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05-11-15 (3)
wpennsylvania 1505618403 DEPARTMENT OFR"'9X(03-14) REV-15010 OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN Harrisburq,PA 17128-0601 RESIDENT DECEDENT 21 14 0903 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 08 10 2014 09 27 1929 Decedent's Last Name Suffix Decedent's First Name MI CARMODY JAMES W (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ❑X 1. Original Return 2. Supplemental Return 3. Remainder Return(date of death prior to 12-13-82) 4. Agricultural Exemption(date of 5. Future Interest Compromise(date of 6. Federal Estate Tax Return Required death on or after 7=1-2012) death after 12-12-82) ❑X 7. Decedent Died Testate 8. Decedent Maintained a Living Trust 1 9. Total Number of Safe Deposit Boxes (Attach copy of will) (Attach copy of trust.) 10. Litigation Proceeds Received 11. Non-Probate Transferee Return 12. Deferral/Election of Spousal Trusts (Schedule F and G Assets Only) ❑ 13. Business Assets 14. Spouse is Sole Beneficiary (No trust involved) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number LINDA J OLSEN 717 540 4332 First Line of Address 2000 LINGLESTOWN ROAD Second Line of Address ,v SUITE 202 C= C3 M City or Post Office State ZIP Code a ::Q �—� c'7 Q HARRISBURG PA 17110 D0 � t;d CD Correspondent's email address: loisen[a)hazenelderlaw.com REGIST5R1OFWILL E ONI:Y. REGISTER OF WILL USE ONLY DATE FILED MMDDYYYYI CIl co DATE FILED STAMP Side 1 I�II�I III�I'llll��I�I�III��II�I II��I I�III I'll�'I��IIII I'�I 1505618403 1505618403 1505616411 REV-1500 EX Decedent's Social Security Number oeceoenrs Name. Carmody,Jafnes W. RECAPITULATION 1. Real Estate(Schedule A)....................................................................................... 1. 176-o220-00 2. Stocks and Bonds(Schedule B)............................................................................. 2. 230,274-75 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C)......... 3. 4. Mortgages and Notes Receivable(Schedule D).................................................... 4. S. Cash,Bank Deposita and Miscellaneous Personal Property(Schedule E).......... 5. 227,053-00 8. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 8. 33,009-73 7. Inter-Vow Transfers&Miscellaneous NjWProbate Property (Schedule G) " Separate Billing Requested............ 7. 464A09-65 8. Total Gross Assets(total Lines 1 through 7)........................................................ a. 1,13 0,5 6 7.13 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 35,721-12 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 61365-9`1 11. Total Deductions(total Lim 9 and 10)................................................................ 11. 4 2,0 9 5.11 12. Net Value of Estate(Una 8 minus Line 11).......................................................... 12. 1,068,472-02 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J)............................................... 13. 14. Net Value Subject to Tax(Una 12 minus tine 13)............................................... 14. 1,0813,1472-02 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Una 14 taxable at the spousal tax rate,or transfers under Sec.9118 (a)(1.2)X.00 i5. 0.00 18. Amount of Una 14 taxable at lineal rate X .045 1A88,472-02 16. 4 8,981.2 4 17. Amount of Una 14 taxable at sibling rate X.12 0.130 17. 0.00 18. Amount of Line 14 taxable at Collateral rate X A5 0.00 111. 0.00 19. TAX DUE................................................................................................................ 19. 48,981.24 20. FILL IN THE OVAL IF YOU ARE REQUES%TING A REFUND OF AN OVERPAYMENT01 Undw penattles of pwjwy.I deders 1 have examined this roWm,including aco i m iing schedules and statements,and to the best of my knowledge and belief, it is true,oonact and complete.Declaration of preparer other than the peraan resporhsible for firing the mWm is based on aA lofomnstlon of vdlldh preparer has mW knov Wp. OF REJWOWJMLE FOR FILING RETURN Michael J.Carmody AWRESS 4004 1301M 4mce ey,,JMD 20832 SKiNA ER ER P E NTATm Linda J.Olsen 2000 Unglestown R dI Harrlsburg,PA 17110 (�����fl5�"f�����'I�I�II� Side 2 1505618411 REV-1500 EX Page 3 File Number 21-14-0903 Decedent's Complete Address: DECEDENT'S NAME Carmody,James W. STREET ADDRESS 7 Ronald Road CITY STATE 717050 Mechanicsburg PA Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 48,981.24 2. Credits/Payments A. Prior Payments 42,000.00 B. Discount 2,210.53 Total Credits(A +B) (2) 44,210.53 3. Interest (3) 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) 4,770.71 Make Check Payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;............................................................................... ❑ ❑x b. retain the right to designate who shall use the property transferred or its income;................................... ❑ ❑x c. retain a reversionary interest;or............................................................................................................... ❑ 0 d. receive the promise for life of either payments,benefits or care?............................................................ ❑ ❑x 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.................................................................................................................... ❑ 3. Did decedent own an"in trust for' or payable upon death bank account or security at his or her death?....... ❑x ❑ 4. Did decedent own an individual retirement account,annuity,or other non-probate property which ❑ ❑ contains a beneficiary designation?.................................................................................................................. x IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1,1994 and before Jan.1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after January 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)]. The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an adoptive parent,or a step-parent of the child is 0 percent[72 P.S.§9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[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. Rev-1502 EX+(12-12) SCHEDULE A pennsylvania REAL ESTATE DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Carmody,James W. 21-14-0903 All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on schedule F. Attach a copy of the settlement sheet if the property has been sold Include a copy of the deed showing decedent's interest if owned as tenant in common. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Residence- 7 Ronald Rd.,Mechanicsburg-Assessed value of$178,000 multiplied by 176,220.00 Cumberland Co.Common Level Ratio of.99% TOTAL(Also enter on Line 1. Recapitulation) 176,220.00 (If more space is needed,additional pages of the same size) Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule A(Rev. 12-12) Rev-1503 EX+(08-12) SCHEDULE B pennsylvania STOCKS & BONDS DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Carmody,James W. 21-14-0903 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH 1 Charles Schwab Acct.