HomeMy WebLinkAbout03-04-111505610101
REV-1500 Ex `01.1°'
enns lvania OFFICIAL USE ONLY
PA Department of Revenue P Y County Code Year File Number
OEV4RTMENT OF REVENUF
Bureau of Individual Taxes INHERITANCE TAX RETURN
Po Box 2so6oi '21 2010 0593
Harrisburg, PA 1'7128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
174-20-8887 06/04/2010 09/04/1918
Decedent's Last Name Suffix Decedent's First Name MI
WEIBLEY SARA B
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL INAPPROPRIATE OVALS BELOW
~ 1. Original Return O
O 4. Limited Estate O
C1Q 6. Decedent Died Testate O
(Attach Copy of Will)
O 9. Litigation Proceeds Received O
2. Supplemental Return
4a. Future Interest Compromise (date of
death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
O 3. Remainder Return (date of death
prior to 12-13-82)
O 5. Federal Estate Tax Return Required
0 8. Total Number of Safe Deposit Boxes
O 11. Election to tax under Sec. 9113(A)
(Attach Sch. O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
RONALD E. WEIBLEY (717) 761-7210
First line of address
49 SOUTH PIN OAK DRIVE
Second line of address
City or Post Office
BOILING SPRINGS
State ZIP Code
REGISTER OF V~IIL~LS USE ONLYt``w3
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DATE~IL~ CO
PA 17007-9407 '~~
Correspondent's a-mail address: rweibley@cpabr.com
Under penalties of perjury, I declare that I h e examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, corre d complete. Declaration f preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNAT PE SO ESPON FO FILING RETURN DAT
~Q
A RESS
49 SOUTH PIN OAK DRIVE, BOILING SPRINGS, PA 17007-9407
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610101 1505610101
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FILE NUMBER 21-10-0593
REV-1500 EX
Decedent's Name: SARA B. WEIBLEY
Decedent's Social Security Number
174-20-8887
RECAPITULATION _
1. Real Estate (Schedule A) ............................................. 1. 0.00 ',
2. Stocks and Bonds (Schedule B) ....................................... 2. 749,680.17
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 0.00
4. Mortgages and Notes Receivable (Schedule D) ........................... 4. 0.00
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 197,063.34
6. Jointly Owned Property (Schedule F) O Separate Billing Requested ....... 6. 0.00
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
t
d
i
R
7
184
19
119
........
ng
eques
e
(Schedule G) O Separate Bill . .
,
8. Total Gross Assets (total Lines 1 through 7) ............................. 8. 1,065,927.70
9. Funeral Expenses and Administrative Costs (Schedule H) ......... .......... 9. 11,977.38
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ... ........... 10. 3,377.67
11. Total Deductions (total Lines 9 and 10) ...................... ........... 11. 15,355.05 '..
12. Net Value of Estate (Line 8 minus Line 11) ................... ........... 12. 1,050,572.65
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ............. ........... 13. 0.00
14. Net Value Subject to Tax (Line 12 minus Line 13) ............. ........... 14. 1,050,572.65
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) x A_ 0.00
16. Amount of Line 14 taxable
at lineal rate x .0 45 1,050,572.65
17. Amount of Line 14 taxable
at sibling rate X .12 0.00
18. Amount of Line 14 taxable
at collateral rate X .15 0.00
15. 0.00
16. 47,275.77
17. 0.00
18. 0.00
47,275.77 '.
19. TAX DUE ......................................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
1505610105 1505610105
REV-1500 EX Page 3 File Number 21-10-0593
Decedent's Complete Address:
DECEDENT'S NAME
SARA B. WEIBLEY
STREETADDRESS
1 LONGSDORF WAY, CUMBERLAND CROSSINGS
CITY STATE ZIP
CARLISLE PA 17015
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) (1) 47,275.77
2. CreditslPayments
A. Prior Payments _ __-___..._.......__-___________
B. Discount _
-------~---~-------------~---------~~-~-----
Total Credits (A + B) (2)
0.00
3. Interest
(3) 0.00
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund. (4) 0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 47,275.77
Make check payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred :.......................................................................................... ^ 0
b. retain the right to designate who shall use the property transferred or its income : ............................................ ^
c. retain a reversionary interest; or .......................................................................................................................... ^ x^
d. receive the promise for life of either payments, benefits or care? ...................................................................... ^
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. ~ ^
3. Did decedent own an "in trust for" or payable-upon-death bank account or security at his or her death? .............. ^
4. Did decedent own an individual retirement account, annuity or other non-probate property, which
contains a beneficiary designation? ........................................................................................................................ x^ ^
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is
3 percent [72 P.S. §9116 (a} (1.1) (i)].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an
adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2}].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in
72 P.S. §9116(1.2} [72 P.S. §9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1503 EX+ (6-98)
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
SARA 6. WEIBLEY 21-10-0593
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
(If more space is needed, insert additional sheets of the same size)
REV-i5o8 EX+ (ii-io)
`~ '~ pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
SARA B. WEIBLEY 21-10-0593
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. PCN BANK CHECKING ACCOUNT 51-4019-3513 12,889.77
2 MEMBERS 1ST FEDERAL CREDIT UNION ACCOUNT 147345 261.94
3 ORRSTOWN BANK CHECKING ACCOUNT 106000095 135,457.70
4 FIRST NATIONAL BANK OF CHESTER COUNTY CERT OF DEPOSIT #290005729 31,357.99
5 BED, MATRESS, DESK, CHEST OF DRAWERS, LAMP & SMALL TABLE 850.00
6 CASH 123.87
7 CLOTHING AND COSTUME JEWLERY 550.00
g FEDERATED MONEY MARKET FUND 854 -PRINCIPAL -HELD BY ORRSTOWN BANK 7,963.44
g FEDERATED MONEY MARKET FUND -INCOME -HELD BY ORRSTOWN BANK 7,608.63
TOTAL (Also enter on Line 5, Recapitulation) $ I 197,063.34
If more space is needed, use additional sheets of paper of the same size.
REV-1510 EX+ (08-09)
~`~-~ pennsylvania SCHEDULE G
DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
INHERITANCE TAx RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
SARA B. WEIBLEY 21-10-0593
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
ITEM
NUMBER DESCRIPTION OF PROPERTY
INCUIDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND
THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH
VALUE OF ASSET % OF DECD'S
INTEREST EXCLUSION
(IF APPLICABLE) TAXABLE
VALUE
1. ALLSTATE LIFE INS CO. ANNUITY CONTRACT # GA0589387
ARLENE W. ARNDT -DAUGHTER - 25% BENEFICIARY 19,846.33 25 0.00 19,846.33
DONNA J. HOFFMAN -DAUGHTER - 25% BENEFICIARY 19,846.33 25 0.00 19,846.3?
DORIS A. PINA -DAUGHTER - 25% BENEFICIARY 19,846.33 25 0.00 19,846.3
RONALD E. WEIBLEY -SON - 25% BENEFICIARY 19,846.32 25 0.00 19,846.3
2 GIFT TO RONALD E. WEIBLEY -CASH 10,000.00 100 3,000.00 7,000.OC
3 TRANSAMERICA LIFE INS. CO. ANNUITY CONTRACT # 0200PB06353
RONALD E. WEIBLEY -SON -100% BENEFICIARY 19,073.88 100 0.00 19,073.8
4 GIFT TO RONALD E. WEIBLEY - 2005 CADILLAC STS 4DR V6 13,725.00 100 0.00 13,725.OC
TOTAL (Also enter on Line 7, Recapitulation) $ I 119,184.19
If more space is needed, use additional sheets of paper of the same size.
