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HomeMy WebLinkAbout06-22-10 505610145 REV-1500 EX (01-10) C3FF9~ ~` i ,-:~ " Y pennsylvania _.... __......_ .. PA Department of Revenue DEPARTMENT OF REVENUE County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21-09-00938 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 203-10-7678 09252009 02171921 Decedent's Last Name Suffix Decedent's First Name MI Enders John L (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Enders Betty J Spouse's Social Security Number FILL IN APPROPRIATE BOXES BELOW 1. Original Return Q 4. Limited Estate Ox 6. Decedent Died Testate (Attach Copy of Will) 0 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Return 0 4a. Future Interest Compromise (date of death after 12-12-82) Q 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 0 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) 3. Remainder Return (date of death prior to 12-13-82) Q 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 0 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number na [ i r ~ Stephen D. Tiley 717-243-~-~~'8 ~.; -: ~'~' ., ~-- - ~~~~1:~ . c,r-t~ a~~,~" c ~ _~ y ,~ .,) ~'~ i First line of address ~ '__~ _i Frey and Tiley ~ ~~~ -~ ~ - Second line of address - -~~ ~=~~~ ~~ ~ - '~ ' ' 5 South Hanover Stree ~-~' ~'' ,~ City or Post Office State ZIP Code - --- - Carlisle PA 17013 Correspondent'se-mail address: stiley@freytiley. com Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the 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 preparer has any knowledge SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN nnTF ADDRESS Betty ders, 38 Strawb arlisle, PA 17013 SIGN T OF R THAN.~tEF~3ES TATIVE q 1 z i~ ADDRESS Stephen D. Tiley, 5 South Hanover Street, Carlisle, PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610145 1505610145 J 1505610245 REV-1500 EX Decedent's Social Security Number DecedenYsName: John L Enders 203-10-7678 RECAPITULATION 1. Real Estate (Schedule A) ........................................... 1. NONE 2. Stocks and Bonds (Schedule B) ...................................... 2. 2 6 4 9 . 2 4 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. NONE 4. Mortgages and Notes Receivable (Schedule D) .......................... 4. NONE 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) ...... 5. 8 0 0 . 0 0 6. Jointly Owned Property (Schedule F) Separate Billing Requested ........ 6. 3 3 9 O 6 4 . 0 0 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested ........ 7 4 818 O . 0 0 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 3 9 0 6 9 3 . 2 4 9. Funeral Expenses and Administrative Costs (Schedule H) .................. 9. 4 15.0 0 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ............ . 10. NONE 11. Total Deductions (total Lines 9 and 10) .............................. . 11. 4 15.0 0 12. Net Value of Estate (Line 8 minus Line 11) ........................... .. 12. 3 9 0 2 7 8 . 2 4 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ...................... . 13. 0 . 0 0 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... . 14. 3 9 0 2 7 8 . 2 4 TAX CALCULATION -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.o 0 5390, 278.24 15. 0. OO 16. Amount of Line 14 taxable at lineal rate X .0 4 5 16. 0. 0 0 17. Amount of Line 14 taxable at sibling rate X • 12 17. 0 . 0 0 18. Amount of Line 14 taxable at collateral rate X . 15 18. 0 . 0 0 19. TAX DUE ...................................................... .19. 0 . 0 0 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAY MENT ~ Side 2 1505610245 1505610245 REV-1500 EX Page 3 File Number 203-10-7678 Decedent's Complete Address: 21-09-0938 DECEDENT'S NAME John L Enders STREET ADDRESS 38 Strawber Drive CITY Carlisle STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest (1) 0.00 Total Credits (A + B) (2) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in box on Page 2, Line 20 to request a refund. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. 0.00 (5) 0.00 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 : ............................................................................ . ^ ^X b. retain the right to designate who shall use the property transferred or its income : ............................... . ^ ^X c. retain a reversionary interest; or .......................................................................................................... .. ^ ^X d. receive the promise for life of either payments, benefits or care? ........................................................ .. ^ ^X 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................................................................................ . ^ ^ 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? ........................................................................................................... . 0 ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent (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 21 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 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 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 12 percent [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. 0.00 REV-1503 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF SCHEDULE B STOCKS & BONDS FILE NUMBER John L Enders 21-09-00938 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 38 Shares Prudential Financial, Inc Date of death average prive $48.18 See Exhibit "A" 2. 22 Metlife shares Date of death average price $37.20 See Exhibit "B" $1, 830.84 $818.40 TOTAL (Also enter on line 2, Reca (If more space is needed, insert additional sheets of the same size) REV-1508 EX+(6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMNHERITANCEOTAXERETURNANIA PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER John L Enders 21-09-0938 Include the proceeds of litigation and the date the proceeds were received by the estate. (If more space is needed, insert additional sheets of the same size) REV-1509 EX+(01-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER: John L Enders 21-09-00938 If an asset became jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME(S) I ADDRESS I RELATIONSHIP TO DECEDENT q. Betty J. Enders 38 Strawberry Drive, Carlisle, PA 17013 B. C. JOINTLY OWNED PROPERTY: Spouse ITEM NUMBER LETTER FOR JOINT 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 VALUE OF ASSET % OF DECEDENT'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST Miscellaneous -Household Property 1. A. various $1,000.00 50.00% 500 >1yr. 0 M & T Bank, One West High St., Carlisle, PA 17013 2. A. various 0 Acct. No. 31 00391 64451 1 <1yr $9,410.79 100.00% 9,411 Acct. No. 411191 $65,513.51 100.00% 65,514 Acct. No. 15004200926523 $86,520.44 100.00% 86,520 Acct. No. 15004202072027 -See Exhibit "D" $79,451.13 100.00% 79,451 Orrstown Bank, 77 East King St., Shippensburg, PA 17257 3 0 Acct. No. 4000034642 8/31/09 $30,011.84 100.00% 30,012 Acct. No. 4000034779 9/8/09 $15,004.93 100.00% 15,005 Acct. No. 5060061171 10/28/00 $5,002.88 50.00% 2,501 Act. No. 5060061172 -See Exhibit "E" 10/28/00 $6,003.45 50.00% 3,002 Acct. No. 746000103 (Exhibit "G") L~r $8,112.12 100.00% 8,112 Acct. No. 4000029519 (Exhibit "H") L~r $14,012.65 100.00% 14,013 Acct. No. 4000027012 (Exhibit "I") ~,r $25,023.36 100.00% 25,023 0 TOTAL (Also enter on Line 6, Recapitulation) g 339,064 .00 If more space is needed, use additional sheets of paper of the same size. REV-1510 EX+(08-09) I SCHEDULE G Pennsylvania INTER-VIVOS TRANSFERS & DEPARTMENT OF REVENUE INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER John L Enders 21-09-00938 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE 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 CIF APPLICABLE) TAXABLE VALUE 1. Western -Southern Life Assurance Company 0 P.O. Box 2918 0 Cincinnati, Ohio 45201-2918 0 0 Annuity Contract No.: W0020627785 $48,179.52 100.00% 48,180 See Exhibit "F" 0 0 Beneficiary: 0 Betty J.Enders -spouse 0 38 Strawberry Drive 0 Carlisle, PA. 17013 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 TOTAL (Also enter on Line 7, Recapitulation) $I 48,180 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX + (10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER John L Enders 21-09-00938 Decedent's debts must be reported on Schedule I. ITEM A. I FUNERAL EXPENSES: 1. B. 1 ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address 2. Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant 4. 5. 6. 7. 21 City Year(s) Commission Paid: State ZIP Street Address Ciiy State Relationship of Claimant to Decedent Probate Fees: Accountant Fees: Tax Return Preparer Fees: Frey and Tiley Fining fee, Inheritance Tax Return ZIP $400.00 $15.00 TOTAL (Also enter on Line 9, Recapitulation) ~ $ 415 If more space is needed, use additional sheets of paper of the same size. REV-1513 EX+ (01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: John L Enders 21-09-O09RR RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1 ~ Betty J. Enders 38 Strawberry Drive Carlisle, PA 17013 Spouse 100% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUG H 18 OF REV-1500 COVER SH EET, AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 0 If more space is needed, use additional sheets of paper of the same size. ~~ -- ,~ - ~_ S l r• _ LAST WILL AND TESTAMENT - , = . '' - ; OF -.