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HomeMy WebLinkAbout07-17-12Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF GUM{gEIQLA'~~ COUNTY, PENI~ISYLVANIA Name of Decedent Date of Death Ear ~.~ STN R ~~~~~ ~7-~~~- 2®IC~ File Number: ~Z~Csll~- CJ !G~`j Pursuant to Pa. O.C'. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete :.................... Yes ^ No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is YES, state the following: a. Did the personal representative file a final account with the Court? ....... ^Yes ~No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? ............................... Yes ^ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be fled ~,~•ith the Clerk of the Orpr~ans' Court and liiay be attached to this report. C~'7- ~ ~ - 2.c~!'Z "~_ ;... (13 ...J ~. y_.. ~~ ._i a.. ~ ~ . r- ~~ L L i ti ~ ~~ cx. ~..~ 4:.~ rJ Signature n Fili is Form Capacity: Personal Representative ^Counsel Nnme of Person Filing this Form 14 ~5T fM~~ pR ~ v~' Adaress (~R C--~S~-E~ ~~ 1 "7~ I S ~ i ~ - zz~ -~a~zt /~cEc-mil Telephone Form RW-l0 rev. lOJ3.0G - ~,'~J FIRST AND FINAL ACCOUNT OF S. JEFFREY BARNES, EXECUTOR ESTATE OF ELIZABETH R. BARNES, DECEASED FILE NO. 2010 - 01049 July 4, 2012 FINAL DISTRIBUTION OF ASSETS TO BENEFICIARIES Equal 1/3 Shares to Siblings: Cynthia B. Vriens; Gretchen L. Barnes; S. Jeffrey Barnes Net Value of Elizabeth R. Barnes Estate Per 04-29-11 Inheritance Tax Return Resident Decedent REV-1500 (Line 12 -copy attached) $ 319,052.64 Inheritance Tax Paid Per Line 19 of REV-1500 - 14,357.37 Inheritance Tax Return Filing Fee - 15.00 Inheritance Tax. Return Preparation Fee (Boyer & Ritter CPA) - 1,250.00 Gift to Caregiver Mimi Simpson - 2,500.00 Balance of Checking Account for ongoing U-Haul Storage Unit fees, etc* - 7,844.81 Personal Property (furniture & jewelry) Not Yet Distributed** - 15,000.00 Z"/lS,U~5.46 Divide Balance by 3 / 3 Each Beneficiary Has Received $ 92,695 In addition, each beneficiary has received a 1/3 total distribution from the Richard M. Barnes Irrevocable Trust (previously taxed during probate of Will of Richard M. Barnes) PNC Account No. 16-75-010-9427097 which terminated at the death of Elizabeth R. Barnes per attached documents Initial Distribution from PNC OS/10/11 + $ 44,750 Final Distribution from PNC 06/10/11 + $ 14,504 GRAND TOTAL Each Beneficiary Has Received $ 151,949 * Balance of checking account cash to be distributed in 1 /3 shazes to beneficiazies whenever U- Haul Storage Unit is emptied and its tease discontinued. ** Personal Property Value Listed as Asset on Schedule E of attached tax return. Value to be distributed in 1 /3 shares to beneficiaries whenever personal property is sold or otherwise distributed. RECEIPT, RELEASE, REFUNDING AND INDEMNIFICATION AGREEMENT FAMILY SETTLEMENT AGREEMENT ESTATE QF ELIZABETH R BARNES, DECEASED FILE N0.2010-01049 The undersigned, a beneficiary entitled to receive one thurd of the residuary estate of the Estate of Elizabeth R. Barnes, Deceased, does hereby: 1. Acknowledge that I have examined and approve the attached First and Final Account of S. Jeffrey Barnes, Executor, with the same force and effect as if such account had been filed with, and audited, adjudicated, and confirmed absolutely by, the Cumberland County Orphans' Court Division; 2. Waive the fifing of the Account; 3. Acknowledge receipt of the one-third share of the residuary estate in the amount of $151,949 as shown in the Account; 4. Release S. Jeffrey Barnes, both individually and in his capacity as Executor of the WiII of Elizabeth R. Barnes, Deceased, and his heirs, successors, and assigns, from all liability that he may have by reason of his administration of the estate; 5. ' To the extent of the distribution received, agree to refund to Executor any portion of the distribution to which I am not properly entitled even if distributed through negligence, to indemnify him for claims made against him as Executor, and to reimburse him for all expenses and costs incurred in connection with any such claims; and 6. Declare that this instrument shall be governed by the law of Pennsylvania and shall be legally binding upon me and upon my heirs, successors and assigns. C ~~~ In Witness Whereof, I have hereunto set my hand and seal this ____~ day of ~t~' ~ /_ ~., ~ ~-.. _= ..`... Witness ~-~~.