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HomeMy WebLinkAbout12-29-10DECEDENT'S ESTATE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE OF MARTHA N. BLOSER DECEASED No. 21-10-0274 PETTI'ION FOR ADJUDICATION / STATEMENT OF PROPOSED DISTRIBUTION PURSUANT TO Pa. O.C. Rnle 6.9 This form may be used in all cases involving the Audit of the Account of a Decedent's Estate. If space is insufficient, riders may be attached. Attach the spouse's election, if arty; the papers required under items 8-19 inclusive; and any instrument pertinent to the adjudication. INCLUDEATTACHMENTSAT THE BACg OF THIS FORM. ~ a r~ri ~vs a n N t0 r*1r "D Z Name of Counsel: ROBERT R. SLACK, ESQUIRE ~ ~ tv Supreme Court LD. No.: 6267 ~ w Name of Law Firm: LANDIS & BLACK Address: 36 S. Hanover Street, Carlisle, PA 17013 Telephone: (717) 243-3727 Fax:__ robttblack(a~embaramail.com ~~ cn n-i .'i7 ~j ~~ n -~j ~~~ s•~ oc-or rev. 10.13.06 Page 1 of 10 Estate of MARTHA N. BLOSER , ~~~J 1. Name(s) and address(es) of Petitioner(s): Naae: Wilmer S. B-oser, Jr. .tadre.+e: 1 Subdivision Road Newville, PA 17241 Shirley A. Wickard 23 Subdivision Road Newville, PA 17241 Identify any executors or administrators who have not joined in the Petition for Adjudication and Statement of Proposed DisM'bution and state reason: NONE 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 February 11, 2010 ® Letters Testamentary or ~ Letters of Administration were granted to Petitioner(s) on Date of Will (f applicable): December I, 2008 Date(s) of Codicil(s) (if applicable): None Date of probate (if different from date Letters granted): March 19, 2010 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: Sentinel - Apri13, 10 & 17, 2010 Cumberland Journal - Apri16, 16 & 23, 2010 Form OC-01 rev. 10.13.06 Page 2 of 10 Estate of MARTHA N. BLOSER .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 m No l~gg Section 2201 et seq 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): N/A 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? .............................. ®Yes ^ No For, oc-oi rev. /0.13.06 Page 3 of 10 Estate of MARTHA N. BLOSER 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, ail 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): Interest See the attached Notice & (See Will attached I See Will attached Certification For,. oc-ot rev. to.is.o6 Page 4 of 10 Estate of MARTHA N. BLOSER Deceased 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. None C. State why a Petition for Guardian/Trustee Ad Litem has or has not been filed for this Audit (,deg Pa. O.C. Rule 12.4). None Required 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. N/A F~ oc-oi rev. ID.I3.o6 Page 5 of 10 Estate of MARTHA N. BLOSER ~~~ 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 aid Address oJBac6 Claimam Amomot ofGlaim Claim Wfll Claim Admitted? BePaidln ~s None ^Yes ^Yes ^No ^No ^Yes ^Yes ^No ^ No ^Yes ^Yes ^No ^ No ^Yes ^Yes ^No ^ No 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? ................................ mYes ^No Was family exemption allowed? ................................ QjYes ^No Family exemption claimant's name and relationship: Name: Wilmer S. Bloser, Jr. xe/aanshrp: Son Farms OC-0I rev. 10.13.06 Page 6 of 10 Estate of MARTHA N. BLOSER 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, aze as follows: Date Payment Interest t/6/2t)10 10~12~2010 2.IOO.OU o.00 1,o61.a1 0.00 13. On the date of death, was the decedent a fiduciary (personal representative, trustee, guardian, agent under power of attorney) or surety on the bond of a fiduciary? ................... Q Yes ~ No If yes, provide the name of the estate, indicate whether an account has been filed and confnmed 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. t 4. A. Describe in detail any questions requiring adjudication and state the position of the Petitioner(s) as to each question: None B. Has notice of the question requiring adjudication been given to the parties identified in Paragraph 9 above? .................. Yes ~ No N~A 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. None Form oc-0I rev. Io.I3.06 Page 7 of 10 Estate of MARTHA N. BLOSER Deceased 16. Had the decedent been adjudicated an incapacitated person? .......... ^Yes (~ 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. None B. Has notice of the additional receipts and disbursements been given to the parties identified in Paragraph 9 above? ............. ^Yes ^ No N~A I8. If a reserve is requested, state amount and purpose. ,~ 7,366.56 p`~°~: Probate Costs Advanced 843.04 Landis 8t Black -Attorney Fee 4,000.00 Family Exemption 2,523.52 If a reserve is requested for counsel fees, has notice of the amount of fees to be paid from the reserve been given to the parties in interest? ........................................ Yes ^No If so, attach a copy of the notice. In First & Final Account. 19. Is the Court being asked to duect the filing of a Schedule of Distribution? .......................... ^Yes ^No As to real estate only? ........................................ ^Yes [~ No Fwm OC-01 .~. to.rs.o6 Page 8 of 10 Estate of MARTHA N. BLOSER 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 shazes being stated in proportions, not amounts) are as follows: A. Income: rrepo~xd txmra~ee(..) None B. Principal: Propaxd Dimi6rtee(r) None Amoum/P'roportion Amomu/Proparrion Submitted By: {All petitioners must sign. add additional lines ifnecessary): C!/.~~w, iirJ S. Name of Petitioner: Wilmer S. Bloser, Jr. _~t2Ur1L~l~ .~, Lrr'/ ~ ~~r~ Name of P iti er: Shirley A. Wickard Farm oc-01 rev. 10.13.06 Page 9 of 10 Estate of iNARTFIA N. BLOSER Deceased Verification of Petitioner (Verification must be by at least one petitioner.) The undersigned hereby verifies * [that ~.~ he is ndr Executor of the above-trained ~ ~~.~;a, Estate andJ that the facts set forth in the foregoing Petition for Adjudication /Statement of Proposed Distribution which are within the personal knowledge of the Petitioner are true, and as to facts based on the information of others, the Petitioner, after diligent inquiry, believes them to be true; and that any false statements herein are made subject to the penalties of 18 Pa. C.S. § 4904 (relating to unsworn falsification to authorities). SiS~~na~~re of Petiti ner 7'_ u~ilmer S. B~oser. Jr. * 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. /~rr ~G~ Signature of Counsel for Petitioner kobert R. Black Esquire Fom oao! rev. 10.13.06 Page 10 of 10 PROOF OF PUBLICATION State of Pennsylvania, County of Cumberland Lames Kleinlclaus Director of Sales and Mazketin of The Sentinel, of the County and State aforesazd, being duly sworn, deposes and says that THE SENTINEL, a newspaper of general circulation in the Borough of Carlisle, County and State aforesaid, was established December 13,1881, since which date THE SENTINEL has been regulazly issued in said County, and that the printed notice or publication attached hereto is exactly the same as was printed and published in the regulaz editions and issues of THE SENTINEL on the following day(s): Auri13.10, and 17 2010 COPY OF NOTICE OF PUBLICATION .~ pn~ ~ ~ „^„^•~, . ~ i~ ..4 ,..,.'- -_ X'. v' t~.. v4 ~zAl t , . y ~ ~. ` K t aln + , ~~, ~ II}~ .,' ~ ~ ~ ~ ~ f t bi44.i ~ ~ e u 191. ~ ~F~li 19:~ ~? " ~ . a '• t ~ ~~" r ~ : ~ ~4 ~~ ,,~ t~~ta~~ppT}}ioOrn p ~, } W '~},~,p~w` er~,,w„y~ VN.'.:~~~~b. 4~~~.: 1 t b~'~~ f ~ ` ~'1 fhl ~iT ~~Ji~(ii'pyF~(~'[^ Cil Fn'$~~ ~.i 5 1Y„ 1 ~ ~ Y~ f 6" yyl ,,_, Affiant further deposes that he/she is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statement as to time, place and chazacter of publication aze true. ~ , Sworn to and subscribed before ,,,p +t,;~ My commission expires: NOTARIAL tEllt MAMI ANN IIECKEIOORN cARLt3LE eoRO~ual, c ~ERtANp ct~m My Commbsbn ExpUtt Jan 27, 2014 Notary Public PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16, 1929), P. L.1784 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss. Lisa Marie Coyne, Esquire, Editor of the Cumberland Law Journal, of the County and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid, was established January 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly issued weekly in the said County, and that the printed notice or publication attached hereto is exactly the same as was printed in the regular editions and issues of the said Cumberland Law Journal on the following dates, viz: Avri19, April 16, and Apri123, 2010 Affiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. Marie Coyne, TO AND SUBSCRIBED before me this >EUoMr, ![artha lf., deed. -- Late of Uppu Mifflin Township. Co-Executora: Wilmer 3. Bloser, Jr. and Shirley A. Wickard e/o l.andia & Hlack, 36 South Hanovu Street, Carlisle, PA 17013. Attorney: Robut R. Hlack, Es- quire. 23 day of April, 2010 / ~~C • / - Notary NOTARIAL SEAL DEBORAH A COLLINS Notary PubIIC CARLISLE BCRO, CUMBERLAND COUNTY My Commission Expire: Apr 28, 2010 .