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Home My WebLink About10-21-10~'~~-7 ~ D Q c~ DECEDENT'S ESTATE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION n ~o ~~ ~ -~, I-T, ~~~ ~~ ~_7 ~~ i~ i~;Ca-n ~J b ESTATE OF Ina M. Keller ,DECEASED No. 21-09-1175 PETITION FOR ADJUDICATION / STATEMENT OF PROPOSED DISTRIBUTION PURSUANT TO Pa. O.C. RULE 6.9 0 ~, _ - c~ - - N ~- _~ -- r _ _ b -; ~ ;, -~ -i N ~ :~ This form maybe used in all cases involving the Audit of the Account of a Decedent's Estate. If space is insufficient, riders maybe attached. Attach the spouse's election, if any; the papers required under items 8-19 inclusive; and any instrument pertinent to the adjudication. INCLUDE ATTACHMENTS AT THE BACK OF TH/S FORM. Name of Counsel: John E. Slike Esq. Supreme Court I.D. No.: 06262 Name of Law Firm: Saidis Sullivan Law Address: 2109 Market Street Camp Hill, PA 17011 Telephone: 717-737-3405 Fax: 717-737-3407 E-mail: Form ~C-01 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, inc. Page 1 of 10 ~~ ~ Estate of Ina M. Keller ,Deceased 1. Name(s) and address(es) of Petitioner(s): "ame: Jeffrey P. Weaver Address: 512 Wayne Drive Mechanicsburg, PA 17055 Identify any executors or administrators who have not joined in the Petition for Adjudication and Statement of Proposed Distribution and Account and state reason: Is this the first accounting by this fiduciary? ......................................................................... ®Yes ^ No If not, identify Prior accountings, the accounting periods covered, and the date of adjudication of the prior accounting. 2. Decedent died on 12/09/2009 ® Letters Testamentary or ^ Letters of Administration were granted to Petitioner(s) on 12/21/2009 Date of Will (if applicable): 08/26/2004 Date(s) of Codicil(s) (if applicable): Date of probate (if different from date Letters granted): 12/21/2009 Was a bond required? ^Yes ®No If yes, state amount: Are proofs of advertising of the grant of Letters attached? ............................ ••• ®Yes ~ No Dates of advertising of the grant of Letters: 01 /01 /2010 01 /08/2010 01 /15/2010 01 /01 /2010 01 /09/2010 01 /15/2010 Form OC-O1 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, inc. Page 2 of 10 ) ~..I Estate of Ina M. Keller 3. Was decedent survived by a spouse? ....................................................................... If yes, name of the surviving spouse: Deceased Yes ® No 4. Has the surviving spouse filed to take an elective share? ......................... (~Sgg Section 2201 ~ egg. of the Probate, Estates and Fiduciaries Code) If yes, date of election: Yes ~ No 5. In the case of an intestacy, state the names of the decedent's surviving children or surviving issue of deceased children (if none, so state): 6. Did the decedent marry after execution of Will or Codicil(s)? ......... Were any children born to decedent after execution of Will or Codicil(s)? ........................................................ If yes, give names and dates of birth: Name: 7. If required by the Medical Assistance Estate Recovery Act, 62 P.S. §1412, was a request for a statement of claim sent to the Department of Public Welfare? .......................................... Yes ® No Yes ® No Date of Birth: ® Yes ~ No Form ~C-01 Rev. 10.13-2006 Copyright (c) 2006 form software only The Lackner Group, ino. Page 3 of 10 Estate of Ina M. Keller Deceased 8. Written notice of the Audit as required by Pa. O.C. Rules 6.3, 6.7 and 6.8 has been or will be given to all parties in interest listed in item 9 below, all unpaid creditors and all claimants listed in item 10 below. In addition, notice of any questions requiring Adjudication as discussed in item 14 below has been or will be given to all persons affected thereby. A. If Notice has been given, attach a copy of the Notice as well as a list of the names and addresses of the parties receiving such Notice. B. If Notice is yet to be given, a copy of the Notice as well as a list of the names and addresses. of the parties receiving such Notice shall be submitted at the Audit together with a statement executed by a Petitioner or counsel certifying that such notice has been given. C. If any person entitled to Notice is not sui juris (e.g., minors or incapacitated persons), Notice of the Audit has been or will be given to the appropriate representative on such party's behalf as required by Pa. O.C. Rule 5.2. D. If any charitable interest is involved, Notice of the Audit has been or will also be given to th ~ Attorney General as required under Pa. O.C. Rule 5.5. In addition, the Attorney General's clearance certificate (or proof of service of Notice and a copy of such Notice) must be submitted herewith or at the Audit. 9. List all parties (charitable and non-charitable) of whom Petitioner(s) has/have notice or knowledge, having or claiming any interest in the estate as beneficiaries under the Will or Codicil(s) or as intestate heirs if there is a complete or partial intestacy: A. State each party's relationship to the decedent and the nature of each party's interest(s): and Address of Michael Wearer 107Haire AvEnue Lewisburg, PA 17837-9204 Elizabeth Beers 825 North Hanover Street Apartment 1 ~ 1 Carlisle, PA ;,17013-2041 Nephew Eight and one third Sister Eight and one-third percent of the residue, per Paragraph III, Item D of the Last Will and percent, per Paragraph III, Item D of the Last Will and Testament. Form OC-01 Rev. 10.13-2006 Copyright (c) 2006 form software only The Lackner Group, inc. Page 4 of 10 ~~ ~ ~ Estate of Ina M. Keller Deceased Name and Address of Each Party in Interest and Interest Cheri Keller 7022 NW 92nd Place Gainesville, FL 326537843 Jane Lawrence 108 Main Street PO Box 21 Francestowr~, NH 03043-3026 See continuation schedule attached Niece Eigth and one-third percent per Paragraph Ill, Item D of the Last Will and Testament. Niece Eight and one-third percent per Paragraph Ill, Item D of the Last Will and Testament. B. Identify each party who is not sui juris (e.g., minors or incapacitated persons). For each such party, give date of birth, the name of each Guardian and how each Guardian was appointed. If no Guardian has been appointed, identify the next of kin of such. party, giving the name, address and relationship of each. C. State why a Petition for Guardian/Trustee Ad Litem has or has not been filed for this Audit (sg~ PA. O.C. Rule 12.4). D. If distribution is to be made to the personal representative of a deceased party, state date of death, date and place of grant of Letters and type of Letters granted. Form OC-01 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, lno. Page 5 of 10 ( ~ Beneficiaries or Heirs (continuation of Question #9A) Estate of Ina M. Keller Deceased Name and Address of Each Party in Interest Jeffrey Weaver 512 Wayne Drive Mechanicsburg, PA 17055-4984 Barbara Cone 307 Tappan Street #2 Brookline, MA 024455382 Larry Bistline 217 East Gartield Street Shippensburg, PA 172572001 Jean Ream 1145 Pheasant Drive North Carlisle, ~A 17013-1252 Bethany tillage Endowment Fund Attn: J. D. Shuman, Director of Development 325 Wesley Drive Mechanicsburg, PA 17055 The Knights Templar Eye Foundation, Inc. 2000 East State Parkway Suite 1 Schaumburg, IL 601734592 Shriners'~lospitals for Children 3351 North Broad Street Philadelphia, PA 191404131 Relationship and Comments, if any Interest Nephew Eight and one-third percent of the residue, per Paragraph 111, Item D of the Last Will and Testament. Niece Eight and one-third percent, per Paragraph III, Item D of the Last Will and Testament. Nephew Twelve and one-half percent, per Paragraph III, Item D of the Last Will and Testament. Niece Twelve and one-half of the residue, per Paragraph Ill, Item D of the Last Will and Testament. Charity Ten percent (10%) of the residue, per Paragraph III, Item C of the Last Will and Testament. Charity Five percent (5%) of the residue, per Paragraph III, Item B of the Last Will and Testament. Charity Ten percent (10%) of the residue per Paragraph III, Item A of the Last Will and Testament. Form OC-01 Rev. 10-13-06 ~ ~ s Estate of Ina M. Keller Deceased 10. Other than the claim for the family exemption, list the names of all known claimants and the amount of their claims and state whether each claim is admitted. Name and Address of Each Claimant Amount of Claim Claim Admitted? VYllP81aimr Be Full Above Attachment Total If the estate is insolvent, attach a schedule setting forth the order of preference under 20 Pa.C.S. § 3392 and the proposed payments. 