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HomeMy WebLinkAbout11-12-10DECEDENT'S ESTATE COURT OF COMMON PLEAS OF Cumberland .COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION N Q "~' G ~+'~ ESTATE OF Janet W. Bender -° DECEASEI~n C~ ° ~ ~~ • c 5 ~_ ; ~7 r, r ~-2 N ~~ ~ No. 21-08-0796 ~~'~ C7 c.7 "O 4 ~ :_ .. . , , N ',.- c•o r~ p W °-' PETTTION FOR ADJUDICATION / N STATEMENT OF PROPOSED DISTRIBUTION PURSUANT TO Pa. O.C. Rule 6.9 This form may be used in all cases involving the Audit of the Account of a Decedent's Estate. If space is insuj~cient, riders may be 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 BAC% OF THIS FORM. Name of Counsel: Stacy B: Wolf, Esquire Supreme Court I.D. No.: 88732 Name of Law Firm: Wolf & Wolf, Attorneys at Law 10 West High Street, Carlisle, PA 17013-2922 Telephone: 717-241-4436 Fax: 717-241-4437 Perm oc-ol rev. 10.13.06 Page 1 of 10 Estate of Janet W. Bender 1. Name(s) and address(es) of Petitioner(s): Name, William J. Heiser Address: 911 Burnthouse Road Carlisle, PA 17015 Deceased Erma L. Heiser 911 Burnthouse Road Carlisle, PA 17015 Identify any executors or administrators who have not joined in the Petition for Adjudication and Statement of Proposed Distribution and state reason: n/a 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 July 12, 2008 ® Letters Testamentary or ^ Letters of Administration were granted to Petitioner(s) on Julv 31.2008 Date of Will (f applicable): Apri126, 2005 Date(s) of Codicil(s) (if applicable): n/a Date of probate (if d ~erent from date Letters granted): n/a 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: November 13,20,27 & December 4, 2009 Form OGOl rev. 10.13.06 Page 2 of 10 Estate of Janet W. Bender Deceased 3. Was decedent survived by a spouse? ............................. ^Yes m No If yes, name of the surviving spouse: 4. Has the surviving spouse filed to take an elective share? ............. ^Yes ^ No (See Section 2201 et ~. of the Probate, Estates and Fiduciaries Code) If yes, date of election: 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 decedent marry after execution of Will or Codicil(s)? ........... ^Yes m No Were any children born to decedent after execution of Will or Codicil(s)? ........................................... ^Yes m No If yes, give names and dates of birth: Name: Date of Birth: 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? .............................. mYes ^ No Fo„nOG01 .ev. io.~3.06 Page 3 of 10 Estate of Janet W. Bender 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 the 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 Church of Christ 971 Walnut Bottom Road Carlisle, PA 17013 ana Charitable Beneficiary ~ 100% residuary Farm oc-ol rev. 10.13.oh Page 4 of 10 Estate of Janet W. Bender Deceased C. State why a Petition for Guardian/T'rustee Ad Litem has or has not been filed for this Audit (see 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-or rev. 10.!3.06 Page 5 of 10 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. Estate of Janet W. Bender 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 aJClaim Claim Admitted? Will Claim Be Paid In Full? NCO Financial Systems, Inc. for $1024.00 mYes ^Yes Carlisle Regional Medical Center ^No mNo P.O. Box 15273 Wilmington, DE 19850 NCO Financial Systems, Inc. for $33.35 ®Yes ^No ^Yes mNo Carlisle Regional Medical Center P.O. Box 15273 Wilmington, DE 19850 Kinetic Imaging, Ina $11.21 mYes ^No ^Yes mNo 4520 Union Deposit Road Harrisburg PA 17111-2910 Carlisle Cardiology Associates $256.41 mYes ^No ^Yes mNo 850 Walnut Bottom Road, Suite 102 Carlisle PA 17013 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? ................................ ^Yes mNo Was family exemption allowed? ................................ ^Yes mNo Family exemption claimant's name and relationship: Name: Relationship: Farm oc-ot rev. I0. [3.06 Page 6 of 10 Estate of Janet W. Bender 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 ojEach Claimant Amount ojClaim Claim Admitted? WiU Claim Be Paid /n Full? Apex Asset Management for .