Personal Directory - Utah State University Extension · Washington Mutual Account Number: 630 20938...

Personal Directory

Charles Michael Jones 1314 West 400 South Serendipity Utah 84464 Soc Sec 578-92-8491 (435) 747-6512 (home) (435) 512-1235 (cell) (435) 747-]122 (work) September 71955 Ogden Utah Married November 91981 - Amerieon Fork Utah Employer Utah Irrigation Specialists Incorporated

KelIie Anderson Jones 1314 West 400 South Serendipity Utah 84464 Soc Sec 579-14-3780 (435) 747-6512 (home) (435) 512-1234 (cell) (435) 747-8420 (work) April 13 1958 Bliss Utah Married November 9 1981 - Amerieon Fork Utah Employer Bliss County School District

Oldest Son Michael Steven Jones Social Security 577-15-7642 June 14 1983 - Serendipity Utah

Youngest Son Christian Michael Jones Social Security 577-14-9432 April 19 1985 - Serendipity Utah

Oldest Daughter Megan Marie Jones Social Security 578-02-3729 February 9 1988 - Serendipity Utah

Youngest Daughter Cassidy Ann Jones Social Security 578-94-7492 November II 1991 - Serendipity Utah

Kellies Family

Parents John and Alice Roberts Anderson 1492 South 600 West Logan Utah 8432 I (435) 787-8515

Brother Steven Anderson (Melinda) 93 San Patricio Mission Viejo California 96661 (949) 831-0482

Sister Megan Cherie Major (Ryan) 932 St Olaf Way Pnrtland Oregon 94531 (614) 932-9401

Uncle Steven Roberts (Sarah) 58 Taste ofHeaven Drive Serendipity Utah 84464 (435)898-5821

Uncle Karl Roberts (unmarried) 45 West Milldale Blvd San Antonio Texas (456) 349-3928

Aunt Katluyn Jackson (Melvin) 394 Albatross Way Oceanside California 94503 (617) 942-0384

Charles Family

Charles Mother Jessie Jones (John - deceased) Serendipity Utah (435) 898-8274

Brother Peter Jones (Melissa) 49 Cinnamon Drive Phoeniz Arizona (813) 4831

Sister Annabelle Jones Murphy (Phillip) 8321 South 300 East Pocatello Idaho 82931 (934) 483-3920

Uncle Eugene Jones 945 Majestic Meadows Way Serendipity Utah 84464 (765) 898-3948

Financial Information

Checking Accounts Zions Bank Account Number 55630]216 Washington Mutual Account Number 630 20938 1

Savings Accounts Zions Bank Account Number 839 2930 8

Stocks AG Ed~ds amp Sons Inc 15 South Main Street Fourth Floor Logan Utah 84321 (435)750-0331

Utah Independent Bank Serendipity Utah Contact Craig White Manager

Retirement Kellie Utah Retirement Systems Defined Contribution Plans and 40IK 540 East 200 South Salt Lake City Utah 84102-2099

Charles 401 K Plan Manulife Financial The Manufacturers Life Insurance Co Utah Irrigation Specialists Incorporated

Mortgage Wells Fargo Bank Account Number 328853

Credit Cards

Wells Fargo Acc 4465 3951 0085 4961 1-800-642-4720 Wells Fargo qard Services POBox 522 Des Moines Iowa 50302-4961

Citibank 1-800-950-5114 Acc 4128 0033 3853 8310 Citicard POBox 6406 The Lakes Nevada 88901-6406

Discover Card Accl 6011 009323522925 1-800-347-2683 Discover Card POBox 15192 Sears Master Card Wilmington Delaware 19850-5192

Mervyns 1935-2778-93Z 1-800-480-5073 Retailers National Bank clo Mervyns Credit Services 4B-E PO Box 1334 Minneapolis Minnesota 55440-1334

Target 9-805-609-377-90 1-800-659-2396 Retailers National Bank clo Target Credit Services PO Box 1581 Minneapolis MN 55440-1581

RCWiIley Acc 2112534530 1-877-315-0183 801-774-2840

2008

2009

2010

20ll

2012 -

Financial Goals List

Use Power Pay to eliminate credit card debt Pay Off Wells Fargo Citibank RC Willey

Use Power Pay to eliminate credit card debt Pay Off Discover Mervyns Target

Have $3000 in savings Pay Off Mitsubishi Debt Free (except home) by end of2010

Reward Trip if goals are reached 25th Wedding Anniversary Cruise

Work on paying off home early

Money Management Goals Contract

My (our) overall money management goal is

My (our) small goals to achieve this goal include

I iscvfn 1amp-- (NLl Cd eel useshy

2_ kfemrif 6gtvr ampyI

3 S-v ef (ult-s f Iz~ rmrshy

When a goal is reached I (we) will reward myself (ourselves) by the following

To help me (us) achieve my (our) goals the following people will be part of my (our) support system

I (we) do hereby commit to strive daily towards achieving the goals set above

Signature(s) ~~ =lt amptlt IeI 4J

~

Date J~jr I 2C()r

Projection Date of Completion AAiJ ~ 2iJII

HOUSEHOLD SPENDING PLAN

Indicate ofpeople in household FLEXIBLE EXPENSES

Adults 2 Children 4 NOW WHOUSE

Savings S5O00 536000

NET MONTHLY INCOME Groceries $30000 $30000

NOW WfHOUSE Lunch (workschool)

Source I $250000 5300000 Ealing Out $6000 $4000

Source 2 EntertainmentHobbies $6000 $4000

Other Income $50000 LaundrylDryclcaning $4500 $1500

Tolallncome (A) $250000 $350000 Cleaning Supplies $2000 $2000

Clothing $20000 $10000 $27000FIXED EXPENSES GasolinelBusffaxi $24000

NOW WHOUSE NewspaperMagazines $2000

RentMortgage $75000 $120000 AlcohoVCigarcltcs Electric $7500 $12000 ChurchCharily $7500 $12500

GasOil $12000 $12000 TuitionBooks WaterSewer $3000 $6000 BarberBeauty Shop Telephone (basic) $3000 $3000 AUIO Maintenance $2000 $2000

long distance $1500 House Maintenance $12000

cellularpager $6500 DoctorDentist

Trash pickup $1500 Pets

Cable $12500 $6500 Parkingffolls

AUlo payment(s) LouerylBingo

Auto Insumnee $12000 $11200 Other

Life Insumnee $3300 Tolal (D) 5111000 $143000

Child SupportAlimony Medical Insurance EXPENSES

Child Care $131500Other FIXED (B) $177000

Total (D) $131500 $177000 CREDITOR (C) $7500 $30000 $111000 $143000FLEXIBLE (D)

CREDITOR PAYMENTS TOTAL EXPENSES(E $250000 $350000

NOW WHOUSE $15000Installment Loans $7500 Sublmet Expenses from Income (A ~ E)

Credit Card Payments $2500 $2500 TOTAL INCOME (A) $250000 $350000

$5000 $5000 TOTAL EXPENSES (El 52500 00 $350000

DIFFERENCE + or - $000 $000

Total PaymenlJi (C) $7500 $30000

Note If you have accounted for all your expenses including savings your difference should be SOOO Ifyou come

up with a positive number you may want 10 consider allocating the exira money toward your debl andor savings Ifyou come up with a negative number you are spending more than you make Review the spending plan thoroughly 10 examine

where you can trim your expenses

SSN _Applicant Signature


CERTIFICAnON I hereby eenify that I have reecd the above spending plan with the applicant(s) and concur wt it is ~nable

Lender or Counselor Signature

Visa Credit Card Acknowledgement and Confirmation

USU Charter Federal Credit Union PO Box446 Logan UT 84323middot0446 (435) 7534080 (800) 2486361

Charles M Jones 1314 W~st 400 South SerendipitY Utah 84464

Account

Maximum Credit Limit 400000 Date of Agreement 080206

ANNUAL PERCENTAGE RATE (APR) 10900 Daily Periodic Rate 029863

UWe have received and read the USUCCU VISA Credit Card AccountlCardholdcr Agreement and Disclosure By signing below UWe agree to be bound by the tetIm and conditioru of the VSUCCU VISA Credit Card AccountCardholder Agreement UWE have ~tcd one card each IlWe can rtqUeq a different number ofcards and specify to whom they are ismcd by contacting the Credil Union There are com associated with the usc of the card You may conlaa the Credit Union to request specific information aoout the costs at the addIe5s liEted above

oLCu bull 8Date j DaleCHARLES MJOWES

edf1p~~~- Dale I DateKELlJEAS

Credit Life and Disability Imurance i available on tItis Line-ltlf-Crcdit I1Ji iruurnnce is nol required for approval alY-Ie line of credit Credit Life amp Dis3bitily Ineurnnce premiwm are addOO to your balance each month The InDn1h1y rate chngCd for $1000 of oUlJibnding balance arc

PJelUe check lbe desired cOlerage

__ Single Term Life 474 Join Term Lffc 806 __ Di5abilily 2148

TIle wurance will go inlo effect as ~oon as yOIJ ~ig[l and return the policy ~ent to you providing you meet the rcquiremenLs ofllte inlJI3DCC underwriter

This lso your ACKNOWLEDGMENT Pege 1 of 1

FlO Number 14middot2683839 Customer Number 024131630 InvoIce Number 1922435417 Sales Rep KElLY CONNAlLY Puchosc Order NAONUNECUST For 5aIelI (800)414-3355 01((1lt Numbcl 922435411 Il1Oico DalC 09lO9JQ2SIll Fax (800)311-3355 Oltder Oale 08131102 PBymonl Terms MASTER CARD

Cuamptomllr Servka (800)624middot9897 Shipped Via AIRBORNE DEFERRED 3D TlIChnlcaJ Suppol1 (800)624-9096 2901M0101N WlI)biIl Number 74164254065

Dell Onllnll hIIpfwwwdcDcom

SOLD TO SHIPTgt

IIBWNHKPV H0241 3183 0211 711191 1 AB 0301 04408S11OCE 1 011

11111111111111111111111111111111111111111111111111111111111111

Order Shipped Item Number Description U Unit Price Amounl

220-9714 Dimension 8200 SeriesPentium 4 ProceS5lr at 2 4GHz EA 106e00 106800 1 461-5717 FAEE UP9rade 256MB PC800 ADAAM EA 000 000 310-1582 DeU Quiel Key Keyboard EA 000 000 1 320-)453 17 in(1 59 in viawable27dp) E772 Monitor EA 000 000 1 320--0440 64MB GeForCe4 MX Graphics Card with TV-Out EA 000 000 461-28e5 FAEE UP9radel8OGB Ultra ATAloo Hard Drive EA 000 000 340-1927 35in Floppy Drive EA 000 000 420-3079 Microsolt Windows XP Hone EditionEn91ish EA 000 000 1 313-7222 Dell Application Back-up CD Factory Install EA 000 000 412-)189 Dell Support 12Dimension EA 000 000 310-1871 DeU 2-bultoe ScroU Mouse EA 000 000

430-5353 10100 PCI Fast Ethernet NIC Factory Install EA 000 000 313-1583 56K PCI Telephony Modem lor Windows EA 000 000 1 461-1632 Free Upgrade16X DVD-AOMDrive EA 000 000 430--0310 Cyberlink Software ~in9IorOVD Drives EA 000 000 313-2758 Inte9rated Audio EA 000 000 1 313-1487 HarmanKardbn SpeakersH K--695 EA 000 000 340-3801 250MB IomegB2ipEki~t-1n Drive EA 000 000 1 412-)259 SymBntec Nonon Antivirus 2002 OEM middotPaikageEn9Iish90 Day EA 000 000

Trial Version 1 412-)246 Dell Jukebox powered by MusicMatch EA 000 000 1 412-)271 Dell PicllJre StudiOMlageEllpert StandardDimension EA 000 000 1 412-)273 Dell Picture Stuilio PainiShop Pro Try end BuyDimension EA 000 000

_ cmiddot

1 412-)258 6 Months 01 ErthHnk Inlemel Access InclUded EA 000 000 1 412-)279 AOl 70 Factory Install lor US DHS EA 000 000 1 412-)287 AOl 70 Buddy Rom EA 000 000 1 412-)133 MS Worirsuite 2oo2CD with OocurnentationOEMUSEnglish EA 000 000

Dimension 1 950-1260 Type 3- Thien Party Al Home Service 24)(7 Technical EA 000 000

Support Initial Year 1 950-3337 1 Year Limited Warranty EA 000 000 1 950-9797 No Warranty Year 2 and 3 EA 000 000 1 460-8164 OHS Instant S50 Olt EA 000 000

System service Tags JBT4V11

Shi amplor Handlin Subtotal 116700 Taablo Ta

$ 11400 714 bull SC icQ conlrllCl mBy be subjQcllQ sales lax 117414

Any on-s~e Of OIl1c1 service COYCIS DcIl syslem hardware ooIy MASTERCARD 117414middotNOTE NEW REMIT ADDRESS- DEllCATALOG SALESCOupoundCTS TAX IN FLKYNCNVTNTX TAX IN OTHER STATES RELATES ONlV TO 3RD PARTY SERVICE CONTRACTS THE BUYER IS RESPONSIBLE FOR REMITTING ANY ADDITIONAL TAXTOTHE TAXING AlJTHORITIES Balance 000I~T~~tal~~~~~~~~~~~~~PLEASE SEE IMPORTANT TERMS amp COI~DITIONS OF SALE THAT APPLY TO THIS I IVI

htlplwgtMdellcomusiengenlmiscpolicy_008_policyhlm

OR AS FOUND IN THE PRlr~TED DOCUMENT PROVIDED II~ YOUR SYSTEM BOX

9900

For Tax Year 2008

Charles M and Kellie A Jones 1314 West 400 South

Serendipity Utah 84464

Prepared by David White Accounting Serendipity Utah 84464

(435) 747-8320

For Tax Year 2007




(435) 747-8320

For Tax Year 2006




(435) 747-8320

For Tax Year 2005




(435) 747-8320

For Tax Year 2004




(435) 747-8320

Lease Agreement By lhis agreement made and entered in to on January 5 2002 between -_-_-oshy__c-_referred to as lessor and referred to as lessee lessor leases to lessee the premises situated at in lhe City of County of State of Utah for a minimum of six monlhs

Rent Lessee agrees to pay without demand to lessor as rent for the demised premises the sum of$55000 every month beginning February 1 2002 Payments are due on the first day of the month

Quiet Enjoyment Lessor covenants that on paying the rent and perfonning the covenant contained in this lease agreement lessee shall peacefully and quietly have hold and enjoy the demised premises for the agreed lcnn

Use of Premises No smoking is allowed in the premises

No indoor pets arc allowed on premises without consent of the lessor

Lessee shall eomply with alllhe sanitary laws ordinances rules and orders of appropriate governmental authorities affecting the eleanliness occupancy and preservation of the demised premises and the sidewalks connected to demised premises during the tenn of this lease

Condition of Premises Lessee stipulate that he and she have examined the demised premises ineluding the grounds and all building and improvements and lhat they are at the time of this lease in good order good repair safe clean and tenantable condition