• COMMONWEALTH OF PENNSriVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF PROGRAM INTEGRITY DNISION OF THIRD PARTY LIABILITY ESTATE RECOVERY PROGRAM PO BOX 8486 HARRISBURG, PA 17105-8486 April 16, 2010 LANDIS & BLACK ROBERT R BLACK ESQUIRE 36 SOUTH HANOVER ST CARLISLE PA 17013 Re: Martha N Bloser SSN: ###-##-2035 Dear Attorney Black: Pursuant to your letter dated March 30, 2010, the Department of Public Welfare (DPW), Estate Recovery Program, has reviewed the information you provided regarding the above-referenced individual. It has been determined that this individual did not receive any type of assistance during the questioned period. Therefore, according to the information you provided, the Department's Estate Recovery Program will not seek any recovery from this estate. If your client applied for Medical Assistance and had an application and/or hearing pending at the time of death, please advise us and provide any additional information that may affect a recovery by our Department. If you have any questions, please feel free to contact me. Sincerely, ~~ Vince A. Porter Recovery Section Manager (717)772-6604 c~nr~~ BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYLVANIA In re Estate of Martha N. Bloser, deceased, No. 21-10-0274 T0: Center Evangelical Lutheran Church Lori A. Wickard 431 Brandy Run Road 346 Middle Road Newville, PA 17241 Newville, PA 17241 Lonni A. Wickard Trina 0. Kulp 449 Pearson Drive 720 Creek Road Rustburg, VA 24588 Carlisle, PA 17015 Trent 0. Wickard Wesley L Bloser 299 Ridge Road Shippensburg PA 17257 . 20 Blain McCrea Road , Newville, PA 17241 Wendy L. Ott 999 Three Turn Road Wilmer S. Bloser, Jr. Shippensburg, PA 17257 1 Subdivision Road Newville PA , 17241 Shirley A. Wickard 23 Subdivision Road Newville, PA 17241 Please take notice of the death of decedent and the grant of letters to the personal representative(s) named below. You may have a beneficial interest in the estate. Name of decedent: Martha N. Bloser Last known address of decedent: 1 Subdivision Road, Newville, PA 17241 Date of death: February 11, 2010 Place of death: Hershey Medical Center County of grant of original letters: Cumberland County Decedent died ,~_ testate intestate. A copy of the will ,~_ is is not attached. Name, address and telephone number of all personal representatives appointed Name Address Wilmer S. Bloser, Jr. 1 Subdivision Road, Nevwille, PA 17241 Telephone Shirley A. Wickard 23 Subdivision Road, Newville, PA 17241 (717) 776-3428 Name, address and telephone number of all counsel Name Address Robert R. Black, Esq., 36 South Hanover Street, Cazlisle, PA 17013 Telephone (717) 243-3727 Additional information may be obtained from the undersigned. Date: ~ .?JQ ~d Signature Robert R Black, Esquire 36 South Hanover Street Cazlisle, Pennsylvania 17013 (717) 243-3727 Capacity: Personal Representative X Counsel for personal representative ~~, e ~~ D CERTIFICATION OF NOTI F UNDE)Et R TiJE 5 6 fal Name of Decedent: Martha N. Bloser Date of Death: February 11, 2010 Will No.: 21-10-0274 To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above- captioned estate on March 30, 2010. Name Center Evangelical Lutheran Church Lori A. Wickard Lonni A. Wickard Trina O. Kulp Trent 0. Wickard Wesley L. Bloser Wendy L. Ott Wilmer S. Bloser, Jr. Shirley A. Wickazd dr 431 Brandy Run Road, Newville, PA 17241 346 Middle Road, Newville, Pa 17241 449 Pearson Drive, Rustburg, VA 24588 720 Creek Road, Carlisle, PA 17015 299 Ridge Road, Shippensburg, PA 17257 20 Blain McCrea Road, Newville, PA 17241 999 Three Turn Road, Shippensburg, PA 17257 1 Subdivision Road, Newville, PA 17241 23 Subdivision Road, Newville, PA 17241 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None. Date: ~~7 ~~. ,v. ;.1 V . . <._1 _. ~_;_ :, ~.:. ~: ~: ':i T~ "] M1 _• r a_ c^~ o: 4 0 cv ~G ~o~~ G w ~ ~_i, U~ Q~ U ~i lZ_~~ Signature Robert R. Black, Esquire 36 South Hanover Street Carlisle, Pennsylvania 17013 (717)243-3727 Capacity: _ Perso~°:sal Representative ~ Counsel for Personal Representative LAST WILL AND TESTAMENT OF MARTHA N. BLOSER I, MARTHA N. BLOSER, of Upper Mifflin Township, Cumberland County, Pennsylvania, declare this to be my Last Will, hereby revoking all prior wills and codicils. FUNERAL EXPENSES FIRST: I direct the payment of my funeral expenses; i~zcluding my gravemazker, as soon as may be convenient after my death. PAYMENT OF DEATH TAXES SECOND: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of administration of my estate. DISTRIBUTION OF PERSONAL PROPERTY 'T'HIRD: All my personal effects, clothing, furniture, furnishings, jewelry, automobiles, other tangible personal property of every kind, and insurance thereon, I give to my children who do survive me for a period of thirty (30) days, to be divided among them as they may agree or, if they are unable to agree, as my executor may decide. The share of any minor child shall be selected and held by my executor for delivery to such child at termination of minority or, in the discretion of my executor, may be delivered either to the minor or to another to hold for the minor