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HomeMy WebLinkAbout04-0178 PETITION FOR PROBATE and Estate of Kathleen Cecelia Myers No. also known as Kathleen C. Myers To: late of the Borough of Carlisle, Cumberland County Social Security No. 199-07-6539 , Deceased. The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut ors in the last wilt of the above decedent, dated April 5, 2001 and codicil(s) dated n/a GRANT OF LETTERS · Register of Wills for the County of Cumberland Commonwealth of Pennsylvania in the named (state relevant circnmstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h?(~0^ , last f.a_mily or princival residence at Sarah Todd Memorial Home v west South Street, Borough of Carlisle, Cumberland County, Pennsyhlvania 17013 (list street, number and muncipality) Decendent, then 93 years of age, died at Carlisle, Cumberland County, Pennsylvania February 5 ,X1~.2004 Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was noi the victim of a killing and was never adjudicated incompetent: None Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania $ ! (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary t (heron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) MANUFACTURERS AND TRADERS TRUST COMPANY OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA 3 COUNTY OF Cumberland ) :5S The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative,s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this. c:~,~) day of , February 2004 MANUFACTURERS AND TRADERS TRUST~2OMPANY 0~~.. No. ~9/-tS)~t/-/~),v~ Estate of KATHLEEN CECELIA MYERSa/k/a KATHLEEN C. MYERS ~ Deceased DECREE OF PROBATE AND GRANT OF LETTERS February~..~ , 2004 AND NOW the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) datedApril 5, 2001 described therein be admitted to probate and filed of record as the last will of KATHLEEN CECELIA MYERS a/k/a KATHLEEN C. MYERS , in consideration of the petition on and Letters testamentary ' are hereby granted to MANUFACTURERS AND TRADERS TRUST COMPANY FEES Probate, Letters, Etc .......... Shd~ Certificates( ) .......... $ /.5~, Renunciation ................ $. TOTAL Filed .~-~/,V~y.. ~.~,.. ~,~\~?\ .~. .... James D. Flower, Jr., Esquire #27742 ATTORNEY (Sup. Ct. I.D. No.) 26 West High Street, Carlisle, PA 17013 ADDRESS 717-243-6222 PHONE his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 9991086 No. Local Registrar FEB 6 2004 Date H~0S.~I,~,. z,a? COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OI} HEALTH · VITAL RECORDS CERTIFICATE OF DEAI'IH NAME OF OECEDENT (F~a, M~, L~) STYE F;~ NUMeER ,. ~thl~ C. Myers ~s~x J~,~t secu~.u~. ~;~,,~.~..~ ~u(t.~. u~v~ u~,,u, o~,,~. ~ ~~ 199 -- 07 -- 6539 h ~D/~-/n/i I - ' ' , Iii- li:.'Z I ' I-. Wi~ J,,. _ 1000 W. South St. .~s~ --' ~ m,~ ,,. ~rlisle, PA 17013 m~ ,..~ ~rl~d ~ ,~ ~t~ny J. O'~ell ,,. Brid~t A. ~er ~ Jo~ J. ScUll ,mm,~,*'s~um~,~.~ m.M & T T~st ~. 55 S. ~ St. ~rs~rg, PA 1720 ~$ ~: ...... s ........ ...$ ~5~?I`°" I~&'~m-"---==:,l,.: .... , ,~*:.~.~..~ ~r~l.~m~p~m~s~.~l,,,. 2/I~,?~.eE" ~:,:.Ashl~d ~te~ I,,. ~rlisle, PA 17013 ~~ ~ ~'D 012 · - * ,~ ~ [,,b 633 L in Bro~ · ~.?-.~~a=.;. I~,~ .... ~.,~, ' ...... ~ 9 ers ~eral H~, Inc., ~llsl ..m i~. I I°~E OF'muuv ]TI~E OF ,~O.y II. I~ ~ c~u~ I m P~, ~, *.'l I I .......... I ..... ~ ~ ~ ~u~. ~ I~ J.. f~.-~.,,~;~ ........ ~ I~ ~.~. --.-. - ................ --.., .... ~ .... ,, .......................... : .............. ~,,:. mo ~t~ = ~t ~ 1,,, c:\wp5 l\wills\myerskat.wil LAST WILL AND TESTAMENT OF KA THLEEN CECELIA MYERS I, KATHLEEN CECELIA MYERS, of 213 Todd Circle, Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all former Wills, Codicils, or writings in the nature thereof, by me at any time heretofore made, FIRST: I hereby order and direct my Executor, hereinafter named, to pay all my just debts, funeral expenses, testamentary expenses and all Inheritance, Estate, Transfer and Succession Taxes, as soon as may be conveniently done after my death, out of my residuary estate. SECOND: A. I hereby give and bequeath the following specific bequests: The sum of Five Thousand ($5,000.00) Dollars to MRS. ELLENE M. HRINDA, of 14 West Front Street, Jim Thorpe, Pennsylvania 18229; B. The sum of Two Thousand ($2,000.00) Dollars to FRANCIS J. HRINDA, 425 Pine Street, Jim Thorpe, Pennsylvania 18229; C. The sum of One Thousand ($1,000.00) Dollars to the SALVATION ARMY, 20 East Pomfret Street, Carlisle, Pennsylvania 17013; D. The sum of One Thousand ($1,000.00) Dollars to CARLISLE HOSPITAL HOSPICE, of 246 Parker Street, Carlisle, Pennsylvania 17013; c:\wp51 \wills\myerskat.wil AMERICAN 17013; and E. The sum of One Thousand ($1,000.00) Dollars to the CANCER SOCIETY, 117 North Hanover Street, Carlisle, Pennsylvania F. The sum of Two Thousand ($2,000.00) Dollars to the FRANCISCAN MISSION ASSOCIATES, P. O. Box 598, Mt. Vernon, New York 10551- 0598. THIRD: I hereby give, devise and bequeath all the rest, residue and remainder of my estate, not disposed of in preceding portion of this Will, as follows: A. Fifteen (15%) percent to the FIRST UNITED CHURCH OF CHRIST, Carlisle, Pennsylvania; and B. Eighty-five (85%) percent to MANUFACTURERS & TRADERS TRUST COMPANY, of Carlisle, Pennsylvania (hereinafter referred to as "Trustee") as Trustee, IN TRUST, NEVERTHELESS, to be held and administered in accordance with the provisions of paragraph FOURTH hereof. FOURTH: The following provisions shall apply to the Trust established pursuant to paragraph THIRD, subparagraph "D", of this Will: A. The name of this Trust shall be the CHARLES E. MYERS and KATHLEEN CECELIA MYERS FOUNDATION. B. The Trustee shall pay Forty (40%) percent of the net income from this Foundation to DICKINSON COLLEGE, of Carlisle, Pennsylvania, for use in funding and granting scholarships to the students attending said DICKINSON COLLEGE. DICKINSON COLLEGE shall select the students to receive such scholarships, granting c:\wp51 \wills\myerskat.wil preference to graduates of Carlisle High School, Carlisle, Pennsylvania, who are ~n need of financial assistance. Said DICKINSON COLLEGE shall give secondary preference to such graduates of Carlisle High School who participate or intend to participate in athletic programs conducted by DICKINSON COLLEGE. C. Sixty (60%) percent of the net income from the Foundation shall be paid to the CARLISLE AREA SCHOOL DISTRICT, Carlisle, Pennsylvania, to be utilized in funding and granting of scholarships for graduates of Carlisle High School, Carlisle, Pennsylvania, to attend a college or university of their choice. The students to receive such scholarships shall be selected and designated by a committee appointed by the District Superintendent of said School District, and shall be selected on the basis of financial need, scholastic achievement and academic ability. D. The Trustee shall distribute annually the net income of this Foundation. The Trustee shall distribute the income for each taxable year at such time and in such manner as not to become subject to the tax on undistributed income imposed by Section 4942 of the Internal Revenue Code of 1986, or corresponding provisions of any subsequent Federal tax laws. However, the Trustee shall pay expenses of the Foundation out of income before distribution is made for any one year. E. It is my intention that this Foundation, if the Trustee deems it advisable, qualify at the earliest practicable date as a private foundation. If and when this Foundation qualifies as a private foundation, the Trustee shall exercise no power or authority which may jeopardize the status of the Foundation as an exempt organization under Section 501(c)(3) of the Internal Revenue Code of 1986, and regulations c:\wp51 \wills\myerskat.wil appertaining thereunto as they now exist or as they may be amended; nor shall the Trustee engage in any act of self-dealing as defined in Section 4941(d) of the Internal Revenue Code of 1986, or corresponding provisions of any subsequent Federal tax law; nor retain any excess business holdings as defined in Section 4943(c) of the Internal Revenue Code of 1986, or corresponding provisions of any subsequent Federal tax law; nor make any investments in such manner as to incur tax liability under Section 4944 of the Internal Revenue Code of 1986, or corresponding provisions of any subsequent Federal tax law; nor make any taxable expenditures as defined in Section 4945(d) of the Internal Revenue Code of 1986, or corresponding provisions of any subsequent Federal tax law. F. The Foundation shall not carry on propaganda, or otherwise attempt to influence legislation and shall not participate in or intervene in (including the publication or distribution of statements), any political campaign on behalf of any candidate for public office. G. The Foundation shall not discriminate on the basis of race, color, national origin or ethnic origin, nor shall the Foundation, directly or indirectly support any institution which discriminates on the basis of race, color, national or ethnic origin in the administration of its education policies, admissions policies, scholarship and loan programs, and athletic or other school administered programs. H. Notwithstanding any provision of this Foundation, the Trustee shall not distribute any of the net income of this Trust to any organization which does not c:\wp51 \wills\myerskat. wil qualify as an exempt organization under the provisions of Section 501(c)(3) of the Internal Revenue Code of 1986, as amended. FIFTH: Notwithstanding the foregoing, if at the time of the formation of the foregoing Foundation, the principal amount forming the corpus of the Foundation is of such an amount that it is insufficient for said Foundation to be managed practically by a professional fiduciary, the Trustee shall have the power to pay the appropriate proportion of my estate directly to DICKINSON COLLEGE and the CARLISLE AREA SCHOOL DISTRICT (or its foundation) but on condition that said payments shall be only paid to an organization qualified under Section 501(c)(3) of the Internal Revenue