Alterations and Improvements Lessee shall make no alterations to the building on the demised premises or construct any building or make olher improvements of the demised premises without the prior express and written eonsent of lessor

Damage to Premises Iflhe demised premises or any part of lhe demised premises shall be partially damaged by fire or other casualty not due 10 lessees negligence or willful act of that of the lessees employee family agent or visitor the premises shall be promptly repaired by lessor and there shall be an abatement of rent corresponding to the time during which and the extent to which lhe leased premises may have been untenantable However if the leased premises should be damaged other than by lessees negligence or wilful act of that oflessees employee family agent or visitor to the extent that lessor shall decide not to rebuild or repair the term of this lease shall end and the rent shall be prorated up to the time of the damage

Lessee shall not keep or have on the leased premises any article or thing or a dangerous inflammable or explosive character that might unreasonably increase lhe danger of fire on the leased premises or that might be considered hazardous by any responsible insurance company

Utilities Lessee shall be responsible for arranging and paying for all utility services required on the premises within three days of occupying the premises Arrangements for this can be made at the Beaver City offices

Maintenance and Repair

Lessee will at their sole expense kcep and maintain the leased premises and appurtenances in good and sanitary condition and repair during the tenn of this lease and any renewal oflhis lease In particular Icssce shall keep the fixtures in the house or on or about the leased premises in good order and repair keep heaters eiean keep lawn mowed and watered and kcep the walks free from dirt and debris Lessee shall allessees sole expense make all required repairs to the plumbing dishwasher range heating apparatus and eleetrie fixturcs whenever damage to such items shall have resulted from lessees misuse waste or neglect or that of the lessees employee family agent or visitor

Major maintenance and repair of the leased premises not due to lessecs misuse waste or neglect or that of the lessees employee family agent or visitor shall he the responsibility of the lessor

Right oflnspection Lessors shall have lhe right al all reasonable times during the tenn of this lease and any renewal of the lease to enter the demised premises for the purpose of inspecting the premises and all building and improvemcnts of the premises

Default If any defaull is made in the payment of rent or any part of the rent at the times specified in this lease or if any default is made in the perfonnance or of complianee with any other teml or eondition of this lease the lease at the option of the lessor shalltenninate and be forfeited and lessor may re-enter the premises and remove all persons from the premises Lessee shall be given written nOlice of any default or breach Tennination and forfeiture of the lease shall not result if within 7 days of receipt of such notice lessee has corrected the defaull or breach or has taken reasonable effort to correct default within a reasonable time

Notice of Vacancy Lessee agrees to notify lessor of intent to vacate premises within 30 days before actually moving

Cleaning and Security Fee Lessees will pay a $30000 cleaning and security fee prior to occupying the home Carpet will be professionally cleaned prior to the lessees occupying the home After the lessees vaeatc the premises the carpet will be professionally eleaned by the lessors A refund will be given after deducting the cost of carpet cleaning Lessors also agree to leave the home in a clean and acceptable condition and to hilve the eost of any repairs dedueted from their $30000 cleaning and security deposit

Modification of Agreement Any modification of this lease agreement or additional obligation assumed by either party in connection with this lcase agreement shall be binding only if evidenced in writing signed by each party or an authorized representative of each party

In witness whereof each party to this lease agreement has cause it to be executed at Beaver Utah on ~

(Lessor) Date

(Lessor) Date

(Lessee) Date

(Lessee) Date

Prevent Identl~ theft-protect your Social Securl~ number

Your Social Security Statement

Prepared espedally for KELLIE A JONES

Kellie A Jones

1314 West 400 South


T What Social Security Means to You

July 21 2005

See inside for your personaInformation -+ Whats lnolde bullbull _

Your Estimated BencfiL~ 2

Your EarniOls ReCQrd 3

Some Facts About Social Security bullbullbullbull 4

If You Need More Information bullbull _

To Request This Statement In Spanish bull

(Para ampJiidarUna Decaracian en EspanolJ

This Social Security Statemenl will help you understand what Sodal Security means to you and your family This Sfu(emenl can help you better plan for your financial future It gives you eslima(es of your Social Security bemfits under eurrcnllaw Each year we will send you an updated Sla(ement including your latest reported earnings

Be sure to read this SlalemfTlt carefully H you think there may be a mistake plcaie let us know Thats important because your benefits will be based on our record of your lifetime earnings We recommend you keep a copy of this Statement with your financial records Soda_ is r peopIeraD _ bullbullbull Il can help you whether yuure young or old male or female single or with a family Its there for you when you retili but its more than a retirement program Social Security also can provide benefils if you become disabled and help support your family when you die Work to baiId a MCUIe futaR bullbullbull Social Security is the largest source of income for most elderly Americans today It is very important to remember that Social Security was never intended to be your only source of income when you retire Social Security cant do it all You also will need other savings investments pensions or retirement accounts to make sure you have enough money to live comfortably when you retire AIgtoot SodaI Securi1gt _ bullbull Social Security is a compact between generations For more than 60 years America has kept the promise of security for its workers and their families Dut now the Social Security system is facing serious future financial problems and action is needed soon to make sure that the system is sound when todays younger workers are ready for retirement