REV-1511 EX+ (10-09)
~ ::~ pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
SARA B. WEIBLEY 21-10-0593
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' NICKEL FUNERAL HOME, LOYSVILLE, PA 8,232.32
2 FLOWERS FOR FUNERAL 325.00
3 REVERAND TIMMOTHY SADLER -SERVICE 250.00
4 MESSIAH LUTHERAN CHURCH -POST FUNERAL RECEPTION 500.00
5 RICE MEMORIALS -STONE MARKER AND ENGRAVING 1,551.00
B.
1
ADMINISTRATIVE COSTS:
Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
City
Year(s) Commission Paid:
State ZIP
2. Attorney Fees:
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
Claimant
Street Address
4
City State
Relationship of Claimant to Decedent
Probate Fees:
5. Accountant Fees:
6. Tax Return Preparer Fees:
~• TRUCK RENTAL & TEMPORARY STORAGE
TOTAL (Also enter on Line 9, Recapitulation) I $
If more space is needed, use additional sheets of paper of the same size.
763.50
355.56
11,977.38
ZIP
REV-1512 EX+ (12-08}
~~ :, pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
SARA B. WEIBLEY 21-10-0593
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
If more space is needed, insert additional sheets of the same size,
REV-1513 EX+ (01-10)
~ : pennsylvan~a
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE ~
BENEFICIARIES
ESTATE OF: FILE NUMBER:
SARA B. WEIBLEY 21-10-0593
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1. ARLENE W. ARNDT, 85 QUEEN AVENUE, ENOLA, PA 17025 DAUGHTER 19,846.33
2 T/UIW OF S. WEIBLEY FIBIO ARLENE W. ARNDT
25% OF RESIDUE OF ESTATE DAUGHTER 232,097.12
3 DORIS A. PINA,1000 NYACK ST. N.W., PALM BAY, FL 32907 DAUGHTER 19,846.33
4 TIUIW OF S WEIBLEY FIB/0 DORIS A. PINA & SHANNON L. NOLAN DAUGHTER AND
25% OF RESIDUE OF ESTATE GRAND DAUGHTER 232,097.12
5 DONNA J. HOFFMAN, 27 BRANDYWINE DR., BERLIN, NJ 08009 DAUGHTER 251,943.44
6 RONALD E. WEIBLEY, 49 S. PIN OAK DR., BOILING SPRINGS, PA SON 294,742.31
II
SEE SCHEDULE ATTACHED FOR DETAILS AND AMOUNTS
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE.
NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II -ENTER TOTAL NON TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 0.00
If more space is needed, use additional sheets of paper of the same size.
LAST WILL AND TESTAMENT
OF
SARA B. WEIBLEY
I, Sara B. Weibley, of South Middleton, Cumberland County,
~
.
Pennsylvania, being of sound and disposing mind, memory and
~
~.
' understanding, do hereby make, publish and declare this as and
for my Last Till and Testament, hereby revoking all other Wills
and Codicils heretofore made by me.
FIRST
I direct the payment of my just debts and expenses of my last
illness and funeral from my estate as soon after my death a~
conveniently may be done. I direct my body be interred in the
Rest Land Cemetery, Loysville, Pennsylvania.
Further, I authorize my personal representative to expenc
funds from my estate, in such amount as my personal representative
shall consider necessary and desirable for the purchase, erectior
and inscription of a suitable marker for my grave.
All references to my son and daughters shall mean stepson,
stepdaughters and their issue.
S,~-1DIS,
~A~~R ~ SECOND
LINDSAY
26WacHighSurec I give and bequeath the following specific it
e
ms as
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hereafter set forth to my son, Ronald E . Weibley : r:3 ~ ~- ~.r' ~.~':
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1
~OWERIS'~
I.~TDSAY
2G Wesc High Scrac
Carlisle, PA
1. My seven (7) piece, antique oak bedroom set, together
with all comforters, linens and other bedding used
with the set;
2. My seven (7} piece, porcelain dresser set;
3. My maple dining room set, table, matching chairs and
hutch; and
4. My six (6) antique cane bottom chairs.
THIRD
~-
All the rest, residue and remainder of my estate, I give,
devise and bequeath to my children as follows:
1. Twenty-five (25~) percent to my daughter, Donna J.
Hoffman, per stirpes;
2. Twenty-five (25~} percent to my son, Ronald E.
Weibley, per stirpes;
3. Twenty-five (25~) percent, IN TRUST, for the benefit
of my daughter, Sarah Arlene Arndt, also known as
Arlene W. Arndt, on the following terms and
conditions:
(A) To hold, manage, i:~vest and reinvest the
principal so received, and accumulation of income
thereon, and to use, pay and apply the principal
and income as follows:
(1) To pay and apply the income to the
beneficiary at least quarterly.
2
(2) To invade the principal in the event of
illness or emergency as determined in my
Trustee's sole discretion for the benefit of
the beneficiary.
.,~ .,:
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(B) In the event that any beneficiary of this Trust
cannot provide for her basic support and
maintenance needs and is unable to maintain and
support herself from her own resources and
sources of income, my Trustee shall seek such
support for the beneficiary from public sources.
In such event, paragraph 3. (A) (2) of this Trust
shall be null and void and replaced by the
provisions hereinafter concerning the Special
Needs Trust.
FIA`~VERIS,~
LINDSAY
26 Wac High Scrac
c~;~~, r~
{a) This Trust has specifically not been created
to supplant or replace public-assistance
benefits. My Trustee should, therefore,
seek entitlements which are available to
members of the community who are
experiencing disabilities that are
substantially similar to those that the
beneficiary experiences. My Trustee shall
der.~• any request made by any agency or
governmental entity requesting disbursement
of trust funds to satisfy beneficiary's
support needs.
(b) This Trust shall be held and administered
for the benefit of the beneficiary in
recognition that there may be a number of
personal needs other than basic support and
maintenance which may be unavailable to the
beneficiary except through this Trust. This
Trust is intended to satisfy those non-
support needs, as deemed appropriate in the
3
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'ZOWERIS,~
LINDSAY
26 Wac Hlgh Sweet
Carlisle, PA
absolute discretion of the Trustee. This
Trust is not intended to displace any source
of income otherwise available to the
beneficiary for their basic support {such as
food and shelter), including any
governmental assistance program to which the
beneficiary is or may be entitled. It is not
intended to be a resource of the beneficiary
and is not available to the beneficiary. It
is to be a discretionary spendthrift trust
created for non-support purposes.
{c) No part of the corpus of this trust shall be
used to supplant or replace any public-
assistance benefits received by or through
any county, state, federal or other
governmental agency.
(d) During the lifetime of the beneficiary, to
the extent that benefits are not made
available to the beneficiary for other than
basic living expenses, including food and
shelter, my Trustee, in his absolute
discretion, may distribute from income and
principal to or for the benefit of the
beneficiary, for their needs other than
basic support. For the purposes of this
provision, non-support purchases include,
but are not limited to dental care;
unreimbursable medical and dental expenses,
including plastic and reconstructive
surgery, diagnostic work and treatment,
rehabilitative training and experimental
medical services; psychiatric/psychological
services; occupational therapy; prosthetic
devices; dietary needs and supplements; the
differential in cost between shelter for a
shared and private group home or room;
custodial care or supplemental nursing care;
recreation, cultural experiences, outings
and travel, including payment for others to
accompany the beneficiary; telephone and
television, including cable television;
reading and educational materials; exercise
equipment; unreimbursed therapy; and related
insurance. Trustee's discretion in making
distributions authorized hereunder is
absolute with regard to distributions from
4
the Trust estate, and shall be binding on
all interested persons.
