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HomeMy WebLinkAbout03-02-15 (2) J REV-1500 EX`°z-„> � 1505610143 "�,y� OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENTOFREVENVE Po BoxzBoso� INHERITANCE TAX RETURN 2 1 14 0 0 6 7 3 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date ef Birth 06 29 2014 12 27 1925 DecedenYs Last Name Suffix DecedenYs First Name MI CULTON LAVERNE J (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FIL�IN APPROPRIATE OVALS BELOW � 1. Original Return ❑ 2. Supplemental Return � 3_Remainder Return(Date of Death Priorto 12-13-82) � 4. Limded Estate � 4a. Fuwre Imerest Compromise � 5. Federai Estate Tax Return Required (date oi death after 12-12-82) g Decedent Died Testate � Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes � (Attach Ccpy of Will) � (Attach Copy of Trust) — � 9. Litigation Proceeds Received � 10.Spousal Poverty Credit(Date of Death � ��,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 CONFIDENTIAI TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number TERRENCE J KERWIN 717 362 3215 REGISTER OF WILLS US€_QNLY c> '� �-, =-7 �,i First Line of Address � � � �,�� e� ' �,. - 4245 STATE ROUTE 209 � `� � �'' "' �`� ! "� -..• �� , �.., .:-- ;. ...,. r.. : �:7 `, N Second Line of Address � � . , _... � _ : DATEFILED --� - _.'.' City or Post Office State ZIP Code - - �•'a ELIZABETHVILLE PA 17023 � ` ``� � � �, e-, � `�t Correspondent�se-ma�iaddress: tjk@kerwinlawfirm.com Under penalties of perjury,I oer,lare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE F R FILING RET RN ' DATE � Jessica Shadle =•� � � ADD ES 6276 State Raute 209, Lykens, PA 17048 SIGNATURE OF PREPARER OT'.1ER THAN REPRESENTATIVE DATE ��,�,��� ���,��.V Terrence J Kerwin �. �� ��'" ADDRESS Kerwin & Ken�vin, P 4245 State Route i09, Elizabethville, PA 17023 Side 1 � 1505610143 1505610143 � �� J 1505610243 REV-1500 EX DecedenYs Social Security Number �e�ede�c•S Nama. C U L T O N� L A V E R N E J. 2 0 1 1 8 7 2 9 3 RECAPITULATION 156 , 539 . 75 1. Real Estate(Schedule A).......................................................................................... 1. 54 , 980 . 62 2. Stocks and Bonds(Schedule B)............................................................................... 2. 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C).......... 3. 4. Mortgages&Notes Receivable(Schedule D).......................................................... 4. 317 , 055 . 37 5• Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)................ 5. 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............. 6. 7. inter-Vivos Transfers&Miscellaneous Non-Probate Property 1 1 3 , 2 9 7 . 4 2 (Schedule G) ❑ Separate Billing Requested............. 7. g. Total Gross Assets(total Lines 1 through 7).......................................................... 8. 641 , 873 . 16 - - -_ -- - - --------- -- 74 , 046 . 08 9. Funeral Expenses and Administrative Costs(Schedule H)..................................... 9. 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................. 10. 74 , 046 . 08 11. Total Deductions(total Lines 9 and 10).................................................................. 11. 567 , 827 . 08 �2 Net Value of Estate(Line 8 minus Line 11)............................................................. 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J)................................................. 13. 567 , 827 . 08 14. Net Value Subject to Tax(Line 12 minus Line 13)................................................. 14. TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxabie at the spousal tax rate,or transfers under Sec.9116 (a)(1.2)X .00 15. 16. Amount of Line 14 taxable 16. at lineal rate X 045 17. Amcunt of Line 14 taxable at sibling rate X 12 �� 18. Amount of Line 14 taxable 5 6 7 , 8 2 7 . 0 8 �s. 8 5 , 17 4 . 0 6 at collateral rate X .15 19. TAX pUE................................................................................................................... 19. 85 , 174 . 06 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 - 00673 Decedent's Complete Address: D CED N NAME Culton, LaVerne J. - STREET ADDRESS 316 B e I a i r e D r i v e -- _—_— -------_—------------ - ---------_ CITY ------- - —— -- STATE ZIP Shiremanstown PA 17011 Tax Payments and Credits: ��� 85,174.06 1. Tax Due(Page 2,Line 19) -- 2. Credits/Payments A. PriorPayments _ 26,250.00 B. Discount 1,3 81.5.8 Total Credits(A +B) (2) 27,631.58 3. I nterest (3) 0.0 0 4, If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) ___ 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) 5 7,5 4 2.4$ Make Check Payable to: REGISTER OF WILLS, AGENT. � " �� " ��§ �.� ntij bi � e"��a.�� .4» a�.� vs, aca+�.lpt.k.te_,,.�. .:� e4,=o.c--� �9r4.�.w�,,,.oie.a�y ,w3 .�..a..>..-, a,�....a.w,.� + ,. i .. �,. � r ii s �a. �� ��� �..�� t� ,��lru , .�...'!m . .. K . :, ,.�� ..a� �.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 property transferred:.................................................................................. [� [� 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 � C� 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. ��. L .��.j,a�r ..i�.�»gv t, af». .�_.,uP. ��.,'. �. ':�i,» .�� �"';`�^� 50 .,�a� �,.��i+i '-m'��.`��.��: ,x-... �:.-_..'.� ��.,. �,i.�.., .. �".: ,�%�. �} ...r� ����� w�� �:����. , �r ,,«».. �kd d..�.' . 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 �ssets and f I ng a tax1refu�rn a eest II applc ableneven f the surv vsng spouse s�the only b nfefic ary'and the statutory requirements for disclosure of 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 ears 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)(�.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 decedenYs 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,wfiether by bloo�or adoption. ��y.� pennsylvania �,l� DEPARTMENTOPREVENUE SCHEDULE A �rr INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT — FILE NUMBER ESTATE OF Culton, LaVerne J. 21 - 14 -00673 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 wilfing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which 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. Include a copy of the deed showing decedenYs interest if owned as tenant in common. ______ __ ITEM DESCRIPTION VALUE AT DATE OF DEATH NUMBER — - 1 Real estate located at 316 Belaire Drive, Shiremanstown, Lower Allen Township, Cumberland 156,539.75 County, Tax Parcel#48-23-0557-113. Sold on 9/09/14 for net proceeds of$156,539.75. TOTAL(Also enter on Line 1, Recapitulation) 156,539.75 REV•7603 EX+(6-98) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEOENT --- FILE NUMBER ESTATE OF Culton, LaVerne J. 2� - �4 - 00673 _ __ _ All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM � UNIT VALUE VALUE AT DATE OF DESCRIPTION ! I DEATH NUMBER _ ------ --�---- 1 151 shares Mid Penn Bancorp Stock, valued at$15.82 as of date of death i 15.82 i 2,388.82 for a total value of$2,388.82. � 'I 2 259 U.S. Savings Bonds, Series EE ' I 52,591.80 I ' ' �� I'� � ' I � '� �I � ,, I I ; ; ; ; ' i � I � � 'I '� i I I , �, � i I !' ' I �', I �� � I i I, � ' I ' �' I -- �� � ----------- ----- TOTAL(Also enter on line 2, Recapitulation) i 54,980.62 .-� pennsylvania l SCHEDULE E � DEPARTMENTOFREVENUE CASH, BANK DEPOSITS AND MISC. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY —— _---— ---.—_= SCHEDULE E CASH, BANK DEPOSITS AND MISC. COMMONWEALTHOFPENNSYLVANIA PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT conti n ued .