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Home My WebLink About04-20-06 RE.V-548 EX (12-03) INHERITANCE TAX JOINT BANK ACCOUNT COUNTY FILE NUMBER 21-06-0145 ADVANCE PAYMENT WORKSHEET INHERITANCE TAX RECEIPT NUMBER DECEDENT'S NAME (LAST) Britten DECEDENT DECEDENT'S SOCIAL SECURITY NUMBER INFORMATION 174-16-3944 ADDRESS OF DECEDENT 1000 West South Street (FIRST) Dale DATE OF DEATH 02105/2006 CITY Carlisle ZIP 17013 (MIDDLE INITIAL) A STATE PA FINANCIAL INSTITUTION INFORMATION NAME OF FINANCIAL INSTITUTION ADDRESS CITY STATE ZIP TELEPHONE NUMBER ACCOUNT INFORMATION TYPE OF ACCOUNT o SAVINGS 0 CHECKING II OTHER U.S. Bonds o TRUST o CERTIFICATE OF DEPOSIT ACCOUNT BALANCE (INCLUDE INTEREST TO DATE OF DEATH) 136,720.00 ACCOUNT TITLE AS APPEARS ON SIGNATURE CARD OR CD Dale A. Britten or Ronald Britten ACCOUNT NUMBER See attached. ORIGINAL DATE ESTABLISHED 1984 - 1998 SURVIVING JOINT OWNER INFORMATION NAME (Last) Britten ADDRESS 7506 lairds Way CITY Clarksville Department of Revenue Use Only (First) Ronald (Middle Initial) H RELATIONSHIP TO DECEDENT Son PERCENTTAXABLE STATE ZIP CODE MD 21029 TELEPHONE NUMBER TAX RATE (First) (Middle Initial) PERCENT TAXABLE STATE ZIP CODE TELEPHONE NUMBER TAX RATE (First) (Middle Initial) PERCENT TAXABLE STATE ZIP CODE TELEPHONE NUMBER TAX RATE SURVIVING JOINT OWNER INFORMATION NAME (Last) ADDRESS CITY RELATIONSHIP TO DECEDENT SURVIVING JOINT OWNER INFORMATION NAME (Last) ADDRESS CITY RELATIONSHIP TO DECEDENT Note: Please attach to receipt I , i ;. :", :1: _J r'; .;..~ ~J i <:" 1''=--1 ~ !-i ;, ,lit. __I v ~J 3Jl:1:0 O:iGbO=i::() 0.00 Total $ INHERITANCE TAX JOINT BANK ACCOUNT ADVANCE PAYMENT WORKSHEET DIRECTIONS for REV-548 The Advance Payment Worksheet enables the taxpayer to report a specific jointly owned or other non-probate asset to the Department without the filling of an actual inheritance tax return form (REV-1500), and it also allows the taxpayer to qualify for 5% discount if payment is made within (3) three months following the decedent's date of death. WHO MAY USE THE ADVANCE PAYMENT WORKSHEET? 1. Surviving owners of jointly held assets. 2. Beneficiaries of "in trust for" (ITF) accounts. 3. Beneficiaries of other assets not subject to the administration of the decedent's estate by the personal representative. PLEASE FILL IN BLOCKS COMPLETELY SO THAT AN ACCURATE NOTICE OF ASSESSMENT CAN BE ISSUED. DECEDENT INFORMATION · decedent's legal name · social security number · decedent's date of death FINANCIAL INSTITUTION INFORMATION · name & address of bank or branch office . provide bank phone number if available ACCOUNT INFORMATION (LIST ONLY ONE ACCOUNT PER WORKSHEET) . Indicate type of account by checking appropriate box, if other, list specific type (only one account per worksheet). . Account balance at date of death (include interest in total). · Account number . Account title as appears on signature card (identify power of attorney, representative payee, attorney in fact, or PUGMA accounts, IRA's etc. where they may apply). . Original date the account was established in joint ownership. Provide signature cards, trust agreements, and other pertinent documents (if available). SURVIVING JOINT OWNER INFORMATION (USE SEPARATE BLOCK FOR EACH SURVIVOR) · use legal names · social security numbers if known · current address . relationship to decedent to insure correct tax rates DEBTS & DEDUCTIONS If there are no probate assets and the surviving owner has actually paid expenses incurred because of the decedent's death, they can be listed and deducted from the portion of the account balance subject to tax. Include expenses directly related to the decedent's death such as funeral costs, refreshments following the funeral, flowers, cemetery plots and markers, engraving, etc. Provide appropriate documents to substantiate claims. After review by the Department, a formal notice of assessment will be returned to each individual owner indicating the final status of the particular asset that has been reported. Make checks payable to the REGISTER of WILLS, Agent, in the county of the decedent's LEGAL residence. Savings Bond C aiculator 72nt>>-A- ~ 021'2006 liir # Bon lis 1..&1 Up date SelTies !IS- .,.- Denomination J. [:0 ;.;.t 1'"1, ~ ~...,. t. f l.. t~t Page 1 of :' iii'> - .).av~n~ Serial Number Total Interest $76~720.00 Issue Price Serial Number Issue Date Series Denom Total Price $60.,000.00 i 2/1998 EE 12/1998 EE 12/1998 EE 12/1998 EE 12/1998 EE 11/1998 EE EE $500 $250.00 500 250.00 500 250.00 500 250.00 500 150.00 500 250.00 12/1998 12/1998 1=11=1 .L..,.L., 500 250.00 12/1998 EE 12/1998 EE 12/1998 EE 12/1998 EE 12/1998 EE 12/1998 EE 12/1998 EE 12/1998 EE 12/1998 EE 12/1998 EE 12/1998 EE 12/1998 EE 500 .1 50.00 12/1998 1:71=4 L..I...-.. 500 250.00 500 250.00 500 250.00 500 250.00 500 250.00 500 250.00 500 250.00 500 250.00 500 250.00 500 250.00 500 250.00 500 250.00 12/1998 EE 12./1998 EE 1211998 EE 12./1998 EE 12/1998 EE 12/1998 EE 12/1998 EE 500 250.00 500 250.00 ";00 250.00 500 250.00 500 250.00 500 250.00 ~nn 250.00 500 250.00 http:/,'\V\V\vs.publicdebt.treas.gov/BC/SBCPrice Interest Issne Date Tota! 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() 5 /-2 (j{~}(~; U)'~UU{) U:-I.'~UUt, - -" .. l}:-1 / l.lJlj{~} . i...... ..' ;, i it I :t-_ '-, _~ l ..;:.. '-]\_''-_' i'l:: ,-'......! {t. i '-' -'.; ~ '-' ! ~ 05,2(J I.:. (J).':"2(i I ~ # i ~ -"! # ~ J . '--'_'I ~\} I ~ tJ :-' ./ l.lj I ~ U:-"":::U I':' U:-,i~U i.:. ~}""',/}{J;"'::' ,-;),.. ~.\_.H.J() (j ~ -' -:; (j I..:.. U)'''':::'Ui~ -I- 1 / (2 OUt; Directive. I direct that my following existing accounts be given, irrevocably, to my daughter, r-) Judy S. Britten. The balances are all calculated on or about October 15,:.~005.'~ 1. Members 1 st checking, balance of $90,989.00 .:~{~ ~ .,'. (-, '::,-"J 2. Members 1st savings, balance of $217,015.00 <'~f;~; __ .',") - .7": 3. Members 1st money mgt., balance of $38,546.00 ~-::.~:.) :2 ..... -;"1 ~ 4. Members 1 st IRA, balance of $7,687.00, Judy has already b~.~:!!; designated as my beneficiary on this account. 5. USAA, USAAX Growth Fund, balance $272,298.00 6. USAA, USTEX Tax Exempt Long-Term Fund, balance $469,780.00 All of the aforesaid accounts, other than the IRA, had already been placed in joint ownership with Judy, evidencing my intent that she receive these funds upon my qeath. .It is my intent to transfer these funds during my lifetime, rather than at my death. However, I direct that the sum of $62,280.00, from the assigned proceeds, be. . placed in a trust for my cost of nursing home care. I have calculated that amount based upon the current average annual cost at the Todd Home for nursing care in the amou~t of $79,500.00 per year, less my current annual income of $58,740.00. This will guarantee my ability to pay the first thirty six months of nursing .home care, should I need to continue in nursing home care. My daughter Judy to make the choice on my behalf as to place me in assisted living, if I qualify after undergoing rehabilitation, or in nursing home care. I give my residence, and all the furnishings therein, at 7 Greystone Road, Carlisle, Pennsylvania to my daughter Judy S. Britten. I give my Winnebago motor home, the coin sets at my home and my lot with three car garage in Cambria County, to my son Ronald H. Britten. ' I acknowledge that I fully understand and am aware that I am curreotly giving to my heirs virtually all my assets and this is done not through any undue influence but because of .my love for all of them. I also acknowledge that I. am giving substantially . 'l....~.l . (.: ~ <: ~~ ~ --: ;;1 - fIo....') . . . . .-. .---"j f'.:~ ...=.." ..;,.. more of my assets to my daughter, Judy S. Britten, and that I am doing this not because I do not love my children equally, but because I believe that Judy needs more of my assets to meet her future needs. I have accumulated US Savings bonds in joint names for my son, Ronald H. Britten and his sons, "Michael Britten and Andrew Britten. I irrevocably give t~ose bonds to those individuals and direct Judy, who is my agent, to see that the bonds are delivered. I have accumulated US Savings Bonds in joint names for my daughter, Judy S. Britten and her children, Robert S. Young and Morgan Goodling. I irrevocably give Judy her bonds. I do not wish that those for Robert S. Young and Morgan Goodling be delivered directly to them, but that the bonds be transferred to Judy S. Britten as Trustee. The value of the bonds for Morgan Goodling as of October, 2095, amount-to"- $79,240.00 and for Robert Young $76,355.00. The provisions of the trust follow. 1. My Trustee shall set up a separate Trust for each grandchild. My Trustee shall pay principal and income to or for the benefit of my grandchild during his or her life as my'Trustee, in her sole discretion, shall deem advisable for the health, maintenance, support and complete education ot such grandchild. In addition, my Trustee in her sole discretion may advance funds to said beneficiary for the costs of marriage, or the purchasing of a home or costs of entering a business or profession, if my said Trustee shall deem such expense reasonably prudent. 2. Any and all payment or payments of any sum or sums, whether in cash or in kind and whether for pri~al or income, payable to a grandchild, or any of them, shall be made upon the sole receipt of the respective individual to whom the payment is made, and free from anticipation, alienation, assignment, attachment, and pledge, and free from control by the creditors of any such beneficiary. 3. Should the pmcipal of any trust herein provided for be or become too small in my Trustee's disaeli>n to make establishments or continuance of the trust advisable, my Trustee may distribute the remaining principal and any accumulated or undistributed income outrigti to the beneficiaries in the proportions to which they are then entitled to. The re~ and releases of the distributee will terminate absolutely the rights of all persons who might otl1erwise have future interest in the trust, whether vested or contingent, without notice to them and without the necessity of filing an account with the court. 