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06-17-15
tfi,° LennsIvania 1505618403 ,,,,fx(03%-14) REV-1500 OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO Box 280601 INHERITANCE TAX RETURN Harrisburg,PA 17128-0601 RESIDENT DECEDENT 21 15 0101 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 01 04 2015 02 22 1925 Decedent's Last Name Suffix Decedent's First Name Mi SMITH JR. M. D (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 Q1. Original Return 2. Supplemental Return 3, Remainder Return(date of death prior to 12-13-82) 4. Agricultural Exemption(date of El 5. Future Interest Compromise(date of 6. Federal Estate Tax Return Required death on or after 7-1-2012) death after 12-12-82) 7. Decedent Died Testate 8. Decedent Maintained a Living Trust 0 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 KRISTEN LIES ESQ 717 237 4800 First Line of Address 409 NORTH SECOND STREET Second Line of Address SUITE 500 City or Post Office State ZIP Code HARRISBURG PA 171011357 Correspondent's email address: kristen.lieb( bipc.com REGISTER OF WILLS USE ONLY u'> CD WILLS USE ONLY �'} E i --- REGISTER OF„ DATE FILED MMDDYYYY DATE FILED STAMP t #tt C)l ' Side 1 1505618403 505184I 1505618403 ..1 1505618411 REV-1500 EX Decedent's Social Security Number Decedent's Name: Smith, M. Dudley Jr. RECAPITULATION 1. Real Estate(Schedule A)....................................................................................... 1 2. Stocks and Bonds(Schedule B)............................................................................. 2. 2-1799 - 16 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. 116 19 17- 12 6. Jointly Owned Property(Schedule F) [:1 Separate Billing Requested............ 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) [:] Separate Billing Requested............ 7. 3331472 - 38 8. Total Gross Assets(total Lines I through 7)........................................................ 8. 453-i188- 66 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 29-t727-97 10. Debts of Decedent,Mortgage Liabilities and Lions(Schedule 1)............................ 10. 101823-93 11. Total Deductions(total Lines 9 and 10)................................................................ 11. 4a-.551- 90 12. Not Value of Estate(Line 8 minus Line 11).......................................................... 12. 412,636- 76 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J)............................................... 13. 20,000- 00 14. Net Value Subject to Tax(Line 12 minus Line 13).............................................. 14. 392 -t636- 76 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(1.2)X.00 15. 11- 00 16. Amount of Line 14 taxable at lineal rate X .045 9 1115 0 6. 41 16. 41072- 79 17. Amount of Line 14 taxable at sibling rate X.12 11,695 - 37 17. 1,403 - 44 18. Amount of Line 14 taxable at collateral rate X.15 290,434 . 98 18. 431565 - 25 19. TAX DUE................................................................................................................ 19. 49,1[141. 48 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Under penalties of perjury,I declare 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 person responsible for filing the return Is based on all Information of which preparer has any knowledge. SIGNA OF PERSON RESPONSIBLE FOR FILING RETURN Aaron C.Jackson Esq. DATE ADDRESS 404 North SpeoQd Street,Suite 500, Harrisburg, PA 17101 ,Wf DATE ,N42.LJRE 9F PREPARER OTHER THAN REPRESENTATIVE KristenLiebEsq. Z_ le 57 ADDRESS 409 North Second Street, Harrisburg, PA I 111111111111111111111111111111111111111111111111111111111111 Sides 1505618411 1505618411 REV-1500 EX Page 3 File Number 21-15-0101 Decedent's Complete Address: DECEDENT'S NAME Smith, M. Dudley Jr. STREET ADDRESS 3620 Logan Court Unit 7-C CITY STATE ZIP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) 49,041.48 2. Credits/Payments A. Prior Payments 44,000.00 B. Discount 2,315.79 Total Credits(A +B) (2) 46,315.79 3. Interest (3) 4. If Line 2 is greater than Line I +Line 3,enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2,Line 20 to request a refund 5. If Line I +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 25725.69 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;.............................................................................. El Fx� b. retain the right to designate who shall use the property transferred or its income;.................................. c. retain a reversionary interest;or.............................................................................................................. d. receive the promise for life of either payments,benefits or care?............................................................ 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.................................................................................................................. ❑ 3. Did decedent own an'in trust for" or payable upon death bank account or security at his or her death?....... 4. Did decedent own an Individual retirement account,annuity,or other non-probate property which contains a beneficiary designation?.................................................................................................................. Fx] El 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 21years 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)(111)]. • 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 172 P.S.§9116(a)(11)]. • 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-1503 EX+(08-12) SCHEDULE B pennsylvania STOCKS 8i. BONDS DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Smith, M. Dudley Jr. 21-15-0101 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 52 shares of MetLife Shares Account No.C0051054806 53.48 2,780.96 Accrued dividend on Item 1 through date of death 18.20 TOTAL(Also enter on Line 2,Recapitulation) 2,799.16 (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-INS EX+{08-12} SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Smith, M. Dudley Jr. 21-15-0101 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 Cash in Possession 600.00 2 Merrill Lynch Cash Management Account No.872-55916 109,649.59 3 Tangible Personal Property-[Appraised Value$8,229-Donations to Charities(Based on 6,459.00 Appraised Value)$1,7701 4 Comcast Refund-Cable Services 18.71 5 Nationwide Refund-Insurance 147.60 6 USPS Refund for Post Office Box 31.00 7 Verizon Refund 11.22 TOTAL(Also enter on Line 5,Recapitulation) 116,917.12 (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) Rsv-1510 EX+(08-09) SCHEDULE G pennsylvania INTER VIVOS TRANSFERS AND DEPARTMENT OF REVENUE INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Smith, M. Dudley Jr. 21-15-0101 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 5 of OECD's EXCLUSION TAXABLE NUMBER THE DATE OF TROANSFER. ATTAck THEIR OPY OF THE DEEHIPD FOR DECEDENT ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1 Merrill Lynch IRA Account No.872-83169- 330,681.23 330,681.23 Beneficiary: Estate of M. Dudley Smith,Jr. 2 Scott Trade Account No.74020644-TOD Beneficiary: 2,791.13 2,791.13 Richard Dudley Smith(Son) Accrued interest on Item 2 through date of death 0.02 0.02 TOTAL(Also enter on Line 7,Recapitulation) 333,472.38 (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) SCHEDULE H pennsylvania DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN RESIDENT DECEDENT ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Smith,M. Dudley Jr. 21-15-0101 Decedent's debts must be reported on Schedule 1. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s)attached 3$172.96 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio Year(s)Commission Paid 2. Attorneys Fees 20,000.00 See continuation schedule(s)attached 3. Family Exemption: (If decedent's address is not the same as claimants,attach explanation) Claimant Street Address City State ZiD Relationshio of Claimant to Decedent 4. Probate Fees 395.50 See continuation schedule(s)attached 5. Accountant's Fees 2,500.00 See continuation schedule(s)attached 6. Tax Return Preparer's Fees 7. Other Administrative Costs 3,659.62 See continuation schedule(s)attached TOTAL(Also enter on line 9,Recapitulation) 29,727.97 Copyright(c)2013 form software only The Lackner Group,Inc. Form PA4 500 Schedule H(Rev.08-13) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Smith, M. Dudley Jr. 21-15-0101 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses nses 1 Parthemore Funeral Home&Cremation Services,Inc. 3,172.95 H-A 3,172.95 Attorney Fees 2 Buchanan Ingersoll&Rooney PC 20,000.00 H-132 20,000.00 Probate Fees 3 Register of Wills 395.50 H-134 395.50 Accountant Fees 4 Keith Huntzinger 2,500.00 H-B5 2,500.00 Other Administrative Costs 5 Cordier Auctions-Personal Property Appraisal 641.25 6 Cumberland Law Journal-Publication 75.00 7 Journal Mutlimedia-Publication 150.00 8 Reimbursement to Doug Tarlton-Notary and USPS Service for Oath of Subscribing Witness; 2,793.27 Artwork shipping expense 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 Smith, M. Dudley Jr. 21-15-0101 ITEM NUMBER DESCRIPTION AMOUNT H-B7 3.659.52 Copyright(c)2002 form software only The Lackner Group,Inc. Form PA,1500 Schedule N(Rev.6-98) Rev-1512 EX+(12-12) SCHEDULE 1 pennsylvania DEBTS OF DECEDENT, DEPARTMENT OF AXRET INHERITANCE TAX RETURRNN MORTGAGE LIABILITIES AND LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Smith, M. Dudley Jr. ] 2l-1515-0101 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 Ann Callahan-Cleaning Services 270.00 2 AT&T-Long Distance Telephone Service 28.20 3 Auto Assist Now-Caretaker Services 7,752.00 4 Bank of America VISA Account No.4264520058916438-Credit Card 1,735.72 5 Brown Shultz Sheridan&Fritz-Quarterly payroll tax returns 470.00 6 Camp Hill Fire Company No.1 14.24 7 Comcast Account No.09547199419-02.7-Cable Service 211.66 8 Holy Spirit EMS 162.47 9 Internists of Central PA 4.16 10 PA Unemployment Compensation Tax-4th Quarter 2014 payroll taxes 137.07 11 Verizon-Local Telephone Service 38.41 TOTAL(Also enter on Line 10,Recapitulation) 10,823.93 (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) REWIM EX+{01-10} pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Smith, M. Dudley Jr. 21-15-0901 NAME AND ADDRESS OF RELATIONSHIP TOSHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) ($$$) I TAXABLE DISTRIBUTIONS (include outright spousal distributions,and transfers under Sec.9116(a)(1.2)] See attached schedule Total 392,636.75 Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet as-appropriate. NON-TAXABLE DISTRIBUTIONS: II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 The Harrisburg Symphony Association 10,000.00 2 The Program for Female Offenders of South Central Pennsylvania,Inc. 10,000.00 TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE 20,000.00 Copyright(c)2010 form software only The Lackner Group,Inc. Form PA4500 Schedule J(Rev.01-10) SCHEDULE J BENEFICIARIES (Part 1,Taxable Distributions) ESTATE OF: M.Dudley Smith,Jr. 0110412015 059-20-0656 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 1 Valerie Smith Bancroft Sister 11,695.37 9601 N.W.80th Court Fort Lauderdale,FL 33321 2 Rhonda Rowe Benkowitsch Friend 7,796.91 15 Knollwood Building Middletown,PA 17057 3 Janet Caufield Friend 3,898.45 1615 Wyndham Road Camp Hill,PA 17011 4 Amber Gail Holmes(Tarlton) Niece 11,695.37 4650 N.Rainbow Boulevard Bldg.#11,Apt.#1088 Las Vegas, NV 89108 5 Candace Bancroft McKinnis(Hardman) Niece 77,969.12 9601 N.W.80th Court Fort Lauderdale,FL 33321 6 Justin McKinnis Grand Nephew 11,695.37 9601 N.W.80th Court Fort Lauderdale,FL 33321 7 Virginia A.Roth Friend 21,441.51 5 Scotch Circle Duncannon,PA 17020 8 Debra Rowe Sheaffer Friend 7,796.91 123 Cedar Lane Harrisburg,PA 17112 9 Richard Dudley Smith Son 90,506.41 9 Warren Place Brooklyn,NY 11201 1 SCHEDULE J BENEFICIARIES (Part i,Taxable Distributions) ESTATE OF: M. Dudley Smith,Jr. 0110412015 059-20-0656 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 10 Michael Lloyd Tarlton Nephew 11,695.37 811 Green Meadows Road Apt.#211 Columbia,MO 65201 11 Sandra G.Tarlton Sister-in-Law 136,445.96 P.O. Box 750086 Las Vegas,NV 89136 Total 392.636.75 2 05.905 REV(9111) LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. ;e for this certificate, $6.00 ,,....'' m ( This is to certify that the information here given is correctly copied IIH QF p"'. rom a n original eath duly filed with me asLo al Registrar. The eficate ooriginal certificate will be forwarded to the State Vital t v- yam. a Records Office for permanent filing. P 21354381 �'qj o ��a~`' iA o6 1 Certification Number ENT""'"�l Local Registrar _Date Issued Type/Print In COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF HEALTH-VITAL RECORDS Fermanent CERTIFICATE OF DEATH Black Ink State Flte Number: 1.Decedent's Legal Name(First,Middle,Last,Suffix) 2.Sex 3,Social Security Number 4.Date of Death(Mo/Da Y/Y,)(Spell Mo) M. Dudle Smith, Jr. male 059-20-0656 Januar 201 5-Age-Last Birthday(Yrs) 15b.Under 1 Year Sc.Under 1 Da 6.Date of Birth(Mo/Day/Year)(Spell Month) 7a.Blrthp lace(City and State or Foreign Country) 89 Months .Days Hours Minutes Februar 22, 1925 Flushin NY y 7b.Birthplace(County) ueens / Sa.Residence(State or Foreign Country) 8b.Residence(Street and Number-Include Apt No.) 8c.DId Decedent Live in a Township? Penns lvania 3620 Logan Court,Unit 7-C $7Yes,decedent lived in uamrl fl c:,J-. twp. 8d.Residence(County) Cumberland 8e.Residence(Zip Code) 17011 0 No,decedent lived within limits of city/b,ro. 9.Ever In US Armed Forces? 10.Marital Status at Time of Death 0 Married (�'Widowed 11.Survlving Spouses Name(If wife,give name prior to first marriage) ( Yes 0 No 0 Unkno Divorced No r Married 0 Unkno 12.Father's Name(First,Middle,Last,Suffix) 113.Mother's Name Priort0 First Marriage(First,Middle,Last) Maurice Dudley Smith, Sr. Gloria Periz 14a.Informant's Name 14b.Relationship to Decedent 14c.Informant's Mailing Address(Street and Number,CIty,State,Zip Code) Sandra G. Tarlton ister-Tn- a P_O_ Box 750086 Las Ve aS NV 89136 C __ __ _ _ _ _ _ _ __ _151.Place o De-,(Check on V c ne - _ _ If Oeath Occurred in a Hosplta l: Inpailent llf DeaNi Occurred Somewhere Other Than a Hospital O Hospice Faclllfy Z7 Decedent's Home 0 Emergency Room/Outpatient 0 Dead on Arrival 1 0 Nursing Home/Long-Term Care Facility 0 Other(Specify) 15b.Facility Name(If not institution,give street and number) 15c.City orTown,State,and Zip Code 15d.County of Death Holy Spirit Hospital East Pennsboro Twp. , A 17011 Cumberland 161.Method of Disposition 0 Burial Cremation 16b.Date of Disposition 16 c.Pta ce of Disposition(Name of cemetery,crematory,or other place) 0 Removal from State O Donation D Other(Specify) 38rlt�lary 6, Evans Cremator 16d.Location of Disposition(City or Town,State,and Zip) 17a.51 f F ral Service Licensee or Person in Charge of Interment I 11b.License Number s Schae££erstown, PA 17088 FD 012 848 L c 17c.Name and Complete Address of Funeral Facility Parth-M.re FH & CS Inc_ 1303 Brid a Street Naw Cumberland PA 17070 18.Decedent's Education-Check the box that best describes the 19.Decedent of Hlspanlc Origin-Check the 20.Decedent's Race-Check ONE OR MORE races to Indicate what 1- highest degree or level of school completed at the time of death. box that best descrlbes whether the decedent the decedent considered himself or herself to be. 0 8th Brad.or less Is Spanish/Hispanic/Latino. Check the"No" White 0 Korean 0 No diploma,9th-12th grade box If decedent Is not Spanish/Hlspanlc/Latino. 