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HomeMy WebLinkAbout05-15-15 1505610140 REV,1500 EX (02-11)(FI) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 1 4 1 0 4 8 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1 0 2 3 2 0 1 4 1 2 0 3 1 9 4 3 Decedent's Last Name Suffix Decedent's First Name MI C 0 0 L E Y C A R O L A (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 FILL IN APPROPRIATE OVALS BELOW 0 1.Original Return 2.Supplemental Return 3. Remainder Return(Date of Death Prior to 12-13-82) 4.Limited Estate ❑ 4a.Future Interest Compromise(date of 5. Federal Estate Tax Return Required death after 12-12-82) ❑X 6.Decedent Died Testate 7.Decedent Maintained a Living Trust 1 8.Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) 9.Litigation Proceeds Received 10.Spousal Poverty Credit(Date of Death 11.Election to Tax under Sec.9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number S U S A N J H A R T M A N 7 1 7 2 4 9 7 7 8 0 r REGISTER OF WILLSSE ONLY 70. cn �, rn c o rn n First Line of Address :;0 o 1 I R V I N E R 0 W r V__A ,,-t1771 Second Line of Address :Y t1 i CD l.� j 3 -r� City or Post Office State ZIP Code D'TE FILE r C A R L I S L I P A 1 7 0 1 3 Cil U' ©' Correspondent's e-mail address: SUsan@duncanhartmanlaW.com Under penalties of perjury,1 declare 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 FOR FILING RETURN f DAT G->, M..e . ADDRESS 6003 S YHAVEN LANE SPRING TX 77379 SIGNATU F PREPARER OTHER WN REPRESENT TIVE ATE Z PSD SS PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610140 1505610140 J 1505610240 REV-1500 EX(FI) Decedent's Social Security Number Decedent's Name: CAROL A • C O O L E Y RECAPITULATION 1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . 1. 2 3 3 6 9 1 . 2 5 2. Stocks and Bonds(Schedule B) . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . 2• 7 9 1 8 8 4 . 6 0 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) . . . . . 3. 4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . 5. 3 2 5 3 7 . ❑ 7 6. Jointly Owned Property;(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. 7. Inter-Vivos Transfers&Miscellaneous N n-Probate Property (Schedule G) Separate Billing Requested . . . . . . . 7. 6 ❑ 9 6 7 9 . 1 ❑ 8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 1 6 6 7 7 9 2 . 0 2 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9. 1 ❑ 8 ❑ 7 • 5 7 10. Debts of Decedent, Mortgage Liabilities,and Liens Schedule I 10. 1 3 3 5 6 . 9 8 11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 2 4 1 6 4 . 5 5 12. Net Value of Estate(L•ine 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 1 6 4 3 6 2 7 . 4 7 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . 14. 1 6 4 3 6 2 7 . 4 7 TAX CALCULATION-SEE'INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxdble at the spousal tax rate,'or transfers under Sec.9116 (a)(1.2)X.0 _ ❑ . ❑ ❑ 15. ❑ . ❑ ❑ 16. Amount of Line 14 taxable at lineal rate X.045 1 6 4 3 6 2 7 . 4 7 16. 7 3 9 6 3 . 2 4 17. Amount of Line 14 taxable at sibling rate X.12 ❑ . ❑ ❑ 17. ❑ . ❑ ❑ 18. Amount of Line 14 taxable at collateral rate X.15 0 • ❑ 0 18. 0 • 0 0 19. TAX DUE . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 7 3 9 6 3 . 2 4 20. FILL IN THE OVAL IFYOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑X 'J t Side 2 15056101240 1505610240 J S REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: 21 14 1048 DECEDENT'S NAME CAROL A. COOLEY STREET ADDRESS 9 JOSEPH DRIVE CITY STATE ZIP BOILING SPRINGS PA 17007 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 73,963.24 2. Credits/Payments A.Prior Payments 69,000.00 B.Discount 3,631.47 Total Credits(A+B) (2) 72,631.47 3. Interest (3) 4. If Line 2 is greater than Line 1+Line 3,enter the difference.This is the OVERPAYMENT. Fill in oval on Page 2,Line 20 to request a refund. (4) 0.00 5. If Line 1+Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 1,331.77 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 ...................................................................... El0 b. retain the right to designate who shall use the property transferred or its income ...........I................... El0 c. retain a reversionary interest ..................................................................................................... ❑ X❑ d. receive the promise for life of either payments,benefits or care? ....................................................... ED❑ 2. If death occurred after December 12,1982,did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ❑ ❑X 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death? ......... ❑ 0 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation?.................................................................................................. 191 ❑ 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 Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an adoptive parent or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in(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) pennsylvania SCHEDULE A DEPARTMENT OF REVENUE REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: CAROL A. COOLEY 21 14 1048 All real property owned solely or as alenant in common must be reported at fair market value.Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the,relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1. 9 JOSEPH DRIVE 233,691.25 BOILING SPRINGS, PA 17007 [SEE HUD SHEET ATTACHED] TOTAL(Also enter on Line 1,Recapitulation.) $ 233 691.25 If more space is needed,use additional sheets of paper of the same size. REV-1503 EX+(8-12) pennsylvania ' SCHEDULE B DEPARTMENT OF REVENUE INHERITANCE TAX RETURN STOCKS & BONDS RESIDENT DECEDENT ESTATE OF FILE NUMBER CAROL A. COOLEY 21 14 1048 All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. FIDELITY INVESTMENTS ACCT. #2EA-913619 62,271.36 [SEE DOD LETTER ATTACHED] 2. DEUTSCHE ASSET&WEALTH MANAGEMENT ACCT. #26217414 43,379.86 [SEE DOD LETTER ATTACHED] 3. HARBOR FUNDS ACCT. #00121866 47,568.07 [SEE DOD LETTER ATTACHED] 4. MERRILL LYNCH - BLACKROCK BAL. CAP. FUND ACCT. #22Z-46394 82,525.16 [SEE DOD LETTER ATTACHED] 5. MERRILL LYNCH - BLACKROCK BASIC VAL. FUND ACCT. #22Z-46394 26,880.49 [SEE DOD LETTER ATTACHED] 6. AMERICAN CENTURY ACCT.#022-316987696 54,507.91 [SEE DOD LETTER ATTACHED] 7. COLUMBIA MANAGEMENT ACCT. #540-00540005049 44,701.24 [SEE DOD LETTER ATTACHED] 8. MERRILL LYNCH DIRECT DEPOSIT PROGRAM 4,806.00 [SEE DOD LETTER ATTACHED] 9. JANUS FUND ACCT. #41-308106294 27,844.58 [SEE DOD LETTER ATTACHED] 10. OAKMARK FUNDS (110) ACCT. #8000199198 61,110.11 [SEE DOD LETTER ATTACHED] 11. OAKMARK FUNDS (808)ACCT. #8000199198 29,366.96 [SEE DOD LETTER ATTACHED] 12. THE ROYCE FUNDS ACCT. #265-880027796 38,848.53 [SEE DOD LETTER ATTACHED] 13. VANGUARD WINDSOR II FUND ACCT. #09896745017 41,697.83 [SEE DOD LETTER ATTACHED] 14. WELLS FARGO ADVANTAGE FUNDS ACCT.#3212-3903093500 57,595.83 [SEE DOD LETTER ATTACHED] 15. FAM FUNDS ACCT. #28474-00 53,538.44 [SEE DOD LETTER ATTACHED] 16. HENESSEY FUNDS ACCT. #521273 53,204.76 [SEE DOD LETTER ATTACHED] TOTAL(Also enter on Line 2,Recapitulation) $ 791 884.60 If more space is needed, insert additional sheets of the same size Continuation of REV-1500 Inheritance Tax Return Resident Decedent CAROL A. COOLEY 21 14 1048 Decedent's Name Page 1 File Number Schedule B -Stocks& Bonds ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 17. TWEEDY, BROWNE FUND INC. ACCT. #1019179278 62,037.47 [SEE DOD LETTER ATTACHED] SUBTOTAL SCHEDULE B 62,037.47 GRAND TOTAL SCHEDULE B $ 791,884.60 REV-1508 EX+(08-12) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF: FILE NUMBER: CAROL A. COOLEY 21 14 1048 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. M&T BANK ACCOUNT#3740136985 18,905.07 [DOD LETTER ATTACHED] 2, 2000 TOYOTA COROLLA 1,177.00 [KELLEY BLUE BOOK VALUE ATTACHED] 3. CARLISLE REGIONAL MEDICAL CENTER REFUND 275.76 4. PERSONAL PROPERTY 155.00 5. PROCEEDS OF YARD SALE 3,430.00 6. QUANTUM IMAGING REFUND 11.35 7. CARLISLE PROPANE CO. REFUND 126.87 8. FOREST PARK HEALTH CENTER REFUND 4,316.76 9. ERIE INSURANCE REFUND 103.00 10. ERIE INSURANCE REFUND 6.00 11. ERIE INSURANCE REFUND 11.00 12. JEWELRY& MISC. ITEMS -SAFE DEPOSIT BOX CONTENTS 3,743.50 [SEE APPRAISAL ATTACHED] 13. CARLISLE REGIONAL MEDICAL CENTER REFUND 275.76 i . TOTAL(Also enter on Line 5,Recapitulation) $ 32,537.07 If more space is needed,use additional sheets of paper of the same size. REV-1510 EX+(08-09) pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER CAROL A. COOLEY 21 14 1048 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OFTHETRANSFEREE,THEIR RELATIONSHIP TODECEDENrAND DATE OF DEATH %OFDECD'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER.ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IFAPPUCA8l17 VALUE 1. FIDELITY BALANCED ACCT. #216-742647 IRA 539,054.45 100.00 . 539,054.45 DAVID A. COOLEY, SON [SEE DOD LETTER ATTACHED] 2. MERRILL LYNCH-BLACKROCK IRA ACCT. #28x-46394 24,513.67 100.00 24,513.67 DAVID A. COOLEY, SON [SEE DOD LETTER ATTACHED] 3. DODGE &.COX FUNDS.IRA ACCT. #300119363 24,455.21 100.00 24,455.21 DAVID A. COOLEY, SON [SEE DOD LETTER ATTACHED] 4. HENNESSY FUND IRA ACCT. #521274 21,655.77 100.00 21,655.77 DAVID A. COOLEY, SON [SEE DOD LETTER ATTACHED] i f I TOTAL (Also enter on Line 7,Recapitulation) S 609 679.10 If more space is needed,use additional sheets of paper of the same size. I REV-1511 EX+(08-13) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN RESIDENT DECEDENT ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER CAROL A. COOLEY 21 14 1048 Decedents debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. EWING BROTHERS FUNERAL HOME 4,857.65 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State ZIP Year(s)Commission Paid: 2. Attorney Fees: DUNCAN & HARTMAN, PC 4,000.00 3. Family Exemption:(If decedents address is not the same as claimants,attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: REGISTER OF WILLS 1,195.00 5 Accountant Fees: 6. Tax Return Preparer Fees: 7. CUMBERLAND LAW JOURNAL- LEGAL NOTICE 75.00 8. THE SENTINEL-LEGAL AD 179.92 9. HELD IN RESERVE 500.00 r TOTAL(Also enter on Line 9,Recapitulation) $ 10 807.57 If more space is needed,use additional sheets of paper of the same size. REV-1512 EX+(12-12) pennsylvania ' SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER CAROL A. COOLEY 21 14 1048 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. MET-ED 260.93 2. VERIZON 7.71 3. AMERICAN EXPRESS 3,338.02 4. CENTURYLINK 416.50 5. ORKIN 86.47 6. CUMBERLAND GOODWILL FIRE RESCUE