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HomeMy WebLinkAbout12-10-09 (2)1505607120 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue county code veer File Number Bureau of Individual Taxes INHERITANCE TAX RETURN 2 1 0 9 0 0 413 PO 60X.280601 Harrisburg, PA ~~~2s-oso~ RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 174 20 2864 03 18 2009 03 04 1927 Decedent's Last Name Suffix Decedent's First Name MI O'KEEFE M. JANE D (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILL$ X~ 1. Original Return j~~ 2. Supplemental Return l 4. Limited Estate ~ 4a. Future Interest Compromise _ -- (date of dean, after 12-12-02) X g Decedent Died Testate - (Arad, copy or wu) _ ~ -J ~ Decedent Maintained a Living Trust (Anacn copy of rrusq 9. Litigation Proceeds Received '~ ~- ~ 1 p, Spousal Poverty Credd (date of death between 12-31-91 and i-1-95) avMKesrunutn I - I MI5 SECTION MUST BE COMPLETED. ALL Name AMY M. MOYA Finn Name (If Applicable) L.O. OF SUSAN E. LEDERER First line of address 5011 LOCUST LANE Second line of address City or Post Office HARRISBURG State ZIP Code PA 17109 Correspondent'se-mailaddress: Amy~Ledererlaw.com MI 3. Remainder Return (date of death prior to 12-13-82) ~' 5. Federal estate Tax Return Required ~- 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach $ch. O) ~~ tw~,lnrnrt~lnn I wn SHOULD BE DIRECTED TO: Daytime Telephone Number 717 65 2 732, / REGISTEFR" LLS U~NL1G -~ ~"'~ - r~ ~ "1 ~ ~ ~..J `~ ~ -~ ~ -o t . -- - -- -:: . , C t ~ DATE FILED ~ Under penatGes of pery'ury, I declare that I have examined this return, inGuding accompanying schedules and statements, and to this best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative Is based on all information of which IDreparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ~ TG~ ~"'~ /1, `fib' William Bradley Westhafer / o` AL.,//` d 9 ADDRESS Carlisle Pike, Mechanicsburg, PA 17050 OF Pft~ARER O R THAN REPRESENTATIVE 5011 Locust Lane, Harrisburg, PA 17109 Amy M. Moya ~~. / y/ a Side 1 1505607120 150560'',7120 J 150560722D REV-1500 EX Decedent's Social Security Number oecedar,esNama: M. Jane Douglass O'Keefe 17 4 2 0 2 8 6 4 RECAPITULATION 1. Real Estate (Schedule A) ...................................................................................... 1. 2. Stocks and Bonds (Schedule B) ..............................._............................_ . 5 8 , 17 9 . 6 8 ............. 2. 3. Closely Hetd Corporation, Partnership orSole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D) .............................__....................... 4. 5• Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ................ 5. 5 4 , 4 8 8 . 4 4 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 6. 4 . 4 4 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ............. 7, 2 4 , 0 0 0 . 0 0 8. Total Gross Assets (total Lines 1-7) ............................._................................... g, 1 3 6, 6 7 2. 5 6 9. Funeral Expenses & Administrative Costs (Schedule H) ..................... ................. 9. 1 7 , 0 6 3.12 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ............................... . 10. 5 5 6 . 4 5 11. Total Deductions (total Lines 9 & 10) ............................._._................................. 11. ~ 1 7 , 619.5 7 12. Net Value of Estate (Line 8 minus Line 11) .....................:.......~. .: .....:........ 12, 1 1 9 , 0 5 2 9 9 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .............................................. 13, 14. -- Net Value Subject to Tax (Line 12 minus Line 13) .............................................. --- 14, 1 1 9 , 0 5 2 9 9 - --- TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES -- ---- __ --------------- 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x .o0 0 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate X .045 0. 0 0 16. 0. 0 0 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17. 0. 0 0 18. Amount of Line 14 taxable at collateral rate x .15 119 , 0 5 2. 9 9 1s. 17 , 8 5 7. 9 5 19. Tax Due .............................................................. ...... ........................................... 19. 1 7, 8 5 7. 9 5 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 L 1505607220 1505601220 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-09-00413 DECEDENT'S NAME M. Jane Douglass O'Keefe STREET ADDRESS -- 210 Big Spring Road CITY STATE ZIP Newville PA 17241 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penatty if applicable D. I rlterest E. Penalty (1) 17,857.95 16,300.00 857.89 Total Credits (A + B + C) (2) 17,157.89 700.06 700.06 Total Interest/Penalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT. ~ (q) Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (5B) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPIROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :............................................................................. [] c. retain ah eversionary interest; oo. shall use the property transferred or its income :........:.....::.'::....::..: ~ ~I 2. If death occurred after IDecembe o12 it1982ad d decedent transferaproperty within one year of death without L~ III receromg adequate consideration? ............................................................ I _......... ........................................... ~~ L _~ 3. Did decedent own an "in trust for„ or payable upon death bank account or security at his or her death?......... ~ ~~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .............................. ~- ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART O~ F THE RETURN. 