fulton Bank Checking Account#3622-32787 1,078.30 (See attached date of death statement.) 5. Fulton Bank Savings Account#0100-79386 63,778.94 (See attached date of death statement.) 6. Personal Property(contents of household items) 4,000.00 (See attached check from Bruce R. Trostle) 7. Kubota B7100 HST tractor 2,000.00 (See attached check from Matthew Stover) 8. 2004 Chevrolet Impala 3,750.00 (See attached check for purchase.) 9. Refund from Direct TV 7�69 (See attached refund check.) 10. Refund from Church of God Home 216.09 (See attached refund check.) 11. Refund from Blue Cross/Shield 9•75 (See attached refund check.) 12. Refund from Erie Insurance (automobile policy cancellation) 22.50 (See attached refund check.) 13. Refund from Erie Insurance (home owner's insurance policy) 20.00 (See attached refund check.) 14. 2013 Federal Income Tax Refund (personal) 2,546.73 (See attached.) 15. Refund from Millville Mutual Insurance Company(homeowner's insurance) 194.00 (See attached.) 16. Refund of County taxes paid on 621 Stoney Run Road, Dillsburg, PA 190.51 (See attached HUD-1.) TOTAL(Also enter on Line 5,Recapitulation) $ 202 503.22 If more space is needed, use additional sheets of paper of the same size. . ' ' Continuation of REV-1500 Inheritance Tax Return Resident Decedent GORDON W. COLEMAN 21 13 1096 Decedent's Name Page 1 File Number Schedule E -Cash, Bank Deposits, & Misc. Personal Property ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 17. Refund of School taxes paid on 621 Stoney Run Road, Dillsburg, PA 1,573.90 (See attached HUD-1.) SUBTOTAL SCHEDULE E 1,573.90 GRAND TOTAL SCHEDULE E $ 202,503.22 REV-1510 EX+�ti8-09) pennsylvania SCHEDULE G DEPARTMENTOF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCETAXRETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER GORDON W. COLEMAN 21 13 1096 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 INCLUDETHENAMEOFTHETRANSFEREE,THEIRRELATIONSHIPTODECEDENTAND DATEOFDEATH %OFDECD�S EXCLUSION TAXABLE NUMBER THEDATEOFTRANSFER.ATTACHACOPYOFTHEDEEDFORREALESTATE. VALUEOFASSET INTEREST (IFAPPLICABLE) VALUE 1. Emily Coleman (Granddaughter) 6,000.00 100.00 3,000.00 3,000.00 Gift of cash on 4/15/2013 2. Elizabeth Coleman (Granddaughter) 3,000.00 100.00 3,000.00 0.00 Gift of cash on 5/31/2013 3. Sean Coleman (Grandson) 3,000.00 100.00 3,000.00 0.00 Gift of cash on 5/31/2013 4. Richard Coleman (Son) 14,000.00 100.00 3,000.00 11,000.00 Gift of cash on 8/5/2013 5. Donald Coleman (Son) 14,000.00 100.00 3,000.00 11,000.00 Gift of cash on 8/5/2013 6. Elizabeth Coleman (Granddaughter) 3,000.00 100.00 0.00 3,000.00 Gift of cash on 8/5/2013 7. Sean Coleman (Grandson) 3,000.00 100.00 0.00 3,000.00 Gift of cash on 8/5/2013 TOTAL (Also enter on Line 7,Recapitulation) $ 31 000.00 If more space is needed,use additional sheets of paper of the same size. , REV�1511 EX+�08-13) pennsylvania SCHEDULE H DEPARTMENTOf REVENUE FUNERAL EXPENSES AND INHERITANCETAXRETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER GORDON W. COLEMAN 21 13 1096 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Myers Harner Funeral and Burial (incl. flowers) 11,942.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Donald G. Coleman 83,607.57 streetaddress 402 Andrew Circle �;�y Indiana State PA ziP 15701 Year(s)Commission Paid: NOt Paid Yet 2, Attomey Fees: PURCELL, KRUG & HALLER 16,625.00 3, Family Exemption:(If decedenYs address is not the same as claimanYs,attach explanation.) Ciaimant Street Address �i�y State ZIP Relationship of Claimant to Decedent 4. ProbateFees: CUMBERLAND COUNTY REGISTER OF WILLS 193.50 5. AccountantFees: SwinehartAccounting 610.00 6. Tax Retum Preparer Fees: 7, Cumberland County Register of Wills(additional probate fees) 920.00 8. Short Certificate (additional) 10.00 9. Family Settlement Agreement(filing fee) 25.00 10. The Sentinel (advertising of Estate Notice) 221.40 11. Cumberland County Legal Journal (advertising of Estate Notice) 75.00 12. Don Paul Shearer(real estate appraisal) 450.00 13. Kerry Pae Auctioneers (personal property appraisal) 337.50 14. Verizon (maintain real estate for sale) $�.77 15. Met-Ed (maintain real estate for sale) 328.19 16. Daflure Heating and Cooling (to maintain real estate for sale) 209.00 17. United Refrigeration (electrical panel and thermostate for furnace) 165.64 18. H.B. McClure Company(parts to fix and maintain furnace) 251.60 TOTAL(Also enter on Line 9,Recapitulation) $ 151 656.18 If more space is needed,use additional sheets of paper of the same size. ' ' Continuation of REV-1500 Inheritance Tax Return Resident Decedent GORDON W. COLEMAN 21 13 1096 DecedenYs Name Page 2 File Number Schedule H -Funeral Expenses 8�Administrative Costs - B7. ITEM NUMBER DESCRIPTION AMOUNT 19. Sid Harvey Industries, Inc. (parts to maintain furnace) 23.38 20. Vicki Stover(4 bags rock salt to maintain real estate during winter months) 20.00 21. Matthew Stover(several furnace repairs; lawn maintenance; snow plowing & 1,029.00 shoveling; general home maintenance over a period of one year) 22. Jonathan Stover(lawn and general maintenance of real estate for period of one year) 468.00 23. SAC Oil Company(fuel oil to maintain real estate for sale) 838.25 24. Donald Coleman, Executor(reimburse gas/mileage from Indiana, PA to Dillsburg 3,084.19 over period of one year; food; supplies; and maintenance of real estate) 25. Charles D. Hoffman, tax collector-county/municipal tax to maintain real estate for sale 695.34 26. Commonwealth of Pennsylvania registration (maintain vehicle for sale) 36.00 27. Zimmerman's Automotive inspection (maintain vehicle for sale) 89�58 28. Indiana Frame and Axel Company(repairs to vehicle prior to sale) 497.14 29. Erie Insurance(auto and homeowner's ins. to maintain real estate &vehicle for sale) 289.50 30. USPS postage expenses 30.35 31. Inspection Center by Mike Biechler, Inc. (inspection of real estate to prepare for sale) 405.00 32. Jim Hallman Painting and Maintenance (painting, pressure washing, and general 3,200.00 maintenance of entire house to prepare real estate for sale) 33. Christopher Garman, Electrical Contractor(replace GFI outlets throughout home; replace electrical panel box and service wire (mast-meter) 1,177.80 34. Eichelberger Drilling (install UV light system for water filtration per ALS Environmental) 793.94 35. Bennett's Landscaping (trimming; hedging; mulching flower beds) 424.00 36. Boscov's Department Store (drapes to prepare real estate for sale) 110.45 