11. Was family exemption claimed? ....................................................... Was family exemption allowed? ....................................................................... Family exemption claimant's name and relationship: Name: Yes ® No Yes ® No Relationship: Form OC-01 Rev. 10.13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 6 Of 1 O T' ~` J `~ Estate of Ina M. Keller Deceased 12. The amount of Pennsylvania Transfer Inheritance Tax and additional Pennsylvania Estate Tax paid, the date(s) of payment(s), and the interest(s) upon which paid, are as follows: Date Payment Interest 02/16/2010 38,000.00 02/16/2010 1,498.93 03/0`'/2010 1,517.07 06/0/2010 1,579.75 10/05/2010 487.68 2.00 13. On the date of death, was the decedent a fiduciary (personal representative, trustee, guardian, agent under power of attorney) or surety on the bond of a fiduciary? ................................................................ ^ Yes ® Wo If yes, provide ~;he name of the estate, indicate whether an account has been filed and confirmed absolutely and all awards performed, or, in the alternative, how the decedent's estate will be discharged for the decedent's fiduciary administration of the estate. 14. A. Describe in detail any questions requiring adjudication and state the position of the Petitioner(s) as to each question: B. Has notice of the question requiring adjudication been given to the parties identified in Paragraph 9 above? ............................................................ ^ Yes ® No 15. If Petitioner(s) has/have knowledge that a share has been assigned, renounced, disclaimed or attached, provide a copy of the assignment, renunciation, disclaimer or attachment, together with any relevant supporting documentation. Form OC-01 Rev. 10.13-2006 Copyright (c) 2006 farm software only The Lackner Group, Inc. P8 e 7 Of 1 O 9 ~"~" J ~" Estate of Ina M. Keller ,Deceased 16. Had the decedent been adjudicated an incapacitated person? ........................................... ^ Yes ® tVo If yes, attach a copy of the Order if available; otherwise state Court, term, number, date, and name of Hearing Judge. 17. A. List or attach a separate list of additional receipts and disbursements since the closing date of the Account. Date Description Amount B. Has notice of tl:)e additional receipts and disbursements been given to the pa ties identified in Paragraph 9 above? ................................................... ^ Yes ® No 18. If a reserve is requested, state amount and purpose. Amount 24,480.00 P°~°Sa: $14,740.00 for the Executors Fees $ 7,740.00 for the unpaid Legal Fees $ 2,000.00 for filing fees and income taxes If a reserve is requested for counsel fees, has notice of the amount of fees to be paid from the reserve been given to the parties in interest? ................................................................................................. ^ Yes ® IVo If so, attach a copy of the notice. 19. Is the Court being asked to direct the filing of a Schedule of Distribution? ................................................................................ ^ Yes ® IVo As to real estate only? ......................................................................................................... ^ Yes ® No Form OC-01 Rev. 10.13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. P89e 8 Of 1 O ~~ ~ ~ Estate of Ina M. Keller Deceased Wherefore, your Petitioner(s) ask(s) that distribution be awarded to the parties entitled and suggest(s) that the distributive shares of income and principal (residuary shares being stated in proportions, not amounts) are as follows: A. Income: Proposed DisMbutee(s) Amount Proportion Michael Weaver 8.333% Elizabeth Beers 8.333% Cheri Keller 8.333% Jane Lawrence 8.333% Jeffrey Weaver 8.333% Barbara Cone 8.333% Larry Bistline 12.5% Jean Ream 12.5% See continuation schedule attached B. Principal: Proposed DisMbutee(s) Amount Proportion Michael Weaver 8.333% Elizabeth` Beers 8.333% Cheri Keller 8.333% Jane Lawrence 8.333% Jeffrey Weaver 8.333% Barbara Cone 8.333% Larry Bistline 12.5% Jean Ream 12.5% See continuation schedule attached Submitted By: (All petitioners must sign. Add additional lines if necessary): N f P titioner: Jeffrey P. Weaver Name of Petitioner: Name of Petitioner: Form OC-O1 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, inc. Page 9 of 10 Proposed Distributions of Income (continuation of Page 9) Estate of Ina M. Keller ,Deceased A. Income: Proposed Distributee(s) Bethany Village Endowment Fund The Knights Templar Eye Foundation, Inc. Shriners Hospital for Children Amount Proportion 10% 5% 10% Form OC-01 Rev. 10-13-06 ~~ Proposed Distributions of Principal (continuation of Page 9) Estate of Ina M. Keller B. Principal: Proposed Distributee(s) Bethany Village Endowment Fund The Knights Templar Eye Foundation, Inc. Shriners Hospital for Children Amount Proportion 10% 5% 10% Deceased Form OC-01 Rev. 10-13-06 `~ ~ J ~ tl Estate of Ina M. Keller __ Deceased Verification of Petitioner (Verification must be by at least one petitioner.) The undersigned hereby verifies * [that nersne is fine of the above-named name of corporation ~~ and] that the facts set forth in the foregoing Petition for Adjudication /Statement of Proposed Distribution which are within the personal knowledge of the Petitioner are true, and as to facts based on the information of others, the Petitioner, after diligent inquiry, believes them to be true; and that any false statements herein are made subject to the penalties of 18 Pa. C.S. §4904 (relating to unsworn falsification to authorities). ~~~ Si re Petitioner Jeffrey P. Weaver Signature of Petitioner Signature of Petitioner * Corporate petitioners must complete bracketed information. Certification of Counsel The undersigned counsel hereby certifies that the foregoing Petition for Adjudication/ Statement of Proposed Distribution is a true and accurate reproduction of the form Petition authorized by the Supreme Court, and that no changes to the form have been made beyond the responses herein. Si ture of Counsel for Petitioner n E. Slike Esq. Form OC-01 Rev. ~a~~-2oos Copyright (c) 2006 form software only The Lackner Group, inc. Page 10 of 10 PROPOSED DISTRIBUTIONS TO BENEFICIARIES Current Value Fiduciary 10/15/2010 Acquisition or as noted Value TO: Barbara Cone Cash -Distribution of Principal $ 24,721.53 Cash Distribution of Interest $ 288.37 TO: Bethany Village Endowment Fund Cash -Distribution of Principal $ 33,932.51 Cash Distribution of Interest $ 400.14 TO: Cheri Keller Cash -Distribution of Principal $ 24,721.53 Cash Distribution of Interest $ 288.37 TO: Elizabeth Beers Cash -Distribution of Principal $ 21,431.60 Cash Distribution of Interest $ 297.38 TO: ,Jane Lawrence Cash -Distribution of Principal $ 24,721.53 Cash Distribution of Interest $ 288.37 TO: Jean Ream Cash -Distribution of Principal $ 37082.48 Cash Distribution of Interest $ 432.60 25,009.90 34,332.65 25,009.90 21,728.98 25,009.90 37,515.08 - 38 - PROPOSED DISTRIBUTIONS TO BENEFICIARIES Continued Current Value 10/15/2010 or as noted TO: Jeffrey Weaver Cash -Distribution of Principal $ 20,096.61 Cash Distribution of Interest $ 288.37 TO: Lar Bistline Cash -Distribution of Principal $ 37082.48 Cash Distribution of Interest $ 432.60 TO: Michael Weaver Cash -Distribution of Principal $ 24,721.53 Cash Distribution of Interest $ 288.37 TO: Shriners Hospjtals for Children Cash -Distribution of Principal $ 33,932.51 Cash Distribution of Interest $ 400.14 TO: The Knigh Temular Eye Foundation. Inc. Cash - Eistribution of Principal $16,966.25 Cash Distribution of Interest $ 200.07 Fiduciary Acquisition Value 20,384.98 37,515.08 25,009.90 34,332.65 17,166.32 Total 303,015.34 -39- L ^~ W Y `r' _= N ~ ~ A0 W }~ ~ L N W ~_ N L ~ ~+ d L ~ ~ ~ ~ ~ Q ~L ~ •_ ~L ca a C O ~ ~ < ~. F 41 G O C O .