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 tax rate imposed on the net value of transfers to or for the use of thle surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statutedoes not exempt a transfer to a surviving spouse from tax, and thel statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death h:o or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent (72 P.S. §9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72'i P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Rsv-1503 E)(+ (5-88) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER O'Keefe, M. Jane Douglass 21.09-00413 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 002068702 69 shares of AT8tT, Inc., -held at Merrill Lynch, 25.680000 1,771.92 Account No. 872-10520, titled to M. Jane Douglas O'Keefe ($25.680000/share) 2 885215558 514.615 shares of Thornburn Income Builder Fund 12.260000 6,309.18 Class A -held at Merrill Lynch, Account No. 872-10520, titled to M. Jane Douglas O'Keefe ($12.260000/share) $ 990286976 32,718 shares of ML Bank Deposit Program -held at 1 32.718.00 Merrill Lynch, Account No. 872-10520, titled to M. Jane Douglas O'Keefe ($1.00/share) , 4 5a~s728a 785.669 shares of Loomis Sayles Strategic Income 10.300000 8,092.39::• Fund Class A -held at Merrill Lynch, Account No. 872-10520, titled to M. Jane Douglas O'Keefe ($10.300000/share) 5 Sa~sTt~ 883.534 shares of Loomis Sayles invt Grade Bd Fd CI 9.640000 8,517.27 A -held at Merrill Lynch, Account No. 872-10520, titled to M. Jane Douglas O'Keefe ($9.640000/share) 6 Cash -held at Merrill Lynch, Account No. 872-10520, p,82 titled to M. Jane Douglas O'Keefe 7 744320102 34 shares of Prudential Financial Inc -Account No. 22.65 770.10 0003149510, titled to M. Jane O'Keefe ($22.65/share) TOTAL (Also enter on Line 2, Recapitulation) 58,179.68 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form pA-1500 Schedule B (Rev. 6-98) Rev-1508 F~t+ (6-981 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER O'Keefe, M. Jane Douglass 21-09-00413 InGude the proceeds of IRigation and tha date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Savings Account No. 82004-00, -held at Members 1st Federal Credit Union, titled to 610.40 M. Jane O'Keefe (50.21 accrued interest) 2 Checking Account No. 65198689, -held at M8T Bank, titled to M. Jane O'Keefe 8,822.53 (50.10 accrued interest) 3 Savings Account No. 15004208558451, -held at M&T Bank, titled to M. Jane O'Keefe 39.790..95 (53.47 accrued interest) ~. 4 Check from M8T Bank - (refund of line of credit account #12044428602476001) 1 12.36 " : ; 5 Check from Millennium Pharmacy Systems, Inc. - (refund of prescription serviice) •: 188.64 6 Check from Presbyterian Homes - (.refund of accommodations) 3,359.38 7 Check from Holy Spirit Hospital - (refund of overpayment) 519.00 8 Check from PEBTF - (refund from Health Insurance) 685.18 9 Personal property 500.00 TOTAL (Also enter on Line 5, Recapitulation) I 54,488,44 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form fr~A-1500 Schedule E (Rev. 6-98) Rev76118 EX+ (6-98) COMAAONNIEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER O'Keefe, M. Jane Douglass 21-09-00413 ff an asset was made joint within one year of the decedent's date of death, It must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Robin Piacine B. C. 181 Ridge Hill Road Niece Mechanicsburg, PA 17050 JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOIN TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH ALOE OF ASSE ~0 OF D~CD'S INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST 1 A 11/21/200 Savings Account Na 296021-00, -held at 8.87 50.000°/a 4.4x4 Members 1st Federal Credit Union, titled to M. Jane O'Keefe aind Robin Piacine TOTAL (Also enter on Line 6, Recapitulation) I 4.44 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PV1-1500 Schedule F (Rev. 6-98) Rev-1510 EXti (6.98) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER O'Keefe, M. Jane Douglass 21-09-00413 This schedule must he completed and filed ff the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DE INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST 'EXCLUSION (IIF APPLICABLE) TAXABLE VALUE 1 Cash gifted to Robin Piscine, niece, on 9/24/2008 24,000.00 3,000.00 21,000.00 (within 1 year of death) 2 Cash gifted to William Bradley Westhafer, 6,000.00 3,000.00 3,000.00 nephew, on 9!25/2008 (within 1 year of death) TOTAL (Also enter on Line 7, Recapitulation) 24.000.00 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form F-A-1500 Schedule G (Rev. 6-98) REV-1151 E)(+ (12-99) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & IN RE3IDE~NCTEDECEDEr~rrRN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER O'Keefe, M. Jane Douglass 21-09-00413 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees Law Offices of Susan E. Lederer 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Cumberland County Register of Wilis 5. Accountant's Fees James Pivonka, CPA 6. Tax Return Preparers Fees 7. Other Administrative Costs See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 12,181.06 4,000.00 252.00 330.00 300.06 17,063.12 Copyright (c) 2002 form software only The Lackner Group, Inc. Form i~A-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER O'Keefe, M. Jane Douglass 21-09-00413 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Funeral Home 11.751.06 2 Olive Garden - (funeral luncheon) 122.51 3 Funeral clothing for decedent 107.49 4 Gingrich Memorials - (memorial inscription) 200.00 H-A Subtotal 12.181.06 Other Administrative Costs 5 Cumberland Law Journal - (Estate advertising) 75.00 6 Carlisle Sentinel - (Estate advertising) 145.06 7 Cumberland County Register of Wills - (filing fee - PA Inheritance Tax Return and 30.00 PA Inventory) 8 Cumberland County Register of Wills - (additional probate costs) 50.00 H-B7 subtotal 300.06 Copyright (c) 2002 form software only The Lackner Group, Inc. Form WA-1500 Schedule H (Rev. 6-98) Rev-1512 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, ~ LIENS ESTATE OF FILE NUMBER O'Keefe, M. Jane Douglass 21-09-00413 Include unreimbureed medical expanses. ~~~ ~~~..