37. Kmart Department Store (toilet seat; weed killer; misc. supplies to prepare real estate) 87.44 38. Winding Hill Window Cleaning (clean windows to prepare real estate for sale) 300.00 39. Heather Loudon (clean of real estate) 50.00 40. AK Ventures(Dillsburg Glass Service) (repaired broken storm window) 45.58 41. Leeway Inc. (trailer rental to remove property from real estate prior to sale) 80.00 42. Indiana Insurance Company(homeowner's policy until sale of real estate) 454.00 43. Peck's Septic Service (repair septic for real estate settlement) 2,574.00 44. Peck's Septic Service(inspection for real estate settlement) 225.00 45. Charles Hoffman (tax certification for real estate settlement) 15.00 46. York County 1% Real Estate Transfer Tax 2,690.00 47. Keller Williams of Central PA(real estate broker fees) 7,100.00 48. Hooke, Hooke& Eckman (real estate broker fees) 6,725.00 49. Charles Hoffman (2014-2015 real estate taxes due at settlement) 2,046.07 SUBTOTAL SCHEDULE H-67 35,604.01 • REV-1512 EX+(12-12) pennsylvania SCHEDULE I DEPARTMENTOFREVENUE DEBTS OF DECEDENT� INHERITANCETAXRETURN MORTGAGE LIABILITIES& LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER GORDON W. COLEMAN 21 13 1096 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. Quantum Imaging 4.67 (paid prior to death but check not cleared) 2. Cardiovascular Associates 21.00 (paid prior to death but check not cleared) 3. New York Life premium 105.60 (paid prior to death but check not cieared) 4. Jonathan Stover(lawn maintenance performed prior to death) 42.00 5. Met Ed 67.17 (Electric bill due at time of death) 6. Verizon 97�90 (Phone bill due at time of death) 7. Spirit Physician Services, Inc. 49.74 (medical bill) 8. Hospitals of Central PA 60.07 (medical bill) 9. Wellspan Physician Services 40.00 (medical bill) 10. 2013 PA Schedule 40 95.00 (decedent's final state income tax return) TOTAL(Also enter on Line 10,Recapitulation) $ 583.15 If more space is needed, insert additional sheets of the same size. REV-1513 EX+(01�f0) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: GORDON W. COLEMAN 21 13 1096 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec.9116(a)(1.2).] 1. Donald G. Coleman Lineal 402 Andrew Circle, Indiana, PA 15701 One-half residuary estate 2. Richard G. Coleman Lineal 2426 Hewitt Street, League City, TX 77573 One-half residuary estate 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. Monaghan Presbyterian Church 5,000.00 1185 Gettysburg Pike Dillsburg, PA 17019 TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 5 000.00 If more space is needed,use additional sheets of paper of the same size. ' K TABLE OF CONTENTS A. Copy of Last Wili & Testament dated 5/30/1995 and Codicil dated 7/7/31/2008. B. Copy of HUD-1 for sale of real estate. C. Copy of GNB Financial Services, Inc. stock certificates and Yahoo finance Date of Death stock quote. D. Copy of PNC Investments Date of Death valuation. E. Copy of Woodbury Brokerage Date of Death Combined Account Portfolio. F. Copy of PNC Bank checking and savings account Date of Death values. G. Copy of Fulton Bank checking and money market Date of Death values. H. Copy of Bruce Trostle's check for purchase of contents of real estate. I. Copy of Direct TV refund check. J. Copy of Church of God Home, Inc. refund check. K. Copy of Blue Cross/Blue Shield refund check. L. Copy of Erie Insurance homeowner's and auto policy refund check. M. Copy of 2013 Federal Income tax refund check. N. Millville Insurance Company refund check. O. Copy of Matthew Stover's check for purchase of Kubota tractor. P. Copy of Don Coleman's check for purchase of 2004 Chevy Impala. � , �- T----�.-a �—..._� y , - t� � -.- e .:-- v�$ �� �x�. �- ��v -_ `-'•'L�ST WII,L �ATD TESTAMEATT 8�' �:��._:.� � � , ��_ _ ; 'GORDON W. CAI,EMAN ' .,;� ,.i � „ �':+ `� r�,� � ��.I;,_:,GORDON,W: COLEMAN, of Dillsburg, York �Count � ! - �,., �, ,, �r t�J�1��i'• Pe �isy�vania, �` declare this to be my Last Will and Testament, and revoke any and all Wills and Codicils made by me, ITEM I: I direct that all my just debts �and funeral exp�ins��, irl�iu�ii�' ui-- ' .. .as��. � . - � , g y EJtQ.'v'c aiiczinc�l c�it�a �.�� -G-s.ti�=i Sa�_ C� i;;j �3S'F' illness, shall be paid froinany residuary est�.te as soon as � practicable after my decease, as a part of the� e xpense of the administration of my estate. ITEM II: I give, devise and bequeath the rest, residue and remainder of my estate of every nature and wheresoever situate in equal shares, one share to each of my children, RICHARD G. COLEMAN and DONALD G. COLEMAN, or their issue, er � stirpes. In default af any such issue, then to my surviving ) child or his issue, er stirpes. - � � � ITEM III: All Federal, state and other death taxes payable because of my death with respect zo the property ; forming my gross estate for- �ax purposes, r,���-���r oi ��� � passing under this Will, including any interest or penal�y imposed in connection with such tax, shall be considered a part of the expense of the administration of my estate and shall be paid out of the residue of my estate, without apportionment or right of rei_mbursemente � � EXHIBIT � � . . � � ITEM IV: I direct that no executar or his successor serving hereunder be required to post bond or enter security in � any jurisdiction. � . ITEM V: I appoint my son, DONALD G. COLEMAN, Executor of this my Last Will and Testament. Should my son, DONALD G. COLEMAN, fail to qualify or cease to act as Executor, I appoint �v son, RICFiP?dU G. COLEMAN, Executor of this my Last Will and Testament. � ITEM VI: I appoint my son, RICHARD G. COLEMAN, guardian of the estate of any minor beneficiaries. Should my son, RICHARD G. COLEMAN, fail to qualify ar cease to act as IGuardian, I appoint PAMELA AUSTIN Guardian of the estate of any minor beneficiaries. Such guardian shall not be required to post bond or enter security in any jurisdiction. ITEM VII: Where appropriate throughout this my Zast Will and Testament, all references herein to the singular or the masculine shall include the plural or the feminine, respectively. IT� VIII: I d.,ir�ct my persanal ret�resentative to� emplay HOWARD B. KRUG as attorney for my estate. This provision is made solely at my request and without urging or suggestion by the said HOWARD B. KRUG. � 2 � � .. . ,_ I IN WITNE5S WHEREOF, I have �hereunto set my hand and seal this �-j� day of ��� 1995. � � � . / c i�r� . �-z�C. �t ��-� -�-�.