Today U1ere are almost 3G million Americans age 65 or older Their Social Security retirement benefits are funded by todays workers and their employers who joinlly pay Social Security taxes - just as the money Utey paid into Social Security was used to pay benefits to those who retired before them Unless action is taken soon to strengthen Social Security in just 12 years we will begin paying more in benefils than we colled in taxes Without changes by 2041 U1C Social Security Trust Fund will be exhausted By then Ule number of Americans 65 or older is expected to have doublcd Therewont be enough younger people working to pay all of the benefits owed to those who are retiring At that point there will be enough money to pay only about 74 cents for each dollar of scheduled benefits We will need to resolve these issues soon to make sure Social Security continues to provide a foundation of protection for future generations as it has done in the past SodaI SauriY On Tho lid Visit wwwMlclal6ecurllggopon the Internet to learn more about Social Security You can read our publications use the Social Security Benefit Calculators to calculate future benefits apply for retirement spouses or disability benefils or subscribe to eNws for up-to-date information about Social Security

~~~ Jo Anne B Bamqart

Commissioner

These estimates of the future financial status of the Social Security program were produced by the actuaries at the Social Security Administration based on Ule intennediate assumptions (rom the Social Security Trustees Annual Report to the Congress

Tou~ Esti~ate~Be~efits To qualify for benefils you earn credits through your We cant provide your actual benefit amount until you work - up to four each year nus year for cX3ffiple you apply for bcncfils And lhat amount IDZV difFer from the earn one credit for each $920 of Iilges or scU-employmcnl estingta staled below because income When youve earned $3680 youve earned your (1) Your earnings may increase or decrease in the future four crcdils (or U1C year Most people need 40 crcdiL~ (2) Your cslimaLcd benefils are ba5cd on current law earned over their working lifetime to receive retirement The law governing benefit amounb may changemiddot benefits For disability and survivors b~cfils young people (3) Your benefit amount may be affected by mllitary need fCotr credits La be eligible aervlce railroad cmploymeat or penamplolUi poundamed

We checked your records 10 sec whether you have earned through work on which )IOU did DOt pay Social enough credits to Qualify for benefits If you havent Securily taL VisIt tI1fllUISOCalsecuritggooImgstatemcnt earned enough yet to qualify for any type of benefiL we to see whether your Social Security benefit amount cant give you a benefit estimate now If you continue will be affected to work well give you a benefit estimate when you do Quawfy Cenerally estimates for older vOrkers are more accurate

What we B55Dmed -If you have enough work crediLc than thme for younger workers because theyre based on a we estimated your benefit amounts using your average longer earnings history with fewer uncertainties such as earnings over your working lifetime Ior 2005 and later earnings nucLuations and future law changes (up to retirement age) we assumed youll continue to l1lese eslimalei arc in todays dollars Mer you slart receiving work and make about the same as you did in 2003 or 2004 benefits they will be adjusted for cost-of-living increases We also included credits we assumed you earned last year and Ulis year

~Retirement YOll have larnd enough creui 10 ljlllliiy for henefil5 At your current e1ruiniolt ratl if you sLop workillg ltlnJ sLlrl receiving bellefits Al ale 62 your paymenl would hl thoul $ 1029 a lIIonlh If yuu conlinue working until

your full reliremelltage (G6 and 1 monUls) yourpilmenl would be about $ 15-13 illllonth aile 70 your paymenl WQulJ be aboul $ 2016 it 11101111

~Dlsnbmly uu have elrned enough neJils lo qualify for benefiL~ If ynu become disabled right now

Your paymenL would be aboul $ 1236 it monU1

Famll) If Oll gel retiremenl or disability benefiL~ your spouse and children ltlIiO may Qualify for benefil5

bull Survlvors Oll have eilrned enough credils for your family Lo receie Ule followin~ benefiLs if you die Ulis e1r

Your child $ 965 a monlh Your spouse who is caring for your dlild $ 965 a manU Your spouse who reaches full relirement age $ ] 287 a monU Total family benefiLs cannoL be more lIlan $ 2342 a monlh

Your spouse or minor child may be eligible for a special one-time deaUl benefit of $255

Medicare You have earned enough crediLs lo Qualify for Medicare at age 65 Even if you do nol retire at age 65 be sure lo contact Social Securily three monU15 before Our 65Ul birthday to enroll in Medicare

~Your utlmated benefits are bMed on curnmt lnw Congress has made changu to the law In the past and can do so at all) Ume The law goemlng benefit amounts may change because b)l 2041 the payroll tues collected wlll be enough to p~ onl) about 74 percent of scheduled benefits

2

bull bull

T Help Us Keep Your Earnings Record Accurate

You your employer and Social Security share responsibility for the accuracy of your earnings record Since you began working we recorded your reported earnings under your name and Social Security number We have updated your record each time your employer (or you if youre self~mployed) reported your earnings Remember its your earnings not the amount of taxes

you paid or the number of credits youve earned that

bull determine your benefit amount When we figure that amount we base it on your avcfilge earnings over your lifetime If our records arc wrong you may not receive alllhc benefits to which you are entitled T Review thb chm1 carefalb using your own records

to make sure our information is corred and that weve recorded each yeaT you worked Youre the only person who can took at the earnings chart and know wheUler it is complete and cor reeL

Some or all of your earnings from lut year may not be shown on your Statement It could be that we still were processing lasl years earnings reports

when your Statement was prepared Your complete earnings for last year will be shown on nexl years Statement Note If you worked for more lhan one employer during any year or if you had both earnings and self-employment income we combined your earnings for the year

Y Theres a HmJt on the amount of eaJIlidg5 OIl wbkh you pay Soda Seanily IDes eadJ yrar The limit increases yearly Earnings above Ule limit will nol appear on your earnings chart as Social Securily earnings (For Medicare taxes the maximum earnings amount began rising in 1991- Sina 1994 aU of )Our earnings are taxed for Medicare)

Y Call w right away at 1-800-172-1213 (7 am-7 pm your local time) if any earnings for years before last year are shown incorrectly If possible have )Our W-2 or tax return for those years alJailable (If you live outside the US follow the directions at the bottom of Page )

YourEamJogt ReoonI at a GlaDce-------------------------- shyrour Tued rourTucd rourTued rOllr T-~(d

hlnl YOll 5ocial51clIrily ~Icdicuc ymiddotlrYou Social ampcuritr ~kdiC1rlt WOth1 Earning5 WiJing5 WQr~d EarIJiliR~ f1mjnll~

1972 $ 107 $ 107 1990 $ 15652 $ 15652 1973 0 0 1991 22389 22389 ]97 0 0 1992 21288 23288 1975 1831 1831 1993 2030 2lt1lt130 1976 1880 1880 ]99 2j761 25761 1977 2311 2313 199j 27511 27511 1978 299 299 1996 3]Ast 31Ast 1979 1991 1991 1997 3716 3-1716

]998 3795 3795 1980 7093 7093 1999 3766 3766 1981 13A89 ]389]982 9A90 990 2000 38732 38732 1983 0 0 2001 6059 6059 19amp1 0 0 2002 513H 5133 1985 0 0 2003 9971 9971 1986 563 563 20M 8861 8861 1987 0 0 1988 1332 1332 1989 236 236

Tolal Soclal Securlly and Medlcaft laIn paid over your wo~ caner throuth the last year ftported on the claart above Estimated taxes paid for Social Security Estimated taxes paid for Medicare

You pilid $3120 You paid $7945 Your employers paid $33926 YoUr employers paid $7898

Nole You currenl(y pay 62 pen~1 of your ampIl1rry up 10 $ilOOOO1n Social Securlly laIesand lAG penenlln Medican laIn on your cnllft ampIliaI) Your employer also pQ)a 62 pen~t ~ Soebl Securlly lues and 145 pencnt in Medican laJes for you Ifyou aft relf-employedyou pay the combined employee ud employer amount of 1201 perant In Soclal Securlly laJes and 29 pen~lln Medlcaft laIl5 on your net umiDl

3

Q7210SR 09Al 0277J2

T Some Facts About Social Security -AbDul Social Spoundcurily and Medicare bullbullbull Social Security pays retirement disabilll) family and SUljvon benefits fwlcdi[re a icparalc program run by lhe Centers for 1-1cdicare and Medkaid SCl~ce~ helps pay for inpalicnt hospiLaI care lIursing cafe doelors fcc and other medical services and supplies to people age 65 and older or to people who have been retciving Social Security disability benefits for two years or more Your Social Security covered earnings qualify you for both programs For more information about Medicare visillDlDWomedIcaregoD or call 1-800-633-4227 (tTY 1-877-486-2048 if you arc deaf or hard of hearing) Here are some facts about Social Serurity benefits

Rethemeot - If you were born before 1938 your full rclircmcntagc is 65 Because ora 1983 change in the law the full retiremenl age will incrca5c -gradually to 67 for people born in ]960 or later

Some people relire before their full retiremenl age You can reEre as early as a~e 62 and take your benefits at a reduced rate Iryou continue working arter your full retirement age you can receive hilhcr benefits hecause of additional earnings and special credil~ for delayed retiremenL

T Disability - Ir you become disabled before futl retirement age you call receivc disability benefiL after six months if you hlve -- enough credits from earnings (depending un your

age you must have tltInled six to 20 of )lJur credits in thc three to 10 )1ilrs before you hecame disabled) ilIld

- a physical or mental impairment Ulats expected to prevent you from doing substantial work for a year or more or result in death

T FamDy - If youre eligible for disability or retirement benefits your current or divorced spouse minor children or adult children disabled before age 22 also may receive benefils Each may qualify for up to about 50 percent of your benefit amounl The tolal amount depends on how many family members qualify

T SorvivarB - When you die certain members of your family may be eligible for benefits - your spouse age 60 or older (50 or older if

disabled or any age if caring for your children YOWlger than age 16) and

--- your children if unmarried and younger than age 18 sliU in school and younger than 19 years old or adult children disabled before age ZZ

If you are divorced your eX-spouse could be eligible for a widows or widowerS benefit on your record when you die

Rec~ive benefllA and still work bullbull You call conLinue to work and still gel retirement or survivors benefits If youre younger than your full retirement age there arc limits on how much you can earn without affecting your benefIt amounL nle limits change cIch year When you apply for benefits II well tell you what the lifnils are al lha time and whether work would affect your monthly benefits When you reach II full retirement age the earnings limits no longer apply

IIBeFore you decide to retire Think about your benefits (or the long term Everyones situation is differenL For eXilmple be sure to consider the advantages and disadvantages of early retiremenL If you choose to receie benefits before you reach full retirement age your benefits will be permanently reduced Howeler youll receive bcnefiL~ for a longer period of time

To help you decide when is tile best time for YOl to retire we offer a free booklet Social SecurityshyUeliremrml Hlm-efils (Publication No 05-10035) lhat provides specific information about rclirellleni You can calculate fulure retirement benefits on our wehsile al UJUJUJsociaslcurltggov by usin~ the Social Se111rily Bmefi Calculalors There arc other free publications that you may find helpful including

T Understanding The Benefits (No 05+10024) - a i1eneral explilnalioll of all Social Security benefits

T Now Your Retirement Benefit Is FigfltTd (No 05-10070) - an explanation of how you ~-ttl

calculate your bencfit

T The Windfaff Elimination ProlJision (No 05-]0045)shyhow it affects your reLirelll~nt or disability benefits

T Govemmerll Pension Olfscl (No 05middot10007)shyexplanation of a law lhat affects spouses or widow(er)s benefils and

T Idcnlily TileR And Your Sociat Security Number (No 05-10064) - what to do if youre a victim of identity theft

We also have other leaflets and lact sheets with infonnation about specific topics such as military service sc1f-employmentor foreign emptoymcnl You can request Social Security publications at WItJU)SOCalslaaitygou or by calling us at 1-8OD-772middot121S

IFyou need mon informaUon-Visit UlUlwoSodQsecuritggoI1ImgstQtement on the Internet conlact any Sodal Security office ca1l1-800-772-1213 or write La Social Security Adminislration Office of Earnings OperttLiolls PO Box 33026 Baltimore MD 21290-3026 If youre deaf or hard of hearing Colli 1TY 1-800-325-0778 If you hlttve queslionc ilbout your personal informaHoll you JIlllst prOide your complele Social Security number Ifyour address is inmrrecl 011 this Statemenl ask the Inlernal ~evcnue Senice to send you a Forrn 8822 We dont keep your address if youre not receiving Social Security benefits

Pam solicimr una DeclQrtJcl6n en -cfilJaliol Uam-c tlI1-800-772middot-1213

fom SSI_7oos_m-SllOI_20151 4

III

QUARTERLY STATEMENT July 1 2007 bull September 30 2007

401(k) SAVINGS PLAN Kellie A Jones

1314 West 400 South MANAGING YOUR ACCOUNT

Serendipity Utah 84464 VJWWursorg 1-801-366-7720 (Iocall 1-800-688-4015 (loll-free)

Account Number

Account Balance $3758517

ACCOUNT SUMMARY FYI FROM URS This Quarter Need a form

Do you know lfIat most of lfIe lorms you may need to manageBeginning Balance $3669640 your account are available 00 our website Brochures and Deposits $21348 inlormational publications are also available ooline You can WlthdrawalsITransfcrs $000 access URS forms and publicalions by going to WiWursorg and Investment results $67529 clicking on the Online Formsor Publicalionsbuttons localed 00

Ending Balance $3758517 lfIe left side of the home page This is aQuick and easy way to get the lorms you need to complete most transaclions If for some reason the form you need is not there please call us atThe ending balance may not reffecl your laest contributions due fo timing of payroll 801-366-7720 or 800-688-4015contributions from your employer

CURRENT HOLDINGS by FUND 01 Number Unit Fund Total Balance of Units Value 8alance