~` ayu.,c w nc~cu, Guuuwnal pages oT Ine same 312e) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF O'Keefe, M. Jane Douglass NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I~ TAXABLE DISTRIBUTIONS [include outright spof distributions and trar under Sec. ~116(a)(1 Robin Piscine 181 Ridge Hill Road Mechanicsburg, PA 17050 William Bradley Westhafer 6604-A Carlisle Pike Mechanicsburg, PA 17050 FILE NUMBER 21 X09-00413 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE DECEDENT (Words) ' ($$$1 Do Not List Trusteet.~ I Niece ~ Nephew Joint account; Schedule a gifting Schedule G gifting; 100~°/0 01 residual es#ate Total Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 150p coy II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 21,004.44 98,048.55 119,052.99 'r sheet TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-15oa c:nvFR ~cWG~T ~ .... ....... opyng c orm software only The Lackner Group, Inc. Form P14-1500 Schedule) (Rev. 6-98) SCHEDULE J BENEFICIARIES Last Will anod Testament ~O n~ U'' M. Jane Douglass O'Keefe I, M. Jane Douglass O'Keefe, also known as Jane O'Keefe, also known as M. Jane O'Keefe, also known as M. Jane Douglass, a resident of Mechanicsburg, Cumberland County, Pennsylvania, revoke any prior wills and codicils made by me and declare this to be my Last Will and Testament. Article One Family Information I have made provision for the following individuals in my will: Name Relationship William Bradley Westhafer nephew Robin S. Piacine niece Annette G. Gilbert niece I have made no provision in my will for my nephew, Cazl Westhafer, Jr., ar my stepson, Michael John O'Keefe, because I feel they have been otherwise well provided for. Article Two Specific and General Gifts Section 2.01 Specific Distribution to William Bradley Westhaf~r As soon as practicable after my death, I give my real estate located at 12 Poplar Drive, Mechanicsburg, Cumberland County, Pennsylvania to William Bradley Westhafer. If William.Bradley Westhafer should predecease me, I give the property subject to this distribution to Robin S. Piacine. Death taxes shall be apportioned to this distribution, notwithstanding the provisions of Article Eight. Property passing under this Section shall pass subject to all liens, security interests or other encumbrances on the property. Page 1 Section 2.02 Disposition of Tangible Personal Property I give all my remaining tangible personal property, together with any insurance policies covering such property and claims under such policies in accordance with a "Memorandum for Distribution of Personal Property" or other similar writing directing the disposition of such property, which shall be dated and signed by me. Should I leave multiple written memoranda that conflict as to the disposition of any item of tangible personal property, the memorandum with the most recent date shall control as to those items that are in conflict. If the memorandum with the most recent date conflicts with a provision of this Will as to the specific distribution of any item of tangible personal property, the provisions of this Will shall control as to those items that are in conflict. I intend that the writing qualify to distribute my tangible personal prroperty under applicable state law. Section 2.03 Contingent Distribution of Tangible Personal Property Any tangible personal property not disposed of by a written memorandum, or if I choose not to leave a written memorandum, all such property shall become part of my residuary estate. Section 2.04 Definition of Tangible Personal Property For purposes of this Article, my tangible personal property shall include but not be limited to my household furnishings, appliances and fixtures, works pf art, motor vehicles, pictures, collectibles, personal wearing apparel and jewelry, books, sporting goods, and hobby paraphernalia. Section 2.05 Encumbrances and Incidental Expenses of Tangible Personal Property My Executor shall distribute property under this Article subject to liens, security interests or other encumbrances on the property. My Executor shall pay, as an administration expense, the reasonable expenses of storing, packing, insuring, transporting and otherwise caring for my tangible personal property until actual delivery of each article of property to the appropriate beneficiary, Page 2 Article Three My Residuary Estate Section 3.01 Definition of My Residuary Estate All the remainder of my estate, including property referred to above that is not effectively disposed of, shall be referred to in my will as my "residuary estate." Section 3.02 Disposition of My Residuary Estate I give my residuary estate outright to William Bradley Westhafer. If William Bradley Westhafer predeceases me, I give my residuary estate outright to Robin S. Piacine. If Robin S. Piacine predeceases me, I give my residuary estate outright to Annette G. Gilbert. If Annette G. Gilbert predeceases me, my Executor shall distribute my residuary estate as provided in Article Four entitled "Remote Contingent Distribution." Article Four Remote Contingent Distribution If, at any time, there is no person or entity qualified to receive fmal distribution of my estate or any part of it, then the portion of my estate with respect to which the failure of qualified recipients has occurred shall be distributed to those persons who would inherit it had I then died intestate owning the property, as detexmined and in the proportions provided by the laws of Pennsylvania then in