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Home My WebLink About04-07-11ESTATE OF DOROTHY H. MELLOTT File No. 21-09-1.146 FAMILY SETTLEMENT AGREEMENT °~ .: _ ,,,. -r ; C.' ~ J .~ ~ `. r ~ .i ~` ~J .:..., .. ~ .~ ~ ~J = . , + `,~, ~/ ~, ce THIS AGREEMENT made this ~~day of ___, 2011 BETWEEN: JANE L. CARL, being the residuary legatee under the Last Will and Testament of Dorothy H. Mellott, late of the Borough of Shippensburg, Cumberland County, Pennsylvania, AND .1ANE L. CARL, Executrix of the Estate under the Last Will and Testament of Dorothy H. Mellott, deceased, WHEREAS, Dorothy H. Mellott died December 5, 2009, testate, and under her Will left her residuary estate to the party herein; and WHEREAS, Letters Testamentary were granted to Jane L. Carl on December 1 1, 2009, by the Register of Wills of Cumberland County, Pennsylvania; and WHEREAS, all assets of the late Dorothy H. Mellott have been liduidated or distributed and all her debts paid in full, and further the period of four months having been terminated since the first advertisement of the issuance of Letters to the said Executrix, the said party hereto desires to waive the duty of the Executrix to file a First and Final Account with Proposed Schedule of Distribution for purposes of confirmation by the Court of Common Pleas of Cumberland County, Orphan's Court Division., AND FURTHER desires that a Family Settlement Agreement be executed, which Family WEIGLE & ASSOCIATES, P.C. -ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 Settlement Agreement will be duly recorded among the deed records in and for Cumberland County. NOW, THEREFORE, WITNESSETH, that the party hereto, in consideration of the premises above stated, and of the Accounting and Proposed Schedule of Di stribution attached hereto and made a part hereof, and the receipt of her distributive share as therein shown, does bind herself to the said Distribution and Accounting as set forth anal further mutually releases Jane L. Carl, Executrix, from all claims and demands whatsoever arising out of settlement of the Estate of Dorothy H. Mellott. The party hereto does further agree that should any liability come due to t:he estate of the said decedent after the signing of this agreement, she does hereby covenant and agree with the aforesaid personal representative that she will contribute pro rata :her share of the estate to satisfy any and all claims, demands, suits, or causes of action which may be successfully prosecuted against the said estate or the aforesaid personal representative after the signing, sealing and delivery of this family settlement agreement and final release. IN WITNESS WHEREOF, the party has hereunto set her hand and seal tl~ie day and year first above written. WITNES ~`..~ dl - SF;AL ~ ) .1a e .Carl WEIGLE & ASSOCIATES, P.C. -ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURCi, PA 17257-1397 ~~, ~` ~,~ COMMONWEALTH OF VIRGINIA r SS COUNTY OF ` IX~1.~ A X On this, the ~ ~ day of ,~'~ (~ Y~ ~ ~- ? O l 1, before me, the undersigned officer, personally appeared JANE L. CARL, 1<now~n to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. .