0 Black or African American 0 Vietnamese D High school graduate or GED completed gF No,not Spa nlsh/Hlspanlc/Latin', 0 American Indian or Alaska Native 0 Other Asian D Some college credit,but no degree Yes,Mexican,Mexican American,Chicano 0 O Native Hawaiian Aslan Indian 0 Associate degree(e.g.AA,AS) 0 Yes,Puerto Rican 0 Chinese E3 Guamanian or Chamorro Bachelor's degree(e.g.BA,AB,BS) Cl Yes,Cuban 0 Filipino 0 Samoan Master's degree(e-g.MA,MS,MEng,MEd,MSW,MBA) 0 Yes,other Spanish/Hlspanlc/Latino 0 Japanese 0 Other Pacific Islander 0 Doctorate(e.g.PhD,EdD)or Professional degree (Specify) 0 Other(Specify) .MD DDS DVM LLB,JD -51.Decedent's Single Race Self-Designation-Check ONLY ONE to Indicate what the decedent considered himself or herself to be. 22 a.Decedent's Usual Occupation-Indicate type of work 20 White 0 Japanese 0 Samoan done during most of working Ilfe. DO NOT USE RETIRED. 0 Bl ackor Afrlcan American 0 Korean 0 Other Pacific Islander V ce President Financial 0 American Indian or Alaska Native 0 Vietnamese O Don't Know/Not Sure AC1V:L Or 0 Aslan Indian 0 Other Aslan 0 Refused 22b.Kind of Business/Industry 0 Chinese 0 Native Hawaiian 0 Other(Specify) 0 Filipino 0Guamanian or Chamorro Financial ITEMS 231-23d MUST BE COMPLETED 23a.Date Pronounced Dead(Mo/Day/Yr) 23b.Signature of Person Pronouncing Death(Only when applicable) 23c.License Number BY PERSON WHO PRONOUNCES OR CERTIFIES DEATH 23d.Date Signed(Mo/Day/Yr) 24.Time of Death � \ (>, 2S.Was Medica Exam r Coroner n[acted7 0 Yes rfYAo CAUSE OF DEATH I Approximate 26.Part I. Enter the chain of event,-dise...s,Injuries,or complications-that directly caused the death. DO NOT enter terminal events such as cardiac arrest, I Interval: respiratory arrest,or ventricular fibrillation without showing�SJh._e etiology. DO NOT ABBREVIATE. Enter only one cause on a line. Add add ltional lines If necessary. Onset to Death 1 IMMEDIATE CAUSE ---------------1 a. Q�p)Y`Q 1 1 (Final disease or condltlon Due to( as a consequen of): resulting In death) Sequentially list conditions, Due to(or as a consequence of): 1 if any,leading to the cause I listed on line a. Enter the I UNDERLYING CAUSE Due to(or as a consequence of): (disease or Injury that 1 u. -nttlated the events resulting d. 1 c In death)LAST. Due to(or as a consequence of): 26:Part If. Enter other significant condition,contributing to death but not resulting in the underlying cause given In Part I. 27.Was an autopsy perfo rrr�d7 O Yes `a 28.Were autopsy findings available to complete the cause o 11th? m O Yes No 29.If Female: 30.Did Tobacco Use Contribute to Death? 31.Ma r of Death E Not pregnant within past year D Ye O Probably Natural D Homicide O Pregnant at time of death 0 Unknown 0 Accident 0 Pending Investigation 0 Not pregnant,but pregnant within 42 days of death 0 Sulclde 0 Could not be determined m 0 Not pregnant,but pregnant 43 days to 1 year before death 32.Date of Injury(Mo/Day/Yr)(Spell Month) 0 Unknown if pregnant within the past year 33.Time of Injury 34.Place of Injury(e.g.home;construction site;farm;school) 35.Location of Injury(Street and Number,City,County,State,Zip Code) 36.Injury at Work.. 137,If Transp,rtati,n Injury,Specify: 38.Describe How Injury Occurred: 0 Yes 0 Driver/Operator 0 Pedestrian 0 No - 0 Passenger 0 Other(Specify) 391 C ler-physician certlfled nurse practitioner,medlcal a dlner/coroner(Check only o e): Certifying only-To the best of my knowledge,death o raj due to these(s)and m . stated. 0 Pronouncing 1L C,,tIfying o the best of y knowledge,death occurred at the time,date,and place,and due to the causes)and manner stated. 0 Medical Examiner/Cor -On of a nation and/or Investigation,In my opinion,death occurred at the time,date,and place,and due to the (s) d �-s stated. Signature of certifier. Title of ce rtlfler: a `-tom Ucense Number: J O/ 39b.Name,Address an Ip Code of Person Completing Cause of Death Item 26) 39c.Da Slgn (Mo/Day/Yr) if 15-3 f 40.Registrar's Dtsirlct Number 41.Reglstra is Signa y� 42.Registrar Ile Dat (Mo/Day/Y,j S 43.Amendments 2 `(.d "^ F'0;-143 Dlsoosltion Permit No. CJS WILL OF M. DUDLEY SMITH, JR. 1, M. DUDLEY SMITH, JR., of Cumberland County, Pennsylvania, do make this my Last Will and Testament, hereby revoking all Wills and Codicils at any time heretofore made by me. FIRST: Tangible Personal Property. I give my tangible personal property to my spouse, CAROLYNE L. CIBART SWARTLEY SMITH, if my spouse survives me. If my spouse, CAROLYNE L. CIBART SWARTLEY SMITH does not survive me, then I direct that the specified items of my tangible property be distributed in accordance with the provisions of a signed memorandum or letter of instruction, which would be found with a copy of this will or with my other valuable papers. Any property not so designated or not taken under the provisions of the memorandum, I direct my executor to have sold at auction and the proceeds added to my residuary estate. SECOND: Remainder. I give the rest, residue and remainder of my estate, real, personal and mixed to my wife, CAROLYNE L. CIBART SWARTLEY SMITH, if she survives me. If she does not survive me, then in that event, I give the following: A. Specific devises: 1 1 give the sum of TEN THOUSAND ($10,000.00) DOLLARS to the PROGRAM FOR FEMALE OFFENDERS now known as THE PROGRAM; and 2. 1 give the sum of TEN THOUSAND ($10,0.00.00) DOLLARS to the HARRISBURG SYMPHONY, Page 1 of 6 B. Residue of Estate. If my wife, CAROLYNE L. CIBART SWARTLEY SMITH, does not survive me, I give the rest, residue and remainder of my estate wheresoever situate to be distributed as follows: 1. I give to RICHARD DUDLEY SMITH, my oldest son, TWENTY-TWO AND A HALF (22.50%) PERCENT; 2. 1 give to SANDRA G. TARLTON, my wife's sister, THIRTY- FIVE (35%) PERCENT; 3. 1 give to CANDACE BANCROFT McKINNIS, TWENTY (20%) PERCENT; 4. 1 give to JUSTIN McKINNIS, THREE (3%) PERCENT; 5. 1 give to VALERIE SMITH BANCROFT, THREE (3%) PERCENT; 6. 1 give to DEBRA ROWE SHEAFFER, TWO (2%) PERCENT; 7. 1 give to RHONDA ROWE BENKOWITSCH, TWO (2%) PERCENT; 8. 1 give to JANET CAULFIELD, ONE (1%) PERCENT; 9. 1 give to VIRGINIA A. ROTH, my business partner, FIVE AND A HALF (5.50%) PERCENT. 10. 1 give to AMBER GAIL HOLMES, THREE (3%) PERCENT; 11. 1 give to MICHAEL LLOYD TARLTON THREE (3%) PERCENT; Page 2 of 5 12. 1 have intentionally not included in my will, my son, CHARLES ROBERT SMITH. THIRD: Cremation. It is my desire that I shall be cremated. If my spouse, CAROLYNE L. CIBART SWARTLEY SMITH, does not survive me, the decision of when and if to hold a memorial service shall be made at the will of SANDRA TARLTON, or in the event of her death, RICHARD DUDLEY SMITH. FOURTH: Spendthrift Provision. While in the hands of my executor, and until actually paid over or delivered to the persons entitled thereto, the interest of beneficiaries in the income or principal of my estate shall not be subject to assignment, pledge, attachment, or the claims of creditors. FIFTH: Powers of Fiduciaries. In addition to the powers conferred by law, my executor shall have the following powers to be exercised in such executor's absolute discretion: to retain for distribution in kind, without duty of diversification, all property owned by me at my death, or to sell all or any part of such property, upon such terms as my executor deems advisable; to hold any proceeds and other cash uninvested or to invest in all forms of property, without restriction to so-called "authorized" or "legal" investments and without regard to diversification; to exchange or lease for any period of time any real or personal property and to give options for sales,. exchanges, and leases; to exercise all rights of security holders, to compromise any claim or controversy without court approval; to delegate discretionary powers; to employ investment counsel, custodians of trust property, brokers, agents, accountants and attorneys and to act without independent investigation upon their recommendations; and to make Page 3 of 6 distributions in cash or in kind at current values, in undivided interests or non-pro rata