$358.46 mYes ^Yes Physician's Alliance Ltd. ^No ®No 1891 Santa Barbara Drive #204 Lancaster PA 17601 .Apex Asset Management for $1089.97 mYes ^No ^Yes mNo Carlisle Physician Management 1891 Santa Barbara Drive #204 Lancaster PA 17601 Alexander Springs Emer. Phys. $53.38 mYes ^No ^Yes mNo P.O. Box 37720 Philadelphia PA 19101-7720 Blue Mountain Anesthesia Assoc. $78.96 ®Yes ^No ^Yes m No P.O. Box 947 Chambersburg PA 17201-0947 If the estate is insolvent, attach a schedule setting forth the order of preference under 20 Pa.C.S. § 3392 and the proposed payments. 1 L Was family exemption claimed? ................................ ^Yes p~No Was family exemption allowed? ................................ ^Yes ~No Family exemption claimant's name and relationship: Relationship: Form oc-or rev. lo.r3.oe Page 6 of 10 ~~'~ h~ Estate of Janet W. Bender 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 ofEacA Claimant Amoanr of Claim Claim Admitted? Will Claim Be Paid In Full? Eastern Account System of $28,78 mYes ^Yes ^No mNo Connecticut, Inc. for Comcast P.O. Box 837 Newtown CT 06470-0837 Embarq $43.43 ®Yes ^No ^Yes mNo P.O. Box 96064 Charlotte, NC 28296-0064 J.C. Christensen and Associates, Inc. $940.68 ®Yes ^No ^Yes mNo for AAC/Fingerhut P.O. Box 519 Sauk Rapids MN 56379 CBCS 24 for PPL $213.22 mYes ^No ^Yes mNo P.O. Box 164059 Columbus OH 43216-4059 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? ................................ ^Yes ~No Was family exemption allowed? ................................ ^Yes ~No Family exemption claimant's name and relationship: Relationship: Form OC-Ol rev. !0./3.06 Page 6 of 10 A~a~~tl~ 4 Estate of Janet W. Bender ,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 /merest n/a 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 m No If yes, provide the 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 questionsrequiring 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. Farm oc-Or rev. 10.13.06 Page 7 of 10 Estate of Janet' W. Bender Deceased 16. Had they decedent been adjudicated an incapacitated person? .......... ^ Yes m No If yes, attach a copy of the Order if available; otherwise state the 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. B. Has tiotice of the additional receipts and disbursements been given to the parties identified in Paragraph 9 above? ............. ^Yes ^ No 18. If a reserve is requested, state amount and purpose. ,____. 345.67 ru,~s~: Additional attorney's fees and miscellaneous costs associated with service of notice of the instant petition upon all creditors and interested parties. 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? ........................................ mYes ^No If so, attach a copy of the notice. 19. Is the Court being asked to direct the filing of a Schedule of Distribution? .......................... mI'es ^ No As to real estate only? ........................................ ^Yes m No Form OC-01 rev. 10.13,06 Page 8 of 10 Estate of Janet W. Bender 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 Distributee(s) Amount/Proportion n/a B. Principal Proposed DuMbutee(s) AmounNProportion n/a Submitted By: (All petitioners must sign. Add additional lines tf necessary): ~~ . ~ - ~~~__ , Name of Petitione illiam J. Heiser ~i~~~~~~Dd ei~P~.