2 Income 54298 16320207 S88615 10 Bond 213855 17235515 $368590 12 Balanced 119745 36478561 $436813 1110 13 Large Cap Value 237401 20607264 $489219 nw 1300 Large Cap llldex 48591 96989957 $471284 160 Large Cap Growth 494492 12164762 $601538 15 International 153318 36784442 $563972 12 Small Cap 188654 24810487 $468060

lQOOOO) $2704261 -iLoan=== ~2~1~04~2~6~O__ 100 AccountTotal $3758517

This is a snapshot ofyour currenf account holdings as of the Quartermiddotend date The percent3ges are rounded 10 the nearesllt110le pefCent

1013

KElliE A JONES 401(k) SAVINGS PLAN

JUly 12007 - September 302007

INVESTMENT of FUTURE DEPOSITS AU new money inlo your account will be allocated as lallows

1000 80ml 1000 Balancer 2000 Large Cap Value 2000 Large Cap Index 2000 laJge Cap Growth 1000 Intemalional 10000_~Small- _

10DOO Account Total

These are the allocations you IliJve instructed us 0 use when depositing any nell contributions 0 your account You may cllange lese future allocations at any lime

FUND PERFORMANCE Quarter Year

Fund Just Emled to Oat~ 1 Year 3 Years 5 Years

Income 125 372 498 455 423 106 320 494 376 435Balanced 323 776 1238 1052 1163

lJrge Cap Value -195 507 1190 1521 1819 large CaP Index 202 895 1611 1283 15m large Cap Growth 939 1574 2143 1382 1233 Internalional 128 1144 2110 2198 2223 Small cap middot356 275 1201 1319 1918 Short Horiwn 168 510 859 612 646 Medium Horizon 194 667 1179 1050 1152 long Horizon 144 806 1482 1375 1521 Group Annuity 116 354 474 474 485

The investment results shown are tile actual rates of return (or eacll lund during the period indicated Past performance is nor a guarrnlee of fUture results These investment fund options are nat FDIC insured nOI deposits or obligatioflS of or guamnteed by any financial instilution and nol guaranteed by fIe Uflh Retirement Sysfems ot any government agency All returns slQwn are net of administrative and investment management lees The 3 and 5year mfums am annualized The Group AnnUity Fund is closed to lurther cotltribufiofls

ACCOUNT ACTIVITY SUMMARY Beginning Employee Employer Wilhdrawals Investment Ending

Fund Balance Deposits Deposits Translers Results Balance

Income $87524 SOoo SOOO $000 $1091 $88615

$353023 so 00 $2134 $6042 $7391 $3685go Balanced $414988 SOoo $2134 $6042 $13649 5436813 large Cap Value $482233 so 00 54270 $12084 $-9358 $489219 large Cap Index $445520 $000 $4270 $12084 $9410 5471284 large Cap Growth $533955 SOOO 54270 S12084 $51229 $601538 International $548568 SOOO $2134 $6042 $7228 $563972 Small Cap $476840 SOoo $2135 $5036 $-15952 $468060 loai1 _-__ $326989 $000 $DDD $-60414 $3851 $27D426 Total $36696AD SODD $21348 $000 $07529 $3758517

NDnCE Please examine his statement If the tJ3lances sholVTl are nol CtJrrect please write promptly giving details ofany differences to our audilofS Deloltte amp Touche althe folioLVing address DeloiNe amp Touche Attn URS 2gg South Main Suite 1900 SlC Utah 841 rrmiddot1919 Include your name Social Security number and a CtJpy of this statement If this sltltemenl is CtJrrecf no reply is necessary

lOAN SUMMARY Original Quarter Quarter

Originallon loan Loan Beginning Principal Ending In(erest Dale Amount Rale Balance Paid Balance PaId 10123103 $1068942 50DO $326989 S56563 $27D426 $3851

This secion describes any loons 100 IICNe oustanding wirIJ Uf1S OJrrent loan policy alia tot one oulsmnding loan per aCCJun (401(k) and 457)

2 of 3

Account Number 12345678

Current Employer UTAH STATE UNIVER51lY

SERVICE CREDIT PER SVSTEM AS OF DECEMBER 31 2005

NONCONTRIBUTORY STATE AND SCHOOL [2J 15667 YEARS

To determine a montho 8J1owatIce estirTl81e go 10 the Utah Rotremem System web site 8 wwIursOlg and cliek on the RelIremerrt Benefit EstlrTI81e Cslculalor link Follow the guklas and usa InlormatiOn rom this ancl pr9lltous stltements 10 determine an 9$1IrTI81ec1 8J1owatIce

Jl you ate a member In mora than one Retlremsm System II you ate a part-time elected or appolmed oflicl8J or If you ate employed with two or more emplyenls 8 the sarne tlme you will need to contact the Retirement Otllca Retlramerrt System refets to one ol the folloNlng

Public Empojees Comrlbutory Retlremem System (Local Gowrnm9rltStale ancl School EmplCyenlampS) PubDc Empojees Noncontributory Retirement System (Local GowrnmentSlBJe and SChool Employees)

Public Salety Retlremem System9 (members pEN10rming pUblic safety saMce)

Areflghters Retlramam System (members performing lIreflgtner service)

Judges Retiremem Systems - you will need to comact Utah Retirement Otllca lor an estlmale

Utah Governors ancl Leglsla1ors Retirement Plan bull you wiU naed to contact Utah Aetlremsnt Otlice IU at astlnal

Free seminars

Are you on track to retire the way you want Dont make the same mistake many people make waiting too long before they get their retirement planning In order

Utah Retirement Systems offers tree retirement planning seminars to assist you with these and other questions Two different semInars are offered al several locations throughout the state The Pre-Retirement Seminar Is designed for those who are withIn five years of retirement The Personal Planning Seminar Is for those who are at the beginning or middle of their careers For additional information visit our web site at wwwursorg or call us at (801) 366-n50 or 1-BOO-753-nSO

I 2005 DEFINED BENEFIT RETIREMENTI ANNUAL STATEMENT

2005 TRANSACTIONS PER SYSTEM NONCONTRIBUTORY SYSTEM

STATE AND SCHOOL

Month Salary

JANUARY 412500

FEBRUARY 412500

MARCH 412500

APRIL 412500

MAY 412500

JUNE 412500

JULY 431100

AUGUST 431100

SEPTEMBER 448600

OCTOBER 436933

NOVEMBER 436933

DECEMBER 436933

Total Salary $ 5096599 Total Service 1000

IF YOU HAVE ANY QUESTIONS REGARDING THIS STATEMENT CALL 801middot366-7700 OR 1-800-365middot8772

Defined Benefit Retirement Summary

Public (1) Public (2) Public (3) Firefighters (4) JudgesIS) Governors amp (5) Employees Employees Safety System Systems Legislators Contributory Noncontributory Systems RetIrement Plan System System

Qualifications (YearsAge)

4atage65 10 a age 62 20 al age 60

4 al age 65 10 at age 62 20 at age 60

4 at age 65 10 al age 60 20 al any ag~

4 a agc 65 10 al age 60 20 al any age

6 at age 70 10 al age 62 20 a age 55

ltI al ag~ 65 10 a age 62

30 at any age 25 a any age 25 at any age 30 at any age

Formula 125 to 6130f75 200 71f75to

2 all years 25 10 20 yrs 2 over 20 yrs

25 [0 20 yrs 2 ovcr 20

50 [0 10 yrs 225 to 20 yr5

Governors $11lt10 per month

present 10 over 20 per term 01 office

Maximum None None 70 70 75 Legislators 52520 per monlh per year of serviccmiddotmiddot

Final Averago Salary

Iligholsi 5 years

Highest J years

Highesl J years

rlighesl J yeilrs

Highest 2 years

NfA

Cost of Living 40 Simple 4 Simple 25 Simple 4 Simple 4 Compounded 4 Simple (MaIimum)

bull Actuarial reGuction Eligiblo aMllr 1 yom percentage incrcase based on original beno(lt and chlmgn in CPI Increased semimiddotannually by CPI

Retirement Systams Highlights 6rochuros

are ilvallebloJJpon requast (B01) 366-nOO or (BOO) 365-an2

or vIsit tho URS web site wwwursorg

aY 212J1200~

Hourly 1375 800 11000 Federal 5004 21574 Hourly 5150 850 43775 Fica Ret 3396 3396

Fica Med 794 794 UT HH 2313 868a

54775

11507 34452Totals

UtahState UNIVEiRSITY locfDept

DPHASS

Deposit Dale

061007

Deposit Amount

middotmiddotmiddotmiddotmiddotmiddotmiddot43268

bullbull DIRECT DEPOSIT ADVICE

Kellie A Jones 1314 West 400 South Serendipity Uth 84464

NOT A CHECK bullbull DIPECT

DIRECT DEPOSIT ADVICE NON-NEGOTIABLE

DEPOSIT ADVICE bullbull NOT A CHECK bullbull

VOID

AUTHOIUZpoundDSIGNATURES I

$636

THE TRUSTEES OF SUNRISE ENGINEERING 401(K) PLAN

Retirement Account CHARLES M JONES Your retirement account valul 015 of 0613012007 1314 West 400 South $1463110 Serendipity Utah 84464

April 01 2007 bull June 30 2007

Your personal rate of return This period 605 For last 12 months 1956 Since your account inception 1437 (AnnuanZld)

Looking back This period ClllInge in your ((ount this

period 5173893 Beginning balance 512amp9217

06130106 0V3G06 12131106 DJI3flOl Dti3fJID7

---- Emflo~ee contributions Employee + employer cantributions -- Ending blllencc

- bull ~_ bull ~ _ -~~ ----~_ - --bull_--------_bull-------------shy

S15OOO $12800

S10600

$8400

$6200

$4000

Money in Employee money 70253 Employer money 22782

Net change 80858 bullbull 0_ 0_ _ bullbullbullbullbullbullbullbullbullbullbull __ bullbullbullbullbullbull bullbull - bullbullbullbull - bullbull 0- bullbullbullbullbullbull o or Ending balance 51463110

bullbullbull bullbullbullbullbullbullbullbullbullbull00 0 bullbull _ C bullbullbullbullbullbull o 0- bullbullbullbull

-------------------------shy Outstanding loan balance Total value Including loans

91760 51554870

----------------------shy

Looking ahead Your date of birth is September S 1958 If you retire at 67 in ZOZ5 your projected retirement accoUnt value will be 511415674 in todays dollars (net of inflation) Based on the projected balance we have calculated the mOllhly income in todays dollars you can reasonably expect your account to genera1e until age 86 The- Social SlIIcurlty benefit shown Is the avenge Social Security benerrt pBld to retlreos today your boneflt will likely be B different Bmount

Your projected monthly income

$2000 $7600

$7200

$800

$400 $0

ProjllutiOfl1 are based on contributions made over the last 12 months lind your cUfTent account value They assume you afe following a blanced Investment strategy (60 stocks 40 bonds) growing at an assumed average rate of 426 afreran adjustment for inflation of 22 and comider youryears to ratirement This chart is forilustratJve PUrpOSfS only and does not guarantee future account value or future performance For detlJlls (IJII the number below

$7674 bull Retiremenlllccoun1(RAj II SociIl15eturity(55)bull Total

Your projected monthly income Retirement account $63629 Soda I Security $103800 Total monthly Income 5167429

bull Your retirement years arent that far ott Setting aside what youll need to help meet your retirement income goals is especiallY Important logon to wwwlhpenslonscom for financial and retirement planning information offered in conjunction with CNNMoneyTM under Personal finance topics You just might find a way to add to what youre currently contributing and make your goals that much more attainable

For questions about your account with John Hancock USA visit wwwjhpenslonscom or 1-800-395-1113 (1800-363middot0530 Espanol) Monday - Friday 8am bull 8pm ET

IIII~IIIIII mllllllllllll~ IIII

Rtlrement account of

CHARLES M JONES

Your profile at a glance YJur current portfolio alfocation

Your current portfolio is following a growth strategy This strategy places an emphasis on growth and assumes that youre comfortable riding the ups and downs of the stock market Your portfolio profile description may change as the value of some of your investment options change over time or if you change your strategy Check your account profile periodically to help ensure that your current portfolio and your ongoing contributions are allocated in line with your desired investment strategy Reviewing your strategy can be especially important if your financial circumstances or your lifestage change To make a change to your account please call us at 1-800-395-1113 (English) or 1-BOO-363-0530 (Espanol) or go online at wwwihpensonscom

AC(Dunt 01 v~lue ~count

~ lntl~ S241399 1650 ~ Growth 8 Income 29021B 1984

_Growth 298478 2040 CJ Aggressive Growth 633015 4326

Total account value 51463110 loan 8alance S91160 Total inclUding loam S1554870

Your outstanding fOlJn bfllflnce is not included in your current IJflocfltion Current profile

What investment options make up your account Cllrront ongoing Unitt held A5 of

portfolio 04101fC7 06ll01C7Irtructlonttt

Income

Retirement Account April 01 2008 - June 30 2008

Your ongoing contribution allocation

Your ongoing contributions are folloWing a growth strategy This strategy places an emphasis on growth and assumes that youre comfortable riding the ups and downs of the stock market Your portfolio profile description may change as the value of some of your investment options change over time or If you change your strategy

of oniloncontriblltlons

2000 2000

2000 4000

Ongoing

Unit value 01 ot + Vllue III of 040107 063007 04101(01 06l007

JH PIMCO Total Return JH lM Partners Glb HIgh Yield

761 1000 1000

65359047 44821061)

70739284 48155632

515917378 26998195

S15746012 26998114

5104428 l2HI26

5111387 130012

Growth amp Income JIt Amelltan Funds Am 8alanced LBO 200 10658104 11454860 21889570 22973097 23332 26317 JH T Rowe Price EqUity rnc 298 300 9410265 10037813 40694642 43420719 38296 43585 JH Davis New York Venture 00 00 20497438 21861645 31401807 33434420 64367 73094 JIt Mtrtual Beacon 520 00 5150980 5480407 132009701 13aB22514 67999 76081 JIt Wetlz Partners Value 86 500 17257258 18438960 36740720 38581429 63405 71141 Growth JIt Fidelity Advisor DIY Grwth 186 200 40B3725 4377135 58173289 62279998 23798 27262 JH Franlllln 8alance Sheet 512 500 6135674 6517832 112618589 117130877 69100 76345

JH Mutual Discovery 225 200 4342007 4598164 66726201 71658939 28973 32951 lit BlackRock large Value 286 300 16756234 17921459 21900825 23313357 36698 41781 JHT Rowe Pnce 81ue Chip 283 300 7547707 8083749 47305968 51280266 357D6 41454 JIt Excelsior Value amp Restruct 538 500 11733575 12463343 57391200 63132862 67342 78685 Aggresiive Growth IH Templeton Fore~n a53 800 39735507 42229732 27504465 29539577 109291 124746

JIt AIM Constellation 748 aoo 22638531 24269808 41691662 45078307 94385 109405 JH Legg Partners Agg Growtfl 737 800 18573689 19913330 50892525 54129629 94528 101791

(continuedj

Page 20f 5

Faculty and Exempt Staff Benefits at a Glance

2007-2008

THE AVERAGE VALUE OF YOUR EJ1PLOYEE BENEFITS While salaries ditTer the average taxmiddotfree benefit package is equal to approximatel 44 of your annual

salary excluding the value of paid time otT

HEALTH CARE BENEFITS

Medical Insurance Dental Insurance White 0 tion

(Lower employee premiums higher cost at time of service) Medical and Extended Annual deductible of 5750 per person51500 per family 535 per physician visit 5250 per incident for major diagnostic testing 5250 per visit emergency room co-pay Medical maximum out of pocket of 53000 per person56OOO per family Prescriptions You pay 55 for generics 35 for formulary and 50 for nonmiddot formulaf)middot Rx maximum out of pocket of 51500 per person per ear

BlueO tion (Higher employee premiums lower cost at time of service) Medical and Extended Annual deductible of S250 per person5500 per family 530 per physician visil 5200 per incident for major diagnoslic testing 5200 per visit cmergency room co-pay Medical ma(imum out of pocket of 52500 per person55OOO per family Prescriptions You pay 55 for generics 35 for formulary and 50 for non-formulary Rx maximum out of pocket of51250 per person per