-. _-._._-._ _------- — - FILE NUMBER ESTATE OF Culton, LaVerne J. 21 - 14 -00673 Include the proceeds of litigation and the date the proceeds were received by the estate.All property jointiy-owned with the right of survivorship must be disclosed on schedule F. ITEM DESCRIPTION I VALUE AT DATE OF NUMBER DEATH _ 15 Welis Fargo Certificate of Deposit i 12,627.27 Account#XXX3715 i 16 Wells Fargo Certificate of Deposit �i 3,593.87 Account#XXX1968 ' 17 � M &T Bank Checking Account#24921203 I 71,272.08 18 M &T Bank Certificate of Deposit �, 5,996.88 Account#31003916013219 � 19 Santander Certificate of Deposit I� 21,889.42 � Account#7672495003 � 20 Santander Certificate of Deposit ��; 25,410.23 Account#7672495119 � �I 21 Santander Certificate of Deposit 11,651.67 Account#1685226647 'I! I 11,948.74 22 Mid Penn Bank Certificate of Deposit ! i Account#309003116 � 23 I Mid Penn Bank Certificate of Deposit 21,731.08 Account#309003117 � 24 ; Baldwin wall clock and vase, chair, sofa, marble top table, pictures I� 200.00 25 Brown Citrine ring with two diamonds � 200.00 26 I Gold chain ' 25.00 I, ! il II I�� Page 2 of Schedule E SCHEDULE E CASH, BANK DEPOSITS AND MISC. COMMONWEALTHOFPENNSVLVANIA PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT co nti n ued -_– REV-1510 EX�(08-09) �; pennsylvania :�'� DEPARTMENTOFREVENUE SCHEDULE G INHERITANCETAXRETURN INTER-VIVOS TRANSFERS 8� RESIDENTDECEDENT MISC. NON-PROBATE PROPERTY ESTATE OF Culton, LaVerne J. FILE NUMBER 21 - 14 -00673 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.___ _ - .—� � ITEM DESCRIPTION OF PROPERTY I DATE OF DEATH I %OF I exc�usioN T TAXABLE VALUE Include the name of the transferee,their relalionship to decedent i VALUE OF ASSET I DECD'S (�F APPLICABLE) �'�, NUMBER and the date of transfer Attach a copy of the deed for real estate INTEREST I-- - --- • y 55,707.33 �I 100% ' T 55,707.33 1 23 U.S. Savmgs Bonds Series HH, payable on death I I to Nancy J. Grosser. See attached sheet � i � ' i ' 2 ; Wells Fargo IRA Account#XXX7110 �� 3s,113.42 I� 100°/o �� ' 38,113.42 Beneficiary: Nancy Grosser, Cousin �, �I I 3 I Welis Fargo IRA Account#XXX4078 I� 19,a�s.s� � 100% '�'�,I ', 19,476.67 Beneficiary: Nancy Grosser, Cousin I i , � ' �� ' , I ; I� � � �� ; i i ; � � ' �I I ', �', ;� �� � I , �I , ,'I, I �, I '' I � ' , , , � � I� I'� �I ' I, � � ii � ' �I ,I I 'li I II ' , ', I I ' ;I I� I ,! '� I � ', - --- TOTAL(Also enter on line 7, Recapitulation) ', 113,297.42 REV-1511 EX+(10-09) � pennsylvania � SCHEDl1LEH ' DEPARTMENT OF REVENUE FUNERAL�ISES AND INHERITANCE TAX RETURN ANIAINIJ"1'RA'rl V G CWC� RESIDENT DECEDENT fV.J11111 ---- FILE NUMBER ESTATE OF Culton, LaVeme J. 21 - 14 -00673 _____ — --- -- -- Decedent's debts must be reported on Schedule I. --- _ ITEM DESCRIPTION AMOUNT NUMBE � FUNERAL EXPENSES: -- - -- -------------— A. 1 � John R. Shultz Funeral Home 9,109.10 �.—_---- I � ,I g, I ADMINISTRATIVE COSTS: �. 'I Personal Representative's Commissions Name of Personal Representative(s) Nancy Grosser Jessica Shadle 26,256.19 , Street Address 120 Damview Road � city Media state PA zip 17063 Year(s)Commission Paid 2015 2. Attorney's Fees Kerwin & Kerwin, LLP --Terrence J. Kerwin 26,256.19 3. Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation) Claimant Street Address �i�y State Zip Relationship of Claimant to Decedent 4. Probate Fees �I 418.50 I I 5. AccountanYs Fees I 6. Tax Return Preparer's Fees 7. Other Administrative Costs � Santander Bank-fee for date of death balances 20.00 I See attached 11,986.10 TOTAL(Also enter on line 9, Recapitulation) � 74,046.08 Schedule H Funeral E�enses& COMMONWEALTH OF PENNSYLVANIA �in�����nued INHERITANCE TAX RETURN RESIDENT DECEDENT ---- FILE NUMBER ESTATE OF Culton, LaVerne J. 21 - 14 -00673 2 Register of Wills-additonal Short Certificates 45.00 3 Cumberland Law Journal - Estate Notice 75.00 4 The Sentinel - Estate Notice 254.26 5 Notary Fees 10.00 6 Postage 32.65 � Hospice 6,874.56 8 Refuse and sewer 134.97 9 Real estate taxes 2,195.30 �o PA American Water 45.89 11 Alert 82.15 � �2 �� Verizon 102.51 13 Jeff Lauver- lawn mowing 235.00 14 PPL 83.44 15 I PA American Water 29.54 is PPL 39.27 �� Lawn mowing 120.00 �8 PRS Radon 840.00 19 PPL I 27.34 2o Spirit Physician Services 15.00 �i i Page 2 of Schedule H Schedule H Funeial E�es& COMMONWEALTH OF PENNSYLVANIA �n��C��nued INHERITANCE TAX RETURN RESIDENT DECEDENT . - -- = FILE NUMBER ESTATE OF Culton, LaVerne J. 21 - 14 -00673 z� Lawrence Widders � 527.35 � 22 � PA American Water I 6.82 23 Lawn mowing I 30.00 24 I Holy Spirit �� 10.10 25 �I M &T Bank-cost of estate checks 29.95 zs Register of Wills - Releases 15.00 27 I Register of Wills-additional Probate Fee 100.00 2$ I Closing costs, e.g. postage, copies I 25.00 i � I� Ili I I � � � I� I I� I '� il � I � � 1� I �, I Page 3 of Schedule H Rev-ia�s ex+�o�-io� �, pennsylvania SCHEDULE J � DEPARTMENT OF REVENUE gENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ______—_ __...._--- - — — - ESTATE OF FILE NUMBER Culton, LaVerne J. 21 - 14-00673 --- RELATIONSHIP TO SHARE OF ESTATE I AMOUNT OF ESTATE NUMBER ' NAME AND ADDRESS OF PERSON(S) DECEDENT I (Words) — ($$$) I R E C E I V I N G P R OPERTY Do Not List Trustee(s) ' . _.. _ _ --- ----- --�------ -�- --r—�—�--�� -- I I� :T�BLA E DISTRIBUTIONS[include outright spousal � distributions,and transfers under Sec.9116(a)(1.2)] I� I'I 1 �I�I Doroth Saltzer � Mid Penn Bank � Y � 508 Main Street �I '� stock plus personal I �� Lykens, PA 17048 � �! property items ��, I I � I, �I j 2 ! Jessica Shadle � Personal property � � 627G State Route 209 �, items plus 1/3 , �' Lykens, PA 17048 j residue �� I I 3 ': Karen Grosser Parsons Personal property ; �� 29 Grayson Drive �! '�� items ' Belle Mead, NJ 08502 � 'I ', � I i II , i 9 ' p li I��Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet,as a propriate. I II. NON-TAXABLE DISTRIBUTIONS: A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN I B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 REV•1513 EX+�01-10) �. pennsylvania SCHEDULE J �� DEPARTMENT OFREVENUE INHERITANCETAXRETURN BENEFICIARIES continued RESIDENT DEGEDENT ESTATE OF FI�E NUMBER Culton, LaVerne J. 21 - 14 - 00673 I words) — ---- _—___ _ __ r--- — AMOUNT OF ESTATE ' ELR ATIONSHIP TO SHARE OF ESTATE I NUMBER �I� NAME AND ADDRESS OF PERSON(S) � DECEDENT ( ' �$$$� RECEIVING PROPERTY _ � Do Not List Trustee(s) �_ __ _ _ I � I. �TAXABLE DISTRIBUTIONS[include outright spousal � distributions,and transfers ' under Sec.9116(a)(1.2)] � �I. Personal ro ert I 4 II Carol Gates p p y � 440 Berry Lane items plus 1/3 Media, PA 19063 residue �I, i ; i 5 II Suzanne Gates ' Personal property ' I items � 440 Berry Lane i I, I� Media, PA 19063 I 6 �I Mosca Kalathas I $2,000 plus personall� � 3315 Hartzdale Drive ; property items I ; Camp Hill, PA 17011 I � i � , Personal ro ert �II 7 I Tessie Kalathas p P y ' 3315 Hartzdale Drive � items �; ICamp Hill, PA 17011 ' I ' � 8 �I Tina Kalathas � �� Personal property ' i 3315 Hartzdale Drive � items ' Camp Hill, PA 17011 !, 9 '� Nanc Grosser I Personal property I y � ' 120 Damview Road ' items plus 1/3 ! i, Media, PA 19063 I, residue I � �� �I ��I � ; � � ' 'I I ; � , � , , ��I � I II I �'I ,,I ', � ' I' — I�----- – — ----- - -- -- � Page 2 of Schedule J FORM No. 27—DEED FROM A CORPORATION, Act 1901. G! ,,.�.;'FL-C;FiC"c OF THE i:,f._�r"t^pF L'r.rDS �' � ¢ i:J'��� ����Lu�� 5 I 5a Pi'1 19vfi ��—CL'61_c;',.;.`;�C�U1�TY c FGt�NSI'L'+AIJIA - ,���p �(.p �'s`�`�- day of J�°"'��� A.D.one thousand nine aj � knvdred and S iXty—S].X ( 1966) between the Corporation by the name, atyle and tiEle of BEL-AIEE HOMES, INC. , a Pennsylva2��a-corporation having its principal place- of business in the Borough of Shiremanstown, County of Cumberland and State of Pennsylvania, party of tl�e one part and JOHN E. CULTON and LaVEENE J. CLTLTON� his wife, , � of Borough of Ly,kens, Co,mtpof Dauphin in the State of Pennsylvania, p�.rti.es of the other part �t�ne,SSPf� That tl�e said party Of the �f irst part . for 8nd in con- � siderntion of the aum of Three Tkiousand� Five Hundred ----------------------- ------- (�P3�500.00� Dollars, lawful=money of the United States, to it in hand paid by the said parties of tYie s'econd part : at the time of the esecution hereof,the receipt n:hereof is hereby acknowledged, has,granted�bargained�eold, aliened, enfeoffed, released and confirmed, and by theae presents doee grant, bargsin, aell, alien, enfeo$', zo- Lease and confirm unto tLe ssta parties of the secorid part, their heirs . and assigne� " all thet cextain piece or parcel of land,aituate in the TOWY1Ship of Lower Allen, County of Cumberland and State of Pennsylvania, bounded and described as follows, to wit: BEGINNING at a point on the southern line of Belaire Drive, said point being at the dividing line between Lots Nos. 5 and 6 on the hereinafter