#2111-4167 198.842.13 2 Fidelity Mutual Funds#2AV-483290 18.949.29 3 242 shares of MetLife 51.5840083 12.483.33 TOTAL(Also enter on Line 2. Recapitulation) 230.274.75 (If more space is needed,additional pages of the same size) Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule B(Rev.08-12) Rev-1508 EX+(08-12) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Carmody,James W. 21-14-0903 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Dept.of Unclaimed Property-MetLife Demualization 391.49 2 Members 1st CD#877-0040 5.274.73 3 Members 1st CD#877-0041 38,477.18 4 Members 1st CD#877-0049 30,437.83 5 Members 1st CD#877-0050 42.114.00 6 M&T Bank CD#31003923040627 110,233.11 7 Members 1st Savings#877-0000 124.66 TOTAL(Also enter on Line 5. Recapitulation) 227,053.00 (If more space is needed,additional pages of the same size) Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule E(Rev.08-12) Rev-1509 EX+(01-10) pennsylvania SCHEDULE F DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Carmody,James W. 21-14-0903 If an asset was made joint within one year of the decedenPs date of death,it must be reported on schedule G. SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT A. Scott W. Carmody 7 Robert Dr. Son Mechanicsburg, PA 17050 B. C. JOINTLY OWNED PROPERTY: LETTER DESCRIPTION OF PROPERTY %OF DATE OF DEATH (NCLUDE NAME OF NUMBER OR SIIMILARrANCIAL IDENTIFY NG(TUTION AND BANK NUM ER.ATTACH DEEDUNT DATE OF DEATH DECD VALUE OF ITEM FOR JOINT MADE $ DENT'S INTEREST TEREST NUMBER TENANT JOINT JOINTLY-HELD REAL ESTATE. VALUE OF ASSE INTEREST DECE 1 A 11/13/2003 M&T Bank Checking#21675864-Jt.with son, 44,729.60 50.000% 22,364.80 Scott 2 A 11/13/2003 M&T Bank Checking#950744310-Jt.with 21,289.85 50.000% 10,644.93 son,Scott TOTAL(Also enter on Line 6. Recapitulation) 33,009.73 (If more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group,Inc. . Form PA-1500 Schedule F(Rev.01-10) Rev-1510 EX+(08-09) SCHEDULE G pennsylvania INTER-VIVOS TRANSFERS AND DEPARTMENT OF MISC. NON-PROBATE PROPERTY RET INHERITANCE TAXAXRETURRNN RESIDENT DECEDENT ESTATE OF FILE NUMBER Carmody,James W. 21-14-0903 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % DECD'S EXCLUSION TAXABLE INCLUDE NUMBER THE DATE OF TRANSFERS ATTACH A COPYFEREE THEIR OF THE DEIP TO DECEDENT ED FOR REAL ESTATDE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1 Charles Schwab IRA Acct. 2111-4166--Beneficiary is 89,092.71 100.000% 89,092.71 decedent's 3 sons. 2 Erie Family Life,Flex Prem. Def. NQ Annuity #563315 111,707.22 100.000% 111,707.22 3 M&T Bank-IRA#35004202556849--3 sons are 111,640.99 100.000% 111,640.99 beneficiary 4 TransAmerica IRA Acct.02CBT062231 --Beneficiary 43,765.69 100.000% 43,765.69 is decedent's 3 sons 5 US Series EE Savings Bonds(170)-POD to 3 sons, 2 33.787.04 33,787.04 grchild 6 US Series I Savings Bonds(9)POD to 3 sons,2 74,016.00 74,016.00 grandchildren TOTAL(Also enter on Line 7, Recapitulation) 464,009.65 (If more space is needed,additional pages of the same size) Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule G(Rev.08-09) REV-1511 EX+(08-13) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RESIDENT DECEDENT RETURN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Carmody,James W. 21-14-0903 Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 14,502.50 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio Year(s)Commission Paid 2. Attorney's Fees Hazen Elder Law 13,667.50 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) 3,500.00 Claimant Scott Carmody Street Address 7 Ronald Road City Mechanicsburg State PA ZiD 17050 Relationship of Claimant to Decedent Son 4. Probate Fees Register of Wills 590.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 210.00 7. Other Administrative Costs 3,259.12 See continuation schedule(s) attached TOTAL(Also enter on line 9, Recapitulation) 35,729.12 Copyright(c)2013 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.08-13) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Carmody,James W. 21-14-0903 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Mt. Rose Cemetary 1.495.00 2 Neill Funeral Home 13.007.50 H-A 14,502.50 Other Administrative Costs 3 Allstate-homeowners insurance 668.10 4 Central Penn Business Journal-estate notice 176.00 5 Cumberland Co. Law Journal-estate notice 75.00 6 Fetrow Electric-electrical repair 101.93 7 Hampton Twsp-sewer/trash-Sept.2014-Jan.2015 315.80 8 Hazen Elder Law-disbursements 64.09 9 Journal Multimedia-Central Penn-estate notice 176.00 10 PA American Water-Sept.2014-March 2015 283.11 11 Postage-reimburse Executor 15.16 12 PP&L Electric-Sept.2014-March 2015 405.55 13 Register of Wills-fee to file Petition to enter copy of Will for Probate 55.00 14 UGI-gas,Sept.2014-March 2015 923.38 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Carmody,James W. 21-14-0903 ITEM NUMBER DESCRIPTION AMOUNT H-137 3,259.12 Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98) Rev-1512 EX+(12-12) SCHEDULE 1 pennsylvania DEBTS OF DECEDENT, DEPARTMENT OFMORTGAGE LIABILITIES AND LIENS RET INHERITANCE TAXAXRETURRNN RESIDENT DECEDENT ESTATE OF FILE NUMBER Carmody,James W. 21-14-0903 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Comcast-cable 132.17 2 Golden Living-Nursing Home 755.46 3 Hazen Elder Law-fees 2,672.50 4 Michael Langan,Treasurer/Personal PerCapita tax 11.00 5 Michael Langan,Treasurer/real estate taxes for 2014 summer 1.496.12 6 PA American Water 43.60 7 PA Dept.of Revenue-2013 personal income tax return 252.00 8 PPBL Electric 59.60 9 UGI -gas 22.41 10 US Treasury-2013 personal federal Tax 5.17 11 US Treasury-2013 personal Income tax return 845.00 12 Verizon-telephone 70.96 TOTAL(Also enter on Line 10, Recapitulation) 6,365.99 (If more space is needed,additional pages of the same size) Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-12) REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Carmody,James W. 21-14-0903 RELATIONSHIP TO NUMBER NAME AND ADDRESS OF DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE PERSON(S)RECEIVING PROPERTY (Words) ($$$) Do Not Lost Trustee(s) ITAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec.9116(a)(1.2)] Mark A.Carmody Son One-third of the 6033 Williams Drive Residue Mechanicsburg, PA 17050 Michael J Carmody Son One-third of the 4004 Boleyn Terrace Residue Olney, MD 20832 Scott W.Carmody Son One-third of the 7 Ronald Road Residue. Mechanicsburg, PA 17050 Total Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet as appropriate. NON-TAXABLE DISTRIBUTIONS: II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10) REGISTER OF WILLS CERTIFICATE OF CUMBERLAND COUNTY GRANT OF LETTERS PENNSYLVANIA ti ®F c M I ��,�\ No. 2014- 00903 PA No. 21- 14- 0903 .7 �\ Estate Of: JAMES W CARMODY O I• —�D Z, (First,Middle,Last) V Q Late Of: HAMPDEN TOWNSHIP \ o CUMBERLAND COUNTY Deceased 1750 Social Security No: WHEREAS, on the 17th day of October 2014 an instrument dated September 16th 2002 was admitted to probate as the last will of JAMES W CARMODY (First,Middle,Last) late of HAMPDEN TOWNSHIP, CUMBERLAND County, who died on the 10th day of August 2014 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, LISA M. GRAYSON, ESQ. , Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: MICHAEL J CARMODY and MARK A CARMODY who have duly qualified as EXECUTOR(RIX) and have agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURTHOUSE, CARLISLE, PENNSYL VA NIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 17th day of October 2014. dmu �1 tJ%s t fEsC.Q MIS 'Y- - i) Deputy **NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) �V r�r, m t'll c_. cn o Last Will and Testament Of James W Carmody September 16 , 2002 Last Will and Testament Of _ James W. Carmody c �, m c> I, James W. Carmody, of Cumberland County, PennsylvVhiOj Q7:07 declare this to be my Last Will and Testament, hereby revokm'g any Will previously made by me. rn _4 -> I — I direct the payment of all my just debts and funeral:Expense& clo out of my estate as soon as may be practical after my death. II — I bequeath all of my automobiles and other articles of personal and household use , including, but not limited to household goods, furniture, personal effects and other tangible personal property, in equal shares to my sons, Mark A. Carmody, Scott W. Carmody and Michael J. Carmody, to be divided among them as they may agree, or, in the absence of an agreement as my executors may deem appropriate, provided that any article which my executors consider unsuitable may be sold and the proceeds thereof added to my residuary estate. Should any of my sons not be living at the time of the distribution, his bequest contained in this paragraph only shall lapse. III — Since my son, Scott W. Carmody lives with me, he should be offered the first opportunity to purchase my home at the net fair market value at the time of my death. If my son, Scott W. Carmody does not wish to purchase the home then either of my other two sons should be offered the opportunity to acquire the home at the net fair market value. If none of my sons wish to acquire the home, the home should be sold. The proceeds from the sale, either to one of my sons or public sale shall be added to my residuary estate and divided equally among my sons, Mark A. Carmody, Scott W. Carmody and Michael J. Carmody. Last Will and Testament of James W. Carmody—Page 2 IV- There is four groups in which my sons have been named as designated beneficiary or co-owner. This will not be changed, however, the following explanation should be considered: 1. Insurance policies — Met-Life and Civil Service — One third to each of my sons. Both Met-Life and Civil Service should be notified so that additional payments would not be necessary. Both are automatic. 