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HomeMy WebLinkAbout07-30-15 pennsylvania 1505618403 J DEPARTMENTOFREVIFIX(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 14 11716 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 07 14 2014 05 29 1925 Decedent's Last Name Suffix Decedent's First Name MI SMITH LOUIS E (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ❑X 1. Original Return 2. Supplemental Return 3. Remainder Return(date of death prior to 12-13-82) 4. Agricultural Exemption(date of 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) EJ 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 EDMUND G MYERS (717) 761 4540 First Line of Address 301 MARKET STREET Second Line of Address PO BOX 109 City or Post Office State ZIP Code LEMOYNE PA 17043 Correspondent's email address: eqm _jdsw.com REGISTER OF WILLS USE ONLY REGISTER OF WILLS USE ONLY DATE FILED MMDDYYYY C'7 . DATE FILER-S!tP c rtrr ) = '.70 © 3 C.7 1.:7 Side 1 o `_n a C.:; _ a 111111111 IIII 4 �- =1 1505618403 1505618"03 �� -a 1505618411 REV-1500 EX Decedent's Social Security Number Decedent's Name: Smith, Louis E RECAPITULATION 1. Real Estate(Schedule A)....................................................................................... 1. 110-1000 - 00 2. Stocks and Bonds(Schedule B)............................................................................. 2. 69,818 - 76 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. 2 2116 17 - 5 9 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) ❑ Separate Billing Requested............ 7. 8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 4 01,4 3 6 - 3 5 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 401365 . 08 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 7,097 - 10 11. Total Deductions(total Lines 9 and 10)................................................................ 11. 471462 - 18 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 3531974 - 17 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J)............................................... 13. 106,192 - 25 14. Net Value Subject to Tax(Line 12 minus Line 13)............................................... 14. 247,781 - 92 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. 0 . 00 16. Amount of Line 14 taxable at lineal rate X .045 176,987 . 09 16. 7,964 . 42 17. Amount of Line 14 taxable at sibling rate X.12 0 . 00 17. 0 . 00 18. Amount of Line 14 taxable at collateral rate X.15 70,794 - 83 18. 101619 - 23 19. TAX DUE................................................................................................................ 19. 181583 . 65 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. SIGNATURE OF PERSON RESPON IBLE FOR FILING RETURN Linda L Gould ADDREfSS 1340 Oak Drive, Macungie, PA 18062 SIGNATUR F PR6PARER OTHER THAN REPRESENTATIVE Edmund G. Myers '7 .Zq ofTf� ADDRESS L.t(,JJ6 301 MARKET STREET, Lemoyne, PA 111111111111111111111111111111111111111111111111111111111111 Side 2 1505618411 1505618411 REV-1500 EX Page 3 File Number 21-14-0716 Decedent's Complete Address: DECEDENT'S NAME Smith, Louis E STREETADDRESS 376 Lowther Street CITY STATE ZIP Lemoyne PA 17043 Tax Payments and Credits: 1. Tax Due(Page 2, Line 19) (1) 18,583.65 2. Credits/Payments A. Prior Payments 15,000.00 B. Discount 578.95 Total Credits(A +B) (2) 15,578.95 3. Interest (3) 26.12 4, If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2,Line 20 to request a refund 5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 3,030.82 Make Check Payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;............................................................................... ❑ ❑x b. retain the right to designate who shall use the property transferred or its income;.................................. ❑ ❑x c. retain a reversionary interest;or............................................................................................................... ❑ d. receive the promise for life of either payments,benefits or care?............................................................ ❑ ❑x 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.................................................................................................................... ❑ FxI 3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... ❑ ❑x 4. Did decedent own an individual retirement account,annuity,or other non-probate property which contains a beneficiary designation?.................................................................................................................. ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1,1994 and before Jan.1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after January 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)]. The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an adoptive parent,or a step-parent of the child is 0 percent[72 P.S.§9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)]. A sibling is defined, under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. Louis E Smith Date of Death Mon,Jul 14,2014 3 Months After DOD Tue,Oct 14,2014 Click here if Paid Total Paid at Not Paid at at Discount Date Paid Tax Paid Discount Discount ® Fri,Oct 10, 2014 11,000.00 11,000.00 ❑ Thu, Mar 26,2015 4,000.00 4,000.00 Tax Discount A. Tax Paid at Discount(per above) 11,000.00 x 5/95 = 578.95 B. ❑Tax Due if Entire Balance paid on/before Tue. Oct 14. 2014 x r)/95 = C. Total NET Tax Paid/To be Paid at Discount 11,000.00 x 5/95 = 578.95 D. Discount C. 11,000.00 x 5/95 = 578.95 (1)* F. 18,583.65 x 5% = 929.18 (2)* Lesser of(1)or(2)above 578.95 E. Tax Credit(C+ D) 11,578.95 F. GROSS Tax Due(Page 1, Line 19) 18,583.65 G. Balance of Tax Due 7,004.70 The calculations in(1)and(2)are intentionally different. Item (1)computes the amount of discount based upon an assumed NET payment. Item (2)computes the maximum potential discount based upon an actual GROSS principal tax due. Thus,a discount always equals the NET payment x 5/95, or the GROSS tax x 5%. Louis E Smith #Days to Add Amt on which interest based 3,004.70 for Holiday Filing Deadline Decedent Date of Death Mon,Jul 14,2014 Tue,Apr 14, 2015 9 Months After DOD Tue,Apr 14, 2015 Final Payment Date Wed,Jul 29,2015 Suggested Interest 26.12 Daily Interest Amount PrincipalTaxDue 18,583:65 Year Rate #Days for Year Credits 15,578.95 1990 .000301 Interesti 26.12'1 1991 .000301 TaxDuej 3,030.82 1992 .000247 1993 .000192 1994. .000192 1995 .000247 1996 .000247 1997 .000247 1998 .000247 1999 .000192 2000 .000219 2001 .000247 2002 .000164 2003 .000137 2004 .000110 2005 .000137 2006 .000192 2007 . .000219 2008 .000192 2009 .000137 2010 .000110 2011 .000082 2012 .000082 2013 .000082 2014 .000082 2015 .000082 106 26.116852 2016 2017 2018 2019 2020 Suggested Interest 26.116852 Note: does not include interest for dates before 1990. Rev-1502 EX+(12-12) SCHEDULE A pennsylvania REAL ESTATE DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Smith, Louis E 21-14-0716 All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on schedule F. Attach a copy of the settlement sheet if the property has been sold Include a copy of the deed showing decedent's interest if owned as tenant in common. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Real Estate-376 Lowther Street, Lemoyne,Cumberland County, PA-Real Estate sold on 110,000.00 June 15, 2015. A copy of the HUD-1 Settlement Sheet is Attached TOTAL(Also enter on Line 1, Recapitulation) 110,000.00 (If more space is needed,additional pages of the same size) Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule A(Rev. 12-12) Rev-1503 EX+(08-12) SCHEDULE 6 pennsylvania STOCKS & BONDS DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Smith, Louis E 21-14-0716 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 693475105 792 shares of PNC Financial Services Group Inc-Com. 88.155 69,818.76 Valued using EstatVal and valuation is attached to this Return TOTAL(Also enter on Line 2, Recapitulation) 69,818.76 (If more space is needed,additional pages of the same size) Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule B(Rev.08-12) Rev-1508 EX+(08-12) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Smith, Louis E 21-14-0716 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 Westfield Homeowners Insurance-Claim/Settlement for Damage to Roof 142.56 2 Commonwealth of PA/SERS Annuity Payment 1,734.96 3 PNC Bank Certificate of Deposit Account No.21001019750-—Date of Death Account 20,020.82 Balance Letter from PNC is Attached to this Return for Items 3 through 13 4 PNC Bank Certificate of Deposit Account No.21001019752 5,003.97 5 PNC Bank Certificate of Deposit Account No.31000161319 20,027.80 6 PNC Bank Certificate of Deposit Account No.31100286131 20,033.41 7 PNC Bank Certificate of Deposit Account No.31200147330 7,013.17 8 PNC Bank Certificate of Deposit Account No.31400163426 5,005.72 9 PNC Bank Certificate of Deposit Account No.31400188386 20,036.80 10 PNC Bank Certificate of Deposit Account No.31700133019 10,022.09 11 PNC Bank Checking Account No.5140130811 11,475.56 12 PNC Bank Perfomace Money Market Account No.5030121658 39,203.60 13 Santander CD Account No.2335129942-—Date of Death Account Balance Letter from 5,000.00 Santander is attached to this Return for