Code, as amended. If the Trustee should ever decide that the purposes of this Trust could be carried out more effectively through a corporation, it shall have the power to form a charitable corporation, under the laws of Pennsylvania, or of any other state of the United States, and to transfer to it all of the assets and activities of the Trust. All incorporation expenses shall be treated as expenses of the administration of the Trust. SIXTH: No part of the income or principal of the property held under any Trust shall be subject to attachment, levy or seizure by any creditor, spouse, assignee or trustee or receiver in bankruptcy of any beneficiary prior to his or her actual receipt thereof. The Trustee shall pay over the net income and the principal to the parties herein designated, as their interests may appear, without regard to any attempted c:\wp51 \wills\myerskat.wil anticipation, pledging or assignment by any beneficiary under a Trust, and without regard to any claim thereto or attempted levy, attachment, seizure or other process against said beneficiary. SEVENTH: The Executor of my estate, and the Trustee of any Trusts hereunder, subject to any Trusts hereunder, subject to the limitations herein, shall possess among others, the following powers: A. To retain any investments which I may have at my death, including specifically those consisting of the stock of any bank even if I have named such bank as my Executor herein, so long as my Executor may deem it advisable to my estate so to do. B. To vary investments, when deemed desirable by my Executor, and to invest in such bonds, stocks, notes, real estate mortgages or other securities or in such other property, real or personal, as the executor shall deem wise, without being restricted to so-called "legal investments", and without being limited by any statute or rule of law regarding investments by fiduciaries. C. In order to effect a division of the principal of my estate or for any other purpose, including any final distribution, the Executor is authorized to make said divisions or distributions of the personalty and realty partly or wholly in kind. In the event a division or distribution is made in kind, such division or distribution shall be made at the fair market value of the property at the date of division or distribution. Should it appear desirable to partition any real estate, the Executor is authorized to make, join in and c:\wp51 \wills\myerskat. wil consummate partitions of lands, voluntarily or involuntarily, including giving of mutual deeds, recognizances, or other obligations, with as wide powers as an individual owner in fee simple. D. To sell either at public or private sale and upon such terms and conditions as the Executor may deem advantageous to the estate, any or all real or personal estate or interest therein owned by the estate severally or in conjunction with other persons or acquired after my death by my Executor, and to consummate said sale or sales by sufficient deeds or other instruments to the purchaser or purchasers, conveying a fee simple title, free and clear of all trust and without obligation or liability of the purchaser or purchasers to see to the application of the purchase money or to make inquiry into the validity of said sale or sales; also, to make, execute, acknowledge, and deliver any and all deeds, assignments, options or other writings which may be necessary or desirable in carrying out any of the powers conferred upon my Executor in this paragraph or elsewhere in my Will. E. To mortgage real estate, and to make leases of real estate. F. To borrow money from any party, including my Executor, to pay indebtedness of mine or of my estate, expenses of administration or inheritance, legacy, estate and other taxes, and to assign and pledge assets of my estate therefor. G. To pay all costs, taxes, expenses and charges in connection with the administration of my estate. H. To vote any shares of stock which form a part of the estate, and to otherwise exercise all the powers incident to the ownership of such stock. c:\wp5 l\wills\myerskat.wil I. In the discretion of my Executor, to unite with other owners of similar property in carrying out any plans for the reorganization of any corporation or company whose securities form a part of the estate. J. To do all other acts in the Executor's judgment deemed necessary or desirable for the proper and advantageous management, investment and distribution of the estate. K. To allocate any property received or charge incurred to income or principal or partly in each as the Trustee may deem reasonable. EIGHTH: Any person who shall have died at the same time as the Testatrix, or in a common disaster with her, or under such circumstances that it is difficult or impossible to determine which died first, shall be deemed to have predeceased her. NINTH: The Trustee shall have the power to modify any provision of this Trust, but only to the extent necessary to enable the charitable foundation to qualify for a charitable deduction for Federal Estate Tax purposes, and to continue as a perpetual charitable trust. LASTLY: I nominate, constitute and appoint MANUFACTURERS AND TRADERS TRUST COMPANY, of Harrisburg, Pennsylvania, to be the Executor of this my Last Will and Testament. No Executor shall be required to file bond in this or any other jurisdiction. The Executor and Trustee shall receive compensation in accordance with its standard schedule of fees in effect when its services are performed. c:\wp51 \willsLmyerskat. wil IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~-¢4 ~o~ ~/ ,~oo~. - ~athleen Cecelia Myers SIGNED, SEALED, PUBLISHED and DECLARED in the presence of: 9 c:\wp51 \wills\myerskat. wil COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS I, KATHLEEN CECELIA MYERS, 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; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged befor~ me, by, KATHLEEN CECELIA MYERS, the Testatrix, this &~- L'--~'X day of ~ ,2001. Kathleen Cedelia Myers, Testa~ [ ~ap/I: ublic ' 10 c:\wp51 \wills\myerskat. wil COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS We, James D. Flower, Jr and John Schall the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testatrix sign and execute the instrument as her Last Will; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; 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. and Sworn or affirmed to and subscribed to before me by James D. Flo%zer, Jr. John Schall this '~'(::~ dayof~O~,~'/ 11 !CATHLEEN CECELIA MYERS SAIDIS, SHUfF, FLOWER & LiNDSAY 26 WEST H~GH STREET CARLILSE, Pa 170i3 CERTIFICATION OF NOTICE UNDER RULE Name of Decedent: KATHLEEN CECELIA MYERS a/k/a KATHLEEN C. MYERS Date of Death: February 5, 2004 Estate No.: 21 - 04-0178 To the Register: 5.6(a) of the I certify that notice of the beneficial interest estate administration required by Rule of the Orphan's Court Rules was served on or mailed to the following beneficiaries above-captioned estate on February 21~', 2004. Ellene M. Hrinda Francis J. Hrinda Salvation Army Carlisle Hospital Hospice American Cancer Society Franciscan Mission Associates First United Church of Christ Dickinson College Carlisle Area School District 14 West Front Street, Jim Thorpe, PA 18229 425 Pine Street, Jim Thorpe, PA 18229 20 East Pomfret Street, Carlisle, PA 17013 246 Parker Street, Carlisle, PA 17013 117 North Hanover Street, Carlisle, PA 17013 P. O. Box 598, Mt. Vernon, New York 10551-0598 30 North Pitt Street, Carlisle, PA 17013 P. O. Box 1773, Carlisle, PA 17013 623 West Penn Street, Carlisle, PA 17013 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None Date: February ~,~-~ ,2004 '~-,~IDIS, SHUFF, FLowERTM& LINDSAY James D. Flower, Jr. 26 West High Street Carlisle, PA 17013 Telephone (717) 243-6222 __ Personal Representative x Counsel for Personal Representative REVISED CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Estate No.: To the Register: KATHLEEN CECELIA MYERS a/k/a KATHLEEN C. MYERS February 5, 2004 21 - 04 - 0178 I certify that notice of the beneficial interest estate administration required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on March 2, 2004. Name Address American Cancer Society 3211 North Front Street, Suite 100 Harrisburg, PA 17110 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None Date: March ",--..__~ SAIDIS, SHUFF, FLOWER & LtND~AY Name Address James D. Flower, Jr. 26 West High Street Carlisle, PA 17013 Capacity: Telephone (717) 243-6222 Personal Representative x Counsel for Personal Representative REVISED CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Estate No.: To the Register: KATHLEEN CECELIA MYERS a/k/a KATHLEEN C. MYERS February 5, 2004 21 - 04 - 0178 I certify that notice of the beneficial interest estate administration required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on March 4, 2004. Name Hospice of Central Pennsylvania Successor to Carlisle Hospital Hospice Address P. O. Box 266 Enola, PA 17025 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None Date: March 4/// ,2004 GE: ~.