~ ame of Petitioner: Erma L. Heiser Porm oc-o~ rev. lo.r3.o6 ~ Page 9 of 10 Estate of Janet W. Bender Verification of Petitioner (Verification must be by at least one petitioner.) Deceased The undersigned hereby verifies * [that heishe he is ade executor of the above-named name ofeorpararivn Estate of Janet W. Bender 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, aRer 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). Signature of Pe ' over * 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. ~ n Form OG01 rev. !0.13.06 Page 1 O Of I O THE CENTRAL PENN BUSINESS JOURNAL Proof of Publication Under the Pennsylvania Newspaper Advertising Act 45 Pa.C.S. §101, etsey. Commonwealth of Pennsylvania ; SSj County of Dauphin Jerome Zary, being duly sworn according to law, deposes and says: That he is the controler of and duly authorized agent for JOURNAL PUBLICATIONS INC., a corporation organized and existing urider the laws of the Commonwealth of Pennsylvania, with its principal office and place of business at 1500 Paxton Street, in the city of Harrisburg, County of Dauphin, State of Pennsylvania; that the THE CENTRAL PENN BUSINESS JOURNAL, a newspaper of general circulation distributed and circulated in Dauphin, Cumberland, Lancaster, Lebanon and York counties , is published by the said JOURNAL PUBLICATIONS INC. at 1500 Paxton Street, in the City, County and State aforesaid; and that THE CENTRAL PENN BUSINESS JOURNAL was established September 9th, 1984 and has been continually published ever since; That the printed notice or publication which is securely attached hereto is exactly as printed and published in the weekly editions/issues of the CENTRAL PENN BUSINESS JOURNAL which appeared on the 13rh 20rh and 2Th day(s) of November 2009. That neither he nor said Corporation 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 This is a statement published by 70URNAL PUBLICATIONS INC. PUBLICATION COPY ESTATE NOTICE Letters testamentary in the Estate of Janet W. Bender, deceased, late of Carlisle Borough, Cumbedand County, Pennsylvania, who died July 12, 2008, have been granted to the undersigned. All persons having claims against the estate of .the decedent shall make known the 'same to the undersigned or their attorney and all persons indebted to the decedent shall make payment to the undersigned without delay. William J. & Erma L. Heiser t:/o STACY B. WOLF, ESQUIRE WOLF 8 WOLF, ATTORNEYS AT LAW 10 West High Street Carlisle, PA 17013 717-241-4436 f~ %7 ~~~. Jerome Z Sworn to and subscribed before me this Ol ~ay of 1 \,~"/-09 .4. D. NOTARY PUB IC .,._~_:. _NGTARIA~ LSEAL~`....._.._....-,. - Heather Marie Beshom NGTARY PUBLIC City et :`+??chanicsburg, Cumberland County _ Mrun~s,on Ex~res 08122/2010 Publisher's Receipt for Advertising Cost JOURNAL PUBLICATIONS INC., publisher of the CENTRAL PENN BUSINESS JOURNAL, newspaper of general circulation, distributed and circulated in Dauphin, Cumberland, Lancaster, Lebanon and York counties, hereby acknowledges receipt of the aforesaid notice and publication costs and certifies that the same have been duly paid. THE CENTRAL PENN BUSINESS JOURNAL Rr. Estate of Janet N'. Bender By ........................ _............. _....................... \YOLF & WOLF, ATTORNEYS AT LAW 10 West High Street Carlisle, PA 17013 Attention: STACY B. WOLF, ESQUIRE 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, v1z: November 20 November 27 & December 4 2009 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 hatter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. ~`-~ ~-' Marie Coyne, Bender, Janet W., decd. Late of Carlisle Borough. Executors: William J. and Erma L. Heiser c/o Stacy B. Wolf, Es- quire, Wolf do Wolf, Attorneys at Law, 10 West High Street, Car- lisle, PA 17013. Attorneys: Stacy B. Wolf, Esquire, Wolf & Wolf, Attorneys at Law, 10 West High Street, Carlisle, PA 17013, (717) 241-4436. r-8'WORN TO AND SUBSCRIBED before me this 4 day of December, 2009 ~. / f,. r ~ / J ... ~.~ .~_,~. fem.-~.; r ~ >?. ~'~ ;:~ ~~_., .. ;k._ Notary ^fOL4Rlkl SEAL ~ ~~~~!t;.l. tCLri, CL 4lti'L:.PJt7 CCri."J'i~" t,~ r.o~ - ~ ~ ~ r ~ Y s: ~u. f , ,i P, ,gyp; : ft, 2.,7 U ;nom..-.... ~~_,-:,s. ._ __9.w a..,-~_,. , Proposed Schedule of Distribution of Unsecured, Non-Priority Debts, Pursuant to 20 Pa.C.S. §3392 of the Estate of Janet W. Bender, Deceased File No 21-08-0796 Undistributed Principal on Hand Stacy B. Wolf, Esquire -Counsel Fees Reserve for expenses/court costs Creditor Comcast Embarq AAC/Fingerhut PPL Claimed Amount $ 28.78 $ 43.43 $ 940.68 $ 213.22 Total $ 1,226.11 $ 345.67 $ 300.00 $ 45.67 Proposed Payment $ - $ - $ - $ - $ - $ - $ - Schedule Required per Question 10, page 6 Wow & WOLF NATHAN C. WOLF ATTORNEYS AT LAW 10 WEST HIGH STREET C?,RLISLE, PENNSYLV.