Items 14 through 17 14 Santander CD Account No.2335129967 10,000.00 15 Santander CD Account No.2335130064 5,000.00 Total of Continuation Schedule See attached page TOTAL(Also enter on Line 5, Recapitulation) 221,617.59 (If more space is needed,additional pages of the same size) Copyright(c)2012 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev.08-12) Rev-1508 EX+(08-12) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT continued ESTATE OF FILE NUMBER Smith, Louis E 21-14-0716 ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 16 Santander CD Account No.2335130452 30,000.00 17 Verizon -Refund on Account 109.52 18 Personal Property Sold at Auction 4,867.00 19 Foremost Insurance-Refund of Homeowners Insurance 448.00 20 Real Estate-376 Lowther Street, Lemoyne,Cumberland County, PA- 277.13 Reimbursements/Refunds of County($242.38)and School ($34.75)Taxes . A copy of the HUD-1 Settlement Sheet is Attached 21 The Ecumenical Community Home-Refund on Account 5,774.48 22 U.S.Treasury-Refund on Decedent's 2014 Federal Individual Income Tax Return 268.00 23 Westfield Homeowners Insurance-Refund 29.00 24 Westfield Insurance-Reimbursement of Homeowners Insurance 124.00 TOTAL(Also enter on Line 5, Recapitulation) 221,617.59 Copyright(c)2012 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev.08-12) REV-1511 EX+(08-13) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RESIDENT DECENT RETURN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Smith, Louis E 21-14-0716 Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Linda L Gould Street Address 1340 Oak Drive city Macungie State PA zip 18062 Year(s)Commission Paid 10,000.00 2. Attorney's Fees JOHNSON DUFFIE 12,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) Claimant Street Address City State Zio Relationship of Claimant to Decedent 4. Probate Fees 473.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 155.00 7. Other Administrative Costs 17,736.58 See continuation schedule(s) attached TOTAL(Also enter on line 9, Recapitulation) 40,365.08 Copyright(c)2013 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.08-13) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Smith, Louis E 21-14-0716 ITEM NUMBER DESCRIPTION AMOUNT Other Administrative Costs 1 Cumberland Law Journal-Notice of Estate Administration 75.00 2 Expenses for Auction/Chuck Bricker,Auctioneer 2,324.00 3 Faith A. Nicola,Tax Collector 444.57 4 Foremost Insurance-Homeowners Insurance 1,079.00 5 George Young-Grass cutting,Snow removal,ice chopping,other miscellaneous 2,610.00 maintenance to real estate 6 Gingrich's Plumbing-Sewer Pipe Repair Work 2,901.00 7 Karl Stine Clean out of Decedent's Residence 250.00 8 Lemoyne Boro-Sewer 653.25 9 PA American Water 232.16 10 Penn Waste 130.50 11 PPL 340.34 12 Real Estate-376 Lowther Street, Lemoyne,Cumberland County, PA-Settlement Charges. A 4,540.00 copy of the HUD-1 Settlement Sheet is attached 13 Reserves: Additional Miscellaneous Administrative Expenses 150.00 14 Reynolds Restoration-Roof Repair 392.56 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, Louis E 21-14-0716 ITEM NUMBER DESCRIPTION AMOUNT 15 Santander Estate Checking Account No.2781794074-Monthly Maintenance Fees on 75.00 Account of$7.50 per month for 10 months 16 Terminex 310.58 17 UGI 810.62 18 Westfield Insurance-Homeowners Insurance 418.00 H-137 17,736.58 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98) Rev-1512 EX+(12-12) SCHEDULE 1 pennsylvania DEBTS OF DECEDENT, DEPARTMENT OF REVENUE INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS RESIDENT DECEDENT ESTATE OF (FILE NUMBER Smith, Louis E 21-14-0716 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 Alert Pharmacy Services-Hospital Medications 118.84 2 Checks Clearing After Date of Death 455.00 3 Community Life Team -Ambulance Transport 109.00 4 Faith A. Nicola,Tax Collector-Real Estate Tax 845.52 5 Lemoyne Boro-Sewer 65.00 6 Messiah Lifeways at Messiah Village-Final balance due/Residential Account 4,098.00 7 PA American Water 47.47 8 Penn Waste 43.50 9 PPL 79.92 10 The State Employee Retirement System -Refund of Overpayment 925.31 11 UGI 26.70 12 Verizon Financial 267.79 13 Verizon Wireless 5.25 14 West Shore Tax -Per Capita Tax 9.80 TOTAL(Also enter on Line 10, Recapitulation) 7,097.10 (If more space is needed,additional pages of the same size) Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-12) REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Smith, Louis E 21-14-0716 NAME AND ADDRESS OF RELATIONSHIP TOSHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) ($$$) Do Not List Trustee s I� TAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec.9116(a)(1.2)] 