I Year

BASIC BENEFITS Examinations fillings Xrays sealanls etc covered at 80 Sealanls are covered for dependent children only

GENERAL Maltimum benefit per person per conlrlct year On all dental bencfits is 5 1500

PROSTHETICS Dentures bridges crowns implants ctc covered at 50

ORTHODONTICS Eligible benefits are paid at 50 Maximum benefit on onhodonlks is 51500 per person per lifetime

Refer to your Summary Plan Description Booklel for full details

RETIREMENT BENEFITS

T1AACREF Retirement Plan

If you enrolled in the TIAACREF retirement program the University contributes 142 of your annual gross earnings You designate how this contribution is invcsted among the T1AA and CREF investment options

SOCIAL SECURITY BENEFIT5

Social SccuritylMedkarc

The University shares the cost of your Social 5ccurityIMedieare benefits in 2006 by contributing 62 of your salary up to 55840 with a taXable wage base of5942oo for Social Security A contribution of 145 is made for Mcdicare on all eamings You will match these contributions by payroll deduction Social Security provides several imponant benefits in the form of retirement payments disability payments medical benefits under Medicare and death benefits paid to a spouse or dependent

Sickness and Disabili Benefits Life Insurance Benefits Sick Leale

Faculty and Professional staffon Fiscal Year base appointments are prolided 12 days of sick leave per cakndar )ear Unused sick leave may accumulate to a maximum of 130 days

Em 10 ee Tenn Life Insurance The Unilersity pays the premium for one times annual salary rounded to the nearest 5 000 to a maximum of5250ooO An employee may enroll in supplemental insurance up to a lesser of five times annual salary or 5300000 without evidence of insurnbility if done at the employees initial enrollment for benefits In addition this can be increased in units of51OOOO to a maximum of S500000 with evidence ofinsurnbilitv

Short Tenn Disabili Short-term disability is available lasting 150 days or less These benefits cover 6667 of your salary while disabled In addition your medical dental and life insurnJlce progrnms remain in force and a continued conuibution to your retirement plan is made This is a volunwy progrnm and requires enrollment to participate The COSt is S4 per month for emolovees

D ndent Tenn Life Insurnnee You may enroll your spouse and dependent children in a number ofterm life insurnJlce programs Basic life SIOOOO ofcovernge for spouse and S5000 for dependents Voluntary Dependent Life Units of SIOOOO to a maximum ofS250OOO for spouse Units ofS5Ooo to a maximum ofS20OOO for dependents wilhout evidence of insurability

Other im ortant Benefits Tax deferred suppkmental retirement accounts Early retirement incentive program Phased retirement incentive program Reduced tuition of 50 (according to policy) Flexible spending accounl Free audit of USU courses for you amp your spouse Jury military and emergency kave programs Bookstore discount ID card privileges and discounts AUlo and Homeowners program Long Term Care Emolovee Wellness oroeram

Lonl Term Disabilitv This progrnnl covers disabilities that extend beyond 150 days Your salary is protected at the rate of 6667 While disabled if you qualify your premiums for medical and denial insurnJlee will be paid and a continued contribution to your retirement Dian will be made

Workers Comoensation Coverage is provided for medical hospital (paid at 100) and lost wage COSIS (paid at 6667) due to an on-the-job injuryillness

VACATION AND HOLIDAYS

Annual Lele

Annual leave 5 earned allhe rnte of 183 days per month or 22 days per year for eligible facully and professional staffon fiscal year appointments (2 months) Academic year appoimments do not cam annual leave Annual leave will accrue on a calendar basis and may not exeeed 30 days

Holidays

Facully and professional staffon fiscal year base appointments earn r2 paid holidays per year Employees with appointments that are less than full-time but 50 time or greater are eligible for paid holidays that fall within the period which services are performed

Additional and specific information may be obtained in the Omce of Human Resources regarding these programs This Slaltmem is prepared in non-techicallanguage and only highlighTS yaur benefit~middot

~pecific technical interprerafia of III( benefifs provided is amiable ill fh~ ariols legal documents prOliding cOlmiddoterage The bellefilS olltlined llere are baud upon YOllr eligibiiIY according fO the terms of YOllr appoimmelt and Ihe ossumption tllat 1011 hove enrolled in the programs ampIeral programs require premillm sharing ollbe pari of The employee

- ~ -

Patient name _Vaccine Administration Record Birthdate _

for Children and Teens Charillumbcr -

Typu of Oatil glvcm SOUflO Va((lno Vacclno Informallon Slgnalunl1 Vaccine VIclnCl SltCl Slalomont lnlllais of(modoytyrl (FSP1 shy

(g~neriltClbblevlCl~on) lot Mfr DaleonVlS4 DatolJiwn vaccinator

Hopatltls S _----shy -shy(eg HepB HihHepB DTpHepBJ1V) ----- -shy -

Gie 1M -

Olphthorla Totanus -Portus8ls (eg DTaP DToP-Hib -DToPmiddotHepBmiddotPV DT -DToP-HibmiddotIPV Tdtp DTaPIFV Td) Give 1M -shy

Haomophlu5 ---shy -shyfnuonzao typo b (eg Hib HihHepB bullbull -shyDTaP-lIib-IPV --- DTnP_Hib) G 1M

~

10110 - _bull ---shy -shy-shy - --~_-

(eg D DToPmiddotHrpDIV DTlPmiddotHihlPII UTUmiddotIPV) _shy -Give liV SC or r~l _---shy -Giegtll alber 1M

-

PnoumococcII1 - __--shy~shy

(q CV conjugale _

PPV (lQly~~hgtridc) --shy -Give rev 1M Gimiddote PPV SC or 1M --shy -shy - -

Rotavlruamp (RotI) -shyGic orLl (pO)

Moasles Mumps Rubana(eg MMR MMRV) Givc SC

Vorlcolla (eg V~

MMRV) Gimiddotc SC

Hepatttl9 A (HepA) Give 1M

Meningococcal (cgbull MCV4 MPSV4) Gn~

MCV41M oro MPSV4 sc Human papillomavlus (eg HPV) Give TM

Innuonu (eg llV ingtlliv~Ied lAlV livo ~ltenu3ltd) Give llV 1M Gimiddote IAIV IN

Othor

I Record lh gbullbullbb lIuon (or lh lype of Vice gn (eg OTPmiddotHh CV) 01 Ibe Indo IIllmbullbull

2 Reord the ltour f Ill ndn given ith F (FdUymiddotuppondj S (Sill bull ouppol1cd) or P (upponcd try Prjl huulamplOltlt or olh rival fund)

3 Rceltgtlaquollhe 111 h= vlcene adnd OJ lIh RA (Rghl Arm) LA (Lofl Amo) RT(Righl Thigh) LTCLcft Thigh) IN ([nlranI) or po (by moulb)

4Rceord the publiion d of exh VIS 1Itgt the ltal il i gin In the pa~enL

Slor mbilUn nltlto fill in fOf loIh KJlUl antigen in lb eombinat~

_~~~1022fdmiddotItem fPJ022(l(EJ

Patient name Vaccine Administration Record Binhdale _

for Adults Chart number _

Defore ~dminis(ering aJly vaccines give the pllicnt COpiel of all pertinent Vaccine Informllion Statements (VISs) and make sun heshe undernwdlt the risks and bencfiu of tile middotaceines) Update the puienls pclional recon card or provide a nell one whenever yOll administer vaccine

Typo of 010 glvon Soureo Vaeelno Vatclno IllformaUon Slgnaturel Vaccine Vacclna 51to1 ---- Stahlmant Initials oflmoidaylyr) (FSP)

(llenoriG abbflMoUon) Lol Mfr DaloonVIS Oalll given vaccinator

Tofanull Dlphthorla Porlus6ls (eg Td Tdap) Give 1M

HopaUtl6 A (eg HepA HcpAmiddotlJtpBj Give 1M

HopaUtis B -(eg HcpD HepA-HepB) ---Gi 1M - -

Human paplllomavlrus -(HpV)

Give 1M __shy -- shy -shy ----- shy -

Moaslos Mumps Rubolla -(MMR Giw SC

Varie-oUa (Var) Gi-e SC

Pneumococcal polysaccharide (JpVj -Gil SC or Tht

Menln~ocOCCIlI eg CV4 ltunjugale MPSV4 polyueelwide) Give MCV4 1M Give MPSV4 SC

Zo~r(Zos)Oie Sc

InnUon8 (eg TIV inaotiYlkd LAIY live allenullM) Give11VlM Oive LAIV 1Jl

-

Othor

Othor

I Record the generic Ibbnviallon for lhe type of vaeeine given (eg ppV HepAmiddotHepD) 101 the Inamp name

2 Reeord lhe source of lhe Yliccine given 1$ either F (f~denllymiddotsupported) S (S~tNlpparted) or P (IUpported by Private insurance ar 0Ihcr PriYlte [unds)

3 Record Ihe site wh~re vaccine wu adminslertd lU cither FA (Rihl Ann) LA (Idl Arm) RT (RighI Thigh) LT (Idl Thigh) IN (lntlllllUlJJ)

4 Rclord lhe publication dlIle of ah VIS lU -elll$ the date il is glYer to ~

patienl

5 For eombination vacei~ fill in I row for each ~parale InUen inlhe tommiddot binalion

Patient name ~egl1n ~ ZontsVaccine Administration Record Binhdate February 9 1988

for Children and Teens Jti1837Chart number

Typo of Date given Source VacclnO Vacclno InformaUon Signatural Vaccine Vacclno Silo Statoment Initials 01(moId3Ylyr) (FSP)

(lllfltfk DbbnlVilllJoo) Lot Mfr Dmlll on VIS 0110 giVllnt vaccinator

HopaUUs S --2lltUA PU (tg HepB HilrHepB

nDThP-HepB-lPV) Give 1M ~

Olpllthorla Totanus Portussll t2amp (eg DTaP DTaPHib DTBP-HcpB-IPV01 DgtP 80 0lt f 647Q 0lt DThP-Hib-IPV TdAp D7gtP S 07 07 f RT 74981 DTIPmiddotWV Td) Give 1M

Hllomophnlls 2 HiJmiddotH 1 03 06 f RT DCP Influonzllo typo b Hw-H 8 60506 f RT DCP (cg Hib Hilgt-HcpB

HWHtp8 20507 f LT DCPOTllP-Hib-IPV DThP-Hib) Gi-e 1M

Pallomiddot W _403 06 L LT 0306 DCP (cg1PY DTaP-HcpBmiddotIPV IPV 60506 f ( as 06 DCP DThf-Hib-IPY UTaP-IPV) Git IPV 5C or 1M IpV 40307 10307 DCP Give all OIhllll 1M

Pnoumococcal PCV WYE 30 02 06 DCP (eg PCV oonjuglllc WYE 9 30 02 6 OS 06 DCPPPJ polycchuidc) Gie PCV 1M WYE 9 30 02 8 07 06 DCP Give ppJ SC 1M

S91-123 WYE 9 30 OZ 2 Os 07 DCP

Rotavlrus (Rota) Give ond (po) P -f F M 0lt 60506 DCP

2 MoeBloB Mumps Rubolla(eg M bull MMRVGiveSC M Vorlcolla (e Yu MMRV) Give C

HopeUt1s A (HepA) H 0307 MRK 3 Zi 06 0301 DCP Give 1M

MRK 3 21 06 10 03 01 DCP Monln=cal (eIMCV4 4)GM MCV4 1M and MPSY4 sc HIlman papmomavtrus (eg HPV) GiclM

InfiuonlJl (eg nv TlV 100906 P Kr UI061S9 fPl 63006 10~06 DCP inxtivalcd lAIY lic TIV 111306 P Kr UI061S9 fPl 63006 11r306 DCP luntIro) Give TTY 1M Give lAlJ IN TlV 10f~01 P Kr U4631SZ fPl 71601 101601 DCP

Olhor

I RcconIhe gric Ilgtlgttevilll rOltll~ rpr-ofnlaquolne glv~n ~s DtIIPmiddotHib fCV no 3 Reecnllhe ile whore Vlcdne WU odminbleml u either RA (RltIl Ann) U (d Ihe IlIde me Ann)lO(Righl Thigh) LT(Lcft Thigh) IN (illlnnuol)orpo(by lMIIlb)

2 Record the 0 or tll~ v_ine gi bullbulln u ~lLher I (Fdulllymiddotl~pponod)S (5111e_ 4 Reecnllhe publi~ diu of each VIS u oil u llIc dote Il 1I ciwn 10 the pWcnl IUpponod) 01 P (11l~ by p~ In~rina 0 ~ fri bullbull1e (undo) S For combllllllOft neel till In I ft1Il for qch ltqnnle liC In lbe rombil1llioa

DimbAedbrthe1tTlflllJOzationAc1iooCoordion bull (651)647-9009 bull WMYirTvnJnireo-g bull WMY~neinrOfllllliooo-g

Patienl name Micfli1eCs ZonesVaccine Administration Record Birthdale Zune 14 1983

for Children and Teens Chart number 2345678

Vaccine Typo of

Vaccine (I~neric BbbrevlaUon)

Dale glvon Source (motdayl)r) (FSP)2

Vacclno 5110 I---c----- shy

lol Mfr

Vacclno lnronnatlon Sliltemont

Dale on VIS~ Dale given

Signaturel Initials 01

vaccinator

01_ ITADce

~ na mw

Pnoumococcal (cg PeV conjugale PPV poly~l=idc)

GiC PCV 1M Give PPV SC or 1M

RolavlNS (Rotll) Give 01111 (po)

PCV 20205 F LT-PCV 10205 F RT

PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV

Measlos Mumps Rubolla(eg MMR MMRV) Give SC

Varlcolla (eg VIJS MMRV) Give SC

HopatJthr A (HcpA) Give 1M

Monlngococcal (eg MCV4 MPSV4) Give MCV41M llIvI MPSV45C

Human paplUomavlrus (eg HPVj Give 1M

~

Innuonzal (eg TIV inutiOltcd LAIV Ij~

nltenuedj Give TIV 1M GiC LAIV IN

Olhor

TlV faaSOS F M U09743 SPI 71fBIOli fa 0005 Ttl

I--T~1~V- rtfgtLO~5-t~F-+~RA-+_~U~O~~Z~lt4~3-+~fP~1_t-tO~~Z~~025-1~12t~O~5~02f-t_~D~C~P--t TlV fOfli06 F LA Uf061Sf SPI li300li 10f606 MAT

I Reord lh ne abbrVlltlon flgtllhlypeofuccne CCO (eg DTd-Hb PCV) nol ) Record lh dt where n wUldmlnlllrcd 1l11ht RA (Rlgh Ann) LA (Lell lb tndc me Arm) RT (RighlThlgh)IT (lcflThigh) IN (1nl=I) or po by mOlllh)

2 Reord lh source of th vleci 11 IS cithe F (FcdbullbullamplIyuppol1d) S (Slt 4Rceord lhe publiCllion al r bullbullch VIS IS well as theale it i gi bullbull 10 the pali~

luppond) III r (Iupponcd by rrirll nJUmlce III Olhet rivole (uods) ~Fol combi li _cines rill ill_row for etch stp~e ampllifC in lhe rombinJjioo

DistrtUld by he Immunization Pdion COollrtion bull (651) 647-9(($ bull wnwimmunizeorg bull wnwvucineinformationorg

bullbullbullbull

bullbullbullbullbull

Experian - Printable Full Report of8

EI CJose window Experian

A world of Insight

Online Personal Credit Report from Expertan for

Experian aedit reoort oreoamltl for Index ~ Print report CHARLES M JONES - ~[I1$Jl1I~lLsl8fIltljlXl

Your repon numDeJ IS - R~ul1~L~1lW~~-~

- P~[ lnformalOO

Iteport date - tlI-PSlYlQlrn_~fi2lL~

0610412008 -~tjLlsect

- KngN your rights

Experlan collects and organizes Information about you and your aedlt history from public records yauraedltors and other reliable sources By law we caMot dlsdose cartaln medical Information (reiaUng to pIlyslcal menlal or behavlonll healltl or coodIUon) Although we do nol genemJly coiled such InfonnatlonII could appear In the name of a data furnisher (Ie CanoerCenter1 lila reports your payment h1slOlyto Ull 11 so those names display In your report bUlln reports 10 others they display only es MedIcal Information Provider Consumer statemenlslnducled on your report al your request IIlaI corrtaln medicallnformallon are disclosed 10 others

To relUtrl to your report In lhe near future log on (0 YIWWexperlancomlconsumat and seled -view your report agaIn or Dispute and then enter your report number

If you disagree with InformaUon In this report relum 10 lhe Report SummalY page and follow the Inslrudlons ror dlspuUng

Accounts In Good Standing

Those Items may stay on your ~ repoI1lor as long as they am open Onoa an aceount III dosed or peJd off It may conUnuo to appear on your repoI1lor up 10 ten year

HSBClBSBUY Addross Accounl Numbor PO BOX 15524 WILMINGTON DE 19850 (800) 877-2700 Address Idontlflcatlon Numbor 0170742370

Status OpenlNeverlata Date Oponod Typo Crodlt LlmlUOrlglnal Amount

- ltXlRoported Sinco High Balanco Tonns 09rlWT $358NA

Rocont Balanco Dato of Status Monthly Paymont $0 pBId as 01 02I200a021200 Rocont Paymont Last Roportod Responsibility SO021200 IndMdual

Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331

BelWeen sep 2007 and Jan 2008 yourcrodilllrnlllhlgh baJanoe wallS700

Hourly 13~75 BOO 11000 Federal 5004 21574 Hourly 5150 B50 43775 Fica Ret 3396 3396

Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs

Fed S 0 00 StaIB SO 00

UtahState loeIDapl Daposlt Dale Deposit Amount UNIVERSITY

DPHASS 061001 43268

DIRECT DEPOSIT ADVICE NOT A CHECK DIRECT DEPOSIT ADVICE NOT A CHECK

Charles M Jones VOID DIRECT DEPOSIT ADVICE 1314 Wcsl400 South bullbull NON-NEGOTIABLE bullbull

Serendipity Utah 84464 AurnORIZED SIGNATVRES

Kellies Family

Parents John and Alice Roberts Anderson 1492 South 600 West Logan Utah 8432 I (435) 787-8515