~NL~ 17013 wolfandwolf a,embardmail.com STACY B. WOLF PHONE 717-241-4436 Carlisle Church of Christ 971 Walnut Bottom Road Carlisle, PA 17013 November 12, 2010 Re: Estate of Janet W. Bender, Estate No. 21-08-0796 Dear Sir or Madam: FACSIMILE 717-241-4437 Enclosed, please find a copy of the First and Final Account and the Petition for Adjudication of the Estate of Janet W. Bender, which was filed with the Court today on behalf of William and Erma Heiser, the executors of the estate. As you will see, there were not sufficient funds to provide for a distribution to you, because there were no funds left after the costs of administration of the estate were paid. Even the claims of the various creditors were unpaid because there were not sufficient funds. Nevertheless, as a potential beneficiary of the estate it is my duty as your counsel for the executors of the estate, to provide you with notice of the filing of the Account and the Petition so that any objections to the account maybe raised. I am also providing notice to you in accordance with the Pennsylvania Rules of Orphans' Court concerning the request being made to the Court for a reserve amount for counsel fees to be paid to my office in the amount of $300.00. Please note that you do have the opportunity to object to any reserves requested or other distributions proposed until the schedule of distribution and the account submitted for the estate is confirmed on January 11, 2011. Please take note that the Account will be presented for confirmation in Courtroom No. 1 of the Cumberland County Courthouse, Carlisle, Pennsylvania at 9:30 a.m. on Tuesday, January 11, 2011. Objections to the Account must be filed in writing at the Office of the Register of Wills, Cumberland County Courthouse, PA not later than 9:00 a.m. on Tuesday, January 11, 2011, with a copy served upon me. In the absence of Objections, the Account will be confirmed on January 11, 2011 and the Estate will be closed with the Court approving the proposed zero distribution to you as set forth herein. If you have any questions, please feel free to contact my office. Thank you for your time and understanding in this matter. Enclosure Very,.truly you/r~s, I ~ ' ~ J L~~ Stacy B olf . ~~~~ ~~ IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION N0.21-08-0796 ESTATE OF JANET W. BENDER, DECEASED LATE OF CARLISLE BOROUGH, CUMBERLAND COUNTY FIRST AND FINAL ACCOUNT OF WILLIAM J. & ERMA L. HEISER, EXECUTOR(RI7s7 Date of Death: July 12, 2008 Letters Testamentary Granted: July 31, 2008 First Complete Advertisement of Grant of Letters: November 20, 2009 GROSS ESTATE: (Total of Income and Principal Receipts) $ 1,748.67 SUMMARY AND INDEX PRINCIPAL Receipts $ 1,748.67 Less Estate Expense, Debt Disbursements & Repayment rv of Loan Funds paid to Estate for Expenses $ (1,403.00) C-7 ° -r-~ D Less Reserves for Unpaid Expenses $ 345.67 ( ) .77 ~ 7~ ~ < ~? O .. ~ Adjusted Balance $ - ~ C ~- tTt ' ^ ' ,~_ C.n 1'1 7 , . l Balance before Distributions $ - ~ ~ -'~ '~ ..; `r ~ r ~ N _ ~ Distribution to Beneficiaries of Property $ - ~ ~ ~~ c W Principal Balance Re**+~+*+i*+g $ - INCOME Receipts $ - Income on Investments $ - Less Disbursements $ - Balance before Distributions $ - Cash Distribution to Beneficiaries $ - Income Balance Remaining $ Proposed Cash Distributions to Beneficiaries Proposed Repayment of Liabilities per Schedule of Distribudon $ - Total on Hand (rerenxt already deducted) 3 - Diffemnce $ - PRINCIPAL RECEIPTS 1 F&M Trust Checlung (Account No. 34-57389) $ 800.02 2 Various Personal Property Sold $ 421.25 3 Rent rebate $ 450.40 4 cash $ 77.00 5 $ - 6 $ - 7 $ - 8 $ - 9 $ - 10 $ - 11 $ - 12 $ - 13 $ - 14 $ - 15 $ - 16 $ - 17 $ - 18 $ - 19 $ - TOTAL PRINCIPAL RECEIPTS: $ 1,748.67 2 PRINCIPAL