4. Any funds not distributed to a grandchild, at the time of my daughter's death, shall be distributed to the.grandchild, subject to the terms and conditions of any' trust that she may hereafter create. All the gifts in this Directive, shall be split between the years of 2005 and 2006 so as to maximize the federal unified gift and estate tax credit. Executed this the 2tflb day O~\or, 2005. c2. ~~~ Dale A. Britten REV-548 EX (12-03) , INHERITANCE TAX JOINT BANK ACCOUNT COUNTY FILE NUMBER 21-06-0145 ADVANCE PAYMENT WORKSHEET INHERITANCE TAX RECEIPT NUMBER DECEDENT'S NAME (LAST) Britten DECEDENT DECEDENT'S SOCIAL SECURITY NUMBER INFORMATION 174-16-3944 ADDRESS OF DECEDENT 1000 West South Street (FIRST) (MIDDLE INITIAL) Dale A DATE OF DEATH 02/05/2006 CITY STATE ZIP Carlisle PA 17013 NAME OF FINANCIAL INSTITUTION FINANCIAL INSTITUTION INFORMATION ADDRESS CITY STATE ZIP TELEPHONE NUMBER TYPE OF ACCOUNT o SAVINGS o CHECKING o TRUST o CERTIFICATE OF DEPOSIT II OTHER U.S. Bonds ACCOUNT INFORMATION ACCOUNT BALANCE (INCLUDE INTEREST TO DATE OF DEATH) 194,796.80 ACCOUNT TITLE AS APPEARS ON SIGNATURE CARD OR CD ACCOUNT NUMBER Dale A. Britten or Judy Britten NAME (Last) Britten SURVIVING ADDRESS 158 South Hanover Street JOINT OWNER CITY INFORMATION Carlisle RELATIONSHIP TO DECEDENT Daughter NAME (Last) SURVIVING ADDRESS JOINT OWNER CITY INFORMATION RELATIONSHIP TO DECEDENT NAME (Last) SURVIVING ADDRESS JOINT OWNER CITY INFORMATION RELATIONSHIP TO DECEDENT ORIGINAL DATE ESTABLISHED 1983 - 2001 S Department of Revenue Use Only PERCENT TAXABLE (First) Judy (Middle Initial) STATE ZIP CODE PA 17013 TELEPHONE NUMBER TAX RATE (717) 245-9605 (First) (Middle Initial) PERCENT TAXABLE STATE ZIP CODE TELEPHONE NUMBER TAX RATE (First) (Middle Initial) PERCENT TAXABLE STATE ZIP CODE TELEPHONE NUMBER TAX RATE ~~ =z ~d 02 tldV qGilZ Note: Please attach to receipt r ,,",",\, ("\'j',.,', I :~ \ ~/ ;::~:;:;;;~:~\ I ':)' 1('\11 'I \ IJ-)' lh' (h~ :.J't.. :1v J:v ....'-'i,..;V'-'- Total $ 0.00 INHERITANCE TAX JOINT BANK ACCOUNT ADVANCE PAYMENT WORKSHEET DIRECTIONS for REV-548 The Advance Payment Worksheet enables the taxpayer to report a specific jointly owned or other non-probate asset to the Department without the filling of an actual inheritance tax return form (REV-1500), and it also allows the taxpayer to qualify for 5% discount if payment is made within (3) three months following the decedent's date of death. WHO MAY USE THE ADVANCE PAYMENT WORKSHEET? 1. Surviving owners of jointly held assets. 2. Beneficiaries of "in trust for" (ITF) accounts. 3. Beneficiaries of other assets not subject to the administration of the decedent's estate by the personal representative. PLEASE FILL IN BLOCKS COMPLETELY SO THAT AN ACCURATE NOTICE OF ASSESSMENT CAN BE ISSUED. DECEDENT INFORMATION · decedent's legal name · social security number · decedent's date of death FINANCIAL INSTITUTION INFORMATION · name & address of bank or branch office · provide bank phone number if available ACCOUNT INFORMATION (LIST ONLY ONE ACCOUNT PER WORKSHEET) · Indicate type of account by checking appropriate box, if other, list specific type (only one account per worksheet). · Account balance at date of death (include interest in total). · Account number · Account title as appears on signature card (identify power of attorney, representative payee, attorney in fact, or PUGMA accounts, IRA's etc. where they may apply). · Original date the account was established in joint ownership. Provide signature cards, trust agreements, and other pertinent documents (if available). SURVIVING JOINT OWNER INFORMATION (USE SEPARATE BLOCK FOR EACH SURVIVOR) · use legal names · social security numbers if known · current address . relationship to decedent to insure correct tax rates DEBTS & DEDUCTIONS If there are no probate assets and the surviving owner has actually paid expenses incurred because of the decedent's death, they can be listed and deducted from the portion of the account balance subject to tax. Include expenses directly related to the decedent's death such as funeral costs, refreshments following the funeral, flowers, cemetery plots and markers, engraving, etc. Provide appropriate documents to substantiate claims. After review by the Department, a formal notice of assessment will be returned to each individual owner indicating the final status of the particular asset that has been reported. Make checks payable to the REGISTER of WILLS, Agent, in the county of the decedent's LEGAL residence. Savings Bond Calculator Page 1 of 5 M ~0 Savin~ 02/2006 UI) date Help Series Denomination Serial Number Issue Date I EL..A. ... $"~ . # Bonds Total Price Total Interest Total Value YTD In1 132 $92.000~OO $102.796~80 $194.796~80 $1.33{ Issue Interest Next Final Serial Number Issue Date Series Denom Price Interest Value Rate Accrual Maturit: 12/2001 I $1,000 $1,000.00 $182.40 $1,182.40 7.76% 03/2006 12/203: 12/2001 I 1,000 1,000.00 182.40 1,182.40 7.76% 03/2006 12/203: 12/2001 I 1 ,000 1,000.00 182.40 1,182.40 7.76% 03/2006 12/203: 12/2001 I 1,000 1,000.00 182.40 1,182.40 7.760/0 03/2006 12/203: 12/2001 I 1 ,000 1,000.00 182.40 1,182.40 7.76% 03/2006 12/203: 12/2001 I 1,000 1,000.00 182.40 1,182.40 7. 760/0 03/2006 12/203: 12/2001 I 1,000 1,000.00 182.40 1,182.40 7.760/0 03/2006 12/203: 12/2001 I 1,000 1,000.00 182.40 1,182.40 7. 760/0 03/2006 12/203: 12/2001 I 1 ,000 1,000.00 182.40 1,182.40 7.760/0 03/2006 12/203: 12/2001 I 1,000 1,000.00 182.40 1,182.40 7.76% 03/2006 12/203: 10/2001 I 1 ,000 1,000.00 238.40 1,238.40 6.630/0 03/2006 10/203: 10/2001 I 1,000 1,000.00 238.40 1,238.40 6.63~~ 03/2006 10/203: 10/2001 I 1 ,000 1,000.00 238.40 1,238.40 6.63% 03/2006 10/203: 10/2001 I 1 ,000 1,000.00 238.40 1,238.40 6.63% 03/2006 10/203: 10/2001 I 1 ,000 1,000.00 238.40 1,238.40 6.63% 03/2006 10/203: 10/2001 I 1,000 1,000.00 238.40 1,238.40 6.63% 03/2006 10/203: 10/2001 I 1,000 1,000.00 238.40 1,238.40 6.63% 03/2006 10/203: 12/1998 EE 500 250.00 81.40 33 1. 40 3.61% 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331.40 3.61% 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331. 40 3.61% 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331.40 3.61% 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331. 40 3.61% 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331. 40 3.61010 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331. 40 3.610/0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331.40 3.610/0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 33 1. 40 3.61% 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331.40 3.610/0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 33 1. 40 3.610/0 03/2006 12/202~ http://\V\V\vs.publicdebt.treas.gov/BC/SBCPrice 4/18/2006 Savings Bond Calculator Page 2 of 5 12/1998 EE 500 250.00 81.40 33 1. 40 3.610;0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331. 40 3.610;0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331.40 3.610;0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 33 1. 40 3.610/0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331.40 3.610;0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331.40 3.610/0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331.40 3.610/0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331. 40 3.61010 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331.40 3.610;0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331.40 3.610/0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 33 1. 40 3.610/0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331. 40 3.610/0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331.40 3.610;0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331. 40 3.610/0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 33 1. 40 3.61~~ 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331.40 3.610;0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331.40 3.610;0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 33 1. 40 3.61010 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331.40 3.610;0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331. 40 3.610;0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 33 1. 40 3.610;0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331. 40 3.610;0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331.40 3.610;0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331. 40 3.610;0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331.40 3.610;0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331. 40 3.610;0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331.40 3.610;0 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331. 40 3.61% 03/2006 12/202~ 12/1998 EE 500 250.00 81.40 331.40 3.610;0 03/2006 12/202~ 10/1997 EE 1 ~ 000 500.00 211.20 711.20 3.42% 03/2006 1 0/202~ 10/1997 EE 1,000 500.00 211.20 711.20 3.420/0 03/2006 1 0/202~ 10/1997 EE 1,000 500.00 211.20 711.20 3 .42~~ 03/2006 1 0/202~ 10/1997 EE 1 ,000 500.00 211.20 711.20 3.420/0 03/2006 1 0/202~ 10/1997 EE 1 ,000 500.00 211.20 711.20 3.42% 03/2006 1 0/202~ 10/1997 EE 1 ,000 500.00 211.20 711.20 3 .42~~ 03/2006 1 0/202~ 10/1997 EE 1,000 500.00 211.20. 711.20 3.42% 03/2006 10/202~ 10/1997 EE 1,000 500.00 211.20 711.20 3 .42~~ 03/2006 1 0/202~ 10/1997 EE 1,000 500.00 211.20 711.20 3 .42~~ 03/2006 1 0/101~ http://\vwws.publicdebt.treas.govIBC/SBCPrice 4/18/2006 Savings Bond Calculator Page 3 of 5 10/1997 EE 1,000 500.00 211.20 711.20 3.420/0 03/2006 10/202~ 10/1997 EE 1,000 500.00 211.20 711.20 3.42% 03/2006 1 0/202~ 10/1997 EE 1 ,000 500.00 211.20 711.20 3.42% 03/2006 1 0/202~ 10/1997 EE 1,000 500.00 211.20 711.20 3 .42~~ 03/2006 10/202~ 10/1997 EE 1,000 500.00 211.20 711.20 3.42% 03/2006 10/202~ 10/1997 EE 1,000 500.00 211.20 711.20 3.42% 03/2006 1 0/202~ 10/1997 EE 1,000 500.00 211.20 711.20 3.42% 03/2006 1 0/202~ 10/1997 EE 1,000 500.00 211.20 711.20 3.420/0 03/2006 10/202~ 10/1997 EE 1,000 500.00 211.20 711.20 3.42010 03/2006 10/202~ 10/1997 EE 1,000 500.00 211.20 711.20 3.42% 03/2006 10/202~ 10/1997 EE 1,000 500.00 211.20 711.20 3.420/0 03/2006 1 0/202~ 11/1990 EE 10,000 5,000.00 6,448.00 11,448.00 4.00% OS/2006 11/202( 11/1990 EE 10,000 5,000.00 6,448.00 11,448.00 4. OO~~ OS/2006 11/202( 11/1990 EE 10,000 5,000.00 6,448.00 11,448.00 4.00% OS/2006 11/202( 01/1989 EE 5,000 2,500.00 3,696.00 6,196.00 4. OO~'O 07/2006 01/20 P 01/1989 EE 5,000 2,500.00 3,696.00 6,196.00 4.00% 07/2006 01/20 1 ~ 01/1989 EE 5,000 2,500.00 3,696.00 6,196.00 4.00% 07/2006 01/201~ 01/1989 EE 5,000 2,500.00 3,696.00 6,196.00 4.00% 07/2006 01/20 1 ~ 01/1989 EE 5,000 2,500.00 3,696.00 6,196.00 4.00% 07/2006 01/201~ 01/1989 EE 5,000 2,500.00 3,696.00 6,196.00 4.000/0 07/2006 01/201~ 01/1989 EE 5,000 2,500.00 3,696.00 6,196.00 4.00% 07/2006 01/20 1 ~ 01/1989 EE S,OOO 2,500.00 3,696.00 6,196.00 4.00% 07/2006 01/201~ 04/1987 EE 5,000 2,500.00 4,076.00 6,576.00 4.00% 04/2006 04/20 1 ~ 04/1987 EE 5,000 2,500.00 4,076.00 6,576.00 4.00% 04/2006 04/20 1 ~ 04/1987 EE 5,000 2,500.00 4,076.00 6,576.00 4.00% 04/2006 04/20 r 04/1987 EE 5,000 2,500.00 4,076.00 6,576.00 4.00% 04/2006 04/20r 05/1983 EE 500 250.00 647.20 897.20 3 .4 7010 OS/2006 OS/20 1 ~ 05/1983 EE 500 250.00 647.20 897.20 3.47010 OS/2006 OS/20 1~ 05/1983 EE 500 250.00 647.20 897.20 3.47010 OS/2006 OS/20 1 ~ 05/1983 EE 500 250:00 647.20 897.20 3.47010 OS/2006 OS/2012 05/1983 EE 500 250.00 647.20 897.20 3.47010 OS/2006 OS/20 L 05/1983 EE 500 250.00 647.20 897.20 3.47010 OS/2006 OS/2012 05/1983 EE 500 250.00 647.20 897.20 3.47010 OS/2006 OS/20 L 05/1983 EE 500 250.00 647.20 897.20 3.47010 OS/2006 OS/20 1 ~ 05/1983 EE 500 250.00 647.20 897.20 3.470/0 OS/2006 OS/20 L 05/1983 EE 500 250.00 647.20 897.20 3.470/0 OS/2006 OS/2012 05/1983 EE 500 250.00 647.20 897.20 3.47010 OS/2006 OS/20 L 05/1983 EE 500 250.00 647.20 897.20 3.470/0 OS/2006 OS/2012 http://vvwvvs.publicdebt.treas.govIBC/SBCPrice 4/18/2006 Savings Bond Calculator Page 4 of5 05/1983 EE 500 250.00 647.20 897.20 3.470/0 OS/2006 OS/20 L 05/1983 EE 500 250.00 647.20 897.20 3. 