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11-01-10 (2)
J 1505610143 REV-1 X00 Ex io,_,o, ,~- OFFICIAL USE OILY PA Department of Revenue Pennsylvania Oo,x,ti ~, Yeerj Bureau of Individual Taxes ~~TM--~~ .PO Box.26oso~ , INHERITANCE TAX RETURN 21 ~Q~, Harrisburg, PA 1712&0601 RESIDENT DECEDENT . i 0538 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 188"20 6009 05 15 2010 O1 27 1930 Decedent's Last Name Suffuc Decedent's First Name '~ MI ORNER DUAYNE J (If Applicable) Enter Survivin® Spouse's information Below ~ Spouse's Last Name Suffix Spouse's First Name I MI ORNER ELIZABETH J Spouse's Socal Security Number THIS RETURN MUST BE FILED IN DUPLICgTd V~IITH THE .REGISTER OF WILLS' FILL IN APPROPRIATE OVALS BELOW ! 'I 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder, Red unh (dam of death prbr t012-13--~8~ 2), 4. Limited Estate ~ 4a, Future Irrtereat Compromise ~ 5. Federal Estate (date ~ dsalh after 12-12-02) ^ TSIx Return Required ® 8• i~~ ~ ~) ~ ~ 7. ~'~~ ~'^o T""t 8. Total Number ~f ~5afe Deposk Boxes 9. Litigation Proceeds Received ~ 10. ~I 1~~~{~ ~ 11. Eie~ toi tax under Sec. 9113(A) (Attach Sch. CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL. TAX INFOR TI ~ SHOULD BE DIRECTED TO: Name Daytime Tels)~h n~ Number AARON C JACKSON ESQ 717. 234 X1121 r+.a ~..~ REGISTER USE iiMLY _^ C First Line of address ~. , ,. "'~ ~ ' 111 NORTH FRONT STREET ~ -- Second line of address ~ Z "~~ ~; PO BOX 8 8 9 ~ ` ~;' ~', D City or Post Office - State ZIP Code . _ ILED HARRISBURG PA 171080889 Corresportdsnt's e-mail address: " ajackson~tuckerlaw.com ~~ Under penattks of perjury, I declare that I have exarNned this return, h>cludin~ ar~omparlying schedules and statements, and to the ft is true, oorred and complebs. Declaration of praparer other than the personal representative is tx+sed on aN intormetion of which t ss anyo. ~~' SIG OF PERSON PONSIBLE FOR NG DA7E ~ ~ J ce Orner Stiles ~ ~/ ~ s i 6423 Lee i hwa Arlin ton VA 22205 PARER O R REPRESENTATNE DATE /Ckron C. Jackson Esq. ~ Ao ss i 111 North Front t, Harrisburg, PA T Side 1 1505610143 15056101 _ - _ ~ 4 I 1505610243 REV-1500 EX ',~•~ Orner, Duayne J. DecedeM'8 S al Security Number 188 2~ 6009 RECAPITULATION 205,000.00 1. Real Estate (Schedule A) ....................................................................................... 1. 23,279.26 ~ Z. Stocks and Bonds (Schedule B) ............................................................................. 2. , I 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3. I 4. Mortgages & Notes Receivable (Schedule D) ........................................................ 4. I 43 , 243.98 5. Cash, Bank Deposits 8~ Miscellaneous Personal Property (Schedule E) ............... 5. 6. Jointly Owned Property (Schedule ~ ^ Separate Billing Requested............ 6. Ili 6 , 5 7 3.8 0 7. Inter-Vivos Transfers 8 MisceNaneous -Probate Property arate Billin Re ~ Se ested l 27 , 552.00 g ............ p qu (Schedule G) 7, l 8. Total Gross Assets (total Unes 1-7) ..................................................................... g, 11305 , 64 9.04 9. Funeral Expenses 8 Administrative Coats (Schedule H) ....................................... 9. 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) .............................. 10. 11. Total Deductions (total Lines 9 & 10) ................................................................... 11. 12. Nat Value of Estate (Line 8 minus Line 11) .......................................................... 12. 13. Charitable and Governmental Bequesb/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ............................................... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................... 14. TAX COMPUTATION - 3EE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 0 00 15 (a>(1.2) x .00 . . 16. Amount of Line 14 taxable 248 992.68 16. at lineal rate X .045 ~ 17. Amount of Line 14 taxable 0 00 17 at sibling rate X .12 . . 18. Amount of Line 14 taxable 0 0 0 18 at collateral rate X .15 . . 19. Tax Due ................................................. .:............................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTIN~i A REFUND OF AN OVERPAYMENT. 1505610243 Side 2 46,783.62 9,872.74 56,656.36 ',248,992.68 248,992.68 0.00 11,204.67 0.00 0.00 11,204.67 15056~O~43 J III i REV-1500 EX Page 3 Decedent's Comlpleb Address: Ftle Number 21-10-0538 DECEDENTS NAME Orner, Ouayns J. STREET ADDRESS 11 Village Drive CITY Mechanicsburg STATE PA IZIP 17050 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 10,000.00 567.78 C1) Total Credits (A + B) I, (2) 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Pags 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. Make Check Payable to: REGISTER OF WI PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE ~' K3) (4) (5) 11,204.67 10,567.79 636.88 TE BLOCKS 1. Did decedent make a transfer and: ', Yss No a. retain the use or income of the ro transferred :.......................................................................' P party +....... b. retain the right to designate who shall use the property transferred or its income :..........................G..,.... c. retain a reversionary interest; or ......................................................................................................a........ x d. receive the romise for life of either a manta, benefits or care? ................. 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death w tfr x recewrng adequate consxteretfon? ............................................................................................................~..~~ ^ Q 3. Did decedent own an "in trust for' or payable upon death bank axount or security at his or her death7~..,... ^ ^x 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation7 ............................................................................................... 4 ,... 0 ^ IF THE ANSYVER TO ANY OF THE ABOVE QUE3TION313 YES, YOU MUST COMPLETE SCHEDULE G AND FI ,E IT jAS PART OF THE RETURN. For darts of death on or after July 1, 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of transfers ~o air 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 January 1, 1995, the tax rate imposed on the net value of tronafers to or for the use of tNe s~ry"'Wring 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 teq ir{ements for disclosure of assets and tiling 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 yet n3 of age or younger at death to orifor ~h{s use of a natural parent, an adoptive parent, or a stepparent of the child is 0 percent [72 P.S. §9118 (a) ( )] .The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 perclent except as noted in 72 P.S. §9118 1.2) [72 P.S. §9118 (a) (1)]. . The tax rate imposed on the net value of transfers to or for the use of the decedenfa siblings is 12 percent [72 P.S. §9 16 (a) (1.3) . A sibling is defined under Section 9102, as an individual who has at bast one parent in common with the decedent, vjr ~r by bloo~ or adoption. I -- _ ~. I o..._~ RM Fxa ~~ ~ ~u~ --- ~----- ~ - ~ SCHEDULE A REAL ESTATE COMaONNiEALTM of PElINSYIVANM N~ERRANCE TAX RETURN Rt~IDENT DECEDENT ESTATE OF FILE', N ER Orner Dua ne J. 211 538 I a bnnnt M eonrnon mwt b~ npabd ~t Tair muk~t wiw. Fair m~lnitnvpalw is ddinsd u tM p~ at wh~ All rsN prop«ty owned soMly orYnns o(M6 wtlYr h d b h « M ~ d ~ ~ ~h bropeAy wrouid be vent hd I p sxo arps s vesn a gp ~ty vNo ish ip mu~M ~neTw~dieMdb F b Jointry w itl rift M w whk Rssi . Altseh a copy of the ssttlsmsat sheet N the property ha been sold Include a copy of Ihs deed ahowlrp dscsdsnYs intsrat N owned a tenant in common. ITEM VALUE AT DATE NUMBER DESCRIPTION ' OF DEATH 1 Real Estate -Real estate located at 11 Village Road, Mechanicsburg, Cumberland Cohn , PA 205,000.00 per Settlement Statement dated September 24, 201 O (attached hereto). i III I i I ~, ~I I ~ i li I i ' ' , TOTAL (Also enter on Line 1, Recapitulati n I 205.000.00 ,,. ,,,,-o -,,.-,o ro , , Copyright (c) 2009 form software ony The Lackner Group, Inc. ,a. ,,~..., w ~ .a., ~ a~.o, Form ~A !