-~- , :~ ~~ ~ ~' (SEAL) AZITA 6EIRAMAMIRABADY Notuy Public CammonweeltA of Vir~lnia 7~3694Q Mr Commisalon Expires Oct 31, 2013 WEIGLE & ASSOCIATES, P.C. -ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURCi, PA 17257-1397 In the Court of Common Pleas of Cumberland County, Pennsylvania Orphans' Court Division File No. 21-09-1146 Estate of Dorothy H. Mellott, Deceased Borough of Shippensburg, Cumberland County First and Final Account Jane L. Carf, Executrix Date of Death: Date of Incapacity, if any: Date of Executrix's Appointment: Date of First Complete Advertisement: Accounting for the period: 12/05/2009 None 12/11 /2009 12/18/2010 12/05/2009 to 03/04/2011 Purpose of Account: Jane L. Carl, Executrix, offers this Account to acquaint interested parties with the transactions that have occurred during the Administration. It is important that the Account be carefully examined. Requests for additional information or questions or objections can be discussed with: Jerry A. Weigle Esquire Weigle & Associates, P.C. 126 East King Street Shippensburg, PA 17257 717/532-7388 Supreme Court I.D. No. 01624 SUMMARY OF ACCOUNT Estate of Dorothy H. Mellott, Deceased PAGES Proposed Distributions to Beneficiaries 20 PRINCIPAL Receipts: This Account Net Gain (or Loss) on Sales or Other Dispositions Less Disbursements: Debts of Decedent Funeral Expenses Administration Expenses Federal, State & Local Taxes Commissions Fees Family Exemption Balance Before Distributions Transfer to (from) Principal Distributions to Beneficiaries Principal Balance on Hand For Information: Investments Made Changes in Holdings INCOME Receipts This Account Net Gain (or Loss) on Sales or Other Dispositions Less Disbursements Balance Before Distributions Transfer to (from) Income Distributions to Beneficiaries Income Balance on Hand For Information: Investments Made Changes in Holdings COMBINED BALANCE ON HAND Signature Verification 3-5 Current Value 316,776.87 Fiduciary Acquisition Value 316,776.87 1,014,251.73 0.00 1,014,251.73 6 6 6-9 9 9 10 11 12 90,397.56 12,215.16 34,465.63 40,000.00 0.00 29,094.47 0.00 206,172.82 808,078.91 0.00 502,705.13 305,373.78 13 -16 11,609.09 0.00 11,609.09 17 206.00 11,403.09 0.00 o.oo 18 11,403.09 19 316,776.87 21 22 Assets Listed in Inventory (Valued as of Date of Death) SCHEDULE A RECEIPTS OF PRINCIPAL Cash Cash from M & T Bank Lock Box 1,505.86 Cash from Orrstown Bank Lock Box 964.50 F & M Trust Certificate of Deposit 2990187 25,841.61 Accrued interest on above item through date of death 45.13 F & M Trust Certificate of Deposit 2994889 33,300.03 Accrued interest on above item through date of death 223.52 F & M Trust Checking Account 70780 2.258.59 Accrued interest on above item through date of death 0.00 M 8~ T Bank Certificate of Deposit 0318829 2,290.93 Accrued interest on above item through date of death 2.07 M ~ T Bank Certificate of Deposit 0319158 2,000.00 Accrued interest on above item through date of death 40.98 M 8~ T Bank Certificate of Deposit 3803770 6,000.00 Accrued interest on above item through date of death 2.80 M & T Bank Certificate of Deposit 4396469 15,000.00 Accrued interest on above item through date of death 42.00 M 8~ T Bank Certificate of Deposit 6719817 2,604.14 Accrued interest on above item through date of death 3.57 M & T Bank Certificate of Deposit 7876723 29,084.46 Accrued interest on above item through date of death 150.18 M & T Bank Certificate of Deposit 7876898 7,054.86 Accrued interest on above item through date of death 23,23 M 8~ T Bank Certificate of Deposit 7876905 71,402.56 Accrued interest on above item through date of death 235.13 M 8~ T Bank Certificate of Deposit 7878050 2,172.83 Accrued interest on above item through date of death 34.46 M 8< T Bank Checking Account 97388130 13,799.47 Accrued interest on above item through date of death 3.38 M & T Bank Checking Account 98189352 11,06'7.04 Accrued interest on above item through date of death ;Z.74 Orrstown Bank Certificate of Deposit 27544 5,851).14 Accrued interest on above item through date of death 14.28 Orrstown Bank Certificate of Deposit 28327 83,550.67 Accrued interest on above item through date of death 9.27 -3- Fiduciary Acquisition Value SCHEDULE A RECEIPTS OF PRINCIPAL Continued Orrstown Bank Certificate of Deposit 28328 84,119.72 Accrued interest on above item through date of death 2.52 Orrstown Bank Certificate of Deposit 28329 24,97'1.49 Accrued interest on above item through date of death 0.75 Orrstown Bank Checking Account 102002012 7,478.62 Accrued interest on above item through date of death 0.03 Patriot Federal Credit Union 13-month Certificate of 57,035.17 Deposit Accrued interest on above item through date of death 0.00 Patriot Federal Credit Union 15-month Certificate of 24,166.78 Deposit Accrued interest on above item through date of death 137.68 Patriot Federal Credit Union Prime Share Account 2,203.82 Accrued interest on above item through date of death 0.99 Total Cash P l P ersona roms Gross Proceeds of Public Sale of Personal Property - 11,925.50 6-11-10 Personal Property - at appraised values 1,225.00 Total Personal Property ~ ~ .4.1 . $ U. S. Savings Bonds -Series E, EE, and HH. Bonds 315,890,39 Payable on Death to Jane L. Carl, daughter. U. S. Savings Bonds -Series E, EE, and HH. Bonds 73,500.00 jointly owned with Jane L. Carl, daughter. U. S. Savings Bonds -Series E, EE, and HH. Bonds in 6,792.56 name of decedent only -cashed in 2-17-2010. U. S. Savings Bonds -Series E, EE, and HH. Bonds in 4,359.44 name of decedent only. Total Bonds R I E t t ea s a e 206-208 Roxbury Road, -Borough of Shippensburg, 75,000.00 Cumberland County, PA -gross proceeds of sale 10 -12-10 Total Real Estate Fiduciary Acquisition Value 516,698.00 13,150.50 400,542.39 75,000.00 -4- SCHEDULE A RECEIPTS OF PRINCIPAL Continued Fiduciary Acquisition Value Total Receipts 1,005,390.89 01 /11/2010 05/28/2010 02/12/2011 10/12/2010 12/05/2009 01 /11 /2010 01 /11 /2010 02/18/2010 10/12/2010 Comcast Cable -refund 5.53 Commonwealth of Pennsylvania -state income tax 106.00 refund Commonwealth of Pennsylvania -refund of PA 5,612.38 inheritance tax County Tax Proration at real estate settlement 118.13 ECM Insurance -refund of homeowner's premium 7'3.67 Family Traditions -refund 7.20 Fogelsanger-Bricker Funeral Home -refund 100.00 Patriot Federal Credit Union Life Insurance -proceeds 2,000.00 of policy School Tax Proration at real estate settlement 837.93 Total Subsequent Principal Receipts 8,860.84 Total Adjustments and Subsequent Receipts 8,sso.s4 Total Receipts of Principal 1,014,251.73 -5- SCHEDULE C DISBURSEMENTS OF PRINCIPAL 12/17/2009 Debts of Decedent Walter Drake -balance due on order at date of death 12/22/2009 Meals on Wheels -November final billing 12/28/2009 Century Link 12/28/2009 PA Department of Revenue - 4th quarter 2009 estimated income tax 12/28/2009 U. S. Treasury - 4th quarter 2009 estimated income tax 12/31 /2009 Guideposts 04/07/2010 Department of the Treasury - 2009 federal income tax Total Debts of Decedent Funeral Ex ep nses 12/11/2009 Lollipop Shop -reception items 12/12/2009 Family Traditions -reception 12/14/2009 Fogelsanger-Bricker Funeral Home 12/14/2009 Spring Hill Cemetery 12/14/2009 Tim Wyrick -grave opening Total Funeral Expenses Administration Ex enses 12/08/2009 Jane Carl -executrix postage expenses 12/11/2009 Register of Wills, Cumberland County -Letters Testamentary and Short Certificates 12/17/2009 Kough's Oil Service 12/17/2009 Larry Weaver -lawn maintenance 12/18/2009 Rebecca Lehman -care of house 12/28/2009 Cody Lehman -snow removal 12/29/2009 Cumberland Law Journal -advertising Letters Testamentary 12/31/2009 Penelec 16.99 54.00 20.62 160.00 930.00 23.95 89,192.00 90,397.56 75.00 446.66 10,843.50 750.00 100.00 12,215.16 23.80 743.50 453.08 90.00 280.00 50.00 75.00 23.94 -s- SCHEDULE