(SEAz) GORDON W. COLEMAN The preceding instrument, consisting of this and two other typewritten pages, was, on the date thereof signed, published and declared by GORDON W. COLEMAN, the Testator therein named, as and for his Last Will, in the presence of us, who, at his request, in his presence, and in the presence of � each ather, have subscribed our names as witnesses hereto. �l�tC�c.��1�g� [f���,�residin at �.l��LU' - �. , g � .� �, � � �/ J . , - �h,�';�;�5-� (� �����-�(.f� residing at �-2�i.���it.rh.� �� . � � • ' /y t . [.l � 3 TM..,�,x i _4.___ . . . . .. . . . . . . . ' � COMMONWEALTH OF PENNSYLVANIA - SS. COUNTY OF DAUPHIN . � `�' ' and WE, GORDON W. COZEMAN, ���1�i1i�•(I� ��.I'1.US ����i���� n �.���`����� �� , ���;���� , the Testator and the . witnesses., respectively, whose names a're signed to the attached or foregoi�ng instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the .instrument as his Last Will, and that he had signed willingiy anci tnat he execu�e�. ��ic as �.i� i�ee aiici voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, � signed the will as witnesses and that to the best of their knowledge the Testator was at that time eighteen years of age or older, of sound mind and under no canstraint or undue influence. �,��� �1 ����.�-�.... GORDON W. COLEMAN � . �`������.,��-f���� �' �'��_ Wi�ess �� 7 � �` ��.�yN4�� L(' .� �..�,-�c-t� W,i�nes s f Subscribed, sworn to and acknowledged before me by GORDON W. COLEMAN, the Testator, and subscrihe�and sworn to h�fore me' by ��9�C��tjl� ��ht�S ���pt�� i and �°�?,�/�<3�!-P� � ����L_.. � _, c��tx����se��. . this � >�' day of �(;:�f , 199�. . � . . ,/L�.��/'.�-���- : . � � . : . , ; _...._.:�-- . . - . . Notary Public � - Notarial Seal Cheryl L Welsh,Notary Public Harnsburg,Dauphin County (VIy Commission Expires May 11,1995 �, ._ � __ . _ __ __ ____ _ _ - � -- �__� �_� ����:�� - - - - � ��.� t ., -. _ - ,; ,_ _ _ „ ., :, � � :�_ �OC�%C%/ t0 t/]� � �:;_�. :� _, .: ,t :� .. _`. : Las� �!/ill and �esfar�en� -� �; � ,- ; „ �� o� _ _. �,'u t _.� � ;'i � :;I_, . 1 , . Gordon VV Co%man �,, ::,I, GOR[��N�W. COLEMAN, of Dillsburg, York County, Pennsylvania, declare this t�� :'���;�.: ; - �,:-; _ o be f�he sole codicil to my Last Will dated May 30, 1995. ITEM 1. t hereby revoke ITEM ii of my Last Will and Testament dated May 30, 1995 and in lieu thereof provide as follows: ITEM 11: I give, devise and �equeath the rest, residue and remainder of my estate of every nature and wheresoever situate as fo(lows: A. I give the sum of$5,000 to the Monaghan Presb}rterian Church located af 1185 Gettysburg Pike, Dillsburg, Pennsyivania. B. i give, devise and bequeath the rest, residue and remainder of my = ,� estate of every nature and wheresoever situate in equal shares, �.-. one share to each of my children, RlCHARD G. COLEMAN and � DONALD G. COLEMAN, or their issue,�er stir es. in defauli of any such issue, then to my surviving child or his issue, �er stir es. ITEM !1: I hereby revoke ITEM I[I of my Lasf Will and Testament dated May 30, '1995 and in lieu thereof provide as follows: iTEM II1: All Federaf, state and other death fiaxes payable because ofi my death with respecf to the property forming my gross estate for tax purposes, whether or not passing under this WiII, including any interest or penal�ty imposed in connection with such tax, shall be considered a part of the expense of the administration of my.estate and shall be paid out�of the residue of my estate, without apportionment or right of reimbursement. However, under no circumstances, shall the gift to the Monag_han � Preshyterian Church be reduced by virtue af any taxes or expenses of any kind, thereby retaining the entire charitabfe deduction of$5,000. ' - - - ___ _. � _ _ _ 1 i Eii� 111: ln all other respects, I i�ereby ratify, confirm and republish my Last Will dated May 30, 1995, together with this sole Codicil, as and for my Lasfi Wi11. IN WITNESS WHEREOF, l have hereunto set�my hand this �1�� day of �J � � � , 2008. � ����� ��-����� GORDON W. COLEMAN Signed, published and �eclared on the daie thereof by the above named GORDON W. COLEMAN as and for the sole Codicil to his Last Will dated May 3Q, 1995 in fhe presence of us, who at his request, in his pres�nce, and in the presence of each other, have subscribed our names as witnesses hereto. ����.��,� � lJ��e^�J���residing at ����1�5��-�.Q-�,, DA �� � � � � � _. -r�c� �_ �.�.«--�.�: residing at �7�c.�.��,�,�.,,_ ��4 � / . . CdM�ONWEALTH OF PENiVSYLVANf . A COUNTy O� DAUPHIIV : ss: � WE, GORDON W. Cp�E�yAN, � �,{�,��� ' �.� ,� . , c.�,,;_. . � , the Testator and th, a►�d names are signed io the atfached or fore Qi� W�tnesses, respectivel 9 g instrument, being firs�duly swo�� do�se hereby dec[are to fhe undersigned authoriiy that the Testator signec� a�d execufed �he �nstrument as his sole Cadicil to his Lasi Wil� dated Ma S�9�ed�����ng�y and tf�at he executed ii as his free an y 30� 'g9� tc , and fhat he i�ad therein expressed, and that each of the v��fnesses �nd��juntary a��for the purposes Testator, signed the Godicii as witnesses and that fo j�he presence artd hearing of fhe Testator was at that time eigf�teen years of age or ot he �eS{���heir knowEedge, the constrain� or undue influence. der, of sound mind and under no ; � . � � � . � -��/'/�- � GORDOI�,I 4���'� - � W. COLEIVlqN �eal � i ��� � ��� � w�t SS � ���� ; � �. � . . ' °Z �Ni�ness -�"'��'�-' � Subscribed, sworn to and acknowtedged before me b � the Testator, and subscribed and sworn to before rne ►� y GORDON W. COLEMAN, �,�.. Y�'c rvl t��.�L� 5- ���i �}-�C� and � - � � . ,�sc�,�; , witnesses, this ,c� �ay of - , 2008. � � Notary blic �- MHiO(��L-�OF PENIV Noiarial Seai V �� Angeta S.Shaa�er,Nofa �Y ei Harrisfwrg Dau ry Public �Cc►nmis�ron � ptvn Co��, � ��ber,Penns �res Jan.23.20i2 ' Ytvania Asso�ia�n of �� - ' OMB Approval No.2502-0265 ��p�, '��r��������� A. Settlement Statement(HUD-1) �"II�II�II;� `�$w o.��s� 1. ❑FHA ' 2.QRHS 3. �✓COnV.Uf1i0S. 6.File Number: 7.Loan Number. 8.Mor,ga�e Insuran;,e�Case Number. 4. ❑VA 5.