Loading...
HomeMy WebLinkAbout08-06-09 ~ ~ 1505607121 REV-1500 EX UH-05 ( ) PA DeperlmeM d Revenue OFFICIAL UBE ONLY Bureau d Individual Taxes Coudy Code Year File Number PDBOx211osot INHERITANCE TAX RETURN Haaisbure. PA 17128-0607 RESIDENT DECEDENT 2 1 0 8 0 9 8 1 ENTER DECEDENT INFORMATION BELOW Sodal Securry Number Date of Death Date of Birth 1 7 0 1 8 9 7 3 6 0 8 2 8 2 0 0 8 1 2 0 9 1 9 2 2 Decedent's Last Name Suffix Decedents First Name MI J O N E S O L I V E R H (N Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Sodal Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® t. Original Retum ~ 2. Supplemental Retum ~ 3. Remainder Realm (date of death pnorto 12-13-82) 4. IJmited Estate ~ qa. Future Interest Compromise (date of ~ 5. Fetlerel Estate Tax Relm Required death after 12-12-82) ® 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of vwl0 (Attach Copy of Trust) 9. Li0ga0on Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Eledion to fax under Sec. 9113(A) between 12-31-91 and 1-1-95) (ABadt Sch. O) CORRESPONDENT - THIS SECTIDN MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFH7ENTULL TAX INFORMATION SHOULD BE DH2ECTED T0: Name Dayfime Telephone Number R O G E R 8 I R W I N E S Q U I R E 7 1 7 2 4 9N2 3 5 3 Finn Name (If Applicable) `;' _ RE ~ OF WILCffDSE O)IL'Y',. ~-; I R W I N 8 M c K N I G H T P C '~ c - `~ r-,-o First Ilne of aAArra¢e ~ r~= n ~ 6 0 W E S T Second line of address Ciry or Post Office C A R L I S L E Cortespondent's e-mail address: P O M F R E T S T R E E T State ZIP Code L P A 1 7 0 1 3 1 :. Lym ~ _. _.. '=cn F -~0~ _ ~, - rJ ~ CJ ~' DATE FILEO n Side 1 L 1505607121 1505607121 r '[22L09SOS4 422L09S054 Z aPIS eo•20222 1N3WAtld1l3A0 NV d0 ONfld31! tl ONLLS3flb3a 3Mtl nOA dl ltlAO 3Hl NI llid 'OZ .BL ................................................ en0 ~1'BL 0 0. 0 'SL p 0• ~ SL" X a;eJ Ie~ale0oo le algexel qL sun;o lunounr •gL 0 0. 0 'LL ~ 0 ~ ZL' X aler Bu11Qls le elgexe; 4L au!l l0 3unowV 'U B O' 2 0 2 2 2 ~gL h 0' S E 6 4 h 2 sro' x eye, leeup;e algexel4laull;o lunowy 'gl 0 0' 0 'gL 0 0' 0 - o'x(Z'LHe) 9L L6 '~S ~epun s~e}aueq ~o'alei xq lesnods ew;e algexW 4L aull to lunowy 'SL 8311M 3l9tlOl~ddtl aOd SNOIlOnlIlSN133S - NOIltllndWOO Xtll h 0 • S E 6 8 h 2 '4L ~ ~ ~ ~ ~ ~ ~ • ~ • ~ • ~ ~ ~ ~ ~ ~ (EL aul~ snulw ZL aull) ~l o; ioefQnS enleA laN '4L h 2 2 0 • 0' S E' 2 4 •2 2 ' 0 E L 6 9 6 4 h 9 B 2 E B 2 h E 'EL ... ,ZL ... ' L L ... 'OL ... .8 ... ............... (f alnPa4aS) spew ueeq lou sey xe; aJ uo~ala ue 4o!4~'n col slsnrl EL L6 oag/slsenbeg Ieluewweno0 pus algelPe4~ 'EL ...................... (LL aurl snulwgeul~)aPris3 JO enIeA leN 'ZL ........................ (0 L 9 6 seu!~ lelol) suoponpea lelol ' L L ......... (I a1nPe4~S)suer+g'se911!gel~eBeByoW'luepeoa0;o siga0 'OL ............. (H alnPa4~S) slso~ en4egsNIwPV'8 sesuedx3 laaeunj 'g 9 E• L 0 2 4 6 2 .g ... ........................ (tl scull lelol) s;eaay ~+~J I~l '9 9 6. 0 Q 6 2 6 .L ... .... Pe7senbea BulII!8 eleaedeg n (~J alnPe4oS) ' ~ OB),1 snoauelleOSIW g spa;sued song-~alul ~adad a)egad- L • ' ~9 ... ... Pe;senbea Bu!II!S a;e~edeS ~ (~ alnPa4oS) /~yedad peump,(gulof 'g h h h L B [ E • 'S ... . (3 alnPa4oS) RYadad leuoswd snoeuellaoslW g s;lsodaO Hues 'yse~ 'S 'C 2 h 6 6 L 'C • .b ... ..................... (0 a1nPa~pS) algenleoea salory +g aeBeBUOW 'b • .E ... .. (O alnPe4oS) dl4sroLapdad-aWS io dl4sieuued 'uope~odio0 PIBH Rlesol0 'E 0 0 0 • .Z ... ............................... (8 alnPa4oS)spuoS Pue s~1S 'Z 5 L L S E 4 . . L .. ...................................... (y alnPa4~S) slelsa Iee21 ' L 0 0 0 0 6 L n 2 Nou~nnllavo3a 9 E L 6 6 4 O L 2 S3N0I' •H 2J3AI10 ~~""N`'jOBp°'BQ ~egwnry punoeg leloo3 s,;uepeoep X3 OOS L-h321 422L095052 REV-1500 FM Pegs 3 Decedent's Complete Address: DE DENTS NAME OLIVER H. JONES STREET ADDRESS 87 GREENFIELD DRIVE CITY CARLISLE STATE PA ZIP 17015 Flle Number 21 08 0981 Tax Payments and Credits: 1 • Tax Due (Page 2 Une 19) 2. CreditslPaymenls A. Spousal Poverty Credit B. Pdor Paynrents C. Discount (1) 11,202.08 TolalCredits(A+g+C) (2) 0.00 3. InteresUPenalty if applicable D. Interest E. Penalty 4. fi Une 2 Is greater than Llne 1 +Une 3, enter the ddfeence. This is the OVERPAYMENT. FIII In oval on Pape 2, Une 20 to request a refund. 5. If Line 1 +Une 3 is greatw than Line 2, enter the difference. This is the TAX DUE. A. Enter the Interest on the tax due. Total InteresUPenalty (D+E) (3) 0.00 (4) 0.00 (5) 11,202.08 (5A) B. Enter the total of Line 5 +5A. This is the BALANCE DUE. (5B) 11,202.08 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the uae w income of the property transferred : ................................................................. ..... ^ b. retain the dght to dealgnate who shall use the property transferred or its income : .......................... ..... ^ c. retain a reversionary interest; or ..........................:................................................................ ..... ^ d. receive the promise fw life of either payments, benefits or care9 .................................................. ..... ^ 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration7 ................................................................................. ...... ^ 3. Did decedent own an 'in Wst for' or payable upon death bank account or security at his or her death? ... ...... ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designafion? ............................................................................................ ...... ® ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. '.b '~ ~ Y k'a'`~i'43gg~"ar,,.~4~h~ai*.iafl,~e~ 9 e~5 @ g'#~~a9 ~ .i. , `~ .e3 «~t~ "§ J{~ ~r,3 r ~, r~. a,2 5 7. , r. .. t~, ,. , a.. 93®3 aYaasl, ailme~e x'Y~P~ d~ ,~ raw ,-„a :~$.a1., l:an! .aam. ,... ie eC:~r .ln„~:#, ~ m~,alr~.m.i,:.., ..~ ,.. ,: '...x t. For dates of death on or after July 1,1994 and before January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent (72 P.S. §9116 (a) (1.1) (i)). For dates of death on or after January 1,1995, the lax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [/2 P.S. §9116 (a) (1.1) (ii)]. The statute does not exemol a transfer to a surviving spouse from tax, and the statutory requirements tw disclosure of assets and filing a lax return are still applicable even if the surviving spouse is the only beneficiary. Fw dates of death on w after July 1,2000: The tax rate imposed on the net value of transfers from a deceased child twenty one years of age w younger al death to or for the use of a natural parent, an adoptive parent, w a stepparent of the child is zero (O) percent [/2 P.S. §9116(a)(1.2)]. The tax rate Imposed on the net value of transfers to w for the use of the decedent's lineal beneficiaries is four and one~half (4.5) percent, except as noted in 72 P.S. §9116(1.2) [/2 P.S. §9116(a)(1)). The lax rate imposed on the net value of transfers to or fw the use of the decedent's siblings is twelve (12) percent (72 P.S. §9116(a)(1.3)). Asibling isdefined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood w adopfion. REV-1502 ~ + (eA8) SCHEDULE A COMMONWEALTH OF PENNSriVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT Ali real gopsrty owned wkly or u a tenant in wmmon must be reported at fak mertretvalue. Pair market value B defined u the pdce at which propeM1y would be ezcharged between a wlltng buyer and a willing seller, neitlner being compeNed to buy araeY, bdh having reuonable knowkvlge of the relevant facts. ITEM 147 enter on line (If mom space Is needed, insert addNbnal wheels of the same size) REV-7503 E)f +(8-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERRANCE TAX RETURN RESIDENT DECEDENT OLIVER H. JONES 21 08 0981 All property Jobtylowned witll RpM of sunWoBhlp must be dlscbsed on SoheduN F. DESCRIPTION 1. ISERIES HH SAVINGS BOND -INVENTORY 2. 45 SHARES OF FEDERAL NATIONAL MORTGAGE ASSOCIATION 45 X $7.95 = $357.75 3. TOTAL (Also enter on line 2, Recapitulation) ~ $ VALUE AT 357.75 (If mole sDece is needed, insert additional sheets of the same size) REV-1508 6X ~ (6-ea) SCHEDULE E CDMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER OLIVER H. JONES __ 21 08 0981 Indude the pnxeeda of Iltlpatlon end ele date the Drocaeds were received by the eStaOB ITEM JMBER DESCRIPTION 1. COINS -APPRAISAL ATTACHED 2. I PERSONAL PROPERTY -APPRAISAL ATTACHED 3. ORRSTOWN BANK -CERTIFICATE OF DEPOSIT #4000023943 4. ICASH ON HAND VALUE AT DATE OF DEATH 1,591.75 6,061.00 10,337.73 3.73 TOTAL (Also enter on line 5, Recapitulation) I S (If more space is needed, insert edditlonal sheets of the same size) REV-7509 E2C+(6-g8) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN OLIVER H. JONES 21 08 0981 H an asset vws made Joint wkhin one year of the deadenCs date of death, k must be reported on &hedule G. SURVNING JOINT TENANT(S) NAME A. C JOINTLY-OWNED PROPERTY: 400 WEST 43RD STRE NEW YORK, NY 10036 ADDRESS DECEDENT ITEM NUMBER LETTER FOR JgNf TENANT DATE MADE JgNT DESCRIPTION OF PROPERLY INCLUDE NAME OF FINANCWL INSTITU110N AND BANKACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH QED FORJgNTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A. 06/1999 EDWARD JONES -ACCOUNT NUMBER #377-05460 63,748.87 50. 31,874.44 TOTAL (Also enter on line 6, Recapitulation) I S 31 874.44 (If more space b needed, insert additlonal sneers of the same size) REV-1510 FX+(8-98) COMMONWEALTH OF PENNSYLVANIA SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY es I w I t ur FILE NUMBER OLIVER H. JONES 21 08 0981 This schedule must be wmpleted and flied H the answer M any of quesfblis 1 thmuph 4 on the reveres stile of the REV-1500 COVER SHEET b yes. ITEM NUMBER DESCRIPTION OF PROPERTY iNCWOETNE xNAEOFTHE IMNBFHiEE, 1XaRR8ATI0N&IIrl00ECE0 NFNTAND TXEMTEOFTWiNefERATTACHAW%OFTHEREWFORRFIL~TATE DATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST EXCLUSfON prerRicRa~ TAXABLE VALUE 1. PNC BANK -IRA #75900030057 43,886.92 100. 43,866.92 2. AMERICAN FUNDS -#$1236208 48,114.04 100. 48,114.04 TOTAL (Also enter on Iine 7 Recapitulation) ~ S 91 980 96 (If more space is needed, InseR additional sheets of the same size) REV-1511 EX+(10-06) scHEOV~ie x COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES 8r INHERRANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER OLIVER H. JONES 21 08 0981 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. EWING BROTHERS FUNERAL HOME, INC. 3,258.84 2. EVERETT MARBLE $ GRANITE WORKS, INC. 110.