shares. SIXTH: Payment of Taxes. All estate, inheritance, and succession taxes, including interest and penalties, payable with respect to property included in my gross estate, including any property not forming part of my testamentary estate, shall be paid from the principal of my residuary estate, at such times and in such manner as my executor deems advisable, without apportionment or right of reimbursement. SEVENTH: Appointment of Executor. A. Appointment, I appoint AARON C. JACKSON, as the executor of this my will, under advisory of SANDRA G. TARLTON and fiscal manager, YVONNE EVANS. B. Executor's Compensation. Any individual executor serving hereunder shall be entitled to compensation which is commensurate with his or her set-vices to my estate. Any corporate executor serving hereunder shall be entitled to shall be entitled to compensation for its services hereunder in accordance with its schedule of charges in effect from time to time during the period in which its services are performed, C. No Bond Required. Under no circumstances shall any personal representative appointed hereunder or otherwise be required to post bond in any jurisdiction. EIGHT: Headings. The bold headings used throughout this Will are for convenience only. I do not intend such headings to be used in the construction and interpretation of this Will. Page 4 of 6 WITNESS my hand this J : ""day of _ :-% �. -- -' �, 2013. 1. j � , _. _ (SEAL) M, �UDL-EY �il11TH, JR. Page 5 of 6 Signed, published and declared by the above named Testator, M. DUDLEY SMITH, JR. as the Testator's last Will in the presence of us who at the Testator's request, in the Testator's presence and in the presence of each other have hereunto subscribed our names as witnesses. " .. � ( " � -/" ', .. e ,e /. --,. ) rp V(Z' -t't� , &C - 1 Name Address Name Address Page 6 of 6 AFFIDAVIT OF WITNESSES COMMONWEALTH OF PENNSYLVANIA ) SS: COUNTY OF CUMBERLAND ) We, M. DUDLEY SMITH, JR., -�.;� I,a;':s' ; ,rGr;l1 I<1("r',�'?r) and _ t Testator and witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as the Testator's last Will and that the Testator signed willingly, and that the Testator executed it as the Testator's free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, 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. WITNES-SE,S M. DUDLEY SMITH, JR. Subscribed, sworn and acknowledged before me by M. DUDLEY SMITH, JR., and subscribed and sworn to before I:( me by �and `- witnesses this ;i; day of (;�- 2013. otaryPublic MY COMMISSION EXPIRES: COMMONWEALTH OF PENNSYLVANIA HBGDB:135759-1 017374-024979 Notarial Seal Pauline Patti Thomas,Notary Public Lemoyne Daro,Cumberland County My commurlon Expires Mbr�h 24,2015 MtMUR,PENNSYLVANIA ASSOCIATION OF NOTARIES MET Historical Prices I MetLife, Inc. Common Stock Stock- Yahoo I Finance Page 1 of 1 Horne lvlail Sear::h News Sports Finance Weather Games Answers Screen Flickr Mobile I More y4.Upgrade to the new Firefo: Search Finance Search Web Sign in Mail Finance Home My Portfolio My Quotes News Market Data Yahoo Originals Business&Finance Personal Finance CNBC Contributors Enter Symbol LuokUp Fri,Jan 9,2014,1 1 53AM ES'i'-U.S Alaikets close in 4 his 7 mins Reportan Issue Dow 0.82%Nasdaq 0.69% MetLife,Inc.(MET)-NYSE Add to Portfolio 51.41 0.57(1.10%) 11:53AM EST-Nasdaq Real Time Price Historical Prices Get Historical Prices for: GO] Set Date Range n Daily Start Date: Jan V 02 2015 Eg.Jan 1,2010 Q Weekly End Date:(_Jan v 05 2015 O Monthly 0 Dividends Only Get Prices First I Previous I Next I Last Prices Date Open High Low Close Volume Adj Close' Jan 5,2015 53.42 53.63 51.88 52.11 6,520,200 52.11 Jan 2,2015 54.48 54.76 53.63 53.91 3,911,700 53.91 Close price adjusted for dividends and splits. First I Previous I Next I Last ADownload to Spreadsheet Currency in USD. a-f) . 5 5 2 r j C r-\ 2. 2- 5 3 . Li8 !sem P-azy-About our Ads-Terms-send Feeds—;,-Yahoo!-ABC News Network o".1"are ma!-time for NASDAQ.NYSE_and NYSE MKT.See olso dolav times(or other exchanges.A.lt infonnolinn provided"as is"for informational purposes only,not intended for trailing perp?`res or advice.Noilhar Ynhool nar ony of independent orov,den:is imble for any informational r?rrors inromplrlenass,or delays,or Irr any actions iakan in raiianra m1 informalion contained Ixeroin.6y accassmg the Yahoo!Site.you agrc-o nut to red!stioula the information found lhe.j6i. Puraemenhil:;om;?any data parvided by Caoilal IQ Historical chart da!;:and drily updales provided by Commodity Systems.Inr.(CSI)Intemztlionai histoioal chart data,daily updates,fund surnmwy,fund paninrmanaa,dividend data and i'Vii—bigsta,Index(tato provided try Ivlominysl,i Inc http://finance.yahoo.com/q/hp?s=MET&a=00&b=02&c=2015&d=00&e=05&f=2015&g=d 1/9/2015 © Bank of America 64-1278 1 r�f ( `f t�(� em Atlanta,Dekalb County,Georgia 611 GA Loll//;t��t `2Ur }L1,a lk PLEASE DEPOSIT THIS CHECK PROMPTLY. LMP.QRTANT.TA:ICRE`f,,.R,,,.ROGUMP,:T€;A:;T`AC.HED;; Nay $****EIGHTEEN DOLLARS AND TWENTY CENTS**** Check Number:0022993891 08 Dec 2014 Pay t0 the M DUDLEY SMITH JR order of PO BOX 60571 HARRISBURG PA 17106-0571 $****1 8.20**** + Authorized Officer Senior Vice President&Treasurer Dividends on MetLife,Inc.common stock MUAQ Computershare Inc. Authorized Si nalure(s) 250 Royatt St,Canton,MA 02021 } u1002299389Lu" 1:0GLLL27881: 335 987 093Lu" o R POSTALSERVICETES Serial Number Year Month Day _ Post e�ca U.S.Dollars and Cents ," 22411888380":!"'-*:', $ .1 LAmdant . THIRTY ONE-DOLLARS rx (00 Pay toJ r Clerk ( r / r� fir,. rn From + � 11 Address CE 'c MAIN OFFICE WINDOW vS POSTAI- ERVf 'Address 1425 CROOKED HILL RC Memo o zoos uonca smroa vasim semco.np euyrua a.•ua. - SEE REVERSE WARNING•NEGOTIABLE ONLY IN THE U.S.AND POSSESSIONS 1:00000800 21: 5 2 21, 1 1888 380 its Merrill Lynch Wealth Management Bank of America Corporation t Historical Date of Death Valuation M Dudley Smith 872-55916 Date of Death 01/0412015 Report Type Date Of Death Valuation Date 01/04/2015 Number of Account(s) 1 Processing Date 01/08/2015 MR M DUDLEY SMITH JR DCSD Number of Security(s) :4 PO BOX 60571 HARRISBURG PA 17106-0571 Account#872-55916 Shares Security High/Ask Low/Bid Mean and/or Div and Int Security or Par Description Adjustments Accruals Value 1) 64,740.0000 ML BANK DEPOSIT PROGRAM (990286916) 1.000000 64,740.00 2) 1,048.2500 BLACKROCK EQUITY (09251M306) DIVIDEND FD C 01/02/2015 0.00000 24.29000 MKT 24.290000 25,461.99 3) 1,069.6950 BLACKROCK GLOBAL(09251T301) ALLOCATION FD INC C 01/02/2015 0.00000 18.18000 MKT 18.180000 19,447.05 4) ! 00.0000 MARGIN i 0.55 1 MR M DUDLEY SMITH JR DCSD Number of Security(s) :4 PO BOX 60571 HARRISBURG PA 17106-0571 Account#872-55916 Shares Security High /Ask Low/ Bid Mean and/or Div and Int Security or Par Description Adjustments Accruals Value Total Value $109,649.59 Total Accrual $0 Total $109,649.59 Total Security Value : $109,649.59 Total Accruals : $0 Total Combined Value : $109,649.59 The information herein has been obtained from a source we believe to be reliable,but we do not guarantee its accuracy or completeness.Merrill Lynch does not provide tax,accounting or legal advice.Any tax statements contained herein were not intended or written to be used,and cannot be used for the purpose of avoiding U.S.,federal,state or local tax penalties.Please consult your advisor as to any tax,accounting or legal statements made herein. Disclosures: •There is NO fee associated with the use of this application at this time. •Alternative Date of Death valuations are not available in this application.Please consult your tax advisor for assistance in obtaining this report. •Report may include trades that are not settled as of valuation date. •All security positions are based on trade date. •Money funds,money market and/or bond/fixed income mutual funds may or may not include dividends/interest accruals prior to month end payment. •For accounts