-_ . ~ cn _. -- `JOHN L. ENDERS I, JOHN L. ENDERS, married man, of 630 North West Street, in the Borough_9f Carlisle,: _ ' Cumberland County, Pennsylvania, being of sound and disposing mind, memory ands understanding, do hereby make, publish and declare this as and for my Last Will and Testamen4"' hereby revoking and making void any and all Wills by me at any time heretofore made. 1. I direct my hereinafter named Executrix or Executrices to pay all of my just debts and funeral expenses as soon after my death as may be found convenient to do so. 2. I direct that all inheritance, transfer, succession, estate and death taxes which may be payable on account of my death shall be paid from the residue of my estate regazdless of whether the assets upon which such taxes are based are included in my probate estate. 3. All of the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath to my wife,BETTY J. ENDERS, her heirs and assigns, to the exclusion of my children, born and unborn, provided my said wife, Betty J, Enders shall survive me by a period of ninety (90) days. 4. Should my said wife Betty J. Enders predecease me or fail to survive me by the aforesaid period of ninety (90) days, then in such event all of the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath in equal shares to my two daughters, their heirs and assigns, provided each of them shall survive me by a period of ninety (90) days, they being REBECCA JEAN KAROLY and BETSY LOUISE SHAFFER, but should either of them fail to so survive me, then the share such deceased daughter of mine would have received shall pass to such of her issue as shall survive me by a period of ninety (90) days, their heirs and assigns, per stirpes, but should there be no such issue, then the share such deceased daughter of mine would have received shall be added to the share of my other daughter, her heirs and assigns, per stirpes. 5. Should any person less than 21 years of age be entitled to distribution from my estate, in such event I nominate, constitute and appoint my hereinafter named Executrices and their successors, as guardian of the estate of each such person and authorize and direct such guardian to pay the income arising therefrom together with so much of the principal thereof as in the opinion of such guardian is necessary or desirable to be expended for the benefit of such person, and upon such person attaining 21 years of age to pay to him or her the then remaining principal together with any undistributed income. 6. I hereby nominate, constitute and appoint my wife, BETTY J. ENDERS as Executrix of this my Last Will and Testament, but should she predecease me or fail to qualify or cease serving as such, then in such event I nominate, constitute and appoint my two daughters, REBECCA JEAN KAROLY and BETSY LOUISE SHAFFER, or either of them, as alternate or successor Co- Executrices, and I further direct that none of them shall be required to post any bond to secure the faithful performance of her duties in the Commonwealth of Pennsylvania or in any other jurisdiction. 7. In addition to the powers conferred by law, my hereinbefore named Executrix and Guardian and their successors, are authorized and empowered: a. To invest any part of the trust corpus in such securities, investments, or other property as may be deemed advisable and proper, irrespective of whether the same are authorized for the investment of trust funds under the laws of any governing jurisdiction. b. With respect to any corporation, the stocks, bonds, or other securities of which may be held, to vote in person or by proxy on any shares of stock; to consent to the merger, consolidation or reorganization of such corporations; to consent to the leasing, mortgaging or sale of the property of any such corporations; to make any surrender, exchange or substitution of such stocks, bonds or other securities as an incident to the merger, consolidation or reorganization of such corporations; to pay all assessments, subscriptions and other sums of money which may be deemed wise and expedient for the protection and maintenance of the proportionate interest of the investment in such corporations; to exercise any option or privilege which may be conferred upon the holders of such stocks, bonds, or other securities of such corporations either for the conversion of the same into other securities or for the purchase of additional securities, and to make any and all necessary payments which may be required in connection therewith; and generally to have and exercise as to all such stocks, bonds and other securities, the powers of an individual owner who is not under trust obligation. c. To hold the trust corpus in one or more consolidated funds in which separate shares shall have undivided interests. ~7"": ~"r,~.