❑Conv.Ins. MS63507 504176006 C.NOte: This fortn fs fumished lo give you a statement of aclual settlement cosls.Amounls paid to and by the settlement agent are shown.Items marked°(p.o.cJ'were paid oulside ihe closing;they are shown here for infortnational purposes and are not included in ihe totals. D.Name 8 Address of Borrower. E.Name&Address of Seller. F.Name 3 Address of Lender: JOHN S.PALUSCIO JR.AND THERESA J.PALUSCIO ESTATE OF GORDON W.COLEMAN FOOTE CAPITAL MORTGAGE COMPANY 318 MOUNTAIN ROAD 621 STONY RUN ROAD 17 EAST HIGH STREET DILLSBURG,PA 17019 DILLSBURG,PA 17019 SUITE 102 CARI_ISLE."PA 17013 G.Property Location: H.Settlemenl Agent �DISON SETTLEMENT SERVICES-CARLISLE, I.Settlement Date 1 Disbursement Date ��C g/23/2014 i 9/23/2014 621 STONY RUN ROAD 59 S.PITT STREET,CARLISLE,PA 17013(717) DILLSBURG,PA 17019 (YORK) 24�2�2� (38000PD00230000000) P�ace Oi Seltlement: 59 S.PITT STREET,CARLISLE,PA 17013 (717)243-2121 100.Gross Amount Due From Borrower 400.Gross Amount Due To Seller 101.Conlract sales p�ice' $269,000.00 401.Contract sales rice a269,000.00 _ �--- 102:'Personal PropeRy 402.Personal Pro erty ____.__ 103:Serilement Char es to BoRower line 1400 $9,023.11 403. __ 104. 404. -- - -- 105. 405. Adjustments for items paid by seller in advance Adjustments for items paid by seller in advance 106.City/town taues 406.Cit/town taxes 107.County taxes 9/23l2014 to 12131/14 $190.51 407.County taxes 9/23/2014 to 12131/1d $190.51 108.School Tax 9123I2014 to 6/3012015 $1,573.90 408.School Tax 9/23/2014 to 6/30/2015 $1,573.90 109. 409. 110. 410. 11 L 41 t. 112. 412. 12�7.Gross Amount Due From Borrower $27g,787.52 420.Gross Amount Due To Seller 5270 764.47 200.AmountsPaid B Or In Behalf Of Borrower 500.Reductions Irt Amount Due To Seller ' 201.DeposiGor Earnest Money $5,000.00 50t.Excess de osit see instructions 202':Principal amount of new loan $215,200.00 502.Settlement Cha�es to Seller line 1400 $19,329.00 203:Existing loan taken subject to 503.Existing loan taken subject to 204. 504.Pa off of f rst mort a e loan 205. 505.Payoff of second mortgage loan 206. 506.See Addendum 506 $2,oa6.o7 207 507.Disbursed as roceeds $5,000.00 _ 208. 508. 209. 509. _ - Adjustments for items unpaid by seller aa�uscmen�s tor ttems un am ny sener __ _ 210:Cityltown taxes 510.City/town taxes ___ __- 21L Countytaxes 511.Count taxes 212.Assessments 512.Assessments _ 213. 513. 214 ' 514 215.' 515. 216. 516. 217: 517. 218: 518. - 219. ' 519. 220.Total Paid BylFor Borrower $220,200.00 520.Total Reduction Amount Due Seller $21,375.07 300.Cash At Settlement From/To Borrower 600.Cash At Sett,ement TolProm Seller 301:GrossAmount Due From Borrower(line 120) $279,787.52 601.GrossAr�ount Due To Seller(line 420) $270,764.41 302:Less Amounts Paid By/For Borrower(line 220) $220,200.00 602.Less Deduction in Amt.Due To Seller line 520 $21,375.07 303.Cash .❑�From ❑ToBorrower $59,587.52 603.Cash ✓❑To ❑FromSeller T�249,389.�a EXHIBIT � a D � 700.Total Real Estate Broker Fees Paid From > Pald From Divisionbf Commission(Iine 7001 as follows: Borrowars Seller's 701.$6,725.00 to Keller Williams of Central PA Funds at Funds at Setllement Settlement 702:$6,725.00 to Hooke Hooke&Eckman 703:Commission paid at Settlement $13,450.00 704:Broker fee to Keller Williams of Centraf PA $375.00 705:Broker Fee to Hooke Hooke&Eckman $245.00 800:1tems Payable In Connection With Loan �� ,>. .�_,r�; � � � � � 801.Our ori ination charge$727.00 (from GFE#t) 802.Your credit or charge points)for the specific interest rate chasen (rom GFE#2) 803:Your adjusted origination charges (from GFE A) $727.00 804:Appraisal Fee to Streetlinks Lender Solution(POG$425.00 by John S.Paluscio Jr.and Theresa J.Paluscio)(from GFE#3) 805.Credit Report to Credit Plus (from GFE#3) $68.62 806.Taxservice to Foole Capital Mortgage Company (from GFE#3) 807.Flood Certification to foote Capital Mortgage Company (from GfE#3) 900.Items Re uired B Lender To Be Paid In Advance 901.Daily interest charges from 9123/2014 to 10/1/2014 @ 27.2685/day to Foote Capital Mortgage Company (from GFE#10) $218.15 902.Mortgape Insurance Premium (from GFE#3) 903.Homeownets insurance for 12.00 months to MMG Insurance (from GFE#11) $1,038.00 1000.Reserves Deposited With Lender 1001.Initial deposit tor your escrow account (from GFE#9) $948.34 1002.Homeowners insurance 3.00 months @$86.50 per month$259.50 1003.Mortgage insurance 0.00 months @ per month 1004.Property taxes 8.00 months @ $59.13 er month$473.04 1005.School Tax 4.00 months @$170.51 per month$682.04 1007.Aggregate Adjustment($466.24) 1100.TitleChar es 1101.Title services and lender's title insurance (from GFE ii4) $1,978.00 1102.Settlement or closing fee to Madison Settlement Services-Carlisle,LLC 1103.Owner's title insurance to Madison Settlement Services-Cadisle,LLC (from GFE#5) $265.00 1104.Cenders title insurance to Madison Sefllement Services-Carlisle,LLC $1,778.00 1105.Lender's title policy limit $215,200.00 1106.Owner's ti0e policy limit' $269,000.00 1107.AgenYs portion of the totaf title insurance premium to Madison Settlement Services-Carlisle,LLC $1,736.55 1108.Undenvritets ortion of the tolal title insurance remium to Old Republic National Title Insurance Com any $306.45 1109.CPL Fee to OId Re ublic National TiUe Insurance Compan $125.00 1110.Courier(20)EDocs(55)to Madison Settlement Services-Cadisle,LLC $75.00 1200:Govemment Recordio and Transfer Char es 1201:Government recording charges from GFE#7) $180.00 1202.Deed$75.00 Mortgage$105.00 Releases$ 1203.Transfer taxe; jirom Gr"e";��) b2;tiyUAU $2,690.OU 1204.City/County4ax/stamps Deed$2,690.00 Mortgage$ CitylCounty tax/stamps Deed$2,690.00 Mortgage$ 1205.Statetaxlstamp5 Deed$2,690.00 Mortgage$ State tax/stamps Deed$2,690.00 Mortgage$ 1300.Additional Settlement Char es 1301.Required services that you can shop for (from GFE#6) $665.00 1302.Survey ' 1303.Pesi lnspection 1305:Taz Cert Paid to Charles Hotfman to Madison Settlement Services-Carlisle,LLC S15.o0 1306.Se tic Inspection to Peck's Septic Service $440.00 $225.00 1307,Pest&Radon Screening to Alpha Home Inspection $225.00 1308.Septic Pumping&Repair to Peck's Septic Service $2,574.00 �� : � � i $9,023.11 $19,329.00 Compadson of Good Faith Estimate(GFE)and HUD-1 Charges Good Faith Estimate HUD-1 Charges'That Cannot lncrease HUD-1 Line Number Our origination charge #801 $727.00 $727•00 Your creditbr charge(points)for the specific interest rate chosen # 802 Your adjusted originatlon charges #803 $727.00 $727•00 Transfertaxes #1203 �w2,690.00 $2,690,00 Charges That in Total Cannot Increase More Than 10% Good Faith Estimate HUD-1 Government recording charges #1201 $180.00 $180.00 Appraisal Fee to Streetlinks Lender Solution(POC$425.00 by John S. #804 $425.00 $425.00 Credit Report to Credit Plus #805 $75.00 $68.62 Pest&Radon Screening #1307 $225.00 $225.00 # # # # $905.00 $898.62 � -$6.38 Of -0.70497% Charges That Can Change Good Faith Estimate HUD-1 Initial tleposit for your escrow account #1001 $2,760.00 $948.34 Daily interest charges #901 $27,2685/day $327.22 $218.15 Homeowner's insurance � 903 $720.00 $1,038.00 Title services and lender's tiAe insurance #1101 $2,204.50 $1,978.00 Owners title insurance to Madison Settlement Services-Carlisle,LLC #1103 $100.00 $265.00 Septic Inspection #1306 $225.00 $440.00 Loan Terms Your initial loan amount is $ 215,200.00 Your loan term is 30.00 years Your initial interest rate is 4.625% Your initial monthly amount owed for principal,interest,and any $ 1,b06.43 i�c!ed�s mortgage fnsurance is �✓Principal �✓Interest ❑Mortgage lnsurance Can your interest rate rise7 0✓No. ❑Yes,it can rise lo a maximum of %.The first change will be on and can change again every after .Every change date,your interest rate can increase or decrease by %.Over the life of the loan,your interest rate is guaranteed ro never be lower than %or higher than %. Even if you make payments on time,can your loan balance rise? Q✓No. Q Yes,it can rise to a maximum of$ • Even if you make payments on time,can your monthly amount ✓❑No. ❑Yes,the first increase can be on and the monthly amount owed tor principal,inlerest,and mortgage insurance rise? owed can rise to$ The maximum it can ever rise to is$ • Does your loan have a prepayment penalty? 0✓No. ❑Yes,your maximum prepayment penalty is$ • Does yourioan have a balloon payment? �No. ❑Yes,you have a balloon payment oi$ due in years on . Total monthly amount owed induding escrow account payments �]You do not have a monthly escrow payment for items,such as property taxes and homeowner's insurance.You must pay these items directly yourself. �✓You have an additional monthly escrow payment of$ 316.14 that results in a total initial monthly amount owetl of$ 1,422.57 .This includes principal,interest,any mortgage insurance and any items checked below: ✓�Property taxes �]✓Homeowner's insurance ❑Flood insurance �School Tax ❑ � Note:If you have any questions about the Settlement Charges and Loan Terms listed on lhis form,please contact your lender. ' Supplemental Page HUD-1 Settlement Statement Addendums for Page 1 Amount Addendum 506 a 2014 15 School Tax to Charles D Hoffman $2,046.07 b Earnest money retained by Keller Williams of Central PA $0.00 Total: $2,046.07 Itemization Buyer Seller Line 1204 a City/County taxlstamps Deed$2 690 00 Mortgaqe$ Total: $0.00 $D.00 Line 1205 a State tax/stamps Deed$2 690 00 Mortqaqe$ Total: $0.00 $0.00 I have carefully reviewed lhe HUD-1 SetUemenl Statement and to ihe best of my knowledge and belief ii is We and accurate stalement of all recelpU and disbursements matle on my account or by me in this transaction. I fudher cedifV that I have received a copV of the HUD-1 Settlement Slatemenl. BORROWERS SELLERS ����''' �-%�� � .�rx�.�'� ��., �,�, vJOHN S.PALUSCIO JR. Donald G.Coleman,Execu!or - J " E SAJ.PALUSCIO , The HUD-1 Settlement Statement which I have prepared is a We and accurale accounl of this trensaction.I have caused or I will cause the funds to be disbarsed In accordance with this statement. 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Finance Page 1 of 2 Home Mail News Sports Finance Weather Games Groups Answers Screen Flickr Mobile I More Search Finance �mittWeb tfait Finance Home My Portfolio Market Data Business&Finance Personal Finance Yahoo Originais CNBC Enter Symbol ���, Look Up Fri,May�6,2014,2:D4pm EDT-US Markets close in 1 hr and 56 mins Dow�0.14%Nasdaq+30.25°'� GNBF 0.00 =•: d��i�x��, ��TRADE' Spend&manage OPEN AN ACCOUNT your cash. '�Amerltrade O , - ZA _� EWTRfNE SECURITICS LLC GNB Financial Services,Inc.(GNBF) -omer orc *Fouow Get the big picture on all your investments. 147.00 0.��{�.��%� Apr4 . SyncyourYahooportfolionow Historical Prices Get Historical Prices for:�� GO Set Date Range QQ Daily Start Date: OCt V 9�2013 Eg.Jan 1,2010 Q�l�leekly � End Date: OCt V �2013 Q Monthly �Dividends Only Get Prices First�Previous�Next�Last Prices � . Date Open High Low Close Volume Adj Close' � � Oct 9,2013 58.00 58.00 58.00 58.00 0 56.79 � � 'Close price adjusted for dividends and splits. First�Previous�Next�Last ' f`'Download to Spreadsheet Currency in USD. �if"Vanguard. ', Ad Topics That Might Interest You... I 1.Top Stocks to Buy 5.Invest in Goid _............................................................ ...._............_._..__._................_......_................... 2.Dividend Income Funds 6.Medicare Plan Offers _............__........_............................_........ .......__.........._..................._................_........._ ' 3.Top Stocks of 2014 7.Best Income Funds _._............................_...............__._... ........_............._..._._.................._............__..._..... ' 4.High-Dividend ETFs 8.Hot Penny Stock Picks Feedback ads Privacy-About Our Ads-Tertns-Send Feedback-Y8h00�-/'.BC NBW S NENJOfk http://finance.yahoo.com/q/hp?s=GNBF&a=09&b=9&c=2013&d=09&e=9&f=2013&g=d 5/16/2014 1i�1�E5!NE�1 I� �Aem6er FINRp and SIPC . December 2,2013 Donald G Coleman,Executor Estate of Gordon W Coleman 402 Andrew Circle Indiana;PA 15701_ _ _ Dear Sir: Attached is the Date of Death Valuation you requested for the Estate of Gordon W Coleman. This Date of Death Valuation was done by our Estate Resolution Desk. If you have any questions,please contact them at(800)622-7086. The Account Number is 001-281182, and was opened as an individual account on January 12, 2006. The balance as of date of death is on the attached. Sincerely, . ,� _ � ----- �._._ .�,J-- ��. �/:=�..-- v� �---�-� ..._-- i,u. Donna J Pollock,Assistant to Charles E Little, CFAO, CFPO Financial Advisor, Senior VP Enclosure ?�!C fn�estments L�C Niember of i hc?��!C Financial Ser�rices GrouQ EXHIBIT 2 East Main Street Mechanicsbura Fennsyl�:ania i7055 � ► \ vwl�:�.nnc.com J ,..�r���'�l"`I'O"j`'�1e� Impnrtantlnvestor InFormatian:Securities and brokerzg2 services are provided by PNC investnents LLC,member RNRA and SIPC. ,..