2. I.R.A.s — Currently the IRA's are at Allfirst Bank at 9.35% and at Schwab Brokerage in Mutual Funds. Since I am over 701/21 withdraw based on the schedule requiring withdrawal. Money will be withdrawn from Schwab first then from the account at Allfirst Bank which expires in December,2006. The other account at Allfirst does not expire until December. 2009. Each of my sons will have options and each should use the option that is best for him, as allowed by law. 3. Series I Bonds — Three bonds in the amount of$5,000.00 each were purchased in joint names with my individual sons. This was considered as a gift to each of my sons in the year 2001, therefore any or all of my sons who want or need the money from the bonds can have them at any time. Please note that the total of gifts given to my sons , other than the bonds was only $2,000.00, therefore the gifts in 2001 was less than the $10,000.00, even if the bands were included. 4. The checking account at Allfirst Bank is in my name and Scott's name. All automatic payments are through this account. This account usually has between $5,000.00 and $10,000.00, which are used to pay all automatic items which include Utilities, Charge Accounts, Insurance, Taxes, etc. I do not believe that anything should be done with this other than transferring the amounts and automatic payments to Scott's checking account, because within two months, all money in this account would be used. Most, if not all of the expenses would have been incurred prior to my death. Last Will and Testament of James W. Carmody — Page 3 V -- I devise and bequeath all of the rest, residue and remainder of my estate of every nature and whatsoever situate in equal shares to my sons Mark A. Carmody, Scott W. Carmody and Michael J. Carmody, or their issue, per stirpes (Direct descendents). VI — I appoint my sons, Mark A. Carmody, Scott W. Carmody and Michael J. Carmody to be Executors of. this, My lust Will and Testament. I direct that my Executors shall not be required to enter bond or furnish surety in any jurisdiction. VII — I authorize my Executors to exercise the following powers in addition. to those given by law, to be exercised in their sole discretion: a. To retain any or all assets of my estate, real, personal or mixed, without regard to any principle of diversification, risk or productivity. b. To invest in all forms of property as may from time to time be authorized for Pennsylvania fiduciaries or Executors. c. To sell at public or private sale, to exchange, mortgage or lease for any period of time, including to any of my beneficiaries under the terms of this Will and including during the time of administration of my estate, and to repair, alter or improve any real or personal property and to give options and provide for the sale, exchange or lease for such prices and upon such terms and conditions as they deem proper or to transfer any real estate, in kind, to any beneficiary of my estate in satisfaction , in whole or in part of a beneficiaries' distribution share of my estate. d. To compromise any claim or controversy. Last Will and Testament of James W. Carmody—Page 4 e. To make distributions hereunder in cash, in kind, or partly in cash and partly in kind. f. To make any distribution hereunder for the benefit of minor beneficiaries or others who, in their opinion, are incapacitated through illness, age or other causes, directly to the beneficiary thereof, to the natural or legal guardian or the person who has custody of such beneficiary, or to apply any such distribution directly to the benefit of such beneficiary. The receipt of such persons to whom payment is made or entrusted shall be a complete discharge of the fiduciary'in respect thereof. g. In general, to exercise all powers in the management of any funds which any individual could exercise in the management of similar property owned in his own right upon such terms and conditions as to them may seem best and to execute and deliver all instruments and to do all acts which they deem necessary or proper to carry out the purpose of this Will. In witness whereof, I have hereunto set my hand and seal to this, My Last Will and Testament this /L day of September,2002. Ja es W. Carmody Signed, sealed, published and declared by the above-named Testator, James W. Carmody, as and for this Last Will and Testament in the presence of us, who hereunder subscribed our names at his request as witnesses thereto, in the presence of said Tes t r anh plhqr. r �.dkdress: Cr Cz _ Address- Last Will and Testament of James W. Carmody -- Page S Commonwealth of Pennsylvania: County of Cumberland We the undersigned, the Testator and the witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and Testament and that he signed willingly (or willingly directed another to sign for him), and that he executed it as his free will and voluntary act for the purpose therein expressed, and that each of the trustees signed the Will as witnesses and that to the best of their knowledge the Testator was at that time eighteen years of age or older, of sound mind, and under no constraint or undue influence. Ja es W. Carmody /A"J� Witness V .l f it�ness Subscribed, sworn to and acknowledged before me by the Testator and subscribed and sworn to before me by both witnesses, this 1 4� day of SeptemberL 2002, NfAa Public tdatariai:gal Cynthia L.Thom:rs,iJota.ry f'ub°iC [HampdenTY�P.,Cum eriand.C.vur)ty y Commission Expires tdc r. ,2t74 Member,Pennsylvanis Association of Nota;ies REV-485 EX(05-04) V, 48500041046 SAFE DEPOSIT dh BOX INVENTORY PA Department of Revenue PLEASE USE ORIGINAL FORM ONLY Social Security or Death Certificate Number Date of Death County Code Year File Number 08/10/2014 21 14 0903 Decedent's Last Name Suffix First Name Ml Carmody James W 13 ADDRESS OF DECEDENT STREET. CITY: STATE: ZIP CODE: 7 Ronald Rd. Mechanicsburg PA 17055 13 NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX NAME: Mark A. Carmody and Michael J. Carmody STREET ADDRESS: CITY: STATE: ZIP CODE: 6033 Williams Dr. Mechanicsburg PA 17050 NAME,ADDRESS AND RELATIONSHIP(IF ANY)TO DECEDENT,OF PERSON(S)PRESENT AT THE BOX OPENING a. NAME: RELATIONSHIP: Mark A. Carmody _Executor and son STREET ADDRESS: CITY: - • V STATE: ZIP CODE: 6033 Williams Dr. Mechanicsburg PA 17050 b. NAME: RELATIONSHIP: Michael J. Carmody Executor and son STREETAIDDRESS: CITY:. STATE: ZIP CODE: 4004 Boleyn Terrace 01hey MD 20832 c. NAME: RELATIONSHIP: STREET ADDRESS: CITY: STATE: ZIP CODE: NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED NAME: M&T Bank STREET ADDRESS: CITY: STATE: ZIP CODE: 5528 Carlisle Pike Me.chlanicsburg PA 17050 NAME OF PERSON MAKING LAST ENTRY DATE AND TIME OF LAST ENTRY Scott Carmody 7/28/14 2:35 am DATE OF CONTRACT TO RENT BOX NUMBER OF BOX IMIFTjrTLE UNDER WHICH BOX IS REQUESTED 12/07/2005 196 James*W: or Scott W. Carmody NAME AND ADDRESS OF PERSON(S)HAVING ACCESS TO BOX a. NAME: b. NAME: James W. Carmody Scott W Carmol STREET ADDRESS: STREET ADDRESS: 7 Ronald Rd. 7 Ronald-Rd., CITY: STATE: ZIP CODE: CITY: STATE: ZIP CODE: Mechanicsburg PA 17050 Mechanicsburg PA 17050 NAME AND TITLE OF EMPLOYEE TAKING THE INVENTORY WAS A WILL IN THE BOX? El YES R] NO If yes, a. Date of will: b. Name and address of personal representative,if named in the will NAME: STREET ADDRESS: CITY: STATE: ZIP CODE: c. Name and address of attorney,if any NAME: Linda J. Olsen, Esq.,_ STREET ADDRESS: CITY: STATE: ZIP CODE: 2000 Linglestown Rd. Ste, 202 Harrisburg PA 17110 48500041046 48500041046 REV-485 EX SAFE DEPOSIT BOX INVENTORY Page— of INSTRUCTIONS (1) Cash: Report total only. (2) Stocks:List in detail every common or preferred certificate,warrant or other rights found in box.Stocks are to be designated by name of company,certificate number,date of certificate,name in which stock is registered,and number of shares and class of stock. (3) Obligations of U.S.Government: Number of items,date of issue,face value,names in which registered and type of ownership, i.e.,jointly held,payable on death,etc. (4) Bonds: Designate by name,amount,serial number,or other designation. (Bearer Bonds) (5) Bank and Savings and Loan Passbooks: State name of depositor,number of book,last date appearing in book,name of bank and branch,and balance. (6) Jewelry,Coins,Stamps, Manuscripts,etc: List and describe as fully as possible. (7) Deeds,Mortgages,Current Insurance Policies or other evidences of indebtedness: List and describe as fully as possible. (8) All other contents. (9) Return completed form to: DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT.280601 HARRISBURG,PA 17128-0601 ITEM NO. ITEM DESCRIPTION I CERTIFY UNDER PENALTY OF PERJURY THAT THE ABOVE RECORD IS PERSON RECEIVING COPY OF CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. SAFE POSIT BOX INVENTORY: NA INE SI ATU PRT NA NAa AND CHEC PPROPRIATE B X ELOW: PRINT TITLE DATE CHECK APPROPRIATE BOX: / W Executor(trlx) E]Administrator(trix) - Q'`Estate Representative n Joint owner of safe deposit box NOTE: Attach additional 81/2" x 11" sheet(s) if necessary or use duplicates of this page of form. The Department is authorized by law,42 U.S.C.§405(c)(2)(C)(i),to require disclosure of Social Security numbers in connection with administering state tax laws.The Department uses the Social Security number to identify the decedent and personal representatives of the estate.The Commonwealth may also use the information in exchange of tax information agreements with Federal and local taxing authorities.The state law prohibits the Commonwealth's personnel from disclosing confidential tax information except for official purposes. 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Z n cn w W z O Nw- UO ! r w LL0 CIA u� ® m F mooLLI + LU z Z U 4 �y:Z:) o z o W zLu L" W .� O LL 0 v9C, Z Q O 0: U •aJ 2 O U Z 1 m W O �1 XZ Q h III in w Z r &OMITO 'IVEA.LTH OF ENNSY LVANtA j l S,S: . . ................ COVNTY, j het 'ilr1) I the Offi for Recording of Deeds, Mortgages, etc. in and for the Countyy of C .....��'..,..... in Deed I3ooZc ..... Voh ...f ......._....................... Page ITIiUlrEis MY Hand and Seal of Office, Lhis ................................. .............................................. day of _.,..................._...... .......... Anno Doinini 1946 7lwA TATE TFIAf. F;-:R TAX Amount r..y4 ME-SIMPLE DEED---Typc+v he f 12th day of Janu iry in the ,year of our Lord One Thousand Nine Iiundrrid and s y 9150) iPr1UPP1t W.I7ZIAMM H. NELSON and LO'TTIF, Y. NEMON, his wife, of the City of Harrisburg, County of Dauphin and State of Pennsylvania, parties of the first part A N D JAMS W. CtMODY and NANCY L. CA'1^tFiOOY, his wife, of Hampden Township, Cumberland County, Pennsylvania, parties 1 FIE ' a i. •�.•.v��q xFc�xa... ((�+�f ff�4P`.> I Iiia."�..�^ t� w �T 0ngrrr with all and singular,the tenements, hereditaments and appurtenances to the same belong- ing or in anywise appertaining, and the reversion and reversions, remainder and remainders, rents, issues and profits thereof;ArihafirDall the estate, right, title, interest, property, claim and demand whatsoever, both in law and equity,of the said part it=s of the first part, of, in, to or out of the said premises, and every part and parcel thereof Cn f atir U11h to ' 11lb the said prem;ses, with all and singular the appurtenances, unto the said part ies of the second part, their heirs and assigns, to and for the only proper use and behoof of the said part Jeg of the second part, their heirs and assigns forever, .C1I� THE SAM parties of the first part for themselves, heir 4 hr.irs, executors and administrators, do by these, presents, covenant, grant and agree to and with. the .raid part ies of the second part, their heirs and assigns, that they , the said 4parties of the first part for themselves, their heirs all and singular the hereditaments and premises hereinabove described and granted or mentioned, and in- icndwd.so to be, with appurtenances, unto the said part ies of the second part, their heirs arid'6s�i7nF,'again.sf the said part Jes of fhe first part and their heirs and against all and every other :'persorz�or'p'r�J;Is whomsoever, larufulty claiming or to claim the same or any part thereof, They shall and will, by these presents, IF.4RRJN7.' AND FOREVER DEFEND 1 q the said mart ies of the first part has .r hPr�urcfa {r%t j IE1T hands and teats the day and year first above, written. u ( 'K�4z ... ........ t v...... ........... . (SEdL) Signed, Sea.ded and Dehirered � ..._.............. .. .... ............... ..w...._. ...........,........ .... ..._.. (Sl:,ll.) } ��� It1�7ii•.rL.f i itf>`°.�fii£D•lkr'P::E: of Ttit Ca t3 t1F Ctdw �5 & ' Rf.CI}FDtk QF.DumR COMMONWEALTH OF PENNSYLVANIA CUMBEE'thi G enitrary .SS: 4':icr:Yi tttb -COUNTY. OF ....M..........L?tiU.?IiIN .r f ' •, � ✓ h On this, the »«»._,__l ila.. day of_.......«....._ ..._.............u, arut r5r_.-_..._......._._.........__.___.,_., 19 .6f1 ....., before me # ..............._..,.....-...,,................._.......... ..................,...,...._«......................................,..._.,......................_,., the undersigned {( officer, personally appeared ._.........W H. Nelson and Lottie M. Nelson., his wife t ........................................_.................._......_._._...................................,........._....._......................«.._......_ ....,....................,«...................................,... known to„me (or satisfactorily proven) to be the person .,.,"d.,_...._..........whose name ��_#�.............subscribed to the fggkinuVs{�u s?'ni; and acknowledged that ....».. .. he Z__.»executed the same for the purpose therein contained. �,•. fiv 4W ,A SS.WHEREOF, X hereunto set my hand and of ficial seal. "� .................». — •� 'rji"� •f '�"� fit:1 AR4 i CF iI•It J. �Yt.}t."t.� '�t�tb�t{'i a -.4 �; 4 :Cd My oommission expires:...._ . .{vxlm ' .:k47`lcrti6y Y`ttifg th4t.»tht. PreciseResidence of the Grantee, in the riitft?attipc R, is_ auph;n Coli{tt «............ .��.�.��:.....�.�,,,,..:.....a....w?.,.�.�r►�t.�c�..,....:�:.t�:�.>'�..r......�.�z'�+.{.t�t".t�........���.:.!.�.c: .,,.....,�!1�.c;,c ��t;.t.:`�.�?tiz�: ..r...,l::�{........._......_ r ....................,....,.....,.............._.,..........................,............,................«.«.....,..�.._,»,.,........,.........,.....,,../�'.�.w �,+M........«+.»...y�.c.. ./.,/..rte... ...........»... .. Attorncy,fn�fir ntet e� i t a �-+ 00 14 'S ' 3 i ! ay, ria! C.N •d 100= pj .4 t i i i tq { 1`• F •'r#i f(,4 l.a! E} •� t i1T�,y i p�i r *,t^s*in P V3 +.T., Q ; G t"�•1 i o f` .. e # t".« fey va p'.y. (+.�. V i+l iil i Z i J v 3 W of the second .part, That the said part of the first part,for and in conaideralion, of the sum of Fifteen Thousand, Five Hundred ($15,500.00) - - - - - - - - - - - - Dollars, lareful neoney of the United States of America.,well and truly paidby the said part of the second part to the said part.iesf the first part,at and before the sealing and delivery of these presents, the receipt whereof is hereby acknowledged, have granted, bargained, sold, aliened, eufeoffeil,released, conveyed,and confirmed and by these presents do grant, bargain, sell, alien, enfeoff, release, convey, and confirm unto the said parties of the second part their heirs and assigns, All that certain lot or piece of land situate in Hampden Township, Cumberland. County, Pennsylvania, bounded and described in accordance with a survey and plan thereof made by D. P. Raffensper.ger, Registered Surveyor, dated September 10, 1959, as follows:- BEGINNING at a point on the Easterly side of Ronald Road, which point is one hundred eighty-two and suety-five hundredths (182.65) feet North of the North- east corner of Ronald Road and Robert Drive; thence extending along Ronald Road North P-3.degrees 8 minutes East seventy-five (75) feet to a corner of Lot No. .110 on the hereinafter mentioned plan. of Lots; thence along Lot No. 110, South 66 degrees 52 'minutes East, one hundred twenty-five (125) feet; thence South 23 degree.