mentioned Plan of Lots; thence along the southern line of Belaire Drive, North 66 degrees 36 minutes East, seventy- five (75) feet to a point at t�e dividing; l:ine between Lots Nos. 6 and 7 on said plan; thence along said dividing line, South 23 degrees 24 minutes East, one hundred fifteen (115) feet to a point; thence South 66 degrees 36 minutes West, seventy-five (75) feet to a point at the dividing line between Lots Nos. 5 and 6 on said plan; thence along said diViding,line, North 23 degrees 24 minutes West, one hundred fifteen (11'S) fee� to a point on the southern line of . Belaire Drive, the place of BEGINNING. ; BEING Lot No. 6, B1bck "N" on Plan No. 3 of Shireman Manor � Extension, said plan bei�ng-��recorded in the Cumberland County ' $ecorder's Office in Plan �ook 16, Page 4�3, known and numbered as 316 Belaire Drive. � BEING part of the same premises which Carroll -E. $oth and M. Almeda xoth, his wife, by deed dated August 7, 196� and recorded in the Cumberland County Eecorder's Office 'in Deed Sook "I" , Volume 21, Page 20, granted and conveyed unto the party of the first part herein. UNDEE and SLTBJECT, nevertheless, to easements appearing on record on said plan and to the restrictions as set forth in the Cumberland County Eecorder�s Office in Miscellaneous gecord Book 167, Page �35 and to amended restrictions as set forth in Misc- ellaneous Becord Book 169, Page 685. , 1�,� ,:;� _L'J�� I u w u s h i p o f�,62..�g ��N :� I.,_,.,1�.. . ...' 1..- j , School D����__ Cuni6. Co. Pa. �: ' ' �0, Pe, �Rea��state Tranefer Tex � " �o Real Estate iransfer iax So/ ' ? ' Da -(o Amt. 1 5D/ Date Amt. � ;�� � um . um , o, a„ o � ��1�. ; o. s ,, o . g , `� � 4 . �;, BG0�2 CPAGE �lJ ` � .. _ ...� u��.a„�.Y--- .. "'ESCROWACGOUNT"' 53565 De.�ba: -09/09/14 . "�ait.�.130;,289.75 E�1e I�rber 14 1906OC Ct�ec3t #: ;53.565 , � '��f��Pa.yp'Ib E�tatoe af�Tas�,Tw �T Ua7_trn= � � � �4-0'� f.� � �� �- . 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Y,�� �,�` �Y,�J�'i�be6$� ., .. � .., ., �`.«. ,..�'..� � w9. .�iJs��;._k � . . r,�'Lt��',�...,._..ra M .h�v� ,�w . . . « H 41an�. a � �£ '� ,a����Y 1 i"c:2i,, n'053565u' i:03 L30 LB46�: 53 90060 � 2n■ � � `' OMB Approval No.2502-0265 `'. iii'iii��� A. Settlement Statement (HUD-1) �i� FINAL 6.File Number: 7.Loan Number. 8.Mortgage Insurance Case Number: 1.Q FHA 2,Q RHS 3.Q Conv.Unins. �4-1906GC 3331674767 4. XQ VA 5.Q Conv.Ins. C.Note:This form is fumished to give you a statement of actual settlement costs.Amounts paid to and by the settlement agents are shown Items marked "(p.o.c)"were paid outside the ciosing;they are shown here for infortnatfonal purposes and are not included in the totals D.Name 8 Address of Borrower: E.Name&Address of Seller: F.Name 8 Address of Lender: Brandon E.Green Estate of Laveme J.Culton Quicken Loans,Inc. 660 Boas St.,Harrisburg,PA 17102 1050 Woodward Ave.,Detroit,MI4822Cr1g06 G.Property Location H.Settlement Agent I.Settlement Date:09/09l2014 316 Belaire Dr. Guardian Transfer Corporafion Disbursement Date:09/09/2014 Shiremanstown,PA 17011 4075 Market St.,Camp Hiil,PA 17011 LowerAilen Township Phone:717-909-0700 Fax:717-723�585 Place of Settlement TitleExpress 4075 Market Street,Camp Hill,PA 17071 Printed 09/09/2014 at 9:00 am by AL 100. Gross Amount Due from Bonower 400. Gross Amount Due to Seller , 101. Contract sales price 175,000.00 401. Contract sales price 175,000.00 102. Personal ro 402. Personal ro 103. Settlement charges to bortower Qine 1400) 4,468.77 403. 104. � 105. 405. Ad'ustrnents for items aid b seller in advance Ad ustments for items aid b seller in advance 106. Cityltown taxes to 406. Cityftown taxes to 107. County taxes 09/09/2014 to 12/31/2014 281.59 407. County taxes 09/09/2014 to 12/31/2014 108. Schooltaxes 09/0912014to O6/30I2015 28�'S9 1,810.53 408. Schooltaxes 09/0912014to O6/30I2015 1,810.53 109. SewedRefuse JIAIS 09/09I2014 to 09130Y1014 29.17 409. SewedRefuse J1A/S 09109/2014 to 09/3012014 110. SewerlRefuse Credit 29•» 12.27 410. SewerlRefuse Credit �2 2� 111. 411. 112. Principal CuRailment 1,790.25 412. �Z�• Gross Amount Due from BoRower 183,392.58 420. Gross Amount Due to Seiler 177,133.56 200. Amounts Paid b or in Behalf of Borrower 500. Reductions In Amount Due to Seller 201. DeposR or eamest money 1,000.00 501. 6ccess deposit(see inshvc6ons) 202. Principal amount of new loan(s) 175,000.00 502. Settlement charges to seller(line 1400) 39,&t3.81 203. Existln loa s taken sub'ect to 503. Existin loa s taken sub'ect to 204. 504. Pa off of first mort a e loan 205. 505. Payoff of sewnd mortgage loan 206. SellerAssist 7,000.00 506. SellerAssist 207. 7,000.00 507. 208. Credit for lender paid fees 100.00 508. 209. 509. Ad'ustrnents for items unpaid b seller Ad'ustrnents for items un aid b seller 210. City/town taxes to 510. Ciry/town taxes to 217. County taxes to 511. County taxes to 212. Schooltaxes to 512, Schooltaxes to 213. 513. 214. 574. 215. 515. 216. 516. 217. 517. z�8' S18. 219. 519. 22�• Total Paid b Ifar Bonower 183,100.00 520. Total Reduetion Amount Due Seller 46,843.81 300. Cash at Settlement fromko Borrower 600. Cash at Settlement tolfrom Seller 301, Gross amount due from bortower(line 120) 183,392.58 fip�, Gross amount due to seller Qine 420) 177,133.56 302. Less amounts paid by/for borrower(line 220) 183,100.00 602. �ess reduc6ons in amount due seller Qine 520) 46,843.81 303. Cash ❑X From � To Bonower 292.58 603. Cash QX To � From Seller 13D,289.75 weiam��mwud�'q�layaawrtentlyvallEOMB1cantralnvnber.Nocm00vNyllybas�wrW�',�tld��adaueismaMabry.7NebCsa�Y�edb ` CO1" spxcy may yau namemeM pxeu P�s IM Vartln m a RESPA cwved tr�nnctlm vAM Infarmatlm Mirg tlis a e Previous editions are obsolete Page 1 of 4 HUD-1 ,�_ � ��z.� � 700. TotalRealEstateBrokerFees 10,9ss.00 Paid From Paid From Division of commission Iine 700 as follows: BOITOWe�'S Seller'S 701� $5,745.00 to ColdwellBankerHomesteadGroup Funds at Fu�ds at 702• $5,250.00 �o Coldwell Banker Homestead Group Settlement Settlement 703. Commission paid at settlement 10,995.00 B00. Items Pa able in Connection with Loan 801. Our origination charge (Includes Origination Point 0.000°h or$0.00) $3,937.50 (from GFE#1) 802. Your credit or charge(points)for the specific interest rate chosen $-6,147.75 (from GFE#2) 803. Your adjusted origination charges (from GFE A) -2,210.25 804. Appraisal fee to TSI raisal Services (from GFE�i) 415.00 805. Credit report to CoreLo ic (from GFE#3) 23.85 806. Tax service ro 807. Flood certification to Corelo ic Flood Services (from GFE#3) 5.00 808. Flood Detertnination Fee to CoreL ic Flood Services (from GFE#3) 10.50 809. Tax Certification Fee to Title Source,Inc. $18.00 P.O.C.L'(from GFE�3) 900. Items Required b Lender to be Paid in Advance 901. Daily interest charges from from 09/0912014 to 10101/2014 @ 19.78001day (from GFE#10) 435.16 902. Mortgage insurance premium for months to (irom GFE q3) 903. Homeowners insurance for ears to USAA Casual Ins.Co. (hom GFE#11) 1,040.28 9�• months to from GFE#11 1000. Reserves De osited with Lender 1001. Initial deposit for your escrow account (from GFE#9) 1,029.73 1002.Homeowners insurance 3 months $ 86.69/month $260.07 1003.Mortgage insurance months $ 0.00/month $ 1004.Property taxes months $ O.00lmonth $ 1005.County taxes 8 months $ 73.63/month $589.04 1006.School taxes 4 months $ 182,g5/month $731.80 1007.Aggregate Adjustrnent $-551.18 1100.Title Char es 1101.Title services and lenders tiUe insurance $ from GFE#4 1,650.00 20.00 1102. Sefllement or closing fee to $ 1103. Owners Gtle insurance-First American Title Insurance Company $ irom GFE#,5 127.50 1104. Lenders tiUe insurance-First American Title Insurance Company $1,550.00 1105. Lenders title policy iimit$175,000.00 Lenders Policy 1106.Owners title policy limit$175,000.00 Owners Policy 1107.AgenPs portion of the total title insurance premium $1,370.17 to Guardian Transfer Co oration 1108. Undenvriters portion of the total title insurance premium $307.33 to First American TiUe Insurance Com an 1109. 