~~ d. To sell at public or private sale for cash or upon credit, or partly for cash and partly on credit, and upon such terms and conditions as shall be deemed proper, any part or parts of the estate, and no purchaser at any such sale shall, be bound to inquire into the expediency or propriety of any such sale or to see to the application of the purchase moneys arising therefrom. e. To keep on hand and uninvested such money as may be deemed proper and for such period as may be found expedient. trust estate. To compromise, settle or arbitrate any claim or demand in favor of or against the g. And authorized in the discharge of fiduciary duties, to employ counsel and to detemune and to pay such counsel reasonable compensation which shall be charged against the principal or income of the trust fund, and shall further be entitled to charge against the principal or income such other reasonable expenses and charges as may be necessary and proper to incur for the proper discharge of fiduciary duties and for the proper management and administration of the trust estate. h. In making any division of property into shares for the purpose of any distribution thereof directed by the provisions of the trust, to make such division or distribution, either in cash or in kind, or partly in cash and partly in kind, as shall be deemed most expedient, and in making any division or distribution in kind may allot any specific security or property or any undivided interest therein to any one or more of such shares, and to that end may appraise any or all of the property so to be allotted and the judgment as to the propriety of such allotment and as to the relative value for purposes of distribution of the securities or property so allotted shall be final and conclusive upon all persons interested in the trust or in the division or distribution thereof. i. And authorized to register any shares of stock or other assets of any trust in their own names or in the name of a nominee. To retain and invest in shares of stock of my Trustee. k. To retain any investments including mutual funds which I may own at the time of my death and in addition to invest any part of the Trust corpus in such mutual fund or mutual funds as may be deemed advisable or proper, irrespective of whether the same are authorized for the investment of trust funds under the laws of any governing jurisdiction. 1. To determine from time to time whether all or some portion of realized capital gains shall be treated as ordinary income for distribution to a beneficiary or treated as principal to be retained as part of the corpus, and such designation need not be consistent from one year to another. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament written on one (2) pages, this ~/ ~ day of %.c; , 2003 ~fLi~-!~- Cir'f/11iV+ (SEAL) N L. ENDERS ~.,, Signed, sealed, published, and declared by JOHN L. ENDERS, the Testator above named, as and for his Last Will and Testament, in our presence, who, in his presence, at his request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. ~- ..._~~ . Date 9/25/09 ntial Financial Inc (PRU) (NYSE) U.S. Dollar Price High Low Volume 47.77 48.96 47.39 3,842,600 2 lubnth ~Dai#y) jj~h ~~ 3.