$00 Schedule A (Rev. 11-08) -- __ ,. l Rav-taoa oc* Is-9e1 SCHEDtlLE B STOCKS ~ BONDS CAMaAONVYEALTN of PENNavLVANU ~... INIERTTANCE TAl(RETURN RESIDENT DECEDENT ESTATE OF FILE N MBER Orner, Duayne J. 217 -8538 All propaTty Jointly-owmdwkh Ayht of wrvivonNNp must b~~selwW on Seh~dul~ F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT uA U~ VALUE AT DATE OF DEATH 1 Computershare -Shares, valued per date of death (attached ', 2,137.26 hsroto). 2 Morgan Stanley -Securities account held by Morgan ~! 21,142.00 Stanley, valued per date of death (attached hereto). '~, i li I, i ~~ j ~~~ '~i i i i~ I I~ I TOTAL (Also enter on Line 2, Recapitulation) 23,279.26 (h more apace is needed, additional paysa of the aame alze) Copyright (c) 2002 form software only The Lackner Group, Inc. Form P~-'600 Schedule B (Rev. 6-98) i I I i SCHEDULE E CASH, BANK DEPOSITS, ~ MISC. PERSONAL PROPERTY coesroNwEA~TH of rENNSV~vANU gNERRAN(:E TAX RETURN ~, RE810ENTDECEOENT ESTATE OF FILE'. N ER Omer Dua ne J. 21 ~1 538 Inducts the~o~sd a lap' stbn and u,s daa a,s proceeds wars receivedby tt» estate. ai property jolMly `own.dvvtMi the Ayht orsurvivorship mwt be diecloeedon ecladme F. I ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Comcast -Refund 53.34 2 Suburban Heating Oil Partners, LLC -Refund for oil service. ~ 149.04 3 Aspire Federal Credit Union -Savings account #9395, valued per correspondence dated 1,025.09 7/29110 (attached hereto). I 4 Morgan Stanley Smith Barney -Cash back check. I 300.00 5 PNC Bank -Checking account number 5080567438, valued per letter dated June 17, 2'01 0 14,822.84 (attached hereto). I, 6 PNC Bank -Money Market Savings account number 5006284537, valued per letter dalbed J}~n 15,988.67 17, 2010 (attached hereto). 7 Automobile - 2006 Dodge Charger Sedan 4 door, valued per Kelly Blue Book (attachedd 10,825.00 hereto). II ', i I i i ~, i I i ~i TOTAL (Also enter on Line 5, Recapitulation 43,243.98 (If more space is needed, addwonal papas of the same size) Copyright (c) 2002 form software ony Tha Lackner Group, Inc. Form PA~-1500 Schedule E (Rev. 6-98) I ~ i ens ~,r~ ,e_n~, r --- ---- -~ ~- --~ SCHEDULE F JOINTLY-OWNED PROPERTY ~,„~,~~~„~ INMERRANCE TAX RETURN RESH)ENTDECEDENT ESTATE OF FILET N ER Omer Dua ne J. 21+1 538 k an aaaat vt~aa nnda jolts wkhin one yearof the decadence dab of daalh, k nwat ba nporbd on Gl SURVIVING JOINT TENANT(S) NAME ADDRESS R~ TIONSHIP TO DECEDENT A. B. C. ~, i JOINTLY OWNED PROPERTY: ITEM LETTER DATE DESCRIPTION OF PROPERTY INCLUDE NAME OF FMLWCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH E pFS DATE of DEATH VALUE OF NUMBER FOR JOI MADE NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR ALOE OF ASSE IN REST DECEDENTS INTEREST ~~~ JOINT JOINTLY-HELD REAL ESTATE. 1 04/01/2008 Savings Bonds -Multiple Series EE savings 13,147.60 ' ~OOOX 6,573.80 bonds held jointly with son, valued per ', Treasury Direct (attached hereto). i, I I !I i I ~I i ii I ~ I ~i I I I ' TOTAL (Also enter on Line 6, Recapitulation) 6,573.80 (If more apace is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Foml P~--600 Schedule F (Rev. 6-98) II SCHEDULE 6 INTER VIVOS TRANSFERS 8~ MISC. NON-PROBATE PROPERTY co~oNwFUTN of t~ENNanvANw INNERRANCE TAX RETURN RE810ENTDECEOENT ESTATE OF Orner, Duayne J. This seheduk must be oomplded and fibd if the answer to any a qussliora 1 through 4 on the revers aids of the REV-1500 COVER SHEE4r is ITEM NUMBER DESCRIPTION OF PROPERTY tN ~~ ~ E~OF gTpR~ ISq~p~~ p COPV~O TTHE DEED FoREREEA~L Es ~~. DATE OF DEATH VALUE OF ASSET +s of oECas t~REST ~ Lt~sioN (t~ qp ~~~'c~"~neLE) TAXABLE VALUE 1 Morgan Stanley -IRA account held by Morgan 27,552.00 100.000ek ~ 0.00 27,552.00 Stanley, valued per date of death (attached hereto). !, i '~ I i I~ I i i ~I, i ii i~ I i I !, TOTAL (Also enter on Line 7, Recapitulation) ' I 27,552.00 (If mom space is needed, additlonal papas of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form', P/~-11600 Schedule G (Rev. 6-98) __l~_ Rev-~~a~ ex«haai SCHEDULE H ~~„~,~~.~~~H,,,a FUNERAL EXPENSES S ADMINISTRATIVE COSTS ESTATE OF FILE IN l1~BER Orner, Duayne J. _ 2f-'~0 $38 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION ~! AMOUNT A, FUNERAL EXPENSES: I i i III See continuation schedule(s) attached ~', I 11 078.75 B. I ADMINISTRATIVE COSTS: III, 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio Yearfsl Commission paid ~, i I 2. Attomev's Fees I 10,697.72 See continuation schedule(s) attached '~, i 3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) !, Claimant Street Address City State Zio Relationship of Claimant to Decedent 4. I Probate Fees 473.50 See continuation schedule(s) attached 5. Acxountant's Fees 300.00 See continuation schedule(s) attached 6. Tax Retum Preparer's Fees ~i 7. Other Administrative Costs 24,232.65 See continuation schedule(s) attached TOTAL (Also enter on line 8, Recapitulation) ' 46,783.62 Copyright (c) 2009 form software onty The Lackner Group, Inc. Form t~+A- I I l100 Schedule H (Rev. 10-06) T, -,~... SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF I FILE N~~IABER Orner, Duayne J. 211 -538 ITEM DESCRIPTION '~ AMOUNT NUMBER Funeral Ex 1 China Steakhouse -Family memorial celebration. 453.75 2 Myere Funeral Home, Inc. -Fees for funeral service. ', 10,626.00 I H-A 11,079.75 3 Attorney Fees ', Tucker Arensberg, P.C. -Initial payment for attomeys' fees for legal representation. 3,700.00 4 Tucker Arensberg, P.C. -Second payment for attorneys' fees for legal representations ' 3,700.00 5 Tucker Arensberg, P.C. -Final payment for attorneys' fees for legal representation. ' 3,297.72 H-62 I 10,697.72 6 Probate Fees ', Register of Wills -Initial probate costs charged b Register of Wills of Cumberland Caun~y 423.50 PA. 7 Register of Wills -Fee paid for additional short certificates. 20.00 8 Register of Wills -Filing fee for Inventory and Inheritance Tax Retum. ', 30.00 H-B4 ' 473.50 9 Accountant Fees John Kostokovitch -Preparation of Tax Retum. ', 300.00 H-BS I 300.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Fomh P~1-1b00 Schedule H (Rev. 6-98) i - 1_ ~ __ __. _ ._ SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE N ~IIIBER Omer Dua ne J. 211 538 i ITEM ITI NUMBER DESCRIPTION ', AMOUNT 10 Other Administrative Costs ADT - Securfty services for 8113110 through 8112/10 paid to maintain house for sale. ~~ 45.78 11 ADT -Residential security services. i 85.98 12 ADT -Security services for 9/13/10 through 10/12110 paid to maintain house for sale. ' ', 45.78 13 Alfredos Pizzas -Food for wake I 84.80 14 Alfredos Pizzas -Meal for moving help. ~~ ~ 63.89 15 I Best Buy -Equipment and supplies for video music program at funeral service. 58.28 16 Best Buy -Equipment and supplies for video music program at funeral service.. ~', 134.06 17 Black 8 White Painting -Painting charge paid in preparation of sale of house. 1,825.00 18 I Bob Evans -Breakfast for movere. ' 51.57 19 Central Penn Radon, Inc. -Radon mitigation system Installation in preparation of salt o~ 745.00 house. I 20 Chase credit card. -Credit card payment. ! ' 110.00 21 , Comcast -Cable services for services through 6/20/10 through 7N 9H 0. 103.27 22 Comcast -Cable services for services through 7!20110 through 8/18/10. I 153.68 23 Cumberland Law Journal -Legal advertisement notice. 75.00 24 Don Wagner Landscaping -lawn maintenance paid to maintain house for sale for da df 260.00 service 6/4H0 through 6/25H0. Copyright (c) 2002 form software only The Lackner Group, Inc. Fomh P~1-1600 Schedub H (Rev. 6-98) L I SCHEDULE N FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILF~ N ~IIBER Orner Dua ne J. 211 -4538 i ~ ITEM NUMBER i ~, DESCRIPTION ~ AMOUNT 25 Don Wagner Landscaping -Lawn care. ~ 260.00 26 Don Wagner Landscaping -Lawn maintenance paid to maintain house for sale for da~e ~f' 260.00 service 7/2/10 through 7130110. 27 Don Wagner Landscaping -Lawn maintenance paid to maintain house for sale for dale ~f' 130.00 service 8N2/10 through 8126110. 28 Don Wagner Landscaping -Lawn maintenance paid to maintain house for sale for dale ~f' 130.00 service 8/9H0 through 9123110. ' ', I 28 I Giant -Food for wake. 160.37 30 Giant -Food for wake. I!, I 206.31 31 Giant -Water and beverages for movers. 