1200.Government Reeordin and Trensfer Cha es 1201. Govemment recording charges $ (from GFE#7) 192.00 �2�2• Deed$79.00 Mort a e$113.00 Release$ 1203.Transfer taxes $ (from GFE#8) 1,75p,Op 1204.CitylCounty taxlstamps Deed$1,750.00 Mort a e$ 1205.State Ta�stamps Deed$1,750.00 Mo a e$ 1,750.00 1206. Deed$ Mort a e$ 1207.Cumberland County 1300.AdditionalSettlement Char es 1301.Required services that you can shop for (irom GFE�!6) 1302. Electric Due-AccL 16660-78003 ro PPL Electric UGlities 39.27 1303.Water Due-Acct.102421003650062 to Penns vania American Water Co. Zg yti 1304. Home Warranty to American Home Shield- 460.00 1305. Deed Preparation to Kenvin&Kerwin,LLP 300.00 1306. Inheritance Taxes to R ister of Wills,A ent 26,250.00 ��� � ' � 4,468.77 39,843.81 'Paid outside of closing by(B)orrower,(S)eller,(L)ender,(I)nvestor,Bro(I�er.'•Credit by lender shown on page 1."'Credit by selier shown on page 1. Previous editions are obsolete Page 2 of 4 HUD-1 � RECORD DATE: 05/07/2014 MID PENN BANCORPwe PAYABLE DATE: 05/26/2014 DIVIDEND PER SHARE: •1000000000 ADDRESS CORRECTION CARD-DO NOT MAIL IF INFORMATION IS CARRECT AS SHOWN. FOR YOUR CONVENIENCE,THIS FORM SHOULD BE USED FOR REPORTINGACORRECTION OFYOUR ADDRESS NUMBER OF SHARES: 151.0000 WHICH NOW APPEARS IN OUR RECORDS AS SHOWN BELOW OR VISfT RTCA.CAM TO EFFECTTHIS CHANGE. PAYMENT INFORMATION $15.10 GROSS AMOUNT $37.75 YEAR TO DATE LAVERNE J CULTON LESS WITHHOLDING OF 316 BELAIRE DR SHIREMANSTOWN PA 17011 6503 $.00 FEDERALTAXES $.00 YEAR TO DATE OTHER TAXES YEAR TO DATE $15.10 NETAMOUNT DIVIDEND DEPOSIT REQUEST FOR CHANGE OF ADDRESS Keep this stub—A 1099 Dividend ACCOUNT NO. (SEE REVERSE SIDE) will be provided at year end. R&T ACCOUNT NO. 0006290000 2/4/2015 MPB Hlstcxical Prices�Mid Penn Bancorp Stock-Yahoo!Finance ��,iG� Ansv,�ers Srieen Ric4kr ���A4`ad�r�qr;i�� -�raf��x �, ��om,, P�aii Searcl� ��e�vs Suorts F r�nc� �tl�er Gam�s Search Ficance =&Ig�i�tii`�zh Mail � Finance Home My Portfolio My Quotes News Market Data Yahoo Originals Business&Finance Personal Finance CNBC Contributors Enter Symbol '����ui. Wed,Feb 4,2015,4:01 pm EST-US Markets are cbsad Report an Issue Dow10-.. .. . ,---'i tl � � E�FTRADE OPEN AN ACCWNT �A�iL'�d�O Mid Penn Bancorp Inc.(MPB) -Nasday�nn *Watchlist Add to Portfolio �..�ke �� 15.7r'J i0.19(1.19%� 3:10PMEST Historical Prices Get Historical Prices for. GO� Set Date Range ;��Daily Start Date:',JUn •;29 2014 Eg..Ian 1,2010 �j Weekly end Date:�Jun ���30 2014 (�Monthly ` �)Dividends Only � Get Prices First�Previous�Next�Last �� ; Prices i Date Open High Low Close Volume Adj Close' Jun 30,2014 15.15 15.82 15.15 15.82 1,400 15.52 Jun 27,2014 15.77 15.90 15.75 15.90 2,200 15.60 'Cbse prke adJusted for dNidends and spifts. First�Previous�Next�Last ��'�I Download to Spreadsheet Currency in USD. tiw...iM..............6........,...I.,A,..7�-�A DCi A.�-/1�A.1`70En-'NN dRr�fK1Lc='il1Rf='X11 dRrcrl 1/2 (;alculateci V alue ot Y our Yaper�avmgs l�ond(s) Yage 1 ot 5 Calculated Value of Your Paper Savings Bond(s) Calculator Results for Redemption Date 06/2014 Total Price Total Value Total Interest YTD Interest 12 950.00 52 591.80 39 641.80 761.32 Bonds: 1-259 of 259 Serial # Series Denom Issue Next Final Issue Price Interest Interest Value Note Date Accrual Maturity Rate C263796113E_E EE $100,09/1990,09/2014 09[2020;_ $50 00:.__ _ �110.32. 4.00%0 $160.32, C263786769EE, EE $100 09/1990 09%2014; 09%2020 $50.00 $110.32 4.00%' $160.32 _ C263777552EE' EE $100 08/1990,08/2014 08/2020' _$50.00 $110.32 4.00%: $160.32' -_ __ C310402437EE I EE $100:12/1991',12/2014 12/2021, $50.00. $104.08 4.00% $164.08' _. _._ _ C310390810EE: EE $100111/1991 11/2014 11/2021' $50.00 �104.08 4.00%' $154.08: C310379565EE EE $100:11/1991 11/2014 11/2021_' $50.00,. $104.08 4.00% $154.08 _ _ ._- -_ _ . C259464325EE, EE $100'08/1990,08/2014 08%2020: $50.00, �110.32. 4.00%' $160.321 C242948642EE. EE $100;07/1990�07/2014 07/2020: $50.00 $110.32; 4.00%; $160.32i C242940726EE: EE $100107/1990 07/2014 07/2020 $50 00 $110.32 4.00%; $160.32: C242933698EE EE $100i06/1990_12/2014. 06/2020 __ _�50.00, _ _ �113.52, ..4..00%', $163.52' C242926320EE'. EE $100�06/1990 12�2014 06%2020 $50.00 $113.52: 4.00%: $163.62 C242918757EE'. EE ! $1001,05/1990,11/2014_05/2020; _ $50 00 ___ �113.52 4.00% $163.52 V322008624EE'. EE $100a09/1989 09�2014 09/20191 $50.00 $116.80, 4.00% $166.80; _ _ ... C226705466EE' EE I $100!,il/1989a 11/2014, 11/2019',_ $50 00; .�116.80: 4.00%. �166.80; EE , $100',10%1989 10/2014 10/2019 $50 00;_____$116.80. _4.00%:. $166.80 _ C226690715EE' EE ! $100:10/1989 10%2014 10%2019_ __$50.00 �116.80. 4.00% $166.80 _ C211016442EE', EE $100;09/1989,09%2014,_09/2019„_ �5000;_., $116.80, . 4.00%; �166.80! C226736796EE EE I $100:01/1990 07�2014 01�2020 $50.00 $113.52, 4.00%: $163.52 - - • C226728771EE EE ', $100 i 12/1989,12/2014 12/2019; _$50 00 $116.80 4.00%0' $166.80 _.._ _. _ C226721110EE EE , $100_12/1989.12/2014 12/2019 $50.00, $116.80 4.00%: $166.80I - - C226713267EE' EE : $100;11/1989,11/2014, 11/2019, $50 00 _. $116.80 _4.00%, �166.80: C226744283EE;_ EE ' _ $100 03%199.0.09�2014 _03�2020'{ . __�50 00�_ _ _.$113.52 „4.00% $163.62'_ C266945574EE EE $100;03/1991 09/2014 03%2021 $50 00 �107.16 4.00% $157.16 C276880547EE EE_ ! $100.,03/1991 09/2014_03[2021._ $50.00 _ $107.16 4.00% $157.16. C276867995EE EE $100;02/1991 08%2014 02%2021! $50 00# $107.16_ 4.00%: $ib7.16', ... . .. .. C276855968EE _ _EE ' $100'.02/1991,08/2014. 02/2021 $50.00: _ _$107.16; _4.00%_ , $157.16: C276844824EE' EE $100101/1991 07%2014 O1/2021! $50.00_ $107.16 4.00% $157.16: C276831137EE I EE ' $100'01/1991:07/2014 01/2021) $50 00 i $107.16 . 4.00% �157.16: _ .__-- - C276816929EE' EE $100 12/1990.12/2014 12/2020 $50.00: $110.32 4.00% $160.32: __ C276804671EE _EE $100 12/1990,12/2014_ 12/2020. _ .$50 00__ _ .�110 32 _ 4.00% __ �160 32r C263844979EE EE , $100',11/1990 11%2014. 11%2020;_ $50 00,_ _ $110.32 t 4.00%_; _�160 32, _ __..____ -- , C263830382EE: EE $100'11/1990 11%2014, 11/2020! $50 00; $110.32. 4.00% $160.32 C2638_17701EE EE $100 10/1990 10/2014, 10/2020; , $50.00 $110.32 4,00% $160 32'„ C263805920EE EE $100 10/1990 10/2014 10/2020 $50 00 $110.32 4.00% $160 32. C259472535EE EE $100:08/1990 08/2014 08/2020', $50 00. _ .�110.32, _4.00%; _., $160 32. C226774829EE' EE $100!03/1990 09/2014 03%2020 $50.00, $113.52 4.00% $163.b2 __ - -. . . - - C226767289EE EE $100:03/1990 09/2014 03/2020_ $50.00 $113.52 4.00%'; $163.52 _ _---- -_ C226759671EE' EE $100 02/1990.08%2014. 02/2020 $50.00 $113.52: 4.00%j $163.52 - - - _ C226752035EE' EE ' $100!02/1990_08/2014 02/2020! $50.00 $113.52 4.00% $163.52, C242911209EE' EE ' $100!05/1990 11/2014 05/2020 $50 00 .,. $113.52 , 4.00% _ �163 52 __ C242903788EE EE $100 04/1990y10/2014 04%2020 $50 00: �113.52 4.00%, �163_62 ._ . . - -- C242896147EE' EE $100'.04%1990 10%2014 04/2020 $50.00 $113.52 _4.00% $163.b2 _ C226782573EE EE $100'03/1990 09/2014 03/2020' $50 00 $113 52 4.00% $163.52 - C310368247EE EE $100 10/1991 10/2014 10/2021 $50.00 _.�104 08, 4.00%. __ $154.08i _ _ C310356032EE EE $100'10/1991 10/2014 10/2021 $50.00 $104 08 4.00%: $154.08. C310344014EE EE ' $100_'09/1991 09/2014 09/2021 $50.00 ____ $104 08 _ 4.00%; $154.08' _ _ . C310331862EE' EE $100 i 09/1991 09/2014 09/2021 $50.00 $104.08 4.00% $164.08'. http://www.treasurydirect.govBC/SBCPrice 11/4/2014 l:alcutatect v alue ot Y our raper aavings t3ona(s) rage 1, ot � C29.5317342EE; _EE _; _$100:08/1991:08/2014E08/2021.;___ _ $50_,00;__ __.$104.08: 4.00%i_ $154.08�_ _ _ -- C295304840EE EE $100,08/1991',08%2014 08%2021 $50.00 $104 08 4.00% $154.08 C295283411EEi EE ;_ .$100:08/1991;08/2014 _08/2021 __ �50.00,__ . .$104,08 4.00%,_____$154.08. _ C295281283EE' EE $100 07/1991 07/2014 07%2021_ $50.00, $104.08 4.00% $154.08 C295270161EE'r_EE $100;07/1991'_07/2014 07/2021_ $50.00,_ ____�104.08 _4.00%' �154.08; C295257881EE EE $100106/1991,12/2014 06/2021_ $50.00 $107.16 4.00%: $157.16 C295246001EE, EE $100 06/1991;12/2014 06/2021 .$50 00.. ,_. �107 16i 4 00%. . �157.16r C267007512EE, EE $100_05/199L 11/2014 05/2021, $50 00 ,$107 16 4 00% $157.16, . . . - - . . ._ _ . C266994758EE. EE : _ $100';05/19911 11/2014!05/2021: $50.00, __ .�107.16 _ 4.00%; �157.16: C266981671EE __EE . _$100_;04/1991',10%2014, 04/2021',_ _. $50,00;_ $107.16 .4.00°/q.