with Credit and/or Debit card(s),the cash position may not reflect reduction for purchases of goods or services which are paid for by automatic debit on the Wednesday before the last Friday of each month. •Cash balance may not reflect outstanding checks written prior to valuation date or unsettled cash as of valuation date. •All items flagged"!"and highlighted in red reflect manually adjusted transactions(for price,shares,market value or security name)or positions with no available price. •Asset positions provided to Bank of America/Merrill Lynch from an outside financial institution(i.e.Annuities),may require the Securities Description line to be manually updated. •Fee accruals are not captured in TMA accounts. •All mortgage backed securities have the paydown factor/amortization factor automatically applied. •If the account you are valuing is a"900"series account(international),the values will be reported based on the currency the account holds,not USD.Please also note that if this account is valued along with other USD accounts,you will not receive an accurate valuation;please run these accounts separately from USD accounts held in the client's household. The information herein has been obtained from a source we believe to be reliable,but we do not guarantee its accuracy or completeness. Investment products provided are Merrill Lynch,Pierce,Fenner&Smith Incorporated: -----._..... _.__......__._..-....._....— ......_._.-....._...........---....._. ---- --- -------- ___._... Are Not FDIC Insured Are Not Bank or State Guaranteed May Lose Value 2 Merrill Lynch,Pierce,Fenner&Smith Incorporated is a wholly owned subsidiary of Bank of America Corporation,and a registered broker dealer and member of FINRA and SIPC. Merrill Lynch,Pierce,Fenner&Smith Incorporated is not a tax or legal advisor.Clients should consult a personal tax or legal advisor before making tax or legal related investment decisions. Nothing discussed or suggested in these materials should be construed as permission to supersede or circumvent any Bank of America or Merrill Lynch,Pierce,Fenner&Smith Incorporated policies,procedures,rules,and guidelines. I I i 3 , CO-D T-N JER ANTIQUES rv�iFIREARMS AUCTIONS ESTATES & appraisals REAL ESTATE Appraisal Report The Estate of Dudley Smith 3620 Logan Court Unit 7C Camp Hill, Pennsylvania 17011 Prepared for: Aaron Jackson, Esq., Executor Buchanan, Ingersoll &Rooney PC 409 North Second Street Suite#500 Harrisburg, Pennsylvania 17101 (717) 237-4962 Prepared by: David J. Cordier Ellen E.Miller Cordier Auctions &Appraisals 1500 Paxton Street: Harrisburg, Pennsylvania 17104 Phone: (717)731-8662 Fax: (717) 731-9830 Table of Contents Title Page 1 Table of Contents 2 Surninary 3 - Analysis 4 Conditions of Appraisal " 5 Certification 5 Purpose of Report 6 Method of Valuation 6 Definition of Value 6 Basis of Appraisal 6 Description 6 Appraiser Qualifications 7 Value Listings Appendix A Page: 2 of 13 Summary On December T8,2014,at the request of Aaron Jackson, Buchanan,Ingersoll &Rooney PC, I personally inspected the assets of The Estate of Dudley Smith,3620 Logan Court;Unit 7C, - Camp Hill, Pennsylvania. Value Fair Market Value The Fair Market Value for the property in total is: $8,229.00 This is not the appraisal report. The appraisal report must be read in its entirety. Page: 3 of 13 Analysis Analysis All items in good condition unless otherwise noted. Page: 4 of 13 Conditions of Appraisal The value stated in this Appraisal Report is based on the best judgment of the appraiser given the facts and conditions available at the date of the valuation. The use of the report is limited to the purpose of determining the value of personal property for Estate Tax purposes. Any additional research or testimony required by the client or the court will be billed at the current rates.- Disclosure of the contents of the report is taOvemed by the Standards and Practices of the Certified Appraisers Guild of the America. Certification of Report No prohibited fee was accessed for this report. David J. Cordier and Ellen E. Miller of Cordier Auctions&Appraisals have successfully completed the personal.property appraisal certification program with the Certified Appraisers Guild of America and are members in good standing. This report was prepared in accordance with the Uniform Standards of Professional Appraisal Practice and with the Standards and Practices of the Certified Appraisers Guild of America which has review authority of this report. David J: Cordier and/or Ellen E. Miller have personally examined the subject property. The statements of fact contained in this report are true and correct to the best knowledge and belief of the appraiser. BY David J. Cordier, C.A.G.A. By: Ellen E. Miller,C.A.G.A. Cordier Auctions&Appraisals Cordier Auctions&Appraisals Page: 5 of 13 Purpose of the Report The purpose of this report is to determine the value for Estate Tax purposes for Buchanan, Ingersoll &Rooney PC,Harrisburg, Pennsylvania. Method of Valuation The method of valuation used for this appraisal is the Fair Market Value. Definition of Value Fair Market Value Under the United States Treasury regulation 1.170-1c Fair Market value is defined as: The price at which the property would change hands between a willing buyer and a willing seller, neither being under compulsion to buy or compulsion to sell and both having reasonable knowledge. Basis of Appraisal Valuation Date The date of valuation for determining the value estimation is January 4,2015. Date Appraisal Conducted This appraisal was conducted on December 18,2014. Limitations ofProperty There were no limitations on use or disposition of this property. Description An itemized list with descriptions is in Appendix A. Page: 6 of 13 CORDIER AUCTIONS&APPRAISALS Cordier Auctions&Appraisals was established in 1984. The company specializes in appraisals of antiques, fine art and personal property,estate liquidations and the auction and sale of fine antiques,art and real estate. Cordier Auctions&Appraisals maintains memberships in the Certified Appraisers Guild of America,the Antiques and Collectibles Dealers Association, Inc.,the Antique Dealers Association of Pennsylvania,the Pennsylvania Auctioneers Association and the National Auctioneers Association. Cordier Auctions&Appraisals has conducted appraisal clinics for such organizations as the Harrisburg Area . ._ _... Community College's Older American Days,the Questers, Rohrer Bus Antiquing Road Show Tour, Millersburg Historical Society, Friends of Fort Hunter,West Shore Country Club and the Friends of the Pennsylvania State Museum. Cordier Auctions&Appraisals is an underwriter for the Antiques Road Show on WITF Public Television. DAVID J CORDIER C A.G A.CERTIFIED APPRAISER David J.Cordier is co-owner of Cordier Auctions&Appraisals located in Harrisburg,Pennsylvania. Mr. Cordier has been an antiques and jewelry dealer since 1980 and an appraiser since 1990. David Cordier of Cordier Auctions&Appraisals has successfully completed the personal property appraisal certification program with the Certified Appraisers Guild of America. He is also a National Auctioneers Association accredited Real Estate Auctioneer. Mr.Cordier is a graduate of Winterthur Museum's Winter Institute,a graduate level program in American Decorative Arts. David Cordier has attended classes in the fine and decorative arts at George Washington University,Washington D.C.and the appraisal studies program at New York University,New York. Mr. Cordier studied the arts and decorative arts in Pennsylvania at Penn State University and holds a Master's degree in Business Administration from Penn State Capital Campus. Mr.Cordier is a writer for the Harrisburg Patriot News reporting on antiques and related events in central Pennsylvania. He also wrote a bi-weekly feature column"Eye on Antiques"for the Sunday Patriot News from 2001 to 2006. ELLEN E.MILLER,C.A.G.A.CERTIFIED APPRAISER Ellen E. Miller joined Cordier Auctions&Appraisals in 2000. Ms. Miller holds a Bachelor's degree in Marketing from Shippensburg University and a Master's degree in Business Administration from Temple University. Since joining Cordier Auctions&Appraisals,Ms.Miller has been the Director of Internet Sales,conducting research and documentation of inventory,maintaining client relationships and managing an international customer base. She has been responsible for the sale of several large collections via Internet auction including classic automobiles,antique toys,sports memorabilia and autographs. Ms. Miller has successfully completed the personal property appraisal certification program with the Certified Appraisers Guild of America. Prior to joining Cordier Auctions&Appraisals,Ms. Miller worked in the printing industry in sales and administration. Page: 7 of 13 Appendix A Fair Market Value Living Room 1. $400.00 Persian Rug Full field floral on tan ground. Made in Turkey. Hereke. 