HomeMy WebLinkAbout12-15-14 (2) � 1505610143
REV-1500 EX`°2_„> �
PA De artment of Revenue OFFICIAL USE ONLY
p pennsylvania County Code Year File Number
Bureau of Individual Taxes �PMTMENTOFREVENUE
Po aox.28oso� INHERITANCE TAX RETURN 21 14 0565
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
05 05 2014 04 14 1931
DecedenYs Last Name Suffix DecedenYs First Name MI
JONES JEANETTE E
(If Applicabie)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� 1. Original Retum � 2. Supplemental Return � 3. Remainder Retum(Date of Death
Priorto 12-13-82)
� 4. Limited Estate � 4a.Future Interest Compromise � 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
� 6 Decedent Oied Testate � �• (AttacheCopy�of T usd�a Living Trust O $. TOt81 Numbe�of Safe DepOSlt BOxes
(Attach Copy of Will)
9. Litigation Proceeds Received �p,Spousai Povert Credit(Date of Death 11.Election to tax under Sec.9113(A)
❑ ❑ between 12-31�1and t-i-95) (Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Tetephone Number
GEORGE F DOUGLAS III ESQ 717 249 6333
�
R�I�R OF�S l��LY
� � � � �
� � � �
First Line of Address rn 2 � �
354 ALEXANDER SPRING RO �'�,,. � rn � � v
Second Line of Address �:� � � "T� -�r� -�i1
� � � � � �
• � DATE�1'LED �" f''1'1
City or Post Office State ZIP Code -i7 � � �
CARLISLE PA 17015 � I
CorrespondenYs e-mail address: gdouqlas(a�salzmannhuqhes.com
Under penalties of perjury,I declare that I have examined this retum,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNAT RE OF P N RESPONSIBLE OR FILING RETURN DA
� William A. Jones 11-11�- I�-
ADDRESS
227 W Sixth St, Waynesboro, PA 17268
SIGNAT E OF PREPARER OT R THAN REPR ENTATIVE DAT
� �1 George F Douglas, III Esq. 12-�� 1
ADDRE S
354 Alexander Spring Road, Suite 1, Carlisle, PA 17015
� Side 1 �
1505610143 1505610143
,
l�
� 1505610243
REV-1500 EX
DecedenYs Social Security Number
Decedent'sName: JOII@S� Jeanette E. 169 44 7336
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1.
2. Stocks and Bonds(Schedule B)............................................................................. 2. 9�2 Z 4 . 7 6
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C)......... 3.
4. Mortgages&Notes Receivable(Schedule D)........................................................ 4.
5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 61 , 643 . �6
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers 8�Miscellaneous�nq Probate Property
(Schedule G) U Separate Billing Requested............ 7.
g. Total Gross Assets(total Lines 1 through 7)........................................................ g. 70 , $67 . 82
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 17 , 67 9 . 58
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10. 2 , 991 • 8 9
11. Total Deductions(total Lines 9 and 10)................................................................ ��. ZO � 671 . 47
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. $O , 196. 3$
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. S O , 19 6 . 35
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 15 O . 0 0
(a)(1.2)X.00
16. Amount of Line 14 taxable 50 , 196 . 35 16. 2 ,258 . 84
at lineal rate X .045
17. Amount of Line 14 taxable 0 . ��
at sibling rate X.12 0 . 0 0 17.
18. Amount of Line 14 taxable � . ��
at collateral rate X.15 0 . �0 18.
19. TAXDUE................................................................................................................ 19. 2 �2$8 . 84
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. �
Side 2
� 1505610243 1505610243 J
REV-1500 EX Page 3 File Number 21-14-0565
Decedent's Complete Address:
DECEDENT'S NAME
Jones,Jeanette E.
STREET ADDRESS
210 Mooredale Road
CITY STATE ZIP
Carlisle PA 17015
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 2,258.84
2. Credits/Payments
A. Prior Payments 2,150.00
B. Discount 112.94
Total Credits(A +B) (2) 2,262.94
3. Interest �3�
q. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) 4.10
Check box on Page 2,Line 20 to request a refund
5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5)
Make Check Pa able 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:............................................................................... � 0
b. retain the right to designate who shall use the property transferred or its income:.................................. � �
c. retain a reversionary interest;or...............................................................................................................
d. receive the promise for life of either payments,benefits or care?............................................................ ❑ �
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without ❑ ❑
receiving adequate consideration?....................................................................................................................