- 8 minutes 'West seventy-five (75) feet to a corner of .Lot No. 108; thence along Lot No. 1.08 North 66 degrees 52 minutes West lone hundred and twenty-five (125) feet to the point and place of BEGINNING. BEING Lot No. 109 on a plan of bots entitled "Noll Acrestt as recorded in Plan Book 9 page 0 Cumberland County records. I1AVING THEREON ERECTED a one .story brick and frame dwelling knozm as No. 5 RonA16 Road. . BEING part of the same premises which Frank L. Eberly and Helen II. Eberly, his wife, ;granted and conveyed unto William H. Nelson by heed slated June 28. 1955 and recorded in Deed Book '!N",i Vol. 16, page X52., Cumberland County records. hrirs all and singular the hereditaments and premises hereinabove described and granted or mentioned, and in- tr11d0.sn to be, with appurtenances, unto the :said part ies of the second part, their heirs ftd,iis;�i jns, agaiiast the said part ieg of the first part and their heirs and against all and every other ori' ys yrs w1inmeoever, lawfully claiming or to claim the same or an art thereof, 1., P.: 4 f y 3 Y p f = ` ( They ': [ shall and will,by these presents, WARRANT AND FOREVErn DEFEND '` fit � t�Fl � EIr><Fnf the said part ies of the first part has J�F>her:canto.sk'-eiLr hands and•seab the day and year first above written. ty r t>._,. (SEAL) �._..... .........._ (SEAL) Signed. Scaled mid.Delivered :............:....._,............:...,.........._.......:a............................................... 0E.l.. it the presence of (SEAR.) ....................................._......................_... ..._...........:...._..:........_. _. ... ._.....................,_.......................... SEAL) .,......_............. ... ....,.,......._..............................,._................. .................... .... _. .......(SEAL) ........._......_......_.............:..._......_.........._............._......._. .........._..............__......._........................_......._. _.................... (srAr.) (,SEAL) _............................................ .............,..._....................................:..........._..._......................................................... (SEAL) ......_....................................... _.........................................................................................._.........................,.... (SEAL) ......................._..................... ............................................_._... ................F.........................; (SBAL) t.aiculateci v aloe or Your raper savings t3onci(s) Page 1 of 4 Calculated Value of Your Paper Savings Bond(s) Calculator Results for Redemption bate 08/2014 $58,000.00 $107,803.04 $49,803.04 $2,434.12 Bonds: 1-179 of 179 R185751848EE EE $200 12/1995 12/2014 12/2025 $100.00 $102.32 1.34% $202.32 R185751847EE EE $200 12/1995 12/2014 12/2025 $100.00 $102.32 1.34% $202.32 1 R185751846EE EE $200 11/1995 11/2014 11/2025 $100.00 $102.32 1.34% $202.32 1 R185751845EE EE $200 11/1995 11/2014 11/2025 $100.00 $102.32 1.34% $202.32 1 R185751844EE EE $200 10/1995 10/2014 10/2025 $100.00 $102.00 1.12% $202.00 R185751843EE EE $200 10/1995 10/2014 10/2025 $100.00 $102.00 1.12% $202.00 R185751842EE EE $200 09/1995 09/2014 09/2025 $100.00 $102.00 1.12% $202.00 1 R185751841EE EE $200 09/1995 09/2014 09/2025 $100.00 $102.00 1.12% $202.00 1 R185751840EE EE $200 04/1995 09/2014 04/2025 $100.00 $115.12 4.00% $215.12 1 R185751839EE EE $200 04/1995 09/2014 04/2025 $100.00 $115.12 4.00% $215.12 R18575185SEE EE $200 09/1995 09/2014 09/2025 $100.00 $102.00 1.12% $202.00 R185751857EE EE $200 08/1995 02/2015 08/2025 $100.00 $103.12 1.34% $203.12 R185751855EE EE $200 07/1995 01/2015 07/2025 $100.00 $103.12 1.34% $203.12 5185751856EE EE $200 08/1995 02/2015 08/2025 $100.00 $103.12 1.34% $203.12 R185751854EE EE $200 07/1995 01/2015 07/2025 $100.00 $103.12 1.34% $203.12 R185751853EE EE $200 06/1995 12/2014 06/2025 $100.00 $103.12 1.34% $203.12 R185751852EE EE $200 06/1995 12/2014 06/2025 $100.00 $103.12 1.34% $203.12 R185751851EE EE $200 05/1995 11/2014 05/2025 $100.00 $103.12 1.34% $203.12 i R185751850EE EE $200 05/1995 11/2014 05/2025 $100.00 $103.12 1.34% $203.12 R18575X1849EE EE $200 04/1995 09/2014 04/2025 $100.00 $115.12 4.00% $215.12 R185767203EE EE $200 04/1994 09/2014 04/2024 $100.00 $123.76 4.00% $223.76 R185767202EE EE $200 04/1994 09/2014 04/2024 $100.00 $123.76 4.000/. $223.76 f R185767201EE EE $200 03/1994 09/2014 03/2024 $100.00 $124.56 4.00% $224.56 R185767200EE EE $200 03/1994 09/2014 03/2024 $100.00 $124.56 4.00% $224.56 R185767199EE EE $200 02/1994 09/2014 02/2024 $100.00 $125.28 4.00010 $225.28 R185767198EE EE $200 02/1994 09/2014 02/2024 $100.00 $125.28 4.00% $225.28 R185767197EE EE $200 02/1994 09/2014 02/2024 $100.00 $125.28 4.00% $225.28 R185767196EE EE $200 01/1994 09/2014 01/2024 $100.00 $126.00 4.00% $226.00 R185767195EE EE $200 12/1993 09/2014 12/2023 $100.00 $126.80 4.00% $226.80 R185767194EE EE $200 12/1993 09/2014 12/2023 $100.00 $126.80 4.00010 $226.80 R185767193EE EE $200 11/1993 09/2014 11/2023 $100.00 $127.52 4.00% $227.52 R185767192EE EE $200 11/1993 09/2014 11/2023 $100.00 $127.52 4.00% $227.52 R185767191EE EE $200 10/1993 09/2014 10/2023 $100.00 $128.24 4.00% $228.24 R185767190EE EE $200 10/1993 09/2014 10/2023 $100.00 $128.24 4.00% $228.24 R185767189EE EE $200 10/1993 09/2014 10/2023 $100.00 $128.24 4.00% $228.24 R185767188EE EE $200 09/1993 09/2014 09/2023 $100.00 $129.04 4.00% $229.04 R185767187EE EE $200 09/1993 09/2014 09/2023 $100.00 $129.04 4.00% $229.04 R185767186EE EE $200 08/1993 09/2014 08/2023 $100.00 $129.76 4.00010 $229.76 R185767185EE EE $200 08/1993 09/2014 08/2023 $100.00 $129.76 4.00% $229.76 R185767184EE EE $200 07/1993 09/2014 07/2023 $100.00 $130.56 4.00% $230.56 R185767183EE EE $200 07/1993 09/2014 07/2023 $100.00 $130.56 4.00% $230.56 R185767182EE EE $200 06/1993 09/2014 06/2023 $100.00 $131.28 4.00% $231.28 R185767181EE EE $200 06/1993 09/2014 06/2023 $100.00 $131.28 4.00% $231.28 R185767180EE EE $200 05/1993 09/2014 05/2023 $100.00 $132.08 4.00% $232.08 C800030863EE EE $100 06/1992 12/2014 06/2022 $50.00 $101.04 4.00% $151.04 C800030862EE EE $100 05/1992 11/2014 05/2022 $50.00 $101.04 4M% $151.04 C800030861EE EE $100 05/1992 11/2014 05/2022 $50.00 $101.04 4.00% $151.04 C800030860EE EE $100 05/1992 11/2014 05/2022 $50.00 $101.04 4.00% $151.04 E � littp.//www.treasurydirect.gov/BC/SBC1'rice 12/2/2014 Calculated Vodueo1 Your Paper Savings Bond(s) Page o[4 [800030859EE EE $lOO 04/1992 10/2014 04/2022 $50.00 $101.04 4.009h $151.04 C800030858EE EE $100 04/1992 10/2014 04/2022 $50.00 $101.04 4.00% $151.04 [800030857EE EE $100 06/1992 12/2014 06/2022 ¢50.00 $101.04 *.0096 $151.04 C800830856EE EE $lOU 02/199I 02/2015 02/2022 $50M $104.08 4.00*6 $154.08 C800038855EE EE $100 02/1992 02/2015 02/2022 ¢50.00 $104.08 4.00Y6 $154.08 [800030854EE EE $100 02/1992 02/2015 02/2022 $50.00 $104.08 4.00% $154.08 [800030853EE EE $100 01/1992 01/2015 01/20I2 $50.00 $104.08 4.0096 $154.00 C800030852EE EE $100 01/1992 01/2015 01/2023 $50.00 $104.08 4.00% $154.08 C800030851EE EE $100 12/1991 12/2014 12/2021 $50.00 $/04.88 4.00% $154.08 eg)]030850EE EE $100 12/1991 12/2014 12/2021 $50.00 $104.08 4.00% $154.08 [8008]0849EE EE $100 11/1991 11/2014 11/2021 $50.00 $104.08 4.00% $154.08 [800038848EE EE $100 11/1991 11/2014 11/2021 $50M $104.08 *.00*6 $154'08 [800030047EE EE $100 11/1991 11/2014 11/2021 $50.00 $104.08 4.0096 $154.08 [8000308*6EE EE $100 10/1991 10/2014 10/2021 $50.00 $104.08 4.00% $154.08 [800030845EE EE $100 10/1991 10/201* 10/2021 $50m $104M 4.00q6 $154.08 C80003084+EE EE $100 09/1991 09/2014 09/2021 $50.00 $104.08 4.00% $154.08 [800030843EE EE ¢100 09/1991 09/201* 09/2021 $50M $104.08 4.009h $154.08 [800030842EE EE $100 08/1991 02/2015 08/2021 ¢50.00 $107.16 4.00Y6 $157.18 [800030841EE EE $100 08/1991 02/2015 08/2021 $50.00 $107.16 4.0096 $157.16 C800030840EE EE $100 07y1991 01/2015 07/2021 $50.00 $107.15 4M96 $157'16 C800030839EE EE $100 07/1991 01/2015 07/2021 $50.00 $107.16 4.0096 $157.16 [800030838EE EE $lOU 06/1991 12/201* 06/2021 $50.00 $107.16 4M% $157.16 K18476715*EE EE $200 05/1993 09/2014 05/2023 $100.00 $132.08 4.00% $232.08 R185767153EE EE $200 04/1993 89/2014 04/2023 $100.00 $132.80 *.00q6 $232.80 R185767152EE EE $200 04/1993 09/2014 0*/2023 $zOO-UO $132M 4.0096 $232.80 R185767151EE EE $200 0]/199] 