65" x 101 311. 2. $50.00 Mary Carlton(Washington,20th/21st Century) - watercolors on paper ofree iUi- ning women. Matted andirasilverframes.. Signed lower right"Mary Carlton". 1) 8-3/4" x 8-3/4". Overall 16" x 16-1/4".2) 14" x 20". Overall with frame 21-1/4"x 27-1/2". 3. $1,000.00 Alvar Sunol Munoz-Ramos(Spain/France, 1935- Les Balutrades Suite of 2. I)Les Poetes de la Balustrade. Embossed print.Three figures and violin. Signed and numbered in pencil "EA 8/40". Linen matte and gold painted frame. 22"x 31-1/2". Overall with frame 33-1/2" x 43-1/4". 2)Les Musicians de la Balustrade. Embossed print. Three figures with bird. Signed and numbered in pencil "EA 8/40". Linen matte and gold painted frame.22" x 31-1/2". Overall with frame 33-1/2" x 43-1/4". Circa 1985. 4. $200.00 Alvar Sunol Munoz-Ramos(Spain/France, 1935- Print.Lady overlooking a town. Signed and numbered in pencil 174/175. In wood frame. 21-1/2" x 29-1/2". Overall with frame 24-3/4" x 32-3/4". 5. $700.00 Salvador Dali(Spanish, 1904-1989) Color lithograph.Vermeer de Delft "la lettre". Signed and numbered in Signed pencil 262/350. Matted in gold painted frame. 30-3/4" x 20". Overall with frame 43"" x 31". 6. $200.00 2 Thai Illuminated Leaves From a Buddhist Sutra prayer book or manuscript. Matted in bamboo style gold painted frames. Each 9-3/4" x 25". Overall with frame 13-3/4" x 28-3/4". Condition: Each with horizontal fold across equator. Light surface wear to paint. 7. $300.00 Living Room Furniture Vinyl. Including- two piece sectional,three armchairs with ottomans, four brass and glass top side tables,and TV stand. 8. $1 00.00)Miscellaneous Furniture and Accessories - Including: two small rattan tables, fireplace fender,LG TV,rugs, Christmas decorations,brown vase,etc. Page: 8 of 13 Dining Room 9. 100.00)Dining Room SetdOra+t-d Glass top table and six upholstered side chairs. Reupholstered. Table 42" x 71" x 29-3/4" high. 10. ($800.00)Miseellaneous Glassware&Dishes— Including: 43 Villeroy&Boch wine stems, 10 A. Raynaud Limoges Verdues: lates, 12 Fitz&Floyd Classique chargers,other dishes and glassware,etc. 11. $300.00 Pair of Chinese Ginger Jars Chenghua porcelain. White ground with brown Lotus flower and scroll motif. Unmarked. Probably 19th century. 6"high each. 12. $100.00 Blown Art Glass Vase Blue green to clear. Smooth pontil. Unmarked. 11-3/8" high. 13. �$50.00)Miscellaneous-•-C>OnGC�C6 Including: TV trays,baskets,decanters, knick knacks. Hallway 14. $150.00 Curio Cabinet Two glass doors, glass sides,mirrored back. Interior glass shelves. Chinese Chippendale style. 3.2" x 14-3/4" x 81" high. 15. $400.00 Contents of China Cabinet Including: 2 Lalique Ange stems, I Waterford Millenium,stem, glass plates,assorted other stemware,two cocktail shakers,glass vases, bronze koi fish,Block pitcher, figurines,Tiffany&Co petal shaped bowl,Orrefors bowl#4590-13,and Santa Clara Pueblo pottery wedding vase by Chinana Jemez. 16. $50.00 Salazar(20th/21 st Century) Mixed media,paper cut,embossed.Butterflies Awaken Me Too. Signed,titled, and numbered in pencil 15/100. Matted in gold frame. 24-1/4" x 18-1/4" Overall with frame 31-1/4" x 24-1/4". 17. $20.00 Salazar(20th/2 I st Century) Mixed media,paper cuts,and embossed. I Chase the Illusive Butterfly of Love. Signed,titled,and numbered in pencil 24/100. Matted in gold frame. 5" x 5". Overall with frame 12"x 10-1/4". 18. $1 00.00IMiscellaneous-tonct+e-d Bookshelf,books,small table, unsigned watercolor of orchid, photograph by great nephew Justin McKinniss, small cabinet and Page: 9 of 13 accessories. 19. $200.00 Alvar Sunol Munoz-Ramos (Spain/France, 1935-) Embossed 935- Embossed print. Signed and numbered 57/260. Matted in black and gold frame. 25" x 184/4". Overall with frame 32-1/4" x 26". Bedroom I 20. $100.00 Chinese Print Companion. Signed,dated,titled in pencil. 145/150. With embossed seal.-Matted under mauve in silver frame: 1-9-3/4"-x-1-5--1/2'-".-Overall-., with frame 29-3/4" x 25-1/2". 21. $150.00 Chinese Print An Ancient Melody. Signed,titled, and numbered in pencil 55/175. Bamboo/Asian style frame. 19" x 24-1/2". Overall with frame 30-1/4" x 34-3/411. 22. $70.00)Miscellaneous- b00CXA-zd Including: wood pedestal,pottery lainp. Master Bedroom 23. $100.00)Modern Lacquered Bedroom Set Bedframe,two nig0htstands,entertainment cabinet,dresser, second dresser(in other Bedroom). 24. $100.00 Harold Altman(Pennsylvania, 1924-2003) November 198111. Signed,titled,and numbered in pencil 255/285. Matted in wood frame. 9" x 12-1/4". Overall with frame 18"x 20-1/2". 25. $250.00 Harold Altman(Pennsylvania, 1924-2003) Street Market. Signed,titled,and noted as Artist Proof in pencil. Matted in wood frame. 27-3/4" x 19". Overall with frame 36-1/2" x 27-3/4". 26. $250.00 Harold Altman(Pennsylvania, 1924-2003) Child. Signed,titled,and numbered in pencil 148/265. Matted in gold painted frame. 18-1/2" x 26-1/2". Overall with frame 26-3/4"x 33-3/4". 27. ($250.00)Miscellaneous- t>Oryt-k-cl. Including: computer desk,HP Pavilion 23 computer, filing cabinets, wicker hamper, chaise lounge, wicker stand and chest,accessories, knickknacks, bookcase, books. Bathroom 28. $50.00 Lily Page: 10 of 13 Photograph. Signed and numbered in pencil 153/300. Matted in white metal frame. 17-1/2" x 21-1/2". Overall with frame 22-1/4" x 26-1/4". 29. $50.00 Daisy Photograph. Signed and numbered 3/300 in pencil. Matted in white metal frame. 21-1/2" x 17-1/2". Overall with frame 26-1/4" x 22-1/4". Laundry Room 30. $200.00 GE Profile Washer and Dryer Kitchen 31. ($100.00)Miscellaneous Contents of Kitchen` b0nc4a Including: dishes,pots,pans, utensils,small accessories. . Sun Room 32. ($100.00)Miscellaneous Furniture - boY" 4e-d Including: fold out couch,two arm chairs,plant stand,cabinet, glassware,accessories,brass and glass modern lamp. Coins 33. $300.00 1909$2.50 Indian Head Gold Coin 34. $20.00 2 California Gold Tokens incl 1859 with loop and 1852 35. $30.00 15 1883 V Nickels 36. $60.00 3 1893 Columbian Silver Half Dollars 37. $4.00 1968-D Kennedy 40%Silver Half 38. $20.00 2 1851 Large Cents 39. $40.00 5 2 Cent Coins Two 1864,two 1865, 1868. 40. $50.00 1835 Half Cent 41. $20.00 2 Seated Liberty Quarters(1854, 18.76) 42. $50.00 1875 Twenty Cent 43. $10.00 14 Indian Head Pennies(1863, 1890, 1899, 1898, 1891, 1901, 1905, 1859, 1889, 1900, 1902, 1863, 1907, 1903) Page: 11 of 13 44. $10.00 1852 3 Cent Piece(Star) 45. $50.00 1829 Capped Bust Half Dime 46. $40.00 4 Seated Liberty Silver Dimes(1841, 1872, 1854, 1857) 47. $60.00 5 3 Cent Pieces(three 1866, 1868, 1870) 48. $90.00 6 Half Dimes(1857-0, 1853-0, 1838 with hole, 1855, 1848-0, smoothed O mint mark)-- 49. ark) -49. $30.00 1883 Hawaii silver dime 50. $355.00 US &Foreign coins a. 4 Philippines coins (two 1944 20 centavos, five centavos,ten centavos, 1944 one centavo) ($5) b. 1962 Portuguese I escudo($5) c. 4 Australian magician's coins (1943 3 pence,three 1944& 1943 floring) (-$20) d. 3 early smooth coins($5) e. 2 smoothed US large cents 1818 and 1800 ($40) f. 1863 Italian 2 lire ($20) g. 1812 French silver 5 francs Napoleon& silver 50 centimes 1916 ($65) h. 1935 Finnish 5 pennia($1.50) i. 1891 South Borneo I cent($15) j. 1895 Sarawak 1 cent($5) k. 5 German(1897 5 pfennig, 1881 1 pfennig, 1875 10 pfennig, 1957 2 pfennig, 18671 kreuzer) ($6.50) 1. 