~ ~ ~-~----""'_' ~ ~, -~ ~-- Witness ~ - !; / - Cyn 'a B. Vriens, Beneficiary RECEIPT, RELEASE, REFUNDING AND INDEMNIFICATION AGREEMENT FAMILY SETTLEMENT AGREEMENT ESTATE OF ELIZABETH R BARNES, DECEASED FILE N0.2010-01049 The undersigned, a beneficiary entitled to receive one-third of the residuary estate of the Estate of Elizabeth R. Barnes, Deceased, does hereby: 1. Acknawledge that I have examined and approve the attached First and Final Account of S. Jeffrey Barnes, Executor, with the same force and effect as if such account had been filed with, and audited, adjudicated, and confurned absolutely by, the Cumberland County Orphans` COUrt Division; 2. Waive the filing of the Account; 3. Acknowledge receipt of the one-third share of the residuary estate in the amount of $151,949 as shown in the Account; 4. Release S. Jeffrey Barnes, both individually and in his capacity as Executor of the Will of Elizabeth. R Barnes, Deceased, and his heirs, successors, and assigns, from all liability that he may have by reason of his administration of the estate; 5. To the extent of the distribution received, agree to refund to Executor any portion of the distribution to which I am not properly entitled even if distributed through negligence, to indemnify him for clauns made against him as Executor, and to reimburse him for ali expenses and costs incurred in connection with any such claims; and 6. Declare that this instrument shall be governed by the law of Pennsylvania and shall be legally binding upon me and upon my heirs, successors and assigns. In Witness Whereof, I have hereunto set my hand and seal this ~~ day of / +~~~ Witness ~~ ~ ~4, " ~• ~ ;~ ' ~ ~~ G~ret en L. Barnes, Beneficiary Witness ~-~~-~~ti~ J 1505610105 REV-1500 ex to2_~,, tom; ~ PA Department of Revenue pennsylvartia OFFICIAL USE ONLY Bureau of Individual Taxes """T"`"~ County Code Year File Number PO BOX z8D6oi ~ INHERITANCE TAX RETURN Harrisburg, PA i~i28-o6oi RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 172-26-4029 07/30/2010 11 /09/1931 Decedent's Last Name Suffix Decedent's First Name MI Barnes Elizabeth R (If Applicable) Enter Surviving Spouse's Information Belo Spouse's Last Name n Suffix Spouse's First Name MI t/ __ Spouse's Social Security Numb THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW OD 1. Ongrnal Return O 2. Supplemental Return O 3. Remainder Returr (Date of Death Prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) ~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes (Attach Copy of 1Nill) (Attach Copy of Trust.) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death O 11. Election to Tax under Sec. 9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number Michael B. Devlin, CPA First Line of Address Boyer & Ritter CPAs Second Line of Address 141 W. High Street City or Post Office Carlisle Correspondent's a-mail address: mdeVlln(a)CDabr.COm State ZIP Code PA 17013 REGISTER OF WILLS USE ONLY DATE FILED Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNAT SON - ONSIBLE FOR FI G RETURN DATE ~' ~~~ - ~~ Zit-I' ~ 14 East Harmolf Drive, Carlisle, PA 17015 SI ~ RE OF PREPA ER O~j~R TIiti4N REPRE$.~NTATIVE ~~~A~~~~ ADDRESS 'Y/J~r-~'`~l~/'Q_"`,~ l/.!'/J, JQ- Boyer & Ritter CPAs, 141 W. High Street, Carlisle, PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 156561D105 1505610105 J 1505610205 REV-1500 EX (FI) Decedent's Name: Elizabeth R. Barnes Decedent's Social Security Number 172-26-4029 RECAPITULATION 1. Real Estate (Schedule A) ........................................... .. 1. 0.00 2. Stocks and Bonds (Schedule B) ..................................... .. 2. 179,288.12 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. 31,687.46 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. 3,022.76 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested...... .. 7. 130,670.43 8. Total Gross Assets (total Lines 1 through 7) ........................... .. 8. 344,668.77 9. Funeral Expenses and Administrative Costs (Schedule H) ................. .. 9. 10,127.19 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............. .. 10. 15,488.94 11. Total Deductions (total Lines 9 and 10) ............................... .. 11. 25,616.13 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. 319,052.64 13. Charitable and Govemmentai Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ...................... .. 