___ �157.161 C266969252EE'. EE ; $100�04/1991'10%2014; 04%2021; $50.00; $107.16 4.00%: $157.16i C266957658EE. _EE ;__$100',03/1991!09/2014,03/2021,__ $50.00, _. $107.16, 4,00%; __, �157.16; C161411557EE4 EE $100 02/1988 08�2014 02/2018 $50.00� $127.00. 4 00% $177 00. . . . -----�-� -- C161406965EE; EE ;___$100';02/1988;08/2014„02/2018. _„_ _. $50.00,___ _. $127.00, 4.00%, �177.00, _ _ C161402276EE; EE : $100;01/1988 07�2014,01%2018i $50.00� $127.00r 4.00%: $177.00� . -- C154131743EE:_ EE _ $100;01/1988 07/2014 01�2018i $50.00, _ __$127.00 „4.00%r _ _ �177.00, ____ --- C154127496EE'{ EE i $100:12/1987 12/2014 12/2017: $50.00; $130.52 4.00% $180.52: C154122433EE _ EE .i $100;12/1987:12/2014 12/2017 $50.00 . _ �130.52 4 00%, �180.52. C154118684EE: EE ; _$100.y11/1987r 11f2014,11%20171 _ $50.00, _$130.52t 4,00%_._ _$180..52 C154113263EE; EE $100�11/1987,11/2014. 11%2017I $50.00: $130.52 4.00%' $180.52. C154108360EE EE . __$100',10/1987,10/2014:10/2017; __ $50.00;_ ,_..�130.52, 4.00%;__.__�180.52, ___ C154103822EE EE ; $100:10/1987.10�2014r 10%2017: $50.00� $130.52, 4.00%i $180.b2, ... - - __ .� - - . __. C179521561EEI EE I_ $100„07/1988,07/2014 07/2018;_._ �50 00;_ _.._ $123.52: 4.00%; , , $173.52 __ _ _._ C164773131EE.r EE $100;06/1988.12%2014.06�2018, $50 00; $127.00, 4.00%, $177.00; - - . _$ C164768498EE EE 100:06/1988y12/2014; 06f2018; $50 00: �127.00 4.00% $177.00; C164763830EE1 EE . ,__.$100.;05%1988 11/2014, 05/2018._ __ ,$50 00� ..__ .$127.00t _4,00%;___. $177.00� C164760019EE, EE ; $100.,05%1988,11�2014 05�2018; _$50 00, _ �127.00 _4.00%; $177.00; C164754686EE EE_,r ._,$100.404/1988,10J2014,_04J2018r... ._�50 OOt_.. �127 00r_ 4_00% __ .�177 00 . , C164750089EE; EE I $100;04%1988i 10%2014, 04%2018i , $50 00: _ $127.00; 4.00%0� $177.00_ _ C164745632EE; EE_;___$100;03/1988 09/_2014,03/2018;__ $50.00; __ _, �127.00. 4.00%,__ �177.00;__ C161420828EEa EE : $100iO3/1988 09%2014. 03�2018 $50 00 $127 00 4.00%, $177.00 C161417080EE; EE ; $100;03/1988,09/2014;03J2018r $50 00 �127.00 4.00%! $177.00i C179583815EE EE $100 11/1988 11/2014t 11/2018 . $50 00 , $123 52q 4 00% $173 52 ---....... C179577078EE, EE ; $100;11/1988,11/2014_11/20181 ._ $50 00;__ _ $123.52, 4.00%: �173.52; C179570378EE . _EE t,._,$100,r10(1988r10/2014,_10/2018 ___ _. �50 00r ___ �123,52 4.00% _. �173.62�.__,__, C179563707EE; EE ; $100;10%1988 10�2014 10�2018 $50 OOt $123.52� 4.00%: $173.52� C179557130EE, EE. „____$100;09/1988,09/2014;09f2018;__ $50 00�_ _._ �123.52,_ 4.00%; __ �173.52 __ __ C179550565EE1 EE , $100 09/1988r09�2014}09�2018,.,.__...$50 OOi .. ..$123.52 4 00%t �173 524 _.. C179544145EE, EE ;_. $100_;08/1988,08/2014r08/2018; __ __�50 00; ,_._ �123,52, 4.00%,; _ �173.52; C179538046EE EE ; $100:08/1988,08%2014,08%2018; _$50 OOt $123.52 4.00%: $173 52 C179532964EE�, _EE $100;08/1988;08/2014 08�2018'�___ $50 00,____. .�123.52; 4.00%_; _ �173 52� _ _ C179527031EE: EE ; $100;07/1988r07%2014. 07/2018, $50 00 $123.52 4.00% $173 b2; __. . _-.- - - - - ----�--� - -• C196152204EE EE a $100;04/1989,10/2014 04/2019';. $50 00,, $120.12 4.00%0� 17 ; _ . .. __ C196145855EE. EE _; _ $100.j03[1989 09�2014 .03/2019_ _ _ ___$50 00 ._ _ $120.12r_4,00%;__ _$170 12;. . _ C196140592EE: EE $100;03%1989,09/2014:03/2019 y „$50 00. $120.12 4.00% $170 12, - , _03/2019.;__ _ $50 00;_. _..�120.12, .4.00%; .... $170 12 . C196133057EEI EE_ ;.._ $100;03/1989 09(2014 C196126123EE; EE ; $100�02/1989i 08/2014, 02�2019I $50 00 $120.12 4.00%i $170 12; C196119855EE! EE ' _ $100 02/1989;08/2014 02/2019_!,_ _ $50 00!_ _ �120.12 4.00%{ _ �170 12, C196113798EEy EE , $100 01/1989,_07�2014i01/2019, „$5000 $12012 4.00% $17012 _ .. C196107445EEI EE ;__$100;01/1989 07/2014, O1/2019'__ _ _$50 00;__ _ �120.12, _4.00%;_ �170 12: ___ _ __ C179597139EE! EE : $100i,12/1988.12�2014. 12%2018i $50 00: $123.52. 4.00%; $173 52; - C179590395EE: EE $100�12/1988,12/2014; 12/20181 $50 00 _ _ $123.52, 4.00%; $173 52, C211000624EE; _ EE I, $100;08/1989108/2014 08/2019T _ _ _.$50 OOT_____ �116.80r 4.00%;_ $166 80t__ __ C210992832EE: EE j $100;08�1989 08%2014.y 08%2019: $50 00, __ .�116.80, 4.00%;_ �166 80:__ __ C210986393EE;_ EE _,;__ $100_i08�1989_08/2014:_08%2019;__ �50 00,__.__$116 80 4.00%0,__ �166 80;,__ _ _ C210977905EE; EE $100:07/1989 07%20141 07%2019r _$50 OOa $116 80. 4.00%; $166 80, C210970609EE; EE i $100i07/1989_07/2014:07/2019i $50_00 . �116 80. 4.00%„ _ �166 80i C196184246EE! EE I $100';06/1989 12/2014' 06/2019: $50 00; $120 12 4.00%i $170 12I __. - - � - C196177668EEi EE ; $100_;06/1989 12/2014;06/2019:_ __�50 00; _ �120 12, 4_00%;__ �170 12;__ _ __ C196171018EE; EE „ $100!05%1989 11%2014.05%2019; $50 00 $120 12, 4 00%: $170.12 _ - � . _. _ . . C196164823EE1 EE $100_;05/1989:11/2014 05/2019 $50 00; $120 12, 4.00%, 17 . ,_. ____ _. . C196158547EEr EE ._!__ $100:04/1989 10/2014„04/2019 ._„ $50.001 _$120.12, 4.00%', $170 12,._ ._.,.. C145064639EE! EE ! $100:05�1987_11%2014I 05%2017i $50 00 $134.12. 4.00%; $184 12i http://www.treasurydirect.govBC/SBCPrice 11/4/2014 Lalculated Value ot Your Yaper Javings 13ond(s) Yage 3 of 5 C145068250EE;_. EE ; _$100;06�1987�12/2014:06/2017 i_ $50_,00; _$134.12: „4.00%;_._,.$184._12; _ EE $100,06/1987;12�2014 06%2017 $50 00 _�134.12 4.00% $184.12 _ - � . C145071981E C145074864EE1 EE ; .$100_;07/198T;07/2014; 07/2017;__,_ _ .$50.00 ____$130.52; 4,00%; �i180.52: C145079592EEI EE ; $100;07/1987107%2014 07/2017 $50.00 �130.52 4.00% $180.b2 _. . C145084178EE', EE ; $100;08/1987',08/2014 08/2017; $50.00 __ .__ �130.52, 4.00% $180.52. -- C145087474EE! EE $100;08/1987'08�2014{ 08%2017 $50.00 $130.52 4.00% $180.52: C145092012EE,_.EE .; $100 09/1987,09/2014 09/2017 . ._„$50:00 . .._$130.52 4.00%_.. �180_52 C145096371EE EE ; $100 09%1987 09%2014, 09%2017. $50 00 $130 52. 4.00% $180.b21 • - ------ -�--. .. . C154099136EE: EE $100;09/1987 09/2014, 09[2017!_ $50.00,___ �130.52. 4.00% �180.52 C128383934EE'r _EE t_ �100;01%1987y,07f2014_01/2017r __ _ $50.00,____. �134.12, 4.00%;_ �184._12 _ , C128387638EE: EE � $100:01/1987r07%2014: 01�2017; $50.00 _ $134.12 4.00%: $184.12; -- _ _ C128392185EE: EE : _$100;02/1987;08/2014 02/2017', _ $50.00;______ �134.12 4.00% �184.12: ___ C128395571EE. EE ; $100 02/1987,08%2014 02�2017 $50 00; $134.12 4 00%0 �184.12 . .. . .... ..... _ . C128399520EE, _ EE ;_ $100;03/1987;09/2014: 03/2017, _ $50.00,__ _ �134.12, 4.00%; �184.12, C128403351EE EE . $100;03%1987 09�2014_ 03�2017, $50.00 $134.12 4.00% $184.12 _._ . -- - __ . C128407377EE; EE $100;04/1987!10/2014, 04�2017 $50.00. „ �134.12. 4.00%i �184.12, C128411708EE! EE ; $100y04/1987 10%2014, 04/2017'a $50 00 $134.12 4.00%' $184.12 - < - _ _ _ - C145056916EE� EE : $100;04/1987 10/2014i 04/2017: „�50 00: $134.12 4.00%I �184.12 C145060824EEi___EE ;__$100.r05(1987t 11�2014,05/2017;____ . _._�50 00r ___,_�134.12 4.00%;____$184.12 ___. C114014147EE EE : _$100�04/1986,10/2014 04�2016; $50 00, �163.08 4.00%: $213.08� C114016669EE EE . $100:04/1986_10/2014_04/2016'; _ $50 00„ __ �163.08, ,4.00%: _ $213.08, _ _ __ C114019974EE:� EE $100.04/1986.10�2014, 04/2016; $SO 00. $163.08 4.00%: $213.08 - - - - - C114023730EE:_ EE___;__$100_'05�1986,11/2014,_05/2016;____ . .�50,00,__ __ �163.08,_ _4.00%0, ___$213.08, _ __ , C114027049EEI EE ; $100�05/1986y11%2014. 05�2016, $50 00 $163.08 4.00%i $213.081 - -.. __. C114030142EE; EE $100�06/1986,12/2014 06/2016: $5000, �163.08, 4.00%; �213.08y _ - - C115698758EE. EE ___$100 06/1986 12/2014,_06/2016 __. $50 OOt $163.08t _4.00%0_; __ �213.08}__.__._ _ C115701729EE EE i $100;07/1986,07�2014 07%2016,_ $50 00, , $158 88 4.00%; �208.88 C120934804EEr EE. _,__.$lOQr07/1986 07,(2014*07J2016_t.. ,__�50 00*. _____�158 88r_. 4 00%t...__�208.88_ ._ .__ C120938128EE; EE , $100t08%1986 08%2014 08%2016, $50 00 �158.88i 4.00%! $208.88: .-- - C120941926EE�__EE ';__$100;08�1986,08/2014 08/2016.; _. $50_00,____,�158.88,. 4.00%; �208.88; ____ C120944947EE EE ; _ $100:09/1986R09�2014; 09%2016. $50 00: $158.88r 4.00% $208.88� C120949489EEy EE ; $100;09/1986 09/2014._09/2016i. $50 00, _ �158.88t 4.00%; $208.88 C120953459EE EE $100 n1Q�1986 10�2014 10%2016, .$50 00 $158 88 4 00%} $208.88 - - -• - C120957795EE: EE ; _ $100a10/1986 10/2014,_10/2016 _ $50 00;__„ �158.88,_ 4.00%, �208.88, C12096.1769EE;__EE _;__$100_;10(1986r10,[2014r,10/2016t_._ _$50 001____ �158.88, 4,00%.