EMS 82.28 7. CHASE CARD SERVICES 1,240.13 8. FOREST PARK HEALTH CENTER 263.20 9. HOME CARE ASSISTANCE 230.00 10. A TOUCH OF GRASS- LAWN CARE 752.60 11. CENTURYLINK 8.32 12. CARLISLE REGIONAL MEDICAL CENTER 1,037.91 13. IBIS APPRAISAL SERVICES LLC -JEWELRY APPRAISAL 300.00 14. REBECCA HEIN' 372.68 15. DR. JAMES HAR;DESTY 40.00 TOTAL(Also enter on Line 10,Recapitulation) $ 8,456.98 If more space is needed, insert additional sheets of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent CAROL A. COOLEY 21 14 1048 Decedent's Name Page 2 File Number Schedule I -Debts of Decedent, Mortgage Liabilities, & Liens ITEM NUMBER DESCRIPTION AMOUNT 16. SIRIUS RADIO 20.23 17. U.S. TREASURY 2014 INCOME TAX 4,000.00 18. PA DEPARTMENT OF REVENUE 2014 INCOME TAX 900.00 SUBTOTAL SCHEDULE 1 4,920.23 GRAND TOTAL SCHEDULE 1 $ 13,356.98 REV-1513 EX+(01-10) pennsylvania. SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: - FILE NUMBER: CAROL A. COOLEY 21 14 1048 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec.9116(a)(1.2).j 1. DAVID A. COOLEY. Lineal 6003 SKYHAVEN LANE 100% SPRING, TX 77379 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: 1 A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed,use additional sheets of paper of the same size. REV-1500 Discount, Interest and Penalty Worksheet Discount Calculation Total Amount Paid within three calendar months of the decedent's date of death: 69,000.00 Discount: 3.631.47 Interest Table Year Days Delinquent Balance Due Interest. this time period this year this period Before 1981 1982 1983 1984 1985 1986 1987 1988 through 1991 1992 1993 through 1994 1995 through 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 through 2014 TOTALS Penalty Calculation If the decedent's date of death was on or before March 31, 1993, insert the applicable amount: Total Balance Due on January 17, 1996: Penalty: LAST WILL TESTAMENT OF CAROL A. COOLEY, of 9 Joseph Drive, Boiling Springs, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking any and all other wills and codicils heretofore made by me. FIRST. I direct that all my just debts and funeral expenses be paid from my estate as soon after my death as practically and conveniently may be done. SECOND. I direct that my remains be interred within my family's burial plot in accord with my expressed wishes. THIRD. I authorize my personal representative to expend funds from my estate, in such amounts as my personal representative shall consider necessary and desirable for the purchase, erection and inscription of a suitable marker for my grave. FOURTH. I give, devise and bequeath any and all tangible personal property owned by me at the time of my death unto my husband, DENNIS E. COOLEY, provided he survives me by thirty (3 0) days. In the event he fails to survive me by thirty (3 0) days, I give, devise and bequeath all said tangible personal property unto my son, DAVID A. COOLEY, per stirpes. FIFTH. I give, devise and bequeath any and all real estate owned by me at the time of my death, unto my husband, DENNIS E. COOLEY, provided he survives me by thirty days. In the event he fails to survive me by thirty (3 0) days, I give, devise and bequeath all said real estate unto my son DAVID A. COOLEY, per stirpes. SIXTH. I give, devise and bequeath all the rest, residue and remainder of my estate unto my husband, DENNIS E. COOLEY, provided he survives me by thirty (30) days. In the event he fails to survive me by thirty(30) days, I give, devise and bequeath all the rest, residue and remainder of my estate unto my son,DAVID A. COOLEY, per stirpes. SEVENTH. I direct that any and all Inheritance,Estate and Transfer taxes imposed upon my estate passing under my will or otherwise, shall be paid out of the principal of my residuary estate. EIGHTH. I hereby nominate, constitute and appoint my husband,DENNIS E. COOLEY as Executor of this my Last Will and Testament. In the event of renunciation, death, resignation or inability to act for any reason whatsoever of DENNIS E. COOLEY, I nominate, constitute and appoint my son, DAVID A. COOLEY as Executor of this my Last Will and Testament. I hereby relieve my Executor from the necessity of posting security in connection with his duties, as such, in any jurisdiction in which he may be called upon to act insofar as I am able by law to do so. In addition to the powers conferred by law, I authorize my Executor, in his absolute discretion, to retain in the form received, and to sell either at public or orivate sale anv real or personal nronertv owned by me at the time of my death. NINTH. I have made, or may from time to time make, a written memorandum expressing my desire to give certain items of personal property to specific persons. I urge my Executor and beneficiaries to respect these wishes. Such a memorandum, if made, shall be stored in conjunction with this Will. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of two typewritten pages this // ay of p,; i ) 2002. CAROL A. COOLEY Signed, sealed, published and declared by the above named Testatrix CAROL A. COOLEY as and for her Last Will and Testament, in the presence of us, who, at her request, in her sight and presence and in the sight and presence of each other, have hereunto subscribed our names as witnesses. r l�1 9 COMMONWEALTH OF PENNSYLVANIA . SS. COUNTY OF CUMBERLAND I, CAROL A. COOLEY, Testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will;that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. CAROL A. COOLEY Sworn or affirmed to and acknowledged before me,by CAROL A. COOLEY this /e,day NOTARIAL SEAL of A p . Cynthia L.Carr,Notary Public County of Cumberland South Middleton TwP•, ices Aug 14 2004 My Commission Exp tary Public COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF CUMBERLAND We, and I-, M u v,m e t the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw CAROL A. COOLEY sign. and execute the instrument as her Last Will;that she signed willingly and that she executed as her free and voluntary act for the purposes therein expressed;that each of us in the hearing and sight of the Testatrix signed the will as witnesses; and that to the best of our knowledge, the Testatrix was at that time eighteen(18) or more years of age, of sound mind and under no constraint or undue influence. ` Sworn or affirmed to and subscri"bbre/me� b Uy� SO and OL u , witnesses, thi /6 day of ! N ary Public NOTARIAL SEAL Cynthia L.Darr,Notary Public South Middleton Twp.,County of Cumberland My Commission Expires Aug. 14,2004 C.Note:This form is furnished to give you a statement of actual settlement costs.Amounts paid to and by the settlement agents are shown.Items marked I "(p.o.c)"were paid outside the closing;they are shown here for informational purposes and are not included in the totals. D.Name&Address of Borrower: E.Name&Address of Seller: F.Name&Address of Lender: Dean A.Myers,Lisa M.Myers Carol A.Cooley Estate G.Property Location: H.Settlement Agent: I.Settlement Date:01/08/2015 9 Joseph Drive 1st Advantage Settlement Services Inc. Disbursement Date:01/08/2015 Boiling Springs,PA 17007 6375 Mercury Drive,Suite 102,Mechanicsburg,PA 17050 South Middleton Township 717-591-7755 Place of Settlement: TitleExpress 6375 Mercury Drive,Suite 102,Mechanicsburg,PA 17050 Printed 01/07/2015 at 3:28 pm by VW J-Summary of Borrowees Tranisiaction K Summary of Sellees Transaction 100. Gross Amount Due from Borrower 400. Gross Amount Due to Seller 101. Contract sales price 242,000.00 401. Contract sales price 242,000.00 102. Personal property 402. Personal property 103. Settlement charges to borrower(line 1400) 4,114.00 403. 104. 404. 105. 405. Adjustments for items paid by seller in advance Adjustments for items paid by seller in advance 106. City/town taxes to 406. City/town taxes to 107. County taxes to 407. County taxes to 108. School Taxes 01/08/2015 to 06/30/2015 1,023.66 408. School Taxes 01/08/2015 to 06130/2015 1,023.66 109. 409. 110. 410. 111. 411. 112. 412, 120. Gross Amount Due from Borrower 247,137.66 420. Gross Amount Due to Seller 243,023.66 200. Amounts Paid by or in Behalf of Borrower 500. Reductions In Amount Due to Seller 201. Deposit or earnest money 2,500.00 501. Excess deposit(see instructions) 202. Principal amount of new loan(s) 502. Settlement charges to seller(line 1400) 17,668.50 203. Existing loans taken subject to 503. Existing loans taken subject to 204. 504. Payoff of first mortgage loan 205. 505. Payoff of second mortgage loan 206. 506. 207. 507. 208. 508. 209. Seller Credit 1,000.00 509. Seller Credit 1,000.00 Adjustments for items unpaid by seller Adjustments for items unpaid by seller 210. City/town taxes to 510. City/town taxes to 211. County taxes 01/0112015 to 01/08/2015 11.91 511. County taxes 01/01/2015 to 01/08/2015 11.91 212. School Taxes to 512. School Taxes to 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220• Total Paid by/for Borrower 1 3,511.91 520. Total Reduction Amount Due Seller 18,680.41 300. Cash at Settlement fromlto Borrower 600, Cash at Settlement tolfrom Seller 301. Gross amount due from borrower(line 120) 247,137.66 601. Gross amount due to seller(line 420) 243,023.66 302. Less amounts paid by/for borrower(line 220) 3,511.91 602. Less reductions in amount due seller(line 520) 18,680.41 303. Cash ❑X From ❑ To Borrower 243,625.75 603. Cash ❑X To ❑ From Seller 224,343.25 epo ng-den 1or is co eco o in orm ion e a menu es pet response a co ec mg,--mg,an repo ins e a a is agency may no c e is n erme n,an yeu ata np require a comp e e (his fpm/,unless it displays a curtenlly volitl OMa cenlml numbers Np-Adenllcllly Is a..Z.gis disclosure Is mandatory.This Is tleslgnetl to provide the patties to a RESPA rnvercd irensacllan wllh infpnnalion during iha settlement pmcess. 