(3) Upon the death of my daughter, Sarah Arlene
Arndt, my Trustee shall distribute the then
~-
~~~'
remaining principal and accumulated income
outright to her children, William Arndt,
Bryan L. Arndt and Donna J. Bivens, per
stirpes.
4. Twenty-five (25~) percent, IN TRUST, for the benefit
of my daughter, Doris A. Pina, and my granddaughter,
Shannon L. Nolan, on the following terms and
conditions:
(A) To hold, manage, invest and reinvest the
principal so received, and accumulation of income
thereon, and to use, pay and apply the principal
and income as follows:
(1) To pay and apply the income equally to each
beneficiary at least quarterly.
(2) To invade the principal in the event of
S~AmIS,
E~AW'F:R ~
LINDSAY
Z~w~x;~s~
Culula PA
illness or emergency as determined in my
Trustee's sole discretion for the benefit of
the beneficiary or beneficiaries.
(B) In the event that any beneficiary of this Trust
cannot provide for her basic support and
maintenance needs and is unable to maintain and
5
support herself from her own resources and
sources of income, my Trustee shall seek such
:`~ support for the beneficiary from public sources.
f~~3,i•L'
J In such event, paragraph 4.(A}(2) of this Trust
shall be null and void and replaced by the
provisions hereinafter concerning the Special
Needs Trust.
(a) This Trust has specifically not been created
to supplant or replace public-assistance
benefits. My Trustee should, therefore,
seek entitlements which are available to
members of the community who are
experiencing disabilities that are
substantially similar to those that the '~
beneficiary experiences. My Trustee shall
deny any request made by any agency or
governmental entity requesting disbursement
of trust funds to satisfy beneficiary' s
support needs.
(b) This Trust shall be held and administered
for the benefit of the beneficiary in
recognition that there may be a number of
personal needs other than basic support and
maintenance which may be unavailable to the
beneficiary except through this Trust. This
Trust is intended to satisfy those non-
support needs, as deemed appropriate in the
absolute discretion of the Trustee. This
Trust is :got intended to displace any source
of income otherwise available to the
SAIDIS, beneficiary for their basic support (such as
~ip~l~ ~ food and shelter), including any
LINDSAY governmental assistance program to which the
2GWescHighStreec beneficiary is or may be entitled. It is not '~
culi:le.PA intended to be a resource of the beneficiary
and is not available to the beneficiary. It
is to be a discretionary spendthrift trust
created for non-support purposes.
(c) No part of the corpus of this trust shall be
used to supplant or replace any public-
' 6
i
assistance benefits received by or through
any county, state, federal or other
governmental agency.
t,
~ . (d} During the lifetime of the beneficiary, to
fi
' J,
~= ~ the extent that benefits are not made
~
~~ available to the beneficiary for other than
- basic living expenses, including food and
shelter, my Trustee, in his absolute
discretion, may distribute from income and
principal to or for the benefit of the
beneficiary, for their needs other than
basic support. For the purposes of this
provision, non-support purchases include,
but are not limited to dental care;
unreimbursable medical and dental expenses,
including plastic and reconstructive
surgery, diagnostic work and treatment,
rehabilitative training and experimental
medical services; psychiatric/psychological
services; occupational therapy; prosthetic
devices; dietary needs and supplements; the
differential in cost between shelter for a
shared and private group home or room;
custodial care or supplemental nursing care;
recreation, cultural experiences, outings
and travel, including payment for others to
accompany the beneficiary; telephone and
television, including cable television;
reading and educational materials; exercise
equipment; unreimbursed therapy; and related
insurance. Trustee's discretion in making
distributions authorized hereunder is
absolute with regard to distributions from
the Trust estate, and shall be binding on
all interested persons.
{3) Upon the death of my daughter, Doris A.
~'
~ Pina, my Trustee shall distribute the then
LIl~TDSAY
26WacHighScrac remaining principal and accumulated income
Gdule, PA
as follows:
(a) One third (1/3} of the remaining
principal to Shannon L. Nolan as soon
7
after the date of death of Doris A.
Pina as conveniently may be done;
(b) One half (1/2) of the remaining
,/~. `~'
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~!-~
,- principal and accumulated income f ive
(5) years after the date of death of my
daughter, Doris A. Pina; and
(c) The balance of the remaining principal
and accumulated income ten (10) years
after the date of death of my daughter,
Doris A. Pina.
5. In the event the beneficiaries of the Trust provided
for in paragraph 4 are deceased prior to the
distribution of all principal and income, but are
survived by issue, then to their issue in further
single Trust on the following terms and conditions:
(A) To hold, manage, invest, reinvest the principal
so received, and accumulation of income thereon,
and to use, pay and apply the income and
principal or so much thereof as in Trustee's sole
~ IS, discretion may be necessary for the maintenance,
~
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support, medical expenses and education of my
26 Wat High Strac
C.utisle,PA beneficiaries whether the same be born before or
after the signing of these presents.
(B) The payments authorized by this trust shall be
made without any regard to equality of
8
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~..1~'~;`~'
distribution among beneficiaries and without
further responsibility to a beneficiary or to any
person taking care of a beneficiary. Said
payments may be made by my trustee directly to a
beneficiary, or such of them as may be, in the
sole opinion of trustee, of such age and ability
to handle properly the funds so paid, or may be
made directly to the person having custody and
care of beneficiary, or may be made directly to
any institution entitled to such payment by
reason of services rendered or to be rendered to
any of beneficiary.
(C3 The amount to be paid for the benefit of
beneficiary shall be determined from time to time
by the need of beneficiary, and the amounts and
times of said payments shall be determined by
such need, provided that payments be made at
least monthly.
~~~
LINDSAY
26 Wac High Scrac
Cul'~sle. PA
(D) All payments of principal and income hereby given
shall be free from anticipation, assignment,
pledge or obligations of beneficiaries, and shall
not be subject to any execution or attachment.
(E) All principal and accumulated income, not so
applied, shall be distributed in equal shares to
the beneficiaries, per stirpes, when my youngest
9
then living great grandchild, by reason of
ahannon L. Nolan, attains the age of twenty-two
(22) years. In the event ahan~cioa L. Nolan is not
.,
*~ ~~Z, survived b issue, then to my children, per
Y
stirpes.
F0-
As to all trusts provided for in this my Last Will and
Testament, all payments of principal and income hereby given
shall be free from anticipation, assignment, pledge or
obligations of beneficiaries, and shall not be subject to any
execution or attachments.
FI
I direct that any and all inheritance, estate, and transfer
taxes imposed upon my estate passing under this Will or
otherwise shall be paid out of the principal of my residuary
estate.
s~
In addition to the powers conferred by law, I authorize any
personal representative, trustee or guardian acting under this
SAIDIS, instrument, in his/her absolute discretion:
7~OWF.~t ~
LINDSAY (a) To retain in the form received, or to sell either
26 War High Street
Cariisie,PA at public or private sale any real or personal property;
(b) To exercise any options to subscribe for stocks,
bonds, or other investments.
10
(c) To join in any plan of lease, mortgage,
consolidation, exchange, reorganization or foreclosure of
any corporation in which my estate or any trust may hold
stocks, bonds or other securities;
(d} To sell, transfer, convey, mortgage, pledge,
lease or exchange any property, real or personal, which at
~------
~..r~~lrv 7
any time may form part of my estate, for the payment of
debts or taxes, or for any purpose of administration or
distribution, for such prices and upon such terms as they,
in their sole discretion, may deem wise, and to execute and
deliver deeds of conveyance or transfer thereof;
' (e} To make settlements and compromises on such terms
as they, in their sole discretion may deem wise without the
necessity of obtaining any court approval thereof;
(f) To make distribution hereunder either in cash or
kind, as they, in their discretion may deem wise.