___ �208.88y __ __ C124829884EE EE ; $100:11/1986y 11/2014 11%2016; $50 00; �137.80, 4.00%: $187.80 C124833937EE:_ EE_; _ $100;11/1986�11J2014; 11/2016, ..,�50 00,_____ �137.80 4.00%; $187.80. __ ___ C124837952EE EE r ,.$100 12/1986 12/2014t 12/2016t , $50 00y $137 80, 4.00% $187 80; -- ----- _ ....,... .. . C124841968EE, EE __;_. $100,12%1986 12,(2014, 12/2016;_. _$50_00, __.�137.8Q, 4.00%; �187.80, „ _._. C114004247EE; EE $100r02%1986 08%2014 02%2016y $50 00� $163.08 4.00%: $213.08r __. _ . _ _ . C114007677EE! EE , �100;03/1986,09/2014r 03/2016; _ _ $50 00, . �163.08.__4.00%. �213.08, _ C114010860EE: EE � $100,03%1986h09�2014 03%2016« $50 00 $163:08 4.00% $213.08; -. .. --- - . -- - - C95973599EE'; EE ; _$100:11/1985 11/2014, 11/2015. $50 00 $167.32; 4.00%� $217 32; -- . C95731298EE EE $100_;11(1985r.11/2014__11/2015;__ __._ $50 OOj_.__ $167.32f__4.00%_ . $217.321 _. _ C95733905EEI EE �100 12%1985 12%2014! 12%2015: $50 00, $167.32. 4.00% �217_32 C95737176EE; EE ;__ $100;12/1985Y12�2014. 12/2015, __ ___�50 00;___ �167.32 4.00%_;__. �217_32; _,. C95740423EE', EE ! $100:01%1986 07/2014: O1%2016; $50 00, $163.08s 4.00%0 $213 08a _ - - . C95743718EE i_ EE , $100;01/1986,07/2014,01f 2016' $50 00: $163.08, 4.00% $213 08; _, _ _ C95746983EE EE ; $100 02/1986 08/2014 02/2016e $50 00 .. ._.$163 08 4 00% $213.08} -� -- -- . .. .. _ - - C912399_5_lEE:__EE .j_ $100_;06/1985,12/2014,.06/2015;__ __�50 00, __._ �171.68, 4.00%, 2.1 ; __ ___ C91242753EE! EE $100:07/1985t07�2014 07%2015; $50 00; $167.32; 4.00%: $217 32t - _ C91246303EE: EE $100i07/1985,07/2014,07/2015i $50.00; $167.32{ 4.00%: $217 32i _ -- C94790026EEr EE I $100}08/1985t08/2014;08f2015� _ _$50 00t __ $167.327 4.00%i �217 32i __ .__ C94793302EEr_ EE _ $100.;08/1985.08�2014 08%2015; _ __$50.00 �167.32, 4.00%: �217 32} _ 09/2015;_ _.-�50 00,_ _. $167.32 4.00% �217 32 ._._.. C94799826EE� EE $100:09/1985;09/2014'. 09%2015 _ $50 00: _ $167.32, 4.00% $217 32_ _ _ _ _----- . _.. . ... � _ _.... ., C95963083EEi EE $100;10/1985 10/2014, 10/2015; _ $50 00; _ $167.32. 4.00%� �217 32, _ -_... C95966406EE EE $100;10/1985 10�2014. 10/2015! $50 00 $167 32, 4.00%. $217 32Y ---- -� - - - - . . C95969691EE: EE j $100';10/1985r10/2014't 10/2015I_. $50 00s__ �167 32,.__4 00%;__ �217 32;______ C85852112EE' EE i $100;02�1985,08�2014. 02/2015; $50 00, $171 68'. 4 00%, $221 68; -- � . _ - _ . -- - C85854806EEi EE_ ! _$100'.02/1985 08/2014. 02/20151_ $50 OOt__ $171.68 4.00%' $221 68; __ - - . .. C85857481EEI _EE_ ;__ $100;03/1985t09/2014_03/2015!_. �50 00;_, . �171_ 68i_4.00%, _ �221 68r.__.___ C86958347EE; EE '_ $100:03/1985_09�2014:03/2015I $50 00: $171 68_ 4 00%; $221.68y _ _ http://www.treasurydirect.govBC/SBCPrice 11/4/2014 C;alculated Value ot Your Yaper Savings Bond(s) Page 4 of 5 C86961029EE;.__EE._ ;__$100;04/1985_P 10/2014_;,04/2015�.,,.___$50_.00; _,___�_171_,681__4.00%0;.___$221.68.;_ _ C86963843EE EE $100 04/1985 10%2014 04%2015 $50.00, �171 68 4.00% $221 68, C86966806EE _,EE 100,;05�1985 11/2014 05/2015,____ . $50.00 _ _,_ .�171.68, ._4.00%% $221.68,. . __ $ C82653090EE: EE ' $100�05/1985:11%2014 05%2015. $50.00T �171.68t 4.00%. $221.68, _. _ � - -- C82656824EE! __EE ',__$100_!05/1985;11/2014:05/2015_ __ �50.00,_.___ �171.68, 4.00%„ _ �221.68, __ C91236910EEj EE I $100;06/1985:12/2014 06%2015 $50.00. $171.68. 4.00%i $221.68 .C79169549EE, EE , _$100.09/1984 09/2014,09J2014,__ $50.00, __ �176,12 . .4.00%,. _ �226.12; C79172578EE EE I $100 e 10%1984t 10/2014 10%2014; $50 00, $176 12 4.00%: $226 12. - -....---. . _ . _. C79175322EE; EE I $100:10/1984i 10/2014, 10/2014 $50.00. �176.12, 4.00%: �226.12, C79177660EE!_._EE ___$100_�10/1984'10/2014 10/2014„ _ $50.00i ..__ �176,12 _ 4.00% �226.12 C81592698EE EE $1001 li/1984,11%2014 11�2014 $50.00, $176.12 4.00%; $226.12 C81595462EE! _EE ; $100.11/1984.11/2014. 11J2014: �50.00,_ . __ �176.12, 4.00%0, ___ �226.12! _C81598195EE EE $,100 12/1984 12�2014. 12%2014 $50.00t $176 12 4.00% $226 12 C81600932EE__ EE _ a __$100:12/1984y 12/2014 _12J2014 $50.00 ___ �176.12, 4.00%, ___�226 12 C82771521EE� EE ; $100:01/1985_07/2014 01�2015 $50.00 $171.68 4.00% $22168 -- _ C82774428EE. EE , _ $100,01/1985 07/2014 O1/2015: $50.00n �171.68 4.00% $221.68 C73013034EEa EE : $100;05/1984, 05/2014, $50.00: $180.64, $230.64. MA __ ._ . . .__ - . - -- C73015739EEi EE , _$100,05/1984 __ . 05/2014. $50.00; _ __ �180.64 �230.64 MA C73018201EE,_ EE _t___$100r05�1984* ___ 05�2014r.___ _$50 00* _._ $180.641 t__ �230.64r MA_. C73932670EE, EE ; $100.06/1984 __ 06/2014, $50 00, _.�180.64a _ �230.64 MA C73934838EE; _EE , __�100;06/1984, ___ ,_06/2014. $50.00; �180.64a _ ,___�230.64 MA_ C73937279EE EE $100;07%1984t07/2014,07�2014, $50 00: $176.12 4.00%, $226.12� _ _ C73940008EE EE ;___$100,;07(1984 07J2014 _07/2014._ $50 00;__,_ $176.12, _ 4.00%;___ �226.12y _ . C73942848EE; EE I $100;08/1984 08�2014r08�2014: $50 00� $176.12: 4.00%i $226.12j _ C76574618EE', EE : „$100;08/1984,08/2014, 08/2014: $50 00; _ $176.12, 4.00%:_ $226.12; _C76577507EE EE $100r09%1984t09J2014 09[2014t__ $50 00 __ __ �176 12 4.00%r �226.12 ---- C59071387EE, EE $100312/1983 _ , 12/2013 $50 00, �180 64 , $230.64. MA _C60462572EEt_EE ___$100r12/1983, _,_____ .,.12/2013t ....�50 OOi_._._ _�180 64.. _. , t..__�230.64t„MA_ C60465088EE: EE ! $100:01/1984, . O1j2014'; $50 00: _ �180.64 ; $230.64 MA _. C65956207EEI_ EE ; __$100;01/1984, __ ,.01/2014!___ $50 00: _ __ .�180.64 ;_ �230.64, MA - C65958902EE: EE : $100�02/1984_ ,02/2014 $50 00. $180.64: ; $230 64, MA C65961492EEt EE ; $100:02/1984. ,_02/2014; $50 00: �180.64a �230.64 MA C67543578EE EE y $100r03/1984k . 03/2014. $50 00 $180.64^ i $230 64 .MA . - - ... C67546063EE; EE : $100:03/1984, 03/2014, $50 00, _ �180,64. 230.64: _A -._. _ __ _- - - C67549193EE�__EE t___$100,�04(1984 _ _ , 04/2014_ _ $50 00 .____ �180.64 __ � . �230.64t MA_, C67551689EEa EE a $100:04/1984` 04%2014! $50 00; �180,64, ! $230.64, MA _ C59068777EE;_ EE ;_ $100,11/1983,.._____ . ; il/2013;_ $50 00,____ �180.64, _ ;.___ �230.64, MA C59065645EE EE ., __$.100 11%1983 11�2013_ .$50 OOt ,.$180.64y . . _ .._$230.64r MA _ ...�. . .._ __..3246EE;__EE. ;__ $100;11 1983, _ . _._ li/2013_;__ _._�50 00;,__ �180,64, _._ _;._ �230.64, MA__ C5906 __, , _ / C58460753EEy EE ! $100:10/1983r : 10/2013: $50 00� $180.64, a $230.64; MA _ - C58457607EE! _EE ! _ $100�10/1983. _ 10/2013; $50 00, __ �180.64. _ _;__ �230.64, MA. C56399192EEy EE $100.09/1983 09%2013; $50 00{ __ $180.64 i $230.64. MA _ ... . . - - - _ C56396065EE EE : �100;09/1983i _ 09/2013, $50 00 $180.64 �230.64 MA C56393904EE;_.EE $100;08(1983+ _ 08/201_3,_ $50 00r ___ $180.64, __ __ $230.64 MA C56390659EE'. EE _;__ $100;08(1983, _ 08%2013; _ $50 00 _ �180.64. _ _ ;.___ $230.64- MA_ t - C56388067EE;, EE ,;_._ $100:07�1983, _ _ ;07/2013;____ . ._$50 00:__ _. �180.64.___. _ ;_.__�230.64! MA C41622185EE; EE ; $1D0:03/1983. ,03%2013: $50 00. $180.64, ; $230 64} MA - . . - C41624361EEI EE ; $100;03/1983 ;.03/2013: $50 OOt �180.64: ;___ $230 64{ C41626744EE EE i $100.04/1983{ ;04/2013. $50 00, $180 64 , $230 64 MA . ...... .......�-- :. - .. . .. •---.. C41628700EE_ EE i __ $100�04/19830 __ ',_04/20131 _ $50 OOI �180.64 ,__ �230.64, MA C41631491EEI EE $100t05/1983 I 05/2013 $50 00r $180.64 ! $230 64: MA - - - ---... C43780321EE: EE $100;05/1983. ; 05/2013; $50 00; $180.64. ,_ �230 64 MA - - C43782851EEt__EE _r__ $100t06/1983* __ „06/2013r_ __$50 OOt___ �180.64t _ r__ .�230 64; MA C43785009EE' EE ; $100;06/1983, _ ; 06%2013. _$50 00;_ _ �180.64 __ '.___ �230 64. MA _C43787078EE_ EE _ '._. $100;06%1983, _,_ .., ,_06[2013_;_, _�50 00, _. .$180.64 _ _ _ ;___ .$230 64„_MA_. C43788890EE: EE $100;07%1983 _ .07/2013 $50 00: $180.64, : . $230.64 MA --- - --- _ . _._ C32574698EE;_ EE _i $100}02/1983; __ _ _ _02/2013'; $50 00. _ �230.32 _ �280 32t MA C32572613EE, EE ' $100a02/1983, 02%2013i $50 00 $230.32. $280 32 MA _ - _ - � --- - _C32570331EE! EE_. I, $100;01/1983. _ 01/2013: _ ___�50 00r __ __�230 32 ;_, �280 32 _MA C32568253EE! EE o $100;01�1983_ ,01/2013' $50 00, $230 32 I $280.32 MA . - _ . - - _C32565586EEI _EE , _$100 12/1982_ ____ ♦_12/2012;_ _$50_00,._ $230 32 . _ ,__ $280.32� MA C32563694EE�_ EE. :_, $100;12/1982. _ ___ __ !_12/2012_;_ _._._$50 00;__.., $230 32_ ___ ;_._ �280.32i MA__ C32561011EE! EE i $100;12%1982 . 