[~J c.,- ~ll, l I/0. Capacity: IDIS, SHUFF, FLOWER & LINDSAY Name Address James D. Flower, Jr. 26 West High Street Carlisle, PA 17013 Telephone (717) 243-6222 Personal Representative x Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HA;RRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD REV-1162 EX(11-96) OO4557 FLOWER JAMES D JR 26 WEST HIGH STREET CARLISLE, PA 17013 fold ESTATE INFORMATION: SSN: 199-07-6539 FILE NUMBER: 2104-01 78 DECEDENT NAME: MYERS KATHLEEN CECELIA DATE OF PAYMENT: 10/28/2004 POSTMARK DATE: 1 0/28/2004 COUNTY: CUMBERLAND DATE! OF DEATH: 02/05/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $1,060.29 TOTAL AMOUNT PAID: $1,060.29 REMARKS: M & T SEAL CHECK# 083566793 INITIALS' CCP RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. Prepared by the Pennsylvania Bar Assoclatlon Copyright (c) 1996 form software only CPSystems, Inc. Form #RW-7 (199Z) ESTATE OF KATHLEEN CECELIA MYERS a/k/a KATHLEEN C. MYERS NO. 21-04-0178 INVENTORY 29,007.75 shares of MTB Prime Money Market Fund #142 @ $1.00 per share Interest accrued to date of death 33,399.2360 shares of MTB Short Duration Government Bond Inst. I-Fund $120 @ $9.72 per share 704.026 shares of Ivy WR Advisors, Accumulative Fund A @ $5.76/share Citizens Bank, checking account No. 610073-159-6 1 One Dollar bill found in lock box Proceeds of sale of personal property Proceeds of sale of coins and currency found in lock box as follows: Old Dollar Bills - $1.00 (2); $2.00 (2) 5 One Ounce Gold South African Krugerrand gold pieces 12 1/10th Ounce gold South African Coins Proceeds of sale of gemstones in lock box as follows: 5 colored stones (gems) 6 colored stones (gems) 33 colored stones (gems) 1 silver bracelet, southwestern style 2 earrings and two cuff links, gold colored with claw Citizens Bank, refund of lock box rent Internal Revenue Service, federal income tax refund Cash found at residence U. S. Savings Bond #Q2385678503E, Series E, issued February 1969 owned jointly with Catherine Ann Hrinda, one-half interest $ 29,007.75 2.47 324,640.57 4,055.18 1,558.58 1.00 121.50 2,389.00 26.00 11.00 3,974.00 12.00 68.63 $365,867.68 REV-15DO EX COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 - 04 01 78 COUNTY CODE YEAR NUMBER DECEOENT'S NAME (LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Z MYERS, KATHLEEN CECELIA 199 - 07 - 6539 r"t DATE OF DEATH MM--DD-.YEAR} DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 0 02/05/2004 09/20/]9]0 REGISTER OF WILLS ILl (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER N/A - Itl z z O 0 < ~]1. Original Return [~4. Limited Estate [~] 6. Decedent Died Testate (Attach copy of Will) [~]9. Litigation Proceeds Received [~2. Supplemental Return ]4a. Future Inleresl Compromise (dale of dealh after 12-12-82) ~"] 7. Decedenl Maintained a Living Trust attach a copy of Trust} [10. Spousal Poverty Credit (dale of dealh belween 12-31-91 and 1-1-95) ["-'-~ 3. Remainder Return [date of death p~or 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 Sch O0 THIS SECTION MUST BE COMPLETED ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO NAME James D. Flower, Jr., Esquire FIRM NA,.~E (ii ~plic.~b~e) ~aials, ~nuff, Flower & Lindsay TELEPHONE NUMBER 717-243-6222 ICOMPLETE MAILING ADDRESS 26 West High Street, Carlisle, PA 17013 1. Real Estate (Schedule A) (I) 2. SIocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprielorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) ~l Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Pmbale Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedenl, Mortgage Liabilities, & Liens (Schedule 1) (10) 11. Total Deductions (tolal Lines g & 10) 12. Net Value of Estate (Line 8 minus Line 11 ) 0.00 357,705.97 0.00 0.00 8,093.08 68.63 0.00 24,552.97 3,785.03 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 365,867.68 (11) 28,338.00 (12) 337,529.68 (13) 330,529.68 (14) 7,000.00 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rale 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable al collaleral rate 19. Tax Due 0.00 x.O __ (15) 0 0.00 x.O 6 (16) 0 0.00 x .12 (17) 0 7,068.63 x ,15 (18) 1,060.29 (19) 1060.29 20 ]---1 ~1~#~`g~fa;`~=`~i~;1~'~i:f~]~J~`'`~[e~``1:i~]~L1~T~:~L%~a~am > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < Decedenrs Coml~lete Address: STREETADDRESS 1000 West South Street Carlisle [ STATE PA [ ZiP 17013 CITY Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 1,060.29 Total Credits (A+ B + C ) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line I + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE, A Enter the interest on the tax due, (3) 0.00 (4) 0.00 (5) 1,060.29 (5A) 0.00 (513) 1,060.29 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE, Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; .................... [] [] b. retain the right to designate who shall use the property transferred or its income; ...... [] [] c. retain a reversionary interest; or ......................... [] [] d. receive the promise for life of either payments, benefits or care? ................. [] [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................. ~ [] 3. Did decedent own an "in trust for"o~ayable upon death bank account or security at his or her death? L_l [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ......................... [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under I~enaltlae of I)e~jury, I declare that I have examined this tatum, including a~ompanying eohedulae and statements, and to the best of my knowledge and belief, it is true, correct and complete. Deelaratinn of preparer other than the ~reonel representative is based on all information of which preparer has any know~dge. SIGNA~ER.S~N P~ESP~))(SIBLE FOR FILING RETURN Manufacturers & Traders Trust Company, 55 South Main Street, P. O. Box 459, Chambersburg, PA 17201 . ~,,,~G_NA~URE OF PREPARER O~I'JER THAN RI~PRESENTATIVE ' DATE "',, AD~S§ ' ' '~-Sfffdis, Shuff, Flower, & Lindsay, 26 West High St~t, Carlisle, PA 17013 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 to the use of the surviving spouse is 3% [72 P.S. {}9116 (a) (1.1) (I)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. {}9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 RS. {}9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedenrs lineal beneficiaries is 4.5%, except as noted in 72 RS. §9116(I.2) [72 RS. §9116(a)(1 )]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1S03 EX- (1-97) (1) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER MYERS, KATHLEEN CECELIA 21-04-0178 All property ointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. $ 29,007.75 shares of MTB Prime Money Market Fund #142 @ $1.00 per share Interest accrued to date of death 33,399.2360 shares of MTB Short Duration Government Bond Inst. I-Fund $120 ~ $9.72 >er share 704.026 shares of Ivy WR Advisors, Accumulative Fund A ~ $5.76/share 29,007.75 2.47 324,640.57 4,055.18 TOTAL (Also enter on line 2, Recapitulation) ~' 357,705.97 (If more space is needed, inse~ additional sheets of the same size) REV-1500 EX-(1-97) (1) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS,& MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER MYERS, KATHLEEN CECELIA 21-04-0178 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH Citizens Bank, checking account No. 610073-159-6 $ 2. 3. 4. o 1 One Dollar bill found in lock box Proceeds of sale of personal property Proceeds of sale of coins and currency found in lock box as follows: Old Dollar Bills - $1.00 (2); $2.00 (2) 5 One Ounce Gold South African Krugerrand gold pieces 12 1/10th Ounce gold South African Coins Proceeds of sale of gemstones in lock box as follows: 5 colored stones (gems) 6 colored stones (gems) 33 colored stones (gems) 1 silver bracelet, southwestem style 2 earrings and two cuff links, gold colored with claw Citizens Bank, refund of lock box rent Internal Revenue Service, federal income tax refund Cash found at residence 1,558.58 1.00 121.50 2,389.00 26.00 11.00 3,974.00 12.00 TOTAL (Aisc enter on line 5, Recapitulation) $ 8,093.08 (If more space is needed, insert additional sheets Df the same size) R~[V-lS09 EX * 0-9?) (1) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER MYERS, KATHLEEN CECELIA 21-04-0178 If 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. Catherine Ann Hrinda 14 West Front Street, Jim Thorpe, PA 18229 Daughter o£Niece JOINTLY-OWNED PROPERTY: LETi'ER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. DATE OF DEATH DEC D S VALUE OF NUMBER TENANT JOINT Attach deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENTS INTERES' 2/1/69 U.S. Savings Bond #Q2385678503E, Series E, issued February 1969 $ 137.27 50% $ 68.63 TOTAL (Also enter on line 6, Recapitulation) $ 68.63 (If more space is needed, insert additional sheets of the same size) RE~511 EX- O-97) (1) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER MYERS, KATHLEEN CECELIA 21-04-0178 Debts of decedent must be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A FUNERAL EXPENSES: 1. Ewing Brothers Funeral Home, Inc., balance due on funeral (prepaid) $ 467.50 B. ADMINISTRATIVE COSTS: 1, Personal Representative s Commissions Name of Personal Representative (s) Manufacturers & Traders Trust Company 14,805.36 Social Security Number(s) / EIN Number of Personal Representative(s) Street Address 55 South Main Street City Chambersburg State PA Zip 17201 Year(s) Commission Paid: 2. Attorney Fees JSaidis, Shuff, Flower, & Lindsay, 26 West High Street, Carlisle, PA 17013 I 7,402.68 3. Family Exemption: (if decedents address is not the same as claimant s, attach explanation) Claimant n/a Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 360.00 5. Accountant s Fees 6. Tax Relurn Preparers Fees The Sentinel, advertising estate notice 136.3 l 7. Cumberland Law Journal, advertising estate notice 75.00 Carl L. Spidel, appraisal and labeling of coins 33.00 Ludwigs Jewelers, appraisal of unmounted stones and jewelry items for sale 150.00 Kenny's Auction, sale of personal property 75.01 Kenny's Auction, sale of coins and currency 597.25 Kenny's Auction, sale of gemstones in lock box 7.80 M & T Bank, account administration fee: March- $24.45; April-S31.82; May-S31.47; June-S34.23; July-S38.76; August-S38.07; September-S29.26 228.06 Register of Wills, fee to file Inheritance Tax Return 15.00 Allowance for closing costs 200.00 TOTAL (Also enter on line 9, Recapitulation) $ 24,552.97 (If more space ~s needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE T DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF MYERS, KATHLEEN CECELIA FILE NUMBER 21-04-0178 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 2. 3. 4. 5. 6. 7. 8. 