Brother Steven Anderson (Melinda) 93 San Patricio Mission Viejo California 96661 (949) 831-0482

Sister Megan Cherie Major (Ryan) 932 St Olaf Way Pnrtland Oregon 94531 (614) 932-9401

Uncle Steven Roberts (Sarah) 58 Taste ofHeaven Drive Serendipity Utah 84464 (435)898-5821

Uncle Karl Roberts (unmarried) 45 West Milldale Blvd San Antonio Texas (456) 349-3928

Aunt Katluyn Jackson (Melvin) 394 Albatross Way Oceanside California 94503 (617) 942-0384

Charles Family

Charles Mother Jessie Jones (John - deceased) Serendipity Utah (435) 898-8274

Brother Peter Jones (Melissa) 49 Cinnamon Drive Phoeniz Arizona (813) 4831

Sister Annabelle Jones Murphy (Phillip) 8321 South 300 East Pocatello Idaho 82931 (934) 483-3920

Uncle Eugene Jones 945 Majestic Meadows Way Serendipity Utah 84464 (765) 898-3948









Credit Cards






RCWiIley Acc 2112534530 1-877-315-0183 801-774-2840

2008

2009

2010

20ll

2012 -

















~

Date J~jr I 2C()r










































Account














SOLD TO SHIPTgt


11111111111111111111111111111111111111111111111111111111111111





_ cmiddot










9900

For Tax Year 2008




(435) 747-8320

For Tax Year 2007




(435) 747-8320

For Tax Year 2006




(435) 747-8320

For Tax Year 2005




(435) 747-8320

For Tax Year 2004




(435) 747-8320





















(Lessor) Date

(Lessor) Date

(Lessee) Date

(Lessee) Date




Kellie A Jones

1314 West 400 South



July 21 2005












Commissioner















2

bull bull












1972 $ 107 $ 107 1990 $ 15652 $ 15652 1973 0 0 1991 22389 22389 ]97 0 0 1992 21288 23288 1975 1831 1831 1993 2030 2lt1lt130 1976 1880 1880 ]99 2j761 25761 1977 2311 2313 199j 27511 27511 1978 299 299 1996 3]Ast 31Ast 1979 1991 1991 1997 3716 3-1716

]998 3795 3795 1980 7093 7093 1999 3766 3766 1981 13A89 ]389]982 9A90 990 2000 38732 38732 1983 0 0 2001 6059 6059 19amp1 0 0 2002 513H 5133 1985 0 0 2003 9971 9971 1986 563 563 20M 8861 8861 1987 0 0 1988 1332 1332 1989 236 236




3

Q7210SR 09Al 0277J2

























III





Account Number









1013





10DOO Account Total




Income 125 372 498 455 423 106 320 494 376 435Balanced 323 776 1238 1052 1163





Income $87524 SOoo SOOO $000 $1091 $88615






2 of 3












Free seminars





STATE AND SCHOOL

Month Salary

JANUARY 412500

FEBRUARY 412500

MARCH 412500

APRIL 412500

MAY 412500

JUNE 412500

JULY 431100

AUGUST 431100

SEPTEMBER 448600

OCTOBER 436933

NOVEMBER 436933

DECEMBER 436933










6 at age 70 10 al age 62 20 a age 55



Formula 125 to 6130f75 200 71f75to


25 [0 20 yrs 2 ovcr 20

50 [0 10 yrs 225 to 20 yr5





Iligholsi 5 years

Highest J years

Highesl J years

rlighesl J yeilrs

Highest 2 years

NfA






aY 212J1200~


Fica Med 794 794 UT HH 2313 868a

54775

11507 34452Totals


DPHASS

Deposit Dale

061007

Deposit Amount







VOID


$636










S15OOO $12800

S10600

$8400

$6200

$4000





91760 51554870

----------------------shy



$2000 $7600

$7200

$800

$400 $0








CHARLES M JONES










Income





2000 2000

2000 4000

Ongoing



761 1000 1000

65359047 44821061)

70739284 48155632

515917378 26998195

S15746012 26998114

5104428 l2HI26

5111387 130012




(continuedj

0f 5


2007-2008







I Year






RETIREMENT BENEFITS















Annual Lele


Holidays




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull


Experian - Printable Full Report Page 1 of8


A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268












Credit Cards






RCWiIley Acc 2112534530 1-877-315-0183 801-774-2840

2008

2009

2010

20ll

2012 -

















~

Date J~jr I 2C()r










































Account














SOLD TO SHIPTgt


11111111111111111111111111111111111111111111111111111111111111





_ cmiddot










9900

For Tax Year 2008




(435) 747-8320

For Tax Year 2007




(435) 747-8320

For Tax Year 2006




(435) 747-8320

For Tax Year 2005




(435) 747-8320

For Tax Year 2004




(435) 747-8320





















(Lessor) Date

(Lessor) Date

(Lessee) Date

(Lessee) Date




Kellie A Jones

1314 West 400 South



July 21 2005












Commissioner















2

bull bull












1972 $ 107 $ 107 1990 $ 15652 $ 15652 1973 0 0 1991 22389 22389 ]97 0 0 1992 21288 23288 1975 1831 1831 1993 2030 2lt1lt130 1976 1880 1880 ]99 2j761 25761 1977 2311 2313 199j 27511 27511 1978 299 299 1996 3]Ast 31Ast 1979 1991 1991 1997 3716 3-1716

]998 3795 3795 1980 7093 7093 1999 3766 3766 1981 13A89 ]389]982 9A90 990 2000 38732 38732 1983 0 0 2001 6059 6059 19amp1 0 0 2002 513H 5133 1985 0 0 2003 9971 9971 1986 563 563 20M 8861 8861 1987 0 0 1988 1332 1332 1989 236 236




3

Q7210SR 09Al 0277J2

























III





Account Number









1013





10DOO Account Total




Income 125 372 498 455 423 106 320 494 376 435Balanced 323 776 1238 1052 1163





Income $87524 SOoo SOOO $000 $1091 $88615






2 of 3












Free seminars





STATE AND SCHOOL

Month Salary

JANUARY 412500

FEBRUARY 412500

MARCH 412500

APRIL 412500

MAY 412500

JUNE 412500

JULY 431100

AUGUST 431100

SEPTEMBER 448600

OCTOBER 436933

NOVEMBER 436933

DECEMBER 436933










6 at age 70 10 al age 62 20 a age 55



Formula 125 to 6130f75 200 71f75to


25 [0 20 yrs 2 ovcr 20

50 [0 10 yrs 225 to 20 yr5





Iligholsi 5 years

Highest J years

Highesl J years

rlighesl J yeilrs

Highest 2 years

NfA






aY 212J1200~


Fica Med 794 794 UT HH 2313 868a

54775

11507 34452Totals


DPHASS

Deposit Dale

061007

Deposit Amount







VOID


$636










S15OOO $12800

S10600

$8400

$6200

$4000





91760 51554870

----------------------shy



$2000 $7600

$7200

$800

$400 $0








CHARLES M JONES










Income





2000 2000

2000 4000

Ongoing



761 1000 1000

65359047 44821061)

70739284 48155632

515917378 26998195

S15746012 26998114

5104428 l2HI26

5111387 130012




(continuedj

Page 20f 5


2007-2008







I Year






RETIREMENT BENEFITS















Annual Lele


Holidays




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268




2008

2009

2010

20ll

2012 -

















~

Date J~jr I 2C()r










































Account














SOLD TO SHIPTgt


11111111111111111111111111111111111111111111111111111111111111





_ cmiddot










9900

For Tax Year 2008




(435) 747-8320

For Tax Year 2007




(435) 747-8320

For Tax Year 2006




(435) 747-8320

For Tax Year 2005




(435) 747-8320

For Tax Year 2004




(435) 747-8320





















(Lessor) Date

(Lessor) Date

(Lessee) Date

(Lessee) Date




Kellie A Jones

1314 West 400 South



July 21 2005












Commissioner















2

bull bull












1972 $ 107 $ 107 1990 $ 15652 $ 15652 1973 0 0 1991 22389 22389 ]97 0 0 1992 21288 23288 1975 1831 1831 1993 2030 2lt1lt130 1976 1880 1880 ]99 2j761 25761 1977 2311 2313 199j 27511 27511 1978 299 299 1996 3]Ast 31Ast 1979 1991 1991 1997 3716 3-1716

]998 3795 3795 1980 7093 7093 1999 3766 3766 1981 13A89 ]389]982 9A90 990 2000 38732 38732 1983 0 0 2001 6059 6059 19amp1 0 0 2002 513H 5133 1985 0 0 2003 9971 9971 1986 563 563 20M 8861 8861 1987 0 0 1988 1332 1332 1989 236 236




3

Q7210SR 09Al 0277J2

























III





Account Number









1013





10DOO Account Total




Income 125 372 498 455 423 106 320 494 376 435Balanced 323 776 1238 1052 1163





Income $87524 SOoo SOOO $000 $1091 $88615






2 of 3












Free seminars





STATE AND SCHOOL

Month Salary

JANUARY 412500

FEBRUARY 412500

MARCH 412500

APRIL 412500

MAY 412500

JUNE 412500

JULY 431100

AUGUST 431100

SEPTEMBER 448600

OCTOBER 436933

NOVEMBER 436933

DECEMBER 436933










6 at age 70 10 al age 62 20 a age 55



Formula 125 to 6130f75 200 71f75to


25 [0 20 yrs 2 ovcr 20

50 [0 10 yrs 225 to 20 yr5





Iligholsi 5 years

Highest J years

Highesl J years

rlighesl J yeilrs

Highest 2 years

NfA






aY 212J1200~


Fica Med 794 794 UT HH 2313 868a

54775

11507 34452Totals


DPHASS

Deposit Dale

061007

Deposit Amount







VOID


$636










S15OOO $12800

S10600

$8400

$6200

$4000





91760 51554870

----------------------shy



$2000 $7600

$7200

$800

$400 $0








CHARLES M JONES










Income





2000 2000

2000 4000

Ongoing



761 1000 1000

65359047 44821061)

70739284 48155632

515917378 26998195

S15746012 26998114

5104428 l2HI26

5111387 130012




(continuedj

Page 20f 5


2007-2008







I Year






RETIREMENT BENEFITS















Annual Lele


Holidays




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268














~

Date J~jr I 2C()r










































Account














SOLD TO SHIPTgt


11111111111111111111111111111111111111111111111111111111111111





_ cmiddot










9900

For Tax Year 2008




(435) 747-8320

For Tax Year 2007




(435) 747-8320

For Tax Year 2006




(435) 747-8320

For Tax Year 2005




(435) 747-8320

For Tax Year 2004




(435) 747-8320





















(Lessor) Date

(Lessor) Date

(Lessee) Date

(Lessee) Date




Kellie A Jones

1314 West 400 South



July 21 2005












Commissioner















2

bull bull












1972 $ 107 $ 107 1990 $ 15652 $ 15652 1973 0 0 1991 22389 22389 ]97 0 0 1992 21288 23288 1975 1831 1831 1993 2030 2lt1lt130 1976 1880 1880 ]99 2j761 25761 1977 2311 2313 199j 27511 27511 1978 299 299 1996 3]Ast 31Ast 1979 1991 1991 1997 3716 3-1716

]998 3795 3795 1980 7093 7093 1999 3766 3766 1981 13A89 ]389]982 9A90 990 2000 38732 38732 1983 0 0 2001 6059 6059 19amp1 0 0 2002 513H 5133 1985 0 0 2003 9971 9971 1986 563 563 20M 8861 8861 1987 0 0 1988 1332 1332 1989 236 236




3

Q7210SR 09Al 0277J2

























III





Account Number









1013





10DOO Account Total




Income 125 372 498 455 423 106 320 494 376 435Balanced 323 776 1238 1052 1163





Income $87524 SOoo SOOO $000 $1091 $88615






2 of 3












Free seminars





STATE AND SCHOOL

Month Salary

JANUARY 412500

FEBRUARY 412500

MARCH 412500

APRIL 412500

MAY 412500

JUNE 412500

JULY 431100

AUGUST 431100

SEPTEMBER 448600

OCTOBER 436933

NOVEMBER 436933

DECEMBER 436933










6 at age 70 10 al age 62 20 a age 55



Formula 125 to 6130f75 200 71f75to


25 [0 20 yrs 2 ovcr 20

50 [0 10 yrs 225 to 20 yr5





Iligholsi 5 years

Highest J years

Highesl J years

rlighesl J yeilrs

Highest 2 years

NfA






aY 212J1200~


Fica Med 794 794 UT HH 2313 868a

54775

11507 34452Totals


DPHASS

Deposit Dale

061007

Deposit Amount







VOID


$636










S15OOO $12800

S10600

$8400

$6200

$4000





91760 51554870

----------------------shy



$2000 $7600

$7200

$800

$400 $0








CHARLES M JONES










Income





2000 2000

2000 4000

Ongoing



761 1000 1000

65359047 44821061)

70739284 48155632

515917378 26998195

S15746012 26998114

5104428 l2HI26

5111387 130012




(continuedj

Page 20f 5


2007-2008







I Year






RETIREMENT BENEFITS















Annual Lele


Holidays




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268












































Account














SOLD TO SHIPTgt


11111111111111111111111111111111111111111111111111111111111111





_ cmiddot










9900

For Tax Year 2008




(435) 747-8320

For Tax Year 2007




(435) 747-8320

For Tax Year 2006




(435) 747-8320

For Tax Year 2005




(435) 747-8320

For Tax Year 2004




(435) 747-8320





















(Lessor) Date

(Lessor) Date

(Lessee) Date

(Lessee) Date




Kellie A Jones

1314 West 400 South



July 21 2005












Commissioner















2

bull bull












1972 $ 107 $ 107 1990 $ 15652 $ 15652 1973 0 0 1991 22389 22389 ]97 0 0 1992 21288 23288 1975 1831 1831 1993 2030 2lt1lt130 1976 1880 1880 ]99 2j761 25761 1977 2311 2313 199j 27511 27511 1978 299 299 1996 3]Ast 31Ast 1979 1991 1991 1997 3716 3-1716

]998 3795 3795 1980 7093 7093 1999 3766 3766 1981 13A89 ]389]982 9A90 990 2000 38732 38732 1983 0 0 2001 6059 6059 19amp1 0 0 2002 513H 5133 1985 0 0 2003 9971 9971 1986 563 563 20M 8861 8861 1987 0 0 1988 1332 1332 1989 236 236




3

Q7210SR 09Al 0277J2

























III





Account Number









1013





10DOO Account Total




Income 125 372 498 455 423 106 320 494 376 435Balanced 323 776 1238 1052 1163





Income $87524 SOoo SOOO $000 $1091 $88615






2 of 3












Free seminars





STATE AND SCHOOL

Month Salary

JANUARY 412500

FEBRUARY 412500

MARCH 412500

APRIL 412500

MAY 412500

JUNE 412500

JULY 431100

AUGUST 431100

SEPTEMBER 448600

OCTOBER 436933

NOVEMBER 436933

DECEMBER 436933










6 at age 70 10 al age 62 20 a age 55



Formula 125 to 6130f75 200 71f75to


25 [0 20 yrs 2 ovcr 20

50 [0 10 yrs 225 to 20 yr5





Iligholsi 5 years

Highest J years

Highesl J years

rlighesl J yeilrs

Highest 2 years

NfA






aY 212J1200~


Fica Med 794 794 UT HH 2313 868a

54775

11507 34452Totals


DPHASS

Deposit Dale

061007

Deposit Amount







VOID


$636










S15OOO $12800

S10600

$8400

$6200

$4000





91760 51554870

----------------------shy



$2000 $7600

$7200

$800

$400 $0








CHARLES M JONES










Income





2000 2000

2000 4000

Ongoing



761 1000 1000

65359047 44821061)

70739284 48155632

515917378 26998195

S15746012 26998114

5104428 l2HI26

5111387 130012




(continuedj

Page 20f 5


2007-2008







I Year






RETIREMENT BENEFITS















Annual Lele


Holidays




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268








SOLD TO SHIPTgt


11111111111111111111111111111111111111111111111111111111111111





_ cmiddot










9900

For Tax Year 2008




(435) 747-8320

For Tax Year 2007




(435) 747-8320

For Tax Year 2006




(435) 747-8320

For Tax Year 2005




(435) 747-8320

For Tax Year 2004




(435) 747-8320





















(Lessor) Date

(Lessor) Date

(Lessee) Date

(Lessee) Date




Kellie A Jones

1314 West 400 South



July 21 2005












Commissioner















2

bull bull












1972 $ 107 $ 107 1990 $ 15652 $ 15652 1973 0 0 1991 22389 22389 ]97 0 0 1992 21288 23288 1975 1831 1831 1993 2030 2lt1lt130 1976 1880 1880 ]99 2j761 25761 1977 2311 2313 199j 27511 27511 1978 299 299 1996 3]Ast 31Ast 1979 1991 1991 1997 3716 3-1716

]998 3795 3795 1980 7093 7093 1999 3766 3766 1981 13A89 ]389]982 9A90 990 2000 38732 38732 1983 0 0 2001 6059 6059 19amp1 0 0 2002 513H 5133 1985 0 0 2003 9971 9971 1986 563 563 20M 8861 8861 1987 0 0 1988 1332 1332 1989 236 236




3

Q7210SR 09Al 0277J2

























III





Account Number









1013





10DOO Account Total




Income 125 372 498 455 423 106 320 494 376 435Balanced 323 776 1238 1052 1163