CONVERSIONS INTO CASH GAIN Inventoried at $ - Commissions/Fees $ - Net Proceeds $ Inventoried at $ - Commissions/Fees $ - Net Proceeds $ Inventoried at $ - Commissions/Fees $ - Net Proceeds $ Inventoried at $ - Commissions/Fees $ - Net Proceeds $ Inventoried at $ - Commissions/Fees $ - Net Proceeds $ Inventoried at $ - Commissions/Fees $ - Net Proceeds $ Inventoried at $ - Commissions/Fees $ - Net Proceeds $ LOSS 3 Inventoried at $ - Commissions/Fees $ - Net Proceeds $ Inventoried at $ - Commissions/Fees $ - Net Proceeds $ Inventoried at $ - Conunlssions/Fees $ - Net Proceeds $ Inventoried at $ - Coinmissions/Fees $ - Net Proceeds $ - Inventoried at $ - Commissions/Fees $ - Net Proceeds $ NET LOSS ON CONVERSIONS $ - $ 3 PRINCIPAL DISBURSEMENTS Date Number 7/31/2008 10/11/2007 4/9/2009 2448 01/07/2010 2657 01/07/2010 2656 11/8/2010 Register of Wills - Probate Fees $ (74.00) Attorney Fees $ (1,000.00) Register of Wills -Inheritance Tax Return $ (15.00) Advertising- Central Penn Bus. Jrnl $ (109.00) Advertising- Cumberland Law Journal $ (75.00) Register of Wills -First and Final Account/Advertising $ (130.00) TOTAL PRINCIPAL DISBURSEMENTS Payments for Estate Expenses (Bold Items Above) $ 1,403.00 Authorized Payments of Bills $ _ Subtotal Estate Expenses and Debt Payments Reserves for Unpaid Expenses Wolf & Wolf, Attorneys at Law (Attorney's Fees)* $ 300,00 Misc Costs $ 45.67 *Counsel has reduced fees to ensure all other expenses are paid Subtotal Reserves TOTAL PRINCIPAL DISBURSEMENTS PLUS RESERVES Subtotal Reimbursements of Funds Advanced TOTAL PRINCIPAL DISBURSEMENTS LESS REIMBURSEMENTS & RESERVES S (1,403.00) $ (1,403.00) $ (345.67) $ 1,748.67 $ - $ 1,403.00 4 PRINCIPAL INVESTMENTS DATE INVESTMENT GAIN LOSS Invested $ _ Commissions/Fees $ _ Proceeds $ _ Invested $ _ Commissions/Fees $ _ Proceeds $ _ Invested $ _ Commissions/Fees $ _ Proceeds ~__ _ Invested $ _ Commissions/Fees $ _ Proceeds $ _ Invested $ _ Commissions/Fees $ _ Proceeds $ _ Invested $ _ Commissions/Fees $ _ Proceeds $ _ Invested $ _ Commissions/Fees $ _ Proceeds ~. _ NET LOSS ON INVESTMENTS $ - $ G INCOME DISTRIBUTIONS TO BENEFICIARIES None l~..r~~r. ~ ~~ William J. Heiser, Exec /fir ~~ 1°~6~Y; i d lJ.s~ Em~a L. Heiser, Executrix COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS William J. Heiser, Executor, and Erma L. Heiser, Executrix of the Estate of Janet W. Bender, Deceased, being duly sworn according to law, depose and say that the Account as stated is true and correct and that the Grant of Letters and first complete advertisement thereof occurred ®m~ore than six (G) months before the filing of the Account. Will~i°°am J. Heiser, ~`~~uto~r / Exrna L. Heiser, Executrix Sworn to and subscribed before me this /~ day of /~/oveneb.~ , 2010. Not Public COMMONWEALTH OF PENNSYL Notarial Seal Nathan C. Wolt, Notary Pubifc Carlisle Boro, Cumberland COWyr Ny Commission ExPIAa 1M! Member, Pennsylvania AasOdatlOa IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION N0.21-08-0796 ESTATE OF JANET W. BENDER, DECEASED LATE OF BOROUGH OF CARLISLE, CUMBERLAND COUNTY SCHEDULE OF DISTRIBUTION Amount Available for Distribution as per Account $ - $ - Amount Available for Distribution $ - 74 2 905 Total Amount Claimed , . $ Percentage of Total Amt. Claimed 0.0000% DISTRIBUTION Amount of Claim Amount for DisMbution Carlisle Regional Medical Center $ 1,024.00 5 $ $ Carlisle Regional Medical Center $ 33.3 21 $ Kinetic Imaging, Inc. $ 11. 41 $ Carlisle Cardiology Associates $ 256. Physician s Alliance, Ltd. $ 358.46 97 $ $ Carlisle Physician Management $ 1,089. 38 53 $ Alexander Spring Emer. Phys. $ . Blue Mountain Anesthesia Assoc. $ 78.96 $ $ - $ - Amount Claimed $ 2,905.74 $ - Amount to Be Distributed $ CERTIFICATION ************************************* I hereby certify that the above Schedule of Distribution is true and correct and in accordance with the funds available for distribution. f f ~ ~ r ~,1 (S! PN Dated: AV o >1 I 1 a. d W' m J. Heiser Executor