9. Betra In Home Care, Home Health Aid Service Citizens Bank, checking account maintenance fee Pharmerica, prescription account Pa. Department of Revenue, 2003 personal state income tax Sarah A. Todd Memorial Home, final nursing home bill Sprint, final telephone bill Boyer & Ritter, preparation of 2003 Tax Returns Darlene L. Moyer, Tax Collector, 2004 personal taxes Pa. Department of Revenue, 2003 additional personal state income tax TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) AMOUNT 185.00 20.00 231.55 803.00 2,156.23 9.72 350.00 9.90 19.63 3,785.03 REV-1513 EX- 0-97) (1) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 11, TAXABLE DISTRIBUTIONS (include outright spousal distributions) Ellene M. Hrinda 14 West Front Street, Jim Thorpe, PA 18229 ?rancis J. Hrinda ¢25 Pine Street, Jim Thorpe, PA 18229 Niece Son of Niece $5,000.00 $2,000.00 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS Salvation Army, 20 East Pomfret Street, Carlisle, PA 17013 Carlisle Hospital Hospice, 246 Parker Street, Carlisle, PA 17013 American Cancer Society, 117 North Hanover Street, Carlisle, PA 17013 Franciscan Mission Associates, P. O. Box 598, Mt. Vernon, NY 10551-0598 First United Church of Christ, Carlisle, PA 17013 (15% of residuary estate) Manufacturers & Traders Trust Company, Carlisle, PA, In Trust as follows: Dickinson College, Carlisle, PA, 40% of the net income Carlisle Area School District, Carlisle, PA, 60% of the net income 1,000.00 1,000.00 1,000.00 TOTAL OF PART 11 - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 330,529.68 (if more space is needed, inset1 additional sheets of the same size) 2,000.00 48,829.45 276,700.23 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL Ri~~':!Jr:T: O::;;CE OF NOTICE OF INHERITANCE TAX INHERITANCE TAX DIVISIQN . :.) \ C),PPRAISEt1ENT J ALLOWANCE OR DISALLOWANCE PO BOX 280601 OF DEDUCTIONS AND ASSESSMENT OF TAX HARRISBURG PA 17128-0601 2D05 JM:] 24 1'1'.: h:'1 8: 18 01-25-2005 MVERS 02-05-2004 21 04-0178 CUMBERLAND 101 AIIIO\Int. Rellit.t..d Cl.EEK ORFI" ~"n ,-,." ")T 1-' '-i.... \i i ~-J;.jt) \,.; :"1 : JAMES D F~Ei{JR E'SQ' SAIDIS ETAL 26 W HIGH ST CARLISLE PA 17013 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN *' REY-I!i'47 EXAFP U2-a4l KATHLEEN C MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV =m"'"Ex-"Ai!p"-Cllr-"6'!1-"tiDY"fcE-oF"i:'NIIIR"fflN'fl"YAi!"7\"ppR7\YsEMEti'~""ACLowlN'fl"oR-"""._-"."" -- - "". DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MYERS KATHLEEN C FILE NO. 21 04-0178 ACN 101 DATE 01-25-2005 TAX RETURN WAS: (X I ACCEPTED AS FILED I CHANGED NOTE: I~ an assessment was issued previously, lines 14, IS and/or 16, 17, 18 and 19 will reflect ~igures that include the total o~ ~ returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rat. (15) 16. Allount of line 14 taxable at Lineal/Class A rat. (16) 11. Allount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (IS) 19. Principel Tax Due .00 X 00 = .00 .00 X 045 = .00 .00 X 12 = .00 7,000.00 X 15 = 1,050.00 1191= 1,050.00 RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets III IZI (31 141 (51 (61 (71 .00 357,705.97 .00 .00 8.093.08 68.63 .00 (81 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule Hl 10. Debts/Mortgage Liabilities/Liens (Schedule Il 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governm.ntal Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax [91 1101 24,552.97 3.785.03 1111 IlZ1 1131 1141 NOTE: To insure proper credit to your account~ subMit the upper portion of this form with your tax pay..ent. 365,867.68 'R.~~R no 337,529.68 330,529.68 7,000.00 TAX CR"DTTS: ,OJ AHOUHT PAID DATE NUMBER INTEREST/PEN PAID (-I 10-28-2004 CD004557 .00 1,060.29 TOTAL TAX CREDIT 1,060.29 BALANCE OF TAX DUE 10.29CR INTEREST AND PEN. .00 TOTAL DUE 10.29CR . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I ~~ BUREAU OF INDIVIDUALTAX~S INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* REV-UD7 EX iFP (12-D~1 1 ,~ f.,..;. DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 02-22-2005 MYERS 02-05-2004 21 04-0178 CUMBERLAND 101 KATHLEEN C JAMES D'FloWER SAIDIS ETAL 26 W HIGH ST CARLISLE JR ESQ Allount Re.itted PA 17013 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, sub.it the upper portion of this forI! with your tax pay.ent. CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ... IlV:rl;1J.,.!rAI!"..rGr-.d'J,........;..,.AW'If!n'Ner.,lr.t'l~Al'N'f.b.,.ll:1!'60FN....................... ... ESTATE OF MYERS KATHLEEN C FILE NO. 21 04-0178 ACN 101 DATE 02-22-2005 THIS STATE"ENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NA"ED ESTATE. SHOWN BELOW IS A SU~RY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAY"ENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 01-18-2005 PRINCIPAL TAX DUE:. 1.050.00 PAYMENTS (TAX CREDITS): ~ PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 10-28-2004 CD004557 .00 1,060.29 02-07-2005 REFUND .00 10.29- TOTAL TAX CREDIT 1,050.00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 . SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, ND PAY"ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), VNI MAY 8E DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. ) SCHEDULE OF PROPOSED DISTRIBUTION ESTATE OF KATHLEEN C. MYERS, DECEASED NO. 21-04-0178 AS OF FEBRUARY 23, 2005 Current Value or as Noted # Units Per Item THIRD and Item FOURTH of Last Will and Testament dated April 5, 2001: 15% Combined Residuary Balance on hand paid outright to FIRST UNITED CHURCH OF CHRIST, Carlisle, Pennsylvania $ 49,150.97 85% Combined Residuary Balance on hand to be held in further Trust, Manufacturers & Traders Trust Company, Trustee, to be administered per Item FOURTH, in summary, as follows: 278,522.16 To be known as the CHARLES E. MYERS AND KATHLEEN CECELIA MYERS FOUNDATION, with 40% of net income paid to DICKINSON COLLEGE for scholarship grants - and - 60% of net income paid to CARLISLE AREA SCHOOL DISTRICT for scholarship grants. Combined Balance On Hand, Available For Distribution $327,673.13 ------------ ------------ Fiduciary Acquisition Value $ 49,150.97 278,522.16 $327,673.13 ------------ ------------ MANUFACTURERS AND TRADERS TRUST CO. EXECUTO~~ ('7. / 1'/ By: t1Yf1!...~ John Schall Vice President and Trust Officer r ..:.;>'0 ' ;'-'W iJ tj2 :.~ t}.J ,"-;-..-1 ('~. (,t::' ,~ ~:"'7 _-.."V COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 2k04-0178 ESTATE OF KATHLEEN C. MYERS, DECEASED ===================================== FIRST AND FINAL ACCOUNT OF Manufacturers and Traders Trust Co., Executor ================================================================================ Date of Deilth: February 5, 2004 Date of Executor's Appointment: February 23, 2004 Date of First Advertisement of Letters: March 23, 2004 Accounting for the Period: February 24, 2004 to February 23, 2005 ================================================================================ Purpose of Account: Manufacturers and Traders Trust Co., Executor, offers this account to acquaint interested parties with the transactions that have occurred during this administration. It is important that the account be carefully examined. Requests for additional information or questions or objections can be discussed with: John Schall, Vice President Manufacturers and Traders Trust Co. 55 S. Main Street Chambersburg, PA 17201 717/261-2813 GROSS ESTATE (Principal Receipts + Income Receipts) 372,022.80 ., ., ,10. ,.w '12 :2 \Ll SZ (lTiiq !n UJ i C;C\JW . I SUMMARY OF ACCOUNT Estate of Kathleen C. Myers, Deceased For Period of 02/24/2004 through 02/23/2005 Page Proposed Distributions to Beneficiaries PRINCIPAL Receipts: Per Inventory Filed This Account 1-2 Net Gain (or Loss) on Sales or Other Disposition 3 Less Disbursements: Debts of Decedent 4 Funeral Expenses 4 Administration Expenses 5 Federal and State Taxes 6 Fees and Commissions 6 Family Exemption Balance before Distributions Distributions to Beneficiaries 7-8 Principal Balance on Hand 9 For Information: Investments Made Changes in Investment Holdings 10 INCOME Receipts: This Account 11-12 Net Gain (or Loss) on Sales or Other Disposition Less Disbursements 13 Balance Before Distribution Distributions to Beneficiaries Income Balance on Hand 14 Investments Made Changes in Investment Holdings COMBINED BALANCE ON HAND Current Value 0.00 =====-===-=- 2,602.50 467.50 2,822.27 1,882.92 22,208.04 0.00 Fiduciary Acquisition Value 0.00 365,904.66 (2,003.95) 363,900.71 ___________w___ __..____________ 29,983.23 333,917.48 12,000.00 321,917.48 6,118.14 0.00 6,118.14 362.49 5,755.65 0.00 5,755.65 327,673.13 -==-=-==- - SCHEDULE A RECEIPTS OF PRINCIPAL CASH: 02/24/04 Cash Found in residence at Todd Home 03/11/04 Citizens Bank Checking Acct. #610073-159-6 - Date of death proceeds 03/11/04 Citizens Bank Checking Acct. #610073-159-6 - Accrued interest to date of death 10/07/04 Citizens Bank - Lock box refund 05/03/04 Internal Revenue Service 2003 personal income tax refund 05/05/04 Kenny's Auction - Gross sale proceeds from items at Todd Home room OS/21/04 Kenny's Auction - Proceeds from sale of coins & paper currency found in lock box 07/02/04 Kenny's Auction - Gross proceeds from sale of gemstones from lock box 03/08/04 Miscellaneous Receipt - Profit on sale of 704.026 shs IVY WR Advisors Accumulative Fund A 03/08/04 Miscellaneous Receipt - Date of death value, 704.026 shs IVY WR Advisors Accumulative Fund A -1- 12.00 1,558.57 0.01 11. 00 3,974.00 121. 50 2,389.00 26.00 105.61 4,055.18 Fiduciary Acquisition Value 03/18/04 Miscellaneous Receipt - One-dollar bill worth face value found in lock box 1.00 02/24/04 MTB Prime Money Market - Proceeds from Kathleen C. Myers Trust #415937606 29,007.75 03/02/04 MTB Prime Money Market Accrued interest 2/1/04-2/5/04 from Kathleen Myers Trust 1/415937606 2.47 STOCKS/LlSTED: 02/25/04 33,399.236 units MTB Short Duration Gov't 324,640.57 Bond Fund - From Kathleen Myers Trust #415937606 TOTAL RECEIPTS OF PRINCIPAL............... -2- 41,264.09 324,640.57 365,904.66 SCHEDULE B GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS - PRINCIPAL Gain Loss 08/20/04 33,399.236 units MTB Short Duration Gov't Bond Fund Net Proceeds Fid. Acq. Value 322,636.62 324,640.57 2,003.95 - ~ - - - --- -----. -. - ---. - --- .-. TOTAL GAINS AND LOSSES/PRINCIPAL........... 