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representatlve (s) Street Address City State Zip Year(s) Commissbn Pald: p, AdomeyFees IRWIN & McKNIGHT 10,500.00 3, Family Exemption: (It decedent's address b notthe same as deiment's, atiedl explanatlon) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. ProbaleFees REGISTER OF WILLS 307.00 5. Accountants Fees 6. Tez Relum Preparefs Fees PATRICIA A. ROSENDALE, CPA 460.00 7. REGISTER OF WILLS -FILING FEE 30.00 8. STEVEN W. BARRETT -APPRAISAL ON REAL ESTATE 325.00 9. JOHN CONNOLLY -PAINTING 2,500.00 10. VICTORIA CONNOLLY -CLEANING 450.00 11. UNION HALL LAWN & GARDEN 372.57 12. NOTARY FEES 40.00 13. ROY D. GOTTSHALL -APPRAISAL ON PERSONAL PROPERTY 55.00 14. THE SENTINEL -ESTATE NOTICE 158.62 15. CLOSING COSTS FROM SALE OF REAL ESTATE 12,536.26 18. TOUCH OF COLOR FLOORING -IMPROVEMENT TO REAL ESTATE 3,311.00 17. CUMBERLAND LAW JOURNAL -ESTATE NOTICE 75.00 18. DONALD HEISHMAN -LAWN CARE 300.00 TOTAL (Also enter on line 9, Recapitulation) S 38.680.20 (ti more space b needed, insert additlonal sheets of th same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent OLIVER H. JONES Decedents Name 1 21 OS 0981 Flle Number Schedule H -Funeral Expenses 8r Administrative Costs - 67. ITEM 19. ZIMMERMAN PLUMBING -SERVICE 199.00 20. PATRICK SMITH REALTY -REMOVAL OF DEBRIS IN GARAGE 60.00 21. PATRICK SMITH REALTY -REIMBURSEMENT/REPAIRS 619.41 22. PATRICK SMITH REALTY/JOHN CONNOLLY -PAINTING 2,500.00 23. JOHN CONNOLLY -REPAIRS 62.50 24. VICTORIA CONNOLLY -CLEANING 450.00 SUBTOTAL SCHEDULE H•B7 ~ 3,890.91 REV-1512 EX+(12-03) SCHEDULE I COMMONWEALTH CF PENNSYLVANIA DEBTS OF DECEDENT, IN RES DENT DECEDENT MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER OLIVER H. JONES 21 08 0981 Report debts Incurted by the decedent prior to death which remained unpaid as of the date of death, InelWing unreimburaed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. THOMAS E. APPLEBY -MEDICAL 117.00 2. SOUTH MIDDLETON TOWNSHIP - WATER/SEWER 3. EMBARO-TELEPHONE 4. UNION HALL LAWN CARE -LAWN CARE 5. PNC BANK - REIMBURSEMENT OF IRA PAYMENT 6. ROBERT C. CAIRNS -REAL ESTATE TAXES 7. STATE FARM INSURANCE -HOMEOWNERS INSURANCE 8. UGI -UTILITY 9. MET-ED -ELECTRIC TOTAL (Also enter on line 10, Recapitulation) ~ S 301.00 292.10 172.57 713.43 371.98 498.00 779.55 248.49 (If more apace ~ needed, Insert REV-7513 EX +,(g-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE J BENEFICIARIES NUMBER OLIVER H. JONES 21 08 0981 RELATIONSHIPTODECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Lht Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS pndude Mspouseldistributlona,aMtransfersunder 8116 S i 2 ea (a ( . ) ] 1. THOMAS OLIVER JONES, IN TRUST Lineal 248,935.04 631 JEFFERSON AVENUE WEST REMAINDER HUNTINGTON W. VA 25704 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET u, NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. 8. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET S (If more space is needed, insert additional sheets of the same size) r LAST WILL AND TESTAMENT OF OLIYER HASTINGS JONES I, OLIVER HASTINGS JONES, of South Middleton Township, Cumberland County, Pennsylvania, being of sound mind, disposing memory and full legal age, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils heretofore made by me. ONE. I direct my Executor to pay all of my debts, funeral 'and administrative expenses as soon as convenient after my decease. Furthermore, I direct that all state, inheritance, succession and other death taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property composing of my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid by the Executor of my estate. TWO. My Executor may, at his discretion, compromise claims, borrow money, retain property for such length of time as he may deem proper; lease and sell property for such prices, on such terms, at public or private sales, as he may deem proper; and invest estate property and income without restriction to legal investments unless otherwise provided hereunder. I authorize and empower my Executor to sell any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at public or private sale or sales and to give good and sufficient deeds and/or bills of sale therefor, in fee simple, as I could I do if living. My Executor is authorized and empowered to engage in any business in which I may be engaged at my death, for such period of time after my death as seems expedient to said Executor. THREE. All of my estate, real, personal and mixed, wheresoever situate, of which I may be entitled at the time of my death and any property over which I may have or may hereafter acquire any power of appointment, I give devise and bequeath to my son, THOMAS OLNER JONES, to be held IN TRUST, together with any other assets received by the trustees (hereinafter collectively referred to as the residue), under the following terms and conditions. A. If THOMAS OLNER 70NES is then living, the trustees shall hold all the residue of my estate in a separate trust for the primary benefit of my said son, who is disabled. In providing for the establishment of this trust for