41.27 32 Home Depot, The -Home repaire in preparation of sale of real estate. ~, 21.53 33 Home Depot, The -Home repaire in preparation of sale of real estate. I 137.78 34 Home Depot, The -Home repaire in preparetion of sale of real estate. '~I 3.80 35 Home Depot, The -Home repaire in preparetion of sale of real estate. ' ~~ 25.46 36 Home Depot, The -Home repaire in preparation of sale of real estate. ~ 209.88 37 Home Depot, The -Home repaire in preparetion of sale of real estate. 7.92 38 Home Depot, The -Home repaire in preparation of sale of real estate. ~~ 5.57 39 Home Depot, The -Purchases and returns for home repair in preparetion of sale of real 308.90 estate. ', '~ Copyright (c) 2002 form soflwaro only The Lackner Group, Inc. Fora P II -h1500 Schedule H (Rev. 6-98) I I ~i_ i__~.~ SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE! N FABER Orner Dua ne J. 271 538 NUM ER DESCRIPTION AMOUNT 40 Home Depot, The -Home repairs in preparation of sale of real estate. 37.01 41 Home Depot, The -Home repaire in preparation of sale of real estate. !, ~ 57.21 42 Home Depot, The -Home repaire in preparation of sale of real estate. 12.07 43 Home Depot, The -Home repaire in preparation of sale of real estate. ~ 460.90 44 i Home Depot, The -Home repairs in preparation of sale of real estate. !i i 2.87 45 Longhorn Steakhouse -Family Dinner 'i 140.81 46 Lowe's -Home repairs in preparation of sale of real estate. 162.20 47 Maid to Perfection -House cleaning services. 89.04 48 Minipar Food Mart -Gas charges for moving furniture I~ 50.51 49 Office Depot -Filing cases for administration documents. I 15.74 50 Office Max -Supplies for cleaning and clearing out house in preparation of sale of real 102.72 estate. 51 Office Max - Prinrting and fax cosh for notifications. ~, I 15.90 52 Office Max -Printing of funeral church program. ', 152.83 53 Office Max -Packing supplies. '~ 91.64 54 i Office Max -Copies of Compushare Form with Gold Meedallion PNC Signature ~ I 0.36 55 Olive Garden -Food for wake. '~ 118.48 Copyright (c) 2002 form software only The Lackner Group, Inc. i I, Fomh PEA-1600 Schedule H (Rev. &98) 8CNEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE N ER Omer, Duayne J. 21 ~1 8 ITEM I NUMBER DESCRIPTION AMOUNT i I i 1 Funeral Ex China Steakhouse -Family memorial celebration. ~!, j 453.75 2 Myers Funeral Home, Inc. -Fees for funeral service. ~' 10,626.00 H-A '! i 11,079.75 3 Attorney Fees Tucker Arensberg, P.C. -Initial payment for attorneys' fees for legal representation. '' i, 3,700.00 4 Tucker Arensberg, P.C. -Second payment for attorneys' fees for legal repre:entation'~ i 3,700.00 5 Tucker Arensberg, P.C. -Final payment for attomeys' fees for legal representation. ~'~ 3,287.72 H-62 10,687.72 Probate Fees '~ 6 Register of Wills -Initial probate costa charged b Register of Wills of Cumberland Cdun~y PA. I 7 Register of Wills -Fee paid for additional short certificates. !, S Register of Willa -Filing fee for Inventory and Inheritance Tax Return. ~', Accountant Fees 9 John Kostokovitch -Preparation of Tax Retum. Copyright (c) 2002 forth software onty The Lackner Group, Inc. '~ H-B4 ~~ ~, I i I H-B5 I I ~Ii 423.50 20.00 30.00 473.50 300.00 300.00 Fon» P/~-'600 Schedule H (Rev. 6-98) L. i _i,-. - i SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE' N FABER Orner Dua ne J. 21»70 538 ITEM NUMBER DESCRIPTION - ' AMOUNT 10 r Other Administrative Costs I! ADT -Security services for 8!13!10 through 8!12110 paid to maintain house for sale. II ~~ 45.78 11 ADT -Residential security services. ~~ I 85.98 12 ADT -Security services for 9113110 through 10/12/10 paid to maintain house for sale. I' I 45.78 13 Alfredos Picas -Food for wake ~ 84.80 14 Aifredos Picas -Meal for moving help. I I 63.89 15 Best Buy -Equipment and supplies for video music program at funeral service. I!, I 58.28 16 Best Buy -Equipment and supplies for video music program at funeral servk:e. ! 134.06 17 i Black b White Painting -Painting charge paid in preparation of sale of house. ~, 1,925.00 18 Bob Evans -Breakfast for movere. ~ 51.57 19 Central Penn Radon, Inc. -Radon mitigation system installation in preparation of salt ofj 745.00 house. ~ 20 Chase credit card. -Credit card payment. ~~, 110.00 21 Comcast -Cable services for services through 8/20H 0 through 7/19!10. II 103.27 22 Comcast -Cable services for services through 7120110 through 8119110. I 153.68 23 Cumberland Law Journal -Legal advertisement notice. ! 75.00 24 Don Wagner Landscaping -Lawn maintenance paid to maintain house for sale for da~es o~ 260.00 service 6/4/10 through 6125!10. li Copyright (c) 2002 form software only The Lackner Group, Inc. I Form P~-1600 Schedule H (Rev. 6-98) I _i i SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FIL~ N BER Orner Dua ne J. 21'-1 538 ITEM NUMBER DESCRIPTION AMOUNT 25 Don Wagner Landscaping -Lawn care. 'I 260.00 26 Don Wagner Landscaping -Lawn maintenance paid to maintain house for sale for date ~f', 260.00 service 7/2/10 through 7/30H 0. 27 Don Wagner Landscaping -Lawn maintenance paid to maintain house for sale for da~6e fl 130.00 service 8f12l10 through 8/26/10. ' 28 Don Wagner Landscaping -Lawn maintenance paid to maintain house for sale for date f' 130.00 service 9/9110 through 9123110. 29 Giant -Food for wake. I 160.37 30 I Giant -Food for wake. ~i 206.31 31 Giant -Water and beverages for movere. ~'~ 41.27 32 I Home Depot, The -Home repairs in preparation of sale of real estate. ~ 21.53 33 Home Depot, The -Home repairs in preparation of sale of real estate. I' ' I 137.78 34 Home Depot, The -Home repaire in preparation of sale of real estate. ~ ~I 3.80 35 Home Depot, The -Home repaint in preparation of sale of real estate. ~~, ~ 25.46 36 I Home Depot, The -Home repairs in preparation of sale of real estate. 208.88 37 Home Depot, The -Home repaire in preparation of sale of real estate. I 7.92 38 I Home Depot, The -Home repairs in preparation of sale of real estate. III 5.57 39 I Home Depot, The -Purchases and returns for home repair in preparation of sale of r+ejal 308.90 estate. ' i I ~I Copyright (c) I i 2002 form software ony The Lackner Group, Inc. Form', PA I i ~ ~-1600 Schedule H (Rev. 6-98) I SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF I FILE' N~IMiIBER Orner, Duayne J. 21±1aa-538 ITEM NUMBER DESCRIPTION ~~ AMOUNT 40 Home Depot, The -Home repairs in preparation of sale of real estate. 37.01 41 Home Depot, The -Home repaire in preparetion of sale of real estate. ', I 57.21 42 Home Depot, The -Home repaire in preparation of sale of rest estate. I 12.07 43 Home Depot, The -Home repaire in preparation of sale of real estate. I 460.80 44 Home Depot, The -Home repaire in preparetion of sale of real estate. ICI 2.87 45 Longhorn Steakhouse -Family Dinner ! I 140.81 46 Lowe's -Home repaire in preparation of sale of real estate. ICI 162.20 47 Maid to Perfection -House cleaning services. 89.04 48 Minipar Food Mart -Gas charges for moving furniture it 50.51 49 Office Depot -Filing cases for administration documenb. I 15.74 50 Office Max -Supplies for cleaning and clearing out house in preparation of sale of r'4al 102.72 estate. 51 Office Max -Printing and fax costs for notifications. ~, i, 15.90 52 Office Max -Printing of funerei church program. ~ 152.83 53 Office Max -Packing supplies. II 91.64 54 Office Max -Copies of Compushare Fonn with Goid Meedalifon PNC Signature ~, 0.36 55 Olive Garden -Food for wake. !, 116.48 Copyright (c) 2002 form software only The Lackner Group, Inc. I I Fomi P~-1600 Schedule H (Rev. 6-98) r _ i _r SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF Omer, J. FILE N 21+11 ITEM NUMBER DESCRIPTION 56 P.F. Chang's China Bistro -Meal for moving help. AMOUNT 57 Penn Waste, Inc. -Trash bill for period 1011110 through 12/31110 paid to maintain house ~ot sale. ~ I 58 Pennske Truck Rental -Rental cost of moving truck. ~~~ 59 Pennsylvania American Water -Water bill for period 6/25/10 through 7/27110 paid to niai~tt#~in house for sale. 60 Pennsylvania American Water -Water bill for period 5/25H0 through 6/25/10 paid to ~al~t$~in house for sale. 61 Pennsylvania American Water -Water bill for period 7/27/10 through 8/26110 paid to rrMai~t~in house for sale. '~ 62 Pennsylvania American Water -Water bill for period 8127/10 through 9/24/10 paid to rrlai~t~in house for sale. '~~ i 63 Pennsylvania Power and Light -Electric bill for 6125/10 through 7127/10 paid to maintain house for sale. ' ', 64 Pennsylvania Power and Light -Electric bill for 5126/10 through 6/25h0 paid to maintain house for sale. 65 Pennsylvania Power and Light -Electric bill for 7128HO through 8/25110 paid to maintain house for sale. 66 Pennsylvania Power and Ught -Electric bill for 8/26H0 through 9124/10 paid to maintain house for sale. 67 Pep Boys -Gloves for movers. 