5 English&Canadian coins (two 1955 2 cent Caribbean, George V magician's coin, 1884 twenty cents, 1877-0 twenty shilling, 1905 farthing)($25) m. 1889 Straits Settlement 5 cents, 1870 Spanish cingo centimos cingo gramos, 1955 Caribbean 5 cents, 1923 Belgium 5 ces, 1882 Romanian 5 bani, 1895 Hungarian 2kb Magyar,smoothed coin($20) n. 7 Canadian(1918 George V shilling, 1904 10 cents silver, 1959 5 cents, 1914 5 cents, 1933 and. 1964 pennies, 1918 ten cents)($15) o. Mexican/Spanish coins(1868 20 centavos DE P.o, 1868 10 escudo, 1800 Carolus III I reale Mexico mint, 1959 peso Mexico mint, 1891 5 centavos, 1933 1 cent Mexico mint, 1936 10 centavos, 1903 20 centavos, 1944& 1956 20 centavos, 1906 1 cent) ($55) p. 1566 Tudor Queen Elizabeth hammered coin ($25) q. Asian(10 sen,aluminum, 5 sen,20 sen, 1863 & 1866 Hong Kong I mil, WWII 5 sen, 10 sen,two 7.2 candareens Wang-Tung&Yoo-Kien, four Victoria 5 cents incl 1888, 1881, 1901, 1900 Hong Kong,4 holed coins) ($90) Page: 12 of 13 r. Fare token Philadelphia($1) 8 224.00 Total Page: 13 of 13 .j�h_Sr i�n �+'q� �, ,tom _-. . . .• �� it,� � t�tY..l' � F Ota.JPG 01b.JPG 02a.JPG 03a.JPG 03b.JPG C.f gyp, r 4 T_ pap, T—"'2' i -r��,�-re• r" OCa.JPG 05a.JPG 06a.JPG 06b JPG 06c.JPG 078.JPG 07b.JPG 07c.JPG 07d.JPG 07e.JPG a C ` `, - •�' +!; -.u� ire 08a.JPG 08b.JPG 08cJPG 08d.JPG 08e.JPG "YY 09a.JPG 10a.JPG 10b.JPG 10c.JPG 10d.JPG Egg ;- ,r F� Imo'®`�� .�„�� - -- yr l �'.cy`•;iri��'� ti �-s_�„ .'��:t t �. .-• :,'l4• �rr �1 Irl!i �� �" �N���, +* l:,'�d `'.'II�I Y"'. a. }�,� •f`�yrd-r`•'a` � �""�; 1 *����_ •i`�.Ft y ,�-�•c'_s+„��p �.i •i.,� ;tt��y 1` '�+�- .��� �CJJ;_J� rsJf�jp-J:7�Mr_Fi��. � ,. f .�� _i�-''� •`�p.a Jlt''T'•s� _��.� tLy �`-`•'�i' -. } ''l�•rS3A.` ��Y'c + 'y+^ J1 } �: I t. u 19a.JPG 20a.JPG 21a.JPG 22.JPG 23a.JPG IiA �J 23b.JPG 23c.JPG 23d.JPG 23e.JPG 24a.JPG At t � y iin IL 25a.JPG 26a.JPG 27a.JPG 27b.JPG 27c.JPG 27d.JPG 27e.JPG 27CJPG 279.JPG L 27h.JPG ,. '. 27i.JPG 27j.JPG 27k.JPG 28a.JPG 29a.JPG ";A."A' 30a.JPG 31 a.JPG 31b.JPG 31 c.JPG 31 d.JPG LF J�RIM n. 31e.JPG 31f.JPG 31g.JPG 32a.JPG 32b.JPG 32c.JPG 32d.JPG 32e.JPG 32f.JPG 32g.JPG 32h.JPG 33-35.JPG 36-38.JPG 39.42.JPG 43.JPG - (D 44-48.JPG 49-50a.JPG 50b.JPG 50c.JPG 50d.JPG 50e.JPG x PINK HANDS OF HOPE Date: 5325 E. Trindle Road Mechanicsburg, PA 17050 Initials (PHOH): Description Pieces Bags Description Pieces . Bads Clothing Household Items ce, Accessories Toys Food Miscellaneous Estimated Value of Donations: Donor's Signature: Donor's Name: .7 Address, City, State, Zip: Donor is responsible for assigning value to don ti s. smust u Ate ingood condition or better to be deductible. *Pink Hands of Hope has not furnished goods or services to the donor in exchange for this contribution. THANK YOU FOR YOUR TAX DEDUCTIBLE DONATION THAT PROVIDES HOPE FOR AREA WOMEN WITH BREAST CANCER /7`0 frac,, fz � � S;7 THE SALVATION ARMY RECEIPT FOR DONATED GOODS To: zz, ; lj Date: t/L�'/ / U This will acknowledge, WITH THANKS, the donation of the listed articles or goods to The Salvation Army to assist in the furtherance of its rehabilitation program for men and women. Description of Articles: ndition: j7 Valuation of gifts in kind are the privilege and responsibility of the donor.A Salvation Army Valuation Guide (MS-36B) for fair market value will be supplied on request. Contributions are deductible for income tax purposes to the extent allowed by law.* HARRISBURG, PA Address of Center Signature of Administrator or Representative *Note:Due to record keeping and reporting requirements imposed by the Internal Revenue Service,the Salvation Army requests all donors who will require the Salvation Army to execute a Form 8283, "Non-cash Charitable Contribution,"for contributions over$5,000 to present such forms for execution at the time of the donation.The Salvation Army will not be able to execute such forms at any time thereafter if the donated property cannot be traced.The Salvation Army is required to report to the Internal Revenue Service the sales proceeds of any single item for which the donor claimed a deduction of more than$500 and/or when the donor has contributed more than$5,000. VALUATION GUIDE FOR THE ITEMS DONATED TO THE SALVATION ARMY The following is a list of the average price charged in our stores if the items are in good condition. New expensive items would be higher and damaged materials less.The list is for your guidance only.Itis recommended that you have an appraisal for valuables over $200. The following paragraph is a copy of the IRS Rules. From publication 526, Internal Revenue Service Charitable Contributions: Requires that the contributor attach to his/her income tax return, the following information: 1) Name and address of the organization to which the contribution was made. 2) Date of contribution. 3) Description of property, including its condition. 4) Cost of property. 5) Fair market value showing method utilized in determining fair value. 6) Amount claimed as deduction. Additional information is required for any single item contribution for which a deduction in excess of$200.00 is claimed. Check with your local IRS Office in such instances. LADIES'CLOTHES LOW HIGH FURNITURE LOW HIGH DRY GOODS LOW HIGH Blouse $2.00 $7.50 Air Conditioner $20.00 $45.00 Blankets $2.50 $6.00 Bathrobes 2.50 .-8.50 Barbecue 10.00 15.00 Bedspreads. ..._ _ 3.00 12.00 Boots 2.00 4.50 Bed Complete(double) 60.00 145.00 Chair Covers 5.00 35.00 Bras 1.00 3.00 Bed Complete(single) 35.00 85.00 Curtains 1.50 4.00 Bathing Suits 4.00 7.50 Bicycles 15.00 45.00 Drapes 8.50 15.00 Coats 10.00 55.00 Carriage 5.00 100.00 Pillows 2.00 6.00 Dresses 4.00 16.00 Chest 25.00 45.00 Sheets 2.00 5.00 Evening Dresses 10.00 35.00 China Cabinet 85.00 150.00 Throw Rugs 1.50 4.00 Fur Coats 25.00 70.00 Clothes Closet 15.00 30.00 Towels .50 2.00 Fur Hats 7.00 12.00 Coffee Table 15.00 45.00 Foundation Garments 3.00 8.00 Convertible Sofa Handbags 2.00 10.00 (with mattress) 85.00 150.00 Hats 1.00 5.00 Crib(with mattress) 25.00 75.00 Jackets 4.00 8.00 Desk 25.00 125.00 Nightgowns 4.00 8.00 Dresser(with mirror) 20.00 85.00 Pant Suits 6.50 10.00 Dryer 45.00 85.00 Socks .40 1.25 End Tables 10.00 25.00 Suits 6.00 30.00 Floor Lamps 7.50 22.00 Shoes 2.00 5.00 Folding Beds 20.00 45.00 Shorts 3.00 7.00 Heaters 7.50 22.00 Sweaters 3.50 12.50 High Chairs 10.00 35.00 Slips 1.00 4.50 Hi Riser 35.00 60.00 Slacks 3.50 7.50 Kitchen Cabinets 25.00 75.00 Kitchen Chair � 2.50 7.00 MENS'CLOTHING LOW HIGH Mattress(double) 20.00 50.00 Jackets $7.50 $15.00 Mattress(single) 15.00 35.00 Overcoats 15.00 40.00 Play Pen 7.50 20.00 Pajamas 2.00 3.50 Radio 7.50 50.00 Pants/Shorts 3.50 8.50 Refrigerator(working) 75.00 250.00 Raincoats 6.00 12.00 Rugs 20.00 75.00 Suits 15.00 45.00 Secretary 50.00 125.00 Slacks 5.00 10.50 Sewing Machine 15.00 75.00 Shirts 2.50 10.50 Sofa 35.00 85.00 Sweaters 2.50 8.50 Studio Couch 35.00 85.00 Shoes 3.50 10.50 TV(B/W working) 25.00 80.00 Swim Trunks 2.50 5.50 TV(Color working) 75.00 225.00 Tuxedo 10.00 35.00 Trunk 5.00 22.50 Under Shirts 1.00 2.50 Typewriter 7.50 22.50 Under Shorts 1.00 3.50 Upholstered Chair 25.00 55.00 Vacuum Cleaner CHILDRENS'CLOTHING LOW HIGH (working) 10.00 35.00 Blouses $2.00 $6.00 Washing Machine Boots 1.00 10.50 (working) 35.00 125.00 Coats 4.50 12.50 Wardrobe 20.00 60.00 Dresses 3.50 10.50 Jackets 3.00 18.00 COMPLETE Jeans 3.50 8.50 FURNITURE SETS LOW HIGH Pants 3.50 8.50 Bedroom Set $350.00 $800.00 Snowsuits 1.00 8.50 Dining Room Set 150.00 850.00 Shoes 2.50 8.00 Kitchen Set 35.00 125.00 Skirts 1.50 4.50 Sweaters 2.50 6.00 Slacks 3.00 6.00 Shirts 2.00 4.50 Socks .60 1.50 Underwear 1.00 1.50 i 74020644 01/2015 Page 1 of 2 i Branch Office �.