0.00 2,003.95 LESS LOSS............................. 2,003.95 NET GAIN OR LOSS........................... (2,003.95) =-=-=-==---=-= -3- 02/25/04 03/11/04 03/12/04 03/17/04 03/22/04 02/25/04 SCHEDULE C DISBURSEMENTS OF PRINCIPAL SCHEDULE C-l DEBTS OF DECEDENT Betra In Home Care - Home health aide services Citizens Bank - Maintenance fee charged on checking acct. 11610073-159-6 Pharmerica - Prescription drug expense Sarah A. Todd Memorial Home Final nursing home bill Sprint - Final telephone bill 185.00 20.00 231.55 2,156.23 9.72 TOTAL DEBTS OF DECEDENT............................. SCHEDULE C-2 FUNERAL EXPENSES Ewing Brothers Funeral Home, Inc.. Funeral expenses over prepayment made during lifetime of Kathleen C. Myers 467.50 TOTAL FUNERAL EXPENSES.............................. -4- 2,602.50 467.50 03/01/04 03/15/04 03/24/04 03/29/04 04/01/04 05/05/04 OS/21/04 07/02/04 10/26/04 10/26/04 SCHEDULE C - 3 ADMINISTRATION EXPENSES Darlene L. Moyer, Tax Collector Per capita tax due as of 1/1/04 9.90 Carl L. Spidel - labeling of coins sale Appraisal & & bills for 33.00 Ludwig's Jewelers - Identification, appraisal & preparation for sale of unmounted stones & jewelry items 150.00 Boyer & Ritter - Preparation of 2003 individual income tax returns 350.00 The Sentinel Legal advertising & proof of publication 136.31 Kenny's Auction Fee for sale of items from Todd Home room 75.01 Kenny's Auction - Auctioneer's fee for coin & currency sale 597.25 Kenny's Auction Auctioneer's fee for gemstone sale 7.80 Register of Wills - Fee to file PA inheritance tax return 15.00 Saidis, Shuff, Flower & Lindsay Reimbursement for probate fees $360 & advertising to Cumberland Law Journal $75 435.00 -5- 11/04/04 12/31/04 03/16/04 06/21/04 10/26/04 12/31/04 12/31/04 Saidis, Shuff, Flower & Lindsay - Reimbursement for filing fees 13.00 RESERVE - For miscellaneous administrative expenses 1,000.00 TOTAL ADMINISTRATION EXPENSES....................... SCHEDULE C-4 FEDERAL AND STATE TAXES Pennsylvania Department of Revenue - 2003 personal income tax return 803.00 Pennsylvania Department of Revenue Additional income tax due 2003 personal return 19.63 Register of Wills, Agent - PA Inheritance tax 1,060.29 TOTAL FEDERAL AND STATE TAXES....................... SCHEDULE C - 5 FEES AND COMMISSIONS Manufacturers & Traders Trust Co. - Executor's fee - TO BE PAID 14,805.36 Saidis, Shuff, Flower & Lindsay - Attorney's fee - TO BE PAID 7,402.68 TOTAL FEES AND COMMISSIONS.......................... TOTAL DISBURSEMENTS OF PRINCIPAL.................... -6- 2,822.27 1,882.92 22,208.04 29,983.23 SCHEDULE D DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES 03/10/04 American Cancer Society Ellene M. Hrinda 03/10/04 Francis J. Hrinda 03/10/04 American Cancer Society - Specific bequest per Item Second E of Will Ellene M. Hrinda - Specific bequest per Item Second A of Will Francis J. Hrinda - Specific bequest per Item Second B of Will Franciscan Mission Associates 03/10/04 Franciscan Mission Associates - Specific bequest per Item Second F of Will 03/10/04 Hospice of Central Pennsylvania Hospice of Central Pennsylvania - Specific bequest per Item Second D of Will -7- 1,000.00 5,000.00 2,000.00 2,000.00 1,000.00 Salvation Army 03/10/04 Salvation Army - Specific bequest per Item Second C of Will TOTAL DISTRIBUTIONS TO BENEFICIARIES...... -8- 1,000.00 12,000.00 =-= - PRINCIPAL BALANCE ON HAND # Units Description Current Value Fiduciary Acquisition or as Noted Value MTB Prime Money Market 321,917.48 321,917.48 321,917.48 321,917.48 ===-==--==-= -9- SCHEDULE F CHANGES IN INVESTMENT HOLDINGS - PRINCIPAL MTB Short Duration Gov't Bond Fund 02/25/04 08/20/04 33,399.236 units inventoried (33,399.236)units sold 0.000 ------=---= -10- Cost 324,640.57 (324,640.57) 0.00 SCHEDULE G RECEIPTS OF INCOME SCHEDULE G-1 DIVIDENDS MTB Short Duration Gov't Bond Fund - - - - ~ . - - . ~ . - - . . - . - . - . . - - - . . - - - - - -. 03/01/04 03/02/04 04/01/04 05/03/04 06/01/04 07/01/04 08/02/04 09/01/04 404.98 67.18 From Kathleen Myers Trust 11415937606 517.46 513.94 557.12 630.92 615.17 352.41 TOTAL DIVIDEND INCOME..................... SCHEDULE C-2 INTEREST Citizens Bank Checking Acct. 11610073-159-6 ---.---------------------..-- 03/11/04 Interest MTB Prime Money Market ...-.. -.... - --- -- .-- ------ 03/01/04 03/02/04 2.48 9.34 Interest 2/1/04-2/5/04 from Kathleen Myers Trust 11415937606 04/01/04 04/01/04 05/03/04 05/03/04 06/01/04 06/01/04 07/01/04 07/01/04 0.30 12.43 0.59 9.80 12.50 0.90 1.19 13.76 -11- 3,659.18 3,659.18 0.29 08/02/04 08/02/04 09/01/04 09/01/04 10/01/04 10/0lj04 11/01/04 11/01/04 12/01/04 12/01/04 Olj03/05 01/03/05 02/01/05 02/01/05 1.87 17.51 2.68 132.69 3.51 335.40 4.42 387.95 5.18 413 .66 6.90 504.19 570.85 8.57 TOTAL INTEREST INCOME..................... TOTAL RECEIPTS OF INCOME.................. -12- 2,458.67 2,458.96 6,118.14 02/15/05 SCHEDULE I DISBURSEMENTS OF INCOME Income Commission - Manufacturers & Traders Trust Co. - 3/15/04-2/15/05 362.49 TOTAL DISBURSEMENTS OF INCOME...... ............ -13- 362.49 II Units . Description INCOME BALANCE ON HAND Current Value or as Noted 5,755.65 MTB Prime Money Market 5,755.65 Fiduciary Acquis ition Value 5,755.65 -----~-~------- --------------- -=-==-==-=====~ -=-=-==-- -14- 5,755.65 COMMONWEALTH OF PENNSYLVANIA ) : ss. COUNTY OF CUMBERLAND ) JOHN SCHALL, VICE PRESIDENT AND TRUST OFFICER OF MANUFACTURERS AND TRADERS TRUST COMPANY, Executor of the Estate of KATHLEEN C. MYERS, Deceased, being duly sworn according to law, deposes and says that the Account as stated is true and correct and that the Grant of Letters and the first complete advertisement thereof occurred more then four (4) months prior to the filing of the Account. MANUFACTURERS AND TRADERS TRUST COMPANY Executor By !iZfild(" John Schall, Vice President and Trust Officer Sworn and subscribed to before me this ~^t/ daYOf~A~_~ ,2005 ~-1,^A 8~~dd. NOTARIAL SEAL MERLENE J MARHEVKA. NOTARY PUBLIC (;,I'.,nllSIf:. CUMBERLAND COUNTY. PA ,"> MY COMM1S$IO~~ EXPIRES JUNE B. 2006 . 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ID..~~ -caa~ ::T.... -III CD 3 ::TQ.CDCD ..a.a. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ( a j- 0'1- { '7 J" ESTATE OF KATHLEEN C. MYERS, DECEASED RECEIPT, RELEASE AND INDEMNIFICATION AGREEMENT This Receipt, Release and Indemnification Agreement (hereinafter called the "Release") is given this '11 It-- Day of 0//fIIf ,2005, by First United Church of Christ, 30 North Pitt Street, Carlisle PA 17013 (hereinafter called the Beneficiary") to and in favor of Manufacturers and Traders Trust Company, Executor of the Kathleen C. Myers Estate (hereinafter called the "Bank"). WITNESSETH: WHEREAS, the Beneficiary, pursuant to the Last Will and Testament of Kathleen C. Myers is beneficially interested in the above referenced estate; and WHEREAS, it is the intention and desire of the Beneficiary that the Bank make the distribution described herein; NOW, THEREFORE, intending to be legally bound hereby, the Beneficiary represents, warrants, covenants and agrees as follows: I. Examination of Formal Accounting. The Beneficiary does hereby declare that they have examined and approved the formal accounting submitted to the Beneficiary by the Bank and finds the same to be true, correct and satisfactory in all respects. 2. Receipt, The Beneficiary requests the above named Bank to make distribution of the following property (adjusted for subsequent income and expenses) and effective upon delivery to the undersigned of the property shown as distributable, acknowledges receipt of such property. Cash distributIon per First and Final Accouut of $49,150.97 The Beneficiary does further acknowledge that the aforesaid distribution represents the Beneficiary's entire interest in the above referenced estate and is being made in full and complete satisfaction thereof. 3. Release. Having reviewed and examined the said formal accounting, and upon having received the above described property distribution, the beneficiary does by these presents remise, release, quit- claim and forever discharge the Bank, its employees, successors and assigns, from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever, for or by reason of its administration of the above referenced estate, or any other act, matter, cause or thing whatsoever. 4. Indemnification. The Beneficiary agrees to indemnify the Bank and hold it harmless, to the extent of any funds or assets received by the Beneficiary hereunder, from and against the Beneficiary's pro rata share of any and all liabilities, losses, damages, costs, verdicts, judgments, awards and expenses (including attorney's fees and other costs or expenses of defense) to which the Bank may be subjected by reason of its administration of the estate, as well as the settlement thereof by means of an informal distribution. The Beneficiary further agrees to: 1. Refund or return, promptly upon the Bank's written demand, any funds or assets distributed by the Bank to the Beneficiary, if the distribution thereof is determined at any time to have been an erroneous or negligent distribution to the Beneficiary, whether such error or negligence was or was claimed to have been premised upon a mistake oflaw or of fact. 2. Modify and displace any otherwise applicable period limiting the time within which the Bank's action to collect an erroneous or negligent distribution must be commenced, so as to provide that the Bank need not commence an action to collect an erroneous or negligent distribution to the Beneficiary until two (2) years after such time as the Bank shall have obtained actual knowledge of such error or negligence. The provisions of this Release shall be deemed severable in the event that one or more thereof shall be deemed invalid or unenforceable, with the effect that the remaining provisions shall persist as if such invalid or unenforceable provision had never been a part hereof. In addition, the construction, effect, validity and performance of this Release shall be governed in all respects by the laws of the Commonwealth of Pennsylvania, without regard to its conflict of laws provision. This Release shall bind the Beneficiary, their heirs, representatives, successors, and assigns together with any person with respect to whom the Beneficiary is a natural or appointed guardian. The Beneficiary hereby acknowledges that this Release may be filed at any time, at the discretion of the Bank, with any court of competent jurisdiction, and the Beneficiary consents to any such filing. IN WITNESS WHEREOF, the Beneficiary has executed and sealed this Release on the date first above inscribed. First United Church of Christ 7h~~~ By TI2E.Mu i2E-R. Title 7,J:. dO~ - td.S Corporation Tax Identification Number . . COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND On this Q+{'t day of (~, /v,..R authority, personally came J!v11 ( I if:! P ( (' Q u.IS 6 rJ himself/herself to be the /12 2: 11 S u. k eJE ~ corporation, and that he/she as such / re rxs: U rt' r , being authorized to do so executed the foregoing instrument for the purposes therein contained by signing the name of the corporation by himself/herself as m ;'{JuJ..e i (Iou /)64) , 2005, before me, the undersigned , who acknowledged of First United Church of Christ, a l-/~ X'V/L'r / Notary Public I~I (SEAL) _!'