3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... ❑ ❑X
4. Did decedent own an individual retirement account,annuity,or other non-probate property which ❑ ❑
contains a beneficiary designation?.................................................................................................................. X
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1,1994 and before Jan.1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after 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)]. 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 decedenYs lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)j.
. 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-7503 EX+(6-98)
SCHEDULE B
STOCKS 8� BONDS
COMMON W EALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENTDECEDENT
ESTATE OF FILE NUMBER
Jones, Jeanette E. 21-14-0565
AII propeRy jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM CUSIP VALUE AT DATE
NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH
� 113 shares of Prudential Financial,Inc. 81.635 9,224.76
TOTAL(Also enter on Line 2, Recapitulation) 9,224.76
(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+(��-10)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, 8� MISC.
DEPARTMENT OF REVENUE
INHERITANCETAXRETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Jones, Jeanette E. 21-14-0565
Include lhe proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 TIAA CREF-final retirement payment 69.78
2 TIAA CREF-final stock payment 113.43
3 M8T Bank,Checking Account No.90037189 10,822.16
Accrued interest on Item 3 through date of death 0.03
4 M&T Bank,Savings Account No. 15004224164688 50,303.79
Accrued interest on Item 4 through date of death 0.41
5 M�T Relationship Savings 325.01
6 Quantum Imaging�Therapeutic Associates,Inc.-refund 8.45
TOTAL(Also enter on Line 5, Recapitulation) 61,643.06
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev. 11-10)
REV-1511 EX+�70-09) SCHEDULE H
pennsylvania
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Jones,Jeanette E. 21-14-0565
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
N MBER
q. FUNERAL EXPENSES:
See continuation schedule(s)attached 6,009.26
g. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
William A.Jones Wayne E.Jones
StreetAddress 227 W Sixth St.
city Waynesboro state PA zio 17268 3,540.00
Year(s)Commission Paid
2. Attorney's Fees Salzmann Hughes, P.C.
3,500.00
3. Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation)
3,500.00
Claimant Vonnie J. Schmohl
Street Address 210 Mooredale Road
City Carlisle State PA Zia 17015
Relationshio of Claimant to Decedent SpOUS@
223.50
4. Probate Fees
5. AccountanYs Fees
g. Tax Return Preparer's Fees
906.82
7. Other Administrative Costs
See continuation schedule(s)attached
TOTAL(Also enter on line 9, Recapitulation) 17,679.58
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 FILE NUMBER
Jones,Jeanette E. 21-14-0565
ITEM DESCRIPTION AMOUNT
NUMBER
F�neral Exnenses
1 Ewing Brothers Funeral Home,Inc.-funeral services 5,955.00
2 Ewing Brothers Funeral Home,Inc.-balance due for funeral services 54.26
H-A 6,009.26
Oth r Administrative Costs
3 Computershare-service fees to sell securities in order to administer the estate 20.04
4 Salzmann Hughes, P.C.-reimbursement for payment to Cumberland Law Journal for legal 75.00
advertising
5 Salzmann Hughes, P.C.-closing costs and final fees for income tax preparation, postage 600.00
and miscellaneous contingencies in order to administer the estate
6 The Sentinel-Legal advertising 211.78
H-B7 906.82
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
Rev-1512EX+(�2-08) gCHEDULE 1
pennsylvania DEBTS OF DECEDENT,
DEPARTMENTOFREVENUE MORTGAGE LIABILITIES AND LIENS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF 21-14-0565
Jones, Jeanette E.
