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Home My WebLink About02-17-15 (2) � 1505610105 REV-1500 EX(oz-ii)(FI)�£ PA Department of Revenue pennsylvania OFFICIAL USE ONLY Bureau of Individual Taxes ""�"`�„ County Code Year File Number Po Box Zsosoi INHERITANCE TAX RETURN Harrisburg,PA i�iz8-06oi RESIDENT DECEDENT � ' I� ' Q�� ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY , 09/11/2013 10/07/1922 _ Decedent's Last Name Suffix DecedenYs First Name M� McMillen Carolyn p (If Applicable)Enter Surviving Spouse's information Below Spouse's Last Name Suffix Spouse's First Name MI �N/A Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE __ _ REGISTER OF WILLS FILL IN APPROPRIATE OVALS BEIOW O 1.Originai Retum C� 2.Supplementai Return p 3. Remainder Return(Date of Death Priorto 12-13-82) O 4.Limited Estate O 4a. Future Interest Compromise(date of p 5. Federal Estate Tax Return Required death after 12-12-82) O 6.Decedent Died Testate O 7. Decedent Maintained a Living Trust _ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) O 9.Litigation Proceeds Received O 10. Spousal Poverty Credit(Date of Death O 11. Election to Tax under Sec.9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number Robert R. Black, Esquire (717)243-3727 �; c, �.� � � =�' rn REGISF�R�WILLS U3EQNL� ,� C_,7 � 1"'"t ...._ 1._"I - C,"� Q7 C''� 'J _ � C:;5 First Line of Address ' ,. r- � ' f'_' _- � �' -�7 , .,� 36 South Hanover Street � ,-., _ _ _ :� ., -z Second Line of Address , ._ -- �y _ _ _ _ _,� .._:3 .._ , ..... ►� _ c:, t_� ;-' t-ri City or Post Office State ZIP Code DATE FILED u � _ . � � --r� Carlisle PA 17013 .__ CorrespondenYs e-mail address: Under penalties of pery'ury,I deciare 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 PE ON RESPONSIBLE FOR FILING RETURN DA E �� `�t ��- �%��- �v� �''r, �C�.�, � �13�(� ADDRESS 60 Con Str et, Cariisle, PA 17013/2624 Walnut Bottom Road, Carlisle, PA 17015 SIGNATU F O H T RE�IVE p ADDRESS 36 South Hanover Street, Carlisle, PA 17013 � PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056101�5 15056101�5 � \ ' � 1505610205 REV-1500 EX(FI) DecedenYs Social Security Number Decedenrs Name: Carolyn O. McMillen RECAPITULATION 1. Real Estate(Schedule A). .... . .. . .. ...... ... . .... ...... . ..... . ....... 1. 0.00 2. Stocks and Bonds(Schedule B) . . . . . . . . . . ... . . .. ... . .. .. . ... ... . . .. . .. 2. 1,117.46 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . . . .. 3. 0.00 4. Mortgages and Notes Receivable(Schedule D) . .. .. . . ..... . . . . .. . . ..... . . 4. 0.00 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E).. . . . . . 5. 0.00 6. Jointly Owned Property(Schedule F) O Separate Billing Requested .... . . . 6. 0.00 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested.. . . . . .. 7. �.�� 8. Total Gross Assets(total Lines 1 through 7). . . . . .... ... .. . .. . .. . .. .. . ... 8. 1,117.46 9. Funeral Expenses and Administrative Costs(Schedule H). . ... . ..... . . .. . .. . 9. 0.00 10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule I)... . .. . .. .. . ... 10. 0.00 11. Total Deductions(total Lines 9 and 10). . . ..... . ... .. .... ... . .. . . .. .. . . . 11. �.�� _ _. _ 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . .. ... . ... . .. ... . . . .. . . . 12. 0.00 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) .. ... . . . .. ..... . . . . .. . . . 13. 0.00 14. Net Value Subject to Tax(Line 12 minus Line 13) . .......... . .. ....... .. . 14. 1,117.46 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. 16. Amount of Line 14 taxable at lineal rate X.0_ �g. 17. Amount of Line 14 taxable at sibling rate X.12 17, _ 18. Amount of�ine 14 taxable 1 1 17.46 at collateral rate X.15 � 18. 