the benefit of my said son, I am aware of the special circumstances and disabilities affecting THOMAS OLIVER JONES which may cause or will cause him to be eligible for various local, state and federal benefits and entitlements, as well as possible assistance provided by various private agencies and organizations. The primary purpose of this trust is [o assure that THOMAS OLNER JONES achieves his maximum potential and leads as full, independent and normal a life as possible. To that end, it is my wish that the trustees view themselves not only as trustees in the traditional sense, but also as protector, guardian and advocate for my said son. Correspondingly, the trustees shall expend the income and principal of the trust in ways that best further these goals, and under the following terms and conditions. 1. The trustees, within their complete and unfettered discretion, shall apply the income and principal of the trust in furtherance of the purposes of the trust as set forth in Paragraph A. above and generally to enhance the life of my son, THOMAS OLNER JONES, if living, as he now lives, but only to the extent not provided for by insurance or by Federal, State, local or any other assistance programs of any nature whatsoever, including Supplemental Security Income benefits under the Federal Income Maintenance Program as then existing. To the extent that benefits are not made available to THOMAS OLNER JONES for other than, basic living expenses, including food and shelter, the trustees, in their absolute discretion, may distribute from income and principal, for the benefit of THOMAS OLNER JONES, for his needs other than basic support. Any income not so expended shall be accumulated and added to principal. For the purposes of this provision, non-support purchases include, but aze not limited to dental care; unreimbursable medical and dental expenses, not covered by Medicare or Medicaid, including plastic and reconstructive surgery, diagnostic work and treatment, rehabilitative training and experimental medical services; psychiatric/psychological services; occupational therapy; prosthetic devices; dietary needs and supplements; custodial care or supplemental nursing care; recreation, cultural experiences, outings and travel, including payment for others to accompany THOMAS OLIVER JONES; telephone and television, including cable television; reading and educational materials; intemet access; exercise equipment; unreimbursed therapy; and related insurance. The trustees' discretion in making distributions authorized hereunder is absolute with regard to distributions from the trust estate, and shall be binding on all interested persons. The income and principal of this trust may therefore be used as judged necessary and appropriate as a supplement to, but not to supplant, such Federal, State, local or other assistance, and to the extent the income of this trust is not used, the trustees may accumulate the income and add it to the principal of the trust. While the trust for my son, THOMAS OLIVER JONES, remains in existence, the trustees may also expend such amounts of income and principal therefrom as they, in their sole discretion, may deem necessary for ihe, health, maintenance, support and complete education, including prepazatory, college and postgraduate or professional training, of my other children, and grandchildren, but only if the trustees determine that such child or grandchild does not have sufficient funds otherwise available. Nevertheless, this trust is for the primary benefit of my son, THOMAS OLNER JONES, and his present and future needs shall be considered first. 2. The trustees aze empowered to collect and expend on behalf of my said son, THOMAS OLNER JONES, all governmental financial assistance benefits to which he is otherwise entitled; provided that such funds shall not be co-mingled with the other funds of this trust. 3. In the exercise of discretion with respect to income and principal distributions for THOMAS OLNER JONES, if any, the trustees shall bear in mind my express desire to preserve, to the greatest extent possible, this trust's assets for eventual distribution to the beneficiaries named hereinafter, whether outright or in trust. The foregoing sentence is in no way intended to limit the sole and absolute discretion of the trustees with respect to such distributions of to give any remainderman any right to challenge any distribution made by the trustees in the proper exercise of such discretion. Rather, said sentence is intended to aid the trustees and any Court or administrative agency in properly interpreting my intent in establishing this trust, namely, that the needs of my son, THOMAS OLNER TONES, be provided for only to the extent that governmental benefits and entitlements and other resources aze either unavailable, inadequate, or have been exhausted, 4. If any govemmental agency determines that this Trust is an "available resource" to be utilized and exhausted to pay for services for THOMAS OLNER JONES, otherwise provided by public funding, then .the trustees may, at their complete discretion, elect to terminate this trust, in which case the bust assets may be distributed in accordance with paragraph five (5) below as if my said son, THOIv1AS OLNER JONES, was then deceased. 