Income $87524 SOoo SOOO $000 $1091 $88615






2 of 3












Free seminars





STATE AND SCHOOL

Month Salary

JANUARY 412500

FEBRUARY 412500

MARCH 412500

APRIL 412500

MAY 412500

JUNE 412500

JULY 431100

AUGUST 431100

SEPTEMBER 448600

OCTOBER 436933

NOVEMBER 436933

DECEMBER 436933










6 at age 70 10 al age 62 20 a age 55



Formula 125 to 6130f75 200 71f75to


25 [0 20 yrs 2 ovcr 20

50 [0 10 yrs 225 to 20 yr5





Iligholsi 5 years

Highest J years

Highesl J years

rlighesl J yeilrs

Highest 2 years

NfA






aY 212J1200~


Fica Med 794 794 UT HH 2313 868a

54775

11507 34452Totals


DPHASS

Deposit Dale

061007

Deposit Amount







VOID


$636










S15OOO $12800

S10600

$8400

$6200

$4000





91760 51554870

----------------------shy



$2000 $7600

$7200

$800

$400 $0








CHARLES M JONES










Income





2000 2000

2000 4000

Ongoing



761 1000 1000

65359047 44821061)

70739284 48155632

515917378 26998195

S15746012 26998114

5104428 l2HI26

5111387 130012




(continuedj

Page 20f 5


2007-2008







I Year






RETIREMENT BENEFITS















Annual Lele


Holidays




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268




For Tax Year 2008




(435) 747-8320

For Tax Year 2007




(435) 747-8320

For Tax Year 2006




(435) 747-8320

For Tax Year 2005




(435) 747-8320

For Tax Year 2004




(435) 747-8320





















(Lessor) Date

(Lessor) Date

(Lessee) Date

(Lessee) Date




Kellie A Jones

1314 West 400 South



July 21 2005












Commissioner















2

bull bull












1972 $ 107 $ 107 1990 $ 15652 $ 15652 1973 0 0 1991 22389 22389 ]97 0 0 1992 21288 23288 1975 1831 1831 1993 2030 2lt1lt130 1976 1880 1880 ]99 2j761 25761 1977 2311 2313 199j 27511 27511 1978 299 299 1996 3]Ast 31Ast 1979 1991 1991 1997 3716 3-1716

]998 3795 3795 1980 7093 7093 1999 3766 3766 1981 13A89 ]389]982 9A90 990 2000 38732 38732 1983 0 0 2001 6059 6059 19amp1 0 0 2002 513H 5133 1985 0 0 2003 9971 9971 1986 563 563 20M 8861 8861 1987 0 0 1988 1332 1332 1989 236 236




3

Q7210SR 09Al 0277J2

























III





Account Number









1013





10DOO Account Total




Income 125 372 498 455 423 106 320 494 376 435Balanced 323 776 1238 1052 1163





Income $87524 SOoo SOOO $000 $1091 $88615






2 of 3












Free seminars





STATE AND SCHOOL

Month Salary

JANUARY 412500

FEBRUARY 412500

MARCH 412500

APRIL 412500

MAY 412500

JUNE 412500

JULY 431100

AUGUST 431100

SEPTEMBER 448600

OCTOBER 436933

NOVEMBER 436933

DECEMBER 436933










6 at age 70 10 al age 62 20 a age 55



Formula 125 to 6130f75 200 71f75to


25 [0 20 yrs 2 ovcr 20

50 [0 10 yrs 225 to 20 yr5





Iligholsi 5 years

Highest J years

Highesl J years

rlighesl J yeilrs

Highest 2 years

NfA






aY 212J1200~


Fica Med 794 794 UT HH 2313 868a

54775

11507 34452Totals


DPHASS

Deposit Dale

061007

Deposit Amount







VOID


$636










S15OOO $12800

S10600

$8400

$6200

$4000





91760 51554870

----------------------shy



$2000 $7600

$7200

$800

$400 $0








CHARLES M JONES










Income





2000 2000

2000 4000

Ongoing



761 1000 1000

65359047 44821061)

70739284 48155632

515917378 26998195

S15746012 26998114

5104428 l2HI26

5111387 130012




(continuedj

Page 20f 5


2007-2008







I Year






RETIREMENT BENEFITS















Annual Lele


Holidays




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268




For Tax Year 2007




(435) 747-8320

For Tax Year 2006




(435) 747-8320

For Tax Year 2005




(435) 747-8320

For Tax Year 2004




(435) 747-8320





















(Lessor) Date

(Lessor) Date

(Lessee) Date

(Lessee) Date




Kellie A Jones

1314 West 400 South



July 21 2005












Commissioner















2

bull bull












1972 $ 107 $ 107 1990 $ 15652 $ 15652 1973 0 0 1991 22389 22389 ]97 0 0 1992 21288 23288 1975 1831 1831 1993 2030 2lt1lt130 1976 1880 1880 ]99 2j761 25761 1977 2311 2313 199j 27511 27511 1978 299 299 1996 3]Ast 31Ast 1979 1991 1991 1997 3716 3-1716

]998 3795 3795 1980 7093 7093 1999 3766 3766 1981 13A89 ]389]982 9A90 990 2000 38732 38732 1983 0 0 2001 6059 6059 19amp1 0 0 2002 513H 5133 1985 0 0 2003 9971 9971 1986 563 563 20M 8861 8861 1987 0 0 1988 1332 1332 1989 236 236




3

Q7210SR 09Al 0277J2

























III





Account Number









1013





10DOO Account Total




Income 125 372 498 455 423 106 320 494 376 435Balanced 323 776 1238 1052 1163





Income $87524 SOoo SOOO $000 $1091 $88615






2 of 3












Free seminars





STATE AND SCHOOL

Month Salary

JANUARY 412500

FEBRUARY 412500

MARCH 412500

APRIL 412500

MAY 412500

JUNE 412500

JULY 431100

AUGUST 431100

SEPTEMBER 448600

OCTOBER 436933

NOVEMBER 436933

DECEMBER 436933










6 at age 70 10 al age 62 20 a age 55



Formula 125 to 6130f75 200 71f75to


25 [0 20 yrs 2 ovcr 20

50 [0 10 yrs 225 to 20 yr5





Iligholsi 5 years

Highest J years

Highesl J years

rlighesl J yeilrs

Highest 2 years

NfA






aY 212J1200~


Fica Med 794 794 UT HH 2313 868a

54775

11507 34452Totals


DPHASS

Deposit Dale

061007

Deposit Amount







VOID


$636










S15OOO $12800

S10600

$8400

$6200

$4000





91760 51554870

----------------------shy



$2000 $7600

$7200

$800

$400 $0








CHARLES M JONES










Income





2000 2000

2000 4000

Ongoing



761 1000 1000

65359047 44821061)

70739284 48155632

515917378 26998195

S15746012 26998114

5104428 l2HI26

5111387 130012




(continuedj

Page 20f 5


2007-2008







I Year






RETIREMENT BENEFITS















Annual Lele


Holidays




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268




For Tax Year 2006




(435) 747-8320

For Tax Year 2005




(435) 747-8320

For Tax Year 2004




(435) 747-8320





















(Lessor) Date

(Lessor) Date

(Lessee) Date

(Lessee) Date




Kellie A Jones

1314 West 400 South



July 21 2005












Commissioner















2

bull bull












1972 $ 107 $ 107 1990 $ 15652 $ 15652 1973 0 0 1991 22389 22389 ]97 0 0 1992 21288 23288 1975 1831 1831 1993 2030 2lt1lt130 1976 1880 1880 ]99 2j761 25761 1977 2311 2313 199j 27511 27511 1978 299 299 1996 3]Ast 31Ast 1979 1991 1991 1997 3716 3-1716

]998 3795 3795 1980 7093 7093 1999 3766 3766 1981 13A89 ]389]982 9A90 990 2000 38732 38732 1983 0 0 2001 6059 6059 19amp1 0 0 2002 513H 5133 1985 0 0 2003 9971 9971 1986 563 563 20M 8861 8861 1987 0 0 1988 1332 1332 1989 236 236




3

Q7210SR 09Al 0277J2

























III





Account Number









1013





10DOO Account Total




Income 125 372 498 455 423 106 320 494 376 435Balanced 323 776 1238 1052 1163





Income $87524 SOoo SOOO $000 $1091 $88615






2 of 3












Free seminars





STATE AND SCHOOL

Month Salary

JANUARY 412500

FEBRUARY 412500

MARCH 412500

APRIL 412500

MAY 412500

JUNE 412500

JULY 431100

AUGUST 431100

SEPTEMBER 448600

OCTOBER 436933

NOVEMBER 436933

DECEMBER 436933










6 at age 70 10 al age 62 20 a age 55



Formula 125 to 6130f75 200 71f75to


25 [0 20 yrs 2 ovcr 20

50 [0 10 yrs 225 to 20 yr5





Iligholsi 5 years

Highest J years

Highesl J years

rlighesl J yeilrs

Highest 2 years

NfA






aY 212J1200~


Fica Med 794 794 UT HH 2313 868a

54775

11507 34452Totals


DPHASS

Deposit Dale

061007

Deposit Amount







VOID


$636










S15OOO $12800

S10600

$8400

$6200

$4000





91760 51554870

----------------------shy



$2000 $7600

$7200

$800

$400 $0








CHARLES M JONES










Income





2000 2000

2000 4000

Ongoing



761 1000 1000

65359047 44821061)

70739284 48155632

515917378 26998195

S15746012 26998114

5104428 l2HI26

5111387 130012




(continuedj

Page 20f 5


2007-2008







I Year






RETIREMENT BENEFITS















Annual Lele


Holidays




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268




For Tax Year 2005




(435) 747-8320

For Tax Year 2004




(435) 747-8320





















(Lessor) Date

(Lessor) Date

(Lessee) Date

(Lessee) Date




Kellie A Jones

1314 West 400 South



July 21 2005












Commissioner















2

bull bull












1972 $ 107 $ 107 1990 $ 15652 $ 15652 1973 0 0 1991 22389 22389 ]97 0 0 1992 21288 23288 1975 1831 1831 1993 2030 2lt1lt130 1976 1880 1880 ]99 2j761 25761 1977 2311 2313 199j 27511 27511 1978 299 299 1996 3]Ast 31Ast 1979 1991 1991 1997 3716 3-1716

]998 3795 3795 1980 7093 7093 1999 3766 3766 1981 13A89 ]389]982 9A90 990 2000 38732 38732 1983 0 0 2001 6059 6059 19amp1 0 0 2002 513H 5133 1985 0 0 2003 9971 9971 1986 563 563 20M 8861 8861 1987 0 0 1988 1332 1332 1989 236 236




3

Q7210SR 09Al 0277J2

























III





Account Number









1013





10DOO Account Total




Income 125 372 498 455 423 106 320 494 376 435Balanced 323 776 1238 1052 1163





Income $87524 SOoo SOOO $000 $1091 $88615






2 of 3












Free seminars





STATE AND SCHOOL

Month Salary

JANUARY 412500

FEBRUARY 412500

MARCH 412500

APRIL 412500

MAY 412500

JUNE 412500

JULY 431100

AUGUST 431100

SEPTEMBER 448600

OCTOBER 436933

NOVEMBER 436933

DECEMBER 436933










6 at age 70 10 al age 62 20 a age 55



Formula 125 to 6130f75 200 71f75to


25 [0 20 yrs 2 ovcr 20

50 [0 10 yrs 225 to 20 yr5





Iligholsi 5 years

Highest J years

Highesl J years

rlighesl J yeilrs

Highest 2 years

NfA






aY 212J1200~


Fica Med 794 794 UT HH 2313 868a

54775

11507 34452Totals


DPHASS

Deposit Dale

061007

Deposit Amount







VOID


$636










S15OOO $12800

S10600

$8400

$6200

$4000





91760 51554870

----------------------shy



$2000 $7600

$7200

$800

$400 $0








CHARLES M JONES










Income





2000 2000

2000 4000

Ongoing



761 1000 1000

65359047 44821061)

70739284 48155632

515917378 26998195

S15746012 26998114

5104428 l2HI26

5111387 130012




(continuedj

Page 20f 5


2007-2008







I Year






RETIREMENT BENEFITS















Annual Lele


Holidays




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268




For Tax Year 2004




(435) 747-8320





















(Lessor) Date

(Lessor) Date

(Lessee) Date

(Lessee) Date




Kellie A Jones

1314 West 400 South



July 21 2005












Commissioner















2

bull bull












1972 $ 107 $ 107 1990 $ 15652 $ 15652 1973 0 0 1991 22389 22389 ]97 0 0 1992 21288 23288 1975 1831 1831 1993 2030 2lt1lt130 1976 1880 1880 ]99 2j761 25761 1977 2311 2313 199j 27511 27511 1978 299 299 1996 3]Ast 31Ast 1979 1991 1991 1997 3716 3-1716

]998 3795 3795 1980 7093 7093 1999 3766 3766 1981 13A89 ]389]982 9A90 990 2000 38732 38732 1983 0 0 2001 6059 6059 19amp1 0 0 2002 513H 5133 1985 0 0 2003 9971 9971 1986 563 563 20M 8861 8861 1987 0 0 1988 1332 1332 1989 236 236




3

Q7210SR 09Al 0277J2

























III





Account Number









1013





10DOO Account Total




Income 125 372 498 455 423 106 320 494 376 435Balanced 323 776 1238 1052 1163





Income $87524 SOoo SOOO $000 $1091 $88615






2 of 3












Free seminars





STATE AND SCHOOL

Month Salary

JANUARY 412500

FEBRUARY 412500

MARCH 412500

APRIL 412500

MAY 412500

JUNE 412500

JULY 431100

AUGUST 431100

SEPTEMBER 448600

OCTOBER 436933

NOVEMBER 436933

DECEMBER 436933










6 at age 70 10 al age 62 20 a age 55



Formula 125 to 6130f75 200 71f75to


25 [0 20 yrs 2 ovcr 20

50 [0 10 yrs 225 to 20 yr5





Iligholsi 5 years

Highest J years

Highesl J years

rlighesl J yeilrs

Highest 2 years

NfA






aY 212J1200~


Fica Med 794 794 UT HH 2313 868a

54775

11507 34452Totals


DPHASS

Deposit Dale

061007

Deposit Amount







VOID


$636










S15OOO $12800

S10600

$8400

$6200

$4000





91760 51554870

----------------------shy



$2000 $7600

$7200

$800

$400 $0








CHARLES M JONES










Income





2000 2000

2000 4000

Ongoing



761 1000 1000

65359047 44821061)

70739284 48155632

515917378 26998195

S15746012 26998114

5104428 l2HI26

5111387 130012




(continuedj

Page 20f 5


2007-2008







I Year






RETIREMENT BENEFITS















Annual Lele


Holidays




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268
























(Lessor) Date

(Lessor) Date

(Lessee) Date

(Lessee) Date




Kellie A Jones

1314 West 400 South



July 21 2005












Commissioner















2

bull bull












1972 $ 107 $ 107 1990 $ 15652 $ 15652 1973 0 0 1991 22389 22389 ]97 0 0 1992 21288 23288 1975 1831 1831 1993 2030 2lt1lt130 1976 1880 1880 ]99 2j761 25761 1977 2311 2313 199j 27511 27511 1978 299 299 1996 3]Ast 31Ast 1979 1991 1991 1997 3716 3-1716

]998 3795 3795 1980 7093 7093 1999 3766 3766 1981 13A89 ]389]982 9A90 990 2000 38732 38732 1983 0 0 2001 6059 6059 19amp1 0 0 2002 513H 5133 1985 0 0 2003 9971 9971 1986 563 563 20M 8861 8861 1987 0 0 1988 1332 1332 1989 236 236




3

Q7210SR 09Al 0277J2

























III





Account Number









1013





10DOO Account Total




Income 125 372 498 455 423 106 320 494 376 435Balanced 323 776 1238 1052 1163





Income $87524 SOoo SOOO $000 $1091 $88615






2 of 3












Free seminars





STATE AND SCHOOL

Month Salary

JANUARY 412500

FEBRUARY 412500

MARCH 412500

APRIL 412500

MAY 412500

JUNE 412500

JULY 431100

AUGUST 431100

SEPTEMBER 448600

OCTOBER 436933

NOVEMBER 436933

DECEMBER 436933










6 at age 70 10 al age 62 20 a age 55



Formula 125 to 6130f75 200 71f75to


25 [0 20 yrs 2 ovcr 20

50 [0 10 yrs 225 to 20 yr5





Iligholsi 5 years

Highest J years

Highesl J years

rlighesl J yeilrs

Highest 2 years

NfA






aY 212J1200~


Fica Med 794 794 UT HH 2313 868a

54775

11507 34452Totals


DPHASS

Deposit Dale

061007

Deposit Amount







VOID


$636










S15OOO $12800

S10600

$8400

$6200

$4000





91760 51554870

----------------------shy



$2000 $7600

$7200

$800

$400 $0








CHARLES M JONES










Income





2000 2000

2000 4000

Ongoing



761 1000 1000

65359047 44821061)

70739284 48155632

515917378 26998195

S15746012 26998114

5104428 l2HI26

5111387 130012




(continuedj

Page 20f 5


2007-2008







I Year






RETIREMENT BENEFITS















Annual Lele


Holidays




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268







Kellie A Jones

1314 West 400 South



July 21 2005












Commissioner















2

bull bull












1972 $ 107 $ 107 1990 $ 15652 $ 15652 1973 0 0 1991 22389 22389 ]97 0 0 1992 21288 23288 1975 1831 1831 1993 2030 2lt1lt130 1976 1880 1880 ]99 2j761 25761 1977 2311 2313 199j 27511 27511 1978 299 299 1996 3]Ast 31Ast 1979 1991 1991 1997 3716 3-1716