RepoR debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
VALUE AT DATE
ITEM DESCRIPTION OF DEATH
NUMBER
1 Cumberland Goodwill Fire Rescue EMS Inc.-balance due for medical services on 03/29/2014
82.80
2 J.L.Hardesty-balance due for medical services on 01/24/2014
4.90
3 Millennium Pharmacy Systems Inc. -balance due for prescription drugs
15.32
4 Pinker&Associates-balance due for medical services on 12/24/2013
8.36
5 Spirit Physician Services,Inc. -balance due for medical services on 03/20/2014
13.80
2,866.71
6 Thornwald Home-balance due
TOTAL(Also enter on Line 10, Recapitulation) 2,991.89
(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 1(Rev. 12-08)
REV-1513 EX+(07-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE gENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF 21-14-0565
Jones,Jeanette E. RELATIONSHIP TO
SHARE OF ESTATE AMOUNT OF ESTATE
NAME AND ADDRESS OF DECEDENT (Words) �$$$�
NUMBER PERSON(Sl RECEIVING PROPERTY
I. TAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116 a 1.2 11,289.27
� Wayne E.Jones
Son 115th Residue
360 Mooredale Road
Carlisle, PA 17015
y William A.Jones
Son 1/5th Residue 11,289.27
227 W.Sixth Street
Waynesboro, PA 17268
Son 1/5th Residue- 5,039.27
3 David L.Jones less$5,000 loan
233 Pole Cat Road
Landisburg, PA 17040
4 Vonnie J.Schmohl
Daughter 1/5th Residue 11,289.27
210 Mooredale Road
Carlisle, PA 17015
5 Daniel W.Jones
Son 1/5th Residue 11,289.27
477 Summit Drive
Pittsburgh, PA 15228
Total 50,196.35
Enter dollar amounts for distributions shown above on lines 15 throu h 1 S on Rev 1500 cover sheet,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 11 -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 FormEPA 1500 Schedule J(Rev.01-10)
Copyright(c)2010 form software only The Lackner Group,Ina
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LAST
WILL AND TESTAMEN�' ; �; � -_; �
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I, JEANETTE E. JONES, of Dickinson Township, Cumberland County, Pennsylvania,
being of sound mind, disposing memory and full legal age, do hereby make, publish and declare
this to be my Last Will and Testament, hereby revoking all Wills and Codicils heretofore made
by me.
ONE. I direct my Executor or Executrix, as the case may be, to pay all of my
debts, funeral and administrative expenses as soon as convenient after my decease. Furthermore,
I direct that all state, inheritance, succession and other death taxes imposed or payable by reason
of my death and interest and penalties thereon with respect to all property composing of my
gross estate for death tax purposes, whether or not such property passes under this Will, shall be
paid by the Executor or Executrix of my estate. Further, to the extent that sufficient assets exist
in my estate, any and all inheritance or other estate taxes, whether to non-charitable or charitable
beneficiaries, shall be paid by my Executor or Executrix from the residuary of my estate.
TWO. My Executor or Executrix inay, at his or her discretion, compromise
claims, borrow money, retain property for such length of time as he or she may deem proper;
lease and sell property for such prices, on such terms, at public or private sales, as he or she may
deem proper; and invest estate property and income without restriction to legal investrnents
unless otherwise provided hereunder. I authorize and einpower my Executor or Executrix to sell
any realty and/or personalty owned by me at iny death and not specifically devised or
bequeathed l�erein, at public or private sale or sales and to give good and sufficient deeds and/or
bills of sale therefor, in fee simple, as I could do if living. My Executor or Executrix is
authorized and empowered to engage in any business in which I may be engaged at my death, for
such period of time after my death as seems expedient to said Executor or Executrix.
THREE. I give, devise and bequeath all of my estate of whatever nature and
wherever situate in the following manner:
A. To my children, WAYNE E. JONES of Carlisle, Pennsylvania,
WILLIAM A. JONES of Waynesboro, Pennsylvania, DAVID L. JONES of
Landisburg, Pennsylvania, VONNIE J. SCHMOHL of Carlisle, Pennsylvania, and
DANIEL �V.JONES, of Alamogordo,New Mexico, in equal shares, per stirpes.
g. My son, WALTER E. JONE5, has predeceased me and is intentionally
left out of my will.
C, The share of my son, DAVID W. JONES, shall be reduced by the sum of
$5,000 to repay the Estate for a loan that was provided to DAVID `V. JONES by his
parents, R WA�'NE JONES and JEANETTE E. JONES.
FOUR. I hereby nominate and appoint my sons, WILLIANI A. JONES
and WAYNE E. JONES, to be the Executors of this my Last Will and Testament.
FIVE. No person(s) shall benefit hereunder unless such beneficiary shall survive
me by sixty (60) days.
SIX. No Executrix or Executor acting hereunder shall be required to post bond or enter
security in this or any other jurisdiction.
SEVEN. No beneficiary may assign, anticipate or pledge its interest in any income
or rincipal held or distributable hereunder, and no beneficiary's creditors may levy, attach or
P
otherwise reach any such interest.
�
EIGHT. If any person or institution entitled to share in any distribution
under the terms of this my Last Will and Testament becomes an adverse party in any proceeding
to contest the probate of this Last Will and Testament, such person or institution shall forfeit his,
her or its entire interest inherited hereunder and all provisions in favor of such person or
institution shall be declared void and of no effect. The share of such person or institution so
forfeited shall be distributed as part of the residue hereof except that if such person or institution
is entitled to share in the said residue, that interest shall be distributed proportionately to the
other residuary distributees.
��
� WITNESS WHEREOF, I have hereunto set my
hand and seal this day of
March, 2011.