5. Upon the death of my said son, THOMAS OLNER JONES, or in the event he should predecease me, the principal of this trust as then constituted, together with any accrued and undistributed income thereon, shall be distributed in the following manner: A. One Hundred (100%) percent thereof shall be distributed, in equal shazes, unto my children and grandchildren if they are living at the time of distribution; and if any of my said children or grandchildren are not living at the time of such distribution, then the shaze which such deceased other child or grandchild would have received hereunder, if living, shall be distributed unto such deceased child or grandchild's issue living at the time of such distribution, per stirpes; and if any of my said children or grandchildren are not living at the time of such distribution and leave no issue then living, then the share which such deceased child or grandchild would have received hereunder, if living, shall be distributed equally unto those of my other remaining children and grandchildren. B. If, at the time of distribution, any income or principal shall be payable to any person who is under the age of twenty-one (21), the trustees shall hold such income and principal until such person reaches the age of twenty-one (21) and shall be entitled to apply such income and principal to the health, maintenance, education and support of such person without the appointment of any guardian or committee or any authority of court. C. All .shares of principal and income shall, until actual distribution to the respective beneficiaries, be free from the debts, contracts, alienations and anticipations of any beneficiary or beneficiaries, and the same shall not be liable to any levy, attachment, execution or sequestration. D. Upon the death of any income beneficiazy, any accrued, accumulated or undistributed income held or received by the trustees shall be paid to the person or persons for whose benefit the principal producing such income is continued in trust or to whom such principal is distributed under the terms hereof. E. All dividends on shazes of a corporation, forming a part of the principal, which are payable in the share of the corporation itself of the same kind and rank as the shares on which such dividend is paid shall be deemed principal. FOUR. I nominate and appoint. WILLIAM ANDREW JONES and RICHARD HASTINGS JONES to serve as Trustees of the trust created in Paragraph Five hereof. WILLIAM ANDREW JONES will have the final say as to any matter related to this trust, unless he is unwilling or unable, at which time RICHARD HASTINGS JONES will then have the final say as to any matter related to this trust, FIVE. I nominate and appoint WILLIAM ANDREW JONES to be the Executor of this my Last Will and Testament. Should he die before my death, renounce or refuse to serve for any reason or die leaving any of my estate unadministered, Inominate and appoint RICHARD HASTINGS JONES as Substitute Executor. SIX. No person(s) shall benefit hereunder unless such beneficiary shall survive me by sixty (60) days. SEVEN. No Executor or Trustee acting hereunder shall be required to post bond or enter security in this or any other jurisdiction. EIGHT. No beneficiary may assign, anticipate or pledge his or her interest in any income or principal held or distributable hereunder, and no beneficiary's creditors may levy, attach or otherwise reach any such interest. NINE. The validity and administration of any trust established hereunder and any questions or disputes relating to the construction or interpretation of any said trusts shall be governed and construed in accordance with the laws of the Commonwealth of Pennsylvania. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~~ day of September, 2005. ~~L k Z'/~`~ ya 6 (SEAL) OLIVER HASTINGS J E Signed, sealed, published and declared by the above-named person as and for a Last Will and Testament, in our presence, who at said person's request, in said person's presence and in the presence of each other have hereunto set our names as subscribing witnesses. ~~ ACKNOWLEDGMENT AND AFFIDAVIT WE, OLIVER HASTINGS JONES, SHARON L. SCHWALM and CHERYL L. CLELAND, the testator and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declaze to the undersigned authority that the testatrix signed and executed the instrument as her last will and that she had signed willingly, and that she executed it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the will as a witness and that to the best of their knowledge the testatrix was, at that time, eighteen yeazs of age or older, of sound mind and under no constraint or undue influence. ~. OLIVER HASTINGS J ES ~; ' SAIL(/ X72 i~ J?~I..GuJ. HARON L. SC~~~~~ , CHERY L.CLELAND COMMONWEALTH OF PENNSYLVANIA . SS: COUNTY OF CUM$ERLAND Subscribed, sworn to and acknowledged before me by OLIVER HASTINGS JONES, the testator herein, and subscribed and sworn to before me by SHARON L. SCHWALM and CHERYL L. CLELAND, witnesses, this nZ' day of September, 2005. 