88 PNC Bank -New check printing fee for estate account 146.00 4.34 343.66 52.43 48.61 40.78 48.78 182.46 151.72 138.32 127.74 42.38 17.99 Copyright (c) 2002 form soflwaro only The Lackner Group, Inc. Fomh P/~--1b00 Schedule H (Rev. 6-98) SCHEDULE N FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE N~!(~ER Orner, Duavne J. 21+1 -4538 ITEM NUMBER DESCRIPTION j AMOUNT -- 69 Pro Lab -Fee for testing servkes regarding the residence. ~, 30.00 70 Ramada -Executrix's stay for cleaning out property. ', 196.36 71 Real Estate settlement charges -Total of closing cosh for sale of Decedent's residenlce Ipbr 10,464.80 Settlement Statement dated September 24, 2010 (attached hereto). 72 Sentinel, The -Legal advertisement notice. ', 219.40 73 Sheetz - Ga:olive for moving truck. ', 41.32 74 St. Katherine Drexel -Funerel expense. 250.00 75 Staples -Supplies for cleaning and clearing out house in preparation of sale of real e~te. I 2.11 76 Staples -Supplies for church programs ' 80.83 77 Staples -Supplies for cleaning and clearing out house in preparation of sale of real ~str~t~. 136.10 78 Stlles, Joyce Omer -Mileage reimburesment - trevel from Arlington, VA to Mechanic~'bu~g, 1,880.00 PA for funerel, executrix duties, cleaning out of home and preparation of home for sells. I~ ( 6 tlmes from 5l17H0 through 9/24/10). ', 79 Target -Supplies for cleaning and clearing out house in preparatlon of sale of real e~ta~e~ 18.07 80 Target -Equipment and supplies for video music program at Funerel service. ', 288.56 81 Target -Supplies for cleaning and clearing out house in preparetlon of sale of real es#ta~e. 48.91 82 Target -Supplies for cleaning and clearing out house in preparation of sale of real edta~e I 8.00 83 Terminex -Real estate inspectlon for sale of house. ~, 106.00 Copyright (c) 2002 form aotlware ony The Lackner Group, Inc. JJi,' Four} Pq-500 Schedub H (Rev. 6-98) I! ~ I SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS '' continued ESTATE OF FILE! N ~IIIBER Omer, Duayne J. 21+7 -638 ITEM NUMBER DESCRIPTION II AMOUNT 84 Terminix -Fes for termite report regarding the residence. i I 10.60 85 I TGI Friday's -Meal for moving help 69.00 86 The UPS Store -Transport of Items to beneficiaries. 'i 291.62 87 I The UPS Store - Transport of items to beneficiaries. 758.13 88 The UPS Store - Transport of items to beneficiaries. II 70.40 89 I Tri-State Shredding Corp. -Shredding of confidential/personal documents. ~, 19.00 90 U.S. Postal Service -Stamps for thank you notes for funeral ~', 17.60 91 U.3. Postal Service -Mailing charges for personal Items given to family. ', I 88.99 92 U.S. Postal Service -Mailing charges for personal items given to family. ', 38.85 93 U.S. Postal Service -Mailing charges for personal items given to family. ', ~I 44.54 84 U.S. Postal Service -Mailing charges for documents to estate attorney. ', 18.30 95 U.S. Postal Service -Express mailing charges for distributions to beneficiaries. 14.70 96 U.S. Postal Service -Mailing charges for pereonal items given to family. ii 60.55 97 Verizon -Phone bill for services from 6!19/10 through 7/18/10 paid to maintain house,~for siale. 10.27 98 Verizon -Phone bill for services from 7/19/10 through 8118/10 paid to maintain house for slate. 69.91 99 Verizon -Phone bill for services from 7/19/10 through 8H 9H 0 paid to maintain house Ifor~ stale. I 71.88 100 Verizon -Phone bill for services from 8120110 through 9/24H 0 paid to maintain house ~for{ sale. 10.67 Copyright (c) 2002 form software ony The Lackner Group, Ina Fom1 P/~-~fS00 Schedule H (Rev. 6-98) I I T ______ _ _ ___ _ SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE N NIGER Omer Dua ne J. 21 7 -0838 ', ITEM NUMBER DESCRIPTION I AMOUNT __ 101 Vital Records -Charge for 10 addltlonal death certificates 90.00 H-B7 '~, 24,232.65 I i i ~~ I I I'~ Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA~1600 Sd~edule H (Rev. 6-98) rew.~a~z ex. nz.as- scHe~u~e i +~+ DEBTS OF DECEDENT, MORTGAGE LIABILITIES, ~ LIENS COAIGOI~NYEALTH of aElrravWAN1A INHERITANCE TA%RETURN '~..,. '~, RE810ENTDECEDENi ESTATE OF FILE' N ER Orner Dua ne J. 21 1 538 RapoR daWa fnwmd by tfn dacadant glor b death that nxminad unpaW at the dab of daatl-, Indudlnp unraimbunu-d ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Comcast -Cable services 132.96 2 Don Wagner Landscaping -Landscaping needs ordered prior to death I 690.00 3 Giant -Household and grocery items provided to deceased prior to date of death, I 35.29 reimbursed to Joyce Omer Stiles. 4 i Loan payment -Home equity loan. 349.90 5 Panera Broad -Food for visiting family and friends. I, 111.32 6 Pansra Bread -Food for wake. ' 42.39 7 Pennsylvania Amerkan Water -Water bill 69.28 8 Pennsylvania Power and Ltght -Electric bill li 125.23 9 PNC Bank -Loan account number 4001008109570202. '~, I 7,211.00 10 Sackey, Bane -Check written prior to death 270.00 11 Silver Spring Township Authority -Sewer charges for period of 4/1H0 through 6/30Hf~ I ' 106.00 12 Target - Pereonal can items provided to deceased prior to date of death, reimbursed Ito 141.03 Joyce Omer Stiles. 13 Target - Pereonal care Items provided to deceased prior to date of death, reimbureed Ito 78.94 Joyce Omer Stiles. ' I 14 Verizon -Phone bill 92.33 15 Visiting Angels -Services for May per invoice dated 5118110. i '! 175.50 Total of Continuation Schedule ~ gee attached page TOTAL (Also enter on Line 10, Recapitula~io ) I 9,872.74 (IT more apace fa needed, additlonel pspes OT the aeme size) Copyright (c) 2009 form software ony The Lackner Group, Inc. Forth I~A~1~00 Schedule I (Rev. 12-08) _I ~ _. Rw-1512 EX+ (i-9!) SCHEDULE 1 ~+ DEBTS OF DECEDENT, MORTGAGE LIABILITIES, ~ LIENS ~"~ ~""" continued ~~ ESTATE OF FILE' N MABER Omer Dua ne J. 2111 538 ITEM I VALUE AT DATE NUMBER DESCRIPTION ', ~ OF DEATH 16 Walmart - Pereonal care items provided to deceased prior to date of death, reimbu 33.00 Joyce Orner Stiles. li I 17 Wegmans -Household and grocery items provided to deceased prior to dabs of deatfw', 'I 208.36 reimbursed to Joyce Omer Stiles. i TOTAL (Also enter on Line 10, Copyright (c) 2002 form software only The Lackner Group, Inc. Form Pl~--j ~I 9.872.74 Sk~edule I (Rev. 6-98) Estate of Duayne J. Orner, deceased Estate No. 21-10-0538 Re: PA Inheritance Tax Return List of Exhibits '~ A. Death Certificate ~I B. Letters Testamentary issued by Cumberland County Register o~ ills on May 24, 2010, including Last V1Lill & Testament of the Decedentld ted November 6, 2001 !, C. Settlement Statement, dated September 24, 2010, of sale of D dent's real estate located at 11 Village Drive, Mechanicsburg, PA 170 D.. Account valuation from Computershare+ ', II E. Account valuation for Securities held by Morgan Stanley I, F. Account valuation correspondence held by Aspire Federal Credit ~Jt~ion G. Account valuation correspondence for checking and savings held ~y PNC Bank H I. J Kelley Blue Book's online appraisal of 2006 Dodge Charger Se~ar~ 4 door j Treasury Direct's online valuation of Savings Bonds ', I Account valuation for IRA held by Morgan Stanley EXHIBIT A H105.905 RE9.(3/~9) This is to certify that this is a true copy of the record which is on file in the Pennsylvania Department of Health, in accordance with the Vital Statistics Law of 1953, as amended. WARNING: It is illegal to duplicate this copy by photostat or photograph. 5787826 No. aQr ~~~ Linda Caniglia State R~gistrar ~0 8110 N,06•U9 ~ „Woos coMMONrreAUH OF PENHSrivANU1 • DEPARTMENT OF FIEII~TN • vrrA~ nECORDB " CERTIFlCATE of DEATH. ls.. .na.