700. Total Real Estate Broker Fees $4,300.00 Paid From Paid From Division of commission line 700 as follows: Borrower's Seller's 701. $4,300.00 to Re/MaxlstAdvantage Funds at Funds at 702• $0.00 to Settlement Settlement 703. Commission paid at settlement 4,300.00 800. Items Payable in Connection with Loan 801. Our origination charge (Includes Origination Point 0.000%or$0.00) $ (from GFE#1) 802. Your credit or charge(points)for the specific interest rate chosen $ (from GFE#2) 803. Your adjusted origination charges (from GFE A) 804. Appraisal fee to (from GFE#3) 805. Credit report to (from GFE#3) 806. Tax service to from GFE 43 807. Flood certification to from GFE#3 808. to 900. Items Required by Lender to be Paid in Advance 901. Daily interest charges from from 01/08/2015 to 02/01/2015 @$0.00/day (from GFE#10) 902. Mortgage Ins.Premium for months to (from GFE#3) 903. Homeowner's insurance for months to (from GFE#11) 904. months to from GFE#11 1000. Reserves Deposited with Lender 1001, Initial deposit for your escrow account (from GFE#9) 1002.Homeowner's insurance months @$ 0.00/month $ 1003.Mortgage Insurance months @$ 0.00/month $ 1004.City Property Tax months $ 0.00/month $ 1005.County Property Tax months $ 51.74/month $ 1006.School Taxes months @$ 178.94/month $ 1007.Aggregate Adjustment $ 1100.Title Charges 1101.Title services and lender's title insurance $ from GFE#4 1102.Settlement or closing fee to $ 1103. Owner's title insurance-First American Title Insurance Company $ from GFE#5 1,610.00 1104. Lender's title insurance-First American Title Insurance Company $ 1105. Lender's title policy limit$0.00 Lender's Policy 1106.Owner's title policy limit$242,000.00 Owner's Policy 1107.Agent's portion of the total title insurance premium $1,368.50 to 1 st Advantage Settlement Services Inc. 1108. Underwriter's portion of the total title insurance premium $241.50 to First American Title Insurance Company 1109. 1110. Notary to Vickie Welker 5.00 1111.Tax Certification Fee to 1 st Advantage Settlement 10.00 Services Inc. 1200. Government Recording and Transfer Charges 1201. Government recording charges $ (from GFE#7) 79.00 1202• Deed$79.00 Mortgage$ Release$ 1203.Transfer taxes $ (from GFE#8) 2,420.00 1204.City/County tax/stamps Deed$2,420.00 Mortgage$ 1205.State Tax/stamps Deed$2,420.00 Mortgage$ 2,420.00 1206. Deed$ Mortgage$ 1207. $ 1300.Additional Settlement Charges 1301.Required services that you can shop for (from GFE#6) 1302.Reimbursement for Septic Repairs to Tracy Wei el 150.5 1303.Home Warranty to American Home Shield 450.0 1304.Attorney Fees to Duncan&Hartman 500.0 1305. Septic Inspection to Eco Tech $475.00 P.O.C.13 1306. Roof Repair to Pennsylvania Roofing Co. 250.00 1307.Reimbursement Septic Pumping to Tracy Weigel 240.00 1308. Inspection to Peck's Septic Service $161.46 P.O.C.B 1309. Escrow of Inheritance Tax to 1st Advantage Settlement 1 9,348.00 r r r r 4,114.00 1 17,668.50 HUD CERTIFICATION OF BUYER AND SELLER I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief,it is a true and accurate statement of all receipts and disbursements made on my account or by me in this transaction.I further certify that I have received a copy of the HUD-1 Settlement Statement. Dean A.Myers r Lisa M.Vyers Aar-oote.�st SeftlementAgent The HUD-1 Settlement Statement which I have prepared is a true and accurate account of this transaction.1 have caused or will cause the funds to be disbursed in accordance with this statement. ,5- SETTLEMENT At;E / DATE OFidefifv, furs January 05,2015 DAVID A COOLEY 6003 SKYHAVEN LN SPRING,TX 77379-2440 Dear David A Cooley: As requested,please find the Date of Death Account Valuation for the Estate of Carol A Cooley. Estate Valuation Account Number: 2EA913619 Individual TOD Value Date: 10/23/2014 Share Symbol Security Description Qty Value Price FSPHX FIDELITY SELECT HEALTH CARE 283.968 $62,271.36 $220.00 Total Securities: $62,271.36 Estate Valuation Account Number: 216742647 IRA BDA Value Date: 10/23/2014 Share Symbol Security Description Qty Value Price FBALX FIDELITY BALANCED 3769.235 $84,581.64 $22.44 FEQIX FIDELITY EQUITY INCOME 4972.683 $299,554.42 $60.24 RTN RAYTHEON CO COM NEW 1067.846 $104,269.82 $97.65 FSEVX SPARTAN EXTENDED MARKET INDEX FD ADV 950.968 $50,648.56 $53.26 Total Securities: $539,054.44 Cash/Money Markets: $0.01 $1.00 Total Value: $539,054.45 All values included represent the Fair Market Value(FMV)of assets held in the account as of the owner's date of death.The report does not include Limited Partnerships,Options,Precious Metals or Worthless Security positions held in the account as of the date of death nor any accrued dividends not distributed prior to the date of death. Values for any accounts that only hold those asset types are therefore,not included. 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. DOI INI'WBrokerage Services provided by Fidelity Brokerage Services LLC MemberNYSE,SIPC Clearing,custody and settlement services by National Financial Services LLC Member NYSE,SIPC P.O.Box 770001,Cincinnati,OH 45277-0034 Deutsche Asset P.O.Box 219151 & Wealth Management Kansas City MO 64121-9151 January 27, 2015 David.A Cooley 6003 Skyhaven Ln Spring TX 77379-2440 Inquiry#: 21180726 Fund: Deutsche Global Growth Fund-S ............. ........... Account#: XXXXXXX7414 Registration: Carol A Cooley TOD David A Cooley Poa Dear Mr. Cooley: I am writing in regard to our recent telephone conversation. Balance of Account Below I have provided the number of shares, share price, and dollar value of the fund in this account as of October 23, 2014. Fund Name (Class S) Number of Share Dollar Value Shares Price I Deutsche Global Growth Fund 1,529.075 $28.37 $43,379.86 Contact Us If you have any questions,please contact one of our Shareholder Services representatives at(800) 728-33337. A representative will gladly assist you Monday through Friday between the hours of 7:00 a.m. and.7-00 p.m. Central Time. Sincerely, '�Ie tra'14io Mutual Fund Representative Harbor Funds December 4, 2014 David A Cooley 6003 Skyhaven Ln Spring TX 77379-2440 RE: Harbor Funds Account for Carol A. Cooley REF 00121866..._ Dear Mr. Cooley, This letter is in response to your request for the date of death value for the above referenced account held by Carol A. Cooley. Our records indicate that on October 23,2014,this account held shares in: Harbor International Fund Net Asset Value (NAV) $66.43/share Total Shares Owned 716.063 shares Account Value $47,568.07 If you have any questions, please contact one of our Shareholder Services Representatives at 800- 422-1050, Monday through Friday,from 8:00 a.m.to 6:00 p.m. Eastern time. Sincerely, Ivan Simic Harbor Funds P.O. Box 804660 Chicago,Illinois 60680-4108 800-422-1050 1 www.harborfunds.com / 0 \.