3. Mn, Nomry Pudic Ctnnbarland Canty i Expires Od. 3, 2008 e P~aNwe egtlom en aeeelere A. Settlement Statement Iann H11p.1 rye~rel Nmpbock430e2 U.8. DepeMleM b Hawirp ant Utben Development L OPxA 2. C1FloFiA 3. (]Conv.UWm. QFJeNumbv 7. [aEO Nowm6se[ B. MwI{yeloemanceCexNember C. Nore: ~smw yy~.~wwp lywlyM ~beyq~rywtr bpxpew sMssssbybhbwb TMbEWress 9s111emsM System WeW11Ne:tlbewlmebbssblyreetrbMbbellllbe mMw oMrebBwkms PelWYeupon D. NAh@ OP BORROWPR: 8mme R. Weitu7 E. NAME OF sEltea: TAe Pafete of Oliva H. Jmee P. NAME OPLeNDES: Fire[Netiond BOOk of Cllw[er Comty O.l'ROPERTY ADDREBS: GI 61een5old Ihivb, t:arliele, P& 170I$ x. sarn.eemNrgc~rr: PA Real Estate Settlement Services, LLC BrreWlwv PmelywoEler~ e~im.Ib~W MbbwbM On~w~uE~wnw sw0gw+wibe.r~moro°itla mam.~ina~awm~ns Nnnmr~0iq°ewnrew~iw~insmm.a"~abw'°waa mb~0iamir.nwm. Irw bi elw m W eee lM ybw Ptawl q qW eNbYetFw~egolbn rv ere lpWetleyMbwwltle Yw eebemwteWe FVweG>y W. M p Pill KU[wrebgePO~be1MiMOn wmpetMN~2CM Vw'M WiIIi011NLL¢b~qwyW beM4YM nber.lW mWbEWeelwtlNlwawwW OwWYM iPepirv.l°w'nlytlulbenulleewlpen en Me Nbmwe4 mYmmgWPYq bmtlewlbngerbw. iIN: /_ 9ELLEly8I81mNTUNEIBI: / 9E11Efl181 NEW IMI11N8MOPE88: BELLEPHSI PXONE NUM9EN8: (H1 WI r~.wueemnme en oowtlu A~~uw ,weimn ,...~.,. U.S. DEPARTM&ff OF NOUSBJGAND URBAN DEV®.OPMENT File Number. 3U09-1054 PFOE2 i ItlN tlntlMIrvYNE.1 M,~H ~pNtl I~ M~ei,nMe,~tlMN,~iuo° a~.m.gytl.~, eeWl a u'. ew w em..awum.mm Yi nuuW w a.mwmnnm.a wmv.emumuM m. mnr im itlnnn ,a rt~ Whip ONM~O~P~B IIM~FOmIUPFIY LIEB~U O~WNNLTION Icatl~msM~w M~uE.~M,1tlmb~bbOMW~ImY~CYO'Me~tlb~iYl,m~enLp NbYw.NOn GN WCLUDE• RNE MD IRPRI80NIENi. PoF OE~MU9 EEETRE te: U.E. CWE BECTIUN 1001 P1b 9EClgN 1010. C a • N Oaa O C go.a~a G q y N ~N C1 N N N g91S+ ~ ~i n v $,oo~ e m m'o . ~~~~~ ?ill yy~j0 d N (~ ep G ~.~~:m~ ~~Q~~ mwy m x~~.a =~Km~ d c~ ~~a~c ~e m _. ~~~~~ K ~p° 30.~~ SK WN }~T ~Sm~~ m~ ~~ x~ m ~m ?~ia 9 9 rte. Q + ~ ^ ~ c w o`ff'" _ ab.z ~~'~Zg s~,co ~. ? a o~~~ ~ ~ m w m ~ngZ y.Z a." 3 ~ `~~ y n a a a''~ $~~N o 8Q N t~ J ~ o ~ ~ o ~ ~ ~~ o i ~ 6i N p fn l6 ~ ~ 3 ~ W ~ ~ wd Z G x3 ~ =w N a, °.L ~: V ~~ .~ o$ 0 N r D ~ ~; N O < `~ 7 O ~ Z p 0 m a m ~v~ i ~ ~ ~ ~ ~ '0 .. ~ 3, T Q. '• w_ m ~v3sm 3W°~mo x y~ ~~~ Z o 0 A ~ t~0 FNM: Historical Prices for FANNIE MAE -Yahoo! Finance Page 1 of 2 Yahoo! My Yahoo! Mail More Get Yahoo! Toolbar Hi, Karen Sign Out Help ~•. ____ YAH~fe FINANCE Search WEBSEARCN ~..__-. _.. _._~m._ _._.___._ -_._m_._- ---_.__m_ _..___-_ Dow'a 5.28% Nasdaq ~ 5.07% Thu, Nov 20, 2009, 4:99PM ET - U.9. Markeb clowd. Fannie Mae (FNM) Historical Prices SET DATE RANGE Finance Search At 4:03PM ET: 0.33 i 0.05 (13.18%) Get Nlstorical Prleee for: _._ -GO Q Daily ) Anri~io'1•{~,. Start Date: Aug 28 2008 ' Eg. ]an 2, WeeM -'--^o zoo3 ~ Y End Data: Aug 28 ,.2008 ~ Monthly Current OffQr9 -~ QDlvidends Only from Get Prices..: LendingTreee $200,000 First ~ Prev ~ Next ~ Last for Orly 51,215/MOnd1 PRICES Date Open High Low Close Volume ~~ Close` 5300,000 28-Aug-08 7.08 7.95 6.67 7.95 128,474,900 7.95 for Oniy `Close price adjusted for divitlends and splits. 51,799/MOnth First ~ Prev ~ Next ~ Last Download To Soreadsheet #400,000 for Only 52,366/Month >ra ®Add to Portfolio Yd Set Alert 0 Emaii to a Friend Ge[ Mletoricel Pritae for Another SymDOI: _ GO Symbol Lotkun • Stock Screener SDIIts • Masers & Accuisi8ons ~h~^~ http://finance.yahoo.com/q/hp?s=FNM&a=078cb=28&c=2008&d=07&e=28&f=2008&g=d 11/20/2008 pftoan, aad°j8a~~ tPTES TRUST ~pMFANT ~ N aMaaana uxitcu s sa ~~ b ~iP 4}~O N ~~ unN+' ~* ~ ~-~~~ q ~ ~~ r t v a 0 .z 0 z D N N m N a a a n `. ~ ~.. o ~ P N ~: ~ $x z a = 0 ~ ~ n b p a s f• 5. c n o t ~ o w ~' o s ~' 0 r 2 P Z N p ii. ~\' ~~,~~:) `" ~~ . TN 9 !~ NN Ln A ~N SN bn N 1~ t ~a~ anucvii s8asnsu+3~„R mm ~I a~°°~rv~pP ®~-`P~t. ti, ,y,~ y~=-a- ~ ~~.~2,~N~t:~Ef ~/L. / ~. I ~ J~ r ~ .~ G~/(i r2~ r- ~--- - -- - --- , f ~ ~ . r r ~y~. ~ E~~ . ~~1 ~fc~L _-~--. _..____. __..._ _.. ___..__~~. /., 4! _ ` i ~_ ~~'-~' _-_..._~_.___...._____._._.__._._.-dL4_- .- ,' I ~~ - -- __ _ .--_~ --- ~ ._ _ . _ --- j ~~ Xs~!' d~ -- ----~g ~"~ -------------------~ ~i --- -- -------/O r ~-- , iii y~ i ~ ~..^ ~.J1srL._._----- ~ s~~ ------ -------. "^~ - - ,< .-~ ~,G ~, ---~ f '2 . ~~ ~ - --- -. __ - - -_- - ~z - v ~i~ j i Ifl __ _ ___ _.-- I- ----- r~_ f- - ,____.__ ~ - -- ___ ~~ .~ _. __... • /~ n ~ ~ G o~ `.-. ---- /_.21.C _ ! "iu~~~t~/z~Z_._` [/eLIJ'"-LLLL/! i 480.00+ _ _ jt-689.00 + 4r892.00+ __ __-. - __-- __.._ --~ o~' i 6,061• k _.___ _ - -----. ...._._..------- _ __ OL{VER H. JONES ESTATE d/o/d -AUGUST 28, 2008 Appraisal by: Harry E.Donson 243-8943 CARLISLE COIN SHOP 25 Circle Drive Cariisle, PA 17013 GU S','(v a.r t~oW~-/ .____~~~ 715 .~ S i ~v.~ ado fl~,v r----_ X 7 4 ~. -_~ ,~,~g~, ~-~~ - l~z x',25. ~2 ~ ~~ ~q~~ 9`3/0 P~~ ~`~~~~ ~ ~ D aio ~oc-ns ~tYtP'~'~.