during minority and the receipt of the minor or such other person shall be a complete discharge of my executor. Any items not so disposed of shall be sold by my executor and the proceeds added to my residuary estate. BEQUESTS FOURTH: I give the sum of Twenty-five Thousand and no/00 ($25,000.00) Dollars to my son, Wilmer S. Bloser, Jr., or his issue, this Bequest to be paid in full prior to the payment of any of the following Bequests. initials a. To The Center Evangelical Lutheran Church, 1498 Center Road, Newville, PA 17241, Three Thousand and no/00 ($3,000.00) Dollars; b. To my granddaughter, Lori A. Wickard, One Thousand and no/00 ($1,000.00) Dollars; c. To my grandson, Lonni A. Wickard, One Thousand and no/00 ($1,000.00) Dollars; d. To my granddaughter, Trina 0. Kulp, One Thousand and no/00 ($1,000.00) Dollars; e. To my grandson, Trent O. Wickard, One Thousand and no/00 ($1,000.00) Dollars; f. To my grandson, Wesley L. Bloser, One Thousand and no/00 ($1,000.00) Dollars; and g. To my granddaughter, Wendy L. Ott, Une Thousand and no/00 ($1,000.00) Dollars. DISTRIBUTION OF RESIDUE FIFTH: I give the rest of my estate in equal shares to my son and daughter, namely Wilmer S. Bloser, Jr. and Shirley A. Wickard or their issue, per stirpes, living on the thirty-first day following my death. ADOPTED AND AFTERBORN PERSONS SIXTH: This will shall not be modified by the birth to or adoption by me of any child under the age of 18 years, but references herein to my "children" or "issue" shall include any such child. In the construction of any device or bequest herein to any person or persons described by relationship to me or to another, any person adopted when under the age of 18 years, whether adopted before or after my death shall be considered the "child" and "issue" of his adopting parent or parents. initials 0 PROTECTION OF BENEFICIARIES (Spendthrift Provision) SEVENTH: No interest in income or principal shall be assignable by a beneficiary or available to anyone having a claim against a beneficiary before actual payment to the beneficiary. Provided, however, any beneficiary may assign any part or all of the beneficiary's interest in my estate to any one or more of my descendants or to any one or more of the beneficiary's descendants. MINORS AND INCAPACITATED BENEFICIARIES EIGHTH: If any income or principal shall be payable to any person who shall be a minor or who shall be incapacitated for any reason, my executor as trustee shall hold such income and principal during minority or incapacity and shall be entitled to apply such income and principal to the health, maintenance, support and education of such person during minority or incapacity without the appointment of any guardian or committee or any authority of court. My executor as trustee shall be entitled to make direct application hereunder or to make application by payment of income and principal to the parent or other person in charge of such minor or incapacitated person, or to his or her guardian or to a custodian under the Uniform Transfers to Minors Act. Any remaining income and principal to which such person shall be entitled shall be distributed to such person upon the termination of minority or incapacity. My executor as trustee shall have the same powers as my executor. POWERS OF EXECUTOR NINTH: I confer upon my executor the right to sell or otherwise convert any real or personal property at public or private sale, at such time or times, in such manner, and for such price or prices, and on such terms and conditions as my executor shall determine, and to execute and deliver good and sufficient conveyances, assignments and transfers of the property, without liability of any purchaser for the application of any consideration; to borrow money and to secure its payment by mortgage of real or personal property, pledge of investments, or otherwise, without liability on the part of the lenders to see to the application thereof; to retain any investments at discretion; to invest and reinvest at discretion, without restriction to so-called "legal investments"; to make distribution in cash or in kind; to allocate and distribute different kinds or disproportionate shares of property or undivided interests in property among beneficiaries, in cash or in kind, or +~ initials partly in each; and to do all other acts and things necessary or appropriate in the management, administration and distribution of my estate. APPOINTMENT OF EXECUTOR TENTH: I appoint Wilmer S. Bloser, Jr. and Shirley A. Wickard, or the survivor thereof, executors of my will. WAIVER OF BOND ELEVENTH: I direct that no fiduciary hereunder shall be required to furnish bond in any