4 7O~ OS/2006 OS/20 1~ 05/1983 EE 500 250.00 647.20 897.20 3.47010 OS/2006 OS/20 L 05/1983 EE 500 250.00 647.20 897.20 3. 4 7O~ OS/2006 OS/20L 05/1983 EE 500 250.00 647.20 897.20 3.47010 OS/2006 OS/20 L 05/1983 EE 500 250.00 647.20 897.20 3.4 7O~ OS/2006 OS/20 1 ~ 05/1983 EE 500 250.00 647.20 897.20 3.4 7O~ OS/2006 OS/20 1 ~ 05/1983 EE 500 250.00 647.20 897.20 3. 4 7O~ OS/2006 OS/20 L 04/1983 EE 500 250.00 683.20 933.20 3.200/0 04/2006 04/20 1 ~ 04/1983 EE 500 250.00 683.20 933.20 3 .200~ 04/2006 04/20 1 ~ 04/1983 EE 500 250.00 683.20 933.20 3.200/0 04/2006 04/20 L 04/1983 EE 500 250.00 683.20 933.20 3 .200~ 04/2006 04/201~ 04/1983 EE 500 250.00 683.20 933.20 3 .200~ 04/2006 04/20L 04/1983 EE 500 250.00 683.20 933.20 3 .200~ 04/2006 04/20 1 ~ 04/1983 EE 500 250.00 683.20 933.20 3.20010 04/2006 04/20 L 04/1983 EE 500 250.00 683.20 933.20 3 .200~ 04/2006 04/20 1 ~ 04/1983 EE 500 250.00 683.20 933.20 3.20010 04/2006 04/201~ 04/1983 EE 500 250.00 683.20 933.20 3 .200~ 04/2006 04/20 1 ~ 04/1983 EE 500 250.00 683.20 933.20 3.200/0 04/2006 04/20 L 04/1983 EE 500 250.00 683.20 933.20 3 .200~ 04/2006 04/20 1 ~ 04/1983 EE 500 250.00 683.20 933.20 3.200/0 04/2006 04/20 L 04/1983 EE 500 250.00 683.20 933.20 3 .200~ 04/2006 04/20 1 ~ 04/1983 EE 500 250.00 683.20 933.20 3.20010 04/2006 04/20 L 04/1983 EE 500 250.00 683.20 933.20 3 .2 Oo~ 04/2006 04/20L 04/1983 EE 500 250.00 683.20 933.20 3.20010 04/2006 04/20 1 ~ 04/1983 EE 500 250.00 683.20 933.20 3.200~ 04/2006 04/20 1 ~ 04/1983 EE 500 250.00 683.20 933.20 3.20010 04/2006 04/20 1 ~ 04/1983 EE 500 250.00 683.20 933.20 3.200~ 04/2006 04/201~ View 10 I Viewing Bonds 1-132 Note Description NI Not Issued NE Not Eligible for PaYl11ent P5 Includes 3-111onth interest penalty MA Matured and Not Earning Interest Please rate this service. http://\V\vws. publicdebt.treas.govIBC /SBCPrice 4/18/2006 ......- .. --- ---~-- .-.- '--' - ---- - Directive' . I direct that my following existing accounts be given, irrevocably, to my daughter, Judy S. Britten. The balances are all calculated on or about October 15'r?005. ~ 0.. ,.I ~. .-.. ,~.: 1. Members 1 st checking, balance of $90,989.00 '~S1 ~ ~;' ~::~ . , ~ () -:,.., :..-;. '.' ) 2. Members 1st savings, balance of $217,015.00 :.~:~};~ _ ".: ~~ 3. Members 1st money mgt., balance of $38,546.00 .o:2.:;?, ~ . ~~~~ 4. Members 1st IRA, balance of $7,687.00, Judy .has already b~~!!\ "F;i .,";..~ - ~, designated as my beneficiary on this account. '. ... 5. USAA, USAAX Growth Fund, balance $272,298.00 6. USAA, USTEX Tax Exempt Long-Term Fund, balance $469,780.00 All of the aforesaid accounts, other than the IRA, had already been placed in joint ownership with Judy, evidencing my intent that she receive the'se funds upon my qeath. .It is my intent to transfer these funds during my lifetime, rather than at my death. However, I direct that the sum of $62,280.00, from the assigned procee.ds, be . placed in a trust for my cost of nursing home care. I have calculat.ed that amount based upon the current average annual cost at the Todd Home for nursing care in the amour:tt of $79,500.00 per year, less my current annual income of $58,740.00. This will guarantee my ability to pay the first thirty six months of nursing 'home care, should I need to continue in nursing home care. My daughter Judy to make the choice on my behalf as to place me in assisted living, if I qualify after undergoing rehabilitation, or in nursing home care. I give my residence, and all the furnishings therein, at 7 Greystone Road, Carlisle, Pennsylvania to my daughter Judy S. Britten. I give my Winnebago motor home, the coin sets at my home and, my lot with three car garage in Cambria County, to my son Ronald H. Britten. I acknowledge that I fully understand and am aware that I am currently giving to my heirs virtually all my assets and this is done not through any undue influence but because of .my love for all of them. I also acknowledge that I.am giving substantially .-., . -. ::- ~ ", - . .. . ~ . ~ more of my assets to my daughter, Judy S. Britten, and that I am doing this not _ because I do not love my children equally, but because I believe that Judy needs more of my assets to meet her future needs. I have accumulated US Savings bonds in joint names for my son, R!Jnald H. Britten an.d his sons, Michael Britten and Andrew Britten. I irrevocably give t~ose bonds to those individuals and direct Judy, who is my agent, to see that the bonds are delivered. I have accumulated US Savings Bonds in joint names for my daughter, Judy S. Britten and het children, Robert S.Young and Morgan Goodling. I irrevocab~y give Judy her bonds. I do not wish that thos~ for Robert S. Young and Morgan Goodling be delivered directly to them, but that the bonds be transferred to Judy S. Britten as Trustee. The value .of the bonds for Morgan Goodling as of October, 2095, amount-to-- $79,240.00 and for Robert Young $76,355.00. The provisions of the trust follow. 1. My Trustee shall set up a separate Trust for each grandchild. My Trustee shall pay principal and income to or for the benefit of my grandchild during his or her life as my. Trustee, in her sole discretion, shall deem advisable for the health, maintenance, support and complete education ot such grandchild. In addition, my Trustee in her sole discretion may advance funds to said beneficiary for the costs of marriage, or the purchasing of a home or costs of entering a business or profession, if my said Trustee shall deem such expense reasonably prudent. 2. Any and all payment or payments of any sum or sums, whether in cash or in kind and whether for p~al or income, payable to a grandchild, or any of them, shall be made upon the sole receipt of the respective individual to whom the payment is made, and free from anti~n, alienation, assignment, attachment, and pledge, and free from control by the crediors of any such. beneficiary. 3. Should the pmcipal of any trust herein provided for be or become too small in my Trustee's disaelion to make establishments or continuance of the trust advisable, my Trustee may dstribute the remaining principal and any accumulated or undistributed income ou~ to the beneficiaries in the proportions to which they are then entitled to. Th~ re~ and releases of the distributee will terminate absolutely .- ---~-_.~ -_......~--_. ~ . . . the rights of all persons who migh~ otrierwise have future interest in the trust, whether vested or contingent, without notice to them and without the necessity of filing an account with the court. 4. Any funds not distributed to a grandchild, at the time of my daughter's death, shall be distributed to the.grandchild, subject to the terms and conditions of any' trust that she may hereafter create. All the gifts in this Directive, shall be split between the years of 2005 and 2006 so as to maximize the federal unified gift and estate tax credit. Executed this the 2t"'~ day O~\rc-; 2005. c2&Pk-/~ Dale A. Britten . . .... ... . -..... - .. . .. -.. ~ -..... - - _. ... ... . ., :;'~'::~~~~~~~{~'~;~:" ,. . . t"~: . ,.. . : ~:.\:- i.!.- ': . - ...... .~.. .. 7" J> .~ '. .' .' ,.. ,.... '.. ., . .' '". -..' . . ':. .,~'~,~~:;~~5f:~~.; <~i/'/:1:t~'~:l~~;.;':~~: ~ . . ~:~:';.~.t~.~.<',.:;.... .... ..::....<......_~ . '. >', :t~.9\'7:' " - .. .... .,: . . " .: < t-tb:_.':?~~':":">~'. ". .~ .~ . . . . ":'" "::~~I:t;(:~.. ": :,': '.-1- :":-,. .. "f ..:.".:.... RIiV-548 EX (12-03) INHERITANCE TAX JOINT BANK ACCOUNT COUNTY FILE NUMBER 21-06-0145 ADVANCE PAYMENT WORKSHEET INHERITANCE TAX RECEIPT NUMBER DECEDENT'S NAME (LAST) Britten DECEDENT DECEDENT'S SOCIAL SECURITY NUMBER INFORMATION 174-16-3944 ADDRESS OF DECEDENT 1000 West South Street (FIRST) Dale DATE OF DEATH (MIDDLE INITIAL) A 02/05/2006 CITY Carlisle STATE PA ZIP 17013 NAME OF FINANCIAL INSTITUTION FINANCIAL INSTITUTION INFORMATION ADDRESS CITY STATE ZIP TELEPHONE NUMBER TYPE OF ACCOUNT o SAVINGS o CHECKING o TRUST o CERTIFICATE OF DEPOSIT II OTHER U.S. Bonds ACCOUNT INFORMATION ACCOUNT BALANCE (INCLUDE INTEREST TO DATE OF DEATH) 45,680.00 ACCOUNT TITLE AS APPEARS ON SIGNATURE CARD OR CD Dale A. Britten or Michael Britten ACCOUNT NUMBER ORIGINAL DATE ESTABLISHED 1985 - 1993 NAME (Last) Britten SURVIVING ADDRESS 3434 Crestmoor Drive JOINT OWNER CITY INFORMATION Woodbury RELATIONSHIP TO DECEDENT Grandson NAME (Last) SURVIVING ADDRESS JOINT OWNER CITY INFORMATION RELATIONSHIP TO DECEDENT NAME (Last) SURVIVING ADDRESS JOINT OWNER CITY INFORMATION RELATIONSHIP TO DECEDENT (First) Michael (Middle Initial) Department of Revenue Use Only PERCENT TAXABLE STATE ZIP CODE MN 55125 TELEPHONE NUMBER TAX RATE (First) (Middle Initial) PERCENT TAXABLE STATE ZIP CODE TELEPHONE NUMBER TAX RATE (First) (Middle Initial) PERCENT TAXABLE STATE ZIP CODE TELEPHONE NUMBER TAX RATE Note: Please attach to receipt \::"\ t-i ~~ \ ~::~~L""'IJj.~ !t'~~ ~J~(~-\!~~ n~~r;~r;J3d -;'\J Jv,....l--!V \...I...J'-'......... Total $ 0.00 INHERITANCE TAX JOINT BANK ACCOUNT ADVANCE PAYMENT WORKSHEET DIRECTIONS for REV-548 The Advance Payment Worksheet enables the taxpayer to report a specific jointly owned or other non-probate asset to the Department without the filling of an actual inheritance tax return form (REV-1500), and it also allows the taxpayer to qualify for 5% discount if payment is made within (3) three months following the decedent's date of death. WHO MAY USE THE ADVANCE PAYMENT WORKSHEET? 1. Surviving owners of jointly held assets. 2. Beneficiaries of "in trust for" (ITF) accounts. 3. Beneficiaries of other assets not subject to the administration of the decedent's estate by the personal representative. PLEASE FILL IN BLOCKS COMPLETELY SO THAT AN ACCURATE NOTICE OF ASSESSMENT CAN BE ISSUED. DECEDENT INFORMATION · decedent's legal name · social security number · decedent's date of death FINANCIAL INSTITUTION INFORMATION · name & address of bank or branch office · provide bank phone number if available ACCOUNT INFORMATION (LIST ONLY ONE ACCOUNT PER WORKSHEET) · Indicate type of account by checking appropriate box, if other, list specific type (only one account per worksheet). · Account balance at date of death (include interest in total). · Account number · Account title as appears on signature card (identify power of attorney, representative payee, attorney in fact, or PUGMA accounts, IRA's etc. where they may apply). · Original date the account was established in joint ownership. Provide signature cards, trust agreements, and other pertinent documents (if available). SURVIVING JOINT OWNER INFORMATION (USE SEPARATE BLOCK FOR EACH SURVIVOR) · use legal names · social security numbers if known · current address · relationship to decedent to insure correct tax rates DEBTS & DEDUCTIONS If there are no probate assets and the surviving owner has actually paid expenses incurred because of the decedent's death, they can be listed and deducted from the portion of the account balance subject to tax. I nclude expenses directly related to the decedent's death such as funeral costs, refreshments following the funeral, flowers, cemetery plots and markers, engraving, etc. Provide appropriate documents to substantiate claims. After review by the Department, a formal notice of assessment will be returned to each individual owner indicating the final status of the particular asset that has been reported. Make checks payable to the REGISTER of WILLS, Agent, in the county of the decedent's LEGAL residence. Savings BGnd CalcuI~[tGr 11ud~,'l~ ~~ (\ 'j /') (\l\~ VL.IL.VVV -rl # Bon lis II... ...1.:-:0*6 __.1,1' '\......