~ 1 ~ ~~ ~-~ d~ °"`~"7 ~t4~~~~- r~ Ox~s~rowly B~ A Tradia!ion of Excellence OCTOBER 03, 2008 70: ROGER B IRWIN FROM: ANDREW OTT BRANCH EXECUTIVE OFFICER P.O. BOX 250 SHIPPENSBURG PA 17257-0250 RE: ESTATE OF OLIVER H JONES DATE OF DEATH: AUGUST 28, 2008 77 East King Street P.O. Box 250 Shippenstnug, PA 17257 IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD, ON THE ABOVE DATE, THE FOLLOWING ACCOUNTS WITH ORRSTOWN BANK: CHECKING ACCOUNTS ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST SAVINGS ACCOUNTS ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPAL 8 ACCRUED INTEREST CERTIFICATES OF DEPOSIT ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST 4000023943 OLIVER H JONES alt©1d~~: ~: 10,326.40 + 11.33 = 10.337.73 Art Amundsen Fnancial Advisor EdwardJones MANINO BENSE OF INVESTING October 23, 2008 Attorney Roger B. Irwin 60 W. Pomfret St. Carlisle, PA 17013-3243 OCT 2 4 2008 IRWIN & NkKNIGNi UIW OFFICES Dear Roger Name of Deceased: SSN:170-18-2589 Aarount Registration: Account Number: Date of Death: Date of Valuation: 21 West High Street Carlisle, PA 17013 Bus. 717-258-4688 www.edwardjones.com RECEIVED Oliver H Jones Oliver H Jones >£ William Jones -opened O6J1999 377-05460 August 28, 2008 August 28, 2008 The total value of these securfties was $ 83,748.87 on 08/28/2008. In addition, the total accrued interest and accrued dividends was $ 352.70. Although this number is believed to be correct, its accuracy is not guaranteed. The values listed are as of August 28, 2008, the day that Oliver H Jones passed away. The values were obtained from an outside historical pricing service, and while we beileve that they are reliable, we do not guarantee their accuracy. Please let us know 'If you need any other information or assistance. You ruly, Ar Amundsen Financial Advisor _ _ _ _ __ uec. 17. LUVO ~.V:VOnwi rfu~ tlRlul~ 41!-IVY1141 1V O, 9111 Y. I ~~ t.BADINBTH£11/iY December 15, 2008 Roger B Irwin Attorney at Law 60 West Pomfret St Carlisle, PA 17013-3222 RE: Oliver H Jones SSN: 170-18-9736 DOD: 08-28-2008 Deer Mr. Irwin: In response to your request far Date of Death (DOD) balances for the customer noted above, our show the following: IRA Ac ant 57 Account 9590003009 Established: 06.27-2005 OLIVER H JONES DOD balance: $ 43,866.92 + 5.27 accrued interest Foz beaeficiary information, please call 1-888-762-4727. Please note that this office provides date of loath balaaooa for deposit accoums (IRAs, CDs, Checking and 5avinga). We do not proem say tlnsneisl tr9aaaclions or provlde•statemmts. If you noel assietanoe with any of these items, please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sinctroly, National Financial Services Center PNC Bank, N.A. Member FDIC ~uu ur-~uu~~w~u~ i~: ~~ unn~iuwn umm ~i nnfi i,~u ~uu,u ,~~~.-~- ' HoldingsbXlrnrestor _._______.. Oliver H Jones Bradley Gerlach Combined coo lio fio w Pomfret street pre: oeiz6nD carllae, PA 17013 erased: ., ~ 717-zaD-oeo3 Oliver H Jones Aod Name:CBBT COST IRA OLIVER H JONES 605A' POMFRET ST CARLISLE PA 17013-3243 Aeet Na00081238206 Aoetrype:CB&T IRA Rep. No:15B55 ...:..:.:..•:.. , • _..a i.;~.::: ~ , ....,.:m.l::~ .:...:..:....:~IIrkK';''`, +~AeaetTJRWr 74emer->:: r ° . anal:'; .:a.4...,.,-..z-r '.tWBn f s ~... „ .;.;js:la::.~ R' K :, .; ':+.~.'„-- h ~..,,.-i:i: };:!' ~ ` ,9_a,. IN ,~.. :,:,~,. :. .. ~ }'r .~<{"Wh. !3 _Mix~- U R • ~ :'}v 'i , _........• 5n~=:.~:'il.:::~ti:dy..,:_.:n::v"!.:G.YY•in,:vii.a.ve.:::~.°„~e MERICAN FUNDS CAP INC BUILDR CAIBX ,:,c:e::::-~.r:rvv.....~:-.: BLEND , :,::5~?:::::::.r.:.... ~._..:::,v~v: ~ CAN , . . .., . L.... .... .: :. •... ... .: ;; 321.03 ., .. -,••..n Jr::.__.... 54.68 , , .. 17,521.82 A MR ICAN FUNDS INC FND OF AMECX A EQURY MII~ CAN 971.58 56.99 18,507.13 M A B WASHINGTON MUTUAL INVESTOR8 AWSH7G EOUr1Y AMERICAN 468,88 30.04 14,085.10 FUNDS Aacoun! Telel: 548,11x.04 Imeeto/iMal: .11x04 ~~ p Inmmgob If pexnM4 wiMioul Kmmpanyinp disUuNC po0e _-_' ..-v . v Papa 1 a 2 • Ewing Brothers Funeral Home, Inc. 630 South Hanover Street . / Carlisle, PA 17013- (717)243-2421 September 4, 2008 William Jones 400 W. 43rd St., Apt 11-T New York, NY The Funeral Service for Dr. Oliver H. Jones We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please feel free to contact us if you have any questions in regard to this statement. THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT, AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS. 1. PROFESSIONAL SERVICES Services of Funeral Director/Staff , $2595.00 FUNERAL HOME SERVICE CHARGES $2595.00 THE COST OF OUR 3ERVICES, EQUIPMENT, AND MERCHANDISE THAT YOU HAVE SELECTED $2595.00 Cash Advances Clergy/Mass Offering, Certified Copies of the Death Certificate , Flowers. 1 Additional day Refrigeration , Sunday Memorial Service Sentinel Obituary w/Photo . TOTAL CASH ADVANCES AND SPECIAL CHARGES . Total Total Cost . SUB-TOTAL INITIAL PAYMENT /DISCOUNT !CREDITS TOTAL AMOUNT DUE $100.00 $30.00 $74.20 $45.00 $]25.00 $389.64 $763.84 $3358.84 $3358.84 _ !(A{teks ~,O(.~(~y v~ 100.00 - C •I `~ c ~' v $3258.84 The unpaid balance over 30 days is subjected [o a 1.50 % service charge per month - 18.0000 % per annum. 