>~.. an rewnsi STATE 0448b5 ,.NrrdhadtdpitleiddAbt,rap Duayne Joseph Orner x~aie a~188 ~ _6009 ~ ~ 5, 2010 S Apt pal gyldry) IAda , Iloda 1 a DAY d BYU 7. a4dW a /a PYa d Orlo SO """ °"` '~" ~" January 27,1930 Cleviand, Ohio "°"s"'~ daA ^ DOA ~+ ^ ER I O ^ °r"` ^ INtldra ^ 01w • Sptaj Yrs. ~A M ea ceaq a ore eG ar, eo,o, rr. a am ea retry Nnr M ~ bdrra4 yM dorladtrd~ e. 1Mr oaar+a NYpric oaob'+ ra ,a woK AaMcr bdr, aaknua dt Cumberland SNver Spring 11 Village Road a ~'~' a°'" "~ White rrra R.b ere, eto.) ,,. abeaeCeUe.t deedctlr ebda a,.lbederr ,x wr De«dne ew b rr ,3 Dreerel Ederslr ~' aly ~ ~ oroMb4 x ~wwj 1a sa,~bo spar p.r~ ~+ adage m.1 Air Trai~°roler ede'P~'G~'i'1i~eM US. Ared raaat ea„a,w ~ s,~,,,o„r p,a { «sF~ ~~ r« ^ Ne >~ IYti,pMierelee~dy/ben,eYb,~ae,r- K O a O aaapeaet rm ribs. ,rasmb PA ~aa ,n.'~Yr,orea.+uab n p ~ g T*v. , PA 17050 Mechanics U rg b ,m.~, Cumberland Taarr~T nd^ ~a edr+e ~~~ 11.rdnreNrrp~t,nidse,be~aerq .Duayne C. Orner ,A.NdhehNrrp4d,altlde,eeidreunrr) Aneina "Pat" 1rYe1 t0i' "p1ebr' "r' R19' ~""~' Victoria J. Riegel ~, ~ ~0 ~~ongv~ew ~~e Mechartks rg, PA 17050 ?1aWMddOfgeetym o ^p,p~ ^panYao 2,0.Debd0YpoeYon~ModA,dey.Yea) ~Ie,t~YrdDYpoetoepMrdaarlry,,aarlMpad!rrPYal ' 21d LoeMrlpl~beM1eW.LOred ~,ser ^ n.adbse. ~ M ta.rlr~ ^ ~ May 21,2010 Cahrary Cemetery A ltoona PA 16602 ^ r« ~ orr ~ s.rb, rt+~ ~ ppp12662.~ ~~~ ~~ fwyerai Homa, Inc. 37 East Main Stnret~ nic:burg, PA 17055 Aaa whr hrldr~ ddlrlir.~YrrdO~'M~Ydp+'I~rwrOMb) Zb.lkarNewEa 2'ic.Geb .jai ^rradwtb ~ e 1 X ~ RN'" 5 ~~ ~ a~ 0 ~ a ,+~ ~ 5 -~ ~~ V '" ~M1 a.n 0. . ar 2/. TYr d ?S. DeY dl.Yer) 28. 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O O ,, ~ ~ V d ~ u wrs Na S~ y 7 9 b ~ y CAMP Hq1, PA 17td11 ,_, -_ REGISTER OF WILLS CUMBERLAND COUNTY PENNSYLX/ANtA No. Estate Of: DUAYNEJ ORNER (Flier, Midd/s, Lesfl Late Of : S/L VER SPR/NG TOWNSHIP CUMBERLAND COUNTY Deceased Social Security No: 188-20-6009 WHEREAS, on the 24th day of May 2010 an instrument c~at~~d November 6th 2001 was admitted to probate as the last wi'~I of DUA YNE J ORNER r>=~c Mlddle carp l a t e of SILVER SPR/NG TOWNSHIP, CUMBERLAND County, i who died on the 15th day of May 2010 and, ~ WHEREAS, a true copy of the will as probated is annex~d hereto. THEREFORE, I, GLENDA EARNER STRASBAUGH Regi s ter ~, of Wills in and for CUMBERLAND County, in the. Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY t©: JOYCE ORNER STILES it who has duly qualified as EXECUTOR(R/Xl and has agreed to administer the estate according to law, tall of which fully appears of record in my office at CUMBERLAND COUN~'Y QOURT HOUSE, CARL/SLE, PENNSYL VAN/A. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 24th day of May 2010. ~~ ~, * *NOTE* * ALL NAMES ABOVE APPEAR FIRST MIDD ( LE, LAST) ', CERTIFICATE OF GRANT OF LETTERS PA No . ~ f - 10- 0538 LAST WILL AND TESTAMENT OF DUAYNE JOSEPH ORNER I, DUAYNE JOEEPH ORNER, of Cumberland County, Pennsyly ~ declare this to be my Last- Will, hereby revoking all prior wills and codicils. FUNERAL EXPENSES FIItST: I direct the payment of my funeral expenses, including miy ~ravemarker, as soon as maybe convenient after my death. I, PAYMENT OF DEATH TAXES SECOND: I direct that all taxes that maybe assessed in conseque~nc iof my death, of whatever nature and by whatever jurisdiction imposed, shall be ~ d from my residuary estate as a part of the expense of administration of my estate. PERSONAL PROPERTY THIRD: I bequeath those items of my household furnishings, per~o effects, ' and personal property as I may set forth in a separate signed memoranduu~. the persons named in that memorandum. ', DISTRIBUTION OF RESIDUE FOURTH: I give the entire residue of my estate to my wife, Eliza a 'Jane Omer, providing she shall survive me for a period of thirty (30) days. Ifs a shall not so survive me, I give the entire residue to my children, equally, provided that e ~ share of any child who predeceases me or dies on or before the thirtieth day follow~in any death shall be distributed to his or her issue, per stirpes, living on the thirty-first ~ 'following my death, and in default'of any such then-living issue, such share shall be ~d to the share or shares for my other children. If neither my wife nor childrenshah s 've me for a period of thirty (30) days, the entire residue shall be distributed acco g to the intestacy laws of Pennsylvania. ~ o: o _ _ ~ rr "> y ~ ~ ~1 r1J''1 ~~ J[ __ rr't~~_1 ~ Q 4' ~~ V "T 1 i i ', r_ _ _ ~. PROTECTION OF BENEFICIARIES (Spendthrift Provision) . FIFTH: No interest in income or principal shall be assignable by ~ja available to anyone having a claim against a beneficiary before actual pa ' beneficiary. TRUSTEE OF.ESTATE OF MINORS AND INCAPACITATED BENEFICIARIES SIXTH: If any income or principal shall be payable to any perso a .minor or who shall be incapacitated for any reason, my executor, as trust~e such income and principal during minority or incapacity and shall be entie such income and principal to the health, maintenance, support and educa o: person during minority or incapacity without the appointment of any guar!di committee or any authority of court. My trustee shall be entitled to make'jd application hereunder or to make application by payment of income and pri parent or other person in chazge of such minor or incapacitated person, orlt~ guardian or to a custodian. under the Uniform Transfers to Minors Act. Thu discharge of all the trustee's duties, pay any minor's shaze deemed imprac~i~ administration to the parent or other person in charge. of the minor or to his guardian or to a custodian for the minor under the Uniform Transfers to Iv.~i remaining income and principal to which such person shall ,be entitled sha~] to such person upon such person reaching the age of 18. My trustee shall powers as my executor and. shall serve without bond. POWERS OF EXECUTOR SEVENTH: I confer upon my executor the right to sell or otherwi~ real or personal property at public or private sale, at such time or times, in and for such price or prices, and upon such terms and conditions as my ex~ determine, and to execute and deliver good and sufficient conveyances, as~ transfers thereof, without liability of any purchaser for the application of ~ consideration; to borrow money and to secure its payment by mortgage of,~ personal property, pledge of investments or otherwise, without liability on' lenders to see to the application thereof; to retain any investments at disc and reinvest at discretion, without restriction to so-called "legal investmen distribution in cash or in kind; and to do all other acts and things necessaryr in the management, administration and distribution of my estate. to the or hp shall be a ,k~a11 hald i to apply ~ of such ~ or ipal to the is or her .e may, in of her ks Act. Any distributed the same evert any manner, rshall cents and or part of the to invest A make __ ..__ ,_ T - APPOINTMENT. OF EXECUTOR EIGHTH: I appoint Jovice Omer Stiles, executrix of my will. If J'o ~e Orner Stiles is unable or unwilling to qualify as executrix or having qualified is ur~a'ble or unwilling to act, I then appoint Duayne Michael Orner as executor hereof: $ direct that my executor shall not be required to fiunish security in any jurisdiction. I ' INTERCHANGEABILITY OF LANGUAGE NINTH; Words used in the singulaz may be read to include the p or the plural may be read as the singulaz. Similazly, the masculine fo~riri may belr ' to include the feminine and neuter; the feminine maybe read to include the masculine aid neuter; and the neuter may be read to include the masculine and feminine.. ~, HEADINGS TENTH: The headings used on the vazious paragraphs of this wil~ a included for convenience only and shall have no legal significance. I have .signed this will this ~ ~~ day of /l/0 6 a~ 2001 Yf~+ ~ ~ , Dfiayne J~eph Offer ~' /~ Thomas J. ens ACKNOWLED~EMEN'T and AFFIDAVIT '; COMMONWEALTH OF PENNSYLVANIA: SS. COUNTY OF CUMBERLAND I, Dwayne Joseph Omer, the testator in, and Thomas J. Ahrens andl endy J. Jacobs, the witnesses to the last will, the attached or foregoing instrumen , ho have signed the instrument, having been duly qualified according to law do d o ~ and. say: (a) that I, the testator, do hereby acknowledge that I signed and ex~c ted the instrument as my last will, that I signed it willingly and as my ire and voluntary act for the purposes therein expressed; and ', (b) that we, the witnesses, were present and saw the testator sign aid eh~ecute the instrument as his last will, that he signed it willingly and execute ft as his free and voluntary act for the purposes therein expressed; that each bf uis in the hearing and sight of the testator signed the will as a witness anc~ ~t to the best of our knowledge the testator was at that time 18 or more years', o I age, of sound mind and under no constraint or undue influence. /7 ,_ ! .