SEVENTH
I do hereby nominate, constitute and appoint my son, Ronald
E. Weibley, to acfi as Executor of this my Last Will and
~ Testament. Provided, however, that if he is unwilling or unable
~
~
LIlVDSAY to act as Executor, I direct the duties of Alternate Executor be
26 Wat High Sccrec
c.~l~~. PA performed by Donna J . Hoffman .
EIt3HTH
I do hereby nominate, constitute and appoint Co-Trustees
for all Trusts created by this my Last Will and Testament. The
11
Trustees shall be Ronald E. Weibley and a financial institution
authorized to provide trust services in the Commonwealth of
Pennsylvania as designated by Ronald E. Weibley. Provided,
however, that if for any reason, his designation of an
institutional co-trustee is not permitted, then the co-trustee
shall be LeTort management & Trust Company or its successor.
NINTH
I direct that no personal representative, guardian, trustee
or other fiduciary appointed under this instrument shall be
required to give bond for the faithful performance of their
duties in any jurisdiction.
IN WITNESS WHEREOF, I, Sara B. Weibley, have hereunto set
my hand and seal to this my Last Will and Testament, consisting
of twelve typewritten pages, the first eleven of which bear my
initials in the margin for identification, this ~~ ~ day of
i, ~~ _~-u~~~i-~ 2009.
Sara 8. Weibley, Test~~rix
IS,~
LINDSAY
26 West High Street
Carlisle, PA
12
Signed, sealed, published and declared by the above-named
Testatrix, Sara B. Weibley, as and for her Last Will and
Testament in the presence of us, who have hereunto subscribed
our names at her request as witnesses thereto, in the presence
of s estatrix and of each other.
,•
ADDRESS 26 West High Street
Carlisle, PA 17013
,,r -~. ADDRESS 26 West High Street
Carlisle, PA 17013
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
WE, Sara B . Weibley, :~: %hf~^r~ ~.. _~~_ :'~~ ~ ~ and
_ L~^~yc.er ~.'~t: ~~~ the Testatrix and witnesses, respectively
whose names are signed to the foregoing or attached instrument,
being first duly sworn, do hereby declare to the undersigned
authority that the Testatrix signed and executed the instrument
as her Last Will and Testament and that she signed willingly and
that she executed as her free and voluntary act for the purposes
therein expressed, and that each of the witnesses, in the
presence and hearing of the Testatrix signed the Will as witness
and that to the best of their knowledge the Testatrix was at the
time 18 or more years of age, of sound mind and under no
constraint or undue influence.
~ X ~ r
Sara 8. 'bley, Testa rix
Robert C. Saidis Witness
Bernyce Badowski , Witness
FLOWER ~~
I.~TDSAY
2G Wesc High Scrcec
Cuiisk, PA
Subscribed, sworn to and acknowledged before me by Sara B.
Weibley, the Testatrix, and subscribed to and sworn or affirmed
to before me by ~_,- ~v - ~ ~ ~ ~; / , and ~c~2.v~/Gc~ ~/~C,p~,~~~~r
witnesses, this ,•~~ day of •,.~';~_~=~y t~~ 2009.
.~ .-.
BllR9ABA & 8'[884 ~M '~
~iis~ eo~r pA Notary Publ i c
~ Ise 7 301t 13
r ~
REGISTER OF WILLS
CUMBERLAND COUNTY
PENNSYLVANIA
CERTIFICATE OF
GRANT OF LETTERS
No . 2010- 00593 PA No . 21- 10- 0593
Estate Of : SARA B WEIBLEY
foist, Middle, List/
Late Of : SOUTH MIDDLETON TOWNSHIP
CUMBERLAND COUNTY
Deceased
Social Security No : 174-20-8887
WHEREAS, on the 9th day of Apri I 2010 an instrument dated
September 24th 2009 was admitted to probate as the last will of
SARA B WEIBLEY
Ifisl, Middle, test!
late of SOUTH M/DDLETON TOWNSH/P, CUMBERLAND County,
who died on the 4th day of June 2 010 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wi I1 s in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters TESTAMENTARY to:
RONALD E WEIBLEY
who has duly qualified as EXECUTOR~RIX)
and has agreed to administer the estate according to law, all of which
fully appears of record in my office a t CUMBERLAND COUNTY CDURT HOUSE,
CARLISLE, PENNSYLVANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 9th day of April 2010.
eg stei o ~
putt'
* *NO?'E* * ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
RECEIPT FOR PAYMENT
GLENDA FARMER STRASBAUGH
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17Q13
Receipt Date: 6/092010
Receipt Time: 12: 4:23
Receipt No.: 1061438
WEIBLEY SARA B
Estate File No.: 2010-00593
Paid By Remarks: SRO PALD E WEIBLEY
------------------------ Receipt Distribution ------ ------- ------- ----
Fee/Tax Description Payment Amount Payee Name
PETITION LTRS TEST 660.00 CUMBERLAND COUNTY GENERAL FUN
WILL 15.00 CUMBERLAND COUNTY GENERAL FUN
SHORT CERTIFICATE 60.00 CUMBERLAND COUNTY GENERAL FUN
JCS FEE 23.50 BUREAU OF RECEIPTS & CNTR M.D
AUTOMATION FEE 5.00 CUMBERLAND COUNTY GENERAL FUN
Check# 1435 ----------------
$763.50
Total Received......... $763.50
SARA B. WEIBLEY
FILE NUMBER 21-10-0593
DATE OF DEATH JUNE 4, 2010
EXPLANITORY NOTES AND 5CHEDULE ATTACHMENTS
SCHEDULE E - CASH, BANK DEPOSITS & MISC. PERSONAL PROPERTY:
FIRST NATIONAL BANK OF CHESTER COUNTY CERT. OF DEPOSIT # 290005729
CHECK RECEIVED AT MATURITY ON 7/2/2010
INTEREST INCOME EARNED IN 2010 PER 2010 FORM 10991NT
ESTIMATED VALUE AT 1/1/2010
DAYS FROM 1/1/2010 TO 7/2/2010
DAYS FROM 1/1/2010 TO 6/4/2010
566.98 X 155/183 = INTEREST EARNED TO 6/4/2010
VALUE AT 6/4/2010
SCHEDULE G - INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY:
31,357.99
91 DAYS 65 DAYS
VALUE VALUE VALUE
ALLSTATE LIFE INS. CO. ANNUITY CONTRACT # GA0589387:
78,968.10 79,552.19 79,385.31
TRANSAMERICA LIFE INC. CO. ANNUITY CONTRACT # 0200PB06353:
18,973.64 19,113.98 19,073.88
2005 CADILLAC STS 4DR V6 PER JUNE 2010 BLACK BOOK USED CAR GUIDE AVE. RETAIL
183
155
31,430.14
(566.98)
494.83
13,725.00
SARA B. WEIBLEY
FILE NUMBER 21-10-0593
DATE OF DEATH JUNE 4, 2010
EXPLANITORY NOTES AND SCHEDULE ATTACHMENTS
SCHEDULE J - BENEFICIARIES:
1. ARLENE W. ARNDT, 85 QUEEN AVE., ENOLA, PA 17025 - DAUGHTER:
25% BENEFICIARY OF ALLSTATE ANNUITY CONTRACT # GA0589387
TRUST UNDER WILL OF SARA B. WEIBLEY F/B/0 ARLENE W. ARNDT, 49 S. PIN
2. OAK DR., BOILING SPRINGS, PA 17007 - DAUGHTER:
25% OF RESIDUE OF ESTATE
3. DORIS A. PINA, 1000 NYACK STREET N.W., PALM BAY, FL 32907 - DAUGHTER:
25% BENEFICIARY OF ALLSTATE ANNUITY CONTRACT # GA0589387
4. TRUST UNDER WILL OF SARA B. WEIBLEY F/B/0 DORIS A. PINA AND SHANNON L.
NOLAN, 49 S. PIN OAK DR., BOILING SPRINGS, PA 17007 - DORIS A. PINA -
DAUGHTER; SHANNON L. NOLAN - GRAND DAUGHTER:
25% OF RESIDUE OF ESTATE
5.