~-'V~~~orr""',,:~ JAN.. ., ~ I ~~~4'"i,.'l',!toIi .t',.~. " ~~ ~ "~';"~'~'~"~JH":; "'1~3 _1(', fl" , '''f".-.t lfM ._...__.,_-_....~ ....-,J".,.....~'.., ...,........... IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY BRANCH ORPHANS' COURT DIVISION ESTATE OF KATHLEEN C. MYERS, DECEASED RECEIPT AND REFUNDING BOND ~d- This Receipt and Refunding Bond (hereinafter called the "Receipt") is given this 1,,/ . Day of 'f})t>.-,,^-L , 2004, by Ellene M. Hrinda, (hereinafter called the "Beneficiary") to and in favor of Manufacturers and Traders Trust Company, Executor of the Kathleen C. Myers Estate (hereinafter called the "Bank") WITNESSETH: WHEREAS, the Beneficiary is a specific legatee or distributee under the Last Will and Testament of Kathleen C. Myers, and WHEREAS, it is the intention and desire of the Beneficiary that the Bank make the distribution described herein prior to filing a formal court accounting in the above referenced estate; NOW, THEREFORE, intending to be legally bound hereby, the Beneficiary represents, warrants, covenants and agrees as follows: Receipt. The Beneficiary requests the above named Bank to make distribution of the following property and effective upon delivery to the undersigned of the property shown as distributable, acknowledges receipt of such property. $5,000 cash per Item Second A The Beneficiary does further acknowledge that the aforesaid distribution represents the Beneficiary's entire interest in the above referenced estate and is being made in full and complete satisfaction thereof. 2. Release. Upon having received the above described property distribution, the beneficiary does by these presents remise, release, quit-claim and forever discharge the Bank, its employees, successors and assigns, from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever, for or by reason of its administration of the above referenced estate, or any other act, matter, cause or thing whatsoever. 3. Refunding Agreement. In exchange for the Bank's willingness to make the distribution hereunder without first securing the benefit of a formal court audit, the Beneficiary agrees to refund or return, promptly upon the Bank's written demand, any funds or assets distributed by the Bank to the Beneficiary, if the distribution thereof is determined at any time to have been an erroneous or negligent distribution to the Beneficiary, whether such error or negligence was or was claimed to have been premised upon a mistake of law or of fact. The Beneficiary further "',' ~ agrees to modify and displace any otherwise applicable period of limiting the time within which the Bank's action to collect an erroneous or negligent distribution must be commenced, so as to provide that the Bank need not commence an action to collect an erroneous or negligent distribution to the Beneficiary until two (2) years after such time as the Bank shall have obtained actual knowledge of such error or negligence. The provisions of this Receipt shall be deemed severable in the event that one or more thereof shall be deemed invalid or unenforceable, with the effect that the remaining provisions shall persist as if such invalid or unenforceable provision had never been a part hereof. In addition, the construction, effect, validity and performance of this Receipt shall be governed in all respects by the laws of the Commonwealth of Pennsylvania, without regard to its conflict of laws provision. This Receipt shall bind the Beneficiary, her heirs, representatives, successors, and assigns together with any children with respect to whom the Beneficiary is a natural guardian. The Beneficiary hereby acknowledges that this Receipt may be filed at any time, at the discretion of the Bank, with any court of competent jurisdiction, and the Beneficiary consents to any such filing. IN WITNESS WHEREOF, the Beneficiary has executed and sealed the Receipt on the date first above inscribed. i!/ dIU r?~' #~l<-C'La;/ Ellene M. Hrinda Tax Identification Number: ;< (' /1," :1 '1- "3,) 77 COMMONWEALTH OF PENNSYL VANIA: COUNTY OF frvJ-t~ On this /,;J.z;I- day of ~ ,2004, before me, the undersigned authority, personally came Ellene M. Hrinda, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within Receipt and acknowledged that she executed the same for the purpose therein contained. Witness my hand and official seal the day and date aforesaid. ~U~{{~ otary Public My commission expires: (SEAL) COMMONWEALTH OF Pf::NNSYLVANlA Notanal Seal E. Candee Warto Notary Public Jim ThOlye Boro, Carbon County My Commission Expires Jan. 7, 2007 Member, Pennsy!van;a Association of Notaries IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY BRANCH ORPHANS' COURT DIVISION ESTATE OF KATHLEEN C. MYERS, DECEASED RECEIPT AND REFUNDING BOND This Receipt and Refunding Bond (hereinafter called the "Receipt") is given this /1 Day of Mt4,ze!'i ,2004, by Francis J. Hrinda, (hereinafter called the "Beneficiary") to and in favor of Manufacturers and Traders Trust Company, Executor of the Kathleen C. Myers Estate (hereinafter called the "Bank") WITNESSETH: WHEREAS, the Beneficiary is a specific legatee or distributee under the Last Will and Testament of Kathleen C. Myers, and WHEREAS, it is the intention and desire of the Beneficiary that the Bank make the distribution described herein prior to filing a formal court accounting in the above referenced estate; NOW, THEREFORE, intending to be legally bound hereby, the Beneficiary represents, warrants, covenants and agrees as follows: Receipt. The Beneficiary requests the above named Bank to make distribution of the following property and effective upon delivery to the undersigned of the property shown as distributable, acknowledges receipt of such property. $2,000 cash per Item Second B The Beneficiary does further acknowledge that the aforesaid distribution represents the Beneficiary's entire interest in the above referenced estate and is being made in full and complete satisfaction thereof. 2. Release. Upon having received the above described property distribution. the beneficiary does by these presents remise. release, quit-claim and forever discharge the Bank, its employees, successors and assigns, from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever, for or by reason of its administration of the above referenced estate, or any other act, matter, cause or thing whatsoever. 3. Refunding Agreement. In exchange for the Bank's willingness to make the distribution hereunder without first securing the benefit of a formal court audit, the Beneficiary agrees to refund or return, promptly upon the Bank's written demand, any funds or assets distributed by the Bank to the Beneficiary, if the distribution thereof is determined at any time to have been an erroneous or negligent distribution to the Beneficiary, whether such error or negligence was or was claimed to have been premised upon a mistake of law or of fact. The Beneficiary further agrees to modify and displace any otherwise applicable period of limiting the time within which the Bank's action to collect an erroneous or negligent distribution must be commenced, so as to provide that the Bank need not commence an action to collect an erroneous or negligent distribution to the Beneficiary until two (2) years after such time as the Bank shall have obtained actual knowledge of such error or negligence. The provisions of this Receipt shall be deemed severable in the event that one or more thereof shall be deemed invalid or unenforceable, with the effect that the remaining provisions shall persist as if such invalid or unenforceable provision had never been a part hereof. In addition, the construction, effect, validity and performance of this Receipt shall be governed in all respects by the laws of the Commonwealth of Pennsylvania, without regard to its conHict of laws provision. This Receipt shall bind the Beneficiary, her heirs, representatives, successors, and assigns together with any children with respect to whom the Beneficiary is a natural guardian. The Beneficiary hereby acknowledges that this Receipt may be filed at any time, at the discretion of the Bank, with any court of competent jurisdiction, and the Beneficiary consents to any such filing. IN WITNESS WHEREOF, the Beneficiary has executed and sealed the Receipt on the date first above inscribed. !'-'7 ~/ ~n~tiirl-jc7C--""~ Tax Identification Number: /(,'7 '. S',,7 , ?/& '0 COMMONWEALTH OF PENNSYLVANIA: COUNTY OF U'J.. 'LL{/~ '\ \~, ~\ On this day of _I~ Q; \ C h ,,2004, before me, the undersigned authority, personally came Francis J. Hrinda, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within Receipt and acknowledged that he executed the same for the purpose therein contained. Witness my hand and official seal the day and date aforesaid. COi\..'1'U,l 0'\ ()}\J.1LOf\ (SEAL) Notary Public ~ My commission expires: NOTARIAL SEAL CONNIE D. BROWN, Nolaty Public Lower Towamenslng Twp., Carbon Co. My Commission Expires Nov. 25. 