167.62 19. TAX DUE .. .. .... ... .. . . ... . . ... ... .... . . . .. .. . . ..... . . .. ..... . . . . 19. 167.62 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p Side 2 L 1505610205 1505610205 J REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME Carolyn O. McMiilen - -- ----.._-----__ __ _-- __ _——_ __ _ _---..._. ------ _._._ _...---. ....---- --------- STREETADDRESS Bethany Village, 5225 Wilson Lane, Suite 335 — -..----- ---- --------------- ---T-------- CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 167.62 2. CreditslPayments A.Prior Payments 0.00 B.Discount 0.00 --------- -- -_ Total Credits(A+B) (2) 3. Interest (3) 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2,Line 20 to request a refund. (4) 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 167.62 Make check payabie to: REGISTER OF WILLS, AGENT. , ,., . m �,>;�. � , .. ._ .� .,.,. � 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 properry transferred.......................................................................................... ❑ � b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ � c. retain a reversionary interest .............................................................................................................................. ❑ � d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ � 2. If death occurred after Dec. 12, 1982,did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................................. ❑ � 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑ � 4. Did decedent own an individual retirement account,annuity or other non-probate property,which 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. f 1 M;4�,t�2''R4:. E .��'� . , � � . . , .. - �e.. r t .a,;i.. �,a.''�`'v, �.a�s.�a,��4s�« For dates of death on or after July 1,1994,and before Jan.1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)�.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 retum are still applicable even if the surviving spouse is the oniy beneficiary. For dates of death on or after July 1,2000: . The tax rate imposed on the net value of transfers from a deceased chiid 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 chiid 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)]. • 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. FEV-i5o3 EX+(8-iz) ' �pennsylvania SCNEDULE B DEPARTMENTOFREVENUE INHERITANCE TAX RETURN STOCKS & BONDS REStDENT DECEDENT ESTATE OF FILE NUMBER Carolyn O. McMill 21-13-1020 All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1' 118 shares of Banco Santander,CUSIP Number 05964H105. See attached documents 1,117.46 original certificate iost. Account unknown to executrices TOTAL(Also enter on Line 2, Recapitulation) $ 1,117.46 If more space is needed, insert additional sheets of the same size . r T.AST WILL AND TESTAMENT OF GAROLYN 0. McMILLEN I, CAROLYN O. McMILLEN, of 2013 Harvard Avenue, Camp Hill, County of Cumberland, Commonwealth of Pennsylvania, being of sound mind and memory, do make, publish and declare this my Last Wil]. ard Testament, hereby revoking and declaring null and void any and all Wills and Codicils by me at any time heretofore made. FIRST: I direct my Executors to pay my �ust debts, the expense of my last illness and my funeral expenses from the property passing under this Will as an expense and cost of administering my estate, as soon after my death as may be found convenient. Now I direct that a brief, closed casket service be held following my death and that my burial be at the Rolling Green Cemetary. SECOND: I give, devise and bequeath all that I possess in this world, including bo�h real and personal property, to my five (5) nieces, GAIL McMILLEN BLACR, of 60 Conway Street, �arlisle, Pennsylvania, 