�j, �\o BarikGnarntec� Arncities znd other insurance preducts are of(ered by PNC Insuranc=_Services LLC,a Licenseo insurance agency. � dl�1V�STIl��,1��T5 � � M1fem6erFiiJRFznd51PC December 2,2013 Donna Pollock Donna oollockC�pnc com RE: 001-281182/Gordon Coleman-Indiv(dual Dear ponna: The value of the above-referenced account on October 9th,2013 is as fo�lows: Amount .t � Symbol/ < Accrued ' Description j Cusip DOD Price �OD Value Interest 35,000.000�BEAVER CNTY PA INDL DEV AUTH POLLUTN CTL I074876GD9 $100.OS) $ 35,018.55 $ 35,018.55 $ 691.25 30,000.000 CHESTER CNTY PA INDL DEV AUTH WTR FACS 16559VAA0 $100.72 $ 30,215.10 $ 30,215.10 $ 283.33 30,000.000 DELAWARE CNTY PA INDL DEV AUTH REV 246018EC5 � 3100.21 $ 30,063.60 $ 30,063.60 $ 163.08 25,000.000 DILLSBURG PA AREA AUTH SWR REV SWR REV 254242EA4 30,00O,OOp'ELIZABETH TWP PA SAN AUTH SWR REV REV BDS 286767DG0 $�02.40 $ 25,600.75 $ 25,600.75 $ 187.50 30.U00.000 LANCASTER CNTY PA HOSP AUTH REV HOSP 514045YK3 $�00.77 $ 30,230.40 $ 30,230.40 $ 456.00 � 20,000.000 MIFFLINBURG AREA SCH DIST PA GO BDS SER. 598575EE4 a91's� $ 2�.484.20 $ 27,484.20 $ 90.00 � 20,000.000 MONTGOMERY CNTY PA GO BDS SERIES-C 613579TN1 $�00.39 $ 20,078.60 $ 20,078,60 $ 285.00 29,171.684 OPPENHEIMER PENNSYL MUNICIPAL CLASS A 683940100 $���18 $ 20,836.00 $ 20,836.00 $ 266.00 30,0OO.OpO pENNSYLVANIA ST PUB SCH BLDGAUTH LEASE 709207DE1 $����Z �292,300.27 $ 292,300.27 $ _ 25,000.000 S103.00 $ 30,899.10 $ 30,899.10 $ 533.00 25,000.000 709207DL5 $99.75i $ 24,936.50 $ 24,936.50 $ 44q,44 25,000.000�PHILADELPHIA PA ARPT REV AIRPORT REV BDS ��78��K�2 $9Z.13 $ 23,031.50 $ 23,031.50 $ 400.00 15,000.000 SOUTH FORK MUN AUTH PA HOSP RE1/HOSA REV 83786D8V8 $��'S1 � 25,126.25 $ 25,126.25 $ 356.25 25,000.000 UNIONTOWN AREq pq SCH DIST GO BDS SER. 909087GW2 $�00.03 $ 15,003.75 $ 15,003.75 $ 214.38 � $98.64 $ 24,661.00 $ 24,661.00 ( $ 24.17 � � $655,485.57 $ 4,394.40 Grand Total(Market Value+Accrued Interest)� I$659,879.97 'Note:DOD price is based off the closing price on the day the client has passed away,if this is a non-business day the price will be taken from the previous business day's ciosing price. If you have any questions,please contact our Estate Resolution Desk at 800-622-7086. Sincerely, Omar Omar PNC�nvestments,LLC. Estate Resolution Desk The summaries,prices,quotes and/or statistics Contained herein have been obtained from sources believed to be reliable but are not necessarily complete and cannot be guaranteed.They are provided for informational purposes only.Past pertormance does not guarantee future resuits. r'(�'C(nvestments LLC �?ember of The��IC Financial Se-�,�iws Group 2 East Main Streei Niechanicsbw g Pennsylvania 17055 w✓wrw�.onc.com i � ��'>j"0`�l"�QC Importantinvenorfnformation:5ecuriti2s and brokera e services are rovided 6 PNC Investment;LLC,mem6er FIMRA and SIPC. .','•\o B��k Guar_niec Annuities and other insurance products are o�fered by PNC Insuran e Services LLC,a licensed insurance agency. Holdings by Investor Gordon W Coleman STEPHEN A MARRAZZO Combined Account Portfolio 621 Stoney Run Road Stephen Marrazzo Date: 10/09/2013 Dillsburg,PA 17019 5291 Devonshire Rd Created: 12/30/2013 Harrisburg,PA 17112 Gordon W Coleman Acct Name:Woodbury Brokerage Acct No:7F1181439 AcctType:individual _ _ __ _ _ _ _ _ _ _ _ _ _ _ Asset Name Ticker AssetType Mgt.Name Quantity Price($) Value(;)i _ _ _ _ _ _ ALLEGHENY CNTY PA HIGHER ED BONDS 5,000.00 109.78 5,517.83 BLDG AUTH UNIV REV DUQUESNE UNIV PROJ-RFDG 5.500% 03/01/16 B/E BROKERAGE MONEY MARKET CASH BROKERAGE 24,304.10 1.00 24,304.10 MONEY MARKET CECILTWP PA MUN AUTH SWR BONDS 30,000.00 82.43 24,948.28 REV RFDG-GTD 3.875% 02/01/43 B/EDTD 04/10/12 CLB DAUPHIN CNTY PA GEN AUTH REV BONDS 10,000.00 100.18 10,181.13 OFFICE PKG-RIVERFRONT OFFICE 6.000%01/01/25 REG DELAWARE CNTY PA AUTH HOSP NON-CLASSIFIED 50,000.00 92.35 46,965.67 REV HOSP 05.00000%12/15/2031 REV BDS CROZER-KEYSTONE HLTH SYS SER. ERIE CNTY PA HOSP AUTH REV BONDS 25,000.00 100.57 25,690.11 HAMOT HEALTH FNDTN 5.000%11/01/35 B/EDTD 04/11/06 CLB JOHNSTOWN PA REDEV AUTH SWR BONDS 25,000.00 99.92 25,135.19 REV RFDG 4.125%08/15l28 BIEDTD 02/15/07 CLB LANCASTER PA RFDG 4.500% BONDS 25,000.00 96.86 24,707.50 11/01/37 B/EDTD 04/01/07 CLB LOWER PAXTONTWP PATAXABLE- BONDS 20,000.00 102.86 20,601.00 SER D-BUILD AMER BDS ISSUER SUBSIDY 6.345%04l01/39 B/E MONTGOMERY CNTY PA HIGHER BONDS 25,000.00 95.70 24,281.29 ED&HEALTH AUTH REV HOLY REDEEMER HLTH SYS 5.250% 01/01/36 B/E NEW KENSINGTON PA MUN SAN NON-CLASSIFIED 20,000.00 85.28 17,332.16 AUTH SWR REVRFDG 3.875%12/01/33 B/EDTD 05/08/12 CLB PENNSYLVANIA HSG FINAGY BONDS 25,000.00 99.40 24,874.83 SINGLE FAMILY MTG REV SER 96- A 4.650%10/01/31 B/EDTD 11/30/06 CLB PENNSYLVANIA HSG FINAGY BONDS 25,000.00 100.19 25,074.61 SINGLE FAMILY MTG-SER 90A 4.700%10/01/25 B/EDTD 09/14/05 CLB PENNSYLVANIA STTPK COMMN OIL BONDS 35,000.00 107.13 38,116.67 FRANCHISE TAX REV RMKT 5/20/08 5.000%12/01/25 B/EDTD 08/14/03 CLB EXHIBIT Incomplete if presented without accompanying disclosure pages � Page 1 of 5 Holdings by Investor Gordon W Coleman STEPHEN A MARRAZZO Combined Account Portfolio 621 Stoney Run Road Stephen Marrazzo Date: 10/09/2013 Dilisburg,PA 17019 5291 Devonshire Rd Created:�2/30/2013 Harrisburg,PA 17112 __ __ __ _ _ _ _ _ _ _ _ __ Asset Name Ticker AssetType Mgt.Name Quantity Price($) Value($)� _ _ _ ___ _ _ ._ _ _ __ _ _ _ ___ _ __ PENNSYLVANIA STTPK COMMN NON-CLASSIFIED 25,000.00 83.03 21,080.22 TPK REV SUB-SER B 3.625%12l01/32 B/EDTD 10/30/12 CLB PHILADELPHIA PA GAS WKS REV BONDS 20,000.00 99.99 20,187.49 1998 GEN ORDINANCE-4TH SER 5.000%08/01/32 B/EDTD 12/30/02 CLB PHILADELPHIA PA GAS WKS REV BONDS 20,000.00 100.09 20,290.82 RFDG-1975 GEN ORDINANCE- 17TH SER 5.000% 07J01/26 B/E PITTSBURGH PA SCH DIST SER BONDS 25,000.00 102.72 25,796.61 B 4.400%09/Ol/25 B/EDTD 11/01/05 CLB ST MARY HOSP AUTH PAHEALTH BONDS 30,000.00 100.29 30,687.30 SYS REV RFDG-CATHOLIC HEALTHEAST-SER A 5.000% 11/15/40 B/E Account Total: $455,772.82 InvestorTotal: $455,772.82 Incomplete if presented without accompanying disclosure pages Page 2 of 5 s.� January 8,2014 Don Coieman 402 Andrew Cir Indiana,PA 15701 RE: Name: Gordon W Coleman SSN: 172-24-8052 DOD: 10/09/2013 Dear Mr. Coleman: In response to your request for Date of Death(DOD)balances for the customer noted above, our . records show the following: Checking Account Account#5004882605 Established: 11/23/2005 GORDON W COLEMAN DOD balance: $ 396.16+0.00 accrued interest Savings Account Account# 5004882592 Established: 11/23/2005 GORDON W COLEMAN DOD balance: $ 98,407.9U+6.65 accrued interest Please note that this office provides date of death balances for deposit accounts(IRAs,CDs,Checking and _ Savings). We do not process any financial transactions or provide statements. If you need assistance with any of these items,please call 1-888-PNC-BANK(1-888-762-2265)or stop by your local PNC Bank branch office. Sincerely, National Financial Services Center PNC Bank,N.A. Member FDIC EXHIBIT � a �1tonBarik LISTENING IS JUST THE BEGINNING° January 10,2014 Donald G Coleman 402 Andrew Cir Indiana PA 15701 Dear Mr. Coleman, RE: Gordon W Coleman,deceased 10/9/2013 In response to your recent inquiry concerning the accounts maintained in the name of the decedent,please be advised that the following accounts were open at the date of death: Checking#3622-32787,opened 5/30/03, date of death balance $107830, (accrued interest of.O1 would not have been payable had the account been closed on the date of death)titled in his name alone with Donald G Coleman as power of attorney. Money Market#0100-79386, opened 8/28/00,date of death balance$63776.33, plus accrued interest of$2.61,titled in his name alone with Donald G Coleman as power of attorney. If you should have any further questions,please do not hesitate to contact me at 717-327-2497. Very truly yours, , � `[', ~ �: ;'i�is irf�rr�.