DONNA J. HOFFMAN, 27 BRANDYWINE DRIVE, BERLIN, NJ 08009 - DAUGHTER:
25% BENEFICIARY OF ALLSTATE ANNUITY CONTRACT # GA0589387
25% OF RESIDUE OF ESTATE
6. RONALD E. WEIBLEY, 49 SOUTH PIN OAK DRIVE, BOILING SPRINGS, PA 17007 -
SON:
25% BENEFICIARY OF ALLSTATE ANNUITY CONTRACT # GA0589387
100% BENEFICIARY OF TRANSAMERICA ANNUITY CONTRACT # 0200P606353
GIFT - CASH - GIVEN WITHIN 1 YEAR OF DATE OF DEATH
GIFT - 2005 CADILLAC STS 4DR V6 - GIVEN WITHIN 1 YEAR OF DATE OF
DEATH
25% OF RESIDUE OF ESTATE
TOTAL:
19,846.33
232,097.12
19,846.33
232,097.12
19,846.33
232,097.11
19,846.32
19,073.88
10,000.00
13,725.00
232,097.11
SARA B. WEIBLEY
FILE NUMBER 21-10-0593
DATE OF DEATH JUNE 4, 2010
EXPLANITORY NOTES AND SCHEDULE ATTACHMENTS
NOTE REGARDING THE ITEMS NOTED IN THE SECOND PARAGRAPH OF THE LAST WILL AND TESTAMENT OF
SARA B. WEIBLEY: THE DECEDENT WAS LIVING IN AN INDEPENDENT LIVING COTTAGE AT CUMBERLAND
CROSSINGS, CARLISLE, PA, AND WAS IN THE PROCESS OF UPDATING HER LAST WILL AND TESTAMENT IN
MAY 2008 WHEN SHE BECAME QUITE ILL AND WAS HOSPITALIZED. IN JUNE 2008, SHE WAS
TRANSFERRED TO THE SKILLED CARE FACILITY AT CUMBERLAND CROSSING, CARLISLE, PA, WHERE SHE
CONTINUED RECOUPERATION THROUGH JUNE 30, 2008. ON JUNE 30,2008, BASED UPON HER DOCTOR'S
RECOMMENDATION, SHE WAS TRANSFERRED TO THE ASSISTED LIVING SECTION OF CUMBERLAND
CROSSINGS, CARLISLE, PA, WHERE SHE REMAINED UNTIL THE DATE OF HER DEATH.
WHEN IT BECAME EVIDENT THAT SHE WOULD NOT BE ABLE TO RETURN TO HER INDEPENDENT LIVING
COTTAGE, SHE DECIDED TO GIVE UP HER COTTAGE AND BECOME A PERMANENT RESIDENT AT THE
ASSISTED LIVING FACILITY. ACCORDINGLY, SHE VACATED HER INDEPENDENT LIVING COTTAGE IN
NOVEMBER 2008. WHEN SHE VACATED HER COTTAGE, SHE GAVE ALMOST ALL OF HER COTTAGE
FURNISHINGS TO HER CHILDREN AND COMMUNITY CHARITABLE ORGANIZATIONS. AS A PART OF THIS
PROCESS, THE ITEMS MENTIONED IN THE SECOND PARAGRAPH OF HER LAST WILL AND TESTAMENT WERE
GIVEN TO RONALD E. WEIBLEY IN DECEMBER, 200$. THEREFORE, THOSE ITEMS ARE NOT INCLUDED IN
THIS RETURN SINCE THEY WERE TRANSFERRED MORE THAN ONE YEAR PRIOR TO THE DATE OF HERE
DEATH.
Charlene Feuchtenberger, Fiduciary Officer
Orrstown Financial Advisors
77 East King Street, Shippensburg, PA 17257
Date of Death: 06/04/2010
Valuation Date: 06/09/2010
Processing Date: 01/10/2011
Estate of: Estate of Sara B. Weibley
Account: 50 00 2175 0 10
Report Type: Date of Death
Number of Securities: 33
File ID: S. WEIBLEY 2175
Shares Security Mean and/or Div and. Int: Security
or Par Description High/Ask Low/Bid Adjustments Accruals Value
1) 100 AT&T INC (002068102)
COM
New York Stock Exchange
06/04/2010 29.54000 24.03000 H/L
24.285000 2,428.50
2) 100 CENOVUS ENERGY INC (151350109)
COM
New York Stock Exchange
06/04/2010 28.07000 26.78000 H/L
27.425000 2,742.50
3) 9000 COCA CCLA ENTERPRISES INC (19i219AW9)
New York Bond Exchange
DTD: 09130/1996 Mat: 10(01/2026 7%
06/04/2010 100.00000 A/B
100.000000 4,000.00
Int: 04!01/2010 to 06/09/2010 49.00
4) 100 COLLATE PALMOLIVE CO (194162103)
COM
New York Stock Exchange
06/09/2010 78.39000 77.03000 H/L
77.710000 7,771.00
S) 200 CORNING INC (219350105)
COM
New York Stock Exchange
06/04/2010 16.67000 16.17000 H/L
16.920000 3,284.00
Div: 0.05 Ex: 05/26/2010 Rec: 05/28/2010 Pay: 06/30/2010 10.00
6) 300 EATON CORP (278058102)
COM
New York Stock Exchange
06/09/2010 70.18000 66.86000 H/L
68.520000 20,556.00
7j 213.25 FNMA PASS-THRU LNG 30 YEAR (31376V7A4)
Financial Times Interactive Data
Mat: 01!01/2027 7.000$ Fact: 0.023634
06/04/2010 112.12308 A/B
112.123084 5.65
Int: 05/01/2010 to 05/31/2010, payable 06/25/2010 0.03
Prin: 05/01/2010 to 05/31/2010, payable 06/25/2010 0.01
8) 59.63 FNMA PASS-THRU LNG 30 YEAR (31377D5W7)
Financial Times Interactive Data
Mat: 03!01/2027 6.500$ Fact: 0
06/09/2010 110.14063 A/B
110.140625 N/A
Prin: 05/01/2010 to 05131/2010, payable 06/25/2010 0.40
9) 11029.933 FIDELITY PA TAX FREE PORTFOLIO (316344209)
PENN MUN INCM
Mutual Fund (as quoted by NASDAQ)
06/04/201Q 10.87000 Mkt
10.870000 119,895.37
10) 50000 GENERAL ELECTRIC CO {369604BC6)
New York Bond Exchange
DTD: 12/06/2007 Mat: 12/06/2017 5.25%
06/09/2010 107.63130 Mkt
107.631300 53,815.65
Int: 12/06/2009 to 06/04/2010 1,297.92
Page 1
This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions,
please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.1.1)
Date of Death: 06/04/2010
Valuation Date: 06/04/2010
Processing Date: 01/10/2011
Estate of: Estate of Sara B. Weibley
Account: 50 00 2175 0 10
Report Type: Date of Death
Number of Securities: 33
File ID: S. WEIBLEY 2175
Shares Security Mean and/or Div and Int. Security
or Par Description High/Ask Low/Bid Adjustments Accruals Value
11) 600 HAWKINS INC (920261109)
COM
The NASDAQ Stock Market LLC
06/04/2010 26.15000 23.72000 H/L
24.935000
12) 200 HEWLETT PACKARD CO (428236103)
COM
New York Stock Exchange
06/04/2010 47.10000 45.79000 H/L
46.445000
13) 100 INTERNATIONAL BUSINESS MACHS (459200101)
COM
New York Stock Exchange
06/04/2010 127.10000 124.67000 H/L
125.885000
Div: 0.65 Ex: 05/06/2010 Rec: 05/10/2010 Pay: 06/10/2010
14) 200 JPMORGAN CHASE & CO (46625H100)
COM
New York Stock Exchange
06/04/2010 38.70000 37.50000 H/L
38.100000
15) 200 MICROSOFT CORP (594918104)
COM
The NASDAQ Stock Market LLC
06/04/2010 26.57000 25.62000 H/L
26.095000
Div: 0.13 Ex: 05/18/2010 Rec: 05/20/2010 Pay: 06/1 0/2010