17013, CHARLOTTE McMILLEN RLEIN, of 2624 Walnut Bottom Road, Carlisle, Pennsylvania, 17013-9239, TOMILYN FORBES, LAW OFFICES 'ATR,ICK F.t,nuEx,.rFt. PAGE ONE OF S IX Attarney st Law� 2108 Markei 3tt�aet Astec Building Camp Hill,PA 17011 (717)783•1800 48 3outh Duke Street York,PA 17401 (?17)846-1T88 of W59 N450 Hilgen Street, Cedarburg, Wisconsin, 53012, BONNIE SMITH, of R.D. #3 Box 48, Danville, Pennsylvania, 17821, and RATHRYN BRENNEN, of 427 Grove Street, Bridgeport, Pennsylvania, 19405, living at the ti.me of my death, to share and share alike, per stirpes. If any of my nieces fails to survive me, then I give, devise and bequeath their shares to their issue, per stirpes. THIRD: Any and all payment or payments of any sum or sums, whether in cash or in kind and whether for principal or income, payable to my nieces, shall be made upon the sole receipt of the respective individual to whom payment is made, and free from anticipation, alienation, assignment, attachment, and pledge, and free from control by the creditors of any such beneficiary. FOIIRTH: My Executor(s) and Trustee(s) shall have the following powers in addition to those vested in them by law and by other provisions of this Will, applicable to all property, real, personal and mixed and wheresoever situate, whether principal or income, exercisable without court approval, and effective with respect to each item of said property, until actual distribution Lnw o�icEs thereof: 'ATRICK F.LALTER,JR. Atta�neystLa� A. To retain, as investments, any and all assets of my 2108 Market 3taeet "LL`°`B"''a� estate real ersonal or mixed without regard to any principal Camp Hill,PA 17011 � � P � (71?)783-1800 4a soutn nute sc�s PAGE TWO OF SIX York,PA 17401 {717)848-1789 of diversification, and to purchase and acquire real or personal property, and to hold any and all of such real and personal property retained or acquired without making the same productive of income; B. To permit occupancy of any real estate retained or acquired upon such terms and conditions as they shall deem proper; C. To pay all taxes, charges, and expenses of maintenance, upkeep, improvements, development, protection, preservation and investment of any retained or acquired real or personal property, such payments to be made from either principal or income, as my Executor(s) shall determine; D. To retain or invest any and all funds, whether principal or income, in any real or personal property without restriction to legal investments; to purchase investments as premiums; to exercise all rights of a security holder or shareholder in any corporation; and to lease, mortgage, pledge, give options upon or sell, at public or private sale and without approval of any court and without any responsibility to the buyer Lnw o�tcEs or buyers to see to the application of the purchase price, any real 'ATRICK F.LALIER,JR. AttaneystLew� or personal property, or portions thereof, irrespective of the 2108 Market Strcet ��8�� PAGE THREE OF SIX Camp Hill,PA 17011 (717)783-1800 48 9outh Duke 8tieet York,PA 17401 (717)8!8•1799 manner of ineans by which the same was acquired by my said Executor(s) ; E. To make any payment or distribution herein provided for in cash, kind, or partly in cash and partly in kind, at valuations fixed by my Executor(s) at the time of said distribution. FIFTH: I name and appoint my nieces, GAIL McMILLEN BLACR and CHARLUTTE McMILLEN I�,EIN, to be Co-E$ecutrix' of this, my Last Will and Testament. Should either of my nieces fail to survive me, fail to qualify, or cease to act as an Executrix, then I name and appoint the remaining niece to act as sole Substitute Executris. IN WITNESS WHEREOF, I have hereunto set my hand and seal this �. `.4S � day o f ��2. c , 19 9 2 . �w� � C� c �ti ,�� CAROLYN, . MCMILLEN t.nw o�tcEs ?ATRICK F.LAUEft,JR. Attorney at Lw� 2108 Market 3trcet Aztec Building Camp Hill,PA 17011 c�i�>�a3-ieoo PAGE FOUR OF SIX 48 3outh Dute 3treet York,PA 17401 (?17)898-1T99 t SIGNED, SEALED, PUBLISHED and DECLARED by the above-named Testatrix, CAROLYN O. McMILLEN, as and for her Last Will and Testament, in the presence of us, who, at her request, in her presence and in the presence of each other have hereunto subscribed our names as witnesses . � /`f 'e' � �G '1 /"I u �� /�w�3�iw ,�/-� WIT ESS ADDRESS P � WITNESS ADDRESS Sworn and a firmed to and acknowledged before me, by sca-H H� ,1a'$� and Tt��cey L . `3o��s , this 18�`� day of bw��r , 1992 . � -- .----. ' 'f- r ,�� N TARY PUBLIC �ri�� T��f Fi�'crt: .ci�-i''tl PATNIC�F Lr.•.i�:�;. J�1 A;u:;`,R� �4��•'..!C 5`NAT,4R�n p7CY►P�Sii!F' CAUI��iFi C"."J1,' �.:$ lil�� il�;��1'�.� ��: ��ii . .!. •{�I', �.L.� �i i...i.1 ;� xrravqxa�avan.raa�aNn.s•+a�a��wrwvw.rr.awncn�.nt•_ti �W OC[1CL� '. PATRICK F.LAUER,JA. Atta�aey at LaM 2108 Market 3Lreet Aztec Building Camp Hill,PA 17011 PAGE FIVE OF SIX (�i��Tss-ieoo aa soutn nate str�o York,PA 17�01 (717)848-1799 � COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF CIIMBERLAND : I, GAROLYN O. McMILLEN , the Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualifi.ed according to law, do hereby acknowledge that I signed and executed this instrument as my Last Will; and that I signed it willing and that I signed it as my free and voluntary act for the purposes therein contained. v �'_ �; , , CAROLYN . McMILLEN Sworn to or affirmed to and acknowledged before me by CAROLYN 0. McMILLEN, the Testatrix, this �`_` day of �'c b�^^�Y�T_ , 1992 . �-, � �� ^ �� NOTARY PUBLIC .. � � Y��NRIYSY+II`X'�{�'� a�+'�!C,.�'t d! ::�'.:�ti' �:�tT��n'`L �i,!;.:�: I:1. h:a.'�.��..��` p11,�1�i� L p J}e.':.i,,��` f�jl�l C .�f�� .�\ I � '� •'i i f � . . .'��; '�i 4 .� .r.a.,.,,�w..::.�;,,,.�..:Y� ..,,...�.,..., .,..�...�., ....,...�,. .«r 4 �w�'�C'� 'ATRICK F.LAUEIt,JR. . Atta�ney ai IB�v 2108 Merket 3trcet n��B„'ld"� PAGE S I X OF S I X Camp Hill,PA 1?011 , (717)783-1800 48 South Duke Strcet York,PA 17401 (917)846-1798 CODICIL TO LAST WILL AND TESTAMENT OF CAROLYN O. McMILLEN I, CAROLYN O. McMILLEN, of Bethany Village, I,ower Allen Township, Cumberland County, Pennsylvania, being of sound and disposing mind, do make, publish and declare this as and for a Codicil to my Last Will and Testament dated February 18, 1992. FIRST: I do hereby add to my said Last Will and Testament dated February 18, 1992, a new paragraph SIXTH as follows: SIXTH: I give and bequeath my rings as herein and after set forth: A. My mother's ring containing 2 diamonds: one being 1 and 1/3 carats and the second being 1 and 1/4 carats to my niece, Tomi Fay Forbes, of Cedarburg, WI 53012; B. My engagement ring containing a perfect diamond of.91 carats to my niece Charlotte Klein, of Walnut Bottom Road, Carlisle, PA 17015; C. My Aunt Margaret's ring containing 2 carats being 1 1&3/4 and 6 small 0.4 carat diamonds on the side to my niece, Gail M. Black, of 60 Conway Street, Carlisle, PA 17013. SECOND: Except as herein modified, I do hereby republish and redeclare my said Last Will and Testament of February 18, 1992. � � � I have signed this Codicil this '6� day of ��(�� d`�' , 201� �:1?�h� �i Y�� :�-�,,�� Carolyn n. Millen n , -�?Ii~J�-�� .�CY_��`a Wrtness -, � � �� .