~ r ~ a L ~ _N O ~ Q t ~ V_ Z L` F U O C ~ m x w ~ m ~~ H ~ L c N O O '? ~ .D a a a~i m ago ~ ~ ~ ~ `° ~ ~ rn rn c M V' N N N V N N m O ~ ti °o °o °o °o °o °o °0 0 0 "u v v; v v v co v v ri ri u N M N N N M N N M M ~ U7 u7 (O (D (D U1 (D UJ U) ~ C M O M M M O M M c0 00 s ~ ~ ~ ~ n ~ W W O O O O O O N N U co rn m co cD rn cD co ~ ~ u N M N N N M N N M M V ~ M M M C M M O O u•; (D M U1 u7 u7 M lI7 u7 r ~ C O O O m O) O) O O V V I~ O M M M O M M O 01 01 N N N ~ m m C N M N N N M N N N N 01 t!') 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N N ~ c N w o m a~ N J 3 c O - 0 ._ N c°o v ~ uM'~ ~ v co ~ ~n ~n N ~ ~ N CO A N N M 00 N N N aD O) N M M ~ O 1~ ~ h 0 0 I~ O O r~ v v v ~ o v M M N M N N N M N N M M 000 M 00 000 M M~ O M M aD a0 00 W ao ~ a0 CO O f0 I~ O r h n O~ ~ W a0 O ~ M M M ~ M O n h h 00 h O m N V N N N~ h N Cn m O O O O O I~ O (D (O I~ O O O O O M O O O O CO ~f V ~ CO m d' M M N M N N N M N M M O ~ O N O (O v v V t1') M M M tt) M M E M~ N N N V N N Q~ m 0 0 0 0 0 0 0 CO (D h 0 0 0 0 0 0 0 0 0 N M N N N M N N M M 0 0 0 0 0 0 0 0 0 0 0 M O M M M O M M O O O M O M M M O M M O O O M u7 M M M~ M M 0 0 0 W N 00 W 00 N 00 OD O O to ti c 0 c -a ~ c ~- o ~~~ ~~a 3 U w 0 v ° `m c y n W ~ ~ ~ N ~ N ~ N a> a> U > m m uoi ~ O O c c m E O a~ ~~ ~ O- O w ~ ~ U ~ 3 af6i ~ ~ >, N °' O m~ Y J~ >, N c~ c ~ m ._ m m ~ c N ~ ~ N C N '.~ U_ ~ N L L W J m U -Oi ~~~ m N H 0 69 l0 Q~ N N ~o 0 ~O v OD n O T N tD N t0 co a w ~_ r m x ~ W O w r O v_ M rn y ~ ~ N ~ a m 0 Final Distribution for the Estate of Ina M. Keller Amount of Inheritance Tax Due from Non Probate Property Amt Due Percent Estate Total Inheritance Tax Reimbursement from Beneficiary: Elizabeth Beers 12% 4,001.04 Jeffrey Weaver 15% 4,624.92 $ 8,625.96 Page 4 of Exhibit A LAST WILL AND TESTAMENT OF INA M. KELLER I, INA M. KELLER of Lower Allen Township, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament, hereby revolting any will previously made by me. I. I direct the payment of all my just debts and funeral expenses out of my estate as soon as mays be prac~cal after my death. II. I bequeath certain items of my tangible personal property, not including cash and securities, in accordance with a written list made by me during my lifetime. In the absence of such a list or designation on such a list, I direct my executor hereinafter named sell said articles and that the proceeds be added to the residue'of my estate. III. I devise and bequeath all the rest, residue and remainder of my estate of whatever natux~ and wherever situate unto the following individuals and entities in the proportions indicated: A. Ten percent (10%) of said residue shall be distributed to the Shriners Crippled Children's Hospitals to be used for such purposes as they shall MIDIS ;FLOWER [NDSAY lEYS•AT•L1W Iarket Street p Hill, PA deem appropriate. > B. Five percent (5%} of said residue shall be distributed to the Knight's ~~ Templar Eye Foundation, Inc. to be used for such purposes as they shall deem appropriate. 1 ~_~ /~ . -- - --. _ __.~._......_...._.~..T...~_........ C. Ten percent (10%) of said reside shall be distributed to the Endowment Fund of Bethany Village, Mechanicsburg, PA. D. The remaining seventy-five percent (75%) of said residue shall be divided in nine equal shares among my two living sisters, Elizabeth Beers and Dorothy Bistline, or if they are deceased, to, their issue; my niece and nephew, Jean Ream and Larry Bistline, or if they are deceased to their issue; and my deceased husband's nieces and nephews, Barbara Cone, Jeffrey 'Weaver, Michael Weaver, Sane Lawrence and Cheri Keller, or if any of them is deceased, to their issue. VI. I appoint Jeffrey P. Weaver Executor of this, my Last Will and Testament. Should he fail to qualify or cease to act as such, then I appoint Roberta L. Weaver as Executrix to act in this capacity. None of my personal representatives shall be required to post bond in this or any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal on this, the ~~ di~.y of , 2004. ~n A- ~~I ~ ~ (SEAL) INA M. KELLER MIDIS ~, FLOWER [NDSAY JEYS•AT•LAW 9arkel Street p Hill, PA Signed, sealed, published and declared by INA M. KELLER herein named, on this and two (2) other sheets of paper as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our ~. names as attesting witnesses. w Nam- Addresses. N. e Address 2 COMMONWEALTH OF PENNSYLVANIA } COUNTY OF CUMBERLAND WE, the undersigned, the Testatrix and the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she signed willingly (or willingly directed another to sign for her), and that she executed it as her free will and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and heazing of the Testatrix signed the will as witnesses and that to the best of their laiowledge the Testatrix was at that time eighteen yeazs of age or older, of sound mind, and under no constrain or undue influence. IN~.,~VI. KEI;LER, Testatrix Subscribed, sworn to and aclalowledged before me by the Testatrix, and subscribed and sworn to before me by both witnesses, this ~- day of ~,~~C1/~~.5'~ , 2004. /, j / `I',, ' f .',~. WBALTH OF PENN 1 MANIA Notary Public Notarial Seal 3ellie Allshouse, Notary Public Camp Hill Bono, Cumberland County My Commission Expires Mar. 29, 20Q8 IDIS FLOWER JDSAY 1'S•AT• to W rket Street H111, PA 3 The Patriot-News Co. 812 Market St. Harrisburg, PA 17101 Inquiries - 717-255-8213 SAIDIS, FLOWER & LINDSAY ATTN: JO ANN SEKER 2109 MARKET STREET CAMP HILL PA 17011 cue ~latriot N¢ws Now you know THE PATRIOT NEWS THE SUNDAY PATRIOT NEWS Proof of Publication Under Act No. 587, Approved May 16, 1929 Commonwealth of Pennsylvania, County of Dauphin} ss Marianne Miller, being duly sworn according to law, deposes and says: That she is a Staff Accountant of The Patriot News Co., a corporation organized and existing under the laws of the Commonwealth of Pennsylvania, with its principal office and place of business at 812 to 818 Market Street, in the City of Harrisburg,. County of Dauphin, State of Pennsylvania, owner and publisher of The Patriot-News and The Sunday Patriot-News newspapers of general circulation, printed and published at 812 to 818 Market Street, in the City, County and State aforesaid; that The Patriot-News and The Sunday Patriot-News were established March 4th, 1854, and September 18th, 1949, respectively, and all have been continuously published ever since; That the printed notice or publication which is securely attached hereto is exactly as printed and published in their regular daily and/or S~inday/ Metro editions which appeared on the date(s) indicated below. That neither she nor said Company is interested in the subject matter of said printed notice or advertising, and that all of the allegations of this statement as to the time, place and character of publication are true; and That she has personal knowledge of the facts aforesaid and is duly authorized and empowered to verify this statement on behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolution unanimously passed and adopted severally by the stockholders and board of directors of the said Company and subsequently duly recorded in the office for the Recording of Deeds in and for said County of Dauphin in Miscellaneous Book "M", Volume 14, Page 317. PUBLICATION COPY This ad # 0002034229 ran on the dates shown below: January 01, 2010 ' January 09, 2010 January 15, 2010 i ~~ Sworn t~ubscribed before me thy" d~jdanuary, 2010 A.D. ~.~..