effect. Article Five Designation of Executor Section 5.01 Executor I name William Bradley Westhafer as my Executor. If William Bradley VG'esthafer fails or ceases to act as my Executor, I name Robin S. Piacine as my Executor. Page 3 Article Six General Administrative Provisions The provisions of this Article apply to my probate estate. Section 6.01 No Bond No Fiduciary shall be required to fiunish any bond for the faithful performance of the Fiduciary's duties. If a bond is required by any law or rule of court, no surety shall be required on such bond. Section 6.02 Fiduciary Compensation An individual serving as my Fiduciary shall be entitled to fair and reasonable compensation for the services rendered as a fiduciary. A corporate fiduciary shall be compensated by agreement with an individual Fiduciary or, in the absence of an individual Fiduciary or in the absence of an agreement, in accordance with the corporate fiduciary's published schedule of fees in effect at the time the services are rendered. In addition to receiving compensation, my Fiduciary may be reimbursed for reasonable costs and expenses incurred in carrying out its duties under my will. Section 6.03 Determination of Principal and Income The Pennsylvania Uniform Principal and Income Act shall govern benef ciaries' rights among themselves in matters concerning principal and income. If the Pennsylvania Uniform Principal and Income Act contains no provision concerning a particulaz item, my Fiduciary shall determine in a fair, equitable and practical manner what shall be credited, charged, and apportioned between principal and income. Section 6.04 Distributions to Incapacitated Persons and Persons Under Twenty-Five Years of Age If my Executor is directed to distribute any share of my probate estate to any beneficiazy who is under the age of 25 years or is in the opinion of my Executor, under any form of incapacity that renders such beneficiazy unable to administer distributions properly when the distribution is to be made, my Executor may, as Trustee, in my Executor's discretion, continue to hold such beneficiary's share as a sepazate trust until the beneficiary reaches the age of 25 or overcomes the incapacity. My Executor shall then distribute such beneficiary's trust to him or her. While any trust is being held under this Section, the Trustee shall pay to the beneficiary for whom the trust is held such amounts of the net income and principal as the fiduciary Page 4 determines to be necessary or advisable for the beneficiary's health, education, maintenance and support. Upon the death of the beneficiary before that time, the Trustee shall distribute the trust, including any accrued and undistributed income, to the beneficiary's then living descendants, per stirpes, or, if none, to the beneficiaries named in Article Three, Section 3.02, in the order in which they are named therein. If I have no then living named beneficiaries, the property shall be distributed under the provisions of Article Four entitled "Remote Contingent Distribution." Section 6.05 Maximum Term for Trusts Notwithstanding any other provision of my will to the contrary, unless terminated earlier under other provisions of my will, each trust created under my will shall terminate 21 years after the last to die of the descendants of my maternal and paternal grandparents who are living at the time of my death. At that time, the remaining trust property shall vest in and be distributed to the persons entitled to receive mandatory distributions of net income of the trust and in the same proportions. If no beneficiary is entitled to mandatory distributions of net income, the remaining trust property shall vest in and be distributed to the beneficiaries entitled to receive discretionary distributions of net income of the trust, in equal shares per stirpes. Section 6.06 Representative of a Beneficiary The guardian of the person of a beneficiary may act for such beneficiary for all purposes under my will or may receive information on behalf of such beneficiary. Section 6.07 Ancillary Administration In the event ancillary administration shall be required or desired and my domiciliary Executor is unable or unwilling to act as an ancillary fiduciary, my domiciliary Executor shall have the power to designate, compensate, and remove the ancillary fiduciary. The ancillary fiduciary may be either a natural person or a corporation. My domiciliary Executor may delegate to such ancillary fiduciary such powers granted to my original Executor as my Executor may deem proper, including the right to serve without bond or surety on bond. The net proceeds of the ancillary estate shall be paid over to the domiciliary Executor. Section 6.08 Delegation of Authority; Power of Attorney Any Fiduciary may, by an instrument in writing, delegate to any other Fiduciary the right to exercise any power, including a discretionary power, granted the Fiduciary in my will. During the time a delegation under this Section is in effect, the Fiduciary'to whom the delegation was made may exercise the power to the same extent as if the delegating Fiduciary had personally joined in the exercise of the power. The delegating Fiduciary Page 5 may revoke the delegation at any time by giving written notice to the Fiduciary to whom the power was delegated. The Fiduciary may execute and deliver a revocable or irrevocable power of attorney appointing any individual or corporation to transact any and all business on behalf of the trust. The power of attorney may grant to the attorney-in-fact all of the rights, powers, and discretion that the Fiduciary could have exercised. Section 6.09 Merger of Corporate Fiduciary If any corporate fiduciary acting as my Fiduciary under my will is merged