~ 1JLlayn@'JOSe7JII Vr,~Her / ~ ~~ Witness, Tho as J. Akre ~N11. ~ Mr„~ ~r n sos EXHIBIT C _~ T ~ _ _ ~ed~rk OYB Appmnll No. 2802-0266 ~`` A. Settlement Statement (HUD-1) `~...~'~ p ,,....~ ~ ..M 8. Flle Number: 7. Loan Number: 8. Martyaps1rournc~s b Number: 1. ~ FHA 2 ~ RHS 3. ~ Carn. Uniro. 12504-147893 8D17928758 4. ~ V1 5. Q Corny. Iro. C. No[e: 7hts Ibrm fs fra•Nahed b give you a ateterrxrrt dacfurl asfflement costa. Anaunfs paid b and by the sstMsmsnt spent aro s iterro rrrarked Ypac.)' were paid outalde the closing; Utey are shown hero !brln/prrrratlonal purpores and are not Included fn s. D. Name and Addrsas d Borrower: E Neme andAddrees d SMler. F. Name andAddress d HsaBmr L Stlla Estele d Dueyro J. Omar Nevy Fadsrel Credit Union 11 Vllleps Drive 0423 Lee Highway P.O. Bcr:3328 Medrenlabrrp, PA 17050 Arlihpton, VA 22205 Merrl0eld, VA 22119 G. PropartyLocatlan: H. SettlemantApsrt L Sbtll snlDeta: 11 Vlllaps Drive TudrarAreroberp Real Estate 3arvice Corporation i Mechenicsburp, PA 17050 111 North Frorrt 3trsat 24, 2010 CumbKland Courdy, Peremyivenia Herrisburp, PA t7108 ~ (71734-4121 Place d Seltlarnerrt 111 North Front Street Hama PA 17108 J. Summary of Borrowers treneaetlon K Bum of tlMlds trensaetlon iDO. Gross Amout Due from earrowsr: 400. Gross Amount Due b Seller. 101. ConMed .roe ~. 205 D6D.DO 4ot Cartrad solar a 2D5 a0o.DD 102 Personal 402 PersorW 103. Satlleremrrt b Borrower Une 1 9001.07 403. 104. 404. i 105. 406. rorkems eld SsBsrinadrserp tsroritama aid Ssllerlnadvence 108. C ownTsxa 09126/10 b 01At111 408. C ownTaxa O9f25110 b 01/01M7 5p gp 107. Taxes OSf15110 b 01101/11 98.99 407: Taxa OB/2.5M0 b 01/01/11 , 98.99 108. Sclaol farms Olll25M0 to 07101!11 1 171.81 408. School farms 0925HD b 07101/11 1 171.81 108. qOg• . 110. - 410. 111.. 411. 112 412 120. Gross Amount Due tYorrr Borrower 215,9'13.47 420, Grog Amount Due ro Setlar - 2DB,32240 200. Amount Paid or b Bahelf o- Borrower '600. Reduedorn b Amount Due Seger: 201. It or errrsst m 100.00 501. Excesa It ass irotructlonr 202. Prirai emout d rirw I s .205 000.00 602 Ssttlemert b Sailer Line 140D 4 314.80 203. Fxistl 1 s taken s sct b 5D3, bdstl I a taken s set b ~. 5D4. P Fint 205. 208. 508. Ifrdtlned seller 100 OD 207. rte. _ . 208. 508. . 208. rte, ~ A stmants ror Items un aid Seller ustmarts ror items un aid Seger 210. CI own 7axa b 510. C awn Taxes b 211. Texa b 511. Tara b 212 School taxes to 512 Scfad tams to 213. Seller solar 6150.00 513. Soler aaist 6150.00 214. 514. 215. 515. 218:0 rr~on fee vedit 250.00 518. 217. 517. 218. 518. 219. 619. 220. Tog! Paid !for 211500.00 620. Tog! Reduetlan Amount Due Se6sr ' 1 584.OD 300. Cerh at irorNto Borrower 000 Caeh. et aet6srrrent to/frem Seger 301. Grass artrorst due Tram Borrower 8ne 120 215923.47 001. Gress emourt due b Seller Ins 200 3224D 302 Less enact d Banowsr rrs 220 ( 211506.00 802. Lars rsductlaro due Seller lira ! 1 Q584. 303. Cash X^ From ~ To Borrower 4,423.47 003. Cash X^ To ~ From Soper 195 757 BD , . r rya uraersiprrea hereby eGrnow a s receipt f4 bd~ir.rvtemssd8~.aoy attacfmsr Bartowsr Seller L~ 7M Reasnpe1lp eardan M M aebalen Mlnknnalen N WnsYd eta6'ndneM Nr n~peua er Ana. reMeWnr, and n nstnQWN• ~eNIM rdHrrw. Wanedl*Nrae mnuerhNtl OrremnYN nwneec No wnad~nUryY nnnre4 er dltleaw tenraaawmi InYrnreOn dwMeMMwnntprstea Paps 1 d 3 L. Settlement Ch es 700. Total lisal Esdds Broke FMS P•k From ' PNd Frpn , Divlaion d oanuniss7m Ira es lbllows: e•rrow.r. aw.r. 701 t0 F•ndad FPM ~ 8•a•pr•M 'i adnn•M 703. miss on d al sstll 704. 705. - 800. Marna N in Connadfon vvMlr Lorr 501.Our on natlan krGufa 0 natlon Point % a S 3837.00 from GFE /1 802. Ylxr credit a chrps (polyda) fa the spscMc interMt rate ciwaen i 51250 (trom GFE112) - 803. Ylar adjwtad art rrtlan from GFE riA 4 804. sal iM fA Pamela M. Reilarrbach irdn GFE #t3 POC:350. 505. Credit to fak item GFE 1Ci PDC:15. 808. axaerriea to 1stAmerlcanRE.TaxSvc.,fne. from 45. cod csrddcetfan to Flaod Dafe SarvkM, Inc. from G M3 ' 7. BOQ from E rKi 809. Tax set fM to Istl4nerican R.E Tax Svc.; Inc. OFE~Ki 5. 510. from FE rlCi 511. ~ 900 Hems wind b Lander to Be Paid In Advanp ' 901: Dal irrlsrast from 09J24N0 to 10V01110 7 SD.0000001 from GFE1H0 902 irruarxa lum for monMu to from GFE M3 903. Homeowhar's insurance for 1.0 to U from F 4H1 35. 904. from GFE 1H1 905. (from GFE *11) 1000. RassrvM wlfir Undo[ 1001. Wtlal deposit fa yar Maow account (from GFE #9) 1. s nsurance. 1003. iruurarxx mordha S month S 1004. Properly taxes S 710.43 own Taxes .000 mantle 48.74 per manlh tyTsxas morihs per month AssMSmerds 3.000 mardhs S 27.75 month 1005. s 1006. mordhs Q S Pa mordh 5 1007. morgx Q i per month i 1006. S 1009. Apprepsts adJwtrnant S -351.43 1100. Title M 1101: Title servkas and lender's tide iraursrx:e ( F 150.00 11012. SetBarnan/ a sloe fM i 1103, Owner's tltle Insurance m FidNl NaManel 71de kqursrrce Nom GFE*5 1 .7 1104. Lender's tltle irwurancs b Fidel NsdlorW Insurarxs i 150.00 1105. Lenders dtla I Iimit S 205000.00 1108. Ownsrstltls I Iknit i Z05000.00 1107. a on d Mrs toltl title insurance fun to TutkarArarn Resl Estate Sarvfce G S 1 178.1 1105. lhrdervrritars on dMa total tltle insurance ium to Fidell Natlararl Tide Irourence Com S 207. 1109. 1110. 1111. 1112 1113. 1200. Govemmsnt Reeordlne and TYanafar Cfiarpes 1201. Garammant rsardl to Cumberland Retarder d Ossda Nom GFE 1 .OD 1202. Draed S 54.00 S 90.00 RelsesM S Otlar S 1203. Tnrrter taxes to Cumberland County Retader d Deeds (from GFE 08) 2, .OD 1204. C te:rh S 2,OSD.00 S 1,025.00 1205. State tmd 5 2050.00 S 1025.00 1208. 1207. 1700. Additlonrrl BstfNmarrt Ch M 1301. red servers Met cans fa from GFE rM6 1302 1303. Hams to AHS 435.OD 1304. Lf imr tellers to TuckerArarw RMI Estate Service G 15.00 1305. SM addict disb. aHbS to 1884.50 1400. Total Sattlarrant Ch enter on 9nM 1 Ssetlon J and Ssttlon K 9 .07 4 314.80 eY r•pdna wa•~awb.ewn~t~r•re•.rod..•aawMws. r•ww a. eo.ipwd mpy orww:a n.a• .ne ~ ~ ~I RMI Estate on, SaltlamtlrM Paps 2 d 3 MUD-1 II Compadeorr of Good Faitlr Itistlmate (GFE) aril HUD-1 Charpae Good Filth Eetimab HUD-1 Thst Canna Inueaw HUD-1 tine Nrard»r Our oripirrtlon #801 3,837.00 3,837.00 liar credit ar rdnrps (points tar the speefflc irderest rats ctwsen # 802 51250 51250 Wtr adjtNted aripinrdion charges # B03 4,349.5D 4,349.50 Tmsfarfaos #1203 4,100.00 2,050.00 Govermsrrd recording grerpas #1201 14200 154.00 Chetuas That in Tohl Cannel Inaraase Nkm than 1q% I Good Faith EaUmab I NUD-1 GavsmmeNrecordinp #•'1201 450.00 350.00 CrerUt # ~5 15.00 15.OD Tax servirx #808 45.00 45.00 Flood certifieatlon # B07 7.00 7.00 . Tax set up fee # BOB 5.00 ' 5.00 . Total 52200 ' 42200 Increase between GFE and HUD-1 Charges S -100.OD or', I -19.16 Charya'Ihat Can Cluarye Good Faith Eetlmah ' UD-1 kritlal deposit for your escrow eccourd #1001 677.08 ' 471.54 DattylNersstctrarpes #901 S /day - Homeowrxr's incurares #903. 