~it._~. Notary Public COMMONWEALTM OF PENNSYLVANIA Notarial Seal Sherrie 1. Kiener, Notary PubAc ~Y OF Harrisburg, Dauphin Courrtyy ~ ~ pxpinls Nov 28, 2011 Member, p~~jYi~anla Aa~oGatlon of Notaries PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16, 1929), P. L.1784 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss. Lisa Marie Coyne, Esquire, Editor of the Cumberland Law Journal, of the County and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid, was established January 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly issued weekly in the said County, and that the printed notice or publication attached hereto is exactly the same as was printed in the regular editions and issues of the said Cumberland Law Journal on the following dates, viz: January 1, January 8, and January 15, 2010 Affiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. Lisa Marie Co e, Editor ORN TO AND SUBSCRIBED before me this 15 day of January, 2010 Notary Hd3~r, Iaa 1[., deed. Late of Lower Allen Township. Executor: Jeffrey P. Weaver, 512 Wayne Drive, Mechanicsburg, PA 17055. Attorneys: John E. Slike, Esquire, Saidie, Flower & Lindsay, 2109 Market Street, Camp Hill, PA 17011. NOTARIAL SEAL. DEBORAH A COLLINS NoYcry Public CARLISLE BORO, CUMBERLAND COUNTY PJiy Commission Fxpiras Apr 28, 20i 0 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF PROGRAM INTEGRITY DIVISION OF THIRD PARTY LIABILITY ESTATE RECOVERY PROGRAM PO BOX 8488 HARRISBURG, PA 171058488 July 22, 2010 SAIDIS SHUFE FLOWER & LINDSAY JOHN E SLIKE: ESQUIRE 2109 MARKET ST CAMP HILL PA 17011 Re: Ina Keller SSN: ###-##-7404 Dear Attorney Slike: Pursuant to your letter dated June 22, 2010, the Department of Public Welfare (DPW), Estate Recovery Program, has reviewed the information you provided regarding the above-referenced individual. It has been determined that this individual did not receive any type of assistance during the questioned period. Therefore, according to the information you provided, the Department's Estate Recovery Program will not seek any recovery from this estate. If your client applied for Medical Assistance and had an application and/or hearing pending at the time of death, please advise us and provide any additional information that may affect a recovery by our Department. If you have any questions; please feel free to contact me. • Sincerely, • ~ ' ~ " ' . ~ Vxnce ~A.w P~~ter. . • .: : ; : ~ z~.4b'~~i-3~' $~:~ir,>:~• .~M'aiYdyer': ''. • (71'7•) 77.2-6604~~•~ •~ .. . ±. .. .. .. .. ~ . J.1 .. . • f` ... .~ ... .. T" ... .. _ _ ..... .:+r~ fir- - ~ ` T'. ~ . ~ ~ ... ... :. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 013447 SLIKE JOHN E ESQUIRE SAIDIS SHUFF FLOWER ET AL 2109 MARKET STREET CAMP HILL, PA 1701 1 f~ls ESTATE INFORMATION: ssrv: 175-io-~4o4 FILE NUMBER: 2109-1 175 DECEDENT NAME: KELLER INA M DATE OF PAYMENT: 10/05/2010 POSTMARK DATE: 10/04/2010 COUNTY: CUMBERLAND DATE OF DEATH: 12/09/2009 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 5489.68 TOTAL AMOUNT PAID: REMARKS: RECEIPT TO ATTY CHECK# 1012 SEAL INITIALS: WZ REV-1162 EX111-961 5489.68 RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS TAXPAYER BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION Po Box 2ao6o1 HARRISBURG PA 17128-0601 JOHN E SLIKE ESQ 2109 MARKET S7 CAMP HILL PA 17011 pennsylvania ~ DEPARTMENT OF REVENUE REV-1607 EX AFP C12-09) DATE 07-z6-2010 ESTATE OF KELLER INA M DATE OF DEATH 12-09-2009 FILE NUMBER 21 09-1175 COUNTY CUMBERLAND ACN 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: 5 REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS -ny _ ~E~~~raa~~E~Y~~1~~~~rf2=S~S^^^^•• *** Yt~~ERf~Ti4S1CE ~AX SfiI1~E~E~~S~Fr~A000aR~~ ***••••••••^• •••••••••• ESTATE OF:KELLER INA M FILE NO.: 21 09-1175 ACN: 101 DATE: 07-2¢-2010 THIS STATEMENT PROVIDES CURRENT STATUS OF THE STATED ACN LN THE NAMED ESTATE. BELOW IS A SUMMARY OF THE PRINCIPAL' TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,. A PROJECTED INTEREST FIGURE. DATE OF LAST ASSES:;MENT OR RECORD ADJUSTMENT: 07-19-201D PRINCIPAL TAX DUE: 45,242.17 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) . 02-16-2010 CD012358 2,000.00 38,000.00 02-16-2010 ~D012354 78.89 1,498.93 03-01-2010 CD0124I0 79.85 1,517.07 06-02-2010 CD012845 .00 1,579.75 c AUG p 2 PAYMENT MUST BE MADE BY 09-10-2010*. TOTAL TAX PAYMENT 44,754.49 BALANCE OF TAX DUE 487.68 INTEREST AND PEN. .00 TOTAL DUE INHERITANCE TAX STATEMENT OF ACCOUNT 487.68 ~ IF PAID AFTER THIS DATE, SEE REVERSE SLDE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~~ ~~~, ~ In the Court of Common Pleas of Cumberland County, Pennsylvania Orphans' Court Division File No. 21-09-1175 Estate of Ina M. Keller, Deceased Late of Township of Lower Allen First and Final Accou t ~~ .~~ ' ' r'~ `~~'~ a n _, ` cry ~ ~ , _ _ --- _~%~.J _.t7 ~ ~3 n1 { Jeffrey P. Weaver, Executor _J `~ `TJ ~ ~. i ~~ ~ ~- _~; Date of Death: Date of Executor's Appointment: Date of First Complete Advertisement: Accounting for the 12/09/2009 12/21/2009 01/01/2010 12/09/2009 to 10/1Sron~n Purpose of Account: Jeffrey P. Weaver, Executor, offers this Account to acquaint interested arties with the transactions that have occurred during the Administration. p It is important that the Account be carefully examined. Requests for additional information or questions or objections can be discussed with: John E. Slike Esq. Saidis Sullivan Law 2109 Market Street Camp Hill, PA 17011 717-737-3405 Supreme Court I.D. No. 06262 n; SUMMARY OF ACCOUNT Estate of Ina M. Keller, Deceased For the period of December 9, 2009 through October 15, 2010 Fiduciary Acquisition Pages Current Value Value Proposed Distributions to Beneficiaries** 38-39 Amount Held in Reserve 40 303,015.34 24,480.00 PRINCIPAL 327,495.34 Receipts: This Account 3-8 Net Gain (or Loss) on Sales 9.22 375,690.05 or other Dispositions 3,970.12 Less Disbursements: 379,660.17 Debts of Decedent 23 Funeral Expenses 23-24 586.67 Administration Expenses 25-26 7,368.29 Federal, State & Local Taxes 2,324.97 Commissions 26 38,489.68 Fees Family Exemption 26-27 7,000.00 Balance Before Distributions 55,769.61 Transfer to (from) Principal 323,890.56 Distributions to Beneficiaries Principal Balance on Hand For Information: 28 323,890.56 Investments Made 29 Changes in Holdings INCOME Receipts: This Account 30-35 Net Gain (or Loss) on Sales 3,604.78 or Other Dispositions Less Disbursements: 0 Balance Before Distributions Transfer to (from) Income 3,604.78 Distributions to Beneficiaries Income Balance on Hand 20 For Information: 3,604.78 Investments Made Changes in Holdings COMBINED BALANCE ON HAND 21 Signature Page 24 327,495.34 Verification 25 'See Exhibit "A" SCHEDULE A RECEIPTS OF PRINCIPAL Assets Listed in Inventory (Valued as of Date of Death) ~b Bethany Village -Refund from Asbury Communities, Inc. Bethany Village -Refund from Asbury Communities, Inc. Bureau of Public Debt Highmark Prescription Drug Plan -Premium Refund Merrill Lynch Merrill Lynch IRA Acct 898-79687 -Cash Merrill Lynch Primary Acct 898-03R63 Merrill Lynch Primary Acct 898-61489 Accrued interest on above item through date of death Mutual of Omaha Insurance Company -Refund of partial premium Penn Treaty Network America Insurance Company - Claim #P231272l1 Policy #P231272 Reimbursement for Care at Bethany Village Retirement Center 9/22-9/30/2009 $810.00; 10/1 -10/3/2009 $270.00; 10/8-10/31/2009 $2160.00 Penn Treaty Network America Insurance Company - Policy #P231272 Reimbursement for Care at Bethany Village Retirement Center Penn Treaty Network America Insurance Company - Refund of Premium Pennsylvania Department of Revenue -Refund from for personal taxes PNC Certificate of Deposit 8/13/2010 - 25 Month Fixed Rate of 3.73%; Investment #31400240679 Accrued interest on above item through date of death PNC Checking Account #50-7007-5801 Accrued interest on above item through date of death PNC Money Market Account #50-0096-2544 Accrued interest on above item through date of death Prudential Life Insurance PSI Distribution Fund -Check Number 00803848 Refund from H 8 R Block 949.52 13.50 10.00 36.01 96.35 293.56 5,650.00 971.16 7.50 91.54 3,240.00 4,500.00 138.18 313.10 16,897.23 44.91 8,860.21 0.27 15,521.45 5.16 2,297.06 10.00 53.00 Fiduciary Acquisition Value -3- SCHEDULE A RECEIPTS OF PRINCIPAL Continued Refund from H & R Block Refund from Highmark -Premium refund 12.68 Refund from Penn Treaty -Refund of partial premium 294.76 payment 2,763.34 Reimbursement from Penn Treaty -Reimbursement for medical costs 810.00 Total Cash Ste / k _ c is ~ d 69.0000 shares ABB Ltd -Adr Sponsored 53.0000 shares