~. i~~ ~r~ Imo 2mo 3mo 6mo ~ ~ 5~ No Splits Get another quote any day after 1/2/1970 1 /2/1970 Symbol: Date: 9/25/2009 Go ,~ t'1~~I'c~~~l~'~ ~d~c~ Quotes delayed at least 15 minutes. Market data provided by Interactive Data. Terms & Conditions. Powered and implemented by Interactive Data Manaoed Solutions. ~-s - Prudential IMPORTANT TAX RETURN DOCUMENT ENCLOSED RffNRRfffRAUTO'*5-DIGIT 17013 00256110855903 8 5 5 9 0 3 rrnllliillliilll~rilllllr~l~rnllllllill~l~niirrlllllrinu Recipient JOHN L ENDERS 38 STRAWBERRY DR CARLISLE PA 17013-4440 ~omputershare Computershare PO Box 43033 Providence, Rhode Island 02940-3033 Within USA, US territories 8 Canada 800 305 9404 Outside USA, US territories & Canada 732 512 3782 www.computershare.co~nvestor Holder Account Number 000286]3310 ~u~n IND ~u~u~~o i~w~ 001 CS0107.DOMLNGEQS_PG 1.PRU.145808_74/855903/855903/i6 ntial Financial, Inc. -Combined Dividend Payment 12009 Tax. Form 1099-DIV Account Number 00028673370 Corrected (If checked) Recipient's ID No. 203.10.7678 ' 1099 -DIV -Dividends and Distributions 2009 Copy B -For Recipient payers Federal ID No. 22.3703799 OMB No. 1545-0110 knportant tax information and k being famished to the Internal Revemre Service, ff you are requin:d to file a return, a negligence or other sanction may be imposed on you if this income is taxable and the IRS determines that it has not been reported. pepar6nent of the Treasury - Irnemal Revenue Service lent JOHN L ENDERS 38 STRAWBERRY DR CARLISLE PA 17013440 1b otal Ordinary Qualified 3 Nondividend 4 FEDERAL INCOME 6 Forei n Tax 7 Foreign Cotaitry u Cash U~dation I g I S. Possession D~• {$) Paid ($) or U Payer's Details ,Dividends ($) Dividends ($) Distributions ($) . TAX WITHHELD (Sf 00 0 PRUDENTIAL FINANCIAL INC x,60 26.60 0.00 0 ~ . CIO COMPUTERSHARE P.O. BOX 43010 PROVIDENCE RI 02940-3010 r (Keep for your records) 1099-DIV ividend Confirmation Participating Dividend Gross I Deduction I Deduction I Net ayment Date I Class Description I ghareslUnits I Rate I Dividend ($) Amount ($) Type Dividend ($) COMMON 38 $0.70000 26.60 0.00 NIA 26.60 18 Dec 2009 26.60 0.00 26.60 Year-To•Date Paid E ~~ I ~ 46UTX - ~~~ P R U "~" PLEASE CASHiDEPOSIT THIS CHECK PROMPTLY. t OORX6A-PP-(F2) X570004 - t ..,.... ..~+• i~ MM2384.SCRE(07/09) ;w id (NYSt) u.a. uouar Date Price High Low Volume 9/25/09 36.92 37.66 36.73 4,683,300 No Splits Get another quote any day after 1/2/1970 1 /2/1970 Symbol Date: 9/25/2009 Go ~ NAanth Daily) ~+ 4a7 f~ /~k~f ~y~l .3G t f- 3 1 mo 2mo 3mo 6mo ~ ~ Syr ,, ntera~t~ve Dada Quotes delayed at least 15 minutes. Market data provided by Interactive Data. Terms & Conditions. Powered and implemented by Interactive Data Mana4ed Solutions. ~~~~'~' ® ~ • • - - Irnestor ID 80651414 0310 a .~. HERS ~~ Market Valus e a of Total Market Rg~prd Dffie ,009 value ~ $772.20 it/Og/2p09 gate amount paid to all this distribution payable Dffie Ificiaries in 3,239•n• 12/1a/2oos pw~nd Summary Total Trust Dividend per Interests Trust Interest 2z.oooo Tax Withheld $0.00 $o.7a ~----- Net Distribution ~~ $18.28 _ ire Current 33 Distribution 33 $18.28 34 prior Year 32 Distribution or $18.28 visit ww~-.bnymellon.comisi'~areownerf~r or call 1-800.649-3593. ab~ Your account, You maY members of the Board of r` luiries to elect ~.J qn annual shareholders' ~ flonrgthe transaction of other buubn-'a1in9 ~ieiary Irdortnetion Iurchase or sell shares of MetL'rfe, Inc. common stock rou Trust"), free ~ any commissions or e policyholder Trust (the " Sale Program, as amended. A under the MetLife Pur the p ~ then the ~ brochure describing. r ram is available on the Internet b seleclmg Investor Relations and listed netlife.com Y a pr by calling the number ter Services Information p 9e~ our Trust Interests only in the ou are permitted to transfer y also instruct that all Incas described in the brochurM~ ife, Inc common stock held Bess than all) of your shares of Information regarding your 'rust be withdrawn from the Trust• le Brochure or by al rights may be found in the Purchase and Sa Is number listed above' Directors of MetL'Ife, Inc. a nl 27, 2010. The deadline fors bar 1, expected to be held on Ap • • n is Decem shareholder proposals ~ conslderalion at this meeU stet®mertt will be ~. A copy o1 MetL'rfe, Inc-'s annuaerMarch 31 2010. al°^g with other available free o1 cT~rurst fl/~~ under federal securities laws, Ccrpo ate M~ 1~',metlife.com by selecting. About MetLife, Links, (ii) by writmg to MetLifte• PA 15252-8447 Governance. under Related 7 Pittsburg , Mellon Shareowner Services, PO Box 35844 , calling the number listed above• These and other SE s~ 9~by or (iii) by MetLi4e and the Trust are also available on the Internet at MetLffe G3 ~~ Zppg-Tax Inform ion ease Note: ImPo RM 1099-DIV. U.S. TAX INFORMATION FOR 2009 hDENDS/DISTRIBUTIONS OMB NO.1545-0110 ~RECIPIENTR F~~INCOMETAX WITHHELD RECIPIENT'S TOTAL ORDINARY QUALIFIED DNIDENDS eox a DNIDENDS Box ie $p,p0 IDENTIFICp,TION NUMBER sox to $1628 $1628 Zp3"10-7678 PAYER'S FEDERAL- IDENTIFICA710N NUMBER 'AYER'S Ngnnt i3NY MELLON SHAREOWNER SERVICES AS ',,. ~crnnlAN OF THE METLIFE POLICYHOLDER TRUST SECURITY