~ Sel"ies Jb T Denomination J't -..-- - - Tot~tl Interest $2R~1~O.HH Serial NUlubt'"r Issue DHte Series Den~till Issue- Prict'" 35 Tohtl Price $17~5ou.on $1,000 $500.00 i,OOO 500.00 1..000 500.00 t {\{$\ ~ . '~f'.": \.1 :: (\(\ (\{\ ~'\./V. \./\.1 07/1993 EE i ,000 .:...-,,"'L,l-\, ...-,r, JUU. UU 07/1993 EE 07/1993 EE 07/1993 1:'1:' LL 1,000 500.00 1..000 500.00 l~OOO 500.00 1,000 500.00 1,000 500.00 1,000 500.00 l~OOO 500.00 1,000 500.00 1,000 500.00 1,000 500.00 1,000 500.00 1,000 500.00 1;000 500.00 1,000 500.00 1.000 500.00 1,000 500.00 i.OOO )OU.OU 1,000 500.00 1,OCJO 500.00 1,000 500.00 :r .-~ J-' ...-. I. UUU .- ..., ,,-, 1-' 1-' )UU .UU 07/i993 EE 1.000 500.00 12/1988 EE 12/1988 EE 12/1988 EE 1111988 EE 12/1988 EE 12/1988 EE 12/1988 EE 11/1988 EE 11/1988 EE 12/1988 EE 04/1987 EE 04/1987 EE 04/1987 EE 04/1987 EE 04/1987 EE 04/1987 EE 04/1987 EE 04/1987 EE {l.t 1987 -.-~ t.t: 1.000 500.00 04/1987 EE Uji19~) EE EE EE http' i\'/\V\VS. pub Ii cdebt. treas gCiv,/BC/SB CPrl ce (.13,' i $85 03f19~) H',n.~n IF __.." Serial Numher Interest Value $360 80 $860.80 Tohll V..lue $-t5.(l~UUHt - . ~ - .Page i ot ~ Savint Issue Date YTDlDi $68.t Interest Ne-xt Finid Rute At=\Tual ~lC:\turit~ " ~o.. _.., _.., _1 '/0 360,80 860.80 3.350/(t 07/2006 07/2013 07/1006 OTI2023 360.80 860.80 360.80 860.80 3.350.\) 07/2006 07/2013 07/2006 07/2013 ..,. ,/'rL nr&. JOI).OI,) ~....., ./ ,t...." n'1 oOU. c)\) 3.35Q/o "I 'L- fl ..' J . J ~l "'/ l) 07/2006 07/2023 739.20 L239.20 4.000/0 06/2006 1212018 739.20 1,239.10 4.000/0 06/2006 12/2018 739.20 L239.20 4.00~o 06/2006 12/2018 739.20 i,239.10 4.00~0 06/2006 11/2018 739.20 C239.20 4.00~o 06/2006 12/2018 739.20 1,239.20 4.000"0 06/1006 12/2018 739.20 1,239.20 4.000"0 06/2006 12/2018 739.10 1,239,10 4.00~(, 06/2006 12/2018 739.20 L239.20 4.000..0 06/2006 12/2018 739.10 1,139.20 4.000-"0 06/2006 12/2018 815.20 1.315.20 4.000.0 04/2006 04/2017 S 15.20 i) 15.20 4.000.(, 04/1006 04/1017 815.20 1.315.20 4.000/0 04/2006 04/2017 815.10 L315.20 4.000,'0 04/2006 04/2017 815.10 1.315.20 4.000,0 04/2006 04/2017 815.20 1,315.20 4.0000 0412006 04/2017 S 15 .20 1.315.20 4.0000 04/2006 04,;':2017 815.20 L315.20 4.0000 04/2006 04/201; 81520 1.31520 4.000(1 04/2C)06 i)4/2Ct 1 / 1 r. <)... .-,. r} 1.Udj.":'t.. 'I - ~-. -. .~ ,;-, l.)~U ....:.U 815.20 1,315..20 4.000'0 04/:2006 04/:2017 03/2006 (.13/.201:) 1.08320 f :- ,-. ~ ., ~-, 1,);')j":'U 1.083.20 1.583.20 4.000 I) 4.000 i) 4.000 I) 03/2006 03/2015 03/2006 03/2(1) '1./ I -, i"ll(Ii.: 4'i I !: ~\j\..IU S(~\'ings Bond Calculator 03 1 ~~}S 5 BE 03/ 1985 BE 03/ .i 985 EE 01/1935 EE 03/1 985 EE 03/1985 EE 03/1985 EE u~......... 111 " .1.1;, W .I. '-' I "\ 1;.......;".T lJ.." -I.., I :0-': I v lell III:':. Ill/IILI.., 1-. '_' ! ~ Note De~criptinn NI Not Issued Paue2of2 1.000 500.00 ., ..-,,z-."" ") (\ L533 .20 4.000. 0 03/'2006 03/20 1 ~ 1,U0j _\j 1,000 500.00 1,083.20 L583 .20 -4.000.0 03/2006 03/20 1 .., 1 .000 500.00 J .083 20 1.533 20 4.000.0 ()3/2006 03/201 .., .L 1; 000 500.00 1,083.20 1,583 ..20 4. OO~o 03/2006 03/20 1 :) I ,000 500 00 L08320 I ,583 20 4.. 000.0 03/2006 i)3/20 1 .., 1,000 500.. 00 1,083 .20 1,583 .10 4.0000 03/2006 03/201 ) 1 ,000 500.00 1 J>83.20 1,583.20 4.000'0 03/1006 03 /20 1 .., Nt Not Eligible for PaYlnent P5 Includes J -111onth interest penalty 1\1/\. I'v1atured and Not Earning Interest Please rate this service. (Please print and/or save this page before subnlitting your survey) Service Excellent Good Fair Poor SaVings Bond Calculator , " 1" 'I" Submit Survey Oacat I \ V"-'y" 'T"\""" !i"r.,.....~ . f I 1 ..., I ~ !.~ /.\ Directive' , I direct that my following existing accounts be given, irrevocably, to my daughter. Judy S. Britten. The balances are all calculated on or about October 15,,?005. ~ " - .' :;.J"' 1. Members 1st checking. balance of $90.989.00 .~~;:; .,'. () -:..., 2. Members 1st savings, balance of $217.015.00 ~_~~}f~ ::- , "'J -~..:. 3. Members 1st money mgt.. balance of $38.546.00 _ : ,~?~; ~ 4. Members 1st IRA, balance of $7,687.00, Judy has already been:. , _ .._,--1 . - designated as my beneficiary on this account. .. 5. USAA, USAAX Growth Fund, balance $272,298.00 6. USAA, USTEX Tax Exempt Long-Term Fund, balance $469,780.00 All of the aforesaid accounts, other than the IRA, had already been placed in joint ownership with Judy, evidencing my intent that she receive these funds upon my qeath. ,It is my intent to transfer these funds during my lifetime, rather than at my death. However, I direct that the sum of $62,280.00, from the assigned procee,ds, be ,placed in a trust for my cost of nursing home care. I have calculat,ed that amount based upon the current average annual cost at the Todd Home for nursing care in theamou~t of $79,500.00 per year, less my current annual income of $58,740.00. This will guarantee my ability to pay the first thirty six months of nursing 'home care. should J need to continue in nursing home care. My daughter Judy to make the choice on my behalf as to place me in assisted living. if I qualify after undergoing rehabilitation. or in nursing home care. I give my residence, and all the furnishings therein, at 7 Greystone Road, Carlisle, Pennsylvania to my daughter Judy S. Britten. I give my Winnebago motor home. the coin sets at my home and my lot with three car garage in Cambria County, to my son Ronald H. Britten. ' I acknowledge that I fully understand and am aware that I am currently giving to my heirs virtually all my assets and this is done hot through any undue influence but because of ,my love for all of them. I also acknowledge that I.am giving subst~htially :--; '..~; ;t~ --:'. -i; :.....: ... ) .. ~ t .,'''::; , . c~ ~)~~ - !'....') . . . f" .-.~...~ .'~ .;.. more of my assets to my daughter, Judy S. Britten, and that I am doing this not . because I do not love my children equally, but because I believe that Judy needs more of my assets to meet her future needs. I have accumulated US Savings bonds in joint names for my son, R~nald H. Britten and his sons, Michael Britten and Andrew Britten. I irrevocably give t~ose bonds to those individuals and direct Judy, who is my agent, to see that the bonds are delivered. I have accumulated US Savings Bonds in joint names for my daughter, Judy S. Britten and het children, Robert S. .Young and Morgan Goodling. I irrevocab~y give Judy her bonds. I do not wish that those for Robert S. Young and Morgan Goodling be delivered directly to them, but that the bonds be transferred to Judy S. Britten as Trustee. The value of the bonds for Morgan Goodling as of October, 2095, amount-to-' $79,240.00 and for Robert Young $76,355.00. The provisions of the trust follow. 1. My Trustee shall set up a separate Trust for each grandchild. My Trustee shall pay principal and income to or for the benefit of my grandchild during his or her life as my"Trustee, in her sole discretion, shall deem advisable for the health, maintenance, support and complete education o~ such grandchild. In addition, my Trustee in her sole discretion may advance funds to said beneficiary for the costs of marriage, or the purchasing of a home or costs of entering a business or profession, if my said Trustee shall deem such expense reasonably prudent. 2. Any and all payment or payments of any sum or sums, whether in cash or in kind and whether for pri~al or income, payable to a grandchild, or any of them, shall be made upon th~ sole receipt of the respective individual to whom the payment is made, and free from anti~on, alienation, assignment, attachment, and pledge, and free from control by the crediors of any such beneficiary. 3. Should the pmcipal of any trust herein provided for be or become too small in my Trustee's disaetbn to make establishments or continuance of the trust advisable, my Trustee may cistribute the remaining principal and any accumulated or undistributed income ou~ to the beneficiaries in the proportions to which they are then entitled to.. Th~ re~ and releases of the distributee will terminate absolutely _ _~~ l. !:O.._# ;. ~'.' .~; .~ ~.~:; ::~~ . ---~-r-'- --~---- . .,j--';. ,--' , the rights of all persons who migh.t ot~erwise have future interest in the trust, whether vested or contingent, 'without notiCe to them and without the necessity of filing an account with the court. 4. Any funds not distributed to a grandchild, at the time of my daughter's death, shall be distributed to the.grandchild, subject tethe terms and conditions of any' trust that she may hereafter create. All the gifts in this Directive, shall be split between the years of 2005 and 2006 so as to maximize the federal unified gift and estate tax credit. Executed this the 2'. day O~""r. 2005. . . c2~~~ Dale A. Britten . . - . .. ... .. ___, ........ ... .6.' _ _ _.. _, .. . . . ~ . "~;;'i.;~~~;~,,:;.:.;.-: . ,c.: .. ~ --~; , . ,~. . ;. 1 =:-~. i:;.... '.. . . - > ,. . >.- '. . .- " .... ..' --,., . . · .,.;J"-;-l<;;:i;"::~~~jS';:;'<,,,. . . .::\: 1':9"'~: ~';.. . . . .' . . .:, ,,: .. ';: ,"'T' ,'..;.. .., .'-" :.: ;.:t,;,;;:.:.:::::::->~:. ::. ~~ . . . .. -. . - . , REV-548 EX (12-03) . INHERITANCE TAX JOINT BANK ACCOUNT COUNTY FILE NUMBER 21-06-0145 ADVANCE PAYMENT WORKSHEET INHERITANCE TAX RECEIPT NUMBER DECEDENT'S NAME (LAST) Britten DECEDENT DECEDENT'S SOCIAL SECURITY NUMBER INFORMATION 174-16-3944 ADDRESS OF DECEDENT 1000 West South Street (FIRST) Dale DATE OF DEATH 02/05/2006 (MIDDLE INITIAL) A CITY Carlisle STATE PA ZIP 17013 NAME OF FINANCIAL INSTITUTION FINANCIAL INSTITUTION INFORMATION ADDRESS CITY STATE ZIP TELEPHONE NUMBER TYPE OF ACCOUNT o SAVINGS o CHECKING o TRUST o CERTIFICATE OF DEPOSIT II OTHER U.S. Bonds ACCOUNT INFORMATION ACCOUNT BALANCE (INCLUDE INTEREST TO DATE OF DEATH) 49,672.00 ACCOUNT TITLE AS APPEARS ON SIGNATURE CARD OR CD Dale A. Britten or Andrew Britten ACCOUNT NUMBER ORIGINAL DATE ESTABLISHED 1986-1993 J Department of Revenue Use Only PERCENT TAXABLE NAME (Last) Britten SURVIVING ADDRESS 30460 SW 188th Avenue JOINT OWNER CITY INFORMATION Homestead RELATIONSHIP TO DECEDENT Grandson NAME (Last) SURVIVING ADDRESS JOINT OWNER CITY INFORMATION RELATIONSHIP TO DECEDENT NAME (Last) SURVIVING ADDRESS JOINT OWNER CITY INFORMATION RELATIONSHIP TO DECEDENT (First) Andrew (Middle Initial) STATE ZIP CODE FL 33030 TELEPHONE NUMBER TAX RATE (First) (Middle Initial) PERCENT TAXABLE STATE ZIP CODE TELEPHONE NUMBER TAX RATE (First) (Middle Initial) PERCENT TAXABLE STATE ZIP CODE TELEPHONE NUMBER TAX RATE Note: Please attach to receipt r ~..: ~:, :.