12/2012; $50 OOi _ $230 32_ $280 32, MA http://www.treasurydirect.govBC/SBCPrice 11/4/2014 C;alculated V alue ot Y our Yaper�avings 13ond(s) Page 5 of 5 C32558690EE; . EE ;__$100s11/1982; _ ;il[2012i .. . $50_,00; $230.32;___ _ ; _ -$280.32: MA. C32556393EE EE _$100.q11/1982, _ 11/2012 _$50_00. �230_32 __ ___ $280.32 MA . C32554187EE'. __EE ; $100;10/1982j _10/2012 _._. $50.00; _.__$243,80, _ _ .$293.80, MA - C32551655EEI EE $100 10/1982, 10%2012, $50.00; $243.80. $293.80, MA C32549259EE'_ EE __$100!09/1982 09/2012 _ . $50.00 __�243.80, _ _ _�293.80,-MA C32546853EE EE $100 09/1982 09/2012! $50.00� $243.80 $293.80: MA C32544625EE EE $100 08/1982, ', 08j2012y $50,00,__. �243 80 __ „ ; .. �293.80, MA C32542451EE EE $100i08%1982 ,.08%2012 $50 00; $243 80, $293 80_ MA . . . . . . . _ ... , .-- C32540262EE: EE '. _$100:07/1982; _ _ 07/2012! _ $50.00,_ _ �243.80 _ _ _ _ �293.80 MA C27888020EEi__EE __$100 07/1982'_ _ 07%2012'-.-. $50.00,_-__- �243.80: __. . ___ �293.80: MA C27886278EE' _EE .' _$100;06/1982! 06/2012' _ $50.00_ ___$243.80 $293.80; MA . __. _ . -- C27884036EE EE __$100;06/1982. 06f2012; _ _ $50.00,_. __$243.80 _ _-_ __ $293.80, MA C27882215EE. EE _ $100 06/1982,_ _ 06/2012 _ $50.00, �243 80 _ _ ;_ _ �293.80* MA _ -- - _ . C27879721EE; .EE ! $100:0_5/1982; _ __ , 05[2012 _ �50.00;_- $243.80 _ _ _ . :_. �293.80_MA C27877815EE_ EE , $100;05/1982; 05/20121. $50.00, $243.80; $293.80. MA _ _ - _ _ _ C27875358EE; EE ; _ $100104/1982_ 04/2012; $50,00; . $243.80 �293.80,. MA C27873156EE; EE i, $100iO4/1982 04/2012, $SO 00, $243.80 $293.80 MA C27868532EE ._EE _: $100;03/1982 03/2012; $50 00, _ $243.80, $293.80,_MA_ C27870790EE; EE ;-- $100_;03/1982 __ __ _ 03/2012! _ $50 00;.--._ $243.80: ._ __ ._ ;___ �293.80_MA C27866653EEj_ EE_ i $100�02/1982 _ _ 02�2012' _ _ $50 00.__ $243.80: . $293.80! MA _ -_ _ - C27864314EE'__ EE _. $100;02/1982 _ 02/2012 i_ __ $50.00; _ $243.80 _ _ _� $293.80, MA C27861835EE: EE $100 01/1982, . 01/2012I $50,00j $243.80I $293.80, MA - - _ _ __ -- -.._ .. . C27859222EE _EE _! $100!O1/1982_ O1/2012;_.. .$50 00 ___,. $243.80, _ ___..$293.80, MA Totals for 259 Bonds:$12,960.00:$39 641.80 i !$52,691.80: N otes NI Not Issued _ _ _. __._. _ __ NE 'Not eligible for payment __ _ _ _ P5 'Includes 3 month interest penalty __ __ _ _. MA Matured and not earnin interest http://www.treasurydirect.govBC/SBCPrice 11/4/2014 � r"� 7. �w � � .t bsy i� ��,i l�;.c��.,,s� .z.- _ L�./n�: `'a�C`c'_'—'.��j . . .. _ . - n ��.k°�»!��'� �\��C�..,��t,�'� .'S��i...�lSw:�l'?�'e�a* ����`���w` ���;'��vS��..1i�\`�\�....��\.:�_\; �_...� :�::�\�\'� .\.\\\ `'� .^� -�a� �1, � `,�,z,"'� l�� � ��,�� � ���o���.li�le-�-j f���. • � ��v� �_�t��e��1\��``������.�" (�����✓""r�¢-fi y.���<js � ��'`��� �� �;�.�ll"'�I �4����..��` '�°!I ��i�������\������1�mV1\1\\ \\�,mM4�,'tl��s�� �����i,j/.•:."S3 ��� . 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''���`:�� ;���� \� I�II ' '� i��: m , ` � ` "�� �' �' ' �� � ��i������,�%��:� �, � .. _� ,� � e . � � ,� J�,..:.. . �i��J�UI �Il ............!.:�.1�V.:� 1 ....!!.N....:!..�...1!(,1.( �r��.f . f i�.(_6 � i i i rY � l ���reT�,���6i r.... ............... . ...... . �...�...,..�e:.:4.v... ..,.............. . .....::�.::...:.........:.:_.,.... (r�(( � ..... � ...�.................. �..... .11'nr.K.'..•1llYlilJlUtl.�//iIAnYM11,'.f�:tll)'WT.MY{Ni]J1VO;If:�lrlNM11�'rtr:liV:OLi{�Yf]1Uir]iA:V1l:t/ii(f1N\l 4.i:o{e:•3-}#(TL�7ti)`�VAIh�FlMM1�ll"�L 3K)i�CT�i�li7��fp.Vhll�Akt�l1' � . •_ "�"�STORE IN A SAFE PLACE-IF LOST APPLY FOR A DUPLICATE-ANY ALTERATION OR ERASURE VOIDS THIS TITLE .'t „ ;�� !i� �lt�on Bank LISTENING IS JUST THE BEGINNING� November 14, 2014 Kerwin& Kerwin 4245 Route 209 Elizabethville PA 17023 Dear Mr. Kerwin, RE: Laverne J Culton, deceased 6!29/2014 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: DATE OF DEATH ACC CD# BALANCE INT RATE OPEN ROLL OVER MATURITY 022-0164867 13363.12 55.13 .90 1/14/02 1/14/12 1/14/15 (titled in her name alone)($119.74 interest paid YTD of death) 022-0172563 12780.47 30.49 .75 3/6/02 3/6/14 3/6/17 (tit]ed in her name alone)($157.50 interest paid YTD of death) 022-0186607 7729.20 12.16 .20 12/16/02 9/16/13 12/16/14 (titled in her name alone)($0.00 interest paid YTD of death) If you should have any further questions, please do not hesitate to contact me at 717-327-2497. . Very truly yours, ��°�, t�' � �',� � �` , �,- � ��",, � o" ° � � � �.. ���� �� � �'�_'� , � (��,� : �E1!5 �t1;JiP, , . . � 4t1 u i�;��f,; �,. _ -, . - . - ` �. �`C���� ��� '�''�� � � '� April Billett ;��� '�„` Credit Confirmation Processor �,,: . . ���.�. . 1.800.FULTON.4 • fultonbank.com Pulton Bank,N.A.Member FDIC. Member of the Fulton Financial Family. 0 11/14/2014 KERWIN&KERWIN TERRENCE J.KERWIN 4245 ROUTE 209 ELIZABETHVILLE PA 17023 Re:LAVERNE J CULTON,Deceased. PSECU Reference#3751911493061 Dear Attorney Terrence J.Kerwin: The above referenced person has an account with PSECU which was opened on 06/06/1996. The Share accounts were individually held by LAVERNE J CITLTON. The following are the Date of Death Balances for LAVERNE J CULTON's account with PSECU: Account Date of Death Balances Interest—June 1-29 Savings (S 1) $ 318.16 $ 0.04 Certificate (S51) $13,108.82 $ 9.37 Certificate (S52) $12,782.13 $ 9.14 Certificate (S53) $13,700.79 $14.04 Certificate (S54) $10,225.70 $ 9.67 Certificate (S56) $14,426.90 $13.17 Certificate (S57) $ 7,213.44 $ 8.54 Certificate (S62) $11,305.94 $10.69 Certificate (S63) $ 9,729.59 $ 8.43 The account has been closed. If you have any questions,please contact our department toll-free at(800)237-7328,press 6,extension 3120 or email accountservices(c�psecu.com. Sincerely, i����' Sherry�etz Member Service Representative PSECU P. O. BOX 67013 HARRISBURG, PA 17106-7013 800.237.7328 psecu.com THIS CREDIT UNION IS FEDERALLY INSURED BY THE NATIONAL CREDIT UNION ADMINISTRATION.EQUAL OPPORTUNITY LENDER. � r� a f.' � b � � N � 0. � � � O .'1.^ t� cv � F. � �� O � O\ N � � p�i A.a dS �! V! tf} H3 i. � a` P� � � � O 'b Ir oa �° ro 'n O � � o c°v ., rn � M c� O t� �n � � O � � � � N G� a'' O n Oi cV � a a. � � a` o� �.� vr rs� ur aFr Esr N w„ c0 � � � � � � � ao a o � a� � a a� � � o � «,� o °a° o� o o � z � ° o 'n �o q o M I.�r �'b &9 G9 �ft 'V'} fi? �, L � C3 �w C � � o N � ao � .�3 RC� N O� �O O� X' q �� N `� �' � � p �� 0 � � � � � � r/� O+ N p W &�4 GM? &4 �S V� y '} � � O ;� cd c� � ,�p � 0 � ,�, � q a°Qi � b � � � � � � o 0 a�+ �' p � � � � � � ~ a�7 � � � � � � � � c� Sa � � o � � � a t � � d � � � � 0 0 = o � � � � o� � � 3 a��i d � ., b � w � `,� v d a a ° aCi cMv � � • � v� � N d � � � � � 5 ° �i � o � � � � cL c� o o � :� � p � N d � � i� �Q L� � Y N � � y ,, "� o� o x °a � � ;� :n :d � � S a ° " y �' `� :: a � aUi :� :� '� � o � ❑ a/ "� � � � G � d U � � c'� U .a � � � ,, •� � pc �y , � a y � " �G E" N .°�a m a� � A d' v u aS � t� u � � � •� �' w q a`"i a�i a�i a`"i a�i � y �v c�i w � � O O O O O `� � � � N � a: °: °: °: .=' y � w E � � � � � � � � � .� � w � w a cd � 'd o � GQ b � � 5 d � •y � 5 � � � � a � q a� � y V � � Q '�,�' � ° ° ° ° ° c� d `� � O � y � � U U U U U c� � '}�' � � • � v w y " � � ayi a�i ayi � � a��+ 3 � �„� b O d � � � i.G. r�. � n al � c� � ' C� v � C' ..�r 0 a� a� a� a� v �.�i � E a�i 7 Q A A oG � d .� � .� ,� � z � � H � � ��zs�� 499 Mitchell Road,Millsboro,DE 19966 Records Management Phone 888-502-4349 F ax (302)934-2955 November 19,2014 Kerwin & Kerwin Attorneys at Law 4245 Route 209 Elizabethville,PA 17023 Re: Estate of LaVerne J. Culton Social Securit�: 201-18-7293 Date of Death: June 29, 2014 Dear Sir or Madam: Per your inquiry on November l2,2014,please be advised that at the time of death,the above-named decedent had on deposit with this bank the following: 1. Type ofAccount CheckingAccount Account Number 24921203 Ownership(Names o� LaVerne J. Culton Jessica A.Shadle(POA) Opening Date 09/28/1973 Balance on Date ofDeath $ 71,271.53 Accrued Interest $ .55 Total $71,272.08 2. Type ofAccount Certificate ofDeposit Accaunt Number 31003916013219 Ownership(Names o� LaYeme J. Culton Jessica A.Shadle(POA) Opening Date 08/30/2006 Balance on Date of Death $ S,966.81 Accrued Interest $ .07 _ ____ _ __ __ _ _ . _ _ _ . __ Total $5,996.88 Santander ESTATE OF: LAVERNE J CULTON SOCIAL SECURITY#:201-18-7293 DATE OF DEATH: 06/29/2014 Account#: 7672495003 Type: RETAIL STATEMENT CD Open date_ 11/15/2011 In the name of: LAVERNE J CULTON Date of death balance: $21,879.94 Int.