� p n : m _ m/ a\ \ƒ = / q 2«O (0 CD Gg� E 3 _ I e®> ■ m 2 z >\ $ 7 ƒ x$0 « a ■� w O : «\ G \ E \ R \ R 0 ® $ f$ 0 0 s . o / \_ $ .o= MCD \ % % \ / \\ \ -u\ § kms O / / 0 / $0 / /0 / 0 A # f/ Z ¥ CO /% 0 0 / k� 20+ ƒ �\ �� 0 \ g . 2 O ¥ \ m \ k � p x $ ? k » O . . 0 0 / ƒ $ / f cr k « 0 $ �_ 1 @ c CD CL k� \ \� _ ƒ ° O 3 S \ \ ■ § � CD / .. ., 2. CO $ e c \ $ \ / E \ \ \ " 0 0 0 0 # # O . q . ° § ( C .. .. 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CL S; z so 01 sr K mns M rD' @ 0 :r 06 w CL w co a < U) In 0 c 00 = i6 2� m V) 'CDD CL 00 Gl U) 10cwi 00 0 L:� (D ow0 V3 0 a :3 2 C�< a to in o rL P, 60 :3 CD 0.0 3 0 0 CD T, M CO CD0 ::1 y ('D ID 5'(D CD :7 0 t5 — 2 M 0) CD '2- o ='5 'C:2D' '00 -0 CD 0 ( C eL mLn. 2 Lb. :3 _0 0 CD V F 0 g : -.' CD CD 0 0 -3 M M >CL to U) CD 0 CD W M w pi P,:) I Po- 64 tr oo M CD CD 9 3 CD 0 0 C2. m CD CD CL Z 0 OR CD CL CL 0 cr W UM3 CL X fD N) C) > 2 CL 68 I %C, 5; 0:) (D 0 :' X Ul M E12 co December 4,2014 American Century Investments- DAVID A COOLEY 6003 SKYHAVEN LN SPRING, TX 77379 - — Dear Clients_.. This letter provides the value(s)of account(s)for T.O.D.. As-of-Date Fund Accounts Account Registration Account Share CUSIP Value Balance 10/23/2014 0000022 316987696 Individual Transfer on Death $54,507.91 1,519.596 Not (TOD)Designation Provided If any of the above accounts are IRAs, please note the following: Shares held in a retirement account that is registered under the Internal Revenue Code may not be assigned or pledged to a third party. It is possible that the above information should not be considered in any way in a financial institution's determination of eligibility for financing, including establishing creditworthiness. Loans are not an option for IRAs and Roth IRAs. The value of an account may fluctuate daily in accordance with changes in the market value of the mutual fund shares held in the account. You can calculate the share price for each account by dividing the account value by the share balance. For example, if the account value is$100 and the share balance is 5 shares,the share price is$20 ($100/5 shares). American Century Investments American Century Investments 463121 P.O.Box 419200 (800)345-2021 Kansas City,MO 64141.6200 amedcancenturycom CL-SiA-78851 1305 Columbia Management Columbia Management Investment Services Corp. December 10,2014 P.O. Box 8081 Boston, MA 02266-8081 DAVID COOLEY 6003 SKYHAVEN LN SPRING TX 77379-2440 RE: CORRESPONDENCE# 00778163 CAROL A COOLEY TOD BENEFICIARY INFORMATION ON FILE Dear Mr.Cooley: ...... . ..... ...... .. .......- .... .............. Thank you for contacting Columbia Funds. Listed below is the account balance information that you requested. As of October 23,2014,the balance of Carol A.Cooley's Transfer on Death(TOD)account was as follows: Account Balance Share Balance Net Asset Value(NAV) $44,701.24 1,379.668 $32.40 If you have any further questions or concerns,please feel free to call our office toll-free at 1-800-345-6611. Our Client Service Representatives are available Monday through Friday between 8:00 a.m. and 7:00 p.m.Eastern Time and will be happy to assist you. Please use the correspondence reference number listed above when inquiring about this item. Sincerely, Columbia Management Investment Services Corp. Securities products offered through Columbia Management Investment Distributors,Inc.,member FINRA J A N U S 21 December 5,2014 DAVID A COOLEY 6003 SKYHAVEN LN SPRING TX 77379-2440 REFERENCE: 02217224 ACCOUNT NUMBER 308106294 CAROL A COOLEY Dear Mr. Cooley: This fetter is in response to your request for Janus account information.The account information provided below is unaudited. Date Fund/Account Number Transaction Share Price Shares Dollar.Amount 10/23/14 41/308106294 Balance $61.41 453.421 $27,844.58 If you have any questions, or if Janus may be of additional assistance, please contact us at 800- 525-3713 or visit us online at janus.com. Representatives are available Monday through Friday from 9:00 a.m.to 6:00 p.m. Eastern rime. Sincerely, Elaine Atcheson Investor Services ZAUJAN5011 40 OAKmARKFUNDS P.O Box 219558,Kansas City,MO 64121-9558 December 22,2014 DAVID A COOLEY 6003 SKYHAVEN IN SPRING TX 77379-2440 REFERENCE: 12817864 THE OAKMARK FUNDS DAVID A COOLEY POA FBO CAROL A COOLEY TOD SUBJECT TO TRANSFER AGENCY RULES Dear Mr.Cooley: We are contacting you regarding your recent communication with The Oakmark Funds. In accordance with your request,please see below for the information concerning account number XXXXXX9198 as of October 23,2014. Fund