1 Robyn E Davis Granddaughter Ten(10%) 6405 Sixteenth Avenue East Percent of Palmetto, FL 34221 Residue 2 Linda L Gould Daughter-in-Law Thirty(30%) 1340 Oak Drive Percent of Macungie, PA 18062 Residue 3 Lisa A Listwa Granddaughter Ten(10%) 5279 Chandler Way Percent of Orefield, PA 18069 Residue 4 Debra Varsayni Friend Ten (10%) 401 Steuben Road Percent of New Cumberland, PA 17070 Residue 5 Debra Wilkinson Cousin Ten(10%) 781 Old Silver Spring Road Percent of Mechanicsburg, PA 17055 Residue Total Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate. NON-TAXABLE DISTRIBUTIONS: II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 Endowment Fund of Grace United Methodist Church-30%of Residue 106,192.25 TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 106,192.25 Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev. 01-10) ESTATE OF LOUIS E. SMITH SCHEDULE OF EXHIBITS EXHIBITA Last Will and Testament of Louis E. Smith signed and dated August 12, 2003 EXHIBIT B Receipt of Payment for Inheritance Tax Prepayment of$11,000.00 on 10/10/2014 and Additional Payment to Tax of$4,000.00 on 03/23/2015 EXHIBIT C Copy of Correspondence Emailed to PA Department of Revenue Requesting Extension Time to file Return EXHIBIT D HUD I Settlement Sheet for Real Estate located at 376 Lowther Street, Lemoyne, Cumberland County, PA. Real Estate Sold on June 15, 2015. EXHIBIT E Estate Val Valuation for 792 Shares of PNC Financial Services Group Inc. Stock EXHIBIT F PNC Bank Date of Death Valuation Letter for Certificate of Deposit Accounts, Checking Account and Performance Money Market EXHIBIT G Santander Bank Date of Death Valuation Letter for Certificate of Deposit Accounts, Checking Account and Performance Money Market :717078 LAST WILL AND TESTAMENT BE IT REMEMBERED THAT I, LOUIS E. SMITH, a resident of Cumberland County, Pennsylvania, being of sound mind,memory and understanding,do make,publish and declare this to be my LAST WILL AND TESTAMENT, hereby revoking any and all Wills and Codicils previously made by me. I I declare that I am married to CHRISTINE H.SMITH. II I direct that all my just debts and funeral expenses shall be paid from my residuary estate as soon as practicable after my decease. IQ I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. IV I give,devise and bequeath all my property,whether real or personal,wherever situate, including any property over which I may have a power of appointment to my wife, CHRISTINE H.SMITH,provided that she survives me by thirty(30)days. V If I should predecease my wife, CHRISTINE H. SMITH,I request that she make the following gifts: $1,000.00 to the Shriners Hospitals for Crippled Children, c/o Zembo Temple, Harrisburg,Pennsylvania; $1,000.00 to the Scottish Rite Masonic Museum and Library, Inc., a Massachusetts corporation having its headquarters in Lexington,Massachusetts; $1,000.00 to the Masonic Homes Guest and Building Fund, Elizabethtown, Pennsylvania EXHIBIT A VI If my wife,CHRISTINE H.SMITH,shall predecease or fail to survive me by thirty (3o) days, I give, devise and bequeath all of my property, whether real or personal, wherever situate,including any property over which I may have a power of appointment, as follows: THIRTY PERCENT(3o%)to my daughter-in-law,LINDA G.GOULD,per stirpes; TEN PERCENT(io%)to my granddaughter,LISA ANN HARTZELL,per stirpes; TEN PERCENT (io%) to my granddaughter, ROBYN ELIZABETH BLEILE, per stirpes; TEN PERCENT(io%)to my cousin,DEBRA WII.XINSON,per stirpes; THIRTY PERCENT (3096) to the ENDOWMENT FUND OF GRACE UNITED METHODIST CHURCH,Lemoyne,PA; TEN PERCENT(10%)to our family friend,DEBRA VARSANYI,per stirpes. VII I desire that I be buried in the East Harrisburg Cemetery in the Hartzell Lot,Section 36, Block "D", Lot 26, Grave 1. I request that the Parthemore Funeral Home of New Cumberland handle the fineral arrangements. VII[ I nominate,constitute and appoint my wife,CHRISTINE H. SMITH,as Executrix of this LAST WILL, to serve without bond. If my wife is unable or unwilling to act in that capacity, then I nominate,constitute and appoint my daughter-in-law,LINDA G. GOULD, as Executrix of this LAST WILL,to serve without bond_ IN WITNESS WHEREOF, I, LOUIS E. SMI H, have set my hand to this LAST WILL this yd day of ,2003. eOUIS E.SMITH a Signed,sealed,published and declared by the above-named LOUIS E.SMITH as and for his last Will and Testament,in the presence of us,who,at 's reques -aa�`in his presence, o and in the presence of each other,have hereunto subscribed names esses. ;� r ' ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF CUMBERLAND I, LOUIS