with or transfers substantially all of its trust assets to another corporation or if a corporate fiduciary changes its name, the successor shall automatically succeed to the position of my Fiduciary as if originally named my Fiduciary. No document. of acc$ptance of the position of my Fiduciary shall be required. Article Seven Powers of My Fiduciaries Section 7.01 Grant of Powers My Fiduciaries may perform every act reasonably necessary to administer ~y estate and any trust established under my will. Specifically, my Fiduciaries may exercise the following powers: They may hold, retain, invest, reinvest and manage real or personal property, including interests in any form of business entity and policies of life, health and disability insurance, without diversification as to .kind, amount or risk of non-productivity and without limitation by statute or rule of law. They may partition, sell, exchange, grant, convey, deliver, assign, transfer, lease, option, mortgage, pledge, abandon, borrow, loan, contract, distribute in cash or kind or partly in each at fair market value on the daite of distribution, without requiring pro rata distribution of specific assets and without requiring pro rata allocation of the tax bases of such assets. They may hold in nominee form, continue businesses, carry out agreements, and deal with themselves, other Fiduciaries and business organizations in which my fiduciaries may have an interest. They may establish reserves, release powers, and abandon, settle or contest claims. Page 6 They may employ attorneys, accountants, custodians of the trust assets, and other agents or assistants as deemed advisable to act with or without discretionary powers and compensate them and pay their expenses from income or principal or both. Section 7.02 Fiduciaries' Powers Act In addition to all of the above powers, my fiduciaries may, without prior authority from any court, exercise all powers conferred by my will or by common lbw or by any fiduciary powers act or other statute of the Commonwealth of Pennsylvania or any other jurisdiction whose law applies to my will. My Executor shall have absolute discretion in exercising these powers. Except as specifically limited by my will, these powers shall extend to all property held by my fiduciaries until the actual distribution of the property. Section 7.03 Alternative Distribution Methods My Fiduciary may make any payment provided for under my will as follows: Directly to the beneficiary; In any form allowed by applicable state law for gifts or transfers to minors or persons under a disability; To the beneficiary's guardian, conservator, agent under a durable power of attorney or caregiver for the benefit of the beneficiary; or By direct payment of the beneficiary's expenses, made in a manner consistent with the proper exercise of the fiduciary's duties hereunder. A receipt by the recipient for any such distribution shall fully discharge my Fiduciary. Article Eight Provisions for Payment of Debts, Expenses and Taxes Section 8.01 Payment of Debts and Expenses I direct that all my legally enforceable debts, secured and unsecured, be paid as soon as practicable after my death. Section 8.02 No Apportionment Except as otherwise provided in this Article or elsewhere in my will, my 1~xecutor shall provide for payment of all estate, inheritance and succession taxes payable'' by reason of Page 7 my death ("death taxes") from my residuary estate as an administrative expense without apportionment and shall not seek contribution toward or recovery of any death tax payments from any individual. Section 8.03 Property Passing Outside of My Will Except as to Qualified Retirement Benefits, death taxes imposed with respect to property included in my gross estate for purposes of computing the tax and passing other than by my will shall be apportioned among the persons and entities benefited in the proportion that the taxable value of the property or interest bears to the total taxable value of the property and interests received by all persons benefited. The values as finally determined in the respective tax proceedings shall be the values used for the apportionment of the respective taxes. Section 8.04 Tax Elections In exercising any permitted elections regarding taxes, my fiduciaries may make such decisions as they deem to be appropriate in ail the circumstances and my f duciaries shall be under no duty to make any compensatory adjustment as a consequence of any such election. My Executor may also pay such taxes or interest and deal with any tax refunds, interest, or credits as it shall deem necessary or advisable in the interest of rkiy estate. Article Nine Definitions and General Provisions Section 9.01 Definitions For purposes of my will and for the purposes of any trust established under my will, the following definitions shall apply: (a) Adopted and Afterborn Persons A legally adopted person in any generation and his or her descendants, including adopted descendants, shall have the same rights and shall be treated in the same manner under my will as natural children of the adopting parent, provided such person is legally adopted prior to att~.ining the age of 18 years. A person shall be deemed to be legally adopted if the adoption was legal in the jurisdiction in which it occurred at the time that it occurred. Page 8 (b) Descendants The term "descendants" shall include a person's lineal descendants of all generations. (c) Fiduciary My "Fiduciary" or "Fiduciaries" shall refer to my Executor. My "Executor" shall include any executor, ancillary executor, administrator, or ancillary administrator, whether local or foreign and whether bf all or part of my estate, multiple Executors, and their successors. (d) Legal Representative