09/2014 03/2023 $100.00 $13360 4.0096 $233.60 R185787/50EE EE $208 03/1993 09/2014 03/2023 $100.00 $1]].50 4,00% $233.60 R185707149EE EE $200 02/1993 02/2015 02/2023 $100.00 $190.16 +0096 $296.16 R1857871*8EE EE $200 02/1993 02/2015 02/2023 $100.00 $196.16 4.00v6 $296,18 R185767147EE EE $200 01/1993 01/2015 01/2023 $100.00 $196.10 4.0096 $296.16 R185767140EE EE $200 01/1993 01/2015 01/2023 $100.00 $196.16 4.00% $296.16 R185767145EE EE $200 12/1992 12/2014 12/2022 $100.00 $198.16 4.00% $296.16 R185767144EE EE $200 12/1992 12/2014 12/2022 $100.00 $190.16 4.00% $296.16 R185767155EE EE $200 05Y1993`09/20/4 05/2023 $100.00 $132.08 4.00% $232.08 R185767142EE EE $200 11/1992 11/20/4 11/2022 $100.00 $196.16 4M% $296.16 R185767143EE EE $200 11/1992 11/2014 11/2022 $100.00 $196.16 4.0096 $I96.16 R185707141E[ EE $200 10/1992 10/2014 10/2022 $100.00 $190.16 4.00v6 $296.16 R185767140EE EE $200 10/1992 10/2014 10/2022 $100m $196.16 4M96 $296'16 R1857671]9E[ EE $200 10/1992 10/2014 10/2022 $100.00 $190.16 4.0096 $296.1e R185767130EE EE $200 09/1992 09/2014 09/2022 $100.00 $196.10 4.00% $296.16 n185767137se EE $200 09/1992 09/2014 09/2022 $100.00 $196.16 4.00vm $296.16 m185767136EE EE ¢200 08/1993 02/3015 08/2022 $100.00 $202.08 1.00v6 $302.08 R185767135EE EE $200 08/1992 02/2015 88/2822 $100.00 $202.08 *M% $382.08 R185707134Es EE $200 07/1992 01/2015 07/2022 $100.00 $202.08 4.00% $302.08 C800030811Ee EE $100 07/1992 01/2015 07/2022 $50.00 $101.04 4.00% $151.04 [800030810EE ss $100 06/1992 12/2014 00/2022 $50,00 $/01.0* 4M% $151.04 [800030809EE EE $100 05/1990 11/2014 05/2020 $50.00 $113.52 4.00% $163.52 [800030808eE EE $100 05/1990 11/281* 85/2020 $50.00 $113.52 *.00v+ $163.52 C800030807eE EE $100 0*/19e0 10/2014 0*/2020 $50.00 $113.52 4.00% $163.52 [800030806EE EE $100 04/1990 10/201* 04/2020 $50.00 $113.52 *.00% $163.52 [8000]0805sE EE $100 03/1990 09/2014 03/2020 $50.00 $11I52 4.00«m $163.52 [8000]0804EE EE $100 03/1990 09/2014 03/2020 $50.00 $113.52 +.00% $163.52 [800030803[E EE $100 02/1990 02/2015 02/2020 $50.00 $116.80 4.00% $166.80 [8000]080IEE EE $lOO 02/1990 02/2015 02/2020 $50.00 $115M 4.00v6 $166.80 C808030801sE EE $100 01/1990 01/2015 01/2020 $50.00 $116.80 *.00% $166.80 C800030800sE EE $100 01/1990 01/20/5 01/2820 $50.00 $116.80 +,00% $166.80 C800030799EE EE $100 12/1909 12/2014 12/2019 $50.00 $116.80 4.0096 $166.80 C800030798EE [E $100 12/1989 12/2014 12/2019 $50.00 $116.80 4.0096 $166.80 C800030797sE EE $100 12/1989 12/2014 12/2019 $50.00 $zzaM 4.00% $1e6.80 [800030790sE EE $zDo 11/1989 11/2014 11/2019 $50.00 $116.80 4.0096 $166.80 C800030795EE EE $lOO 11/1909 11/2014 11/2019 $50.00 $110.80 4.0096 $166.80 [0000]0794EE EE $100 10/1989 10/2014 10/2019 $50.00 $115,80 4.0096 $156.80 C800030793EE EE $100 10/1989 10/2014 10/2019 $50.00 $110.80 4.00% $166.80 | C800030792eE ss $zUo 09/1989 09/2014 0e/2019 $50.00 $116.80 4M% $156.80 \ | / littp://www.ti-e,-tSLli-ydirect.gov/BC/SBCPi-ice 12/2/2014 Calculated Value of Your Paper Savings Bond(s) Page 3 of 4 C800030791EE EE $100 09/1989 09/2014 09/2019 $50.00 $116.80 4.00% $166.80 C800030790EE EE $100 08/1989 02/2015 08/2019 $50.00 $120.12 4.00% $170.12 C800030789EE EE $100 08/1989 02/2015 08/2019 $50.00 $120.12 4.00% $170.12 C800030788EE EE $100 07/1989 01/2015 07/2019 $50.00 $120.12 4.00% $170.12 C800030787EE EE $100 07/1989 01/2015 07/2019 $50.00 $120.12 4.00% $170.12 C800030786EE EE $100 07/1989 01/2015 07/2019 $50.00 $120.12 4.00% $170.12 C800030785EE EE $100 06/1989 12/2014 06/2019 $50.00 $120.12 4.00% $170.12 C800030784EE EE $100 06/1989 12/2014 06/2019 $50.00 $120.12 4.00% $170.12 R185767179EE EE $200 03/1995 09/2014 03/2025 $100.00 $115.84 4.00% $215.84 R185767178EE EE $200 03/1995 09/2014 03/2025 $100.00 $115.84 4.00% $215.84 R185767177EE EE $200 02/1995 09/2014 02/2025 $100.00 $116.56 4.00% $216.56 R185767176EE EE $200 02/1995 09/2014 02/2025 $100.00 $116.56 4.00% $216.56 R185767175EE EE $200 01/1995 09/2014 01/2025 $100.00 $117.28 4.00% $217.28 R185767174EE EE $200 01/1995 09/2014 01/2025 $100.00 $117.28 4.00% $217.28 R185767173EE EE $200 12/1994 09/2014 12/2024 $100.00 $118.00 4.00% $218.00 R185767172EE EE $200 12/1994 09/2014 12/2024 $100.00 $118.00 4.00% $218.00 R185767171EE EE $200 11/1994 09/2014 11/2024 $100.00 $118.72 4.00% $218.72 R185767170EE EE $200 11/1994 09/2014 11/2024 $100.00 $118.72 4.00% $218.72 R185767169EE EE $200 10/1994 09/2014 10/2024 $100.00 $119.44 4.00% $219.44 R185767168EE EE $200 10/1994 09/2014 10/2024 $100.00 $119.44 4.00% $219.44 R185767167EE EE $200 10/1994 09/2014 10/2024 $100.00 $119.44 4.00% $219.44 R185767166EE EE $200 09/1994 09/2014 09/2024 $100.00 $120.16 4.00% $220.16 R185767165EE EE $200 09/1994 09/2014 09/2024 $100.00 $120.16 4.00% $220.16 R185767164EE EE $200 08/1994 09/2014 08/2024 $100.00 $120.88 4.00% $220.88 R185767163EE EE $200 08/1994 09/2014 08/2024 $100.00 $120.88 4.00% $220.88 R185767162EE EE $200 07/1994 09/2014 07/2024 $100.00 $121.60 4.00% $221.60 R185767161EE EE $200 07/1994 09/2014 07/2024 $100.00 $121.60 4.00% $221.60 R185767160EE EE $200 06/1994 09/2014 06/2024 $100.00 $122.32 4.00% $222.32 R185767159EE EE $200 06/1994 09/2014 06/2024 $100.00 $122.32 4.00% $222.32 R185767158EE EE $200 05/1994 09/2014 05/2024 $100.00 $123.04 4.00% $223.04 R185767157EE EE $200 05/1994 09/2014 05/2024 $100.00 $123.04 4.00% $223.04 R185767156EE EE $200 04/1994 09/2014 04/2024 $100.00 $123.76 4.00% $223.76 C800030837EE EE $100 06/1991 12/2014 06/2021 $50.00 $107.16 4.00% $157.16 C800030836EE EE $100 06/1991 12/2014 06/2021 $50.00 $107.16 4.00% $157.16 C800030835EE EE $100 05/1991 11/2014 05/2021 $50.00 $107.16 4.00% $157.16 C800030834EE EE $100 05/1991 11/2014 05/2021 $50.00 $107.16 4.00% $157.16 C800030833EE EE $100 04/1991 10/2014 04/2021 $50.00 $107.16 4.00% $157.16 C800030832EE EE $100 04/1991 10/2014 04/2021 $50.00 $107.16 4.00% $157.16 C800030831EE EE $100 03/1991 09/2014 03/2021 $50.00 $107.16 4.00% $157.16 C800030830EE EE $100 03/1991 09/2014 03/2021 $50.00 $107.16 4.00% $157.16 C800030829EE EE $100 02/1991 02/2015 02/2021 $50.00 $110.32 4.00% $160.32 C800030828EE EE $100 02/1991 02/2015 02/2021 $50.00 $110.32 4.00% $160.32 C800030827EE EE $100 01/1991 01/2015 01/2021 $50.00 $110.32 4.00% $160.32 C800030826EE EE $100 01/1991 01/2015 01/2021 $50.00 $110.32 4.00% $160.32 C800030825EE EE $100 12/1990 12/2014 12/2020 $50.00 $110.32 4.00% $160.32 C800030824EE EE $100 12/1990 12/2014 12/2020 $50.00 $110.32 4.00% $160.32 C800030823EE EE $100 12/1990 12/2014 12/2020 $50.00 $110.32 4.00% $160.32 C800030822EE EE $100 11/1990 11/2014 11/2020 $50.00 $110.32 4.00% $160.32 C800030821EE EE $100 10/1990 10/2014 10/2020 $50.00 $110.32 4.00% $160.32 C800030820EE EE $100 09/1990 09/2014 09/2020 $50.00 $110.32 4.00% $160.32 C800030819EE EE $100 09/1990 09/2014 09/2020 $50.00 $110.32 4.00% $160.32 C800030818EE EE $100 08/1990 02/2015 08/2020 $50.00 $113.52 4.00% $163.52 C800030817EE EE $100 08/1990 02/2015 08/2020 $50.00 $113.52 4.00% $163.52 C800030816EE EE $100 07/1990 01/2015 07/2020 $50.00 $113.52 4.00% $163.52 C800030815EE EE $100 07/1990 01/2015 07/2020 $50.00 $113.52 4.00% $163.52 C800030814EE EE $100 06/1990 12/2014 06/2020 $50.00 $113.52 4.00% $163.52 C800030813EE EE $100 06/1990 12/2014 06/2020 $50.00 $113.52 4.00% $163.52 C800030812EE EE $100 06/1990 12/2014 06/2020 $50.00 $113.52 4.00% $163.52 V002837344I I $5,000 01/2006 09/2014 01/2036 $5,000.00 $1,764.00 2.85% $6,764.00 V002837343I 1 $5,000 01/2006 09/2014 01/2036 $5,000.00 $1,764.00 2.85% $6,764.00 V002837342I I $5,000 01/2006 09/2014 01/2036 $5,000.00 $1,764.00 2.85% $6,764.00 V002459522I I $5,000 11/2004 09/2014 11/2034 $5,000.00 $2,082.00 2.85% $7,082.00 V002459521I I $5,000 11/2004 09/2014 11/2034 $5,000.00 $2,082.00 2.85% $7,082.00 V002459520I I $5,000 11/2004 09/2014 11/2034 $5,000.00 $2,082.00 2.85% $7,082.00 I littp://www.treasurydirect.gov/BC/SBCPi-ice 12/2/2014 Calculated Value of Your Paper Savings Bond(s) Page 4 of V0012639411 1 $5,000 04/2001 09/2014 04/2031 $5,000.00 $5,826.00 4.60% $10,826.00 V0012639421 1 $5,000 04/2001 09/2014 04/2031 $5,000.00 $5,826.00 4.60% $10,826.00 V001263940I 1 $5,000 04/2001 09/2014 04/2031 $5,000.00 $5,826.00 4.60% $10,826.00 Totals for 179 Bonds $58,000.00 $49,803.04 $_107,803.04 Notes NI Not Issued NE Not eligible for payment P5 Includes 3 month interest penalty MA Matured and not earning interest littp://www.treasurydii-ect.gov/BC/SBCPt-ice 12/2/2014 o .o a o � v o m a a m O r -1 ° (D 3 3 3 3 3 3 3 3 3 n U) rn DC m .