�t ,., � � _:. �l. ���-� . . �a :+�-tilS;.�:J - Gf�.Ci''' �J (1^ i�� eAC ti�k� uj -i� �1 ^ i (En. :.iJ l.. : if� -�1' fi�; !�jj'7����u I� i[.. ��t�,.,;�: f: ��rl. {� � .,;�,, r;,�s �ns�;,:-�,�,�;., �r��-:,�ar,. ,,,f April Billett �U��a�?,� r � .. ' " - k r r� - � � � �_,; Credit Confirmation Processor - �. �,- , iri�arrr.:�.���� _ � � . , ,�. r �� .� � ,�, ;, , ' _ , ,,�:� ��s;#;.c?� r , ,= � e {., 'a'i!; �f ri: �.i',t .a E..;Y'j 1 - 7,c� ti�FG1i�1 �yE�Cc�� . h � ���a ti '{�fit5. F':i;� - �r ..1� 1�J �Z31��G�1 t:'' .-,.�....,o j `.'",��,;i� � Ciiut��`� y'�iiilC,UT '� %i;;[ii,� EXHIBIT 1.800.FULTON.4 • fultonbank.co � � Fulton Bank,N.A.Member FDIC. Member of the Fulton Financial Fa BRUCE RTROSTLE MASONRY INC Z3OO 120 BLAIRMOUNTAIN RD DILLSSURG PA 17019-9669 • �_ �.� °/'/ 3-7615J360 I3ate >' Pay to the �� � P) i ' ' c� � m.•der of �i"�'� f3 ly�c��t�t+A�N.' z��i �,,P�`Y�, t��, � `}' �j�.(,��L'� � i j � ,g S�e�cU�itY F Iaros � ��'' � Dollars LJ e,��"�°^ �� Citizens Bank° For �m ' �i'0(] 2 300��' �:0 3 60 7 6 1 50�: �8 4 3 i 3 4 50 L Li�' 80 L �� EXHIBIT , � , 0 a • Subscriber Refunds Payment Processing Center 4795 Meadow Wood Lane, Ste 300 DIRECTV Chantilly,VA20151 �"��'1'�II'��'I��I��I'��i�i�l'llllll��ll��il��������������li�'1' 005234 IN CARE OF: DON COLEMAN 402 ANDREW CIR INDIANA, PA 15701-2392 Check Date 04/07/14 Check Number 20335909 --- -- - - ---- -- — -- — _� _ _ _ -----____ - ----- __. ec-- mount _ -- _. $7.69 _ — . _ Dear Subscriber, — Attached below is your refund check for account 063943744. � If you have any questions,you can view your account online at www.directv.com/myaccount or contact DIRECTV = Customer Care at 1-800-531-5000. Sincerely, = DIRECN � � = � � 4 �nc�11�� �er�r� c.� !'e��.�.;� m• 0 •' � '• i '� D B M/S N368 62-38/311 Check Number 2230 E IMPERIAL HWY 20335909 EL SEGUNDO, CA 90245 D 1 RECTV DATE: 04/07/14 PAY EXACTLY: Seven Dollars And 69 Cents �� *********7.6� � TO THE ORDER OF: voio,nFreR,eooa,rs O63J437� NOT VALID IF OVER$t0,oao IN CARE OF: DON COLEMAN*'""` EXHIBIT 402 ANDREW CIR INDIANA, PA 15701-2392 � � � w. Deutsche Bank Trust Company Delaware � _ _-- --- ---- —___ _ _.a s� • . . e a �m e � � - � - s � � a - �-7 a --- a - ��' 20335909�i' �:03 L 100380�: 00537975i�' Gordon �oleman Vendor Code: 002019 Vendor Code 002019 Invoice No. Description Date Amount Discount Withheld NetAmount 09302013 Refund 09/30/2013 216.09 0.00 0.00 216.09 CheckDate: 10/25/2013 Check#: 0000040842 Totals: 216.09 0.00 0.00 216.09 -6harch ot Gc�Home,Ino-Church of Gcd Home;!nc-Church a'God Neme,lnc—Chu;ch c'.Ced Home,Ir.c-Chur�of Cod Home,!nc-Chu��-of God Hame,!nc-Church of G�d Heme,Ina-Ghurch of Ged HomP,!. . _ ' ` � (�F' �\�� i = �� = :_, _ - _ _ `PNC Bank - = P_O Box3822 - `�r�-- - � Ch�arch of God tiorne, lnc . - _ - �o�-No�n Po��te Bi�a_ - �� ��' 801 N. Hanover Street = taR�aste�,PA`"604=_ � 0000040842 Carlisle, PA 17013 � _ -- � �-� TM October 25, 2013 "*Two hundred sixteen and 09/100 dollars...... ... ._. �*******216.09 Pay to the order of ......... ........ ...... ....... ......... . ...... Gordon Coleman c/o Don Colemarr_ _ _ - , �r 402 Andrew Circle - , - _.=�'�4 f•� �`" ,�'�_ ,� _ __= ; � r�j . Indiana, PA 15701 = - ` r �"f }rr � 3' - = �'. �` , _- _ - i.� }�,''�.•'�t�`tr _�l- '�_ti.'-.'�.,�1T r � : ._ .. ._._'__...'_"_'....__...'�." '_" .._..._.._._-___'__ .._._._.. .__ ..__ ._' ._._'_'__"'...___.__ ._......___ _______ __._____-._____-._._ .__'__...._.._.__'___._'_"'._.___._._______."___�.,.. . �. r �...�_ �►'000004084 2i�' �:0 3 � 3 L 2 7 38�: 5004 3 Z4 44 3��' EXHIBIT � J , , - - -- , � - _ _ - CAURCH OF GOD HOME,INC z.:�� _- _ �._ �__ . _ Form PB-01 801 N.HANOVER STREET CARLISLE,PA 17013 RESIDENT# UNIT STMT. DATE ��ON COLEMAN 803273 H103A 09/30/2013 02 ANDREW CIRCLE RESIDENT S INDIANA,PA 15701 'Q�l,l�'��� � : Gordon W.Coleman .J TOTALAMOUNT DUE $8 153.91 � r DETACH AND RETURN THIS PORTION WITH YOUR REMITTANCE $ � V���� AMOUNT REMITTED DATE DESCRIPTION �a�� CHARGES CREDlTS BALANCE Units Balance Forward 8,153.91 4��'�-� ��1.;��U�l,( ,4 ��:(.,�(�' .��?J`��►�,�% `�1(���� Please make checks payable to Church of God Home. Please use the enclosed envelope to mail your payment. _______� �'�1� �.��+ RESIDENT# CURRENT OVER 30 OVER 60 OVER 90 OVER 120 TOTAL AMOUNT 803273 0.00 0.00 0.00 8,153.91 0.00 $ .91 RESIDENT NAME Gordon W. Coleman FortnP&01 � �- (.�(���Cl�:�; �����- .�,�,,.. ae..�.. _ 4. �F �,�_�, � _.Y ��< <_ o- �. .n_ -r . . .,.� � -,.. «�. , ,�.�z.z � , ` • CHECK NUMBER Y Hl hmark Blue Shield s=s ►52'786672 BlueCmss g 3,0 B1ueShield ,�`�p`�"'�"°u`""k B�°`G°"'�B���'�"„�°`'",°° � � Camp Hiil,PA 17089 � m • Pederal Employee Program - . � � - 000008 MO. DAY YR: " PAY TO THE ORDER OF: G ` W C O L E M A N 11 :14 1 3 AMOU NT EXACTLY�EjE�E�E3E�E3E3E3E9 QOLLARSAND 75 CENTS $3E3E�E3E3E3E3EjE3E9. 75 � i.�.►vo. R02028848 c�oaM No. 865-20207842016 TAX NUMBER sArcH No. 111:12 0131=1112 013 0 _ ....-- PNC Bank, Nationsl Association � PHILADELPHIA,PA 19101 NOT VALID nFTER 12 MONTHS AUTHORIZED SIGNATURE HIGHMARK BLUE� ��' S 27866 ? 2��' �:03 i000053�: 861 i?435D4��' EXHIBIT � J � � -4 EST OP GORDON W COLEMAN DECD "Z • DONALD G COLEMAN EXTR CASH — _ �� 402 ANDREW CIR H_� �,�'1, , �Z� a� fNDIANA,PA 15701-2382 E o� K_� � u C?�7 s pp-� �/.�I CHECKS OR TOTAL OEPO5�1 MpYNDTBEAVAIUBLEWflINNEDIATEWITHDRAWAL FROMOTHERSIDE ^ TOTAI � ' SIGN MEAE IF CASH RECENED FROM DEP0.51T �THAS SUB TOTAL � z == B PNCBANK � LESSCASH _ e - rrre saor,x.a oao NET_ C� f�j �,� � 1 �o DEPO5IT .2J �'7 ��c3 �ca�it CGY-i'?C.i���+-�!`Ey�., .�, , - �fr -� � ` `_ �_ .�,.�__�.,.�... �� �:6y00���40 LO�: 5 � � 3009506��' � V{31D i80 RAYS A�TER pe4TE Pt�SlTI'�E PAY PROTEG�ED B�nk ofAmerir�Custom�r�,onoec�ton �'j4 127$ Ba.nk pfl4mer�c�a M A.'