]998 3795 3795 1980 7093 7093 1999 3766 3766 1981 13A89 ]389]982 9A90 990 2000 38732 38732 1983 0 0 2001 6059 6059 19amp1 0 0 2002 513H 5133 1985 0 0 2003 9971 9971 1986 563 563 20M 8861 8861 1987 0 0 1988 1332 1332 1989 236 236




3

Q7210SR 09Al 0277J2

























III





Account Number









1013





10DOO Account Total




Income 125 372 498 455 423 106 320 494 376 435Balanced 323 776 1238 1052 1163





Income $87524 SOoo SOOO $000 $1091 $88615






2 of 3












Free seminars





STATE AND SCHOOL

Month Salary

JANUARY 412500

FEBRUARY 412500

MARCH 412500

APRIL 412500

MAY 412500

JUNE 412500

JULY 431100

AUGUST 431100

SEPTEMBER 448600

OCTOBER 436933

NOVEMBER 436933

DECEMBER 436933










6 at age 70 10 al age 62 20 a age 55



Formula 125 to 6130f75 200 71f75to


25 [0 20 yrs 2 ovcr 20

50 [0 10 yrs 225 to 20 yr5





Iligholsi 5 years

Highest J years

Highesl J years

rlighesl J yeilrs

Highest 2 years

NfA






aY 212J1200~


Fica Med 794 794 UT HH 2313 868a

54775

11507 34452Totals


DPHASS

Deposit Dale

061007

Deposit Amount







VOID


$636










S15OOO $12800

S10600

$8400

$6200

$4000





91760 51554870

----------------------shy



$2000 $7600

$7200

$800

$400 $0








CHARLES M JONES










Income





2000 2000

2000 4000

Ongoing



761 1000 1000

65359047 44821061)

70739284 48155632

515917378 26998195

S15746012 26998114

5104428 l2HI26

5111387 130012




(continuedj

Page 20f 5


2007-2008







I Year






RETIREMENT BENEFITS















Annual Lele


Holidays




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268

















2

bull bull












1972 $ 107 $ 107 1990 $ 15652 $ 15652 1973 0 0 1991 22389 22389 ]97 0 0 1992 21288 23288 1975 1831 1831 1993 2030 2lt1lt130 1976 1880 1880 ]99 2j761 25761 1977 2311 2313 199j 27511 27511 1978 299 299 1996 3]Ast 31Ast 1979 1991 1991 1997 3716 3-1716

]998 3795 3795 1980 7093 7093 1999 3766 3766 1981 13A89 ]389]982 9A90 990 2000 38732 38732 1983 0 0 2001 6059 6059 19amp1 0 0 2002 513H 5133 1985 0 0 2003 9971 9971 1986 563 563 20M 8861 8861 1987 0 0 1988 1332 1332 1989 236 236




3

Q7210SR 09Al 0277J2

























III





Account Number









1013





10DOO Account Total




Income 125 372 498 455 423 106 320 494 376 435Balanced 323 776 1238 1052 1163





Income $87524 SOoo SOOO $000 $1091 $88615






2 of 3












Free seminars





STATE AND SCHOOL

Month Salary

JANUARY 412500

FEBRUARY 412500

MARCH 412500

APRIL 412500

MAY 412500

JUNE 412500

JULY 431100

AUGUST 431100

SEPTEMBER 448600

OCTOBER 436933

NOVEMBER 436933

DECEMBER 436933










6 at age 70 10 al age 62 20 a age 55



Formula 125 to 6130f75 200 71f75to


25 [0 20 yrs 2 ovcr 20

50 [0 10 yrs 225 to 20 yr5





Iligholsi 5 years

Highest J years

Highesl J years

rlighesl J yeilrs

Highest 2 years

NfA






aY 212J1200~


Fica Med 794 794 UT HH 2313 868a

54775

11507 34452Totals


DPHASS

Deposit Dale

061007

Deposit Amount







VOID


$636










S15OOO $12800

S10600

$8400

$6200

$4000





91760 51554870

----------------------shy



$2000 $7600

$7200

$800

$400 $0








CHARLES M JONES










Income





2000 2000

2000 4000

Ongoing



761 1000 1000

65359047 44821061)

70739284 48155632

515917378 26998195

S15746012 26998114

5104428 l2HI26

5111387 130012




(continuedj

Page 20f 5


2007-2008







I Year






RETIREMENT BENEFITS















Annual Lele


Holidays




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268




bull bull












1972 $ 107 $ 107 1990 $ 15652 $ 15652 1973 0 0 1991 22389 22389 ]97 0 0 1992 21288 23288 1975 1831 1831 1993 2030 2lt1lt130 1976 1880 1880 ]99 2j761 25761 1977 2311 2313 199j 27511 27511 1978 299 299 1996 3]Ast 31Ast 1979 1991 1991 1997 3716 3-1716

]998 3795 3795 1980 7093 7093 1999 3766 3766 1981 13A89 ]389]982 9A90 990 2000 38732 38732 1983 0 0 2001 6059 6059 19amp1 0 0 2002 513H 5133 1985 0 0 2003 9971 9971 1986 563 563 20M 8861 8861 1987 0 0 1988 1332 1332 1989 236 236




3

Q7210SR 09Al 0277J2

























III





Account Number









1013





10DOO Account Total




Income 125 372 498 455 423 106 320 494 376 435Balanced 323 776 1238 1052 1163





Income $87524 SOoo SOOO $000 $1091 $88615






2 of 3












Free seminars





STATE AND SCHOOL

Month Salary

JANUARY 412500

FEBRUARY 412500

MARCH 412500

APRIL 412500

MAY 412500

JUNE 412500

JULY 431100

AUGUST 431100

SEPTEMBER 448600

OCTOBER 436933

NOVEMBER 436933

DECEMBER 436933










6 at age 70 10 al age 62 20 a age 55



Formula 125 to 6130f75 200 71f75to


25 [0 20 yrs 2 ovcr 20

50 [0 10 yrs 225 to 20 yr5





Iligholsi 5 years

Highest J years

Highesl J years

rlighesl J yeilrs

Highest 2 years

NfA






aY 212J1200~


Fica Med 794 794 UT HH 2313 868a

54775

11507 34452Totals


DPHASS

Deposit Dale

061007

Deposit Amount







VOID


$636










S15OOO $12800

S10600

$8400

$6200

$4000





91760 51554870

----------------------shy



$2000 $7600

$7200

$800

$400 $0








CHARLES M JONES










Income





2000 2000

2000 4000

Ongoing



761 1000 1000

65359047 44821061)

70739284 48155632

515917378 26998195

S15746012 26998114

5104428 l2HI26

5111387 130012




(continuedj

Page 20f 5


2007-2008







I Year






RETIREMENT BENEFITS















Annual Lele


Holidays




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268




























III





Account Number









1013





10DOO Account Total




Income 125 372 498 455 423 106 320 494 376 435Balanced 323 776 1238 1052 1163





Income $87524 SOoo SOOO $000 $1091 $88615






2 of 3












Free seminars





STATE AND SCHOOL

Month Salary

JANUARY 412500

FEBRUARY 412500

MARCH 412500

APRIL 412500

MAY 412500

JUNE 412500

JULY 431100

AUGUST 431100

SEPTEMBER 448600

OCTOBER 436933

NOVEMBER 436933

DECEMBER 436933










6 at age 70 10 al age 62 20 a age 55



Formula 125 to 6130f75 200 71f75to


25 [0 20 yrs 2 ovcr 20

50 [0 10 yrs 225 to 20 yr5





Iligholsi 5 years

Highest J years

Highesl J years

rlighesl J yeilrs

Highest 2 years

NfA






aY 212J1200~


Fica Med 794 794 UT HH 2313 868a

54775

11507 34452Totals


DPHASS

Deposit Dale

061007

Deposit Amount







VOID


$636










S15OOO $12800

S10600

$8400

$6200

$4000





91760 51554870

----------------------shy



$2000 $7600

$7200

$800

$400 $0








CHARLES M JONES










Income





2000 2000

2000 4000

Ongoing



761 1000 1000

65359047 44821061)

70739284 48155632

515917378 26998195

S15746012 26998114

5104428 l2HI26

5111387 130012




(continuedj

f 5


2007-2008







I Year






RETIREMENT BENEFITS















Annual Lele


Holidays




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268








Account Number









1013





10DOO Account Total




Income 125 372 498 455 423 106 320 494 376 435Balanced 323 776 1238 1052 1163





Income $87524 SOoo SOOO $000 $1091 $88615






2 of 3












Free seminars





STATE AND SCHOOL

Month Salary

JANUARY 412500

FEBRUARY 412500

MARCH 412500

APRIL 412500

MAY 412500

JUNE 412500

JULY 431100

AUGUST 431100

SEPTEMBER 448600

OCTOBER 436933

NOVEMBER 436933

DECEMBER 436933










6 at age 70 10 al age 62 20 a age 55



Formula 125 to 6130f75 200 71f75to


25 [0 20 yrs 2 ovcr 20

50 [0 10 yrs 225 to 20 yr5





Iligholsi 5 years

Highest J years

Highesl J years

rlighesl J yeilrs

Highest 2 years

NfA






aY 212J1200~


Fica Med 794 794 UT HH 2313 868a

54775

11507 34452Totals


DPHASS

Deposit Dale

061007

Deposit Amount







VOID


$636










S15OOO $12800

S10600

$8400

$6200

$4000





91760 51554870

----------------------shy



$2000 $7600

$7200

$800

$400 $0








CHARLES M JONES










Income





2000 2000

2000 4000

Ongoing



761 1000 1000

65359047 44821061)

70739284 48155632

515917378 26998195

S15746012 26998114

5104428 l2HI26

5111387 130012




(continuedj

Page 20f 5


2007-2008







I Year






RETIREMENT BENEFITS















Annual Lele


Holidays




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268








10DOO Account Total




Income 125 372 498 455 423 106 320 494 376 435Balanced 323 776 1238 1052 1163





Income $87524 SOoo SOOO $000 $1091 $88615






2 of 3












Free seminars





STATE AND SCHOOL

Month Salary

JANUARY 412500

FEBRUARY 412500

MARCH 412500

APRIL 412500

MAY 412500

JUNE 412500

JULY 431100

AUGUST 431100

SEPTEMBER 448600

OCTOBER 436933

NOVEMBER 436933

DECEMBER 436933










6 at age 70 10 al age 62 20 a age 55



Formula 125 to 6130f75 200 71f75to


25 [0 20 yrs 2 ovcr 20

50 [0 10 yrs 225 to 20 yr5





Iligholsi 5 years

Highest J years

Highesl J years

rlighesl J yeilrs

Highest 2 years

NfA






aY 212J1200~


Fica Med 794 794 UT HH 2313 868a

54775

11507 34452Totals


DPHASS

Deposit Dale

061007

Deposit Amount







VOID


$636










S15OOO $12800

S10600

$8400

$6200

$4000





91760 51554870

----------------------shy



$2000 $7600

$7200

$800

$400 $0








CHARLES M JONES










Income





2000 2000

2000 4000

Ongoing



761 1000 1000

65359047 44821061)

70739284 48155632

515917378 26998195

S15746012 26998114

5104428 l2HI26

5111387 130012




(continuedj

Page 20f 5


2007-2008







I Year






RETIREMENT BENEFITS















Annual Lele


Holidays




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268















Free seminars





STATE AND SCHOOL

Month Salary

JANUARY 412500

FEBRUARY 412500

MARCH 412500

APRIL 412500

MAY 412500

JUNE 412500

JULY 431100

AUGUST 431100

SEPTEMBER 448600

OCTOBER 436933

NOVEMBER 436933

DECEMBER 436933










6 at age 70 10 al age 62 20 a age 55



Formula 125 to 6130f75 200 71f75to


25 [0 20 yrs 2 ovcr 20

50 [0 10 yrs 225 to 20 yr5





Iligholsi 5 years

Highest J years

Highesl J years

rlighesl J yeilrs

Highest 2 years

NfA






aY 212J1200~


Fica Med 794 794 UT HH 2313 868a

54775

11507 34452Totals


DPHASS

Deposit Dale

061007

Deposit Amount







VOID


$636










S15OOO $12800

S10600

$8400

$6200

$4000





91760 51554870

----------------------shy



$2000 $7600

$7200

$800

$400 $0








CHARLES M JONES










Income





2000 2000

2000 4000

Ongoing



761 1000 1000

65359047 44821061)

70739284 48155632

515917378 26998195

S15746012 26998114

5104428 l2HI26

5111387 130012




(continuedj

Page 20f 5


2007-2008







I Year






RETIREMENT BENEFITS















Annual Lele


Holidays




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268











6 at age 70 10 al age 62 20 a age 55



Formula 125 to 6130f75 200 71f75to


25 [0 20 yrs 2 ovcr 20

50 [0 10 yrs 225 to 20 yr5





Iligholsi 5 years

Highest J years

Highesl J years

rlighesl J yeilrs

Highest 2 years

NfA






aY 212J1200~


Fica Med 794 794 UT HH 2313 868a

54775

11507 34452Totals


DPHASS

Deposit Dale

061007

Deposit Amount







VOID


$636










S15OOO $12800

S10600

$8400

$6200

$4000





91760 51554870

----------------------shy



$2000 $7600

$7200

$800

$400 $0








CHARLES M JONES










Income





2000 2000

2000 4000

Ongoing



761 1000 1000

65359047 44821061)

70739284 48155632

515917378 26998195

S15746012 26998114

5104428 l2HI26

5111387 130012




(continuedj

Page 20f 5


2007-2008







I Year






RETIREMENT BENEFITS















Annual Lele


Holidays




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268





Fica Med 794 794 UT HH 2313 868a

54775

11507 34452Totals


DPHASS

Deposit Dale

061007

Deposit Amount







VOID


$636










S15OOO $12800

S10600

$8400

$6200

$4000





91760 51554870

----------------------shy



$2000 $7600

$7200

$800

$400 $0








CHARLES M JONES










Income





2000 2000

2000 4000

Ongoing



761 1000 1000

65359047 44821061)

70739284 48155632

515917378 26998195

S15746012 26998114

5104428 l2HI26

5111387 130012




(continuedj

Page 20f 5


2007-2008







I Year






RETIREMENT BENEFITS















Annual Lele


Holidays




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268




$636










S15OOO $12800

S10600

$8400

$6200

$4000





91760 51554870

----------------------shy



$2000 $7600

$7200

$800

$400 $0








CHARLES M JONES










Income





2000 2000

2000 4000

Ongoing



761 1000 1000

65359047 44821061)

70739284 48155632

515917378 26998195

S15746012 26998114

5104428 l2HI26

5111387 130012




(continuedj

Page 20f 5


2007-2008







I Year






RETIREMENT BENEFITS















Annual Lele


Holidays




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268





CHARLES M JONES










Income





2000 2000

2000 4000

Ongoing



761 1000 1000

65359047 44821061)

70739284 48155632

515917378 26998195

S15746012 26998114

5104428 l2HI26

5111387 130012




(continuedj

Page 20f 5


2007-2008







I Year






RETIREMENT BENEFITS















Annual Lele


Holidays




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268





2007-2008







I Year






RETIREMENT BENEFITS















Annual Lele


Holidays




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268













Annual Lele


Holidays




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268




- ~ -






Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268









Gie 1M -



~

10110 - _bull ---shy -shy-shy - --~_-


-


(q CV conjugale _




Vorlcolla (eg V~

MMRV) Gimiddotc SC





Othor





















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268


















Zo~r(Zos)Oie Sc


-

Othor

Othor





patienl













S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268















S91-123 WYE 9 30 OZ 2 Os 07 DCP






Olhor






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268






Vaccine Typo of




lol Mfr




vaccinator

01_ ITADce

~ na mw





PCV 60205 F

PCV 30206

IPl

IPl

PI

PI

OfK

9fK

95

Wl

Wle-Wle

3002 2 0705 DCP

93002 10205 DCP

93002 60205 DLW

J3002 30206 ltLV






~



Olhor







bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268




bullbullbullbull




A world of Insight




- P~[ lnformalOO


0610412008 -~tjLlsect

- KngN your rights










Balanco HlstolY 0112008 $285 1212007 $358 1112007 $307 1012007 $314 0912007 $331



Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268





Fica Med 794 794 UT WH 2313 8688

54775

11507 34452TotsJs



DPHASS 061001 43268




Personal Directory - Utah State University Extension · Washington Mutual Account Number: 630 20938...

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Transcript of Personal Directory - Utah State University Extension · Washington Mutual Account Number: 630 20938...