` C C C C C C C C C > n _ O D D D D D D D D D ,���. 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W o O (D w C o t-h N ci (D 'TJ Qo 0 C (n P-U) t7o �j 4Q 6L (D I-- (D a (D (D(D t� G (D (n F H (D " H F'S SZ rt 00 OJ H- d H-O H- H- - rt rt tt, C n O lD lD C H• H- p m � � wwm cdD G� N •• A N O N N I'D rt F-- CD -O A rVIS MEMBERS 1St FEDERAL CREDIT UNION REGULAR SAVINGS ACCOUNT: Account Number/Suffix 179877-00 Date Account Established 11/07/1998 Principal Balance at Date of Death $124.66 Accrued Interest to Date of Death $0.00 Total Principal and Accrued Interest $124.66 Name of Joint Owner None CERTIFICATE OF DEPOSIT: Account Number/Suffix 197877-40 Date Account Established 05/18/2011 Principal Balance at Date of Death $5,274.34 Accrued Interest to Date of Death $0.39 Total Principal and Accrued Interest $5,274.73 Name of Joint Owner None CERTIFICATE OF DEPOSIT: Account Number/Suffix 197877-41 Date Account Established 06/02/2011 Principal Balance at Date of Death $38,473.39 Accrued Interest to Date of Death $3.79 Total Principal and Accrued Interest $38,477.18 Name of Joint Owner None CERTIFICATE OF DEPOSIT: Account Number/Suffix 197877-49 Date Account Established 06/03/2011 Principal Balance at Date of Death $30,434.83 Accrued Interest to Date of Death $3.00 Total Principal and Accrued Interest $30,437.83 Name of Joint Owner None CERTIFICATE OF DEPOSIT: Account Number/Suffix 197877-50 Date Account Established 05/14;2011 Principal Balance at Date of Death $42,109.85 Accrued Interest to Date of Death $4.15 Total Principal and Accrued Interest $42,114.00 Name of Joint Owner None MEEMBERS 1sT FEDERAL CREDIT UNION l/ Tessa L Klugh Lending Insurance Support Specialist October 24, 2014 Estate of: JAMES W CARMODY D` �_ Date of Death: 08/10/2014 Social Security Number: 185-20-7227 r T 5000 Louise Drive • P.O. Box 40 • Mechanicsburg,Pennsylvania 17055 • (800) 283-2328 • www.memberslst.org 00-24-2014 FRi 10:56 134 MANDT BANK#4344 FAX:7172404526 P. 003 Ad iWtrarp a Q,Arce_ iTRANsAmERics 4333 Edgcwogd Road NE LIFE INSURANCE COMPANY CedarRepWIA 324" ww�►r tcaoaa.oecStaAtriiauifecyu+ 08!131209 4 SCOTT W CARMODY 7 RONALD RD MECHANICSBURG, PA 17450-6827 Annuity Policy Number:02CST062231 Dear SCOTT W CARMODY, We have received notification of the death of James W Carmody. We extend our sincere condolences to you for your loss. our records reflect the following information regarding this annuity policy: Annuitant Name: James W Carmody Owner Name: James W Carmody Claimant Name: SCOTT W CARMODY Portion of claim: 33% Annuity Value: $43,765.69 as of 08/1012014 Annuity Type: Qualified Please complete and return the enclosed forms in orderto initiate a death claim on this annuity policy. The following information is being provided to assist you in completing the forms and submitting the appropriate documentation. General Information The financial professional of record will remain on this annuity unless we are notified of a change in writing. Please be advised automatic operations such as Systematic Layouts and Automatic Payments have been stopped. Please submit the following documents upon selection of an option: An original certified death certificate for James W Carmody indicating the manner of death_ • The completed Annuity Claimant's Statement_ If you have a copy of the original annuity policy, please return it with the above required documents. Continue the existinq_Annuity Policy as a Beneficiary IRA Prior to continuing the annuity policy as beneficiary, the Required Minimum Distribution(RMD)for the year of the owner's death must be satisfied if it had not been taken by the owner prior to death. Please complete the RMD information in the appropriate section of the Annuity Clainmrit's Statement_ CLMNF001 OCT-24-2014 FBI 10:55 Alf YA1NDT BANK#4344 FAX:7172404526 P, 002 T p {�+ (� A'da,iaismaiveof". TRA Vs111Y ERicx, 4333 F.dgmwd Road NE LIFE INSURANCE COMPANY C &r RAPW xA $2499 wwvw.tesasamrriraanauities.mm 08/13/2014 MICHAEL J CARMODY 4004 BOLEYN TER OLNEY, MD 20832-2160 Annuity Policy Number:02CBT052231 Dear MICHAEL J CARMODY. We have received notification of the death of James W Carmody. We extend our sincere condolences to you for your loss. Our records reflect the following information regarding this annuity policy: Annuitant Name: Jaynes W Carmody Owner dame: James W Carmody Claimant Name: MICHAEL J CARMODY Portion of claim: 33% Annuity Value: $43,765.69 as of 08/10(2414 Annuity Type: Qualified Please complete and return the enclosed forms in order to initiate a death claim on this annuity policy. The following information is being provided to assist you in completing the forms and submitting:the appropriate documentation_ General Information The financial professional of record will remain on this annuity unless we are notified of a change in writing. Please be advised automatic operations such as Systematic Payouts and Automatic Payments have been stopped. Please submit the following documents upon section of an option: • An original certified death certificate for James W Carmody indicating the manner of death. • The completed Annuity Claimant's Statemerrt. If you have a copy of the original annuity policy, please return it with the above required documents. Con ince the existing Annuity Policy as.a Beneficiary IRA Prior to continuing the annuity policy as beneficiary,the Required Minimum Distribution (RMD)for the year of the owner's death must be satisfied if it had not been taken by the owner prior to death. Please complete the RMD information in the appropriate section of the Annuity Claimant's Statement. _....... ...... _........ 10/30/2014 7:54 :03 AM---....PAGE.... - 4/007- Fax Server TO:AceArchive Historical quote information is obtained from sources believed to be reliable,but its accuracy and completeness cannot be guaranteed. The information is being provided for your personal,noncommercial use only. Charles Schwab& Co., Inc. does not give tax advice and is not responsible for performing mathematical computations beyond those presented. ©2003 Charles Schwab&Co.,Inc.All fights reserved.Member SIPC.DTS 05708(0808-4623) LTR13319-06(03/08) Estate Valuation ►. DATE OF DEATH: 08/10/2014 ESTATE OF: JAMES W CARMODY VALUATION DATE: 08/10/2014 ACCOUNT#: 21114167 N PROCESSING DATE: 10/30/2014 #OF SECURITIES: 11 X Id # Security Type CUSIP Symbol Security Description Shares FMV Price Security Value t` 1) CASH CASH 53,292.86 $1.00000 $53,292.86 0 0 2) MUTUAL FUND 23337R817 SCINX DWS INTERNATIONAL 137.157 $50.67000 $6,949.75 (D FUND CL S 3) MUTUAL FUND 2333BF606 KDCSX DWS VALUE SER INC 256.018 $23.30000 $5,965.22 6 Q' 4) MUTUAL FUND 262000105 PEOPX DREYFUS S&P 500 164.576 $51.52000 $8,478.96 £ INDEX FD 6 m 5) MUTUAL FUND 30254T759 FPACX FPA CRESCENT PORT 346.702 $33.90000 $11,753.20 0 6) MUTUAL FUND 471023200 JAGIX JANUS GROWTH AND 230.918 $46.11000 $10,647.63 Lo INCOME FD r- 7) MUTUAL FUND 471023846 JAOSX JANUS OVERSEAS FD 433.084 $36.97000 $16,011.12 0 N 0 8) MUTUAL FUND 560631575 ICSLX MAINSTAY ICAP SELECT 231.251 $49.85000 $11,527.86 m EQUITY 0 9) MUTUAL FUND 808509855 SWPPX SCHWAB CAP TR S&P 411.986 $30.49000 $12,561.45 500 INDEX 10) MUTUAL FUND 808517106 SNXFX SCHWAB 1000 INDEX 654.601 $51.27000 $33,561.39 FD INV SH Page 1 [ ACCOUNT TITLE: U f� JAMES W CARMODY U C O F Estate Valuation !ti DATE OF DEATH: 08/10/2014 ESTATE OF: JAMES W CARMODY a� � VALUATION DATE: 08/10/2014 ACCOUNT#: 21114167 N PROCESSING DATE: 10/30/2014 #OF SECURITIES: 11 x # Security Type CUSIP Symbol Security Description Shares FMV Price Security Value 0 11) MUTUAL FUND 9498413512 WFLNX WELLS FARGO 1,974.188 $14.23000 $28,092.70 0 ADVANTAGE LARGE W 6 Total Value: 198 842.13 a' Total Accrual: 0.00 Total: $198,842,13 CO O LOW t` W 0 O N O m 0 Page 2 [ ACCOUNT TITLE: U fy a6i JAMES W CARMODY U O F Estate Valuation DATE OF DEATH: 08/10/2014 ESTATE OF: JAMES W CARMODY > VALUATION DATE: 08/10/2014 ACCOUNT#: 21114166 N PROCESSING DATE: 10/30/2014 #OF SECURITIES: 10 x u. # Security Type CUSIP Symbol Security Description Shares FMV Price