�� wit ss ACKNOWLEDGMENT AND AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) I, Carolyn O. McMillen, the testatrix in, and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, having been duly qualified according to law do depose and say. (a) that I, the testatrix, do hereby acknowledge that I signed and executed the instrument as Codicil to my Last Will, that I signed it willingly and as my free and voluntary act for the purposes therein expressed; and (b) that we, the witnesses, were present and saw the testatrix sign and execute the instrument as Codicil to Last Will, that she signed it willingly and executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the Codicil to Last Will as a witness and that to the best of our knowledge the testatrix was at that time 18 of more years of age, of sound mind and under no constraint or undue influence. �!�'1,� _��.�Q G �rolyn O, cMillen, Testatrix � ;J� . Witness , G� .,uru�, a�- Witn s .� � �� '; /, /� G�.:'� Notary Public NOTARIA; SEA� ROBERT R BLACM, Notary Public CARLISLE BORO., CUMBERLANO COUNTY My Commission Expires Sep 28, 2013 Wetts Fargo'Bank,N.A. Payable Date O '��' 5�$� T7-1 Disbursing Agent 9/29/2014 910 � ' ' .*: i - Payable at: • � � Welis Fargo Bank,N.A. AMOUNT OF CHECK One Thousand Eighty Eight�30/100 U.S. Dollars ��--"--��----------��""- PAY TO THE ORDER OF ***$'�,085.30*** GAIL MCMILLEN BLACK& Void aker 180 days CHARLOTTE MCMILLEN KLEIN EX EST CAROLYN O MCMILLEN 60 CONWAY ST � CARLISLE PA 17013-2805 WB09109298 .. ___.._.---- - --- ----- 8091 Auth ized Signature 30 Signature May Be Computer Generated o055885 �i'055685�i' �:09 L000019�: 8730505495ii' September 29,2014 � � � � Banco Santander, S.A. • � • American Depositary Receipts IMPORTANT: Retain this document for your investment,tax,and cost-basis records. See reverse for information about online account access. Account Information Transaction Details Share Balances Account Number 7100082808 Type of Transaction Sale Direct Registration System 0.000 Share Amount -118.000 Total Shares 0.000 GAIL MCMILLEN BLACK& Price per Share $9.4700 CHARI.OTTE MCMILLEN KLEIN EX Effective Date 9/29/2014 EST CAROLYN 0 MCMILLEN Gross Amount $1,117.46 60 CONWAY ST Service Charge $15.00 CARLISLE PA 17013-2805 Commission $14.16 Federal Tax Withheld $0.00 NRA Tax Withheld $0.00 State Tax Withheld $0.00 Net Amount $1,088.30 This advice represents the most recent.sale transaction processed on your account. If you requested an additional transaction(s),the details of that transaction(s)will be mailed to you under separate cover. The shares represented by this statement are fully paid and non-assessable. This statement is a record of addressee rights at the time of issuance. Delivery of this statement of itself conveys no rights to the recipient. This statement is neither a negotiable instrument nor a security. A full copy of any rights,privileges,restrictions,and conditions which may be attached to the securities covered by this statement can be obtained by writing to the Secretary of the Company. osso�a IIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�II *Z6091A30�0�1�1�Y�Y�Y�Y' ,:::::::;.::::;::�:;.:......:..:,.....:,:. .::..:.::.:.:::.:..:.::..::.:...::::::�::.:.:,::::;:;::�;:<:::.::;:;:::::;::::°:: f ,....:,,::.:::,;-�.T� ::�;:�::::;::5i;~r::: :.s.:.,...�.::::.::::...::.:. ..:.: ;;:s:''!:::;:�r,.;; . . ! ::. . .��...,:::::::: ;';:'::.'�... . ... ;:'::; � $ � � �. � �S ;: .... �; � . �. �� : �' :::r.•<.::;:�:;:;:;:: � #. . :1 �#��I .r... , .:::.:..::.:::::.....::.: .�� .��::. i�� .�.. ..H... � -M.y':a::::.'::�� ' � � �'�.'�'��'.'.�..'•.:::::'."::��'.•:...':•.. .. ��.� '. .� A � `J� .� .�. . . �.:... :: J�l•`:�:[:::::':::: :'.R .��.. :�::�. . !�M-i. ..:�.:.:..:�..:•:...� .,. . . . ....:•'::;' ::.•:::::�:i:C:.•''.:.'': ...-..::. . � .......:.:.:. �.� .�+��'...., ...::..:. . . . :. :.........:.:i:i:�i: ' ... . 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PayaBi$a4:' : Wsi(s�ar�a:IIenk N.A Three&64/tb0 U.S. Dollars _, AMOUN7bFCWECK PAY TO THE ORDER OF � _. ***$3.64*** CAROLYN O MCMILLEN 60 CONWAY ST Void after 180 days CARLISLE PA 17013-2805 :::::_.... . . . ...::.:....: ` ::.::.:�.:......................... ..... ; :...