E. SMITH, Testator, 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 as my free and voluntary act for the purposes therein expressed. LdUIS E. SMITH Sworn or affirmed to and acknowledged before me by LOUIS E. SMITH, Testator, this ��2 s+ day of ' 2003. Notary Public v NOTARIAL SEAL DEBORAH L RYAN,NOTARY PUBLIC CITY OF MECHANICSBURG,CUMBERLAND COUNTY MY COMMISSION EXPIRES JUNE 11,2006 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF CUMBERLAND f. We, i � 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 Testator sign and execute the instrument as his LAST WILL, that LOUIS E. SMITH signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and se&'of the Testator signed the Will as witnesses; and that to the best of our ln6#dge, the Testator was at the time 18 years of age or mo , of sound. mind,- d�/under no constraint or undue influence. V Sworn or affirmed to and acknowledged before me this 42W-11day of ,2003. <� C7 Notary Public A NOTSEAL DEBORAH L RYAN,P!0 TARY PU�LJ[; CITY OF fAECHANICSBURG,CUMBERLAND 6OUNi Y Aly COMMISSIOf4 EXPIRES JUNE 11,2008 COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU.OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG,PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE'AND ESTATE TAX OFFICIAL RECEIPT NO. CD 019788 GOULD LINDA L 1340 OAK DRIVE MACUNGIE, PA 18062 ACN ASSESSMENT AMOUNT CONTROL NUMBER ------ fold 101 $11,000-00 ESTATE INFORMATION: SSN: 204-12-9394 FILE NUMBER: 21114-0716 DECEDENT NAME: SMITH LOUIS E DATE OF PAYMENT: 10/14/2014 POSTMARK DATE: 10/10/2014 COUNTY: CUMBERLAND DATE OF DEATH: 07/14/2014 TOTAL AMOUNT PAID: $11,000.00 REMARKS: RECEIPT TO ATTY CHECK# 110 INITIALS: CJ SEAL RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS OCT5 -201 TAXPAYER JOHNSON DUFFIF - EXHIBIT B JERRY R.DUFFIE L A W O F F I C E S BARRIE B.GEHRLEIN RK:HARD W STEWART ANTHO TY T.LUCIDO DAVID G.LUCES �)WON CAftOLYN B.11CCLAIN DAVID btT DELUGE JOHN A.Lucy " JOHN A.STATLER DUFFIE 1V1ATT'HEt�%RIDLEY JEFFREY B.RETTIG KAREN L.MASCIO HARK C.DUFFIE JOHN R.NINOSI{Y OF COUNSEL MICHAEL J.CASSIDY HORACE A.JOHNSON MELISSA R GREEVY C.ROY WEIDNER,JR. WADE D.MANLEY 1914-2014 WRITER'S ExT.No.120 E-MAM egm@jdsw.com April 8, 2015 VIA EMAIL RA-InheritanceTaxExt@state.pa.us Department of Revenue Bureau of Individual Taxes Inheritance Tax Division P.O. Box 280601 Harrisburg, PA 17128-0601 RE: Estate of Louis E. Smith Date of Death: July 14, 2014 Cumberland Co. File No. 21-14-0716 Our File No. 18005-1 Ladies and Gentlemen: This firm represents Linda L. Gould, Executrix of the Will of Louis E. Smith. Mr. Smith died July 14, 2014. The inheritance tax return is due to be filed on April 14, 2015. The Executor is completing information necessary for the Return. We request a 6 month extension to file the Inheritance Tax Return. We thank you in advance. Very truly yours, JO SON, DUFFIE, STEWART& WEIDNER dmund *ers c: Linda L. Gould, Executrix EGM:dlw:692499 301 MARKET STREET P.O.Box 109 LE110YNE.PENNSYLVANIA 1704.3-0109 1A1V1VjDSWCOM 717.761.4540 ; JOHNSON, DUFFIE, ST EXHIBIT C qi �` OMB Approval No.2502-0265 , A. Settlement Statement (HUD-1) 1.Q FHA 2.Q RHS 3.❑Conv.Unins. 6.File Number: 7.Loan Number: 8.Mortgage Insurance Case Number. 32932YOUNG 0242687085 4.❑VA 5. XD Conv.Ins. C.Note:This form is fumished to give you a statement of actual settlement costs.Amounts paid to and by the settlement agents are shown Items marked "(p.o.c)"were paid outside the 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: Justin C.Young Estate of Louis E.Smith Members 1 st FCU 125 North River Road,Wormleysburg,Pa 17043 5000 Louise Drive,Mechanicsburg,Pa 17055 G.Property Location: H.Settlement Agent I.Settlement Date:06/15/2015 376 Lowther Street Cedar Cliff Abstract Agency,Inc. Disbursement Date:06/15/2015 Lemoyne,PA 17043 414 Bridge Street,New Cumberland,PA 17070 Lemoyne Borough 717-774-7435 Place of Settlement: Title6tpress 414 Bridge Street,New Cumberland,PA 17070 Printed 06/12/2015 at 1225 pm by CLT 100.. Gross Amount Due from Borrower. 400. Gross Amount Due to Seller 101. Contract sales price 110,000.00 401. Contract sales price 110,000.00 102. Personal property 402. Personal property 103. Settlement charges to borrower(line 1400) 5,462.66 403. 104. 404. 105. 405. Adjustments for items paid by seller in advance Adjustments for items paid by seller in advance 106. City/torn taxes to 406. City/town taxes to 107. County taxes 06115/2015 to 1213112015 242.38 407. County taxes 06/15/2015 to 12/31/2015 242.38 108. School Taxes 06/15/2015 to 06/30/2015 34.75 408. School Taxes 06/15/2015 to 06/30/2015 34.75 109. 409. 110. 410. 111. 411. 112. 