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... .. 14. 319,052.64 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 .0 15. 16. Amount of Line 14 taxable at lineal rate X A 45 319,052.64 16, 14,357.37 17. Amount of Line 1.4 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 1g_ 19. TAX DUE ....................................................... .. 19. 14,357.37 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610205 1505610205 O REV-1500 EX (FI) Page 3 Decedent's Complete Address: File Number DECEDENT'S NAME Elizabeth R. Barnes STREET ADDRESS 5225 Wilson Lane #1101 CITY Mechanicsburg STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments _____ B. Discount 3. Interest 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. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. Total Credits (A + B) (2) (3) (4} (5) 14,357.37 0.00 0.00 0.00 14.357.37 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 .......................................................................................... ^ b. retain the right to designate who shall use the property transferred or its income ............................................ ^ c. retain a reversionary interest .............................................................................................................................. ^ 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? ....................................................................................... ~ ^ ................................. 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)j. 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(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)J. 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) SCNEDt~LE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Elizabeth R. Barnes 21-10-1049 All property jointly-owned with right of survivorship must be disclosed on Schedule F. (It more space is needed, insert additional sheets of the same size) REV-i5o8 EX+ (ii-so) Pennsylvania SCNEDIJLE E ^EPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETUkN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Elizabeth R. Barnes 21-10-1049 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. ,~ nwic aNa~e a neeaeD, use aaa¢ionai sneers of paper of the same size. REV->5o9 EX+ (o>->o) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF: FILE NUMBER: Elizabeth R. Barnes 21-10-1049 If an asset became jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A• S. Jeffrey Barnes 14 East Harmon Drive son Carlisle, PA 17015 B. C. JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR 701NT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET %a OF DECEDENT'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A . 01!22102 Dollar Bank Passbook Savin Account # 10665637599 9 6,045.52 0 50 /0 3,022.76 TOTAL (Also enter on Line 6, Recapitulation) I $ 3,022.76 If more space is needed, use additional sheets of paper of the same size. REV-1.57.0 EX+ ~U8-U9) Pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Elizabeth R. Barnes 21-10-1049 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 ]NCLUDE THE NAME OF THE TRANSFEREE, TNEIR 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• CB&T Cust IRA/Rollover American Funds Mone Market Acct #82285259 y . Beneficiaries: S. Jeffrey Barnes, Cynthia B. Vriens, and Gretchen L. Bames 130,670.43 100 130,670.4: TOTAL (Also enter on Line 7, Recapitulation) $ I 130,670.43 If more space is needed, use additional sheets of paper of the same size. REV-1.51.1 EX+ Ilq-U9; ~~ i1 Pennsylvania DEPARTMENT Or REVENUEOr REVENUE INHERITANCE TAX RL--TURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Elizabeth R. Barnes 21-10-1049 Decedent's debts must be reported on Schedule I. ITEM NUMBER - DESCRIPTION AMOUNT A. FUNERAL EXPENSES: I' Hoffman-Roth Funeral Home 2,902.07 2. Chaplain gratuity (Carlisle $200) and Honorarium gift to Episcopal Relief (Pittsburgh Service $250) 450.00 3. Sewickley Cemetery burial fee 490.00 a. Rome Monument Works -headstone engraving 140.00 s. Memorial Service expenses -reimbursements to Cindy Vriens and Gretchen Barnes 255.88 s. Memorial Service Luncheon -Carlisle PA service 440.34 7. Funeral Service Luncheon -Pittsburgh, PA 438.18 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: 