C DISBURSEMENTS OF PRINCIPAL Continued 01/04/2010 Cody Lehman -snow removal 25.00 01/04/2010 Rebecca Lehman -care of house 280.00 01/06/2010 Borough of Shippensburg 175.66 01/08/2010 Kough's Oil Service 212.16 01/12/2010 Kough's Oil Service 266.48 02/01/2010 Penelec 77,39 02/02/2010 Rebecca Lehman -care of house 280.00 02/09/2010 Cody Lehman -snow removal 85.00 02/15/2010 Kough's Oil Service 398.96 02/17/2010 News Chronicle -advertising Letters Testamentary 11:3.00 02/22/2010 Rebecca Lehman -care of house 280.00 03/17/2010 Grace Keiter, Tax Collector - 3-1-10 county real estate 532.32 taxes 03/17/2010 Tim Gruver Plumbing 196.00 04/01/2010 S & S Tax Service - 2009 income tax preparation 150.00 04/06/2010 Rebecca Lehman -care of house 350.00 04/06/2010 Tim Gruver Plumbing 196.00 04/07/2010 Borough of Shippensburg 14.1.00 04/07/2010 Kough's Oil Service 341.38 04/07/2010 Register of Wills, Cumberland County -four Short 1 Ei.00 Certificates 04/22/2010 Lake Oil Burner Service 14;1.00 05/01/2010 Rebecca Lehman -care of house 300.00 05/06/2010 Larry Weaver -mowing 6(1.00 05/07/2010 Everett Cash Mutual Insurance Company - 3 months 181'.00 fire policy 05/08/2010 Cody Lehman -clean up 125.00 05/10/2010 Borough of Shippensburg 120.00 05/10/2010 Cody Lehman -clean up 7G.00 05/22/2010 Borough of Shippensburg - dumpster fees 13Ei.60 05/28/2010 Penelec 14•.13 06/02/2010 Kendall's Tree Service -removal of tree causing 1,800.00 sewer problems 06/02/2010 Larry Weaver -mowing 60.00 06/10/2010 Rebecca Lehman -care of house 300.00 06/11/2010 Carl E. Ocker -appraisal fee 75.00 06/11/2010 Expenses of public sale held 6-11-10 4,273.93 -7- 06/15/2010 06/22/2010 06/25/2010 07/02/2010 07/15/2010 07/15/2010 07/15/2010 07/16/2010 07/19/2010 07/29/2010 08/02/2010 08/02/2010 08/26/2010 09/04/2010 09/22/2010 10/10/2010 10/12/2010 10/12/2010 10/12/2010 10/12/2010 10/15/2010 10/15/2010 10/18/2010 10/18/2010 10/26/2010 SCHEDULE C DISBURSEMENTS OF PRINCIPAL Continued T. C. Hauling -clean out of house and garage Borough of Shippensburg - dumpster fees Penelec Larry Weaver -mowing Everett Cash Mutual Insurance Company - 3 months fire policy Grace Keiter, Tax Collector - 7-1-10 county real estate taxes Kough's Oil Service Borough of Shippensburg Lester W. Carl -ink printer cartridge Penelec Larry Weaver -mowing Rebecca Lehman -care of house Penelec Larry Weaver -mowing Penelec Larry Weaver -mowing Real Estate Settlement costs -including Realtor Commission - $4,500.00; Deed Preparation - $125.00; Realty Transfer Tax - $750.00; Borough of Shippensburg final water/sewer billing - $250.62; Home Warranty of America - $420.00; Kirchoffs Termite & Pest Control - $1,123.60 Real Estate Settlement Expense -Seller Paid Closing Costs Real Estate Settlement Expense -Rent Proration October, 2010 Real Estate Settlement Expense -Last month of lease rent Penelec Tim Gruver Plumbing Jane L. Carl - HH bond interest on bonds belonging to Jane L. Carl at date of death of decedent, but deposited to decedent's checking accounts Jane L. Carl -executrix expenses including mileage, tolls, lodging, keys, and miscellaneous expenses Linda K. Klein -notary fee -8- 480.00 62.20 16.81 90.00 192.67 1.16'T.36 108.63 220.50 46.90 17.61 60.00 300.00 16.61 120.00 19.42 90.00 7,169.22 3,000.00 516.00 800.00 11.03 99.05 1,396.25 4,528.04 20.00 SCHEDULE C DISBURSEMENTS OF PRINCIPAL Continued 10/26/2010 Register of Wills, Cumberland County -filing PA 15.00 Inheritance Tax Return 10/26/2010 Register of Wills, Cumberland County -filing Family 100.00 Settlement Agreement 10/26/2010 Weigle ~ Associates, P.C. -reimbursement for 25.00 postage, xerox copies, and long distance