412. 120• Gross Amount Due from Borrower 115,739.79 420. Gross Amount Due to Seller 110,277.13 200. Amounts Paid by or in Behalf of Borrower 500.'Reductions In' Amount Due to Seller' 201. Deposit or earnest money 2,000.00 501. Excess deposit(see instructions) 2,000.00 202. Principal amount of new loan(s) 104,500.00 502. Settlement charges to seller(line 1400) 1,240.00 203. Existing loan(s)taken subject to 503. Existing loci s taken subject to 204. 504. Payoff of first mortgage loan 205. 505. Payoff of second mortgage loan 206. 506. 207. Credit by Seller 3,300.00 507. Credit by Seller 3,300.00 208. 508. 209. 509. 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 to 511. County taxes to 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 109,800.00 520. Total Reduction Amount Due Seller 6,540.00 300. Cash at Settlement from/to Borrower 600. Cash at Settlement tolfrom Seller' 301. Gross amount due from borrower(line 120) 115,739.79 601. Gross amount due to seller(line 420) 110,277.13 302. Less amounts paid by/for borrower(line 220) 109,800.00 602. Less reductions in amount due seller(line 520) 6,540.00 303. Cash QX From ❑ To Borrower 5,939.79 603. Cash X❑ To ❑.From Seller 103,737.13 thtsfotm,unitta0.Qrsplays•artmRb valid OMBtsmllpl numEm.fh mdldmfltl0.Yb almurobmaMa-tory ThshEeS..-. . Pd .Ia RESPAmvmedtmrs Mn wlltl to-.000M th. .W.-A prom Previous editions are obsolete Page I of 4 EXHIBIT D T .- 700. Total Real Estate Broker Fees Paid From Paid From Dtvisi000fcommissiori line 700 as follows: Borrower's'°• Seller's' 701. $0.00 to Funds at".' . . Funds.at. . 702• $0.00 to Settlemeht': .Settlement 703. Commission paid at settlement 800. Items Payable in Connection with Loan 801. Our origination charge (Includes Origination Point 0.000%or$0.00) $645.00 (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) 645.00 804. Appraisal fee to Members 1 st FCU $425.00 P.O.C.B (from GFE#3) 805. Credit report to from GFE#3 806. Tax service to from GFE#3 807. Flood certification to Members 1st FCU (from GFE#3) 1 12.50 808. to 900. Items Required by Lender to be Paid in Advance 901. Daily interest charges from from 06115/2015 to 07/01/2015 @$10.37841day (from GFE#10) 166.05 902. Mortgage insurance premium months to from GFE#3 903. Homeowner's insurance for 1 years to State Farm Insurance Companies (from GFE#11) 481.00 904. months to from GFE#11 1000. Reserves Deposited with Lender ' 1001. Initial deposit for your escrow account (from GFE#9) 993.11 1002.Homeowners insurance 3 months @$ 40.08/month $120.24 1003.Mortgage insurance months @$ /month 1004. Property taxes months $ /month 1005.County taxes 5 months @$ 37.05/month $185.25 1006.School Taxes 13 months 0$ 70.46/month $915.98 1007.Aggregate Adjustment $-228.36 1100.Title Charges 1101.Title services and lender's title insurance $ from GFE#4 1,850.00 1102.Settlement or dosing fee to $ 1103.Owners title insurance $ from GFE#5 25.00 1104. Lenders title insurance $1,200.00 1105.Lenders titre policy limit$104,500.00 Lenders Policy 1105.Owners title policy limit$110,000.00 Owners Policy 1107.Agent's portion of the total title insurance premium $946.00 to Cedar Cliff Abstract Agency,Inc. 1108. Underwriters portion of the total title insurance premium $279.00 to Commonwealth land Title Insurance Com an 1109. 1200.Government Recording and Transfer Charges 1201.Government recording charges $ (from GFE#7) 190.00 1202. Deed$79.00 Mortgage$111.00 Release$ 1203.Transfer taxes $ (from GFE#8) 1,100.00 1204.City/County tax/stamps Deed$1,100.00 Mortgage$ 1205. State Tax/stamps Deed$1,100.00 Mortgage$ 1,100.00 1206. Deed$ Mortgage$ 1300.Additional Settlement Charges 1301.Required services that you can shop for (from GFE#6) 1302. to 1303. to 1304.2015 County taxes to Faith A.Nicola' $444.57 P.O.C.S 1305.2014 School taxes to Faith A.Nicola' $845.53 P.O.C.S 1306.Tax cert fee to Stone LaFaver&Shekletski 10.00 1307. Final sewer M 5-6/15/15 to Lemoyne Borough 130.00 1308. to $ r r _a - , r . r 5,462.66 1,240.00 `Paid outside of closing by(B)orrower,(S)eller,(L)ender,(I)nvestor,Bro(I)er.-Credit by lender shown on page 1.