16) 9000 ORRSTOWN FINL SVCS INC (687380105)
COM
The NASDAQ Stock Market LLC
06/04/2010 23.62000 22.25000 H/L
22.935000
17) 200 PEPSICO INC (713448108)
COM
New York Stock Exchange
06/04/2010 62.46000 61.29000 H/L
61.875000
Div: 0.48 Ex: 06/02/2010 Rec: 06/04/2010 Pay: 06/3 0/2010
18) 10908 PINE BROOK CAP INC (72246F109)
CL A
Other OTC
No pricing information
19) 812.508 PRICE T ROWE GROWTH STK FD INC (741479109)
COM
Mutual Fund (as quoted by NASDAQ)
06/09/2010 26.43000 Mkt
26.430000
20) 1679.516 ROWE T PRICE EQUITY INCOME FD (779547106)
SH BEN INT
Mutual Fund (as quoted by NASDAQ)
06/04/2010 20.39000 Mkt
20.390000
21) 200 TJX COS INC NEW (872540109)
COM
New York Stock Exchange
06/04/2010 95.94950 49.36000 H/L
45.154750
22) 300 US BANCORP DEL (902973304)
COM NEW
New York Stock Exchange
14,961.00
9,289.00
12,588.50
65.00
7,620.00
5,219.00
26.00
91,740.00
12,375.00
96.00
N/A
21,474.59
34,245.33
9,030.95
06/04/2010 23.22000 22.78000 H/L
23.000000 6,900.00
Page 2
This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions,
please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.1.1)
Date of Death: 06/04/2010 Estate of: Estate of Sara B. Weibley
Valuation Date: 06/04/2010 Account: 50 00 2175 0 10
Processing Date: 01/10/2011 Report Type: Date of Death
Number of Securities: 33
File ID: S. WEIBLEY 2175
Shares Security Mean and/or Div and Int Security
or Par Description High/Ask Low/Bid Adjustments Accruals Value
23) 12000 UNITED STATES TREASURY BD (912810DW5)
OTC
DTD: 05/15!1986 Mat: 05/15/2016 7.25%
06/04/2010 127.20300 127.17200 A/B
127.187500 15,262.50
Int: 05/15/2010 to 06/04/2010 47.28
24) 6000 UNITED STATES TREASURY BD (912810EP9)
OTC
DTD: 02/16/1993 Mat: 02/15/2023 7.125%
06/04/2010 135.68750 135.65600 A/B
135.671750 8,140.31
Int: 02/15/2010 to 06/04/2010 .128.72
25) 200 VALE S A (91912E105)
ADR
New York Stock Exchange
06/04/2010 26.77000 25.36000 H/L
26.065000 5,213.00
26) 210.635 VANGUARD/WELLINGTON FD INC (921935201)
ADMIRAL SHARES
Mutual Fund (as quoted by NASDAQ)
06/04/2010 48.25000 Mkt
48.250000 10,163.14
27) 4446.648 VANGUARD/WELLESLEY INCOME FD (921938106)
COM
Mutual Fund (as quoted by NASDAQ)
06/04/2010 20.37000 Mkt
20.370000 90,578.22
28) 1707.769 VANGUARD HORIZON FD INC (922038203)
GLOBAL EQT PTF
Mutual Fund (as quoted by NASDAQ)
06/04/2010 14.65000 Mkt
14.650000 25,018.82
29) 300 VANGUARD WORLD FDS (92204A504)
HEALTH CAR ETF
NYSE Arca Equities Exchange
06104/2010 51.80000 50.47000 H/L
51.135000 15,340.50
30) 8307.997 VANGUARD PA TAX FREE FD (92204L302)
LONG TAXEX ADM
Mutual Fund (as quoted by NASDAQ)
06/04/2010 11.10000 Mkt
11.100000 92,218.77
31) 432.442 VANGUARD INDEX FDS (922908996)
500 IDX FD SHS
Mutual Fund ias quoted by NASDAQ)
06/04f2010 81.33000 Mkt
81.330000 35,170.51
32) 400 XCEL ENERGY INC (98389B100)
COM
New York Stock_ Exchange
06/04/2010 20.54000 20.06000 H/L
20.300000 8,120.00
33) 100 NOBLE CORPORATION BAAR (H5833N103)
NAMEN -AKT
New York Stock Exchange
06/09/2010 28.69000 27.15000 H/L
27.920000 2,792.00
Total value: $747,960.22
Total Accrual: $1,719.95
Total: $749,680.17
Page 3
This report was produced with Estateval, a product of Estate valuations & Pricing Systems, Inc. If you have questions,
please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.1.1)
Date of Death: 06/04/2010
Valuation Date: 06/09/2010
Processing Date: 01/10/2011
Portfolio Endnotes
Money Market:
Total Shs: 15,572.07
Cost: $1.00
Market value: $15,572.07
Accrued Interest: $0.20
Estate of: Estate of Sara B. Weibley
Account: 50 00 2175 0 10
Report Type: Date of Death
Number of Securities: 33
File ID: S. WEIBLEY 2175
FIRST NATIONAL BANK OF CHESTER COUNTY; WEST CHESTER,, PENNSYL`JANIA
MATURITY NOTICE AND DISCLOSURE 6/2=1/10
TERM 18M Certificate of Deposit NUMBER. 29()005729
CURRENT MATURITY DATE: 7/02/10
IF RENEWED THE NEW MATURITY DATE WILL BE: 1/02/12
Sara B Weibley
49 S Pin Oak Dr
Boiling Springs PA 17007-9407
This time deposit account will renew automatically. If you want to make any
changes to this account you must do so within 10 days of the maturity date.
This account has a current balance of $31,343.91 with an interest rate of
3.10000. The new interest rate and annual percentage yield are not yet
determined. They will be available on 7/02/10. You can obtain these rates by
calling (484) 881-4440 or visiting our website www.lnbank.com.
Thank you for banking with us.
COMPOUNDING & CREDITING: Interest will be compounded on a daily basis.
Interest will be credited to your account quarterly or every 6 months.
EFFECT OF CLOSING AN ACCOUNT: If you close your account before interest is
credited, you will receive the accrued interest.
MINIMUM BALANCE REQUIREMENTS: You must deposit $500.00 to open this account
and receive the annual percentage yield.
BALANCE COMPUTATION METHOD: We use the daily balance method to calculate the
interest on your account. This method applies a daily periodic rate to the
principal in the account each day.
ACCRUAL OF INTEREST ON NONCASH DEPOSITS: Interest begins to accrue on the
business day you deposit noncash items (for example, checks).
TRANSACTION LIMITATIONS: You may riot make withdrawals from or deposit into
your account until the maturity date.
EARLY WITHDRAWAL PENALTIES: We may impose a penalty if you withdraw any of the
principal before the maturity date. The penalty imposed will equal six months'
interest.