12/02/008 10:23 FA% 717 761 4398 REELER WILLIAbIS f¢J002/002 Touch of Co]~E'looling P.O. Box 4785 Harrisburg, PA 17111 Bill To Keller Williams Realty Attn: Patrick Smith 4242 Carlisle Pike, Suile 131 Camp Hill, PA 17011 Invoice Date Invoice# llnzrzoos 13394 Address Kellu Wi111emsReslty 67 Greenfield pr. Cariislq PA carpet& vinyl P.O. No. Terms Na 30 Service Date Item Description Quantity Rate Amount 11 /13/08 vinyl Install new shoot vitryl in kitchen, laundry & both 1 1,487.00 1,487.00 baths of 67 Greenfield Dr., Carlisle (includes all prep wor14 cove base, appliances, fumitura, and toilet removals) Carpeting InsWI new carpet end pad throughout 1 1,824.00 1,82A.00 Sales Tax 6.00% 0.00 Thank you for your business, Please vomit to above eddies3. TOtsl 53,311.00 Payments/Credits soon Balance Due 53,311.00 September 26, 2008 RECE9VED Irwin & McKnight SEP 3 0 1008 60 W. Pomfret St. PRW1N & McKNdGHr Carlisle- PA 1701:1 LA'WOF~RICES Dear Sir or Madam, Please find enclosed Union Hall Lawn & Garden Invoice #4080115. This represents services rendered to Mr. Oliver Jones for the month of August 2008. We have been advised to forward this billing to your office for pavmem. If you have any questions or concerns, pleax don't hesitate to contact me at the below address. Thank you for your assistance in the matter. Respectfully, <\\ Penny Duncan Union Hall Lawn & Garden 30 Allison Lane Shippensburg, PA 17257 717-249-8928 office 717-226-2529 cell ' Union Halt Lawn & Garden 30 n Lane ppenslntrg, PA 17257 Bill To Mr. Oliver Jones 67 GreeMreid Drive Carlisle, PA. 17013 invoice _~ 9/1!2008 4080115 Terms IAu as receipt Quarrtity Description Rate Amount Property Services for August ,2008 Shrub 9ed Maintenance; Trimmed shrubs, waBAaQ, edged, deanup; 1n.s~ 172.57 8/78 PA Sales Tax 6.00°/u 0.00 Thank you for your twsiness. Total sn2s~ ~~~~~ February 26, 2009 Irwin & McKnight West Pomfret Professional Bldg 60 West Pomfret St Cazlisle, PA 17013-3222 ATTN: Karen Noel IRA ESA Service Center P O Box 3499 Pittsburgh, PA 15230 '~~sr ~;~;, ~3~4~ ; , "•~~: RE: PNC BANK IRA # 7900011418 Dear Attorney Noel: ?Ih9(i c`~ iVlCiif~!iGiil" "t`ei OFFC_ On September O5, 2008, October O5, 2008 and November O5, 2008 IRA Distribution Checks continued to be mailed to the IRA owner, as elected. We understand these checks were deposited to the Estate of the IR.A owner, following his date of death. Upon notification of his death, PNC stopped the subsequent distributions and contacted the designated beneficiary(s) of the IRA. Therefore, the total amount of the three aforementioned distribution checks must be returned to PNC to properly distribute and report the total to the properly designated IRA beneficiary. Please remit to PNC Bank a check in the amount of $713.43 and mail to: PNC Bank, NA Retirement Services P O Box 3499, Pittsburgh, PA 15230 A revised 2008 Form 1099-R will then be provided reflecting the correct amount reported to the IRS for the deceased IRA owner's distributions prior to his date of death. We apologize for any inconvenience this matter may have caused and thank you for your cooperation in resolving this matter in a timely manner. Should you have any questions regarding this request for remittance, contact me at 1-888-762-4727. Sin ely, Kryst achinko ~ / Retirement Specialist" ~~~ Cc: William Jones ~~ .~ ~+1F,L of Central PA Patrick Smith Realty Date: Name: Phone: men Past Due Amount Due $60.00 "" `I~l~ 40 Pa~lck~9~l~`= ` ~KOPOSAL PROPOSAL SUBMITTED TO: ~~~. ~,rt 1 V oC rCnrVnmw n~. We hereby propose to'tumish the materials and perform the tabor net~esary for the campletton of 4, o ov C.~'c o 4. po A --g- . 0 0 sl A ~ .. ...,r •~ ~ o ~~' 1 ~ .a y 3a ;oo ss3. ao Alf material is guaraMead to be as specified, and the above work to be performed in accordance wRh the drawings arnJ spec'rfications subm d for above work, and Meted in a sulxstantisi worlcmanilke manner for the sum of ' 1v~ ~j.~..rlCt~ c\, c:~~ ~'S't~'i.,~..-''~?,2~; ~;---~onara t$ SS 3, o© with payments to be made as follows: C::l t ~~~ -3? ~~ Respec,Mfuily submitted ~~ S,. Am/ al[eratlon or dewaaon hom ebvre epacMcWons ~°roNirq extra coals c rmi ba axeaua only upon vrcltPn ardor, and wa become an exaa mares Per"r'1c~~ a 5 . Ce •a .a o ~ t.{ over and above tlb eetlmats, AA apreemeld8 aanongenr talon efrlka, ao- °f de1fly8 beyoid Olt C011u' Note -This proposal may be wkhdrawn ' by us if not acxepted within days. __._, AC~CEPI'ANG~ OF PROPOSAL Tfie above prlcesr epedNcaNorrs arrd con~tions are saNatri!ctory and are herel~r acoeptad. You are attdx»'Ized to do the work as spedfied. Paymer>ta wUt be maw as outNned shwa. - Signature Date Signature ~ De+ta PRt1Dnc e ~ .... wwEw uen _ _ _ _ _. ___ 027370 P~o~POSA~. °" ~' Pa0PO6AL N0::.; . 6HEET NO. I i DATE i PROPOSAL SUBMITTED TO: WORK TO BE PERFORMED AT NAM :~ T-ti ~7 ADDRES PNONE NO. AD ESS DATE OF PIANS ARCHITECT We hereby propose to furnish the matarSals and perform the labor necessary for the. completion-of R' J - O.Ot~ a• ~1 ~~ ~~~ L ~- ~a~ n r ~. _ . w All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifications submitted for above work, and completed in a substantial workmanlike manner for the sum of Dollars ($ ~~i, • J ~ with payments to be made as foNows: Respectfully submitted\\_ ~ \~K ~~_ Any alteratlon or devladon from above specifications InvoMing exha costs vrin to exeuned onry upon written order and will become en eAre charge Per over end above the estimate. A11 agreements contingent upon sldkes, ao- cidents, or delays beyond our control. Note -This proposal may be withdrawn by us if not accepted within days. You. are authorized to do the work as Signature Signature r D8118 e MADE IN^SA PROP /~~