-.\ 1;..~:: \ .:::~\c\:r~~ .) '_I;I't' ~/ /:::,7\; Ir{\J~~ !.-., tl\ I :, \ '-" ,n\ 'v tU :/..) Jv :i:rv u-'~.... -J - Total $ 0.00 INHERITANCE TAX JOINT BANK ACCOUNT ADVANCE PAYMENT WORKSHEET DIRECTIONS for REV-548 The Advance Payment Worksheet enables the taxpayer to report a specific jointly owned or other non-probate asset to the Department without the filling of an actual inheritance tax return form (REV-1500), and it also allows the taxpayer to qualify for 5% discount if payment is made within (3) three months following the decedent's date of death. WHO MAY USE THE ADVANCE PAYMENT WORKSHEET? 1. Surviving owners of jointly held assets. 2. Beneficiaries of "in trust for" (ITF) accounts. 3. Beneficiaries of other assets not subject to the administration of the decedent's estate by the personal representative. PLEASE FILL IN BLOCKS COMPLETELY SO THAT AN ACCURATE NOTICE OF ASSESSMENT CAN BE ISSUED. DECEDENT INFORMATION · decedent's legal name · social security number · decedent's date of death FINANCIAL INSTITUTION INFORMATION · name & address of bank or branch office · provide bank phone number if available ACCOUNT INFORMATION (LIST ONLY ONE ACCOUNT PER WORKSHEET) . Indicate type of account by checking appropriate box, if other, list specific type (only one account per worksheet). · Account balance at date of death (include interest in total). · Account number . Account title as appears on signature card (identify power of attorney, representative payee, attorney in fact, or PUGMA accounts, IRA's etc. where they may apply). . Original date the account was established in joint ownership. Provide signature cards, trust agreements, and other pertinent documents (if available). SURVIVING JOINT OWNER INFORMATION (USE SEPARATE BLOCK FOR EACH SURVIVOR) · use legal names · social security numbers if known · current address · relationship to decedent to insure correct tax rates DEBTS & DEDUCTIONS If there are no probate assets and the surviving owner has actually paid expenses incurred because of the decedent's death, they can be listed and deducted from the portion of the account balance subject to tax. Include expenses directly related to the decedent's death such as funeral costs, refreshments following the funeral, flowers, cemetery plots and markers, engraving, etc. Provide appropriate documents to substantiate claims. After review by the Department, a formal notice of assessment will be returned to each individual owner indicating the final status of the particular asset that has been reported. Make checks payable to the REGISTER of WILLS, Agent, in the county of the decedent's LEGAL residence. ~aVlll~to~ . 02/2006 Series fEE;: 0 t~ # Bonus -i-i UIHhlte "'!I'" Total Price $20~OOO.OO Denolllination .t 1,.Ml~ "'!I'" 07/1993 Serial NUDlber Issue Date Series Denolll $i,000 $500.00 07/1993 ^,..,I. "'''''.., VI/I '7'7,j 07/1993 07/1993 07/1993 07/1993 07/1993 07/1993 07/1993 EE 11/1988 11/1988 11/1988 EE ..... i. "'...... L~/l '700 12/1988 11/1988 12/1988 12/1988 J.-"\. ,.. ,-'01"\ l~/l'7oo 11/1988 04/1987 EE 04/1987 04/1987 04/1987 04/1987 04/1987 04/1987 ^.. i, An.., U't/l ';;'0 I EE EE EE EE T"" T"" nn T""T"" nn EE T"" T"" nn T"" ...... te EE EE ............ be T"" T"" be EE T"" T""" ee T"" ...... be EE EE T""" ...... .t.t ...... T"" .t.t T"" T"" .tc EE EE -r- T"" tt T""" T""" en Total Interest $29~672.00 Issue Price 1,000 500.00 i,000 500.00 1,000 500.00 1,000 500.00 1,000 500.00 1,000 500.00 1,000 500.00 1,000 500.00 1,000 500.00 1,000 500.00 1,000 500.00 1,000 500.00 1,000 1,000 I ,000 1,000 1 ,000 1,000 1 ,000 500.00 500.00 ,-^^ ^^ )uv. VU 500.00 500.00 500.00 500.00 1,000 500.00 500.00 1,000 1,000 1,000 1 r.r.^ ,VVV ~r,^ Ar, :)vV.vv 500.00 1,000 500.00 500.00 1,000 500.00 1,000 500.00 http./!\v\V\vs.pubiicdebttreas.gov/BC/SBCPrice Help Serial NUlnbel' Interest Value $360.80 $860.80 360.80 860.80 360.80 860.80 360.80 860.80 360.80 L'\ ,.' ^ n ^ oOV.oV 360.80 860.80 360.80 860.80 360.80 L'\ ,.' ^ L'\ ^ oOV.oV 860.80 3.35~/'o 07/1006 07/1023 07/2006 07/2013 360.80 Total Value $49 ~672.00 Page 1 of 2 Savin~ Issue Date YTD 101 $440. Intel'est Next Final Rate Accrual Maturi~ "'" ;r/\/ ,j.,jJ'?o ... "'''0\ / ,j.,j Y?o 3.3 5~/o ... "'''0\.' ,j . ,j Y?o 3.3 5:'/0 3.35~/0 3.35~/o "" "" t"0\ / .) .,j Y?o 07/1006 07/1013 07/1006 07/1013 07/2006 07/2013 07/1006 07/2013 07/2006 07/1023 07/2006 07/2023 07/2006 07/2023 739.20 1.139.10 360.80 860.80 3.35~'0 07/2006 07/1013 06/1006 12/2018 739.10 1,239.10 4 . OO~"o .f ^ ,__1\ / 4.VV':"'o 06/2006 12/20 i 8 739.20 1,239.20 4.00:'/0 06/2006 12/1018 06/2006 12/2018 739.10 1,139.10 4.00~/0 739.10 1,139.20 4.00~/o 739.10 1,239.20 4.00~/o 739.20 1,139.20 4.00~.'o 739.10 1,139.10 4.00~/o 739.20 1,139.20 4.00~.0 739.10 1,139.20 4.00~/0 06/1006 12/1018 06/2006 12/2018 06/2006 12/2018 06/1006 11/2018 06/1006 11/2018 06/1006 11/1018 815.10 1.315.10 815.10 1,315.10 4.00~'o 04/1006 04/2017 04/2006 04/2017 815.10 1,315.20 815.20 1. """\ 1 .~"""'\ ~-, 1,')1:).~V 8 i 5.10 1,315.10 4. OO~/o ... ,--... .-... i\ / 4. VV';o 815.20 1,315.10 815.20 1,315.10 815.10 1,315.20 .4 ,--... ,...../\ / 4. VV~"O .4 r"\r,t\..- 4.VU':"'0 .. ,-\ ,.....,i"l.l 4. VV~:/o ..f r. r.o / 4.VV,'0 4. OO~o 04/2006 04/20 i7 04/2006 04/2017 04/1006 04/1017 04/2006 04/2017 04/1006 04/1017 04/1006 04/1017 4/1 7/2006 SavIngs Bond Calculator " r... ..; .' 1 .."""\ n ..., V"t! 1 '70 I 04/1987 01/1986 01/1986 o i/i986 EE 01/1986 EE 01/1986 EE 01/1986 01/1986 01/1986 01/1986 01/1986 01/1986 01/1986 01/1986 01/1986 View 10 I VieY\'ing BClnds l-~-+ Note Description NI Not Issued EE EE T""'T"'" ~~ T"""T"'" ~~ T""" T"" ~~ EE EE EE EE EE EE EE EE 1 ,000 500.00 1 ,000 500.00 1.000 500.00 LOOO 500.00 LOOO 500.00 LOOO 500.00 1,000 500.00 ,r,r,-,-, ,. {"",,"'\. I~"'-" 1,VVV :)vu.uu 500 250.00 500 250.00 500 250.00 500 250.00 500 250.00 500 250.00 500 250.00 500 250.00 1'l"'E l~ot Eligible for Paynient P5 Includes 3 -llionth interest penalty :rvL~ Matured and l~ot Earning Interest Please rate this service. 815.10 815.20 1.052.00 1 "'"\ 1 ;- -..." '-I,. 1,':; l:).';:V 1.315.20 1.552.00 4 . OO~o . ,-t. ,-,t}. / "t . VV";/o 1,051.00 1.551.00 4.00~/o 4 . OO~iO Page 2 of 2 04/2006 04/2017 04/1006 04/1017 07/2006 01/1016 1,052.00 1.551.00 4.00~/o 07/1006 01/1016 07/1006 01/1016 1,051.00 1,551.00 4.00~/o 07/2006 01/1016 1,051.00 i,551.00 4.00~IO 07/2006 01/1016 1.051.00 526.00 526.00 526.00 526.00 526.00 526.00 526.00 526.00 J ,,~.... ............ 1 , _ J ~ . vv 776.00 776.00 776.00 776.00 776.00 776.00 776.00 776_ 00 4. OO~'~ 4.000/0 4.00ft/o 4.000/0 4. o <Yt/o 4.000/0 4.000/0 4.000/0 4.000/0 07/1006 01/1016 07/2006 01/20it 07/2006 01/201t 07/2006 Oi/20lt 07/2006 01/201t 07/2006 01/20 IE 07/2006 01/201E 07/2006 01/201E 07/2006 01/201t (Piease print and/or save this page before submitting your survey) Service Excellent Good Fair Poor Savings Bond Calculator Submit Survey http://\V\V\vs.pubiicdebttreas. gov /EC /SBCPrice Reset 4/1 7/2006 :.:;j~~1/{" .. Directive". . I direct that my following existing accounts be given, irrevocably, to my daughter, Judy S. Britten. The balances are all calculated on or about October 15,,?005. ~ --~ ., .' ';..J-". . ~. i .~-: 1. Members 1 st checking, balance of $90,989.00 .~(~ ~ ~.;~ ::::~ .",.. () -:"'"J ~ i: ) 2. Members 1st savings, balance of $217,015.00 : ~:-~:~. '.,0 3. Members 1st money mgt., balance of $38,546.00 .. :~~~ ; .. (~ 4. Members 1st IRA, balance of $7,687.00, Judy has already b~:.-n 0 ~~~.~~.~ . . '-, -~ i" ''":. .~ designated as my beneficiary on this account. ..' __ 5. USAA, USAAX Growth Fund, balance $272,298.00 6. USAA, USTEX Tax Exempt Long-Term Fund, balance $469,780.00 All of the aforesaid accounts, other than the IRA, had already been placed in joint ownership with Judy, evidencing my intent that she receive these funds upon my qeath. .It is my intent to transfer these funds during my lifetime, rather than at my death. However, I direct that the sum of $62,280.00, from the assigned proceeds, be' . placed in a trust for my cost of nursing home care. I have calcula~ed that amount based upon the current average annual cost at the Todd Home for nursing care in the amou~t of $79,500.00 per year, less my current annual income of $58,740.00. This will guarantee my ability to pay the first thirty six months of nursing "home care, should I need to continue in nursing home care. My daughter Judy to make the choice on my behalf as to pla~e me in assisted living, if I qualify after undergoing rehabilitation, or in nursing home care. I give my residence, and all the furnishings therein, at 7 Greystone Road, Carlisle, Pennsylvania to my daughter Judy S. Britten. I give my Winnebago motor home, the coin sets at my home and my lot with three car garage in Cambria County, to my son" Ronald H. Britten. ' I acknowledge that I fully understand and am aware that I am currently giving to my heirs virtually all my assets and this is done not through any undue influence but because of .my love for all of them. I also acknowledge that I-am giving substantially more of my assets to my daughter, Judy S. Britten, and that I am doing this not _ because I do not love my children equally, but because I believe that Judy needs more of my assets to meet her future needs. I have accumulated US Savings bonds in joint names for my son, R~nald H. Britten an'd his sons, Michael Britten and Andrew Britten. I irrevocably give t~ose bonds to those individuals and direct Judy, who is my agent, to see that the bonds are delivered. I have accumulated US Savings Bonds in joint names for my daughter, Judy S. Britten and het children, Robert S. Young and Morgan Goodling. I irrevocab~y give Judy her bonds. I do not wish that those for Robert S. Young and Morgan Goodling be delivered directly to them, but that the bonds be transferred to Judy S. Britten as Trustee. The value of the bonds for Morgan Goodling as of Octob~r, 2095, amount-to - '- $79,240.00 and for Robert Young $76,355.00. The provisions of the trust follow. 1. My Trustee shall set up a separate Trust for each grandchild. My Trustee shall pay principal and income to or for the benefit of my grandchild during his or her life as my'Trustee, in her sole discretion, shall deem advisable for the health, maintenance, support and complete education o( such grandchild. In addition, my Trustee in her sole discretion may advance funds to said beneficiary for the costs of marriage, or the purchasing of a home or costs of entering a business or profession, if my said Trustee shall deem such expense reasonably prudent. 