615.00 735.28 Title services end lender's tltls Insurance #1101 2,343.75 400.00 Ovmer'a tltls Insurance b Fidelity NatlorW Title ltsurenes Comp #1103 1,383.75 1,383.75 Your initlal loan amount is Z 205,000.00 Your loan term is ~ Y~ ' Your inltlal krtersst refs fe 5.0000 % Your Inltlal monthly amount owed for prindpal, interest acrd S 1,100,48 includes any mortpaBe insurance is Q Principd ® Interest j ^ knumcs Can your interest rats riae9 ^X No ^ Yes, it can rise b s maximum d 1f1. Iflrst eharrps will bs on and can ehrge apeln every . Every thongs dMe, your interest rats can Inc atta d}crpse by %. Over the IHe d tlrs loan, your irrtaxsst rate, is b never be lower than % or telpher than ^_% Ewn K you mNn payments on time, can your soar belong rbe7 © No ^ Yes, It can rise b a maximum d 5_,~. ~, C-ven H you. mob paymenb on thee, ear your mouthy © No ^ Yq, the flrsl Inaeass can be on a(b monlhiy amount awed for pdndpal, grteray and mortpepe insurance ties? amount awed can rise b S Tt» maximum h can over rise b is i boas yore loan haw a prepayment penalty? © No ^ Ya, your madman prepayrneN penally le S Does your loan have ^ bMoon peymant7 ^X No ^ Yes, you trove a balloon payment d 5 due fn _ years on Total monthly amount owed hfeludinp escrow aeeottM pryments ^ You. do not have a monWy escrow payment for Items, s{xh properly taores and haneowrrer's Insurance. You must pay tlress Ifem~s elf y yonrseR. 0 You have an additlornsl mornttnly escrow paymsN of 123$.76 ~ resWh In a told INtlel monhly emceed owed d 51,33624. This foci principal, INnrresi, array mortppe instrance end ary items k Below: © property faxes ^X Homeowner's pus ^ Floodineurancs ^ ~, ^ ^ Nobs: K you love cry questlona abort the SdderneN Ctnrpss end loan Terms Ifated on this fonrn, gloves contact your lender. _ I 'i Prps 3 d 3 L IUD-1 I ~ HUD-1 Addendum Borrower(s): Heather L. Stties Seller(s): Estate of Duayne J. Omer. 11 Vi~ge Drive 8423 Lee Highway- Mechanicsburg, PA 17050 '~ Arlington, NA 22205 ', Lander. Navy Federal Credit Union " Seltlemerrt Agent: TuckerArensberg Real Estate Service Corporetion (717)234-4121 Piece of setttemerrt: 111- North Front Street _ Harrisburg, PA 47108 Settlement Date: September 24, 2010 Property location: 11 VGlage Drive ~ Mechanicsburg, PA 17050 '~, Cumberland County, Pennsylvania Additional Disbursements i Payee/Descriptlon Note/Ref No. Borrower ~ Seller ~- Debra Besehore Wiest 11.;584.30 2010 school tax Silver Spring Township Authority Sewage due Total Additional Disbureements shown on Line 1305 ; o.oo; i Adjusted Origination Charge Details Origt~ation Charge to Navy Federal Credit Union Origination CredlUCharge (points) for the speettic interest rate chosen Discount poirrts 0.250% to Navy Federal Credit Union ~ 3j837.00 Total i ' 3 837.00 I Total ;_; Adjusted Origination Charges ; x12.50 512.50 Reserves Depastted with Lender Homeowner's Insurance 2.000. at 61.27 per month CitylTown Taxes 7..000 at 46.74 per month Assessments 3.000 at127.75 per month Aggregate adjustment month Total ~I 122.54 'i 327.18 '~ $83:25 -361.43 Title Services and Lenders,Tille Insurance Details BORROWER ' SELL ~Wlre fee ~ 10.00 to Tucker Arensberg Real Estate Service Corporation Overnight fee 15.00 to "Tucker Arensberg Real Estate Service Corporation YMRNMKi: a is a «kn. to 1a~owrnply mdot falw WRwmnb to the Unibd BhDss ai rhrr or eny MrNlr ram. P~nela~s upon con an hrclud~ n flm end Imprteonmw~t For detalh ee•: Trgn 1a U.a. Codn 8netlon 1007 and S~.tlon 1070. _~ HUD-1 Addendum - Continued Document preparation to TudcerArensberg Real Estate SeMce Corporation Closing service letter to Fidelity National .Title Insurence Company Lender's title insurence to FldeHty National Title Insurance Company Total Owners Title insurance Owners Policy Premium to Fidelity National Title Insurance Company Total 150.00 150.00 75.00 150.00 ~~ ; .400.00 ; .160.00 BORROWER ', SELLER 1,383.75 1,383.75 ; ' 0.00 Lenders Title Insurance 'lass also shown above in Tids aaMws and Landara TIW Inaoranw Detapa BORROWER ', SELLER ~-i--- Lender's Policy Premium tc .Fidelity National Title Insurance Company Lenders Endorsement Charges 150.00 Endorsement Endorsement Charge ~ Total ; 160.00 ; ' 0.00 i I~ i ~. i I~, 1A11RIaM0: a h • atone bo ~maiwlnpy malty tMM aaENmna tD a» Unlhd Bhlw on thb w.argr simfiar form. Penalaw upon osn~ lna.d. a One and r~d.onm.na r~ d.wls...: title v us. cod. sadbn scot .nd aeeaon rota =wt2s~at yep ~, ~~ i ~'a.~ - ~~d -~ ~~~~~ ~7~~~'~ ~~~~ Prtidentiel ~ar~putershare ~' Computers~art~ Trust Company, NA. ~ PO Box 43033 Prtovi emce, RI 02940-3033 Within USA, US territories Fr ~n d~ 800 305 9404 IMPORTANT TAX RETURN DOCUMENT ENCLOSED Outside USA, US territories Fr n da 732 512 3782 ~.. D 0119 5 www.cor~p ershare.com/trnestor Il~rll'llll~ldl~l~~~~~~llll'1~1'~I~I'u~'ll~l~ll"1"i~~~llrirrl ~~, Recipient JOYCE 0 STILES EX EST DUAYNE J ORNER i 6423 LEE HIGHWAY ~ Hader Atxotmt Number ARLINGTON VA 22205 000312849'i11 FID S8NITN CertMed I Yss 3~nbol ' PRU ~~P 744320102 otncsooo~su..cxacrn i!~i~i~omi9srooti9sri Ptudentia{financial, Inc. -Sale Advice 12©1O Tax Folrm 1099-B '~ Corrected (if t~Clced) Copy B -For Recipient Acca,nt N m 0031284611 Form 1Q99-B -Proceeds from Broker and Barter F~cchange Transactions 2010 ~dPle~' ID 32~11s951 Payers F I Ip No. 431912740 Thk k taX irbrrnatlon and k bsing fumklted to the Inbred Reverwe Service. H you a-e required b flk a reh~m, a negligenee OMB No °~ 1545-0715 peudly a oUur srxtlon rtry bra krrpoeed on you p thk Irroome k tsxsbk and the IRS dwrminea that k has not been reporbd, . JOYCE 0 STIES EX EST DUAYNE J ORNER nt of the Troesury -Memel I~wnue Service Recipient 6423 LEE HIGHWAY ~ ARLINGTON VA 22205 i J to Date of Sala 10 CUSIP No z Sttxks, Gross Proceeds ' tx Exchange . Bonds, etc. (~) Reported to IRS I Payer s Deiails 17 Aug ZO10 744320102 2.161.38 Yes I 006PUTERSHARE FEDERAL NCOME ~ ~ ~ ~ P.O. BOX 43010 TA1C WITHMEtD (s) --- [?eStx(ption: Name of Issuer Transaction PROV®ENCE RI 02940.3010 0.00 PRUDENTIAL FMANCUIL INC ,Sale - C01 NOTE: Compulershare wig report the amount in Box 2 to the IRS. The differerx~ tretween the gross proceeds amo~t in Box 2 and the net proceeds you received repesenls any fees, charges, or wiflrltolding taxes you rosy have paid • ~~ ~ • ~ • ~~w ineep Tor your recoms) Summary Thia advice re a result of tfie sale of Plan arMlor Direct Regbtlation shares. Trails ! ' __ SharesNnits Transaction Description Prins Per I Gross Amount I Deduction ~I I Dsduction Net Amount Dattafl ime I ~ Sold ShareNnit (;) of Sales (;) Amoutrt (;) '~, Type I of Sale (;) 081171201009:30 Sale 39.000000 55.420000 2,161.36 24.12 ' rahaatflion Fee 2,137.. 1 .--> Cartptlretrare Tent Conpary, NJ1- as sgettt upon tvrflYn request, vii provide fire name d the exeaNtg brabr deeir aaodsted tvflh the baneadbn(s~ and rrflNn a atrtorsrt d tlrne vA dkcbee the eauroe and amount of catrrpsrrstlon tsoehred icm ltid psrflse h oomscflon vdtlt the transerflfar(s). N arty. fl trade time k oat irtclurled above, k my bs avelehle upon welflen 71 UTX P R U 'E' i 001CD70008 mWx~c~m -- - i EXHIBIT E ~~cc~~nt Information System Output for KATHLEEN BENEFIEL tJ ~.~ U ~ ~~'~ ~~' Sb l~f. A 410 056142 015 2 5/14/10 1 DUAYNE J ORNER 1~0~ 01/27/30 STD WORK (718) 917-1708. HOPVIE (717) 766-9614 TOT-FOR ACCT CSH SWP=AAA/BDPS TYP CASH'A~,A TEFRA=O REV SUMMARY 23=MAY09/APR1~0 O=JAN10/APR10 I O=APR10 1 T.D. CASH BAL 0.00 CR 5 MKT VAL LONG POSITIONS ', 18,113.00 CR 2 S.D. CASH BAL 0.00 CR 6 MKT VAL LONG OPTIONS 0.00 CR 3 CSH AVAILABLE 0.00 CR 7 MKT VAL SHORT POSITIONS I 0.00 CR 4 MTHLY,'ACC INC 0.00 CR 8 MKT VAL SHORT OPTIONS 0.00 CR 9 MNY MKT BAL BDPS 606 CR VAL BELOW FOR PR1'C D POSIT ONLY 10 MKT VAL CUSTODIAL POSIT 2,422 CR 11 TOTAL PENDING DB/CR 0 C ACCT VAL Y.E. 12/'0 ~ 17,186CR 12 TD ACCT VL(1+5+6+9+10-7-8) 21 142 CR ACCT VAL M.E. 04/1 21,844CR 13 TD LONG HOLDGS VAL(5+6+10} 20,535 CR PROJTD CASH JUN/A~U 107+ 14 TD INVESTABLE FUNDS(1+9-4) 606 CR PERCENT INVESTED',( 3/12) 97 - - RECAP OF RECENT ACTIVITIES - - 05/11 SSW- BALLARD POWER SYSTEM INC ...... 0.00 05/.11 SSW+ BALLARD POWER SYSTEM INC ...... ' ! 0.00 04/30 DIVN PIMCO TOTAL RETURN C ...... 3.61CR 04/30 DEL 0 PIMCO TOTAL RETURN C ...... ! 0..00 04/30 DRP 0 PIMCO TOTAL RETURN C 11.13 3.61DB 04/29 BOT 0 BANK DEPOSIT PROGRAM 1.00 O.O1DB 04/29 CPN MORGAN STANLEY SANK N.A. ...... ', O.OlCR A 410 056142 015 END 5/14/10 2 ASSET ALLOCATION FOR MS POSITIONS CASH + MMKT = 3~ EQUITIES = 86~ DUAYNE J ORNER BONDS = 0$ OTHER = 11~ . C.CUSTODTAT, POSITIONS j I MARGINED/ DATE ISSDT QTY/YLD SYMBL MGN PLAN NR DIV RE PRICE VALLtE POLICY # 5/14 606.700 BANK DEPOSIT PROGRAM 1.00 60~. 0 5/12 217.475 PTTCX NETWORKED 1 11.14 2,422,. 