2006 .. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY BRANCH ORPHANS' COURT DIVISION ESTATE OF KATHLEEN C. MYERS, DECEASED RECEIPT AND REFUNDING BOND This Receipt and Refunding Bond (hereinafter called the "Receipt") is given this ~ Day of~, 2004, by The Salvation Army, (hereinafter called the "Beneficiary") to and in favor of Manufacturers and Traders Trust Company, Executor of the Kathleen C. Myers Estate (hereinafter called the "Bank") WITNESSETH: WHEREAS, the Beneficiary is a specific legatee or distributee under the Last Will and Testament of Kathleen C. Myers, and WHEREAS, it is the intention and desire of the Beneficiary that the Bank make the distribution described herein prior to filing a formal court accounting in the above referenced estate; NOW, THEREFORE, intending to be legally bound hereby, the Beneficiary represents, warrants, covenants and agrees as follows: Receipt. The Beneficiary requests the above named Bank to make distribution of the following property and effective upon delivery to the undersigned of the property shown as distributable, acknowledges receipt of such property. $1,000 cash per Item Second C The Beneficiary does further acknowledge that the aforesaid distribution represents the Beneficiary's entire interest in the above referenced estate and is being made in full and complete satisfaction thereof. 2. Release. Upon having received the above described property distribution, the beneficiary does by these presents remise, release, quit-claim and forever discharge the Bank, its employees, successors and assigns, from all actions, SUItS, payments, accounts, reckonings, claims and demands whatsoever, for or by reason of its administration of the above referenced estate, or any other act, matter, cause or thing whatsoever. 3. Refunding Agreement. In exchange for the Bank's willingness to make the distribution hereunder without first securing the benefit of a formal court audit, the Beneficiary agrees to refund or return, promptly upon the Bank's written demand, any funds or assets distributed by the Bank to the Beneficiary, if the distribution thereof is determined at any time to have been an erroneous or negligent distribution to the Beneficiary, whether such error or negligence was or was claimed to have been premised upon a mistake of law or of fact. The Beneficiary further agrees to modify and displace any otherwise applicable period of limiting the time within which the Bank's action to collect an erroneous or negligent distribution must be commenced, so as to provide that the Bank need not commence an action to collect an erroneous or negligent distribution to the Beneficiary until two (2) years after such time as the Bank shall have obtained actual knowledge of such error or negligence. The provisions of this Receipt shall be deemed severable in the event that one or more thereof shall be deemed invalid or unenforceable, with the effect that the remaining provisions shall persist as if such invalid or unenforceable provision had never been a part hereof. In addition, the construction, effect, validity and performance of this Receipt shall be governed in all respects by the laws of the Commonwealth of Pennsylvania, without regard to its conflict of laws provision. This Receipt shall bind the Beneficiary, her heirs, representatives, successors, and assigns together with any children with respect to whom the Beneficiary is a natural guardian. The Beneficiary hereby acknowledges that this Receipt may be filed at any time, at the discretion of the Bank, with any court of competent jurisdiction, and the Beneficiary consents to any such filing. IN WITNESS WHEREOF, the Beneficiary has executed and sealed the Receipt on the date first above inscribed. By Title # I" I, . , .. , L- ~' , ," I ,) - ,::LJI i ,-1 ::),:1 I Corporation Tax ID number I lit:: ,'j't Hi' :,-11'1('\., lcff( '-COMMONWEALTH OF PENNg'~'L V'ANIk I'., (1.j J ,I (",I COUNTY OFCUMBERU.-l'ID \,L) L, f,,,I, I Il, : SS " I rh On this Ii' day of personally came himself/herself to be the 1\ I (I r! ('.11 , 2004, before me, the undersigned authority, who acknowledged of The Salvation Army, a Richard D. Allen ,~lSl'Al<rr SECRETAUl' corporation, and that he/she as such ,~l..<:1'A11, r~ e'"'''lT''''' f' . , . Ii ,~~"""' ""'~'~.Il J...... .. being authorized to do so executed the foregoing instrument for the purposes therein contained by signing the name of the corporation by himself/herself as )~STANT SECItE1iUl''i' IN WITNESS WHEREOF, I hereunto set my hand and official seal the day and date aforesaid. (..." Jq I ('fl~ (SYI Notary Public ') (SEAL) IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY BRANCH ORPHANS' COURT DIVISION ESTATE OF KATHLEEN C. MYERS, DECEASED RECEIPT AND REFUNDING BOND . qH" This Receipt and Refunding Bond (hereinafter called the "Receipt") is given this \ I ' Day of \v'\r,j' C h , 2004, by Hospice of Central Pennsylvania, successor to Carlisle Hospital Hospice, (hereinafter called the "Beneficiary") to and in favor of Manufacturers and Traders Trust Company, Executor of the Kathleen C. Myers Estate (hereinafter called the "Bank") WITNESSETH: WHEREAS, the Beneficiary is a specific legatee or distributee under the Last Will and Testament of Kathleen C. Myers, and WHEREAS, it is the intention and desire of the Beneficiary that the Bank make the distribution described herein prior to filing a formal court accounting in the above referenced estate; NOW, TIIEREFORE, intending to be legally bound hereby, the Beneficiary represents, warrants, covenants and agrees as follows: Receipt. The Beneficiary requests the above named Bank to make distribution of the following property and effective upon delivery to the undersigned of the property shown as distributable, acknowledges receipt of such property. $1,000 cash per Item Second D The Beneficiary does further acknowledge that the aforesaid distribution represents the Beneficiary's entire interest in the above referenced estate and is being made in full and complete satisfaction thereof. 2. Release. Upon having received the above described property distribution, the beneficiary does by these presents remise, release, quit-claim and forever discharge the Bank, its employees, successors and assigns, from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever, for or by reason of its administration of the above referenced estate, or any other act, matter, cause or thing whatsoever. 3. Refunding Agreement. In exchange for the Bank's willingness to make the distribution hereunder without first securing the benefit of a formal court audit, the Beneficiary agrees to refund or return, promptly upon the Bank's written demand, any funds or assets distributed by the Bank to the Beneficiary, if the distribution thereof is determined at any time to have been an erroneous or negligent distribution to the Beneficiary, whether such error or negligence was or was claimed to have been premised upon a mistake of law or of fact. The Beneficiary further agrees to modify and displace any otherwise applicable period of limiting the time within which the Bank's action to collect an erroneous or negligent distribution must be commenced, so as to provide that the Bank need not commence an action to collect an erroneous or negligent distribution to the Beneficiary until two (2) years after such time as the Bank shall have obtained actual knowledge of such error or negligence. The provisions of this Receipt shall be deemed severable in the event that one or more thereof shall be deemed invalid or unenforceable, with the effect that the remaining provisions shall persist as if such invalid or unenforceable provision had never been a part hereof. In addition, the construction, effect, validity and performance of this Receipt shall be governed in all respects by the laws of the Commonwealth of Pennsylvania, without regard to its conflict oflaws provision. This Receipt shall bind the Beneficiary, her heirs, representatives, successors, and assIgns together with any children with respect to whom the Beneficiary is a natural guardian. The Beneficiary hereby acknowledges that this Receipt may be filed at any time, at the discretion of the Bank, with any court of competent jurisdiction, and the Beneficiary consents to any such filing. IN WITNESS WHEREOF, the Beneficiary has executed and sealed the Receipt on the date first above inscribed. By Q,ofG:'tl1rc,1 rA Title # :':..:~ - 2-1[' b2't s' Corporation Tax ID number ~. COMMONWEALTH OF PENNSYL VANIA : SS COUNTY OF CUMBERLAND On this . q n.day of ~, 2004, before me, the undersigned authority, personally came \< '" r e.l'I P ^ r ; s. , who acknowledged himself/herself to be the C. E 0 of Hospice of Central Pennsylvania, rr' a corporation, and that he/she as such Ot~ '( 2 r being authorized to do so executed the foregoing instrument for the purposes therein contained by signing the name of the corporation by himself/herself as Ci: () IN WITNESS WHEREOF, I hereunto set my hand and official seal the day and date aforesaid. ~c.. In. (~~ Notary Public (SEAL) NOTARIAL SEAL HELEN M. GRIFFllli, Nolarl Public I East Pennsboro Twp. Cumllvland Co, My CommissIon ExPires April 18, 2004 ! . IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY BRANCH ORPHANS' COURT DIVISION ESTATE OF KATHLEEN C. MYERS, DECEASED RECEIPT AND REFUNDING BOND This Receillt and Refunding Bond (hereinafter called the "Receipt") is given this / (1 Day of YV1(]~ ,2004, by American Cancer Society, (hereinafter called the "Beneficiary") to and in favor of Manufacturers and Traders Trust Company, Executor of the Kathleen C. Myers Estate (hereinafter called the "Bank") WITNESSETH: WHEREAS, the Beneficiary is a specific legatee or distributee under the Last Will and Testament of Kathleen C. Myers, and WHEREAS, it is the intention and desire of the Beneficiary that the Bank make the distribution described herein prior to filing a formal court accounting in the above referenced estate; NOW, THEREFORE, intending to be legally bound hereby, the Beneficiary represents, warrants, covenants and agrees as follows: Receipt. The Beneficiary requests the above named Bank to make distribution of the following property and effective upon delivery to the undersigned of the property shown as distributable, acknowledges receipt of such property. $1,000 cash per Item Second E The Beneficiary does further acknowledge that the aforesaid distribution represents the Beneficiary's entire interest in the above referenced estate and is being made in full and complete satisfaction thereof. 