2. Any and all payment or payments of any sum or sums, whether in cash or in kind and whether for pri~al or income, payable to a grandchild, or any of them, shall be made upon the sole receipt of the respective individual to whom the payment is made, and free from anti~n, alienation, assignment, attachment, and pledge, and free from control by the crediors of any such,beneficiary. 3. Should the pri1cipal of any trust herein provided for be or become too small in my Trustee's disaelion to make establishments or continuance of the trust advisable, my Trustee may fistribute the remaining principal and any accumulated or undistributed income ou1:r9t to the beneficiaries in the proportions to which they are then entitled to.. The re~ and releases of the distributee will terminate absolutely ,... ~ " the rights of all persons who migh~ ot"erwise have future interest in the trust. whether vested or contingent. without notice to them and without the necessity of filing an account with the court. 4. Any funds not distributed to a grandchild, at the time of my daughter's death, shall be distributed to the.grandchild, subjectto the terms and conditions of any' trust that she may hereafter create. All the gifts in this Directive. shall be split between the years of 2005 and 2006 so as to maximize the federal unified gift and estate tax ~redit. Executed this the 2'. day o~~ 2005. . ~ . . C2. & ~--" Dale A. Britten . . .- .. . ---- ..... . ...... -....... ". . ". :'\>~..:_"':("'~ .~: . . ":':~~tfJ.$;~~7.l.~~..!:." ": .0 . ~;\":-'i." '_. .."' '." . . '<". J..: . '. .J~/-<;;~~~~.~;:~!~;-:~:;: ~. . " ...~A~t>.':~" ", . , . ~ :.~ !.'ct:,\:.:;-,:~:-:~,#::.. . .". .I' . '.~ ..... ~~:. ~ : . ~ ! ..:"!I REV-548 EX (12-03) INHERITANCE TAX JOINT BANK ACCOUNT COUNTY FILE NUMBER 21-06-0145 ADVANCE PAYMENT WORKSHEET INHERITANCE TAX RECEIPT NUMBER DECEDENT'S NAME (LAST) Britten DECEDENT DECEDENT'S SOCIAL SECURITY NUMBER INFORMATION 174-16-3944 ADDRESS OF DECEDENT 1000 West South Street FINANCIAL INSTITUTION INFORMATION ACCOUNT INFORMATION SURVIVING JOINT OWNER INFORMATION SURVIVING JOINT OWNER INFORMATION SURVIVING JOINT OWNER INFORMATION (FIRST) Dale (MIDDLE INITIAL) A DATE OF DEATH 02/05/2006 CITY Carlisle STATE PA ZIP 17013 NAME OF FINANCIAL INSTITUTION ADDRESS CITY ZIP STATE TELEPHONE NUMBER TYPE OF ACCOUNT o SAVINGS o TRUST II OTHER U.S. Bonds o CHECKING o CERTIFICATE OF DEPOSIT ACCOUNT BALANCE (INCLUDE INTEREST TO DATE OF DEATH) 76,870.08 ACCOUNT TITLE AS APPEARS ON SIGNATURE CARD OR CD Dale A. Britten or Robert D. Young NAME (Last) Young ADDRESS ACCOUNT NUMBER ORIGINAL DATE ESTABLISHED 1984 - 2001 (First) (Middle Initial) Department of Revenue Use Only Robert D 419 Factory Street CITY Carlisle RELATIONSHIP TO DECEDENT Grandson PERCENT TAXABLE STATE ZIP CODE PA 17013 TELEPHONE NUMBER TAX RATE (First) (Middle Initial) PERCENT TAXABLE STATE ZIP CODE TELEPHONE NUMBER TAX RATE (First) (Middle Initial) PERCENT TAXABLE STATE ZIP CODE TELEPHONE NUMBER TAX RATE NAME (Last) ADDRESS CITY RELATIONSHIP TO DECEDENT NAME (Last) ADDRESS CITY RELATIONSHIP TO DECEDENT Date Paid :~~i,,~:~~~:ij8Z. ~ Description Amount Paid '(" -, 1"'.' \ ''\ r!""'- ~ If" rt'\IJ ~iV) -rv'H-il ! U-HU,~U,--'=iu.; ..a1 -J .__ V ~ "'-6 Total $ 0.00 Note: Please attach to receipt INHERITANCE TAX JOINT BANK ACCOUNT ADVANCE PAYMENT WORKSHEET DIRECTIONS for REV-548 The Advance Payment Worksheet enables the taxpayer to report a specific jointly owned or other non-probate asset to the Department without the filling of an actual inheritance tax return form (REV-1500), and it also allows the taxpayer to qualify for 5% discount if payment is made within (3) three months following the decedent's date of death. WHO MAY USE THE ADVANCE PAYMENT WORKSHEET? 1. Surviving owners of jointly held assets. 2. Beneficiaries of "in trust for" (ITF) accounts. 3. Beneficiaries of other assets not subject to the administration of the decedent's estate by the personal representative. PLEASE FILL IN BLOCKS COMPLETELY SO THAT AN ACCURATE NOTICE OF ASSESSMENT CAN BE ISSUED. DECEDENT INFORMATION · decedent's legal name · social security number · decedent's date of death FINANCIAL INSTITUTION INFORMATION · name & address of bank or branch office · provide bank phone number if available ACCOUNT INFORMATION (LIST ONLY ONE ACCOUNT PER WORKSHEET) · Indicate type of account by checking appropriate box, if other, list specific type (only one account per worksheet). · Account balance at date of death (include interest in total). · Account number · Account title as appears on signature card (identify power of attorney, representative payee, attorney in fact, or PUGMA accounts, IRA's etc. where they may apply). · Original date the account was established in joint ownership. Provide signature cards, trust agreements, and other pertinent documents (if available). SURVIVING JOINT OWNER INFORMATION (USE SEPARATE BLOCK FOR EACH SURVIVOR) · use legal names · social security numbers if known · current address · relationship to decedent to insure correct tax rates DEBTS & DEDUCTIONS If there are no probate assets and the surviving owner has actually paid expenses incurred because of the decedent's death, they can be listed and deducted from the portion of the account balance subject to tax. Include expenses directly related to the decedent's death such as funeral costs, refreshments following the funeral, flowers, cemetery plots and markers, engraving, etc. Provide appropriate documents to substantiate claims. After review by the Department, a formal notice of assessment will be returned to each individual owner indicating the final status of the particular asset that has been reported. Make checks payable to the REGISTER of WILLS. Agent. in the county of the decedent's LEGAL residence. ,=saVIngs tlOIIC1 calculator page 1 ot ~ ~~ lJ ~ Savinc 02/2006 UI) date Help Series Denoluination Serial Number Issue Date .-t:., ..... 4 aoo # Bonds Total Price Total Interest Total Value YTD Inl 138 $35,,700.00 $-11,,170.08 $76.$70.08 $120. Issue Interest Next Final Serial Number Issue Date Series Denom Price Interest Value Rate Accrual Maturit) 05/1984 EE $200 $100.00 $229.44 $329.44 4.000/0 OS/2006 OS/201-4 10/2001 I 1 ,000 1,000.00 238.40 1,238.40 6.63% 03/2006 10/2031 02/2000 EE 500 250.00 65.40 315.40 3.610/0 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.610/0 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.61% 03/2006 02/203C 02/2000 EE 500 250.00 65.40 3 15.40 3.610/0 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.61% 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.610/0 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.61% 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.610/0 03/2006 02/203C 02/2000 EE 500 250.00 65.40 3 15.40 3.61% 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.610/0 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.61O~ 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.61O~ 03/2006 02/203C 02/2000 EE 500 250.00 65.40 3 15.40 3.61O~ 03/2006 02/203C 02/2000 EE 500 250.00 65.40 3 15.40 3.610/0 03/2006 02/203C 02/2000 EE 500 250.00 65.40 3 15.40 3.61O~ 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.61OiO 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.61% 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.61o,,~ 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.61O~ 03/2006 02/203C 02/2000 EE 500 250.00 65.40 3 15.40 3.61% 03/2006 02/203C 02/2000 EE 500 250.00 65.40 3 15.40 3.61OiO 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.61~/0 03/2006 02/203C 02/2000 EE 500 250.00 65.40 3 15.40 3.61O~ 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.610/0 03/2006 02/203C 02/2000 EE 500 250.00 c 65.40 315.40 3.61010 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.610/'0 03/2006 02/203C http://WW\vs.publicdebt.treas.gov/BC /SBCPrice 4/17/2006 -Savings Bond Calculator Pagelof5 01/1000 EE 500 150.00 65.40 3 15.40 3.61% 03/2006 02/203C 01/2000 EE 500 150.00 65.40 315.40 3 .61 o~ 03/2006 02/203C 01/1000 EE 500 150.00 65.40 3 15 .40 3.610/0 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.610/0 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.61010 03/2006 02/203C 02/2000 EE 500 250.00 65.40 3 15.40 3.61O~ 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.610/0 03/1006 02/103C 02/2000 EE 500 250.00 65.40 315.40 3.610/0 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.610/0 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.610/0 03/2006 02/203C 01/2000 EE 500 250.00 65.40 3 15.40 3.610/0 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.61010 03/2006 02/203C 02/2000 EE 500 250.00 65.40 3 15 .40 3.61% 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.61010 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.61% 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.61O~ 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.610/0 03/2006 02/203C 02/2000 EE 500 150.00 65.40 315.40 3.61% 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3 .61 ~~ 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.610/0 03/2006 02/203C 02/1000 EE 500 250.00 65.40 315.40 3.610/0 03/2006 02/203C 02/2000 EE 500 150.00 65.40 315.40 3.61010 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.61~o 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3 .610/0 03/2006 02/203C 02/2000 EE 500 150.00 65.40 315.40 3.610/0 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.61% 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.610/0 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.61% 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.610/0 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.610/0 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.610/0 03/2006 02/203C 02/2000 EE 500 250.00 65.40 3 15.40 3.610/0 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3 . 61 ~~ 03/2006 02/203C 02/2000 EE 500 250.00 65.40 315.40 3.610/0 03/2006 02/203C 04/1987 EE 1 ,000 500.00 815.20 1,315.20 4.00% 04/2006 04/201 i 04/1987 EE 1,000 500.00 815.20 1,315.20 4. OO~~ 04/2006 04/201 i 04/1987 EE 1 ,000 500.00 815.20 1,315.20 4. OO~/o 04/2006 04/201 i 04/1987 EE 1,000 500.00 815.20 1,315.20 4. OO~/o 04/2006 04/201i http://wwws.publicdebt.treas.gov/BC/SBCPrice 4/17/2006 . Savings Bond Calculator Page 3 of 5 04/1987 EE 1,000 500.00 815.10 1,315.20 4.000/0 04/2006 04/201i 04/1987 EE 1,000 500.00 815.20 1,315.20 4.000/0 04/2006 04/201 i 04/1987 EE 1,000 500.00 815.10 1,315.20 4.000/0 04/2006 04/201i 04/1987 EE 1,000 500.00 815.20 1,315.20 4.00% 04/2006 04/201i 04/1987 EE 1,000 500.00 815.20 1,315.20 4.000/0 04/2006 04/201 i 04/1987 EE 1,000 500.00 815.20 1,315.20 4.00% 04/2006 04/20 1 i 04/1987 EE 1 ,000 500.00 815.20 1,315.20 4.00% 04/2006 04/201 i 04/1987 EE 1,000 500.00 815.20 1,315.20 4 . 