� SCOTTRADE,INC Air--' 4635 HIGH POINTE BLVD b-coulade I STE 83 HARRISBURG PA 17111 i (717)561-1341 M DUDLEY SMITH JR TOD SUBJECT TO STA TOD RULES Account Number Office 3620 LOGAN ST UNIT 7C CAMP HILL PA 17011-2768 74020644 37D Period Beginning .Period Ending 01/01/2015 01/31/2015 INFORMATION UPDATE Investment variety can be a key part of a diversified portfolio.Visit scottrade.com to see our breadth of investment products. Keep in mind that while diversification may help spread risk does not assure a profit,or protect against loss,in a down market. ACCOUNT SUMMARY ACTMTY SUMMARY VALUE THIS PERIOD OPENING TOTAL MONEY BALANCE 2,791.13 � CREDITS: MONEY BALANCES: DIVIDEND/INTEREST INCOME 0.02 BANK DEPOSIT PROGRAM BALANCE" j 2,781.16 OTHER CREDITS 0.00 TOTAL CREDITS 0.02 BROKERAGE ACCOUNT BALANCE 0.00 DEBITS: TOTAL MONEY BALANCE i 2,791.15 DIVIDEND/INCOME EXPENSE 0.00 OTHER DEBITS 0.00 TOTAL ACCOUNT VALUE2,797:15 TOTAL DEBITS 0.00 CLOSING TOTAL MONEY BALANCE 2,791.15 Current Tax Strateav" + Stocks,Options&Bonds: FIFO Funds: FIFO BANK DEPOSIT ACTIVITY Date Transaction Description Amount Balance OPENING BALANCE 2,791.13 01/30/15 INTEREST EARNED INT EARNED BANK DEP PROGRAM 31 DAYS @0.01%APYE 0.01% 0.02 2,791.15 I I I 74020644 01/2015 Page 2 of 2 I CLOSING BALANCE 2,791.15 i BANK DEPOSIT PROGRAM BALANCES` PROGRAM BANK OPENING BALANCE CLOSING BALANCE U.S.BANK,NA 2,791.13 2,791.15 TOTAL PROGRAM BALANCE 2,791.13 2,791.15 'Bank Deposit Program(BDP)deposits are held at the banks listed above. Deposits in BDP Accounts are eligible to be insured by the FDIC up to$250,000 per depositor. Details on FDIC deposit insurance coverage and limitations are available at www.fdic.gov/deposit. If clients have any additional deposits at any of the above banks,they should monitor the total amount of deposits with any one bank to recognize whether they are exceeding FDIC insurance coverage. Scottrade Bank and Scottrade,Inc.are separate but affiliated companies. Securities products offered by Scottrade,Inc,are not deposit obligations of any of the listed banks,are subject to investment risk,are not FDIC insured,may lose value and are not bank-guaranteed. The balance in the Bank Deposit Program in which you have a beneficial interest can be liquidated on your order and the proceeds returned to your brokerage securities account or remitted to you. You can review cost basis information for your account by clicking on the My Account tab after logging into your account and then clicking on"Gain/Loss&Tax Center".Unless you instruct otherwise,Scottrade will use the first in,first out(FIFO)method to calculate your gains and losses.When determining cost basis,Scottrade's default method of tax lot selection is First In,First Out(FIFO).Cost basis educational material can be found in the Knowledge Center, accessible through your account online. The About Your Statement document can be accessed online by logging into your Scottrade account and going to My Account>Account History>Account Statements. I I I I I I I i i Merrill Lynch Wealth Management Bank of America Corporation Historical Date of Death Valuation M Dudley Smith 872-83169 i Date of Death 01/04/2015 Report Type Date Of Death Valuation Date 01/04/2015 Number of Account(s) 1 Processing Date 01/08/2015 MLPF& S CUST FPO Number of Security(s) :6 M DUDLEY SMITH IRRA FBO M DUDLEY SMITH DCSD PO BOX 60571 HARRISBURG PA 17106-0571 Account#872-83169 Shares Security High/Ask Low/ Bid Mean and/or Div and Int Security or Par Description Adjustments Accruals Value i 1) 140.0000 RITE AID CORPORATION (767754104) New York 01/02/2015 7.75000 7.50000 H/L 01/05/2015 7.68800 7.46000 H/L ! 7.599500 1,063.93 2) 2,133.3060 AMERICAN CAPITAL INCOME (140193301) BUILDER CL C 01/02/2015 0.00000 59:55000 MKT 59.550000 127,038.37 3) 4,557.4250 BLACKROCK MULTI ASSET(092561-1344) INCOME PORTFOLIO C 01/02/2015 i 0.00000 11.22000 MKT 11.220000 51,134.30 +' 1 i i MLPF&S CUST FPO Number of Security(s) : 6 M DUDLEY SMITH IRRA FBO M DUDLEY SMITH DCSD PO BOX 60571 HARRISBURG PA 17106-0571 Account#872-83169 Shares Security High 1 Ask Low 1 Bid Mean and/or Div and Int Security or Par Description !' Adjustments Accruals Value 4) 2,193.9450 BLACKROCK EQUITY(09251M306) DIVIDEND FD C 01/02/2015 0.00000 24.29000 MKT 24.290000 53,290.92 5) 2,453.1230 BLACKROCK GLOBAL(09251T301) ALLOCATION FD INC C 01/02/2015 0.00000 18.18000 MKT 18.180000 44,597.77 I 6) 53,555.9400 BANK OF AMERICA, NA RASP (55499U915) 1.000000 53,555.94 Total Value $330,681.23 Total Accrual ' $0 Total $330,681.23 Total Security Value : $330,681.23 Total Accruals : $0 Total Combined Value : 3 $330,681.23 The information herein has been obtained from a source we believe to be reliable,but we do not guarantee its accuracy or completeness.Merrill Lynch does not provide tax,accounting or legal advice.Any tax statements contained herein were not intended or written to be used,and cannot be used for the purpose of avoiding U.S.,federal,state or local tax penalties.Please consult your advisor as to any tax,accounting or legal statements made herein. i 1 Disclosures: i 2 i •There is NO fee associated with the use of this application at this time. •Alternative Date of Death valuations are not available in this application.Please consult your tax advisor for assistance in obtaining this report. •Report may include trades that are not settled as of valuation date. •All security positions are based on trade date. •Money funds,money market and/or bond/fixed income mutual funds may or may not include dividends/interest accruals prior to month end payment. •For accounts with Credit and/or Debit card(s),the cash position may not reflect reduction for purchases of goods or services which are paid for by automatic debit on the Wednesday before the last Friday of each month. •Cash balance may not reflect outstanding checks written prior to valuation date or unsettled cash as of valuation date. •All items flagged'T'and highlighted in red reflect manually adjusted transactions(for price,shares,market value or security name)or positions with no available price. •Asset positions provided to Bank of America/Merrill Lynch from an outside financial institution(i.e.Annuities),may require the Securities Description line to be manually updated. •Fee accruals are not captured in TMA accounts. •All mortgage backed securities have the paydown factor/amortization factor automatically applied. •If the account you are valuing is a"800"series account(international),the values will be reported based on the currency the account holds,not USD.Please also note that if this account is valued along with other USD accounts,you will not receive an accurate valuation;please run these accounts separately from USD accounts held in the client's household. The information herein has been obtained from a source we believe to be reliable,but we do not guarantee its accuracy or completeness. Investment products provided are Merrill Lynch,Pierce,Fenner&Smith Incorporated: Are Not FDIC Insured Are Not Bank or State Guaranteed May Lose Value Merrill Lynch,Pierce,Fenner&Smith Incorporated is a wholly owned subsidiary of Bank of America Corporation,and a registered broker dealer and member of FINRA and SIPC. Merrill Lynch,Pierce,Fenner&Smith Incorporated is not a tax or legal advisor.Clients should consult a personal tax or legal advisor before making tax or legal related investment decisions. Nothing discussed or suggested in these materials should be construed as permission to supersede or circumvent any Bank of America or Merrill Lynch,Pierce,Fenner&Smith Incorporated policies,procedures,rules,and guidelines. i • i I I 1 3