jurisdiction, and if any bond is necessary, no surety shall be required. INTERCHANGEABILITY OF LANGUAGE TWELFTH: Words used in the singular may be read to include the plural or the plural may be read as the singular. Similarly, the masculine form may be read to include the feminine and neuter; the feminine may be read to include the masculine and neuter; and the neuter may be read to include the masculine and feminine. HEADINGS THIRTEENTH: The headings used on the various paragraphs of this will are included for convenience only and shall have no legal significance. I have signed this will this ~ ~ da of /Z y ~~=~~~ , 2008. ~YYI ~'~~~ ~» 23 ~ ~~ Martha N. Bloser Witness Witn ACKNOWLEDGMENT and AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND I, Martha N. Bloser, the testatrix in, and 1~ ~~N~l; ~ Cs-!L /y:/~i and ~ ~~ ~ ~- N ~ . (~ L i (~~~' f l ,the witnesses to the last will, the attached or foregoing instrument, who have signed the instrument, having been duly qualified according to law do depose and say: (a) that I, the testatrix, do hereby acknowledge that I signed and executed the instrument as my last will, that I signed it willingly and as my free and voluntary act for the purposes therein expressed; and (b) that we, the witnesses, were present and saw the testatrix sign and execute the instrument as her last will, that she signed it willingly and executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the will as a witness and that to the best of our knowledge the testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Martha N. Bloser, Testatrix ~~G ~~~~~ Witness COMMONWEALTH OF PENNSYLVANIA C"~"'~-'~'~ ~ ~ ~ ` ~ a6 Notarial Seal Witnes Robert R. Black, Notary Pubik: Carlisle eoro, Cumberland County MY Commission Expires Sept. 28, 2009 ~~ ~~ Notary Public ,, • 4 IN ~. IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF MARTHA N. BLOSER, , ORPHANS' COURT DMSION Deceased NO. 21-10-0274 FIRST AND FINAL ACCOUNT OF WIENER S. BLOSER, JR.and SHIRLEY A. WICKARD, EXECUTORS OF THE ESTATE OF MARTHA N. BLOSER LATE OF UPPER MIFFLIN TOWNSHIP CUMBERLAND COUNTY, PENNSYLVANIA Date of Death: February 11, 2010 Letters Testamentary Granted: March 19, 2010 Letters Advertised: Sentinel - Apri13,10 & 17, 2010 Cumberland Law Journal - Apri16, 16 8c 23, 2010 Account Stated as Final SUNIIVIARY & INDEX Receipts Receipts of Annuity Proceeds Less Disbursements Balance Before Distributions Distributions to Beneficiaries Principal Balance Remaining INCOME Receipts Less Disbursements Income Balance Remaining 10,527.97 70,415.37 10.527.97 70,415.37 70.415.37 00.00 00.00 00.00 00.00 ~~~ PAGE 2 2 3 4 3 3 RECEIPTS OF PRINCIPAL ~ 10 3/19 Western National Life Ins. Co. - #OXP22911 -Payment 3/22 Bankers Life & Casualty Co. -Refund -Health Insurance 3122 Adams County National Bank -Savings Account #5986621 3/220 Adams County National Bank -Checking Account #112208 3/22 Adams County National Bank -Savings Account #9944636 6/9 PSERS -Retirement Adjustment Total Receipts of Principal RECEIPTS OF ANNUITY PROCEEDS 3/2 Nationwide Annuity Contract #07-11522528 (Date of Death Value) 3/23 Western National Life Ins. Co. -Annuity Contract #W236657 (Date of Death Value) 3/23 Western National Life Ins. Co. -Annuity Contract #W238790 (Date of Death Value) 3/23 Western National Life Ins. Co. -Annuity Contract #XP229111 (Date of Death Value) Total Annuity Proceeds 166.10 229.29 500.44 459.06 9,019.13 153.95 10527.97 10,044.15 10,539.66 9,906.34 39.925.22 70 4153? 2 DISBURSEMENTS OF PRINCIPAL X91.4 ent - On Account, Pa. Inheritance Tax 2,100.00 4/28 Register of Wills, Ag 9/17 Register of Wills, Agent - Balance, Pa. Inheritance Tax 1,061.41 RESERVED: Landis & Black -Probate Costs Advanced: Register of Wills -Probate Fees & Short Certificates 265.50 Cumberland Law Journal - Advertise Letters 75.00 The Sentinel -Advertise Letters 187.54 Register of Wills -File Pa. Inheritance Tax 15.00 Register of Wills -Reserve to file Account 03 0.00 Total Probate Fees Advanced 843.04 Landis & Black -Attorney Fees 4,000.00 Wilmer S. Bloser -Family Exemption 2.523.5,E Total Disbursements of Principal 10 27. RECEIPTS OF INCOME NONE DISBURSEMENTS OF INCOME NONE DISTRIBUTIONS TO BENEFICIARIES 3/2 Wilmer S. Bloser, Jr. & Shirley A. Wickard (50% each as 10,044.15 named Beneficiaries) 3/23 Wiener S. Bloser, Jr. & Shirley A. Wickard (50% each as 10,539.66 named Beneficiaries) 3/23 Wilmer S. Bloser, Jr. & Shirley A. Wickard (50% each as 9,906.34 named Beneficiaries) 2 3/23 Wilmer S. Bloser, Jr. (100% as named Beneficiary) 9 Total Advancements to Beneficiaries 70 415 7 WILMER S. BLOSER, JR. and SHIRI,EY A. WICKARD, Executors under the Last Will and Testament of Martha N. Bloser, deceased, hereby declare under penalties of perjury that they have fully and faithfully discharged the duties of their office; that the foregoing First and Final Account is true and correct and fully discloses all significant transactions occurring during the accounting period; that all known claims against the Estate have been paid in full: that the first complete advertisement of the grant of letters was more than four months from the date the account was filed; that, to their knowledge; there are no claims now outstanding against the Estate; and that all taxes presently due from the Estate have been paid. 