00~ic> 04/2006 04/201 i 04/1987 EE 1,000 500.00 815.20 1,315.20 4.000/0 04/2006 04/201i 04/1987 EE 1,000 500.00 815.20 1,315.20 4.000/0 04/2006 04/201 i 04/1987 EE 1,000 500.00 815.20 1,315.20 4.00% 04/2006 04/201 i 04/1987 EE 1,000 500.00 815.20 1,315.20 4.000/0 04/2006 04/201 i 04/1987 EE 1,000 500.00 815.20 1,315.20 4.000/0 04/2006 04/201 i 04/1987 EE 1,000 500.00 815.20 1,315.20 4.000/0 04/2006 04/201i 04/1987 EE 1 ,000 500.00 815.20 1,315.20 4. OO~~ 04/2006 04/201 i 04/1987 EE 1,000 500.00 815.20 1,315.20 4.00% 04/2006 04/201 i 10/1986 EE 1,000 500.00 992.00 1,492.00 4.000/0 04/2006 10/201 E 10/1986 EE 1,000 500.00 992.00 1,492.00 4.000/0 04/2006 10/201 E 10/1986 EE 1,000 500.00 992.00 1,492.00 4.000/0 04/2006 10/201 E 10/1986 EE 1,000 500.00 992.00 1,492.00 4.00% 04/2006 10/201 E 10/1986 EE 1,000 500.00 991.00 1,492.00 4. OO~~ 04/2006 lO/201E 10/1986 EE 1,000 500.00 992.00 1,492.00 4. OO~iO 04/2006 10/201E 10/1986 EE 1,000 500.00 992.00 1,492.00 4.000/0 04/2006 10/201E 10/1986 EE 1,000 500.00 992.00 1,492.00 4.00% 04/2006 10/201E 10/1986 EE 1,000 500.00 992.00 1,492.00 4.000/0 04/2006 10/20 IE 10/1986 EE 1,000 500.00 992.00 1,492.00 4.00% 04/2006 10/201E 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.00% OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.00% OS/2006 OS/2014 http://\VW\vs.publicdebt.treas.govIBC/SBCPrice 4/17/2006 Savings Bond Calculator Page 4 of 5 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/20 1~ 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/20 1~ 05/1984 EE 200 100.00 229.44 329.44 4.00% OS/2006 OS/20 1~ 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/20 1~ 05/1984 EE 200 100.00 229.44 329.44 4.00% OS/2006 OS/20 l~ 05/1984 EE 200 100.00 229.44 329.44 4.00% OS/2006 OS/20 1 ~ 05/1984 EE 200 100.00 229.44 329.44 4.00% OS/2006 OS/20 1 ~ 05/1984 EE 200 100.00 229.44 329.44 4.00% 05/1006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/20 1 ~ 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/20 1 ~ 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/20 l~ 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.000/0 05/1006 OS/20 1~ 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.00% OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.00% OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.00% OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.00% OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.00% OS/2006 OS/2014 05/1984 EE 100 100.00 229.44 329.44 4.000/0 OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.00% OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.00% OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/20 1 ~ 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/2014 05/1984 EE 200 100.00 229.44 329.44 4.000/0 OS/2006 OS/2014 View 10 I Vie,,'ing Bonds 1-1 ~8 Note Description http://WW\vs.publicdebt.treas.gov/BC/SBCPrice 4/17/2006 ~... ------__....._. '.- .-.,1>_ _ .___ _. , Directive' . It. . I direct that my following existing accounts be given, irrevocably. to my daughter. Judy S. Britten. The balances are all calculated on or about October 15'r?005. ~ . I =.:J""'o 1. Members 1 st checking, balance of $90,989.00 .~~ n g 2. Members 1st savings, balance of $217,015.00 >:~:G- . .".' . t' ..OJ -.,:,::, 3. Members 1st money mgt.. balance of $38,546.00 . :.;2~~:"; ;i 4. Members 1st IRA, balance of $7.687.00, Judy .has already b~~~ designated as my beneficiary on this account. 0,0_ 5. USAA, USAAX Growth Fund, balance $272,298.00 6. USAA, USTEX Tax Exempt Long-Term Fund, balance $469.780.00 All of the aforesaid accounts, other than the IRA, had already been placed in joint ownership with Judy, evidencing my intent that she receive these funds upon my ~eath. .It is my intent to transfer these funds during my lifetime, rather than at my death. However, I direct that the sum of $62,280.00, from the assigned proceeds, be' .placed in a trust for my cost of nursing home care. I have calculat,ed that amount based upon the current average annual cost at the Todd Home for nursing care in the amou~t of $79.500.00 per year, less my current annual income of $58,740.00. This will guarantee my ability to pay the first thirty six months of nursing "home care, should I need to continue in nursing home care. My daughter Judy to make the choice on my behalf as to place me in assisted living, if I qualify after undergoing rehabilitation, or in nursing home care. I give my residence, and all the furnishings therein, at 7 Greystone Road, Carlisle, Pennsylvania to my daughter Judy S. Britten. I give my Winnebago motor home, the coin sets at my home and. my lot with three car garage in Cambria County, to my son Ronald H. Britten. . I acknowledge that I fully understand and am aware that I am curre'otly giving to my heirs virtually all my assets and this is done hot through any undue influence but because of .my love for all of them. I also acknowledge that I. am giving substantially :-.; '. .~; it;~ ~', -;..: ~'.' ) o :-a ~ .,' ...::; . . ,..", -..-:', - f"......') ~~~ .~~ f'..~ ...... ."--1 . -=:1 ,..- - more of my assets to my daughter. Judy S. Britten, and that I am doing this not. because I do not love my children equally, but because I believe that Judy needs more of my assets to meet her future needs. I have accumulated US Savings bonds in joint names for my son, R~nald H. Britten anod his sons, Michael Britten and Andrew Britten. I irrevocably give t~ose bonds to those individuals and direct Judy, who is my agent, to see that the bonds are delivered. I have accumulated US Savings Bonds in joint names for my daughter, Judy S. Britten and het children, Robert S. .Young and Morgan Goodling. I irrevocab.~y give Judy her bonds. I do not wish that those for Robert S. Young and Morgan Goodling be delivered directly to them, but that the bonds be transferred to Judy S. Britten as Trustee. The value of the bonds for Morgan Goodling as of Octob~r, 2005, amount-to' _.. $79,240.00 and for Robert Young $76,355.00. The provisions of the trust follow. 1. My Trustee shall set up a separate Trust for each grandchild. My Trustee shall pay principal and income to or for the benefit of my grandchild during his or her life as my"Trustee, in her sole discretion, shall deem advisable for the health, maintenance, support and complete education at such grandchild. In addition, my Trustee in her sole discretion may advance funds to said beneficiary for the costs of marriage, or the purchasing of a home or costs of entering a business or profession. if my said Trustee shall deem such expense reasonably prudent. 2. Any and all payment or payments of any sum or sums, whether in cash or in kind and whether for p~al or income, payable to a grandchild, or any of them, shall be made upon the sole receipt of the respective individual to whom the payment is made, and free from anticipation. alienation, assignment, attachment. and pledge, and free from control by the crediors of any such. beneficiary. 3. Should the pmcipal of any trust herein provided for be or become too small in my Trustee's disaelon to make establishments or continuance of the trust advisable, my Trustee may distribute the remaining principal and any accumulated or undistributed income OU~ to the beneficiaries in the proportions to which they are then entitled to.. The re~ and releases of the ~istributee will terminate absolutely " ~ ~ 1.b: . . the rights of all persons who migh~ ot"erwise have future interest in the trust, whether vested or contingent, without notice to them and without the necessity of filing an account with the court. 4. Any funds not distributed to a grandchild, at the time of my daughter's death, shall be distributed to the.grandchild, subjectto the terms and conditions of any' trust that she may hereafter create. All the gifts in this Directive, shall be split between the years of 2005 and 2006 so as to maximize the fede'ral unified gift and estate tax credit. Executed thisthe 2tflb day O~""r. 2005. . . &~V~~~ Dale A. Britten '< ;~:.~/;:~':'<':.'~'. ." .. :........r. .:":")1' ~ ~; . ./.;.~.. . . :~~~~~~~~~!!~..;::.-~ ' . -';.~-;:,:~/ " ,- . .. - , _. ". ,r.' ....~~/...~~l~.-':;:.j; ;'~!;";~;~:1:~:*:1>~'>:- ..~ '~:"-:~'~.-':' .~~ "-. , . - _.~{ ~:~?~~,. . ~ ,REV-548 EX (12"()3) INHERITANCE TAX JOINT BANK ACCOUNT ADVANCE PAYMENT WORKSHEET COUNTY FILE NUMBER 21-06-0145 INHERITANCE TAX RECEIPT NUMBER DECEDENT INFORMATION DECEDENT'S NAME (LAST) Britten DECEDENT'S SOCIAL SECURITY NUMBER 174-16-3944 ADDRESS OF DECEDENT 1 000 West South Street (FIRST) (MIDDLE INITIAL) Dale A DATE OF DEATH 02/05/2006 CITY STATE ZIP Carlisle PA 17013 , FINANCIAL INSTITUTION INFORMATION NAME OF FINANCIAL INSTITUTION ADDRESS CITY STATE ZIP TELEPHONE NUMBER ACCOUNT INFORMATION SURVIVING JOINT OWNER INFORMATION SURVIVING JOINT OWNER INFORMATION TYPE OF ACCOUNT o SAVINGS 0 CHECKING II OTHER U.S. Bonds o TRUST o CERTIFICATE OF DEPOSIT ACCOUNT BALANCE (INCLUDE INTEREST TO DATE OF DEATH) ACCOUNT NUMBER 81,020.00 ACCOUNT TITLE AS APPEARS ON SIGNATURE CARD OR CD Dale A. Britten or Morgan Goodling NAME (Last) Goodling ADDRESS 123 South West Street CITY Carlisle ORIGINAL DATE ESTABLISHED 1984 - 2001 (Middle Initial) Deportment of Revenue Use Only (First) Morgan M PERCENT TAXABLE ZIP CODE 17013 STATE PA RELATIONSHIP TO DECEDENT Granddaughter NAME (Last) TELEPHONE NUMBER TAX RATE ADDRESS (First) (Middle Initial) PERCENT TAXABLE STATE ZIP CODE TELEPHONE NUMBER TAX RATE (First) (Middle Initial) PERCENT TAXABLE STATE ZIP CODE TELEPHONE NUMBER TAX RATE CITY RELATIONSHIP TO DECEDENT SURVIVING JOINT OWNER INFORMATION NAME (Last) ADDRESS CITY RELATIONSHIP TO DECEDENT ayee If'. \IU::)"'!,) escnplon moun al .JV ' I'-J...I oJ Ss :2 Wd 02 ~dV 900l r- ~. t 1 t f"~_ . . \:r~'" · '~ if: " i ~ -,' "-"! _' , -0, ~ of' Note: Please attach to receipt . 'l , ;;, 1 \ _Iv \-,_L'_'~'IV_J,) !r:-) ](\1 I 1('\ rnn'.r"y)':!\.J ::\'--' ..JvCj0 U:Ut~~..,,\ _JW 0.00 Total $ INHERITANCE TAX JOINT BANK ACCOUNT ADVANCE PAYMENT WORKSHEET DIRECTIONS for REV-548 The Advance Payment Worksheet enables the taxpayer to report a specific jointly owned or other non-probate asset to the Department without the filling of an actual inheritance tax return form (REV-1500), and it also allows the taxpayer to qualify for 5% discount if payment is made within (3) three months following the decedent's date of death. WHO MAY USE THE ADVANCE PAYMENT WORKSHEET? 1. Surviving owners of jointly held assets. 2. Beneficiaries of "in trust for" (ITF) accounts. 