Abbott Labs -Com 1.226.48 Merrill Lynch Acct #898-03R63 2,830.47 42.0000 shares Aetna Inc New -Com 25.0000 shares AGCO Corp -Com 1,290.66 311.1570 shares American Capital Income Builder CL C - 766.75 Mutual Fund (as quoted by NASDAQ 14,926.20 ) Merrill Lynch Acct 898-61489 558.6720 shares American Income Fund of America CL C - Mutual Fund (as quoted by NASDAQ 8,558.86 ) Merrill Lynch Acct 898-61489 49.0000 shares Ansys Inc -Com 22.0000 shares Apache Corp -Com 1,965.15 25.0000 shares Apple Computer Inc -Com 2.037.31 13.0000 shares Garrick Gold Corp -Com 4.855.88 15.0000 shares BHP Billiton Ltd -Sponsored Adr 530.86 242.0000 shares Black Rock Global -Part of Merrill Lynch Acct 1.092.60 #898-79687 3,362.39 600.0000 shares Blackrock Enhcd Govt, Inc. -New York Stock Exchange 10,509.00 Merrill Lynch Acct 898-61489 1,283.1750 shares Blackrock Global Allocation Fd Inc. C -Mutual Fund (as quoted by NASDAQ) Merrill Lynch Acct 898-61489 21,634.33 55,0000 shares Blackstone Group LP -Com Unit Repstg L Pint 733.43 126.0000 shares CBS Corp New CL B 174.0000 shares Cisco Systems Inc -Com 1,723.68 13,000.0000 Citigroup Inc -Com 4,117.71 503.10 Fiduciary Acquisition Value 63,880.49 -4- SCHEDULE A RECEIPTS OF PRINCIPAL Continued 35.0000 shares Coach Inc -Com 34.0000 shares Cognizant Technology Solutions Corp - CL A 40.0000 shares Covidien PLC SHS 61.0000 shares Direct TV Group Hldngs CLA 25.0000 shares Entergy Corp New -Com 68.0000 shares Exxon Mobil Corp -Com 15.0000 shares Flir Systems Inc -Com 55.0000 shares Flowers Foods Inc -Com 8,243.3260 shares Franklin Income FD CL C -Mutual Fund (as quoted by NASDAQ) Merrill Lynch Acct 898-61489 20.0000 shares Fti Consulting Inc -Com 4,000.0000 shares General Elec Cap Corp -Notes GLB 3.500% 8/13/2012 DTD: 8/13/2009 20.0000 shares General Mills Inc -Com 14.0000 shares Goldman Sachs Group Inc -Com 475.0000 shares HCP, Inc. -New York Stock Exchange Merrill Lynch Acct 898-61489 45.0000 shares Hewlett Packard Co -Com 17:0000 shares HSBC Holdings PLC - Spon Adr New 50.0000 shares Ingersoll-Rand PLC 87.0000 shares JPMorgan Chase 8 Co -Com 86.0000 shares Las Vegas Sands Corp -Com 21.0000 shares Liberty Media Corp -Liberty Starz Ser A 70.0000 shares Macys, Inc. 72.0000 shares McDermott Intl Inc -Com 26.0000 shares National-Oilwell Inc -Com 54.0000 shares Nexen Inc -Com 720.0000 shares Nuveen Multi-Strategy -New York Stock Exchange Merrill Lynch Acct 898-61489 143:0000 shares On Semiconductor Corp -Com 840:5930 shares Oppenheimer Rochester National Muni FD CL C -Mutual Fund (as quoted by NASDAQ) Merrill Lynch Acct 8981489 97.0000 shares Oracle Corp -Com 38.0000 shares Packaging Corp American -Com 1,230.78 1,492.77 1,875.80 2,004.16 2,017.13 4,952.10 451.05 1,260.60 16,898.82 906.90 4,164.40 1,374.80 2,294.39 15,078.88 2,223.23 969.00 1,737.00 3,571.79 1,322.25 1,014.51 1,139.25 1,614.60 1,076.79 1,229.65 5,266.80 1,167.60 5,858.93 2,116.54 838.88 Fiduciary Acquisition Value -5- SCHEDULE A RECEIPTS OF PRINCIPAL Continued 60.0000 shares Pepsico Inc -Com 205.0000 shares Pfizer Inc -Com 961.6010 shares Pimco Total Return FD CL A -Mutual Fund (as quoted by NASDAQ) Memll Lynch Acct 898-61489 75.0000 shares Procter & Gamble Co -Com 30.0000 shares Qualcomm Inc -Com 92:0000 shares Regal Entertainment Group - CL A 30.0000 shares Reinsurnce Group America 21.0000 shares Royal Dutch Shell PLC Spons ADR A 54.0000 shares Sba Communications Corp - CL A 19.0000 shares Silgan Holdings Inc -Com 45.0000 shares Staples Inc -Com 217.0000 shares Tai 79.0000 44.0000 43.0000 21.0000 22:0000 20.0000 42.0000 30.0000 95.0000 105.0000 wan Semiconductor Manufacturing Co - AdrSponsored shares Terex Corp New -Com shares Teva Pharmaceutical Industries Ltd - Adr shares Thermo Electron Corp -Com (Thermo Fisher Scientific) shares Transocean LTD 3,694.50 3,703.33 10,471.83 4,654.13 1,335.75 1,287.08 1,378.65 1,247.72 1,719.36 1,024.10 1,077.53 2,359.88 1,473.35 2,310.22 2,054.76 shares Union Pacific Corp -Com 1,679.37 shares United STS Steel Corp New -Com 1,389.08 shares Wabco Holdings, Inc. 908.80 shares Waste Connections Inc -Com 1,027.74 shares Wells Fargo $ Co New -Com 988'80 shares XL Capital Ltd - CL A 2.478.08 Total Stocks /Listed ~.$ 1,864.28 500,000.0000 BP Capital Markets PLC -Company Guamt GLB 03.87% 3/10/2015 Merrill Acct 898-03R63 New York Bond Exchange Dtd: 3/10/2009 Mat: 3/10/2015 3.88% Accrued interest on above item through date of death 5,242.14 47.90 Fiduciary Acquisition Value 219,942.40 -s- SCHEDULE A RECEIPTS OF PRINCIPAL Continued 600,000.0000 Citigroup, Inc. -Subordinated GLB 05.00% 9/15/2014 Merrill Acct 898-03R63 New York Bond Exchange Dtd: 9/16/2004 Mat: 9/15/2014 5.00% Accrued interest on above item through date of death 500,000.0000 E.I. DU PONT DE NEMOURS -GLB 04.875% 4/30/2014 Merrill Acct 898-03R63 New York Bond Exchange Dtd: 4/30/2004 Mat: 4/30/2014 4.88% Accrued interest on above item through date of death 400,000.0000 Federal Natl Mtg Assoc -NOTES 5.375%; 6/12/2017 DTD: 6/08/2007 Accrued interest on above item through date of death 400,000.0000 Hewlett Parkard Co -GLB 06.00% 7/01/2012 Merrill Acct 898-03R63 New York Bond Exchange Dtd: 6/26/2002 Mat: 7/01/2012 6.50% Accrued interest on above item through date of death Accrued interest on above item through date of death 400,000.0000 McDonald's Corp - SER MTN GLB 05.350% 3/01/2018 Merrill Acct 898-03R63 New York Bond Exchange Dtd: 2/29/2008 Mat: 3/01/2018 5.35% Accrued interest on above item through date of death 300,000.0000 Merck ~ Company, Inc. -GLB 05.00% 6/30/2019 Merrill Acct 898-03R63 New York Bond Exchange Dtd: 6/25/2009 Mat: 6/30/2019 5.00% Accrued interest on above item through date of death 5,848.22 70.00 5,433.12 26.41 4,550.63 105.71 4,000.00 114.11 23.83 4,342.55 58.26 3,177.92 68.33 Fiduciary Acquisition Value 7- SCHEDULE A RECEIPTS OF PRINCIPAL Continued Fiduciary Acquisition 500,000.0000 MetLife, Inc. - GLB 06.75% 6/01/2016 Value Merrill Acct 898-03R63 5,729.53 New York Bond Exchange Dtd: 5/59/2009 Mat: 6/01/2016 6.75% 500,000.0000 Prudential Financial, Inc. - Ser Mtn 4.75%; 9/17/2015 DTD: 09/15/2009 5,097.23 Accrued interest on above item through date of death 1,400,000.0000 U. S. Treasury Not 2 55.42 e - .375%; 9/30/2014 DTD: 9/30/2009 14,210.00 7,100,000.0000 U. S. Treasury Note -1.375%; 10/15/2012 DTD: 10/15/2009 11,079.06 Accrued interest on above item through date of death Accrued interest on above item through date of death 63.94 United States Savings Bonds (HH Series) 22.85 Total Bonds 14,000.00 ~s~aae / No Rpm 1 iw1.1~ 83,367.16 Demand Notes with Board of Missions of the Central Pennsylvania Conference 8.500.00 Total Mortgage /Note Receivable Total Receipts 8,500.00 375,690.05 Total Receipts of P rincipal 37s,s9o.o5 -8- SCHEDULE B GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS - PRINCI PAL 12/16/2009 35.0000 shares Coach Inc ~~ ~~ Net Proceeds Fiduciary Acquisition Valu 1,256.65 e -1,230.78 25.87 12/18/2009 10.0000 shares Abbott Labs Net Proceeds Fiduciary Acquisition Valu 539.74 e -534.05 5.69 12/18/2009 20.0000 shares Direct TV Group Hldngs CLA Net Proceeds Fiduciary Acquisition Value 665.77 -657.10 8,67 12/18/2009 25.0000 shares Entergy Corp New Net Proceeds Fiduciary Acquisition Valu 2,070.87 e -2,017.13 53.74 12/18/2009 20.0000 shares Pepsico Inc - Com Net Proceeds Fiduciary Acquisition Valu 1,218.72 12/18/2009 e -1,231.50 -12 78 75.0000 shares Procter ~ Gamble C o Net Proceeds Fiduciary Acquisition Valu 4,656.87 e -4,654.13 2,74 12/23/2009 43.0000 shares Abbott Labs Net Proceeds Fiduciary Acquisition Valu 2,285.46 12/24/2009 e -2,296.42 -10.96 79.0000 shares Terex Corp New Net Proceeds Fiduciary Acquisition Value 1,601.02 -1,473.35 127.67 -9- SCHEDULE B GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS -PRINCIPAL Continued 12/30/2009 30.0000 shares ABB Ltd Net Proceeds Fiduciary Acquisition Value 569.80 -533.25 01/13/2010 50.0000 shares CBS Corp New CL B Net Proceeds Fiduciary Acquisition Value 709.94 -684.00 01/13/2010 1,100,000.0000 U. S. Treasury Note -1.375%; 10/15/2012 DTD: 10/15/2009 Net Proceeds Fiduciary Acquisition Value 11,079.96 -11,079.06 01/13/2010 