As used in my will, the term "legal representative" means a person's guardian, conservator, personal representative, executor, administrator, Trustee, or any other person or entity personally representing a person or the person's estate. (e) Per Stirpes Whenever a distribution is to be made to a person's descendants per stirpes, the distribution shall be divided into as many shazes as there aze then living children of such person and deceased children of such person who left then living descendants. Each then living child shall receive one share and the share of each deceased child shall be divided among such child's then living descendants in the same manner. (fl Shall and May Unless otherwise specifically provided in my will or by the context in which used, I use the word "shall" in my will to command, direct or require, and the word "may" to allow or permit, but not require. In the context of my Trustee, when I use the word "may" I intend that my Trustee may act in its sole and absolute discretion unless otherwise stated in my will. (g) Other Definitions Except as otherwise provided in my will, terms shall be as defined in PA Probate, Estates and Fiduciaries Code as amended after the date of my will and after my death. Section 9.02 Contest Provision If, after receiving a copy of this Section, any person shall, in any manner, directly or indirectly, attempt to contest or oppose the validity of my will, (including ~.ny codicil to my will), or commences, continues or prosecutes any legal proceedings to set my will Page 9 aside, then such person shall forfeit his or her share, cease to have any right or interest in my estate, and shall, for purposes of my will be deemed to have predeceased me. This Section shall not apply so as to cause a forfeiture of any distribution otherwise qualifying for the federal estate tax charitable deduction. Section 9.03 Survivorship Presumption If any beneficiary shall be living at my death, but die within 30 days thereafter, then such beneficiazy shall be deemed to have predeceased me for all purposes of my will. Section 9.04 General Provisions The following general provisions and rules of construction shall apply to my will; (a) Singular and Plural; Gender Unless the context requires otherwise, words denoting the singulaz nnay be construed as plural and words of the plural may be construed as denoting the singular. Words of one gender may be construed as denoting another gender as is appropriate within the context. The word "or" when used in a list of more than two items may function as both a conjunction and a disjunction as the context requires or permits. (b) Headings of Articles, Sections, and Subsections The headings of Articles, Sections, and subsections used within my will are included solely for the convenience and reference of the reader. They shall have no significance in the interpretation or construction of my will. (c) Governing State Law My will shall be governed, construed and administered according to the laws of the Commonwealth of Pennsylvania as from time to tune amended. Questions of administration of any trust established under my will shall be determined by the laws of the situs of administration of such trust. (d) Notices Unless otherwise stated, whenever my will calls for notice, the notice shall be in writing and shall be personally delivered with proof of delivery, or mailed postage prepaid by certified mail, return receipt requested, to the last known address of the party requiring notice. Notice shall be effective on the date personally delivered or on the date of the return receipt. If a party giving notice does not receive the return receipt but has proof that he or she mailed the notice, notice shall be effective on the date it would Page 10 normally have been received via certified mail. If notice is required to be given to a minor or incapacitated individual, notice shall 'be given to the parent or legal representative of the minor or incapacitated individual. (e) Severability The invalidity or unenforceability of any provision of my will shall not affect the validity or enforceability of any other provision of my will. If a court of competent jurisdiction determines that any provision is invalid, the remaining provisions of my will shall be interpreted and construed as if any invalid provision had never been included in my will. I, M. Jane Douglass O'Keefe, hav ng signed this Will in the presence of ~~~~s -~ol~e. ~s~,~/ and ~,~~~ ~ 41: ?~~'~a~c~ who attested it at my request on this day, _IJ~-ws~t- 2-'7 , 2006 at Hamsburg, Pennsylvania, declare ''this to be my Last Will and Testament. ~'?, M.~ane Douglass 'Keefe, Testatri ~' Page 11 The above and foregoing Will of M. Jane Douglass O'Keefe was declared by M. Jane Douglass O'Keefe in our view and presence to be her Will and was signed and subscribed by the said M. Jane Douglass O'Keefe in our view and presence and at her request and in the view and presence of M. Jane Douglass O'Keefe and in the view and presence of each other, we, the undersigned, witnessed and attested the dole execution of the Will of M. Jane Douglass O'Keefe on this day, ~~,~~.,,~~ ;~~_~ 2006. `~`~` ' ~ ~~~~,; -~s u•~} residing at :, residing at U l~ "~ ~ .Tcs ,YL l~ A 1 7 5~"~ 2 3c-E~.i's.k~~ ~:~Y n PENNSYLVANIA SELF AUTHENTICATING AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN I, M. Jane Douglass O'Keefe, the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by M. Jane Douglass O'Keefe, the testatrix, this day, ~j ~j,,i,~ a7 , 2006. M. bane Douglass 'Keefe, Testatrix Notiary Public `J COMMONW~q Ty OF PENNSYLVANIA '-,~~ L~owerUe~el~ NOSY Public Member, Pen ~t9B Qa, ~ Page 12 y °l~ Aesoc-atlon of Notarise COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN We, ~''' '`' ~~~ =~:.