�:::-::,::;;::,::;;::,:,:;;:::::::,;::::�...::..::.....:::.. . .. . ....... .. . . .. ..............:.:..:::::�.:.::<. ;:::,:.:::..;::...:. ` :. , E�os+ .....: ;.... � ; �cft3f��et1�{nas�Ar+z , s� ; :. :Sld►i��.��;8e.�rutifriit�►^�etief'�. .....:2�:��:: � � � �� ' 3 u'0 2 �0 20 3u� +:0 9 10000 L 9i: 68 3 4 9 9 ? 5B 4u� ��- � Direct Registration Account Statement Pa9e1of1 . . � ---�.�-,---�- i. �1��1t`i">1��a��i,i��tii�"��t`�ter��rt�fc�r ,� �t��,;��Y��.�"�itri��c��;a�::rc��;< °,�.� ,�;.� • � � �.,�� ,� ,�� , Questions: U.S.telephone number.888-810-7456,Outside U.S.:651-453-2128 For online account information,please visit www.adr.com/shareholder August 7, 2014 Account Summary Banco Santander, S.A. American Depositary Receipts Account# 7000431694 CAROLYN O MCMlLLEN Direct Registration Information 60 CONWAY ST CUSIP Number: 05964H105 CARIISLE PA 17013-2806 Broker/ Dealer Firm Name: Broker/Dealer Account Number: Broker/Dealer Participant Number: Transfer Agent Account Number: 7000431694 Account Value Market Value Date 8/7/2014 Market Value Price $9.46 Total Market Value $1,116.28 Share Balances Year-to-Date Amounts Direct Registration Service Charges Paid by You $0.00 Global Invest Direct Pro ram �18 000 Commissions Paid by You 9 0.000 Federal Tax Withheld $0.00 Total Shares 118.000 Nonresident Alien Tax Withheld $0.00 State Tax Withheld $0.00 Transaction or Transactfon Price per Gross Settlement Date Service Broke $0.00 „__ _ Type � Share Amount � � Char.�. ._ ____ son e � Dir tio� �_ .}'O`:�'4'f�i:f� ' `...,."" _ —..._..._. ._ ,, Commis N tAmou t __---- umber of 'ect Reglstra . < ` ,�-,'W, . .-_ ---:�,_.----._-,,�._... Shares Batance t .: �,,.t,,, : -5—b � Stock Dividend ��`" >� ; t $0 00 ' '�t�'t3p� $0 000 �,;._._. __ , � s �=, ` � Stock Dividend r� ` � �� 2.00U 'xw'.�.�� ` � #` �' ' �� '�, +: .r,> : $0�� {}.,, $� �� . ,$�C1 Q� 2.00� � ��*„�'''� �� y� � Stock Dividend ��, � � k $0 00 :, ,, ,, �#: $0 000 g '�$a�� ;�+)( ��3 .aF'�$' ��,''^{SS^*ST ^�. i�� C�� ; y ��f,yyy�,j��`��y Z.Q�Q ";.�,r�� { 'i�P{�1�,i� ..'P', u �. ' � � � y.r� ' ! �`�p 't 7�r{a+,}y¢i }'�m"1 �` 'g,�,r y `�' 2, i � � Y' r� "H . �d§4 � �H'. . A"�i :q �c„s 2��t�.a� V #�.!M��4�� '��'��$� �� ` * � 't � t h�� X�� +i r � i t ) �t ) a� +„�a'. 2# J w �f�e� #` 1 �� .4 s w�°t' a�i`Y�.,}�d'3e�,��,} �4� U�n� �` fa�4� - .�' ;;.�?ro s ��': x� �` ,� 5t o ^a �c 7 �'�'.at�.� .� , .��a �` ,x7�1 ^x,s;. ';`� m !�a �;� �, � �"�� s�f M �w�� '� ��n '��`; � ��'�- x�"�}� 4k ��.. fj � r -+ rk t a,��,�'��,»��£r�" yK`"�'� �t�� '''.yy.i�+, Y d ��t a*�� `Yec� 1,x�s � ^�A �, � � .3 t �y• " ,�. M1 � Y4t�,kY A"�Y�� ' �A" 6 "'h ' „fW� �.�( � .i bY k.y+f g+y�W �Y�: y ;, �� x A ._.. _._. ..._.. �`` f'��!�?'� 'T�� ` ;... st».: � 7 r k P'� ��`'�,✓�� } .D� . , r � -.: ..: �. � . �.�. - . . . ... : �..'.9 7 �.1',i� >„ � , ��ur" '� - x ..�..,- .. '_. ""a`' �:,�. This statement represents the Banco Santander ADSs issued to you as a result of your scrip election.A check for cash in lieu of fractional ADS is attached.lf you dld not receive a statement,then you are only entitled to cash in lieu of fractional ADSs. The shares represented by this statement are fully paid and non-assessable. This statement is a record of addressee rights at the time of issuance. Delivery of this statement of itself conveys no rights to the recipient. This statement is neither a negotiable instrument nor a security. A fult copy of any rights, p�IV112geS, restrictions,and conditions which may be attached to the securities covered by this statement can be obtained by writing to the Secretary of the Company. 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