Share Amount Net Asset Value Dollar Amount Oakmark Fund(I 10) 909.512 $67.19 $61,110.11 Oakmark Select Fund(808) 670.938 $43.77 $29,366.96 If you have any questions,please call 1-800-OAKNL RK(1-800-625-6275). Our Investor Services Representatives are available Monday to Friday, 8:00 a.m.to 6:00 p.m.Eastern Time. If you are outside the United States,please call 1-617-483-8327. You may also visit our website at oakmark.com for additional information about our products and services. Sincerely, Steve Peng Vice President r- I.ae-Rom ef-i"tj is C(7f<itil fYla'I'C)SSdAl.t.1CR C(YS PANICS, OINO`ED TO S'AIAJI: PO Box 2.190.12•Kansas City,MO 64121-9012 December 31.,2014 DAVID COOLEY 6003 SK.YHA.VEN LN SPRING TX 77379-2440 REFERENCE: 12819570 The Royce Funds Carol A Cooley TOD Subject To BFDS TOD Rules David A Cooley Poa Dear Mr.Cooley: We are writing in regard to the above referenced account. We would like to confirm the following: The request to transfer shares from Royce Premier Fund Investment Class account number ending in 7796 to an account in your name has been processed. A confirmation statement will be mailed to you under separate cover, The date of death value for the above referenced account on October 23,2014,'was 323;$48:53.'The"account value is calculated by multiplying the number of shares held, 1,799.3760,by the Net Asset Value(NAV)per share,which was$21.59 on this date. If you have any further questions,please feel free to contact our office at 1-800-841-1180, You may also contact us at the above address. Sincerely, Shareholder Services Representative P.O.Box 219012•Kansas City,MO 64121-9012.1-800-841-1180•www.zoycef inds.coin Page > 1 of 1 Carol A.Cooley �Reportor iQ123/201M MF � 4wvy $ 1' 1 �c ..,t:i.."i<.3_....�.4.n..,.,..��. x.._.� C/O David A Cooley Client Services:800-662-2739 6003 Skyhaven Ln Spring,TX 77379-2440 Total report value: $41,697.83 __...........—....._..__._._._......................__.._...__._ �_ _-........._..:......._.____.____ (Total report value includes any accrued dividends.) "E ''. Carol!#:Cooley lnd�yidtaa!Account w xr as � a yFrx a v � « b Acwun#v11ue sum -a Name 1 Fund&Account i Date Pace Per i Accrued i Number Opened i Shares Slare Value# 'Divi dends,% Windsor II Fund Inv 0073-09896745017: 11106/19971,086.148; $38.32; $41,697.83 --.._..._._...__......._.._.... _... ......._..._i.... _ _ Totals $4'1;697 83 $O.60 `Doesn't include accrued dividends. 0403934241 12/31/2014 09:24:32 2'266 . f.£..,,.',5;;(*�,.4;S:a:'iit..<,E•?...;:'?�;:4r January 7, 2015 David A. Cooley 6003 Skyhaven Ln Spring, TX 77379-2440 Dear Mr. Cooley: Thank you for requesting a date-of-death account value for a biMells Fargo Advantage Funds' coon Carol A. Cooley held an individually registered Wells Fargo Advantage Opportunity Fund account. The account value is provided in the following table as of the date she passed away, October 23, 2014: Account Number Share Balance Share Price Account Value 3212-3903093500 1,161.909 $49.57 $57,595.83 Information in this letter is historical and may not reflect the current account balance. Please refer to statements for actual holdings and detailed information. Investment values may fluctuate. If you have any questions or require further assistance,please call us at 1-800-222-8222. Representatives are always available to assist you. Sincerely, Lois A. McGarry Client Relationship Team bi'ells Fargo Funds Management,.LLC,a wholly owned subsidiary of Wells Fargo&Company,provides investment advisory and administrative services for Ifellr Fargo Advantage Funds`'. Other affiliates of lyeM,Fargo&Company provide subadvisory and other services,for the Funds.The Funds are distributed by Wells Fargo Funds Distributor, Member FINRA/SIPC, an affiliate of Wells Fargo&Company. .............._..... __.._...._..__..__ NOT FDIC.jNSUREO a CSO BANK.GUARANTEE-.MAY LOSEVALUE� FAM FUNDS Page 1 of 9 Trade Confirmation Please retain for your records CAROL A. COOLEY FAM Value Fund 9 JOSEPH DR Account No:28474-00 BOILING SPRINGS, PA 17007 11_ Statement Date; 10/23114 _..Income_.Dividends Reinvested....Lonp-Term.Capita.!.Gains.-..Reinvested...Short-nTerm.Cap-4a1.Gains.M:Reinvesfed Trade Amount of Share Shames this Total Gate Transaction Transaction Price Transaction Shares Owned 1/1/2014 Beginning Balance $51,123.30 827.104 827.104 Current market value is$53,53, g,44 based on:1:0/21 price of 4 73 $50 SUBSEQUENT MINIMUM INVESTMENT,SEND YOUR CHECK, FAM Value Fund ALONG WITH THIS PURCHASE FORM, MADE PAYABLE TO: Account No:28474-00 FAM FUNDS P.O.BOX 399 Investment Amount$ COBLESKILL,NY 12043 .Please use this form to add to this account. FOR IRA INVESTING,INDICATE THE TAX *For address changes,please complete the back of this form. YEAR OF YOUR CONTRIBUTION "For instructions on how to change account registrations,please call CAROL A.COOLEY shareholder services at 1-800-453-4392. 9 JOSEPH DR BOILING SPRINGS, PA 17007 All of us serving youe, MMbancorp- Service Navider,LLC hill -.Oda PO Box 701 Milwaukee,Wl 53201-0701 DAVID COOLEY December 1,2014 6003 SKYHAVEN LN SPRING TX 77-379-2440 REFERENCE NUMBER: 00576153 Dear Mr. Cooley: Thank you for contacting Hennessy Funds. This letter is in response to your request we recently received. We are sorry to hear of your loss. The following table shows the values of the accounts as of the close of business on October 23, 2014: Account Number of Shares Net,Asset Value Total Value 521273 1,584.890 $33.57 $53,20436 521274 645.093 $33.57 $21,655.77 Please consider this letter the written confirmation that was requested. Please contact our Shareholder Services Department, Monday through Friday 8:00 a.m.