8.0000 shares United STS Steel Corp New Net Proceeds Fiduciary Acquisition Value 440.96 -363.52 01/15/2010 10,000.0000 Federal Home Ln Mtg Corp -Notes 2.875%; 02/09/2015 Net Proceeds Fiduciary Acquisition Value 10,030.78 -10,046.80 01/15/2010 400,000.0000 Federal Natl Mtg Assoc Net Proceeds Fiduciary Acquisition Value 4,511.13 -4,550.63 01/15/2010 1,400,000.0000 U. S. Treasury Note - 2.375%; 9/30/2014 DTD: 9/30/2009 Net Proceeds Fiduciary Acquisition Value 14,186.73 -14,210.00 Stein 36.55 25.94 0.90 77.44 1_oss -16.02 -39.50 -23.27 -10- SCHEDULE B GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS -PRINCIPAL Continued 01/19/2010 25.0000 shares Cisco Systems Inc -Com ~~ Net Proceeds Fiduciary Acquisition Value 605.32 -591.63 13.69 01/19/2010 15.0000 shares Macys, Inc. Net Proceeds Fiduciary Acquisition Value 249.05 -251.55 01/19/2010 10.0000 shares Regal Entertainment Group Net Proceeds Fiduciary Acquisition Value 146.19 -139.90 6.29 01/19/2010 10.0000 shares Staples Inc Net Proceeds Fiduciary Acquisition Value 250.93 -239.45 11.48 01/20/2010 39.0000 shares ABB Ltd Net Proceeds Fiduciary Acquisition Value 788.96 -693.23 95.73 01/20/2010 42.0000 shares Aetna Inc New Net Proceeds Fiduciary Acquisition V lu 1,301.14 a e -1,290.66 10.48 01/20/2010 25.0000 shares AGCO Corp -Com Net Proceeds Fiduciary Acquisition Value 868.49 -766.75 101.74 01/20/2010 56.0000 Allscripts Healthcare Soluti ons -Com Net Proceeds Fiduciary Acquisition Value 1,081.91 -1,064.45 17.46 ~~ -2.50 -11- SCHEDULE B GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS -PRINCIPAL Continued 01/20/2010 108.0000 Altria Group Inc -Com ~B Net Proceeds Fiduciary Acquisition Value 2,194.58 -2,130.06 64.52 01/20/2010 42.0000 Amgen Inc -Com Net Proceeds Fiduciary Acquisition Value 2,361.63 -2,341.01 20.62 01/20/2010 49.0000 shares Ansys Inc Net Proceeds Fiduciary Acquisition Value 2,109.91 -1,965.15 144.76 01/20/2010 22.0000 shares Apache Corp -Com Net Proceeds Fiduciary Acquisition Value 2,346.27 -2,037.31 308.96 01/20/2010 25.0000 shares Apple Computer Inc -Com Net Proceeds Fiduciary Acquisition Value 5,233.43 -4,855.88 377.55 01/20/2010 13.0000 shares Garrick Gold Corp -Com Net Proceeds Fiduciary Acquisition Value 520.90 -530.86 01/20/2010 15.0000 shares BHP Billiton Ltd -Sponsored Adr Net Proceeds Fiduciary Acquisition Value 1,210.48 -1,092.60 117.88 01/20/2010 55.0000 shares Blackstone Group LP Net Proceeds Fiduciary Acquisition Value 743.04 -733.43 9.61 ~;: -9.96 -12- SCHEDULE B GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS -PRINCIPAL Continued 01/20/2010 500,000.0000 BP Capital Markets PLC Sz.8111 Net Proceeds Fiduciary Acquisition Value 5,322.57 -5,242.14 80.43 01/20/2010 76.0000 shares CBS Corp New CL B Net Proceeds Fiduciary Acquisition Value 1,057.91 -1,039.68 18.23 01/20/2010 149.0000 shares Cisco Systems Inc -Com Net Proceeds Fiduciary Acquisition Value 3,704.10 -3,526.08 178.02 01/20/2010 600,000.0000 Citigroup, Inc. Net Proceeds Fiduciary Acquisition Value 6,120.00 -5,848.22 271.78 01/20/2010 13,000.0000 Citigroup Inc -Com Net Proceeds Fiduciary Acquisition Value 456.47 -503.10 01/20/2010 34.0000 shares Cognizant Technology Solutions Co rp-CLA Net Proceeds Fiduciary Acquisition Value 1,643.54 -1,492.77 150.77 01/20/2010 40.0000 shares Covidien PLC SHS Net Proceeds Fiduciary Acquisition Value 1,971.77 -1,875.80 95.37 01/20/2010 41.0000 shares Direct TV Group Hldngs CLA Net Proceeds Fiduciary Acquisition Value 1,373.07 -1,347.06 26.01 ~;: -46.63 -13- GAINS AND LOSSES ON SALES OR OT ER DI SPOSITIONS -PRINCIPAL Continued 01/20/2010 500,000.0000 E.I. DU PONT DE NEMOURS ~~ Net Proceeds Fiduciary Acquisition Val 5,428.45 ue -5,433.12 01/20/2010 68.0000 shares Exxon Mobil Corp -Com Net Proceeds ' Fiduciary Acquisition Valu 4'725.94 e -4,952.10 01/20/2010 15.0000 shares Flir Systems Inc -Com Net Proceeds Fiduciary Acquisition Valu 476.84 01/20/2010 e -451.05 25.79 55.0000 shares Flowers Foods Inc -Com Net Proceeds Fiduciary Acquisition Val 1,382.68 ue -1,260.60 122.08 01/20/2010 18.0000 shares Fluor Corp New -Com Net Proceeds Fiduciary Acquisition Val 901.07 ue -819.19 81,gg 01/20/2010 20.0000 shares Fti Consulting Inc -Com Net Proceeds Fiduciary Acquisition Valu 895.19 e -906.90 01/20/2010 4,000.0000 shares General Elec Cap Corp Net Proceeds Fiduciary Acquisition Val 4,174.12 ue -4,164.40 9.72 01/20/2010 20.0000 shares General Milis Inc -Com Net Proceeds Fiduciary Acquisition Valu 1,428.98 e -1,374.80 54.18 ~~ -4.67 -226.16 -11.71 -14- SCHEDULE B GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS -PRINCIPAL Continued Sz.;ltlll ~~ 01/20/2010 14.0000 shares Goldman Sachs Group Inc -Com Net Proceeds 2 352 39 Fiduciary Acquisition Value , . -2,294.39 58.00 01/20/2010 105.0000 Great Plains Energy Inc -Com Net Proceeds 2 029 88 Fiduciary Acquisition Value , . -2,062.03 -32.15 01/20/2010 45.0000 shares Hewlett Packard Co -Com Net Proceeds 2 374 62 Fiduciary Acquisition Value , . -2,223.23 151.39 01/20/2010 17.0000 shares HSBC Holdings PLC - Spon Adr New Net Proceeds 992 62 Fiduciary Acquisition Value . -969.00 23.82 01/20/2010 50.0000 shares Ingersoll-Rand PLC Net Proceeds 1 831 48 Fiduciary Acquisition Value , . -1,737.00 94.48 01/20/2010 56.0000 shares International Game Technolo gy -Com Net Proceeds 1 126 75 Fiduciary Acquisition Value , . -1,083.79 62.36 01/20/2010 87.0000 shares JPMorgan Chase & Co -Com Net Proceeds 3 855 79 Fiduciary Acquisition Value , . -3,571.79 284.00 01/20/2010 120.0000 shares Las Vegas Sands Co rp -Com Net Proceeds 2 238 08 Fiduciary Acquisition Value , . _1,844.72 393.36 -15- SCHEDULE B GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS -PRINCIPAL Continued Sx.;ltll] ~~ 01 /20/2010 21.0000 shares Liberty Media Corp Net Proceeds 1 055 56 Fiduciary Acquisition Value , . -1,014.51 41.05 01/20/2010 72.0000 shares McDermott Intl Inc -Com Net Proceeds 1 811 50 Fiduciary Acquisition Value , . -1,614.60 196.90 01/20/2010 400,000,0000 McDonald's Corp Net Proceeds 4 485 26 Fiduciary Acquisition Value , . -4,342.55 142.71 01/20/2010 300,000.0000 Merck & Company, Inc. Net Proceeds 3 140 47 Fiduciary Acquisition Value , . -3,177.92 -37.45 01/20/2010 500,000.0000 MetLife, Inc. Net Proceeds 5 777 08 Fiduciary Acquisition Value , . -5,729.53 47.55 01/20/2010 26.0000 shares National-Oilwell Inc -Com Net Proceeds 1 212 36 Fiduciary Acquisition Value , . -1,076.79 135.57 01/20/2010 54.0000 shares Nexen Inc -Com Net Proceeds 1 275 46 Fiduciary Acquisition Value , . -1,229.65 45.81 01/20/2010 143.0000 shares On Semiconductor Corp -Com Net Proceeds 1 195 47 Fiduciary Acquisition Value , . -1,167.60 27.87 -16- SCHEDULE B GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS -PRINCIPAL Continued 01/20/2010 97.0000 shares Oracle Corp -Com ~~ ~~ Net Proceeds Fiduciary Acquisition Value 2,446.31 -2,116.54 329.77 01/20/2010 38.0000 shares Packaging Corp American -Com Net Proceeds Fiduciary Acquisition Value 902.49 -838.68 63.81 01/20/2010 40.0000 shares Pepsico Inc -Com Net Proceeds Fiduciary Acquisition Value 2,500.77 -2,463.00 37.77 01/20/2010 205.0000 shares Pfizer Inc -Com Net Proceeds Fiduciary Acquisition Value 3,944.17 -3,703.33 240.84 01/20/2010 500,000.0000 Prudential Financial, Inc. Net Proceeds Fiduciary Acquisition Value 5,354.94 -5,097.23 257.71 01/20/2010 30.0000 shares Qualcomm Inc -Com Net Proceeds Fiduciary Acquisition Value 1,451.68 -1,335.75 115.93 01/20/2010 75.0000 Quanta Services Inc -Com Net Proceeds Fiduciary Acquisition Value 1,496.98 -1,625.51 -128 53 01/20/2010 30.0000 shares Reinsumce Group America . Net Proceeds Fiduciary Acquisition Value 1,510.48 -1,378.65 131.83 -17- SCHEDULE B GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS -PRINCIPAL Continued 01 /20/2010 21.0000 shares Royal Dutch Shell PLC S o ns ADR ~~ p A Net Proceeds 1 275 52 Fiduciary Acquisition Value , . -1,247.72 27.80 01/20/2010 54.0000 shares Sba Communications Co rp-CLA Net Proceeds 1 980 15 Fiduciary Acquisition Value , . -1,719.36 260.79 01/20/2010 19.0000 shares Silgan Holdings Inc -Com Net Proceeds 1 045 75 Fiduciary Acquisition Value , . -1,024.10 21.65 01/20/2010 217.0000 shares