'They understand that false statements herein are made subject to the penalties of 18 Pa. C.S.A. 4904 relating to unswom falsification to authorities. G~/ rrz~ j' /5'~ee~h/.Q Wilmer S. Bloser, Jr. Shirley A:: W' kard IN RE: ESTATE OF MARTHA N BLOSER, DECEASED IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION N0.21-10-0274 NOTICE OF FILING ACCOUNT NOTICE IS HEREBY GNEN that WILMER S. BLOSER, JR. and SHIRLEY A. WICKARD, Executors of the Estate of MARTHA N. BLOSER, Deceased, have this date filed their First and Final Account in the above-captioned Estate in the Office of the Register of Wills in and for Cumberland County, Pennsylvania, where the same are filed as public records and may be inspected. Enclosed herewith is a copy of the First and Final Account as filed. YOU ARE FURTHER NOTIFIED that any exceptions or objections to said Account must be filed in writing at the Office of the Register of Wills aforesaid prior to the confirmation of said Account as set forth below. UNLESS written exceptions or objections are filed prior thereto, said Account will be presented to the above-captioned Court in Court Room No. 1 of the Cumberland County Courthouse, Cazlisle, Pennsylvania, at 9:30 A.M., prevailing time, on -('UESn~~~ , ~~q-~Q ~ f / ~ , 2011, at which time said Account will be confirmed. LANDIS & BLACK Date: ~Z ZC1 ~ Robert R. Black, Esquire Attorney for the Estate of Martha N. Bloser NOTICES TO: Center Evangelical Lutheran Church 431 Brandy Run Road Newville, PA 17241 Lori A. Wickard 346 Middle Road Newville, PA 17241 Lonni A. Wickazd 449 Pearson Drive Rustburg, VA 24588 Trina O. Kulp 720 Creek Road Carlisle, PA 17015 Trent O. Wickard 299 Ridge Road Shippensburg, PA 17257 Wesley L. Bloser 20 Blain McCrea Road Newville, PA 17241 Wendy L. Ott 999 Three Turn Road Shippensburg, PA 17257 Wilmer S. Bloser, Jr. 1 Subdivision Road Nevwille, PA 17241 Shirley A. Wickard 23 Subdivision Road Newville, PA 17241 IN RE: ESTATE OF MARTHA N. BLOSER, Deceased IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-10-0274 FIRST AND FINAL ACCOUNT OF WILMER S. BLOSER, JR.and SHIRLEY A. WICKARD, EXECUTORS OF THE ESTATE OF MARTHA N. BLOSER LATE OF UPPER MIFFLIN TOWNSHIP CUMBERLAND COUNTY, PENNSYLVANIA Date of Death: February 11, 2010 Letters Testamentary Granted: March 19, 2010 Letters Advertised: Sentinel - Apri13, 10 & 17, 2010 Cumberland Law Journal - Apri16, 16 8c 23, 2010 Account Stated as Final SUMMARY & INDEX PRINCIPAL PAGE Receipts 2 10,527.97 Receipts of Annuity Proceeds 2 70,415.37 Less Disbursements 3 1 527.97 Balance Before Distributions 70,415.37 Distributions to Beneficiaries 4 70.415.37 Principal Balance Remaining 00.00 INCOME Receipts 3 00.00 Less Disbursements 3 00.00 Income Balance Remaining 00.00 COMBINED BALANCE REM~,~G pp p _ ~ , _ ~~ c~ ~ Vh iii ~j ` w ri ~ ~ ~ ~ N _ f- ` , `~ c , ,> RECEIPTS OF PRINCIPAL 2 3/19 Western National Life Ins. Co. - #OXP22911 -Payment 3/22 Bankers Life 8c Casualty Co. -Refund -Health Insurance 3/22 Adams County National Bank -Savings Account #5986621 3/220 Adams County National Bank -Checking Account #112208 3/22 Adams County National Bank -Savings Account #9944636 6/9 PSERS -Retirement Adjustment Total Receipts of Principal RECEIPTS OF ANNUITY PROCEEDS ~( lU 3/2 Nationwide Annuity Contract #07-11522528 (Date of Death Value) 3/23 Western National Life Ins. Co. -Annuity Contract #W236657 (Date of Death Value) 3/23 Western National Life Ins. Co. -Annuity Contract #W238790 (Date of Death Value) 3/23 Western National Life Ins. Co. -Annuity Contract #XP229111 (Date of Death Value) Total Annuity Proceeds 166.10 229.29 500.44 459.06 9,019.13 153.95 lU 10,044.15 10,539.66 9,906.34 39 9. 