-Credit by seller shown on page 1. Previous editions are obsolete Page 2 of 4 HUD-1 'Com arison of Good Faith Estimate GF and HUD-1 Charges : . Good Faith Estirriate: HUD-1 Cha e6 That Cannot Increase HUD-1 Line Number Our origination charge # 801` 645.00 645.00 Your credit or charge(points)for the specific interest rate chosen # 802 0.00 0.00 Your adjusted origination charges # 803 645.00 645.00 Transfer taxes ft 1203 1,100.00 1,100.00 Charges That in Tdtai,Cannot increase.More Than 10% Good Faith Estimate HUD 1•. •y-; Goverriment iecording charges # 1201 238.00 190.00 Appraisal fee'.7 # 804" 425.00 425.00 Flood certification # 807 12.50 12.50 # 675.501 627.50 $ -48.00 or 7.1058% -jesCha es7hafGari Change:' Good Faith Estimate HUN1`.:. = Initial deposit for your escrow account # 1001 0.00 993.11 Dally interest ctrarges from # 901 $10.37841day 0.00 166.05 Homeownetsinsurance. # 903 0.00 481.00 Title services and lender's title insurance # 1101 1,625.00 1,850.00 Owner's title insurance' # 1103 25.00 25.00 Loan Terms Your initial loan amount is $104,500.00 Your loan term is 30.years Your initial Interest rate is 3.6250% Your initial monthly amount owed for principal,interest,and any mortgage $476.57 includes insurance is ❑X Principal ❑X Interest ❑X Mortgage Insurance Can your interest rate rise? [X]No. ❑Yes,it can rise to a maximum of %.The first change will be on / 1 and can change again every years after 1 1 Every change date,your interest rate can increase or decrease by %. Over the fife of the loan,your interest rate is guaranteed to never be lower than %or higher than %. Even 1f you make payments on time,can your loan balance rise? ❑X No. ❑Yes,it can rise to a maximum of$ Even if you make payments on time,can your monthly amount owed for ❑X No. ❑Yes,the first increase can be on / / and the monthly principal,interest,and mortgage insurance rise? amount owed can rise to$ The maximum it can ever rise to is$ Does your loan have a prepayment penally? ❑X No. ❑Yes,your maximum prepayment penalty is$ Does your loan have a balloon payment? X❑No. ❑Yes,you have a balloon payment of$ due in years on Total monthly amount owed including escrow account payments ❑You do not have a monthly escrow payment for items,such as property taxes and homeowner's insurance.You must pay these items directly yourself. ❑X You have an additional monthly escrow payment of$187.65 that results in a total initial monthly amount owed of$664.22. This includes principal,interest,any mortgage insurance and any items checked below: ❑X Property taxes ❑X Homeowner's insurance ❑Flood insurance ❑ ❑ ❑ Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form,please contact your lender. Previous editions are obsolete Page 3 of 4 HUD-1 Signature Page 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 mein this transaction.I further certify that I have received a copy of the HUD-1 Settlement Statement Justin C.Ing ESTATE OF LOUIS E.SMITH LindaL Gould,Executrix— Settlement Agent The HUD-1 Settlement State en which 1 have prepared is a true and accurate account of this transaction.I have caused or will cause the funds to be disbursed in accordance witif this tement f SETTLEMEN AGENT ` DATE WARNING:IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM.PENALTIES UPON CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT.FOR DETAILS SEE TITLE 18:U.S.CODE SECTION 1001 AND SECTION 1010. Previous editions are obsolete Page 4 of 4 HUD-1 -IfAlmli • • 1 1 • 1 Name of Borrower. Name of Seller. File Number Justin C.Young Estate of Louis E.Smith 32932YOUNG TiDeExpress Prepared 06/12/2015 at 11:18 am Note: This page is furnished to give you an itemization of the amounts shown on Paid From Paid From Lines 1101, 1103 and 1104 of the Settlement Statement(HUD-1).This page Borrower's Seller's accompanies but is not a part of the settlement statement. If a discrepancy Funds at Funds at exists,the information shown on the Settlement Statement(HUD-1)applies. Settlement Settlement. 1100.'Title Charges Amounts Included' ' ih 1ine.lf 01.. 1101. Title services and lender's title insurance 1,850.00 a.ETF Fee $ 50.00 b.Fed-exWrefee 40.00 c. Notary fee 35.00 d.Atfomey fees 525.00 650.00 1102. Settlement or closing fee 1103. Owner's title insurance poli $ 25.00 25.00 1104. Lender's title insurance (policy) 925.00 $ 1,200.00 a.Endorsement 900 EPL-Residential 50.00 b.Closing Service Letter 125.00 c.ALTA Short Form Loan 100.00 (Total 1103+1104) 1105. Lenders title Oolicy limit$104,500.00 - 1106. Owners Title policy limit$110,000:00 1107.Agent's portion of the total title insurance premium $ 946.00 1108. Underwriters ortion of the total title insurance'rem: 279.OD {Tota11107+1108) 1109. 1110. 1111. 