Taiwan Semiconductor Manufacturing Co - Adr Sponsored Net Proceeds 2 378 49 Fiduciary Acquisition Value , . -2,359.88 18.61 01/20/2010 44.0000 shares Teva Pharmaceutical Industries Ltd -Adr Net Proceeds 2 595 09 Fiduciary Acquisition Value , . -2,310.22 284.87 01/20/2010 43.0000 shares Thermo Electron Corp -Com Net Proceeds Fiduciary Acquisition Value 2,088.05 -2,054.76 33.29 01/20/2010 21.0000 shares Transocean LTD Net Proceeds 1 938 91 Fiduciary Acquisition Value , . -1,679.37 259.54 ~~ -18- SCHEDULE B GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS -PRINCIPAL Continued 01 /20/2010 22.0000 shares Union Pacific Corp -Com ~~ Net Proceeds Fiduciary Acquisition Value 1,470.02 -1,389.08 80.94 01/20/2010 12.0000 shares United STS Steel Corp New Net Proceeds 752 99 Fiduciary Acquisition Value . -545.28 207.71 01/20/2010 42.0000 shares Wabco Holdings, Inc. Net Proceeds 1 226 80 Fiduciary Acquisition Value , . -1,027.74 199.06 01/20/2010 64.0000 Wal-Mart Stores, Inc. Net Proceeds 3 493 08 Fiduciary Acquisition Value , . -3,450.00 43.08 01/20/2010 30.0000 shares Waste Connections Inc -Com Net Proceeds 998 09 Fiduciary Acquisition Value . -988.80 9.29 01/20/2010 95.0000 shares Wells Fargo ~ Co New -Com Net Proceeds 2 747 37 Fiduciary Acquisition Value , . -2,478.08 269.29 01/20/2010 105.0000 shares XL Capital Ltd - CL A Net Proceeds 1 801 01 Fiduciary Acquisition Value , . -1,864.28 01/21/2010 81.0000 shares Macys, Inc. Net Proceeds Fiduciary Acquisition Value 1,348.63 -1,323.93 24.70 ~~ -63.27 -19- 01/21/2010 01/21/2010 01 /29/2010 02/04/2010 02/04/2010 02/04/2010 02/04/2010 02/04/2010 SCHEDULE B GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS -PRINCIPAL Continued 82.0000 shares Regal Entertainment Group - CL A Net Proceeds 1 211 72 Fiduciary Acquisition Value , . -1,147.18 35.0000 shares Staples Inc - Com Net Proceeds 895 64 Fiduciary Acquisition Value . -838.08 242.0000 shares Black Rock Global Net Proceeds 3 274 50 Fiduciary Acquisition Value , . -3,362.39 311.1570 shares American Capital Income Builder CL C Net Proceeds Fiduciary Acquisition Value 14,578.58 -14,926.20 558.6720 shares American Income Fund of Am erica CL C Net Proceeds 8 436 18 Fiduciary Acquisition Value , . -8,558.86 300.0000 shares Blackrock Enhcd Govt, Inc. Net Proceeds 4 918 10 Fiduciary Acquisition Value , . -5,254.50 300.0000 shares Blackrock Enhcd Govt, Inc. Net Proceeds 4 924 26 Fiduciary Acquisition Value , . -5,254.50 1,283.1750 shares Blackrock Global AIIoGation Fd Inc. C Net Proceeds Fiduciary Acquisition Value 21,115.71 -21,634.33 Szain 1_oss 63.94 57.56 -87.89 -347.62 -122.68 -336.40 -330.24 -518.62 - 20 - SCHEDULE B GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS -PRINCIPAL Continued ~~ ~~ 02/04/2010 8,243.3260 shares Franklin Income FD CL C Net Proceeds 16,975 90 Fiduciary Acquisition Value . -16,898.82 77.08 02/04/2010 475.0000 shares HCP, Inc. Net Proceeds 13,431 62 Fiduciary Acquisition Value . -15,078.88 -1,647.26 02/04/2010 400,000.0000 Hewlett Parkard Co Net Proceeds 4,424 68 Fiduciary Acquisition Value . -4,000.00 424.68 02/04/2010 720.0000 shares Nuveen Multi~trategy Net Proceeds 5 103 27 Fiduciary Acquisition Value , . -5,266.80 -163.53 02/04/2010 840.5930 shares Oppenheimer Rochester National C Muni FD CL Net Proceeds 5 979 67 Fiduciary Acquisition Value , . -5,858.93 120.74 02/04/2010 961.6010 shares Pimco Total Return FD CL A Net Proceeds 10 514 56 Fiduciary Acquisition Value , . -10,471.83 42.73 02/08/2010 United States Savings Bonds (HH Series) Net Proceeds 14,000 00 Fiduciary Acquisition Value . -14,000.00 0.00 -21 - SCHEDULE B 08/30/2010 GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS -PRINCIPAL Continued Demand Notes with Board of Missions of the Central Pennsylvania Conference SzaiO Loss Net Proceeds 8,500.00 Fiduciary Acquisition Value -8,500.00 TOTAL GAINS AND LOSSES/PRINCIPAL LESS LOSS NET GAIN OR LOSS 0.00 8,189.92 -4,219.80 3,970.12 - 22 - SCHEDULE C DISBURSEMENTS OF PRINCIPAL Bethany Villagg 01/13/2010 Account No. 334 02/08/2010 Account No. 334 31.50 13.50 Hampden Physician Associa p~ 01/04/2010 Account No. KELLER0002 141.99 Pennsylvania Dgoartment of Rev nue 02/08/2010 Amount due and owing on the 2007 state personal income tax 12.68 04/06/2010 Payment for 2009 Personal Taxes 387.00 45.00 141.99 399.68 Total Debts of Decedent 586.67 Funeral Exo n~ec Jeffrey P. Weavgr 12/28/2009 Reimbursement for Funeral Luncheon 12/28/2009 312.36 Reimbursement for organist at funeral service 50.00 12/28/2009 Reimbursement for interment/Service--Interment No. 1,030.00 205-2009 Musselman F meral Home Inc 01/13/2010 Invoice dated December 18, 2009 5,863.62 1,392.36 - 23 - SCHEDULE C DISBURSEMENTS OF PRINCIPAL Continued Peeler's Flower Shon 01 /08/2010 Total Funeral Expenses Administration Exo, ensec Cumberland Law Jo urnal 12/21/2009 Publication of Estate Notice Merrill Lynch Primar y Acct 898-I)3R63 12/30/2009 Portion of consulting fee for December 01/05/2010 Consults fee 1Q2010 PNC Bank 01/21/2010 Check Charge Post Master 01/22/2010 Registered mail Professional Tax Adv i ors Inc 04/06/2010 2009 Tax Preparation Fees 112.31 5,863.62 112.31 7,368.29 75.00 182.97 1,136.94 17.99 33.39 205.00 75.00 1,319.91 17.99 33.39 205.00 -24- Register of Wi1is 12/21 /2009 05/03/2010 05/03/2010 05/18/2010 The Patriot News o 01 /20/2010 Register of Wills Ag~,nt 02/08/2010 10/04/2010 SCHEDULE C DISBURSEMENTS OF PRINCIPAL Continued Probate Fees--Petition Letters Testamentary $310.00; Will $15.00; Short Certificate $20.00; JCS Fee $23.50; Automation Fee $5.00 File Inheritance Tax Return File Inventory Additional probate fees--Invoice #2968 Add Order #0002034229 Total Miscellaneous Administrative Expenses Federal atp~ and L~~al Ta:c"c Prepayment of Inheritance Taxes Additional Inheritance Taxes Total Taxes ~$ Saidis. Flower ~ Lindsay 05/03/2010 Partial Payment of Legal Fees Total Fees 373.50 15.00 15.00 50.00 220.18 453.50 220.18 2,324.97 38,000.00 489.68 38,489.68 38,489.68 7,000.00 7,000.00 7,000.00 -25- SCHEDULE C DISBURSEMENTS OF PRINCIPAL Continued TOTAL DISBURSEMENTS OF PRINCIPAL 55,769.61 -26- PRINCIPAL BALANCE ON NAND # Units Description Current Value 10/15/2010 or as Noted Fiduciary Acquisition Value Bash PNC Estate Account #5004483452 PNC Estate Money Market #5006127128 1,099.65 1,099.65 Total Cash 322, 790.91 322, 790.91 323,890.56 323,890.56 323,890.56 323,890.56 -28- SCHEDULE E PRINCIPAL INVESTMENTS MADE 12/16/2009 34.0000 Las Vegas Sands Corp 522.47 12/16/2009 26.0000 Macys, Inc. 436.23 12/17/2009 22.0000 Great Plains Energy Inc 432.16 12/18/2009 108.0000 Altria Group Inc 2,130.06 12/18/2009 30.0000 Great Plains Energy Inc 570.21 12/18/2009 56.0000 International Game Technology 1,063.79 12/18/2009 64.0000 Wal-Mart Stores, Inc. 3,450.00 12/23/2009 56.0000 Allscripts Healthcare Solutions 1,064.45 12/23/2009 42.0000 Amgen Inc 2,341.01 12/23/2009 28.0000 Great Plains Energy Inc 555.87 12/24/2009 25.0000 Great Plains Energy Inc 503.79 12/24/2009 25:0000 Quanta Services Inc 529.83 12/28/2009 50.0000 Quanta Services Inc 1,095.68 12/30/2009 10.0000 Fluor Corp New 455.22 01/04/2010 8.0000 Fluor Corp New 363.97 01/13/2010 10,000.0000 Federal Home Ln Mtg Corp 10,046.80 Toil _25,561.54 -29- SCHEDULE G RECEIPTS OF INCOME ABB Ltd 01/11/2010 36.72 36.72 American Capital Income,Builder CL C 12/22/2009 159.06 159.06 American Income Fund oti America CL C 12/28/2009 74.64 74.64 Garrick Gold Corn 12/15/2009 Com 2.60 2.60 Black Rock Global 12/16/2009 Dividend 57.63 57.63 Blackrock Enhcd Govt. Inc. 12/18/2009 63.00 12/18/2009 100.20 01 /08/2010 63.00 226.20 Blackrock Global Allocation Fd Inc. C 12/22/2009 229.43 30 SCHEDULE G RECEIPTS OF INCOME Continued 229.43 Blackstone Groun LP 12/11 /2009 CBS Corn New CL B 01 /04/2010 Coach Inc 12/28/2009 Exxon Mobil COrD 12/10/2009 Flowers Foods Inc 12/18/2009 Com Franklin Income FD CL C 01 /08/2010 02/04/2010 Goldman Sachs Groun Inc 12/30/2009 Com 16.50 16.50 6.30 6.30 2.62 2.62 28.56 28.56 9.62 9.62 95.62 91.50 187.12 4.90 4.90 -31 - Hewlett Parkard Co 01 /04/2010 01 /06/2010 HSBC Holdings PLC 01/13/2010 International Game Technoloav 01 /15/2010 