DESCRIPTION TRUST INTERESTS 2009 TO WHOM PAID JOHN L ENDERS 38 STRAWBERRY DRIVE CARLISLE PA 17013440 furnished ehY orncthme~l sanction m Yi be portanttex information and ie ~ig9gence Pa :required to file a return, on you ff this income is taxabis and the IRS determines that h lies not n Shows total ordinary dividends that are taxablej~Ol oe Scheduleul (Form 1040A), to ou as a parti- al or 1040A. Also, report R on Schedule B (Form Ian (ESOP). Report it d. The amount shown may be dividends a corporation paid directly Y r beneficiary of a participant) in an employee stock ownership p ilend on your Form 1040/1040A, but treat It as a plan distribution, not as investment br any other purpose. ~ ell ible for the 15 % or zero Shows the portion of the amount in box 1 A that may 104p/1040A instNCtions for how to determine this amount. Pains rates. See the Form M corm 1040 or 1040A. 51-6516987 REPORTED BYYORK THE BANMEOI.FLONW 4 BOULEVARD N JERSEY CITY, NJ 07310 TION REGARDING THE ABOVE, CALL 1-800.64g-3~ '009 .518 Yes .ywn~ 00028673370 203.10.7678 22.3703799 1545-0110 ~mal Revenue Service Payer's Details .FINANCIAL INC rMPUTERSHARE P.O. BOX 43010 ;E 8102940.3010 Box 4 -Shows backup withholding. For example, a payer must backup withhold on certain pay- our taxpayer identif'~cation numberfor information on ments at a 28 % rate if you did not give Y return as tax withheld. form W-9, Request for Taxpayer Identrfication Number and Certification, backup wthholding. Include this amount on your income tax Nominees. It this form includes amounts belonging to another person, you are considered a nominee recipient. You must file Form 1099-DIV wNh the IRS for each of the other owners ou must furnish a Form 1099-DI the other. See the 200E show their share of the income, and y 9e and W-2G~ wHe is not required to file a nominee r 1098t 3921w3922U 54 owned by General Instructions for Forms 1099, ,^ ~ ~ t ~ ~,.. • Net Dividend ($) 2s.so 26.60 0 1996 Oldsmobile Ciera -Trade In Value, blue book value -Kelley Blue Book '' i(elley B~ Baok THETRUSTEL! RESOURCE __ 1YLtN~ advertisement Page 1 of 2 P~e Send to Printer PROCRErlivE ... ,~crrter ~ . 1996 Oldsmobile Ciera SL Sedan 4D au'vrrt!sement BIDE BOOK ~ TRADE-IN VALllE P/~lIGREIl/t/E Condition Value arAfcT We don't tell you Excellent $1,275 what to pay for car insurance. Good $1,100 ..'_ ~ Fair $800 5100 (Selected) ~' ~ ~~ Vehicle Highlights Mileage: 80,500 ~ • Engine: 4-Cyl. 2.2 Liter Transmission: Automatic Drivetrain: FWD Selected Equipment _ - Standard Air Conditioning Power Door Locks AMJFM Stereo f~xlrvi Power Steering Tilt Wheel Cassette _~„+ Power Windows Cruise Control Blue Book Trade-In Value Kelley Blue Book Trade-In Value is the amount consumers can expect to receive from a dealer for atrade-in vehicle, assuming an accurate appraisal of the vehicle's condition, mileage and features. This value will likely be less than the Private Party Value because the reselling dealer incurs the cost of safety inspections, reconditioning and other costs of doing business. Vehicle Condition Ratings Excellent ",~5~.~, $1,275 • Looks new, is in excellent mechanical condition and needs no reconditioning. • Never had any paint or body work and is free of rust. • Clean title history and will pass a smog and safety inspection. • Engine compartment is clean, with no fluid leaks and is free of any wear ~lichlp riAfArts • Complete and verifiable service records. Less than 5°/n of all used vehicles fall into this category. Good . ~...)N "t..%1,100 • Free of any major defects. • Clean title history, the paints, body. and interior have only minor (if any) Close Window ~~~, ~` ~,,+„• ii.tn~>«, >rhh ~....,~t,h/r TcPr1C`are/Pr;cinuRer,nrt_a~~nx?WebCateaorvld=38&Yearld=1996... 5/2/2010 1996 Oldsmobile Ciera -Trade In Value, blue book value -Kelley Blue Book Page 2 of 2 Li(: "lC~, u - ~i~?2IC die .?G illdf Oi i7ieChafiiCdi ar O%ii2iii5. • little or no rust on this vehicle. • Tires march and have subs*_antial tread wear left. • A "good" vehicle will need some reconditioning to be sold at retail. Most ronsumer owned vehicles fall into this category. / Fdir (Selected) • Some mechanical or cosmetic defects and needs servicing but is still in reasonable running condition. • Clean title history, the paint, body and/or interior need work performed by a professional. • Tires may need to be replaced. • There may he some repairable rust damage. Poor N/A • Severe mechanical and/or cosmetic defects and is in poor running rnnditi0^. • May have problems that cannot be readily fixed such as a damaged frame or a rusted-through body. • Branded title (salvage, flood, etc.) or unsubstantiated mileage. Kelley Blue Book does not attempt to report a value on a "poor" vehicle because the value of these vehicles varies greatly. A vehicle in poor condition may require an independent appraisal to determine its value. * Pennsylvania S/2/2070 i,,+„•/hxnxn~~ lrhl, nnm/khh/i1cPC~C:arc/Pricin~Rennrt_aSnx?WebCate~orvId=38&Yearld=1996... 