1112. .:Total Borrower J, Borrower 'Seller: 1100. Title Chargiiwith PaeeChardo POC or Credit Line 1101 Paid 1101. Title services and lenders title insurance $ a.ETF Fee to Stone LaFaver&Shekletski 50.00 50.00 b.Fed-exhvire fee to Stone LaFaver&Shekletski 40.00 40.00 c. Notary fee to Cash 35.00 35.00 d.Attorney fees to Stone LaFaver&Shekletski 525.00 525.00 1104. Lenders title insurance to Cedar Cliff Abstract Agency,Inc. 1,200.00 1,200.00 <. $ , 1,850.00_ 1,8.50.00 :. Estate Valuation Date of Death: 07/14/2014 Estate of: Smith, Louis E. Estate Valuation Date: 07/14/2014 Report Type: Date of Death Processing Date: 07/28/2014 Number of Securities: 1 File ID: Smith Shares Security Mean and/or Div and Int Security or Par Description High/Ask Low/Bid Adjustments Accruals Value 1) 792 PNC FINL SVCS GROUP INC (693475105) COM New York Stock Exchange 07/14/2014 88.35000 87.00000 H/L 87.675000 Div: 0.480000 Ex: 07/11/2014 Rec: 07/15/2014 Pay: 08/05/2014 + 0.480000 88.155000 69,818.76 Total Value: $69,818.76 Total Accrual: $0.00 Total: $69,818.76 Page 1 This report was produced with EstateVal, a product of Estate Valua+-=-- —" please contact EVP Systems at (818) 313-6300 or EXHIBIT E Sep, 17. 2014 1 ;47PM PNC Bank No. 2652 P. 1 9 O TIN September 17,2014 . Dana L. Wieseman Attorney at Law Johnson,Duffie, Stewart&Weidner,P.C. 301 Market Street PO Box 109 Lemoyne, PA 17043 - 0109 RE: Name: Louis E Smith SSN: 204-12-9394 DOD: 07-14-2014 Dear Ms. Wieserneav In response to your request for Date of Death(DOD)balances for the customer noted above, our records show the following: Certificate of Deposit Account#31700133019 Established: 07-21-1998 LOUIS E SMITH DOD balance: $ 10,012.67+9.42 accrued interest Interest paid 01-01-2014 thru 07-14-2014$ 74.39 YTD Account#31400163426 Established: 08-16-1999 LOUIS E SMITH DOD balance: $ 5,000.00+5.72 accrued interest Interest paid 01-01-2014 thru 07-14-2014$ 37.20* YTD Account#31400188386 Established: 05-30-2000 LOUIS E SMITH DOD balance: $201,025.34+ 11.46 accrued interest Interest paid 01-01-2014 thru 07-14-2014$ 148.79 YTD Account#31100286131 Established; 0224-2006 LOUIS E SMITH DOD balance: $20,020.30+ 13.11 accrued interest Interest paid 01-01-2014 thru 07-14-2014$ 119.17 YTD Pagel of 3- - --- - ----- - ------ EXHIBIT F Sep. 17. 2014 1 ;48PM PNC Bank No. 2652 P. 2 Account#21001019750 Established: 07.06-1992 LOUIS E SMITH DOD balance; $20,016,44+4,38 accrued interest Interest paid 01-01-2014 thtu 07-14-2014$ 116.17 YTD Account#21001019752 Established: 07-15-1992 LOUIS E SMITH DOD balance: $ 5,000.00+3,97 accrued interest Interest paid 01-01-2014 thru 07-14-2014$24,93 YTD Account#31200147330 Established: 01-29-1999 LOUIS E SMIT14 DOD balance: $ 7,008.87+4.30 accrued interest Interest paid 01-01-2014 thru 07-142014$ 52.07 YTD Account 4.31000161319 Established: 08-10-1999 LOUIS E SMIT14 DOD balance: $20,024.52+3.28 accrued interest Interest paid 01-01-2014 thru 07-14-2014 $ 173.31 YTD Checking Account Account#5140130811 Established: 03-13-1984' LOUIS E SMITH DOD balance: $ 11,475.53 +0.03 accrued interest Intezest paid 01-01-2014 thru 07-14-2014$ 0.97 YTD Savings Account Account#5030121658 Established: 07-19-1983 LOUIS E SMITH DOD balance; $ 39,203,49+0,11 accrued interest Interest paid 01-01-2014 thra 07-14-2014$ 4,45 YTD Page 2 of 3 Sep. 11. 2014 1 :48PM PNC Bank No. 2652 P. 3 .p Please note that this office provides date of death balances for deposit accounts(MAS,CDs, Checking and Savings). We do not process any financial transactions or provide statements. If you need assistance with any of these items,please call 1-888-PNC-13ANTA(1-888-762-2265) or stop by your local MBank branch office. Sincerely, National Financial Services Center PNC Bank,N.A„ Member FDIC This message is intended for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt frotn disclosure under applicable law. If the reader of this message is not the intended recipient or the employee or agent responsible for delivering this message to the intended recipient,you are hereby notified that any dissemination, distribution or copying of this communications is strictly prohibited Ifyou have received this communication in error,please notify me immediately by reply or by telephone at 800762-1775 and immediately destroy this faxed document. Page 3 of 3 - A . ` ® _ 09/04/14 Johnson, Duffie, Stewart 301 Market ST; PO BOX 109 Lemoyne, PA 17043 Dear Sir or Madam; N The account information set forth below is being furnished at the request of: Louis E. Smith 376 Lowther ST 0 Lemoyne, PA 17043-20 E Insert customer name has the following account(s)with Santander Bank. 0 Type of Acct Acct No. Date Opened Balance As of date CD 2335129942 09/01/1992 5,000.00 USD 09.04.14 10/01/1992 10,000.00 US 09.04.14 CD 2335129967 CD 2335130064 02/04/1993 5,000.00 USD 09.04.14 CD 2335130452 03/13/1992 30,000.00 US 09.04.14 2 Sincerely, 0 Lee M. Bowers Branch Manager Emmaus 0 NMLS # 129210 z 3 0 2 ' 3 V'p F� S� Q� Z� 1215 Chestnut ST; Emmaus, PA 18049 ° 610.967.6927 ° FaX: 610.965.6182 RECEIVED SEP 0 8 2014 JOHNSON DUFFIE EXHIBIT G