2. Release. Upon having received the above described property distribution, the beneficiary does by these presents renl1sc, release, quit-c1airn and forcv'er discharge the Bank, its employee&;, successors and assigns, from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever, for or by reason of its administration of the above referenced estate, or any other act, matter, cause or thing whatsoever. 3. Refunding Agreement. In exchange for the Bank's willingness to make the distribution hereunder without first securing the benefit of a formal court audit, the Beneficiary agrees to refund or return, promptly upon the Bank's written demand, any funds or assets distributed by the Bank to the Beneficiary, if the distribution thereof is determined at any time to have been an erroneous or negligent distribution to the Beneficiary, whether such error or negligence was or was claimed to have been premised upon a mistake of law or of fact. The Beneficiary further agrees to modify and displace any otherwise applicable period of limiting the time within which the Bank's action to collect an erroneous or negligent distribution must be commenced, so as to provide that the Bank need not commence an action to collect an erroneous or negligent distribution to the Beneficiary until two (2) years after such time as the Bank shall have obtained actual knowledge of such error or negligence. The provisions of this Receipt shall be deemed severable in the event that one or more thereof shall be deemed invalid or unenforceable, with the effect that the remaining provisions shall persist as if such invalid or unenforceable provision had never been a part hereof. In addition, the construction, effect, validity and performance of this Receipt shall be governed in all respects by the Jaws of the Commonwealth of Pennsylvania, without regard to its conflict of laws provision. This Receipt shall bind the Beneficiary, her heirs, representatives, successors, and assigns together with any children with respect to whom the Beneficiary is a natural guardian. The Beneficiary hereby acknowledges that this Receipt may be filed at any time, at the discretion of the Bank, with any court of competent jurisdiction, and the Beneficiary consents to any such filing. IN WITNESS WHEREOF, the Beneficiary has executed and sealed the Receipt on the date first above inscribed. American Cancer Society By 0..1... Cv'--' Title Chief Financial Officer # 25-1798733 Corporation Tax ID number COMMONWEALTH OF PENNSYL VANIA : SS COUNTY OF DAUPHIN On this 19 day of March personally came David Ehrlich , 2004, before me, the undersigned authority, , who acknowledged himselflherself to be the Chief Financial Officer of American Cancer Society, a corporation, and that he/she as such Chief Financial Officer being authorized to do so executed the foregoing instrument for the purposes therein contained by signing the name of the corporation by himselflherself as Chief Financial Officer IN WITNESS WHEREOF, I hereunto set my hand and official seal the day and date aforesaid. NOTARiiti. :,,,,, '..L Jeon A. Salamon, Notary Public lNryTownsbip, Dauphin County M Com....... Expi... Ap< 5. 2004 (SEAL) --- IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY BRANCH ORPHANS' COURT DIVISION ESTATE OF KATHLEEN C. MYERS, DECEASED RECEIPT AND REFUNDING BOND -/.-1-; is Receipt and Refunding Bond (hereinafter called the "Receipt") is given this / ~ Day of "~J~ , 2004, by Franciscan Mission Associates, (hereinafter called the "Beneficiary") to and in favor of Manufacturers and Traders Trust Company, Executor of the Kathleen C Myers Estate (hereinafter called the "Bank") WITNESSETH: WHEREAS, the Beneficiary is a specific legatee or distributee under the Last Will and Testament of Kathleen C Myers, and WHEREAS, it is the intention and desire of the Beneficiary that the Bank make the distribution described herein prior to filing a formal court accounting in the above referenced estate; NOW, THEREFORE, intending to be legally bound hereby, the Beneficiary represents, warrants, covenants and agrees as follows: Receipt The Beneficiary requests the above named Bank to make distribution of the following property and effective upon delivery to the undersigned of the property shown as distributable, acknowledges receipt of such property. $2,000 cash per Item Second F The Beneficiary does further acknowledge that the aforesaid distribution represents the Beneficiary's entire interest in the above referenced estate and is being made in full and complete satisfaction thereof. 2. Release. Upon having received the above described property distribution, the beneficiary does by these presents remise, release, quit-claim and forever discharge the Bank, its employees, successors and aSSIgns, from al! actions, suits, payments, accounts, reckonings, claims and demands whatsoever, for or by reason of its administration of the above referenced estate, or any other act, matter, cause or thing whatsoever. 3. Refunding Agreement In exchange for the Bank's willingness to make the distribution hereunder without first securing the benefit of a formal court audit, the Beneficiary agrees to refund or return, promptly upon the Bank's written demand, any funds or assets distributed by the Bank to the Beneficiary, if the distribution thereof is determined at any time to have been an erroneous or negligent distribution to the Beneficiary, whether such error or negligence was or was claimed to have been premised upon a mistake of law or of fact The Beneficiary further - agrees to modifY and displace any otherwise applicable period of limiting the time within which the Bank's action to collect an erroneous or negligent distribution must be commenced, so as to provide that the Bank need not commence an action to collect an erroneous or negligent distribution to the Beneficiary until two (2) years after such time as the Bank shall have obtained actual knowledge of such error or negligence. The provisions of this Receipt shall be deemed severable in the event that one or more thereof shall be deemed invalid or unenforceable, with the effect that the remaining provisions shall persist as if such invalid or unenforceable provision had never been a part hereof. In addition, the construction, effect, validity and performance of this Receipt shall be governed in all respects by the laws of the Commonwealth of Pennsylvania, without regard to its conflict of laws provision. This Receipt shall bind the Benefici2~/, h~r hei~s, representatives, successors, and assIgns together with any children with respect to whom the Beneficiary is a natural guardian. The Beneficiary hereby acknowledges that this Receipt may be filed at any time, at the discretion of the Bank, with any court of competent jurisdiction, and the Beneficiary consents to any such filing. IN WITNESS WHEREOF, the Beneficiary has executed and sealed the Receipt on the date first above inscribed. Franciscan ~ission ~ssociates. r:. By A~. ~' / / / Title Fxecutive Director ( # 13-1982783 Corporation Tax ID number ..... STATE OF NEW YORK : SS COUNTYOF '(;" ~ ~ch..( I>~t'f' On this 1 ;L ti> day of JIlId rc ~ 2004, before me, the undersigned authority, personally came ;11 " J p \ \,"'1' 13 t"'l n "'" Ie,' , who acknowledged bimseUlherselfto be the f' \lIoI'r,U11 ,/P \), rr;6"'" of Franciscan Mission Associates, a corporation, and that I:le.Ishe as such ('fI'<?' u\,..o \),r<l(~ Of being authorized to do so executed the foregoing instrument for the purposes therein contained by signing the name of the corporation by I>imseWherself as .I'l\.~ '1\,,\ \ '-l'.. ~.......... I c., Of' fY\ IN WITNESS WHEREOF, I hereunto set my hand and official seal the day and date aforesaid. THERESA E. DOUGHER1Y Notary Public, State 01 New YorIc No. 01006022978 Qualllled In ~~)rter County Cummlsslon expires Aj:lr1l12, 20 ?:qf- - C2 '!L nxlv seJIdx3 UOISSfWWOO AlUiloO .I81se40\SeM UI pellllWr10 8.1.~;:oeOO LO 'ON IlIO,\ MeN jO elBIS 'Oflqnd N8IoN AUl3Henoo '3 VS31;13HL L/ /7') l . '11 ~ LIJ~;-W-- 'Notary Public j Cumberland County - Register Of Wills One Courthouse Square -I Carlisle, PA 17013 Phone: (717) 240-6345 Date: 1/04/2006 FLOWER JAMES D JR 26 W HIGH STREET CARLISLE, PA 17013-2922 RE: Estate of MYERS KATHLEEN CECELIA File Number: 2004-00178 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 2/05/2006 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, . ~jJ '.. , c..::,,, I ,A:; . L._ tJ ~ .~7WM:"v_~~ GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Personal Representative(s) Judge \{:[; Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 N fD d t KATHLEEN C. MYERS ame 0 ece en: Date of Death: February 5, 2004 Estate No.: 21-04-0178 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: I. State whether administration of the estate is complete: Yes 0 No 0 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes 0. No 0 b. The separate Orphans' Court No. (ifany) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes 0 No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. James D. Flower, Jr., Esquire Name Said is, Flower & Lindsay 26 West High Street, Carlisle, PA 17013 Address Date: 01/16106 " 717 -243-6222 Telephone No. Capacity: o Personal Representative o Counsel for personal representative c ~; .. "I ~, ! !i , I ~L _ I I \(~