telephone calls 02/23/2011 Maxwell Enterprises -preparation of 2010 fiduciary 255.00 income tax returns Total Miscellaneous Administrative Expenses Federal, State, and Local Taxes 02/17/2010 Register of Wills, Cumberland County - PA 40,000.00 inheritance tax, payment at discount Total Taxes Fees 34,465.63 40,000.00 12/29/2009 Weigle & Associates, P.C. 5,000.00 02/17/2010 Weigle & Associates, P.C. 5,000.00 05/03/2010 Weigle 8~ Associates, P.C. 5,000.00 08/23/2010 Weigle & Associates, P.C. 3,000.00 10/12/2010 Weigle & Associates, P.C. 3,000.00 10/26/2010 Weigle & Associates, P.C. -final balance 8,094•.47 Total Fees 29,094.47 TOTAL DISBURSEMENTS OF PRINCIPAL 206,172.82 -9- SCHEDULE D DISTRIBUTIONS OF PRINCIPAL Dennis W. Carl 05/18/2010 Specific Bequest -CASH 10,000.00 10,000.00 Jane L. Carl 12/05/2009 U. S. Savings Bonds -Series E, EE, and HH as per 315,890.39 attached listing. Bonds Payable on Death to Jane L. Carl, daughter 12/05/2009 U. S. Savings Bonds -Series E, EE, and HH as per 73,500.00 attached listing. Bonds jointly owned with Jane L. Carl, daughter 01/05/2010 Orrstown Bank Certificate of Deposit 28327 83,550.67 01/05/2010 Orrstown Bank Certificate of Deposit 28327 9.27 02/17/2010 U. S. Savings Bonds -Series E, EE, and HH. Bonds in 4,359.44 name of decedent only. 06/11/2010 Cash from M 8~ T Bank Lock Box 1,505.86 06/11/2010 Cash from Orrstown Bank Lock Box 664.50 06/11 /2010 Personal Property 1,225..00 10/18/2010 Patriot Federal Credit Union Life Insurance -proceeds 2,000,.00 of policy 482,705.13 Kevin L. Carl 05/01 /2010 Specific Bequest -CASH 10,000.00 10,000.00 TOTAL DISTRIBUTIONS TO BENEFICIARIES 502,705.13 -10- PRINCIPAL BALANCE ON HAND # Units Description dash Estate Checking Account Total Cash Current Value Fiduciary 03/04/2011 Acquisition 305,373.78 305,373.78 305,373.78 305,373.78 305,373.78 305,373.78 -11- SCHEDULE F CHANGES IN PRINCIPAL HOLDINGS # units rrstown Bank Certifica~~ of Deaosit 28327 12/05/2009 inventoried 12/05/2009 inventoried 01/05/2010 distributed 01 /05/2010 distributed Personal Property 12/05/2009 06/11 /2010 U. S• ~avinas Bonds 12/05/2009 12/05/2009 12/05/2009 12/05/2009 12/05/2009 02/17/2010 inventoried distributed inventoried inventoried distributed distributed inventoried distributed Tota I cost 83,550.67 9.27 -83,550.67 -9.27 0.00 1,225.00 -1,225.00 0.00 315,890.39 73,500.00 -315,890.39 -73,500.00 4,359.44 -4,359.44 0.00 o.oo -12- SCHEDULE G RECEIPTS OF INCOME F & M Trust Certificate of De posit 2990187 02/17/2010 final interest at closing F & M Trust Certificate of Dep osit 2994889 02/17/2010 final interest at closing M & T Bank Certificate of Dep osit 0318829 04/01/2010 final interest at closing M & T Bank Certificate of Dep osit 0319158 03/01/2011 final interest at closing M & T Bank Certificate of Dep osit 3803770 03/01/2011 final interest at closing M & T Bank Certificate of DeA OSit 4396469 03/01/2011 final interest at closing M & T Bank Certificate of Dep osit 6719817 03/01/2011 final interest at closing 63.72 63.72 115.35 115.35 3.97 3.97 23.01 23.01 1.48 1.48 10.49 10.49 27.43 27.43 -13- SCHEDULE G RECEIPTS OF INCOME Continued M & T Bank Certificate of Depo sit 7876723 03/01/2011 final interest at closing 328,78 328.78 M & T Bank Certificat e of Depo sit 7876898 03/01/2011 final interest at closing 36.53 36.53 M & T Bank Certificat e of Depo sit 7876905 04/01/2010 5nal interest at closing 124.73 124.73 M & T Bank Certificat e of Depo sit 7878050 03/01/2011 final interest at closing 23,89 23.89 M & T Bank Checking Account 97388130 03/01/2011 miscellaneous credits and account interest during 124.82 estate administration 124.82 M & T Bank Checking Account 