~-, and v j~1. n~ ~ ,the witnesses whose names are signed to the attached or foregoing instrument, ' eing duly qualified according to law, do depose and say that we were present and saw the testatrix sign and execute'the instrument as her Last Will; that the testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testatrix signed the will as a witness; and that to the best of our knowledge the testatrix was at that time 18 or more years of age, of sound mind, and under no constraint or undue influence. ,/ ~ Witness Tl; , Witne 1 ~ot y Public COMMONWlcA1,TM t3F PENNSYLVANIA J MNotarial Seal l Paxton T~' NOtary' Puff My, ~•~ Member, Pen 1~P~s Oa. 25 X10 Aasoclation of Nota es Page 13 000 !'! d ~ G ~~ H O C O q N V V ~ O t0 t0 ODD ODD v v ~ o~ w ~, o o ~ ~ ~ 0 o c w pO ~' '~ O = ~ O Q~ oo °oc 0~ tOa D oc min ~O D aCD m ~ v, m -~'Z ~~„ p o Z ~ ~ o ~ ~ .~ D '-I D ~ D ~ cn m -v n A .a D ~' O ; : V A v ~' f0 p .. gA ~ O ~ ~ ~ o A $ S . dD Qp W N r O v N ...~ o0 N V ~ ~ O v v v ~ ~ ~ Q ~ n C (~ ... ~ ~ N ~ ~ ~s-* 3 ' ao ,A ~ N : ~ oo n p ~ p v ..~. ~ ~ ... o -°' o Q l~ ~ N vm cD '~• p '.'.O ~j y ~ ~ .. .. ~~ ~~ mr 0.~~-i wcC2 OZy w~--I S f!1 ~p ~ N O ~ i9 =•D ~~'ZO '~o~v~ 3g ~ u+ ~ ~ ~ 00 c~nww ? ~ Z _N T'~n^^ Z C C ~-<-i O ~ n ~. ~. ~ ..a .a ~ n p ~' D ~ ~ ~ N N N ~ ~~ ~S ~ OOO p w y Z ,r N co cO co o> o ~ ~ W C D ~ r D ~ v ~ m D ~ o N A . ~ ~ ~ ~ rn rt p o~ ~ ~ ' .~ ~ n as . o ~' O ~ d d .y c~ = c O ~; o -~ o v o n ~ ~ O ~, H ~ ~ ~ r" ~ N ~ ~ Q~ ~ ~ C fD r/+ N ~ _ C V O ~ Z ~ ~ ~' _ C e G. 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Se' ~, N ~"' y ~ o~ D v o ~, ~ c 3 m~ y c c ~ .- w c~ m m d c ~ w m ?. o y n o o ~ ~ .a c ~ ~ y ~• a. ~ o ~ ~ ~ ~ m o ~ m ~ .~ ~ ~ 3 y c. p ~ ~ ~ ~ y ~ a m ~ g C7 v 3 ~ m °' `~°• 3 D ~ S O 1D ~ p N 'd" C ~ ~ ~ ~ O y r. 7 C O ,,7,• ~ D m `~ w o a n s ~ ~ ~. ~ _ ~ d ~ f1 y m a ° ~ w ~ _m a m d ~ D d ~ N (D '~ ~ -1 O n W Q e = d w d d C c co m .. .. a w V O w oe w O O O H N V A O iD N OD Prudential ~ Financial IMPORTANT TAX RETURN DOCUMENT ENCLOSED """""AUTO" 5•DIGIT 17050 000001831 /000445411 » M JANE 0 KEEFE ~ 12 POPIAR DR ~ MECHANICSBURG PA 17050-2764 ~ Irrrlllrrilllr~rililill~rrrrl,llirrl~llrrilr~l~~rllirlrlrlrlrl ilk 1~ ~~~ r ,N ~, ~omputershare Computershare Shareholder Services Inc ,, PO Box 43033 Providence Rhode Island 02940-3033 Telephone: 800 305 9404 vvuuw.comput~rshare.corq/prudential Holder Account Numbier C 0003149 10 I N D Record Date 27 Nov 2006 Chick Number 0000272535 S3NITIN CeRitied Yes ~ruaenitiai rmanciai, Inc. -Combined nividnnrl D~....,e..~. - ~nn~ ~___ ~__ .___ _.. _ Form 1099-DIV Dividend Confirmation (Keep for your records) Payment Date I Class Description I Participating I Dividend Gross Deduction 'Deduction ShareslUnits Rate I Dividend ($) I Amount ($) I Type I Dividend ($) 21 Dec 2006 COMMON 34 50.95 32.30 0.00 NIA 32.30 Year•TaDate Paid 3230 0'~ 32.30 46UTX P R U '}~ oo2CS7ntx)a OOMOMA(~) PLEA3EGISWDEPOSRTHISCHECKPitr~vnr _ _ _ _ _ _ PRU: Historical Prices for PRUDENTIAL FINCL INC -Yahoo! Finance Page 1 of 2 Yahoo! My Yahoo! Mail More Get the New, Sarer IEB ~'1/~"'~l~ Ci~.i ~t C Now User? °iign Up Sign In Help _ _ ... ~.,t~IW3C7+C~r® F[ft~17~.G Search _. ~ WE8 SEARCH -- _... _ ._ Dow • 0.80% Nasdaq ~' 0.63% Wed Apr 1 2009, 11 39AM ET - U.S. Market dose in 4hrs 2lmins GETQGpTiS [ Finance Search Prudential Financial, Inc. (PRU) r. i °j;; ru~arerrwwori ; Invest year a~a^y... t _.:... Historical Prices SET DATE RANGE Get Historical Prieas for: GO ADVERTISEMENT _........._ .......... ...._..............__........__. ! Daily Start Date: ~ Mar 18 2009 ey. fan 1, : y., Weekly _..........__......_ ................._._._.._.....; 2003 •. End Date: i Mar _.18 ___ ......_, 2009 ~: _.? Monthty +::_) Dividends Only Get Prices At 11:24AM ET: 119,65 t 0.63 (3.31%) 'grade hlciw ~;, x.~, rw.- ~~"~ ~~~ r,,t*rsCo~unRS,uo First ~ Prev ~ Next ~ Last PRICES Date Open High Low Close Volume ~j Close" 18-Mar-09 20.50 25.30 20.00 24,92 21,552,600 24.92 ~ Close price adjusted for dividends and splits. First ~ Prev ~ Next ~ Last r'a't Download To Spreadsheet 'S~~ ski S ~.« ~ Add to Portfolio m t A ert C~ Email to a Friend Get Historical Prices for Another Symbol: ~ ®Svmbol Lnokuo • Stock Screener Splits http://finance.yahoo.coin/q/hp?s=pRU&a=02&b=18&c=2009&d=02&e=18&~2009d3cg=d 4/1/2009 ..:...~,..~..., arc. av.oy rHn !1//aaa,{,/8 _ SAVINGS ACCOUNT: Account Number/Suffix Dafe Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established MEMBERS 1ST FCU INSURANC ~j 0 01 MEMBERS 1~ FEDERAL CREDIT UNION 82004-00 296021-00 11 /01 / 1986 11 /21 /2006 $610.19 $8,87 $.21 $.00 $610.40 $8,87 None Robin Piacine 11/21/2006 BERS 1ST FEDERAL CR IT UNION Danielle A. Kline insurance Services Specialist May 28, 2009 Estate of: M. J. O'KEEFE Date of Death: 03/18/2009 Social Security Number:174-20-2864 5000 Louise Drive P.(7. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283-2328 w~,~, • memberslst.org O~s~x 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Susan E. Lederer Law Offices 5011 Locust Lane Harrisburg, PA 17109 Re: Estate of M. Jane O'Kee e Social Security 174-20-2864 Date of Death: March 18 2009 S~~~,..c~ ~, ~-~ts ~._,~- Phone (888) 502-4349 Fax (302)934-2955 May 20, 2009 Dear Sir or Madam: Per your inquiry dated May 13, 2009, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: t ~ Type ofAccount Checking Account Account Number 65198689 Ownership (Names o,~ MJane O'Keefe* Opening Date 1/28/"/5 Closed 5/8/09 Balance on Date ofDeath $ 8,822.43 Accrued Interest $ 0.10 Total -------------------------------------.._---------_______. $ 8,822.53 TypeofAccount Savings Account Account Number 15004208558451 Ownership (Names o,~ MJane O Keefe* Opening Date 4/8/76 Closed 5/8/09 Balance on Date of Death $ 39, 787.48 Accrued Interest $ 3.47 Total $ 39,790.95 - - 3. Type ofAccount RVL Account Number 120 444 2860247 6001 Ownership (Names ofJ MJane O'Keefe* Opening Date 2/23/04 Balance on Date of Death $0.51 ** This amount is not to be used for pa,~off purposes. For a payoff balance, please caU I-80Q724-2140. Current Balance $12.48 ** This amount is not a payofJ`'balanci~ 4. Type ofAccount Safe Deposit Box Box Number/Location 0000072/Hampden Ownership (Names o,~ MJane O Keefe* Robin S Piacine Opening Date S/1/SO * If upon reviewing the information above, you believe there are additional accounts not referenced, please provide us with an account number and/or name of any possible joint account holder. For any additional) information on the above accounts, including ownership and any changes, closures and/or reimbursement of funds,'. etc., please contact our Hampden Office # 717-255-2293. S~inc(e~rely, t , Tracie Hare Adjustment Services (~ lYl~l ~I1K Line of Credit Pryment Minimum Accoum Dus Payment Numhe r Data Due 12044428602476001 09/21/09 00 0 OOOM NM 017 69 M JANE OKEEFE 181 RIDGE HILL RD MECHANICSBURG PA 17050 Please Indicate Amount Enclosed S I ~:5 ~ 20aa10000~: 444 2860 247600 311t' PLEASE DETACH UPPER PORTION AND RETURN WITH YOUR REMITTeNCF veveal t: Tn tu~T',nnnrlr LINE O R DIT ACCOUNT NUMBER SICCING DATE DAY IPf BILLING PERIOD ----- - - - RATE --- -------- INLMUM P' YMENT DUE DATE 12044428602476001 08/27/09 31 18.00070 09/21/09 °OST ING TRANS- ACTION CREDIT LINE CREDIT IN USE CREDIT AVAILABLE 2000..00 0.0:0 0.00 FEES PREMIUMS &LOANS PAYMENTS &CREDITS BANK REFERENCE NUMBER DATE DATE TRANSACTION DESCRIPTION PERIOD: JUL 28,09 TO AUG 27,09 17/31 07/31 CREDIT BALANCE REFUND 12.36 CR BALANCE REFUND CHECK N8T VISA CREDIT CARD KITH MORLDPOINTS REMARDS: STOP BY ANY M8T BRANCH OR CALL 1-800-724-3222. * * * ~ * * * ~ * * r tE ~ * * * * ~ ~ * ;rt YOUR CREDIT LINE HAS BEEN CANCELLED. * * * * tE ~ * tE * * * tt ~ * * * * * ~ YOUR ACCOUNT HAS SEEN CLOSED AND IS PAID IN FULL. FINA NCE ACCOUNT PREVIOUS LOANS _ RAYMENTS E LiATE NEW -SUMMARY BALANCE ~ DEBITS 8~. CR£DITS PER ITEM FEES BALANCE INTEREST" CHARGE FEES a PREMIUMS • OAO ~~ ! ' i ~ ~ 000 LOANS a cHARCts •• 1236CR 1236 ~ ! ! 0~0 TOTAL 1236CR 1236 ~ ~ ~ Ob0 TYPE OF „ AVERAGE DAILY C:ORRESPOND.ING CREDtT , :-.DAILY.:::: PERIODIC :::. .ANNUAL :: _ .: . _. BALANCE ' :RATE :: PERCENTAGE RATE LOANS a CHARGES "" NORMAL RATE 0, 0 0.0493% (a) 18.000% (e) d This nb nryvary - R Minimum 5•rvice Chugs :R Cnd'n Balerce r Ineludes Owr Limit ~~, Return Cl+ek Fee, Litz Insunrce Premium, Disahility Insunrce Pnmium, Utrmploymertt Imunnu Pnmium. °f Include charges irclWed in the akulation at tM Ifnnq eMrga. PAGE 1 OF 1 Lots (Z/0T) - ~ ; ~ ' h r m Z ~ Z ~ ~ ~ ~ ~ 0 ~ -~ a co '~ i Q a ~ = ~ ~ -~ ~~~ n O {D o :. ~ c _ ~ r ? 'U Q- _ .a ` D N N r r s ~, m ~ ° N :. ~. 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D ~ O 'C i~ ~m~ rn _~o ~ o o O p n Co 'G -+ o "' co 1 ~ CJ ~ I i7i T N "'III ~ ~ m ,~ z ~.: m ~ ~ m ~ y I~ ~ ~ m ~ Z .~ °~ ~ ~ ~ C i ~ v t I ~ ~m n goo ~ c g m z m -~i ~ (~~ ~ ~ a ~ x ~ p r O © z D I p Til 2 n ~ I I~ a o C -m-1 T .~.{ D O CD Z ~ ti ~ pip (~ D N ~ ~ ~ ~ j w cn .~ 12/01/2009 TUE 10:34 FAX 7177955178 SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established MEhIBERS 1ST FCU INSURANC • MEMBERS in FBDERALCRFDIT UNION ~J (~J001 <~~" VZc 82004-00 296021-00 11 /01 / 1986 11 /21 /2006 $610.19 $8.87 $.21 $.00 $610.40 $8.87 Nane Robin Piacine 11 /21 /2006 BE~!R~S~1~ FEDERAL CR DIT UNION C~~~ • -~ Danielle A. Kline Insurance Services Specialist May 28, 2009 Estate of: M. J. O'KEEFE Date of Death: 03/18/2009 Social Security Number: 174-20-2864 5000 Louise Drive F'.C7. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283-2328 vvwR~memberslst.org Page 1 of 1 JANE O'KEEFE a1-~ ~~61~ 3 5 5 6 ROBIN PIACINE,POA 12 POPLAR DRIVE - EC~ICS9URQ PA }~~ DATE // A .~ / PAY TO THE f ... ORDEROF Q; Z-7~ ~af~~ Qd DOLLARS ~ ~ ,,,, ~ ~M&T ank '~'° ~ -~:03i302955~: 65i98689~~3 56 ~, - " - -- - -' r. - n _ ,~ C s Y _ ~ T '/ ' U T •. - 7 ~ 4i ~• _ n -- f - A (s. • _ _ T ~ r i. C - w _`~ C _ _ r e _ „ . - - - •s? ~ . .'. -~~ r ~ - s . _ . S ' ~ _ _ - _ y. _ r _ .. _ .. _ .. .. - _. .. -_ .~ Posting Date Research Seq # Account # Check/Store # DB/CR Dollar Amount Bank # Branch # Deposit Acct # Record Type # 2008 Sep 24 5700863343 65198689 3556 DB $24,000.00 09G 06109 15004217001657 O1 httn•//rnmmtro(11 ~x,P1~~riP~xT/;nn,,;rc,/oPr.,1a4/i»n.•;~r ~ n i~ innnn r_ Page 1 of 1 JANE O'KEEFE o~•7s ROBIN PIACINE,POA 12 POPLAR DRIVE MECFIANICSBUR(3, PA 17050 3 3 r~YTOTHS /~ / / ORDER F t,/t! , s ~~/ ~ ~M&TI3ank 310 3557 DATE ~" O (~ ~ l,000.0~. DOLLARS Lit ."~ ~ ~ ~~ «r .x:03 i30 2955: 65198689~r355? *- ~ -- _ . „f, ~: ., ,_ .~ - _ -- -~, Z ~ h ~ t - ' m:~ - •,~ N {~ G • • S _ ~_ Z :tt ~ C _ - - ~ '~ C _ ' i : .~ F ~ :J r _ - - _ J • ~ e _ _ •.~ ~ - - =~ f - _ ~~ ,; _ _' _ Z 'r C ~ 1. . `, = ~ • -. _~a--t ~,.,,~a.- . _ Posting Date 2008 Sep 26 Research Seq # 5800619332 Account # 65198689 Check/Store # 3557 DB/CR DB Dollar Amount $6,000.00 Bank # 096 Branch # 06109 Deposit Acct # 15004217001657 Record Type # O1 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128.0801 RECEIVED FROM: PENNSYLVANIA '' ~' ' T4NCE AND ESTATE TAX "ICIAL RECEIPT REV-1162 EX111-96) NO. CD 01 1363 WESTHAFER WILLIAM B 6604A CARLISLE PIKE MECHANICSBURG, PA 17050 ACN ASSESSMENT AMOUNT CONTROL NUMBER gad ESTATE INFORMATION: SSN: 174-20-2864 FILE NUMBER: 2109-0413 DECEDENT NAME: DOUGLASS O'KEEFE M JANE DATE OF PAYMENT: 06/15/2009 POSTMARK DATE: 06/ 12/2009 COUNTY: CUMBERLAND DATE OF DEATH: 03/18/2009 101 ~ 516, 300.00 TOTAL AMOUNT PAID: REMARKS: RECEIPT TO ATTY SEAL CHECK#1001 516, 300.00 INITIALS: WZ RECEIVED BY: GLENDA EARNER STRASRAUr?H REGISTER OF WILLS TAXPAYER