WITHDRAWAL OF INTEREST PRIOR TO MATURITY: The annual percentage yield assumes
interest will remain on deposit until maturity. A withdrawal will reduce
earnings.
RENEWAL POLICIES: This account automatically renews at maturity. You will have
10 calendar days after the maturity date to withdraw funds without. penalty.
If account is automatically renewed you will not receive subsequent notice.
/~'~ _
/~
First National PON. Bo h ~t3reet
~`'~"` `fit ~}~~`#~`~ ~{-'~~`'r'i West Chester, PA 19381
484.881.4000
1 nbank.com
Member FDIC
;';"First National Customer Seri~ice Ops -Cashier's Clrec/r
Bank of Chester County
MEMBER FOIC
2 V V /
REDEEM CD 290005729
DATE: 7/09/10 AC'C't)['~'T: 9999772>
RR.1NC[[: 0001
ok[c,[n~ ATOR: U3 0 5 0 0 61
REMITTER: FNB OF CHESTER COUNTY 'r[!~~[[s: 15:22:05
CK AMT: $ 31 , 4 3 0.14
FEE AMT:
TO: ESSTATE OF SARA B WEIBLEY TOTAL: $31,430.14
RONALD E WEIBLEY, EXECUTOR
NON-NEGOTIABLE
~~
1N Bank
A division of Graystone Tower Bank
P. O. Box 523
West Chester PA 19381-0523
(484) 881-4000
Sara B Weibley
49 S Pin Oak Dr
Boiling Springs PA 17007-9407
Payer's
Fed I.D. No.
26-0126034
OMB No_ 1545-0112
Interest Income
Form 1099-INT
Copy B
For Recipient
For year 2010
Recipient's
Tax I.D. No.
174-20-8887
Interest Interest on U.S. Federal Tax
Account Information Income Bonds & Treas Withheld
290005729 T 566.98
290005967 T 85.79
----------------------------------------------------------------------------
BOX 1 Interest income . 652.77
BOX 2 Early withdrawal penalty .
F3UX 3 Interest on u . S . Savings ~3onds and 'i'reas . obligations .
BOX 4 Federal income tax withheld. .
BOX 5 Investment expenses .
BOX 6 Foreign Tax paid
BOX 7 Foreign country or U.S. Possession .
BOX 8 Tax-exempt interest .
BOX 9 Specified private activity bond interest .
BOX 10 Tax-exempt bond CUSIP no. (see instructions). .
This is important tax information and is being furnished to the
Internal Revenue Service . If you are required to f ile a return,
a negligence penalty or other sanction may be imposed on you if
this income is taxable and the IRS determines that it has not
been reported.
(KEEP FOR YOUR RECORDS.)
W H2
StO5TAX2
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0
URRSTQWN~ANK
A Tradition of Excellence
P.O. Ilox 250
Shippensburg, PA 17257
Temp-Return Service Requested
Date 6/10/10 Page 1
Primary Account 106000095
Enclosures
002562 0.6500 AT 0.357 TR00012
Sara B Weibley
49 S Pin Oak Dr
Boiling Springs PA 17007-9407
0
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Starting this summer, if you want to keep overdraft coverage
for ATM and everyday debit card transactions, you must Opt In.
More information regarding this change is coming soon.
A C C O U N T S U MMA R Y
Account Number Account Title
106000095 50+ Interest Checking
4000007622 18-23 Month CD
C H E C K I N G A C C O U N T S
Account Title
50+ Interest Checking
Account Number
Previous Balance
2 Deposits/Credits
3 Checks/Debits
Service Fee
Interest Paid
Current Balance
Sara B Weibley
106000095
41,932.73
103,535.34
10,010.37
.00
4.08
135,461.78
Current Balance Enclosures
135,461.78
.00
Check Safekeeping
Statement Dates 5/11/10 thru 6/10/10
Days In The Statement Period 31
Average Ledger 109,383.41
Average Collected 96,132.46
Interest Earned 4.08
Annual Percentage Yield Earned 0.05
2010 Interest Paid 9.gg
Deposits and Additions
Date Description
5/11 Deposit
5/26 Deposit
6/10 Interest Deposit
Amount
34,972.13
68,563.21
4.08
Electronic Debits and Withdrawals
Date Description
5/25 CHECK/ACC. DELUXE CHECK
PPD
Amount
10.37-
L,.,1 RRS T ~~'~'N 1SANK
A T`radiiion ojExcellence
Date 6/10/10
Primary Account
Enclosures
Sara B Weibley
49 S Pin Oak Dr
Boiling Springs PA 17007
50+ Interest Checking
106000095 (Continued)
Page 2
106000095
--- CHECK SUMMARY ---
Date Check No Amount Date Check No Rmount
6/02 258 5,000.00 6/02 259 5,000.00
* Denotes missing check numbers
Daily Balance Information
Date Balance Date Balance Date Balance
5/11 76,904.86 5/26 145,457.70 6/10 135,461.78
5/25 76,894.49 6/02 135,457.70
~ Interest Rate Stta~mary
0
N
~, 5/10 0.050000
N
~ ~k*~kir*•,F*~/r**i~ic,F~r~k*~t*~!r*~Ir**,F~r*,k,t~t*,t~t****~F~c**,k~yF**ot~t,t*~k~c~k~k,E*~t~c,FyFic,F*~c,t*~k,ti~***~k~t*,Ficici~*~k
O
o C E R T I F I C A T E S O F D E P O S I T
0
c Account Title: Sara B Weibley
0
o° 18-23 Month CD
N Account Number Current Balance Interest Rate Maturi2010ate cc y Interest
N 4000007622 .00 1.290000 11/09/11 357.62
0
0
o THANK YOU FOR BANKING WITH ORRSTOWN BANK
0
N
Total Banking Statement ~ PNCBANK
PNC Bank
For m. period osiosi2o ~ o to osioarlo ~ o
Primary account number: 51-4019-3513
Page 1 of 5
Number of enclosures: 0
01673
SARA B WEIBLEY
49 S PIN OAK DR
BOILING SPRINGS PA 17007-9407
For 24hour banking, and transaction or
interest rate information, sign on to
PNC Bank Online Banking at pnc.com.
~' For customer service call 1-888-PNC-BANK
Monday - Friday: 7 AM - 10 PM ET
Saturday & Sunday: 8 AM - 5 PM ET
Para servicio en espar~ol, 1-866-HOLA-PNC
Moving Please contact us at 1-888-PNC-BANK
® Write to: Customer Service
PO Box 609
Pittsburgh PA 15230-9738
Visit us at pnc.com
TDD terminal: 1-800-531-1648
For hearing impaired clientr only
Relationship Overview
Bank .Deposit Accounts
Description Account Number Deposit Balance
In Brest Checking 51-4019-3513 12,889.77
Totall Deposiits I2,889.77
!n`Jdsttnent Accounts • • l~fay Losc Valuc
PNC Brokerage Account Number: 0086592312 ~ • ro saorr caarancc
Description Market value
on 06/02
Annuities 98,402.85+
Value 98,40 2.85+
Net Value 98,402.85+
Investment balances are provided for informational purposes only. For more details regarding these investements, please refer to your acxount
statement from your investment provider{s1. This information is not intended to replace your regular brokerage account statement{s?.
INIPORTAN~' ACCOUNT INFORMATION
Enclosed is an Addendum. to the Account Agreement for Personal Checking, Savings and Money Market Accounts. As noted
in a previous statement insert, effective August 15th, a new rule will affect our standard overdraft practices and the way we
pay overdrafts on ATM and everyday debit card transactions. The Account Agreement is being amended to reflect these
new practices. Please read the enclosed Addendum and retain it with your records.