3. Beneficiaries of other assets not subject to the administration of the decedent's estate by the personal representative. PLEASE FILL IN BLOCKS COMPLETELY SO THAT AN ACCURATE NOTICE OF ASSESSMENT CAN BE ISSUED. DECEDENT INFORMATION · decedent's legal name · social security number · decedent's date of death FINANCIAL INSTITUTION INFORMATION · name & address of bank or branch office · provide bank phone number if available ACCOUNT INFORMATION (LIST ONLY ONE ACCOUNT PER WORKSHEET) · Indicate type of account by checking appropriate box, if other, list specific type (only one account per worksheet). · Account balance at date of death (include interest in total). · Account number · Account title as appears on signature card (identify power of attorney, representative payee, attorney in fact, or PUGMA accounts, IRA's etc. where they may apply). · Original date the account was established in joint ownership. Provide signature cards, trust agreements, and other pertinent documents (if available). SURVIVING JOINT OWNER INFORMATION (USE SEPARATE BLOCK FOR EACH SURVIVOR) · use legal names · social security numbers if known · current address · relationship to decedent to insure correct tax rates DEBTS & DEDUCTIONS If there are no probate assets and the surviving owner has actually paid expenses incurred because of the decedent's death, they can be listed and deducted from the portion of the account balance subject to tax. Include expenses directly related to the decedent's death such as funeral costs, refreshments following the funeral, flowers, cemetery plots and markers, engraving, etc. Provide appropriate documents to substantiate claims. After review by the Department, a formal notice of assessment will be returned to each individual owner indicating the final status of the particular asset that has been reported. Make checks payable to the REGISTER of WILLS, Agent, in the county of the decedent's LEGAL residence. - Savings Bond Calculator Page 1 of 3 lwvO ,~*~ Savin~ 02/2006 UIHlate Help Series Denontination Serial Nmllber Issue Date In ..... .n 1.000 - ... # Bonds Total Price Total Interest Total Value YTD Inl 57 $J2,..~00.OO $-l8,..~20.00 $81,020.00 $923. Issue Interest Next Final Serial Number Issue Date Series Denom Price Interest Value Rate Accrual Maturi~ 10/2001 I $1,000 $1,000.00 $238.40 $1,238.40 6.63% 03/2006 1 0/203 ~ 10/2001 I 1 ,000 1,000.00 238.40 1,238.40 6.63~/Q 03/2006 10/203: 10/2001 I 500 500 _ 00 119.20 619.20 6.63% 03/2006 10/203: 07/1993 EE 1 ,000 500.00 360.80 860.80 3.350/0 07/2006 07 /202~ 07/1993 EE 1,000 500.00 360.80 860.80 3.35010 07/2006 07 /202~ 07/1993 EE 1 ,000 500.00 360.80 860.80 3.35% 07 /2006 07/202~ 07/1993 EE 1,000 500.00 360.80 860.80 3.35% 07/2006 07 /202~ 07/1993 EE 1 ,000 500.00 360.80 860.80 3.35% 07/2006 07 /202~ 07/1993 EE 1,000 500.00 360.80 860.80 3.35% 07/2006 07 /202~ 07/1993 EE 1,000 500.00 360.80 860.80 3.35% 07/2006 07 /202~ 07/1993 EE 1,000 500.00 360.80 860.80 3.35% 07/2006 07 /202~ 07/1993 EE 1 ,000 500.00 360.80 860.80 3.35% 07/2006 07 /202~ . 07/1993 EE 1,000 500.00 360.80 860.80 3.35% 07/2006 07/202~ 01/1989 EE 5,000 2,500.00 3,696.00 6,196.00 4.00% 07/2006 01/201~ 01/1989 EE 5,000 2,500.00 3,696.00 6,196.00 4.00% 07/2006 01/201~ 01/1989 EE 5,000 2,500.00 3,696.00 6,196.00 4. OO~~ 07/2006 01/201~ 01/1989 EE 5,000 2,500.00 3,696.00 6,196.00 4.00% 07/2006 01/201~ 12/1988 EE 1,000 500.00 739.20 1,239.20 4.00% 06/2006 12/20U 12/1988 EE 1,000 500.00 739.20 1,239.20 4.00% 06/2006 12/20 U 12/1988 EE 1,000 500.00 739.20 1,239.20 4.000/0 06/2006 12/20 1 ~ 12/1988 EE 1 ,000 500.00 739.20 1,239.20 4. OO~;Q 06/2006 12/20 1 ~ 12/1988 EE 1.000 500.00 739.20 1,239.20 4. OO~;Q 06/2006 12/20 U 12/1988 EE 1 ,000 500.00 739.20 1,239.20 4.00% 06/2006 12/20U 12/1988 EE 1 ,000 500.00 739.20 1,239.20 4.000/0 06/1006 12/10U 12/1988 EE 1,000 500.00 739.10 1,239.20 4.00% 06/2006 12/10 1 ~ 12/1988 EE 1 ,000 500.00 739.20 1.139.20 4.000/0 06/2006 12/20 1 ~ 12/1988 EE 1 ,000 500.00 739.20 1,139.20 4. OO~/o 06/2006 11/20U 10/1986 EE I ,000 500.00 991.00 1.491.00 4. OO~/o 04/1006 10/201! http://WW\vs.publicdebt.treas.gov/BC/SBCPrice 4/17/2006 {VlG Savings Bond Calculator Page 1 of 3 10/1986 EE 1.000 500.00 991.00 1.491.00 4.000/0 04/1006 10/10 l( 10/1986 EE 1,000 500.00 991.00 1,491.00 4.000/0 04/1006 10/101 ( 10/1986 EE 1.000 500.00 991.00 1.491.00 4.00% 04/1006 10/101( 10/1986 EE 1.000 500.00 991.00 1.491.00 4.00% 04/2006 10/101( 10/1986 EE 1.000 500.00 992.00 1.491.00 4.000/0 04/2006 10/101 ( 10/1986 EE 1,000 500.00 992.00 1,491.00 4.00% 04/2006 10/101 ( 10/1986 EE 1 ,000 500.00 991.00 1,491.00 4.00% 04/2006 10/101 ( 10/1986 EE 1,000 500.00 992.00 1,491.00 4.000/0 04/2006 10/10i( 10/1986 EE 1,000 500.00 991.00 1.491.00 4.000/0 04/2006 10/101( 02/1984 EE 500 250 _ 00 611. 00 861.00 3.46O~ 08/2006 01/1011. 01/1984 EE 500 250.00 611. 00 861.00 3.46O~ 08/2006 01/1011. 02/1984 EE 500 250.00 611. 00 861.00 3.46~~ 08/2006 02/2011. 01/1984 EE 500 250.00 611. 00 861. 00 3.460/0 08/2006 02/2011. 02/1984 EE 500 250.00 611. 00 861. 00 3.460/0 08/2006 02/2011. 02/1984 EE 500 250.00 611. 00 861.00 3.460/0 08/2006 02/2011. 02/1984 EE 500 250.00 611. 00 861.00 3.460/0 08/2006 02/2011. 02/1984 EE 500 250.00 611. 00 861.00 3.46O~ 08/2006 01/1011. 02/1984 EE 500 250.00 611. 00 861.00 3.46O~ 08/2006 02/2011. 02/1984 EE 500 250.00 611. 00 861. 00 3 .46~~ 08/2006 01/1011. 01/1984 EE 500 250.00 611. 00 861.00 3.46O~ 08/2006 02/2011. 02/1984 EE 500 250.00 611. 00 861. 00 3.46% 08/2006 02/2011. 02/1984 EE 500 250.00 611. 00 861. 00 3.46O~ 08/1006 02/2011. 02/1984 EE 500 150.00 611. 00 861. 00 3.46O~ 08/2006 02/1011. 02/1984 EE 500 150.00 611. 00 861.00 3.46O~ 08/2006 01/2011. 02/1984 EE 500 250.00 611. 00 861.00 3.46O~ 08/2006 02/1011. 02/1984 EE 500 250.00 611. 00 861. 00 3.46O~ 08/2006 02/2011. 02/1984 EE 500 250.00 611. 00 861. 00 3.46% 08/2006 02/2011. 02/1984 EE 500 250.00 611. 00 861.00 3.46O~ 08/2006 01/2011. 01/1984 EE 500 250.00 611. 00 861. 00 3.46O~ 08/2006 02/2011. View 10 I Viewing Bonds I-57 Note Description NI Not Issued NE Not Eligible for PaYlllent P5 Includes 3 -nlonth interest penalty rv1A Matured and Not Earning Interest Please rate this service. http://W\vws.publicdebt.treas.gov/BC/SBCPrice 4/17/2006 Directive' , I direct that my following existing accounts be given. irrevocably. to my daughter. Judy S. Britten. The balances are all calculated on or about October 15..--?005. ~ 1. Members 1st checking, balance of $90,989.00 ':~S1 ~ "?~;~ - ,'. () -:,.-, ~ ': ) 2. Members 1st savings. balance of $217.015.00 ~_~:~}f~ .:::- '., ~3 , ",'.I-:"~": ' . ~ '"') 3. Members 1st money mgt., balance of $38,546.00 .:2~ ~ ~~~~~ 4. Members 1st IRA, balance of $7,687.00, Judy has already b~ iZi,;..~ - i"-' designated as my beneficiary on this account." .,. 5. USAA. USAAX Growth Fund. balance $272,298.00 6. USAA. USTEX Tax Exempt Long-Term Fund. balance $469.780.00 All of the aforesaid accounts. other than the IRA, had already been placed in joint ownership with Judy. evidencing my intent that she receive these funds upon my qeath. .It is my intent to transfer these funds during my lifetime, rather than at my death. However, I direct that the sum of $62.280.00. from the assigned procee,ds. be ,placed in a trust for my cost of nursing home care. I have calculat.ed that amount based upon the current average annual cost at the Todd Home for nursing care in the amou'!t of $79.500.00 per year, less my current annual income of $58.740.00. This will guarantee my ability to pay the first thirty six months of nursing 'home care, should I need to continue in nursing home care. My daughter Judy to make the choice on my behalf as to place me in assisted living. if I qualify after undergoing rehabilitation, or in nursing home care. I give my residence, and all the furnishings therein. at 7 Greystone Road, Carlisle. Pennsylvania to my daughter Judy S. Britten. I give my Winnebago motor home, the coin sets at my home and my lot with three car garage in Cambria County. to my son Ronald H. Britten. . I acknowledge that I fully understand and am aware that I am currently giving to my heirs virtually all my assets and this is done not through any undue influence but because of .my love for all of them. I also acknowledge that I.am giving substantially :--~ ...- - ,-. >. , "J~~r.~' more of my assets to my daughter. Judy S. Britten. and that I am doing this not " because I do not love my children equally. but because I believe that Judy needs more of my assets to meet her future needs. I have accumulated US Savings bonds in joint names for my son. R9nald H. Britten and his sons, Michael Britten and Andrew Britten. I irrevocably give t~ose bonds to those individuals and direct Judy. who is my agent, to see that the bonds are delivered. I have accumulated US Savings Bonds in joint names for my daughter, Judy S. Britten and het children, Robert S. ,Young and Morgan Goodling. I irrevocab.~y give Judy her bonds. I do not wish that those for Robert S. Young and Morgan Goodling be delivered directly to them, but that the bonds be transferred to Judy S. Britten as Trustee. The value 'of the bonds for Morgan Goodling as of October, 2095, amount-to - '. $79.240.00 and for Robert Young $76.355.00. The provisions of the trust follow. 1. My Trustee shall set up a separate Trust for each grandchild. My Trustee shall pay principal and income to or for the benefit of my grandchild during his or her life as my'Trustee, in her sole discretion, shall deem advisable for the health. maintenance, support and complete education o{ such grandchild. In addition. my Trustee in her sole discretion may advance funds to said beneficiary for the costs of marriage. or the purchasing of a home or costs of entering a business or profession. if my said Trustee shall deem such expense reasonably prudent. 2. Any and all payment or payments of any sum or sums. whether in cash or in kind and whether for prirq,al or income, payable to a grandchild, or any of them, shall be made upon the sole receipt of the respective individual to whom the payment is made, and free from anti~on, alienation, assignment, attachment, and pledge. and free from control by the crediors of any such, beneficiary. 3. Should the prKipal of any trust herein provided for be or become too small in my Trustee's disaelion to make establishments or continuance of the trust advisable. my Trustee may mstribute the remaining principal and any accumulated or undistributed income outrirji to the beneficiaries in the proportions to which they are then entitled to. The re~ and releases of the distributee will terminate absolutely ,.. ~ "~ - ~~_.--;---_....':-- ----...-.--.-.- ~ ~. . . the rights of all persons who might otnerwise have future interest in the trust, whether vested or contingent, .without notiCe to them and without the necessity of filing an account with the court. 4. Any funds not distributed to a grandchild, at the time of my daughter's death, shall be distributed to the,grandchild, subject to the terms and conditions of any' trust that she may hereafter create. All the gifts in this Directive, shall be split between the years of 2005 and 2006 so as to maximize the fede.ral unified gift and estate tax credit. Executed this the 2q~ daYO~""r.2005. . C2&.~-/~ Dale A. Britten ";"~':~~~r~:''-'/ . ., .. . -!:'..\.:~:?f;#..;~:~:;.~'. . .. ...::>:::.:.,..:'::":".. ::..... .~:. ...~;: :'~~- . ...:...:~..... . . :~ ~~~z. "'c'" .... .~. .'. .. . , . .., ,:.~ :..', -.~:... . . . ',' . . '< t-_J,l./.f~'-':~':'~~'-'~" .. .~~