7 PIMCO TOTAL RETURN C '' 0 .Cash 'POS 1 OF 3 5 j 03 / 11 0 0.00 T/~ 0.00 S/D 18,113.00 MKT , SECURITY RTG PRICE UNITS MKT V1~L BALLARD POWER SYSTEM INC N/O .2.22 17.Ob0 BOEING CO -U 69.82 251.412 175 HEWLETT PACKARD O 47.43 11.000 ,,~ 0.00 CSH U'E SYMBOL 37 BLDP 53# BA 21# HPQ Morgan Stanley Confidential Data - not an v„~icial statement Page 1 of 1 oaday, May 17,2010 4:19 pm I 'G EXHIBIT F Heilm>I~n. Dawn From: Jackson, Aaron Sent: Thursday, July 29, 2010 3:09 PM To: Heilman, Dawn Subject: FW: Omer Aaron C. Jackson, Esq. 111 North Front Street ~ Harrisburg, PA 17108 Phone: 717.221.7983 ~ Fax:717.232.6802 vCard ~ Bio ~ Website ', THIS TRANSMISSION IS INTENDED ONLY FOR THE USE OF THE ADDRESSEE AND MAY O TAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL, AND EXEMPT FROM DISCLOSURE N ~R APPLICABLE LAW. IF YOU ARE NOT THE INTENDED RECIPIENT, OR THE EMPLOYEE OR AGENT RESP SABLE FOR DELIVERING THE MESSAGE TO THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIE T MT ANY DISSEMINATION, DISTRIBUTION, OR COPYING OF THIS COMMUNICATION IS STRICTLY R I'IIIBITED. IF YOU HAVE RECEIVED THIS COMMUNICATION IN ERROR, PLEASE NOTIFY US IMMEDIATELY. From: Szall, Karen P. [mailto:Karen.Szall@aspirefcu.org] Sent: Thursday, July 29, 2010 3:08 PM To: Jackson, Aaron Subject: RE: Orner Aaron, The date of death value for our member, Duayne Omer, is $1025.09. You're Welcome, Karen From: Jackson, Aaron [mailto:ajackson@tuckerlaw.com] ', Sent: Thursday, July 29, 2010 3:05 PM ', To: Szall, Karen P. Subject: Orner Hi Karen, Pursuant to our telephone conversation, thank you for supplying the date of death value for the'i Orner, number 9395. Thanks, Aaron 1 unt of Duayne n EXHIBIT G _ ~ __ . _-, - __ Jun, 17. 2010 2;46PM PNC BANK 412-105-2747 No, 4504 P. 1 I ~P1VC ~w~Y June ~ ~, 201 a Amon Jackson Tucker Are~sbcrg P.C. 111 N Front St Harrisburg, PA 17108 RE: Dwayne J Omer SSN: 188-20-6009 DOD: OS-15-2010 Dear Mr. Jackson: In. response to your request for Date of Death (DOD) balances for the customer records show the following: Cl'teckin$ Account Account ~ 5080567439 ~~ DUAYNEJORNER DOD balance: $ 14,922.84 ± 0.22 accrued interest Savi~a~s Account Account # 50062$4537 ~~ DUAYNE]ORNER DOD balance: $15,968.67 + 1.18 accrued interest Loan Account The decedent maintained Loaa Account 4001008109570202. For further inform please contact 1-888-762-2265. Select option 1, then option 3 and then 0 (zero). please xemain on the line to speak with a t,oan Financial Service Consultant. . Please note that this offitce provides data of death balances for daposrt accounts (IRAs, C Savit-gs). We do not process any Baanclal transactions or provtda e~tatemenb. If you e any of these ittms, pleax call 1-888-PNC-BANK (1-888-762-2265) or Stop by yow local offica. Sincerely, National~Fina~ncial Services Center PNC Bank, N.A~ Member FDIC Page 1 of 1 ~_ above, our :08-04=1995 03-24-2008 nd assistaace, P~~ ~0. ;hacking and assistsacc with C Bank branch EXHIBIT H 'Good Fair • CloseCloseClose~ ~~ ~~~ ~• SEARCH LOCAL LISTINGS ~20~ C~ S- ~ ~oo~ BLUE BOOK° PRfVATE PARTY VALUE >wMar s THIS Y' EXHIBIT I Calculated Vafue of Your Paper Savings Bond(s) Page 1 of 1 Calculated Value of Your Paper.Savings Bond(s) Calculator Results for Redemption Date 05/2010 Total Price Total Value Total Interest YTD I~nt mast 13 000.00 13 147.60 147.60 5 .2 Bonds: i~~fi of 26 Issue Next Finai Serial # Series Denom pate Accrual Maturity Interest Issue Price.' Interest Bate ',.Value Note EE M84885938 EE ; $1,000.04/2009,.06/2010; 04/2039 _. _,$500.00;,__ , $5 20 . 1 304~r ~ ,$505 20 P5 „ . M84921676EE EE $1,000 , 05/2009:,06/2010; 05/2039 _ $500.00. $2 40 0 70_ _, _ $502 40 _P5_, M84968473EE EE .. $1,000 06/2009 06/2010; 06/2039; ,..$500._00; _$2 00 OJO $,502 OO NE M85019$89EE„ EE _$1,000.07/2009 06/2010.'..07/2039 __,..$500 00;, ..$2 00 _, _.0 700/ ;.$602 00.,. NE. _ M85362540EE EE $1,000.02%2010.06/20,10_y 02(2040.,. ... $500 00 _$0 00 1 20 X500 00 NE _ M8532Z932EE _ EE _ $1,000.; 01%2010,; 06/2010.,,01%2040 , ., $500.00 .. ......0..40.,.. ..1 20% . ., , X500 40 ._ NE , M85277792EE; ., EE .. $1,000;12/2009:06/2010! 12/2039 $500..00; _$0 80,.. _.1,200/ _ ,$500 80! NE M85419320EE EE 03/2010.; 07/20l0,µ.03/2040.,, .,$1,0,00. .. $500 00 _ ., $0 00,_., ..1.20% ,_ ....5500 00,,.. NE _ _. M85066947EE _ EE , $1,000 06f2009..06/2010; 08(2039_;, . _.$500 00;_. ,_ $1 60 ,. 0 7001 . , ;.5501 60:_ :NE._. . M85105974EE _ .. EE .__ ,09/2009,06/2010:,_09/2039 $1,000 , $500 00 $1 fi0 0 700! 5501 60 NE . _ M85160922EE ._ ._ EE . _ $1,000_,10/2009 ~ 06/2010_; 10(2039. , .. _$500.00 ,... ., $1.20: , 0 70.. , e _ . X501 20 NE .. ~ M85239814EE _. EE li/2009:06/2010.11/2039.. ~1,000 ._ $500.00_,_ __$160 1.20°. , ..,5501,60 NE _ M84667731EE EE _ . 06j2010__.12/2038 _ $1,OOQ,12J2008 _.__. $500 00,.__ ,_ ~7 60,; _ 1 30_ _ ,#507 60. P5 __ M84723974EE . _. EE . . $1,000., 01/2009.; 06/2010_. 01/2039_ . „ _ $500.00,. _.. $6.80 1, 30°I ._ ,_ ',5506.80___ .PS. , ,. M84771419EE .. EE „ , $1,000.02/2009 06%2Q10. 022039., .,._ ,.$500 00_.. _ _$6 40.,__ ,.1 30°1 . ..,,#506 40... . PS.. M84817080EE _ EE „ $1,000,03/200906/2010_; 03/2039__ 2 10 0 ,.,,_„_._.$500..00,, 0 ' ..,_,.$6 00, 80 0 1.30°/d 1 400rq ' X506.00, 510 80` P5_ P5 M84451554EE EE 038 6%20 ; 08/ $1,000:08/2008 $500. 0 ' $.1 . . . $ __. __ , ., ., 06499EE M845 EE 8 $1,000 09/2008.06/2010 09/2 0 $500 $ ,. . , M84558346EE „EE ,.$1,000_,10/2008',06/2010„ 10/2036.,, __..$500 00,. ._ $9.60,. .1.40 _.__ . M84612092EE EE_ .$1,000..11%2008__06(2010, 11/2038_, _ $500 00, _ _: $8 00 1 30... ; __ _ 43381EE M842 EE $1,000,04%2008 06/2010_. 04/2038 _ .,. $500_.00! $28 00;_ 3.000/ ..„ . M84295396EE, EE $1,000.,05/2008:06/2010 .05%20,38 $500,.00;_ _$12 40.;,,,, .1.400/ _ _. M84348922EE __EE. ._$1,000_,06/2008.;06/2010. 06j2038_, ., $500 00 ,.$12 00. 1.40% __. . _. M84401473EE EE _07/2008 06/2010. 07/2038...,, _$1,000 . $500,00;. ._$11 20 __ 14% „ M854712827EE _ EE . $1,000.,04/2010.,08/2010 04(2040_ ,,,. ...,..$500 00 ,.. $O.OQ 1 20°! 0:_. , M85512949EE~ EE .,. $1,000;05/2010 09/2010; 05/2040. $500.00; ,.,$0.00 1.40% ; Totals for 26 Bonds i 513.000.00: 8147.60 10 00 1 40 ~ te+n nn: o~ 0 03 I $ Notes NI -Not Issued .. . _. . NE Not eligible for payment _.. _ PS :Includes 3 month interest penalty _ _ _ _.. MA :Matured and not earnin interest http://www.treasurydirect.govBC/SBCPrice P5 rvv.vv: r.r ~2a 00_ P5_ _ .. ~12.40i P5 _..... ~12.d0! P5 ~ ~ ww nr 500.00 NE 500.00, NE 147.60' 7/29/2010 EXHIBIT J tic~~unt. Ynformation System Output . for KATHLEEN BENEFIEL A 410 051868 015 2 5/14/10 1 DUAYNE J ORNER DO~ 01/27/30 STD WORK (718.)917-1708. HOIptE (717)766-9614 SWUNG FROM 487 095724 ON 03/13/00 TOT FOR ACCT CSH SWP=TRA/BDPS TYP: OP I11tA TEFRA=2 REV $UNIlKARY 206=MAY09/APR10 2=JAN10/APR10 1=APR10 1 T.D. CASH BAL 7.20 DB 5 MKT VAL,LONG POSITIONS 6,370.00 CR 2 S.D. CASH BAL 7.20 DB 6 MKT VAL LONG OPTIONS 0.00 CR 3 CSH AVAILABLE 0.00 CR 7 YTD TAXES WITHHELD I 0.00 CR 4 MTHLY ACC INC~ 0.00 CR 8 MKT VAL SHORT OPTIONS 0.00 CR 9 MNY MKT BAL 0 CR VAL BELOW FOR PRI~C 1~ POSIT ONLY. 10 MKT VAL CUSTODIAL POSIT 21,186 CR 11 TOTAL PENDING DB/CR ACCT VAL Y.E. 12/0 25,277CR 12 TD ACCT VL(1+5+6+9+10) 27,552 CR ACCT VAL M.E. 04/1 27,739CR 13 TD LONG HOLDGS VAL(5+6+1OJ 9 CR PROJTD CASH JUN/A~U 38+ 14 TD INVESTABLE FUNDS (1+9-4) 7 DB PERCENT INVESTED','i,_(, 3'/12) 100 CURR YR DEDUCTIBLE CONTRIB 0 PRIOR YR DEDUCTIBLE CON~'r 0 CURR YR NON DEDUCT CONTRIB 0 PRIOR YR NON DEDUCT CONfT 0 DISTRIBUTIONS THIS MONTH 0 DISTRIBUTIONS THIS YEAR; ; 0 -- RECAP OF RECENT ACTIVITIES -- 04/30 DIV 31.78 PIMCO TOTAL RETUR { 04/30 DEL 2 PIMCOI.d,TAL RETURN 04/30 DRP 2 PIMCO TOTAL RETUR { 03/31 DIV 30.91 PIMC0~1 O!TAL RETURN ~~ A 410 051868 015 END 5/14/10 2 DUAYNE J ORNER ASSET ALLOCATION FOR MS POSITIONS CASH + MMKT = 0~ EQUITIES = 23~ BONDS = 0$ OTHER = 77~ C.CUSTODIAL POSITIONS DATE ISSDT QTY/YLD SYMBL MGN PLAN NR DIV RE PRICE VAL 5/12 1,902.020 PTTCX NETWORKED 1 11.14 21;18, d PIMCO TOTAL RETURN C O.Cash POS 1 OF 1 5/03/]0 7.20 T/D 7.20 S/D 6,370.00 MKT SECURITY RTG PRICE UNITS MKT ~ i,7 BOEING CO -U 69.82 91.247 6 MARGINED/ POLICY # 0.00 CSH SYMBOL R BA Morgan Stanley Confidential Data - not an o,~cial statement ' li Monday, May 17,2010 Fage 1 of 1 - ~, 4:20 pm