For more information on your overdraft options, please visit pnc.com/overdraftsolutions.
Effective June 28, 2010, PNC will refund any overdraft item fee if the available balance in your account is overdrawn by $5
or less after all transactions are posted for the day. Although the fee may be refunded, the transaction will be considered
an overdraft occurrence when determining any subsequent overdraft fee. In addition, the Continuous Overdraft Charge wilt
not be assessed if your balance remains overdrawn by $5 or less.
For more Information, please call 1-888-PNC-BANK (762-2265 between T am - 10 pm (E'f) Monday-Friday, and 8 am - 5 pm
(E'T) Saturday-Sunday.
Your individual account statements begin on the following page PNDMLT01-JOB18357-140-YNYNNN-003-004951
r
i v ~.cai L cu.u~it~ ~t.at.c.r><tcita.t.
For the period 05/06/2010 to 06/04/2010
For 24hour information, sign on to PNC Bank Online Banking SARA B WEIBLEY
on pnc.com. Primary account number: 51-4019-3513
Page2of5
Senior Premium Plan Sara B Weibley
Interest Checking Account Summary
Account number: 51-4019-3513
Overdraft Protection Provided By: Contact PNC to estabfiah Overdraft Protection
Balance Summary
Beginning Deposits and Checks and other Ending
balance other additions deductions balance
13,422.39 4,896.89 5,429.51 12,889.77
Average monthly Charges
balance and fees
12, 75 7.21 .00
Transaction Summary
Checks paid/ Check Card POS Check Card/Bankcard
withdrawals signed transactions POS PIN transactions
0 0
Total ATM PNC Bank Other Bank
transactions ATM transactions ATM transactions
0 0 0
Ilnterest Summary As of 06/04, a total of $3.82" in interest was
Annual Percentage Number of days Average collected Interest Paid pall thl5 yeaf.
Yield Earned (APYE) in interest period balance for APYE this period
0.05% 30 12,757.21 .52
/~cdvity Detail
Deposits and Otfier Additions
Oate Amount Description
05/21 1,824.00 Direct Deposit -Tax Refund
US Treasury 220 ~'v?ZXX~';8887
05/28 1,306.24 Direct Deposit -Annuitant
PA Treasury Dept 574
06/01 1,528.13 Direct Deposit - Civil Sere
US Treasury 312 F 2195949 W CSF
06/03 238.00 Direct Deposit - Soc Sec
US Treasury 303 XX~~XX1168D
06/04 .52 Interest Payment
There were 5 Deposits and Other Additions
totaling $4,896.88.
Checks and Substitute Checks
Check Date Reference Check Date Reference
number Amount paid number number Amount
paid number
3014 5,129.00 05/24 0859577 3017 * 100.00 06/01 oa5oss22~
3015 200.51 05/24 0864X659
" Gap in check sequence There were 3 checks listed totaling
$5,428.51.
Daily Balance Detail
Gate Balance Date Balance Date Balance Date Balance
05/06 13,422.39 05/24 9,916.88 06/01 12,651.25 06/04 12,889.77
05/21 15,246.39 05/28 11,223.12 06/03 12,889.25
FORM166R
Total Banking Statement
Q PNCBANK
For 24-hour information, sign on to PNC Bank Online Banking
on pnc.com.
Account number: 51019-3513 -continued
For the period 05/06/Z01 O to 06/04/2010
SARA B WEIBLEY
Primary account number: 51-4019-3513
Page3of5
Achieve your homeownership goals with PNC Mortgage. Whether you are purchasing your first home, moving up to something larger or
refinancing, we have the borrowing options to make your dreams a reality. PNC Mortgage is a division of PNC Bank, National Association, a
subsidiary of PNC. All loans are provided by PNC Bank, National Association and are subject to credit approval and property appraisal. Equal
Housing Lender.
~ti
PN DMLT01-J0B 18357-140-YNYN N N-003-004952
For 24hour information, sign on to PNC Bank Online Banking
on pnc.com.
For the period 05/06/2010 to 06/04/2010
SARA B WEIBLEY
Primary account number: 51-4019-3513
Page4of5
Check Images
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3015 $200.51 05/24/2010
With PNC Online Banking, you can view, print and save up to the most recent 90 days of your canceled checks -front and back -FREE of
charge. Please contact us for additional options.
FORM166R
Reviewing Your Statement
~~ PN C BANK
Please review this statement carefully and reconcile it with your records. Call the telephone number on the upper right side of the. first page
of this statement if:
• you have aay questions regarding your account(s);
• your name or address is incorrect;
you have any questions regarding interest paid to an interest-bearing account.
Balancing Your Account
Update Your Account Register
Compare: The activity detail section of your statement to your account register.
Check Off: All items in your account register that also appear on your statement. Remember to begin
with the ending date of your last statement. (An asterisk {*} will appear in the Checks
section if there is a gap in the listing of consecutive check numbers.)
Add to Your Account Register Any deposits or additions including interest payments and ATM or electronic deposits
Balance: listed on the statement that are not already entered in your register.
Subtract From Your Account Any account deductions including fees and ATM or electronic deductions listed on the
Register Balance: statement that are not already entered in your register.
Update Your Statement Information
Step 1:
Add together
deposits and
other additions
listed in your
account register
but aot on your
statement.
Dusts of Dspooit Amount
Totsl A
Step 2:
Add together
checks and other
deductions listed
in your account
register but not on
your statement.
Step. 3:
Enter the ending balance. recorded oa your statement $
Add deposits and other additions not recorded Total A + $
Subtotal= $
Subtract checks and other deductions not recorded Total B - $
The result should equal your account register balance = $
Total B
Verification of Direct Deposits
To verify whether a direct deposit or other transfer to your account has occurred, callus Monday - Friday: 7 AM - 10 PM ET and Saturday
& Sunday: 8 AM - 5 PM ET at the customer service number listed on the upper right side of the first page of this statement.
Electronic Funds Transfers
Incase of errors or questions about your electronic transfers of if you need more information about a transfer, call us Monday - Friday: 7 AM - 10 PM ET and Saturday &
Sunday: 8 AM - 5 PM ET at the customer service number listed on the upper right side of the first page of this statement. Or, if you prefer, please write us at: Customer Service,
P.O. Box 609, Pittsburgh, PA 15230-0609. If you believe there is a problem, you must contact us no later than 60 days after the ending date of the Rrst statement on which the
er or or problem appeared. You will need to provide the following information:
Your Dame and account number(s);
• A description of the error or the transfer you are questioning. Please explain as clearly as you can why you need more information or why you believe an error was made;
• The dollar amount of the suspected error.
We will investigate your complaint and will correct any error promptly. If the investigation takes longer than 10 business days, we will credit your account for the
amount you think is in error, so that you will have use of the funds during the time it takes us to complete our investigation.
Cock 111~e~bsr or
Dod~dio~ De:criptio~ Amount
. ~~
Member FDIC = Equal Housing Lender
PN DMLT01-JOB 18357-140-YNYN N N-003-004953
Total Banking Statement ~PNCBANK
For 24hour information, sign on to PNC Bank Online Banking
on pnc.oom.
For tt~e period 06/05/Z010 to 07/07/Z010
SARA B WEIBLEY DECO
Primary account numtrer: fit-4019-3513
Page 3 of 4
I:hACI( ~Ml9A!
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5016 f 1,445.00 06/08/2010
With PNC Online Banking, you can view, print and save up to the most recent 90 days of your canceled checks -front and back -FREE of
charge. Please contact us for additional options.
~~
PNDMLT01-,fOB74196-140-NNNNN N-002-005082
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