—7:00 p.m. central standard time,at(800) 261-6950 if we can provide any additional assistance. Sincerely, Julia Wolf U.S. Bancorp Fund Services, LLC As Transfer Agentlor Hennessy Funds usbank.com C )rie, stiz.6 oil 111 a cc Pax TWEEDY, BROWNE FUND INC. wvrvr. r-ee,,V-eo.n December 23,2014 DAVID COOLEY 600') SKYHAVEN LN SPRING TX 77379 Reference Number: 9610750979/4567958 Fund/Account: 0001-XXXXX-X8391 Registration: DENNIS E COOLEY AND CAROL A COOLEY JTWROS Fund/Account: 000I-XXXXXX4215 Registration: DAVID A COOLEY AND KRISTEN L COOLEY JTWROS Dear Mr.Cooley: Thank you for contacting Tweedy,Browne Fund;Inc. The above referenced account number ending in XXY-XXX8391 was valued at$62.037.47. as of the close of business on October 231,2014. This value is based on a balance of 2,322.631. shares at the net asset value of$26.71 per. share. If you have any questions,please contact Shareholder Services at 1-800-432-4789. Our representatives are available Monday through Friday between 9:00 a-m. and 6:00 p.m.Eastern Time and will be pleased to assist you. IVIe also invite you to visit our website at www.tweedv.com. Sincerely; Dennis Leggett Shareholder Services V © MBTBank 499 Mitchell Road,Millsboro,DE 19966 Records Management Phone 888-502-4349 F ax (302)934-2955 January 7;2015 Duncan &Hartman,P.C. Attorney at law One Irvine Row Carlisle,PA 17013 Re: Estate Carol Ann Cooley Social Security: Date of Death: October 23,2014 Dear Sir or Madam: Per-your inquiry on December 29,2014,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 3740136985 Ownership(Names ofi Carol A. Cooley Dennis E. Ccoley Opening Date 0412311998 Balance on Date of Death $ 18,904.73 Accrued Interest $ .34 Total $ 18,905.07 2. Type of Account Safe Deposit Box Box Number/Location 3775/high Street Carlisle Ownership(Names of Co-owner-Carol Cooley Opening Date 09/12/2000 For any additional information on the above accounts,including ownership and any changes,closures and/or reimbursement of funds, please call the High Street Carlisle at 717-2044536 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 Valarie Mercer Records Management +1 ZIP CODE:17007 1 Sign in(or Sign up) ta. -ou �(A Popular at KIBB.conn Kelley Blue Book Best Buy Awards of 2015 Home>Car Values>Toyota > Corolla> 2000> Style> Options >VE Sedan 4D uloyola Aj tcorolla :J 12000 Go Your Blue Boo VIC-Ilue Show Used Car Prices I Price Your Next Car VESedan 4D New Cars You Might Like Edit options Check specs Mileage: 227214 Change to .......... 2015 Toyota Corolla Trade In Get an Instant Q to a Dealer Cash Offer Print report View Price a New Car 2015 Dodge Dart Then browse reviews,photos, neer Good specs and more. Conclition ljeq Good S1,177 2015 Kid Forte Sell Your Current Car Reach millions of buyers on View KBB,com and AutoTradencom Place an ad Fair Condition Pi%rate fIarty Values valid for your area through I'117Q/2014 Track this car's values Tell Us About This Car Owners like you rated the 2000 Co;olla 8.3 out Write your own review Of 10. Next Steps to Selling Your Car Get an Instant Cash Start your offer Auto. Offer Find dealers ready to buy or trade in your car-today! ESTATE APPRAISAL REPORT PERSONAL PROPERTY Personal Property of the Estate of Carol A. Cooley, deceased Personalty Currently Located. Duncan & Hartman, P.C. 1 Irvine Row Carlisle, PA 17013 Ibis Appraisal Services 145 N. Hanover St. Carlisle, PA 17013 Client: Susan J. Hartman, Esq. (Duncan & Hartman, P.C. 1 Irvine Row Carlisle, PA 17013) Intended Users: Susan J. Hartman, Esq. The Family & Beneficiaries of the Carol A. Cooley Estate Any Other Person(s) Authorized by the Client Effective Date of Appraisal: d.o.d. October 23, 2014 Date of Report: April 07, 2015 By: Ibis Appraisal Services 145 N.Hanover St. P.O.Box 24 Carlisle,PA 17013 (717)243-3474 info aibisappraisals.com www.ibisapp.raisals.com Ibis Appraisal Services: Cooley Estate Personalty Appraisal Reported on April 07,2015 Effective Date:Date of Death:October 23,2014 Page 1 of 23 APPRAISAL SUMMARY It is in my opinion, that as of the d.o.d. October 23, 2014 and reported on April 07, 2015 the Fair Market Value of the Estate Personal Property of Carol A. Cooley, deceased: (Three Thousand Seven Hundred Forty-Three Dollars and Fifty Cents) ($3,743.50.00) Category: Coins & Currency $366.25 Category: Jewelry $800.00 Category: Watches $2,577.25 *NOTE. All gold and silver values were calculated using the Gold and Silver Trading Prices as of the Date of Death: October 23, 2014. Gold: $1,229.00. Silver: $17.10. rAlys b; Perv; s, L sa L. Ff n ISA-AM D r for&CEO SA Accre ' ed Member I SA INTERNATIONAL SOCIETY,—/APPRAISERS 'Accredited Member The report must be read in its entirety. The Appraisal Summary ONLY is not the appraisal report. Ibis Appraisal Services:Cooley Estate Personalty Appraisal Reported on April 07,2015 Effective Date: Date of Death: October 23,2014 Page 6 of 23