(YTD)from:01/01/2014 To: 05/10/2014 $7.80 Accrued interest to date of death: $6.12 Other info: CLOSED 8/18/14 Account#: 7672495119 Type: RETAIL STATEMENT CD Open date: 11/15/2011 In the name of: LAVERNE J CULTON Date of death balance:$25,399.23 Int.(YTD)from:01/01/2014 To: 05/10/2014 $9.06 Accrued interest to date of death: $7.10 Other info:CLOSED 8/18/14 Account#: 1685226647 Type: RETAIL STATEMENT CD Open date: 01/27/1997 In the name of: LAVERNE J CULTON Date of death balance:$11,649.82 Int.(YTD)from:01/01/2014 To: 05/31/2014 $4.82 Accrued interest to date of death:$0.96 Other info:CLOSED 8/18/14 Page 2/2 .`: �'� `� � � MIDPENN BANK November 14, ?014 Kerwin & Kerwin Attorneys at Law 424� State Rte 209 Elizabethville PA 17023 Re: Estate of Laverne J Culton Date of Death: June 29, 2014 SSN: XXX-XX-7293 Dear;VIr. Kerwin: In response to your recent letter requesting information on the accounts of Laverne J Culton, I have accumulated the necessary data below: Account Name: Laverne J Culton Account#: 309003116—Cer�ficate of Deposit Date Opened: April 16, 2011 Balance DOD: $11,939.97 Balance Accrued Interest DOD: $8.77 Total DOD Balance: $11,948.74 Date Joint Ownership Established: N/A Account Name: Laverne J Culton Account#: 309003117—Certificate of Deposit Date Opened: August 16,2011 Balance DOD: $21,715.14 Balance Accrued Interest DOD: $1�.94 Total DOD Balance: $21,731.08 Date Joint Ownership Established: N/A As of June 27, 2014 Laverne J Culton owned I 51 shares of Mid Penn Bank stock with a market value of$15.90 per share. If��ouu have any questions, please contact me at (717) 896-5388. 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CD 019650 GUARDIAN TRANSFER CORP 1000 N PRINCE ST LANCASTER, PA 17603 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- fold ---------- ------ 101 � 526,250.00 ESTATE INFORMATION: sstv: 2o1-�s-7293 I FILE NUMBER: 2114-0673 � DECEDENT NAME: CULTON LAVERNE J I DATE OF PAYMENT: 09/10/2014 I POSTMARK DATE: 09/09/2014 � courvTY: CUMBERLAND I DATE OF DEATH: 06/29/2014 � � TOTAL AMOUNT PAID: 526,250.00 REMARKS: RECEIPT TO ATTY CHECK# 53558 INITIALS: HMW SEAL RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS TAXPAYER r LAST WILL AND TESTAMENT OF LaVERNE J. CULTON I,LaVERNE J.CULTON,currently of the Counry of Cumberland and Commonwealth of Pennsylvania,being of sound mind,memory and understanding,do make and publish this, my Last Will and Testament,hereby revoking and making void all former Wills by me at any time heretofore made. FIRST: I direct my hereinafter named Co-Executrices to pay all my legally enforceable debts,funeral expenses,administration expenses,and inheritance,estate,succession or excise taxes,which I owe or may become due on account of my death,as soon as may be convenient after my decease. I direct my hereinafter named Co-Execuh-ices, using their sole discretion, to make arrangements as they deem appropriate,that flowers be placed on my grave in Wiconisco at least on Memorial Day and Christmas each year. SECOND: I give and bequeath all the shares of stock that I own in Mid Penn Bank to DOROTHY SALTZER,if she survives me. THIRD: I give and bequeath my Baldwin wall clock and vase underneath the clock, yellow striped chair in bedroom,gold printed sofa in living room,marble top table iri living room,deer head,pair of quaiis and man with a gun in den,counted cross picture of a church in dining room,picture of a wolf in den,picture in kitchen,and my brown Citrine ring with two GREGORY M.KERWIN diamonds on each side to JESSICA SHADLE. TEPRENCE J.KEFWIN JOSEPN D.KERWIN HOLLY MCCLURE KERWIN � ATTOftNEVS AT LAW page 1 of 4 Pages GL _ (SEAL) aVERNE J. TON ' . , i FOURTH: I give and bequeath my 24-inch Hemngbone gold chain and Lester piano to DOROTHY SALTZER,if she survives me. FIFTH: I give and bequeath all my pewter and Opal ring with a diamond on each side to KAREN GROSSER PA.RSONS,if she survives me. SIXTH: I give and bequeath my Emerald ring with a diamond on each side to CAR.OL GATES,if she survives me. SEVENTH: I give and bequeath all my leather top tables in living room,my Flossie Flirt doll dressed in pink,green reed rocker,my doll dressed in pink in rocker,and my Opal ring with red stones around the Opal to SUZANNE GATES,if she survives me. EIGHTH: I give and bequeath my Heubach doll and crib in den,Cuckoo clock,black desk and chair in den, and black bench in dining room to my dear friend, MOSCA KALATHAS. I also give and bequeath the sum of Two Tl:ousand Do[lars($2,000.00) to MOSCA KALATHAS,if she survives me. NINTH: I give and bequeath my following dolls: Madam Alexander,Bride and Flower Girl,Enchanted doll,Rapunzel,Scarlett,Bonnie Blue,Sailor Boy,Ice Skater,Girl in Army uniform,Little Nanny Etticoat,Indian doll,Easter Sunday,Vermont doll,Andy boy in blue knit outfit,Dankin doll in riding suit,Helen Kish doll,Toddler Girl,Emmaline and Gillian by Robin Wood, and Felt doll in pink with a duck to TESSIE KALATHAS and TINA KALATHAS. TENTH: I give and bequeath all ofmy remaining jewelry,Anna Lee dolls,Christmas GREGORY M. KERWIN decorations,my two handmade Hilda and By-Lo dolls,and my organ to NANCY GROSSER. TERRENCE J.KERWIN ' JOSEPH D.KEAWIN HOILY MCCLURE KERWIN ATTORNEYS AT LAW page 2 of 4 Pages � � (SEt�y,) LaVERNE J. TON ELEVENTH: I give,devise and bequeath all of the rest,residue and remainder of my property,be it real,personal or mixed,whatsoever and wheresoever the same may be situate at the time of my death in equal shares as follows: A. One-third(1/3)of the residue of my estate shall pass to JESSICA SHADLE, if she survives me. In the event JESSICA SHADLE predeceases me or fails to survive me,I direct that her share of the residue of my estate shall pass to NANCY GROSSER AND CAROL GATES,in equal shazes. B. One-third(1/3)of the residue of my estate shall pass to NANCX GROSSER, if she survives me. C. One-third(1/3)of the residue of my estate shall pass to CAROL GATES,if she survives me. In the event NANCX GROSSER or CAROL GATES predeceases me or fails to survive me, I direct that their share of the residue of my estate shall pass to their issue per stirpes. TWELFTH: I nominate, constitute and appoint NANCY GROSSER AND JESSICA SHADLE as Co-Executrices of this,my Last Will and Testament,authorizing and empowering them to sell and convey any and all real estate which I own at the time of my death. I further direct that at the time of my death,there be no public sale of any of my personal property. I also direct that all my antique dolls are to be sold to a doll dealer,who regularly GREGORY M.KEflWIN deals with antique dolls,with the proceeds to pass into the residue of my estate. TERRENCE J.KERWIN Jos[vn D.Kenwin HOLLY MCCLURE KERWIN ATTORNEYS AT LAW Page 3 of 4 Pages (SEAL) LaVERNE J. LTON . � „ ' I I further direct that my Co-Executrices shali have the authority to allow the three residuary heirs to have access to my property at sometime during the administration of my estate so that they could mutually agree to select and divide amongst themselves my fiuniture. Any , items that are not selected by my residuary heirs shall be sold by my Co-Executrices in a manner that conforms with general procedures with respect to the administration of estates. I also fiuther d'uect that my Co-Executrices or personal representative shall not be required to post bond to act in said capacity. IN WITNESS WHEREOF,I,LaVERNE J.CULTON,have hereunto set my hand and seal,to this,my Last Will and Testament,this�day of October,2011. SIGNED,SEALED,PUBLISHED : and DECLARED by the above- . named Testatrix,LaVERNE J. . CULTON,as and for her . Last Will and Testament,in . the presence of us,who at . her request and in the . presence of each other,have , hereunto set our names as . witnesses: �u�rnc�.�u�iiu�-,�' . !��L�L�SEAL) Residin a. . LaVERNE J. TON �� • Residing at: . t`�4t I le,r ura,PA , Page 4 of 4 ges GPEGORY M.KERWIN TEqRENCE J.KERWIN JOSEVH D.KERWIN HOLLY MCCWRE KERWIN ATTORNEYS AT LAW X:\LAX\ LLS\cul[on-laverne•j.wpd