98189352 03/01/2011 interest credits from various certificates of deposit 1,047.30 and checking account during estate administration 1, 047.30 M & T Bank Estate Ch ecking Ac count 01 /11 /2010 0.31 02/11 /2010 0.08 03/11 /2010 0.36 04/11 /2010 0.59 05/11 /2010 0.49 -14- SCHEDULE G RECEIPTS OF INCOME Continued 06/11 /2010 0.10 07/09/2010 0.09 08/11 /2010 ~D.13 09/10/2010 0.10 10/08/2010 ~D.08 11 /10/2010 0.53 12/10/2010 ID.48 01 /14/2011 0.52 02/11/2011 0.50 4.36 Orrstown Bank Certificate of Deposit 27544 03/01/2011 final interest at closing :?.69 2.69 Orrstown Bank Certificate of Deposit 28328 03/01/2011 final interest at closing 866.04 866.04 Orrstown Bank Certificate of Deposit 28329 03/01/2011 final interest at closing 257.08 257.08 Orrstown Bank Checking Account 102002012 03/01/2011 Interest from various bonds, certificates of deposit, 1,155.40 and account during administration of estate 1,155.40 Patriot Federal Credit Unio n 13-month Certificate of Deposit 03/01/2011 final interest at closing 953.06 953.06 -15- SCHEDULE G RECEIPTS OF INCOME Continued Patriot Federal Credit Union 15-month Certificate_of Deaosit 02/17/2010 final interest at closing Patriot Federal Credit Union Prime Share Account 03/01/2011 final interest at closing TOTAL BANK INTEREST Other Income 200208 Roxbury Road 12/18!2009 rent 02/02/2010 rent 03/17/2010 rent 05/06/2010 rent 06/02/2010 rent 07/16/2010 rent 08/06/2010 rent 09/07/2010 rent 10/06/2010 rent 11 /02/2010 rent TOTAL RECEIPTS OF INCOME 144.06 8.01 240.00 1,166.11 1,453.00 240.30 720.60 225.00 480.30 600.03 433.30 728.25 144.06 8.01 5,322.20 6,286.89 6,286.89 11,609.09 -16- SCHEDULEI DISBURSEMENTS -INCOME Exaense /INCOME PA Deaartment of Revenue 02/23/2011 PA Department of Revenue - 2010 fiduciary income tax TOTAL DISBURSEMENTS OF INCOME 2os.oo 206.00 206.00 -17- INCOME BALANCE ON HAND # Units Description dash Estate Checking Account Total Cash Current Value Fiduciary 03/04/2011 L1r_rniicitinn 11,403.09 11,403.09 11,403.09 11,403.09 11,403.09 11,403.09 -18- COMBINED BALANCE ON HAND # Units- Description l~as.h Estate Checking Account Total Cash Current Value Fiduciary o~inai2n~ 7 e..n,.,~,+,~., 316,776.87 316,776.87 316,776.87 316,776.87 316,776.87 316,776.87 -19- PROPOSED DISTRIBUTIONS TO BENEFICIARIES TO: Jane L. Carl Residuary Estate - 100% -CASH 316,776.87 316,776.87 Total 316,776.87 316,776.87 Current Value Fiduciary 03/04/2011 Acquisition or as noted Value 316,776.87 316,776.87 - 20 - In the Court of Common Pleas of Cumberland County, Pennsylvania Orphans' Court Division File No. 21-09-1146 Estate of Dorothy H. Mellott, Deceased Signature Jan .Carl, Executrix -21 - In the Court of Common Pleas of Cumberland County, Pennsylvania Orphans' Court Division File No. 21-09-1146 Estate of Dorothy H. Mellott, Deceased Verification Jane L. Carl, Executrix under the Last Will and Testament of Dorothy H. Mellott, Deceased, hereby declares under oath that he/she has fully and faithfully discharged the duties of his/her office; that the foregoing Account is true and correct and fully discloses all significant transactions occurring during the accounting period; that all known claims against the Estate have been paid in full; that, to his/her knowledge, there are no claims now outstanding against the Estate; that all taxes presently due from the Estate have been paid; and that the grant of Letters Testamentary and the first complete advertisement thereof occurred more than four months before the foregoing Account. This statement is made subject to penalties of 18 Pa. C.S.A. Section 4904 relating to unsworn falsification to authorities. Ja .Carl, Executrix Dated: r - 22 -