5/2/2010 GERTIFtCATE OF TITLE 'FOR A VEHICLE C X11, !~ i, ^`J2$!9q~31IIBB2597-{3[11 7,G3Atl551~3T64g0873 ~ 1996 aLDat1OBILE 5Q21166c'902 EN VEHICLE IDENTIFICATION NUMBER YEAR MAKE /OF~tVEHICfL~E-7p r'7 II ~y r~ ITITLE NUMBER SDfV ~ ~ ~ ~ ~~/ L2J L3 J~ UU~iJ.4J~` (J BODY TYPE DUP SEAT CAP PRIDR TITLE STATE ODOM. PROCD. DATE OUOA,1 MILES I ODOM. STATUS 3,1lI17/91~ ..} ~,7,/12IC19 I ~ ~ ~ DATE PA TITLED DATE OF ISSUE UNLnDEPJ WEIGHT GVWH GCWH ~ TITLE BRANDS /~ W 0 '~ W W N ~.'YC. ''4 ~'.: 'E`tS.15TER~D OWNER(6) BETTY B ENDERS 3~1 ~TRALlBERRY DR CARLISLE `PA 17[]],3 FIRST I7EN FAVOR OF: E C.T.Ei/F- Q~~eY l: ~ ~'~S 1~~• Tl iT FIRST LIEN RELEASED DATE BY AUTHORIZED REPRESENTATIVE MAILING ADDRESS ^29207 BETTY B ENDERS 38 STRAWBERRY DR CARLISLE PA 17[713 SECOND LIEN FAVOR OF: QOfJMETER $TF.TUS 9 =ACTUAL MILEAGE 1 = MILEAGE EJ0.GEEp5 THE MECHANICAL UM1T5 ~ 2:=NOT THE ACTUAL MU.,EAGE ~ 3 =NOT THE ACTUAL MILEAGE-0DQMETEF. l TAMPERING'VERIFIED r. ' 4 =EXEMPT FROM ODOMETER DISCLOS~AF T17LE BRANDS A = AN'nOUE VEHICLE C =CLASSIC VEHICLE D = COLLECTIBLE VEHICLE '. F ,OUT OF COUNTRY G .ORIGIFiALLYMFGD. FOR NON~J°, D}STR19U7,ION H = AGR{CULTURAL VEHICLE ' L =LOGGING VEHICLE P = IS/wAS A POLICE VEHICLE R =RECONSTRUCTED 5 =STREET ROD T =RECOVERED THEFT VEHICLE V .VEHICLE CONTAINS REISSUED VIN W =FLOOD VEHICLE X = ISlWAS A TAXI If a second iienholder is listed upon satisfaction oI the first lien., the first Iienholder must forwartl this Tile to the Bureau of Motor Vehicles with the ' appropriate form antl Tae. SECOND LIEN RELEASED DATE BY AUTHORIZED REPRESENTATIVE I certify as of the tlate of issue, the official records of the Pennsylvania Department • d Transportation ro5ect that tho person(s) or company named herein is the lawlul owner • • of the saitl vehiGe. AND SWORN ALLEN D BIEHLER Secretary of Transportation If a co-purchaser other than your spouse is listed and you want the Gtle to be listed as "Joint Tenants With Right of Survivprship" (On death Of one vEAa owner, tNe goes to surviving owneT.)?CHECK HERE O. Otherwise, the title will be issued aS "Tenants in Common" (On death of one olMner, interest of deceased owner goes to his/her heirs ore&tate). IF NO LIEN, CHECK ^ IS THIS AN ELT? (IF YES, FIN AEOU18ED) YE5 ^ NO ^ 1ST LIENHOLDER FINANCIAL INSTITUTION NUMBER: 1ST LI6NHOLDER NAME STREET. II_ CITY STATE ZIP IF NO 2ND LIEN, CHECK ~ IS THIS AN E1T? (IF YES, FIN REQUIRED) YES ^ NO ^ The uraierslgned heretiq makes appllcaflon Tot CeleNCele of Title t0 .the vehkae tlescrlbed ahave, subjodt to the encumbrances antl elver legal claims set tPM Here. 2ND UENHOLDER FINANCIAL INSTITUTION NUMBER: 2ND L}ENHOLDER NAME - SIGNATURE OF APPLICANT OR AUiHORIZE~ SIGNER STREET SIGNATURE OF CO-APPLICANTRITLE OF ALIrHORIIFn CInNFR C'ITM STATE ZIP ~ ~~' ax~c Understanding wt's mpcxaanC` Secured Message Reply k From: JESSICA REESE <JLREESE@mtb.com> To: stiley@freytiley.com Date: June 21, 2010 12:06:53 PM EDT Subject: DOD.-Enders. Jessica Please print a copy for your files. Please find below the date of death balance for: John Lloyd Enders, social security# 203-10-7678. 1. Account #31003916445511, Balance $ 9395.14 + 15.65 accrued interest = $ 9410.79 Total 2. Account #411191, Balance $65506.30 + 7.21 accrued interest = $65513.51 Total 3. Account #15004200926523, Balance $86504.32 + 16.12 accrued interest = $86520.44 Total 4. Account #15004202072027, Balance $79421.54 + 29.59 accrued interest = $79451.13 Total Thanks, Sue Kimble Adjustment Services/ DOD Unit M&T Bank- "Understanding what's important." Jessica L. Reese Customer Service Representative II Carlisle High Street Office M & T Bank 717-240-4545 ~- Rep~y © 2000-2008 Cisco Systems Inc. All rights reserved. Help ~ Forget me on this computer ,.~~. O~s~rowlvBaNx ? A Tradition of Excellence b ~, ~yA; 'KIn ~'ft s~~+~ K. . ~i':' f ~ .. i t.~ ~ ~.~s >s.- ...,r:. s :~.7~f.>s.>..~»'~.. s7. »~ try ... «iL", s ~us_LF „'.n.~' .. 