Security Value 1) CASH CASH 19,441.31 $1.00000 $19,441.31 O 1 2) STOCK 060505104 BAC BANK OF AMERICA 1,000 $15.15250 $15,152.50 CORP 3) MUTUAL FUND 068278100 BARAX BARON ASSET FD 115.204 $63.86000 $7,356.93 CL 4) MUTUAL FUND 068278209 BGRFX BARON GROWTH FD 110.603 $70.29000 $7,774.28 5) MUTUAL FUND 068278308 BSCFX BARON SMALL CAP FD 223.654 $33.85000 $7,570.69 N O 6) MUTUAL FUND 262000105 PEOPX DREYFUS S&P 500 139.977 $51.52000 $7,211.62 INDEX FD N d 7) MUTUAL FUND 471023200 JAGIX JANUS GROWTH AND 150.499 $46.11000 $6,939.51 -� INCOME FD O N 0 8) MUTUAL FUND 471023846 JAOSX JANUS OVERSEAS FD 110.886 $36.97000 $4,099.46 M 9) MUTUAL FUND 808509210 SICNX SCHWAB 577.733 $10.07000 $5,817.77 INTERNATIONAL CORE E Page I O ACCOUNT TITLE: P [ JAMES W CARMODY U it CHARLES SCHWAB&CO INC CUST IRA CONTRIBUTORY U Q O E Estate Valuation DATE OF DEATH: 08/10/2014 ESTATE OF: JAMES W CARMODY VALUATION DATE: 08/10/2014 ACCOUNT#: 21114166 PROCESSING DATE: 10/30/2014 #OF SECURITIES: 10 LOk w # Security Type CUSIP Symbol Security Description Shares FMV Price Security Value t` O 10) MUTUAL FUND 808517106 SNXFX SCHWAB 1000 INDEX 150.744 $51,27000 $7,728.64 0 FD INV SH r, w Total Value: 89 092.71 p' Total Accrual: 0.00 £ Total: $89,092.71 N O W W N W H O N O M O Page 2 Q ACCOUNT TITLE: D .ti JAMES W CARMODY CHARLES SCHWAB&CO INC CUST N IRA CONTRIBUTORY v C O F Erie Family Life `A Insurance Member Erie insurance Group • Home Office • 100 Erie Insurance Place • Erie,Pennsylvania 16530 814.870.2000 • Toll free 1.800.458.0811 • Fax 814.870.2437 • www-erieinsurance.com December 12, 2014 Hazen Elder Law 2000 Linglestown Road, Suite 202 Harrisburg, PA 17110 Re : Death Claim on James W. Carmody Policy # EE563315 Dear Attorney Woodhouse : We wish to express our deepest sympathy on this loss . In response to your request for information concerning the policy held by James W Carmody, the information follows : The account number/policy number was EE563315 . The sole owner was James M. Carmody. The value of the policy as of August 10, 2014 was $111, 707 . 22 . The type was a non-qualified annuity. The named beneficiaries were Mark Carmody, Scott Carmody, and Michael Carmody, equally. If you have any questions, please call our office at 1-800-458--0811, extension 4340 . Sincerely, Melody A. Bokshan Supervisor Life Claims Agent & Policyholder Services MB :DSS cc : Fetrow Insurance Assocs LLC, AA7646 ` 4 n L'� g G 2 U 14 it The ERIE Is Above All In Service . Y. I NV SS T MSNT Lr}U 1 4 _. I December 21,2014 CORINNE EGGERS WOODHOUSE C/O HAZEN ELDER LAW 2000 LINGLESTOWN RD STE 202 HARRISBURG,PA 17110 Dear Corinne Eggers Woodhouse As requested, please find the Date of Death and / or Alternate Valuation for the Estate of James W Carmody with Fidelity Investments. All information in the enclosed valuation report(s)is(are)based on assets in the above listed Fidelity account(s)as of the date indicated on the report(s). Valuation information is provided through a third party valuation service provider. The report does not include values for Options, Foreign Currency, or Precious Metals held in the account as of the date of death nor some accrued dividends not distributed prior to the date of death. Fidelity does not warranty the accuracy of this information for any particular purpose nor does Fidelity provide legal or tax advice. Consult with an attorney or tax professional regarding any specific legal or tax situation. FOR TRUST ACCOUNTS: Please note that if the account on the valuation is a trust registration reporting under a social security number(SSN),then the cost basis of 100%of the account will automatically be stepped up. If the trust has an employer identification number(EIN),a separate request must be submitted.The letter must include the following three items: 1. A statement that the trust qualifies under the IRS regulation to receive a step up 2. The percentage of the trust that should be stepped up 3. The signature of a currently acting trustee The request to update cost basis should be sent directly to: Fidelity Investments ATTN: Cost Basis 100 Crosby Pkwy, Mailzone KCI K-PR Covington, KY 41015 We hope this information is helpful. If you have any questions about account holdings or need instructions on how to transfer the ownership of the accounts not yet transferred,please visit us at Fidelity.com and search under"Change Account Registration"or call us at 800-544-0003. Fidelity Inheritor Services Representatives are available Monday through Friday from 8:00 a.m. to 6:30 p.m. Eastern time. Sincerely, Fidelity Investments Our file: W902572-1 1 DEC14 Enclosures: Return Envelope Date of Death Valuation J1. -J'111,1_11,' Brokerage Services provided by Fidelity Brokerage Services LLC Member NYSE,SIPC Clearing,custody and settlement services by National Financial Services LLC Member NYSE,SIPC P.O.Box 770001,Cincinnati,OH 45277-0034 ? ,fl, -1 o m rn O rd (o .. N ��-I 10 Q N m (d -H -H >1 rn rn O CJ > 4-4 1J -j r -rl O-,q (Z -.-i 00 00 3: ro �-I H N Q) U) U) H .t-) U N U r1 ro N r1 N (d ,, O Q (l)-H M > (d rn w N h N •• 44 O 'J M N O o d c Lj O I E- N H -U} 1-) N ?4 (d (d O (0 �j 44 r1 co J-) W > U H M W !Z H U Q O U U ?-I U) o U \ r,oo H O 'o N Orl U1 (d � �.o > U) N N �$ M cd •r--) (Y) U) N ro ?i } FCS U) C O H U U - O H U) O �--I CD a U) 10o -H N W M U) � M �i O Iti O rl O a �J o (d r1 r (f O sG > o d Ul N M a rt M 41 -A (d H U) M -) W OO W (n O W Cq 4-4 00 �o O H o N v �o U i �j 41 M 'd (d O to U) �+ 04 E E1 O H (d -u CY 7 W ro Q N Z 4-3 W H (d a .0 aj a co U H W (d J co rl H t-) O O Q do -r1 U O O O .tU pa H N Ql U) N N N -H -rl H — N v (d (1I �-4 a o U U 0 0 -1 �j U W -( rn r1 1--I -A N U (n () -- — I--- N (1) H 00 m O 00 CO N U) F", O �4 O O -1 00 Q+ C� r LO L} U] v 61 3 41 (d M rl rl -Li (d Q U) ?-1 lO ;7 (d (d � Q Q) (d Ln r1 ;J 4-) a� rs a (d �-A O o > U E- -11, -+ CZ 4-4 •OH U) Cr!) O ri FC O -W U) (d (d N 4-t O � U + O (d H .t-) r-I O F- -W n� > a Eo-+ E Q MBTBank 499 Mitchell Road,Millsboro,DE 19966 Records Management Phone 888-502-4349 F ax (302)934-2955 October 24,2014 Hazen Elder Law 2000 Linglestown Road Suite 202 Harrisburg, PA 17110 Re: Estate of James W. Carmody Social Security: Date of Death: Aujzust 10, 2014 Dear Sir or Madam: Per your inquiry on October 20, 2014, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 21675864 Ownership(Names oj9 James W. Carmody Scott W. Carmody Opening Date 08/28/1964 Balance on Date of Death $ 44,729.28 Accrued Interest $ .32 Total $ 44,729.60 2. Type of Account Checking Account Account Number 950744310 Ownership(Names ofi James W. Carmody �ficha�l�'-Ge'r�e�fF9�4j" Scott W. Carmody i i-13 Opening Date 01/15/2002 Balance on Date of Death $ 21,289.81 Accrued Interest $ .04 .................._..................................................................................................r� o ._................. _ '- Total $ 21,289.85 �� �/ LL' CT n 2014 . 3. Type of Account Individual Retirement Account Account Number 35004202556849 Ownership(Names ofi James W. Carmody Opening Date 06/15/2011 Balance on Date of Death $ 111,538.72 Accrued Interest $ 102.27 ... ....................._........................................................................_..........._................ Total $ 111,640.99 4. Type of Account Irrefirota4 Retirneal9ssearfat C�t,2� T+ t'o c �'¢' �. Account Number 31003923040627 ll�• V Ownership(Names of James W. Carmody Michael J. Carmody(POA) Opening Date 08/07/2013 Balance on Date of Death $ 107,815.04 Accrued Interest $ 2,418.07 _..........__............................._..._...._............._...... ........................... Total $ 110,233.11 5. Type of Account Safe Deposit Box Box Number/Location 196/fiampden Ownership(Names of) James W.Carmody Opening Date 12/07/2005 For any additional information on the above accounts,including ownership and any changes,closures and/or reimbursement of funds, please call the Hampden at 717-255-2293. We were unable to locate any safe deposit box for the above-mentioned decedent. This letter does not include any accounts in which the deceased may have been listed as Power of Attorney,Custodian of Uniform Transfers, Representative Payee,or Trustee under a Written Agreement Sincerely, Valarie Mercer Records Management