.,. � E��e Af(ar+�a � katb Cour Geo Ia - �N 2p 6i� � ; �In�ur�nE�� ; ,; . CHECK � $ F _: .. 100 Erie Ins.PI.� Ede,PA 16530 . . . ' . .. . . . ����� .�Q�7 2$Z� MO DAY_YR. � PAY: EXACTLY.TViIENTY TWO DOLLARS AND 50 CENTS 05 tl6 ,�201.4 � � _ , , _ : — � e ;�k.�" � TO THE DRDER OF:ESTATE OF GORDON W COLEMAN $2z.5o , � � �� � ��� ,.. :. ,, - _ , ,::, ; :, . _.::� ,� REFUND REASON POLICY/ACCOUNT NO. AGENT NO. • ' `� _ OTHER REASONS Q081702286 AA7637 � uthonzed S'ignature :� i�' 200i78282iii' �:06 � ii2788�: 329 999 65i4ii' _ ,: ; ,. " ' ' ` ' VQ.ID 180 DAIi'SAFTER Di4TE . '" POSfTNEPAYPRt�TEC�'ED B�kofAmerieaCustomeC�onnec�on : �, 127$ �' i Bank of America N A : � ����' AUaiita DekaltrCoun Geo a ;: �' ita tY: � G11 a: �Insurance' ; - : ,: � :. - i DATE '; CHECK Nd 2U�1803896 < � 100 Erie Ins.PI. Erie,PA`i6530 - , , MO. DAY YR• � PAY. EXACTLY TVIIENTY DOLLARS,AND 00 CENTS 05 �15 `�`2014 y ,: - > TO THE ORDER OF: ESTATE OF GORO�N W COLEMAN S 20.00 � �� "` � _ - . � . _ . � _ p �. . . . . . . _ . . - � ScaaiYh�vs� ,�V 4�dntl�0. T. . . _ . . . . . . CAaiooWIX. G. � . . - - - , � . . �. - � ' . � � . _. � . - �: - �. �; VA:_ m: REFUND REASON POLICY/ACCOUNT NO. AGENT NO. = • r m: PRO'RATE CANCELLATION Q551201216 AA7637 m : . m ut�orize�Signature`; `� n■ 200 L803896ii' �:06 L i L 2�88�: 3 29 999 65 L4ii' f�cvn�.c:;i:;;�.�.��-1� ��� ���c.�I�c�-����4 EXHIBIT $ l� T� - 15-51 . � � ������ ` o0o P 51 1 , 6 6 0, 916 ,� � �.. Check No. �� � , _• � -_ Y_ ,�, 06 02 14 20090904 KANSAS CITY, MO 4034 29232152 �� 000215015904 4034 29232152 I OQ002014142091 ,. ���,i,����iin��,ii,t�����ii��„ii�ii,,,iiil�llii�ini�i�l�illir ray to fj/'�: the order of DONALD G COLEMAN ADM GORDON W COLEMAN bECD ��/i��='�` 402 ANDREW CIR �****2546*73 �,��; INDIANA PA 15701 2392 xEct�s�inr>ecr�ni,ot=r_�te YOID AFTER ONE YEAR �' .�sqt-at_ur_i,-�:ii���i i�-i;i_�,� m;i-rr'rl_i—r��_cli iz 7 " III-'I II' I ( �i.I,;OO2-II I'I'�i'_I�;�;!_'I!SI=,�_� x _I:_ '�'r�, I�l-li:-i-t--t7-i�_i.'„�--P�,-�'--�—��-�_�- � ;i��,_i_Iii�j��i�!�i�?Ti�i�-�iii-�l�����i11'':x�r,i!�i_�I-�i�r:l'rI COLE KANSAS 12/2013 TAX REFUND 30 �=�-�r���I i�'�=�,G�r!4t+LQ diG�i*�jrl��l�i!'-�-I'�- l�;1="— �_i-�_.,_ -,_�.,_��_:;i_ '.�_- 1' INT 7.73 ii!J;�i�i!'�-�p!�-~tr i 1_�''-:_..i ,�1_r' i�_'-�i��:��Ii�i���sl $ i� "�i"�_i�!_;��ti�'+=i.-�i.w_�.,_-l-ril-��`�'•��=i�';�Tr!i=r�L=ii �;I�I—�1-1 =.__.:r�eil���:T-I--,--_it-kt=��rt-1.—�- �i'4� 348ii' �:0000005 LB�: 29 2 3 2 15 24u' 0406 i4 oi DEPOSIT TICKET 60-1273/313 �� EST OF GORDON W COLEMAN DECD �sH "2 ���� ��p� �i DONALD G COLEMAN EXTR � ' =� 402 ANDREW CIR � a� INDIANA,PA 15701-2392 E-J �� �� •� �g� �����) �j � €� K� S ' DATE 'L+�� °12��� CHECKS OR TOTAL - oEros ►ur ee�vNue�wn�uuEou�rewrmoxnw�u. FROMOTHERSIDE � • `-� SIGN XEqE IF CASH qECFJVED FliOM DEP�R R� SUB TOTAL — � W� B PNCBANK ❑ �SS�H _ ' PNC Bank,N.A. 040 � x` NET � � J 'I 10 .` ` "� DEPOSIT CO!=fiT USE L�fF^Si;7iCXET R:Uiic'G=F"R kUF3F;;fTIC rH?'siE�TS.USE I�iGEG C4ct':. �:6400���40 LO�: 5 i L3009506��• EXHIBIT � M Mill�iit�e Mutual lnsurance Company cne�k No. 054769 Millville PA 17846-0280 ESTATE OF GORDON W COLEMAN C/O DONALD COLEMAN 402 ANDREW CIRCLE INDIANA PA 15701 --Mitiville Mutual--Ins�rance Gompany- _ _ _ _ _------ ----___ _--- -__. Millville PA 17846-0280 DATE DESCRIPTION �p� 9/24/14 RETURN PREMIUM ON POLICY 1150246 194.00 INDIANA INSURANCE ESTATE OF GORDON W COLEMAN 823 ROSE STREET INDIANA PA 15701 ' !'JG�'i��L'�4v:7.���`.� �r7�t:.a :^i.t.1'1C.e'�, /�,��;�lf�..�."1 /`�''1�i:'.�.t<� _ � I?1� �a.-���11�;� c��3 4���� � , 1 �//.��.��%�! 1:,?.'��._'•�' Please detach here .• � - •• � • . • . M�"V�'Ie MUtUa' 'nSuranC'e C�mpany FirstColumbiaBank�TrustCo. 215 State Street Millville PA 17846-0280 e�oomsb��,PA. Check No. 547G9 60-0543/0313 Date 9/29/14 Pa �::::>::»:::::r,...:.:..;;;_:..:_:...,..::..:...:;::. :..........::::...:.:..:.:::. .:: <_:.::.;:..:-:::::...:.;<:.>;:::;:::::;::.::_;-::.;:;:.;:.;:;::;:::.>;;;::;-__::.>;:::.;;:->;:.;.;.;::.:_;>:;:::.:,;:.:.;.;.;.:,::::: <:-;;;>:�i._;>: .:: >. ; :>;;::.:::: .�... Y;:.: � . �. � ...��... .�.: �`,��:::y:: :: :. ::=::>: >;»:::;::>.>:::. :::<:::>::::>::>;::>:�:>#:::::>::>:;:::»<.::>:::<::::::>::>::»>::>::>::><::::;:<:::>:::::<:::;:�::>::<:::»::>::::::<::<::;>:.>:;:::><:::::>::::: to the Order ofi �'.f�EfR...�?...#3.�.�.�,�2t�..........................:...::::.::.�:.::::::.:::::._.�.�.�:::.._::::.�.:�:::::..:�;:;;;:_-;:-::.::.;; Dollars ESTATE OF GORD�N W COLEMAN C/O DONALD COLEMAN ******194.00** 402 ANDREW CIRCLE INDIANA PA 15701 Void after 180 days �--------d EXHIBIT -- , � b �Authorized ignatures .. . � :.-. • . �i'054769ii• �:03 ?4450 L►i' g34 sp$11tR313 - Sj��� �, ��� DA�E _ � „ �r MA�H��5 � � PH.717-48ANKROAD �, �a;;;,o� 2g2 OHfl�G Pp 17019 ���;✓/� pllARS U ���. p�L�sa� � _ d�-r, • PAY Z� OF � ��� .�i� � � l� �crt� = ORDER ����/!d -_.- `� '7",'^'_ � �,��....._� = o �._.---� �._ pSEC Pp 17110-2990 �_�1� O�3 4� HARRISBUR=y��� O 4 5 3 q t,4 L 6 7 ��•,�J� � n n�Q� FUR � y L6�: �: Z3�`38 3 EXHIBIT . � DEF'OSIT TICKET 60-1273/313 ' ` ` _� EST OF GORDON W COLEMAN DECD ��Z DONALD G COLEMAN EXTR CASH — • ' 402 ANDREW CIR C -� INDIANA,PA 15701-2392 E� o� 7 , �• �� C - K I ,� s ' DATE ��I`�� CHECKS OR TOTAL - —�T MAYNOTBEAVAllABLEFORIMME0IATEWITHDRAWAL FROMOTHERSIDE � - TOTAL SIGN HERE IF CASH RECEIVED FROM OEPO5IT ITEMS SUB TOTAL � a b� c�,�,�.�, a��, -= B PN CBANK ❑ LESS CASH _ . P � PNC Badc,N.A. 040 xW �_ NET � ��� �v�c� ' "o DEPOSIT 9U t c ... i) �^I�' t ,,. �: 6400���4010�: 5 L 13009506��' DONALD G. COLEMAN 60-7335/2433 1 g g g HELEN H.COLEMAN 402 ANDREW CIR. PH.724-349-5292 � I "/ INDIANA,PA 15701 DATE �I'��'/ / a��'/7 �Shield�' ` OflDER OFE r�II.I C �j �..,"G.iS"T�:%��0�� C�Er�.c7 LL{ � 4 a C:� E c..�i •�.��'� 3;Z S C� �� a �j/�W �i.`.{a"u(Cl. �QV�i4.: ��'� � /��� �� ���' DOLLARS IJ aw�,°`�sa.a o � �i ;::.1 saagsna� 1' 935 Philadelphia St.,Indiana,Pennsylvania 15707 MEMO /����' ryP �-�: 243373358�: 30 L00004 L3 L 7i�' L999 � P�C�1C�6��11� 001 - BEN FRANKLIN (021) 76 BEN FRANKLIN ROAD SOUTH INDIANA, PA, 15701 Cashbox 13 Business Date APR 25, 2014 Calendar Date APR 25, 2014 Deposit 16:06 Transaction Number 00154 Account Type Checking/Savings Account Number XXXXXX9506 Transaction Amount $ 3,750,00 Check Amount $ 3,750.00 s This deposit or vavment is accevted subiect to EXHIBIT uerification and ta the rules end re9ulations of this 6enk. Deposits mav not be euailable for � immediete withdrawal. Receipt should be held until uerified with vaur statement.