�� , �� �� � _ � (SEAL)
��� '
' JEANETTE E. JON�S
Signed, sealed, published and declared by the above-named person as and for a Last Will
and Testament, in our presence, who at said person's request, in said person's presence and in the
presence of each other have hereunto set our names as subscribing witnesses.
,I �, c� � r�,
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C���'�'�`i� .._
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3
COMMONWEALTH OF PENNSYLVANIA:
: ss
COUNTY OF CUMBERLAND �
I, JEANETTE E. JONES, Testatrix, whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I
signed and executed the instrument as my Last Will;
that I signed it willingly; and that I signed it as
my free and voluntary act for the purposes therein expressed.
Sworn or a�firmed to and acknowledged befare me, by JEANETTE E. JONES,
the Testatrix, this Z '�c day of March, 2011.
! �, ,
� Jeanette E. Jp es,Testatrix
COMMONWEAL�Ii OF PENNS1FlVAP1IA
Notarlai Seal
Bonnie Jo Deib[h,Notary Pubik
SNver Spring Twp.,Cumbertand County ,.� '
My C.omtnis�on Expires Sept 25,2013 � ,�--
Member,Pennsvlvania Assodatfon N Ndarie.s � ��,��` _
', `,., Notary Public
� J
�
COMMONWEALTH OF PEI�TNSYLVANIA: : ss
COUNTY OF CUMBERLAND �
We, George F. Douglas, III and Karen Riccard ed acco d n S to laws do depose and sa�y
to the attached or foregomg instrument, being duly qualifi g
that we were present and saw Testatrix sign and execute a volun ameactafoh the purpolse�st there n
signed willingly and that she executed it as her free an rY
expressed; that each of us in the hearing and sight of the Te�i�e 181or more ears of ageeof sound
that to the best of our knowledge the Testatnx was at that
mind and under no constraint or undue influence.
Sworn or affirmed to and subscribed to before me by George F. Douglas, III and
Karen Riccardo this 7th day of March,2011.
_ � - ,�� - ,�/
itness
CAMMONWEAL"fF!OF PEiVNSILVRNIA Vf' � 1�.,� 9� �- �" `,
Nota�tal Seal Witness
BOnrtle lo DeftCh,Notary�blk , __
51Ner Spri�9 T�+P•,Cumbertand5 O�Y ;� I�
My Commission Expires SeP� •,;,�� y)_—
Me�r,t�,Pennsvlvanla AssoCatlon of�� Notary Public
�
J
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prudential Financial Inc.,PRU Historical Quote - (NYSE) PRU, Prudential Financial Inc. ... Page 1 of 1
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Prudential Financial Inc.
Mon.May05,2011
82.36
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p M�B�
499 Mitchell Road,Millsboro,DE 19966 Adjustment Services
Phone 888-502-4349
F ax (302)934-2955
July 22,2014
Salzman Hughes,P.C.
Attorneys at Law
354 Alexander Spring Road, Suite 1
Carlisle,PA 17015
Re: Estate of Jeanette E. Jones
Social Securitv• 169-44-7336
Date of Death• Mav OS 2014
Dear Sir or Madam:
Per your inquiry on July 06,2014,please be advised that at the time of death,the above-named decedent ha on
deposit with this bank the following:
1, Type ofAccount CheckingAccount
Account Number 90037189
Ownership(Names o�
Jeanette E.Jones
Opening Date 06/28/1989
Balance on Date ofDeath $ 10,822.16
Accrued Interest $ .03
---------------------------------------------
Total $1�'822�19
2, TypeofAccount SavingsAccount
Account Number 15004224164688
Ownership(Names o.f}
Jeanette E.Jones
Opening Date 03/30/2011
Balance on Date ofDeath $ 50,303.79
Accrued Interest
$ .41
_._......._..._........................................ .........
Total $50,30420
3, Type ofAccount Savings Account
Account Number 15004230880575
Ownership(Names o� Jeanette E.Jones
Opening Date 02/12/2014
Balance on Date ofDeath $ 325.01
Accrued Interest $ .00
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Total $325.01
For any additional information on the above accounts,including ownership and any changes,closures and/or reimbursement of funds,
please call the High Street Carlisle at 717-240�1536.
We were unable to locate any safe deposit box for the above-mentioned decedent.
This letter does not include any accounts in which the deceased may have been Gsted as Power of Attorney,Custodian of Uniform Transfers,
Representative Payee,or Trustee under a Written Agreement
Sincerely,
Valarie Mercer
Records Management