77 East King Street Shippensburg, PA 17257 June 15, 2010 Frey & Titey Attorneys at Law 5 South Hanover St. Carlisle PA 17013 Attention: Sharon DeVos Shirley Wescott Orrstown Bank PO Box 250 Shippensburg, Pa 17257 Phone 717.530.2515 Re: Estate of: John Lloyd Enders Date of Death: 09/25/09 IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT, ON THE ABOVE DATE, HAD THE FOLLOWING ACCOUNTS WITH ORRSTOWN BANK: CERTIFICATE OF DEPOSIT Account # Title of Account Date opened PrinciRal Accrued Interest DOD Bal 4000034642 John L Enders 8/31/09 30,000 11.84 $30,011.84 Betty J Enders Account # Title of Account Date Opened Principal Accrued Interest DOD Bal 4000034779 John L Enders 9/08/09 15,000 4.93 $15,004.93 Betty J Enders Account # Title of Account Date opened Principal Accrued Interest DOD Bal 5060061171 John L Enders 10/28/00 5,000 2.88 $5,002.88 Betty J Enders ~f`a"~ki : ~' Account # Title of Account 5060061172 John L Enders Betty J Enders Date Opened 10/28/00 Best regards ~~~ ~,.~Shirley Wescott Receptionist Principal Accrued Interest 6,000 3.45 DOD Bal $6,003.45 06/15/2010 TUE 11:30 FAx 5136291799 • • ~ ~ - - - -~ Western &~Southern~ife ---- A rnember of Western 8 Southern Financial Group BETTY ENDERS 38 STRAWBERRY DR CARLISLE, PA 17013 Dear Betty Enders: r~oo2/002 Annuity Operations - -PO-Box-2918--•~ --- Cincinnati, OH 45201-2918 toll free 800.926.1702 fax 513.629,1799 June 15, 2010 Thank you for your request for information on the annuity contract. I hope the following contract information is helpful to you. Annuitant: JOHN ENDERS Owner: JOHN ENDERS Western-Southern Life Assurance Company Contract Number: W0020627785 Date of death valuation: $48179.52 The quoted value information is as of 09-25-2009. If you have any questions, please call our Annuity Operations Department at 1-800-926-1702. A representative will be happy to help you. `~ , Step ani Ann 'ty DC0331-0910 r e ruber Op rations Department Western-Southern Life Assurance Company <~~v+ 6/22/10 Deposit Inquiry 13:47:01 Betty J Enders Account number: 746000103 Messages 1 of 1 Last stmt balance: 64,583.16 Last stmt date: 5/31/10 - Current balance: 103,590.69 Statement cycle: 32 1=View 6=Print T =Tset Control: From To Posted Check No S T/C Debit Credit Balance _ 9/08/09 P 025 .82 8,075.68 9/18/09 I 155 13.08 8,088.76 9 29 09 I 5 23.36 8,112.12 9/30109 I 155 24.66 9/30/09 160 3.02 . 8,139.80 9/30/09 151 .150000000 8,139.80 10/20/09 I 155 12.65 8,152.45 10/29/09 I 155 22.60 8,175.05 10/30/09 I 155 24.65 8,199.70 11/01/09 151 .150000000 8,199.70 11/20/09 I 155 13.08 8,212.78 11/27/09 I 155 23.36 8,236.14 11/30/09 I 155 25.48 8,261.62 11/30/09 151 .15000000a 8,261.62 More... F4=Redsply F6=Bal Inq F7 =Scan Fwd F8=Scan Bkwd F11 =Prior bal F15=EFT F16=Sort F17=Top F18=Botto m F19 =EDI F20=Unfold F22 =T/C F23=Checks a~~ 6/22/10 Time Deposit Inquiry 13:56:34 John L Enders Account number: 4000029519 Redeemed Due to Death Has messages 1 of 1 Original balance: 14,000.00 YTD interest: b9.19 Current balance: .00 Next pmt date: 6/20/10 1=View 6=Print T=Tset Control: From To Opt Posted InputSrc Rate T/C AFF Amount Balance 6/19/09 G 670 D I 32.69 14,000.00 6/19/09 G 673 D Y 32.69 14,000.00 7/20/09 G 670 D I 31.65 14,000.00 7/20/09 G 673 D Y 31.65 14,000.00 8/20/09 G 1.100000 651 14,000.OC 8/20/09 G 670 D I 32.70 14,000.00 8/20/09 G 673 D Y 32.70 14,000.00 9/18/09 G 670 D I 13.08 14,000.00 9/18/09 G 673 D Y 13.08 14,000.00 10/20/09 G 670 D I 12.65 14 000.00 G 673 D Y 12.65 4, 11/20/09 G 67C D I 13.08 14,000.00 11/20/09 G 673 D Y 13.08 14,000.00 12/18/09 G 670 D I 12.66 14,000.00 More... F4=Redisplay F7= Scan forward F8=Scan backward F16 =Sort F17=Top F18=Bottom F20=Fold/Unfold F22 =Trap Codes +~" 6/22/10 Time Deposit Inquiry 13:56:10 John L Enders Account number: 4000027012 Redeemed Transfer to Orrstown Bank Account Has messages 1 of 1 Original balance: 25,000.00 YTD interest: 175.82 Current balance: .00 Nex t pmt date: 6/29/10 1=View 6=Print T =Tset Control: From To Opt Posted Input Src Rate T/C AFF Amount Balance 6/29/09 G 670 D I 65.76 25,000.00 6/29/09 G 673 D Y 65.76 25,000.00 7/29/09 G 670 D I 22.60 25,000.00 7/29/09 G 673 D Y 22.60 25,000.00 8/28/09 G 670 D I 23.35 25,000.00 8/28/09 G 673 D Y 23.35 25,000.00 9/29/09 G 670 D I 23.36 25,000.00 9/29/09 G 673 D Y 23.36 25,000.00 G 670 D I 10/29/09 G 673 D Y 22.60 25,000.00 11/27/09 G 670 D I 23.36 25,000.00 11/27/09 G 673 D Y 23.36 25,000.00 12/29/09 G 670 D I 22.60 25,000.00 12/29/09 G 673 D Y 22.60 25,000.00 More... F4=Redisplay F7=Scan forward F8= Scan backward F16 =Sort F17=Top F18=Bottom F20=Fold/Unfold F22=Tran Codes Exhibit "I"