25.22 70,4 1537 2 DISBURSEMENTS OF PRINCIPAL 24 4/28 Register of Wills, Agent - On Account, Pa. Inheritance Tax 9/17 Register of Wills, Agent -Balance, Pa. Inheritance Tax RESERVED: Landis & Black -Probate Costs Advanced: Register of Wills -Probate Fees 8c Short Certificates 265.50 Cumberland Law Journal - Advertise Letters 75.00 The Sentinel -Advertise Letters 187.54 Register of Wills -File Pa. Inheritance Tax 15.00 Register of Wills -Reserve to file Account 03 0.00 Total Probate Fees Advanced Landis & Black -Attorney Fees Wilmer S. Bloser -Family Exemption Total Disbursements of Principal RECEIPTS OF INCOME NONE DISBURSEMENTS OF INCOME NONE 2,100.00 1,061.41 843.04 4,000.00 2,523.52 10 7.97 3 DISTRIBUTIONS TO BENEFICIARIES QQ 3/2 Wilmer S. Bloser, Jr. & Shirley A. Wickazd (50% each as named Beneficiaries) 10,044.15 3/23 Wimer S. Bloser, Jr. & Shirley A. Wickard (50% each as named Beneficiaries) 10,539.66 3/23 Wilmer S. Bloser, Jr. & Shirley A. Wickazd (50% each as named Beneficiaries) 9,906.34 3/23 Wilmer S. Bloser, Jr. (100% as named Beneficiary) 39.925.22 Total Advancements to Beneficiaries 7070 4~ WILMER S. BLOSER, JR. and SHIRLEY A. WICKARD, Executors under the Last Will and Testament of Martha N. Bloser, deceased, hereby declare under penalties of perjury that they have fully and faithfully dischazged the duties of their office; that the foregoing First and Final Account is true and correct and fully discloses all significant transactions occurring during the accounting period; that all known claims against the Estate have been paid in full; that the first complete advertisement of the grant of letters was more than four months from the date the account was filed; that, to their knowledge; there aze no claims now outstanding against the Estate; and that all taxes presently due from the Estate have been paid. They understand that false statements herein aze made subject to the penalties of 18 Pa. C.S.A. 4904 relating to unsworn falsification to authorities. ~F/ .e,riva. ir, ,5. /.- .n ~ Q , Wilmer S. Bloser, Jr. l% d ~ a " ~ G~ H. ~ c Shirley A{ W' ckazd LAST WILL AND TESTAMENT OF MARTHA N. BLOSER I, MARTHA N. BLOSER, of Upper Mifflin Township, Cumberland County, Pennsylvania, declare this to be my Last Will, hereby revoking all prior wills and codicils. FUNERAL EXPENSES FIRST: I direct the payment o°my funeral expenses, including my gravemarker, as soon as may be convenient after my death. ' PAYMENT OF DEATH TAXES SECOND: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid ftom my residuary estate as a part of the expense of administration of my estate. DISTRIBUTION OF PERSONAL PROPERTY THIRD: All my personal effects, clothing, furniture, furnishings, jewelry, automobiles, other tangible personal property of every kind, and insurance thereon, I give to my children who do survive me for a period of thirty (30) days, to be divided among them as they may agree or, if they are unable to agree, as my executor may decide. The share of any minor child shall be selected and held by my executor for delivery to such child at termination of minority or, in the discretion of my executor, may be delivered either to the minor or to another to hold for the minor during minority and the receipt of the minor or such other person shall be a complete discharge of my executor. Any items not so disposed of shall be sold by my executor and the proceeds added to my residuary estate. BEQUESTS FOURTH: I give the sum of Twenty-five Thousand and no/00 ($25,000.00) Dollars to my son, Wilmer S. Bloser, Jr., or his issue, this Bequest to be paid in full prior to the payment of any of the following Bequests. u initials a. To The Center Evangelical Lutheran Church, 1498 Center Road, Newville, PA 17241, Three Thousand and no/00 ($3,000.00) Dollars; b. To my granddaughter, Lori A. Wickard, One Thousand and no/00 ($1,000.00) Dollars; c. To my grandson, Lonni A. Wickazd, One Thousand and no/00 ($1,000.00) Dollars; d. To my granddaughter, Trina 0. Kulp, One Thousand and no/00 ($1,000.00) Dollars; e. f. g• To my grandson, Trent 0. ($1,000.00) Dollars; To my grandson, Wesley L ($1,000.00) Dollars; and Wickard, One Thousand and no/00 Bloser, One Thousand and no/00 To my granddaughter, Wendy L. Ott, Une Thousand and no/00 ($1,000.00) Dollars. DISTRIBUTION OF RESIDUE FIFTH: I give the rest of my estate in equal shazes to my son and daughter, namely Wilmer S. Bloser, Jr, and Shirley A. Wickard or their issue, per stirpes, living on the thirty-first day following my death. ADOPTED AND AFTERBORN PERSONS SIXTH: This will shall not be modified by the birth to or adoption by me of any child under the age of 18 years, but references herein to my "children" or "issue" shall include any such child. In the construction of any device or bequest herein to any person or persons described by relationship to me or to another, any person adopted when under the age of 18 years, whether adopted before or after my death shall be considered the "child" and "issue" of his adopting parent or parents. -`-=---~1-' initials