Macys. Inc. 01/04/2010 McKesson Corporation. C~ 01 /04/2010 National-Oilwell Inc 12/16/2009 Nexen Inc 01 /04/2010 Nuveen MultiStrateav 12/31 /2009 SCHEDULE G RECEIPTS OF INCOME Continued 130.00 3.60 Spon Adr New 6.80 3.36 3.50 1.80 Com 28.60 2.60 122.40 -32- 133.60 6.80 3.36 3.50 1.80 28.60 2.60 SCHEDULE G RECEIPTS OF INCOME Continued 122.40 Onnenheimer Rochester National Muni FD CL C 12/31 /2009 01/27/2010 02/24/2010 Packaging Corn American 01/15/2010 Pensico Inc 01/04/2010 Com 34.06 35.35 10.02 5.70 27.00 79.43 5.70 27.00 Pimco Total Return FD CL A 12/10/2009 12/10/2009 12/31 /2009 -- 02/01 /2010 02/01/2010 03/01 /2010 Qualcomm inc 12/23/2009 Com 23.24 83.55 29.15 18.19 3.76 2.27 5.10 160.16 5.10 Regal Entertainment Grouo 12/17/2009 CL A 16.56 16.56 -33- SCHEDULE G RECEIPTS OF INCOME Continued Silgan Ho 12/15/2009 Sta Imes In 01 /14/2010 01 /04/2010 Com United STS Steel Cor n New 12/10/2009 Com TOTAL DIVIDEND INCOME Interest/Bank Central Pennsylvania Conference 05/04/2010 Investment Interest Earned Merrill Lynch Primary Acct 898-03R63 01/27/2010 03/09/2010 Merrill Lynch Primary Acct 898-61489 12/31 /2009 3.61 3.71 5.94 1.00 101.19 13.76 12.29 0.04 3.61 3.71 5.94 1.00 1,652.77 101.19 26.05 -34- SCHEDULE G RECEIPTS OF INCOME Continued 01 /27/2010 0.06 0.10 PNC Certificate of De 02/08/2010 posit 8/13/2010 25 Month Fixed Rate of 3.73%; Investment 104.07 #31400240679 104.07 PNC Checking Acco 01 /04/2010 unt #:50-7007-5801 60.00 01 /05/2010 0.07 60.07 PNC Estate Money M 02/22/2010 arket Account 50-0612-7128 Interest 159.89 03/25/2010 Interest 383.11 04/23/2010 Interest 359.01 05/24/2010 Interest 265.24 06/24/2010 Interest 138.09 07/26/2010 ~ Interest 135.46 08/25/2010 Interest 106.94 09/24/2010 Interest 106.98 1,654.72 PNC Money Market A 02/08/2010 ccount #50-0096-2544 5.81 5.81 TOTAL BANK INTEREST TOTAL RECEIPTS OF INCOME 1,952.01 3,604.78 - 35 - INCOME BALANCE ON HAND # Units Description Cash PNC Estate Account #5004483452 PNC Estate Money Market #5006127128 Total Cash Current Value 10/15/2010 or as Noted 78.17 3,526.61 Fiduciary Acquisition Value 78.17 3,526.61 3,604.78 3,604.78 3,604.78 3,604.78 -36- COMBINED BALANCE ON HAND # Units Description PNC Estate Account #5004483452 PNC Estate Money Market #5006127128 Current Value Fiduciary 10/15/2010 Acquisition or as Noted Value 1,177.82 1,177.82 326,317.52 326,317.52 Total Cash 327,495.34 327,495.34 327,495.34 327,495.34 - 37 - PROPOSED DISTRIBUTIONS TO BENEFICIARIES Current Value Fiduciary 10/15/2010 Acquisition or as noted Value TO: Barbara Cone Cash -Distribution of Principal $ 24,721.53 Cash Distribution of Interest $ 288.37 25,009.90 TO: Bethany Village Endowment Fund Cash -Distribution of Principal $ 33,932.51 Cash Distribution of Interest $ 400.14 TO: Cheri Keller Cash -Distribution of Principal $ 24,721.53 Cash Distribution of Interest $ 288.37 34,332.65 25,009.90 TO: Elizabeth Beers Cash -Distribution of Principal $ 21,431.60 Cash Distribution of Interest $ 297.38 i 21,728.98 TO: Jane Lawrence Cash -Distribution of Principal $ 24,721.53 Cash Distribution of Interest $ 288.37 25,009.90 TO: Jean Ream Cash -Distribution of Principal $ 37082.48 Cash Distribution of Interest $ 432.60 37,515.08 - 38. - PROPOSED DISTRIBUTIONS TO BENEFICIARIES Continued Current Value Fiduciary 10/15/2010 Acquisition or as noted Value TO: Jeffrey,Weaver Cash -Distribution of Principal $ 20,096.61 Cash Distribution of Interest $ 288.37 TO: Larry Bistline Cash -Distribution of Principal $ 37082.48 Cash Distribution of Interest $ 432.60 TO: Michael Weaver Cash -Distribution of Principal $ 24,721.53 Cash Distribution of Interest $ 288.37 TO: Shriners Hospitals for Children Cash -Distribution of Principal $ 33,932.51 Cash Distribution of Interest $ 400.14 F TO: The Knights Templar Eye Foundation. Inc. Cash -Distribution of Principal $16,966.25 Cash Distribution of Interest $ 200.07 20,384.98 37,515.08 25,009.90 34,332.65 17,166.32 Total 303,015.34 -39- The Estate of Ina M. Keller Purcose Executors Fees Legal Fees Filing Fees and Income Taxes Amount Held in Reserve Recipient Jeffrey P. Weaver Saidis Sullivan Law Amount Total Reserve 14,740.00 7,740.00 2,000.00 $ 24,480.00 40 In the Court of Common Pleas of Cumberland County, Pennsylvania Orphans' Court Division File No. 21-09-1175 Estate of Ina M. Keller, Deceased Signature ~~ J ~~~ ey .Weaver, Executor -41 - In the Court of Common Pleas of Cumberland County, Pennsylvania Orphans' Court Division File No. 21-09-1175 Estate of Ina M. Keller, Deceased Verification Jeffrey P. Weaver, Executor under the Last Will and Testament of Ina M. Keller, Deceased, hereby declares under oath that he/she has fully and faithfully discharged the duties of his/her office; that the foregoing Account is true and correct and fully discloses all significant transactions occurring during the accounting period; that all known claims against the Estate have been paid in full; that, to his/her knowledge, there are no claims now outstanding against the Estate; that all taxes presently due from the Estate have been paid; and that the grant of Letters Testamentary and the first complete advertisement thereof occurred more than four months before the foregoing Account. This statement is made subject to penalties of 18 Pa. C.S.A. Section 4904 relating to unsworn falsification to authorities. ,- ~,~z~- ~ e ~'.' J P. eaver, Executor Dated: ®G~,~~/' 2D, 2-el y - 42 - N m x Q :~' a~ rn a W N W t0 N O) N N V W O Dl T ~ r_ w w n W r m ?? W ~ m m w s w v m> >' ?~~ m m v .z m rn ~ ~ ~ m m ~ °~ W ~ ~ ~ w ~ m n in o~ m~~ m~ o~ m ~ a co < ~ n m' m m m -• m m m y d ~ to O N Q d ~ C7 f N ~' N T CL ~ O c ~ T > > c a ~ m a o' CT O O do Do N W O OD N QD 0 0 o w w cn w w w cn w 0 0 o w w o w w w o w 0 0 o w w o w w w o w 0 o e o 0 0 0 0~ o 0 cND cN0 A A v A A A v A > (D (D CD (D A (D (D tD A (D >~ j 0 0 ~ 0 0 0 ~ 0 ~ o o bo ao is au ao ao is ao 0 0 V V fn V V V Cn V ~ O O (n Cn Cn CT CT CJ7 U7 N • 0 0 0 0 0 0 0 0 0 0 W W W W W W (17 N Cn (n W fn CT CT7 W Do Uf Cn W Cn C1i (n W A CJt (n W fn Cn Cn W A (n (n N Cn U7 O N W O O Ut O O O W 0 N N j j W j j j W N la cD 0 N N N D fD tD W W O W W W O E ~ ~ ~ COn (On W COf1 0077 COJi W ~ n 0 0 C.J W ~ W W W ~ A J O O) V V O V V V O O W W N N W N N N W N n~~ rn rn cD rn rn rn o rn P NO ~ J O j 0 0 0 j 0 P OD OD W W O W W CJ O G1 ~ Cn CT O O) Cn W O D) O Q) ~ W W N N W N N N W N A W W A A O) A A A O) A n 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Q (D (D N N A N N N A W D (D (D V V ~ V V V ~ O n --~ ~ W W cn W W W to A A O D b 3 0 ~~ C_ l0 D V7 7 N D 3 7 -{ ~ N x m~ m ~o --n s m n (D O X ~ Z N .O. _6 3 O p 7 -w N ~ O' N C x o' 7 O D v7' O 6 c c ^O'" O 7 ~_ ~~ '~. 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C ~ ~ ~ O 3 v ~ m = 1~h ~_ Q .. O y~ W V 00 ~, N W m x Q D 0 y O N rn a m m b V A Of O b O1 N N ~O 01 N N 10 tG A O rn (Sp ~ ~ ~ ~. 90i 7 ~ fl1 ~ N 3 S~ O fD N a' .~ N ~ fD 7 N '~ .Z1 ~ ~ ~ W fR O - fD N ~ N ~ O ~ ~ -1 'NO f0 < N n (D O N fD -• fD fD fD ~ N ~ ~, m m o a ~ n f m ~ m TI Q O o ~ c > > c a ~ m a 0 CT O O OD OD N OD OD OD N W O O O W W (T W W W CT W O O O W W O W W W O W O O O W W O W W W O W 0 0 0 0 0 0 0 0 0 0 0 W W A A m A A A ~ A O O O O pOp O O O pOp V (00 (00 N N A N N N A W (O f0 W W Cr W W W (Ji A A A N O A N A W W A CO A A A QWI O O O O W O O O O O ~ O) 01 O ~1 O O O O O f0 t0 N V A N N N A N (O (O V OD -+ ~1 V ~I ~ O W CT W W W CT O 00 OD ~I J O J_ J V O ~1 N N OD OD OVD 07 OD OD OVD OD O W O O W OD OD OD W OD O O O O W O O O W O W W N N W N N N W ~ W W A O ~1 A A A V (~ (O V O O V V V O A W W ~ f0 OD ~ r .N.a W ~ N N O N N w °~ w w w w aAo 0 v Q C_ O 7 ~ ~ r u m a ai ~, O y n m m D n ~ ~ ~ ~ ... m ~ D 0 n ~D °c N .~-. Q D 0 r .C. O. N 7 W v D ~ yi n ~ ~• v V D. ~ j. O O ppDo ~ m O 'D". O' j ~ c i, a O n n o m m ~ ~ ~~ v ~• ~ D ~ 3 = c O rh ~ ~ <D ~ v ~ y~ m ~ N _ ~.. f y ~ ~D ~ a C ~_ N .~ O X71 ~ Q~ Final Distribution for the Estate of Ina M. Keller Amount of Inheritance Tax Due from Non Probate Property Amt Due Percent Estate Total Inheritance Tax Reimbursement from Beneficiary: Elizabeth Beers 12% 4,001.04 Jeffrey Weaver 15% 4,624.92 $ 8,625.96 Page 4 of Exhibit A