PROTECTION OF BENEFICIARIES (Spendthrift Provision) SEVENTH: No interest in income or principal shall be assignable by a beneficiary or available to anyone having a claim against a beneficiary before actual payment to the beneficiary. Provided, however, any beneficiary may assign any part or all of the beneficiary's interest in my estate to any one or more of my descendants or to any one or more of the beneficiary's descendants. MINORS AND INCAPACITATED BENEFICIARIES EIGHTH: If any income or principal shall be payable to any person who shall be a minor or who shall be incapacitated for any reason, my executor as trustee shall hold such income and principal during minority or incapacity and shall be entitled to apply such income and principal to the health, maintenance, support and education of such person during minority or incapacity without the appointment of any guardian or committee or any authority of court. My executor as trustee shall be entitled to make direct application hereunder or to make application by payment of income and principal to the parent or other person in charge of such minor or incapacitated person, or to his or her guardian or to a custodian under the Uniform Transfers to Minors Act. Any remaining income and principal to which such person shall be entitled shall be distributed to such person upon the termination of minority or incapacity. My executor as trustee shall have the same powers as my executor. POWERS OF EXECUTOR NINTH: I confer upon my executor the right to sell or otherwise convert any real or personal property at public or private sale, at such time yr times, in such manner, and for such price or prices, and on such teens and conditions as my executor shall determine, and to execute and deliver good and sufficient conveyances, assignments and transfers of the property, without liability of any purchaser for the application of any consideration; to borrow money and to secure its payment by mortgage of real or personal property, pledge of investments, or otherwise, without liability on the part of the lenders to see to the application thereof; to retain any investments at discretion; to invest and reinvest at discretion, without restriction to so-called "legal investments"; to make distribution in cash or in kind; to allocate and distribute different kinds or disproportionate shares of property or undivided interests in property among beneficiaries, in cash or in kind, or l~ initials partly in each; and to do all other acts and things necessary or appropriate in the management, administration and distribution of my estate. APPOINTMENT OF EXECUTOR TENTH: I appoint Wilmer S. Bloser, Jr. and Shirley A. Wickard, or the survivor thereof, executors of my will. WAIVER OF BOND ELEVENTH: I direct that no fiduciary hereunder shall be required to furnish bond in any jurisdiction, and if any bond is necessary, no surety shall be required. INTERCHANGEABILITY OF LANGUAGE TWELFTH: Words used in the singular may be read to include the plural or the plural maybe read as the singular. Similarly, the masculine form may be read to include the feminine and neuter; the feminine may be read to include the masculine and neuter; and the neuter may be read to include the masculine and feminine. HEADINGS THIRTEENTH: The headings used on the various paragraphs of this will are included for convenience only and shall have no legal significance. I have signed this will this ~ ~~ da of ~~=CEjv~/j~l'~ y , 2008. ° ~ an~ hit 23 -~ ~ a.. Martha N. Bloser Witness 1 w amass ~' ACKNOWLEDGMENT and AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND I, Martha N. Bloser, the testatrix in, and ~ ~~"NI~I/ ~ ~' I G /YE~i and ~~~ LN ~ . ~~ Li l~~''(1 ,the witnesses to the last will, the attached or foregoing instrument, who have signed the instrument, having been duly qualified according to law do depose and say: (a) that I, the testatrix, do hereby acknowledge that I signed and executed the instrument as my last will, that I signed it willingly and as my free and voluntary act for the purposes therein expressed; and (b) that we, the witnesses, were present and saw the testatrix sign and execute the instrument as her last will, that she signed it willingly and executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the will as a witness and that to the best of our knowledge the testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Martha N. Bloser, Testatrix ~~G ~a~~~ Witness /C. ,~,,,_ /f /j COMMONWEALTH OF PENNSYLVANIA '~:% ~~~+ .f'Z~~~~r-~ ~"t ` NotarlelSeal Witnes ~ ' Robert R. Black, Notary Pubik: Carlisle Boro, Cumberland County MY Commission Expires Sept. 28, 2009 ~~ ~~ Notary Public