0.00 Name(s) of Personal Representative(s) Street Address City ___ State ZIP Year(s) Commission Paid: Z• 3• Attorney Fees: Family Exemption; (If decedent's address is not the same as claimant's, attach explanation.) Claimant 0.00 0.00 Street Address City _ __, State ZIP Relationship of Claimant to Decedent 4• Probate Fees: 477.50 5• Accountant Fees: 6• Tax Return Preparer Fees: 1,200.00 ~• Cumberland Law Journal ($75.00) & The Patriot News ($190.73)- estate advertisements 265.73 B. Estimated closing fees and costs 100.00 9. Zeigler's Moving & Storage -moving personal property from Bethany Apt to storage Unit 477.66 ~D~ U-Haul Storage Unit rent (July to March) 1,769.35 ~ ~ ~ U-Haul Truck Rental and movers to empty storage unit 320.48 ~ 2. Lawrence Knapp - 2010 Individual income tax prep for decedent 400.00 TOTAL (Also enter on Line 9, Recapitulation) $ 10,127.19 If more space is needed, use additional sheets of paper of the same size REV-7.51.7. EX+ ;12-08) Pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT INHERITANCE TAX RETURN , MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Elizabeth R. Barnes 21-10-1049 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1' Verizon -phone bill July 65.29 2. Bank of America -VISA 226.32 3. Continuing Care RX -prescriptions 576.99 4. Anglican Diocese of Pittsburgh -dental insurance final bill 59.42 5. Capital Anesthesia -medical copay 3 99 6. West Shore Endoscopy Center -medical copay 106.76 7. Hampden Physician Associates -medical copay 39.97 8. Continuing Care RX -prescriptions 313.38 9. Bethany Skilled Nursing 6,589.50 10. Bethnay Village -Monthly Fee 1,912.75 11. Associated Cardiologists, PC -medical copay 14.84 12. Verizon -final bills 74.39 13. Capital Anesthesia -medical copay 5 97 14. Central PA Pulmonary Associates, LLC -medical copay 12.80 15. Lower Allen Township EMS -ambulance transport 14.98 16. Camp Hill Emergency Physicans -medical copay 8 80 17. Bethany Skilled Nursing -final bill 2,696.66 18. Bethany Village -final monthly fee (net of $268.86 reimbursement) 1,583.14 19. Pinnacle Health Medical Services -medical copay 15.80 20. West Shore EMS-BLS -ambulance Transport 196.20 21. Pinnacle Health Medical Services -medical copay 38.39 22. Jackson Siegelbaum Gastroenterology -medical copay 16.60 23. Bonnie K. Miller -West Shore School District Local 2010 tax 11.00 24. PA Income Taxes - 2010 balance due on decedent's final return 905.00 TOTAL (Also enter on Line 10, Recapitulation) $ 15,488.94 If more space is needed, insert additional sheets of the same size REV-1513 EX+ (01-10) ~j i~ Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE ~ BENEFICIARIES ESTATE OF: FILE NUMBER: Elizabeth R. Barnes 21-10-1049 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RE oTN tSList Trustee(s)NT AMOOF ESOTATE ARE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1• Cynthia B. Vrien.s daughter 113 2. S. Jeffrey Barnes, 14 East Harmon Drive, Carlisle, PA 17015 son 1/3 and joint account 3. Gretchen L. Barnes daughter 113 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II 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 I $ 0.00 If more space is needed, use additional sheets of paper of the same size. LAST WILL AND TESTAMENT '; O F ELIZABETH R. BARNES ~ - -~ I i i _~ --i~ j` _ ~ c_, - -- c. ; i I I, r j~ { f I, ELIZABETH R. BARNES, of the Township of Upper St. Clair, Allegheny County, Pennsylvania, do make, publish anc~ declare this my Last Will and Testament, hereby revoking any and all Wills and Codicils heretofore previously made by me. FIRST: I direct my Executor to pay my just debts, the expenses of my last i1_lness and my funeral expenses as soon. as may be convenient after my death. '~i I ~j SECOND: Except as I may have provided in a memorandum signed', by me and kept with the original of this WiJ_1 o.r with my copy ~, thereof, I give my personal effects, household effects and other ~' tangible personal property to my husband, RICHARD M. BARNES, if '~~ he survives me, and if he does not so survive me tc my then ~~I Lip-ing children in as nearly equal shares as possible. ..~. ,'' - I THIRD: I give the residue of my estate to my husband, RICHARD M. BARNES, and NATIONAL CITY BANK, Pil=tsbur~~h, i i Pennsylvania, to hold IN TRUST, to invest and reinvest and to I distribute the net income (hereinafter called "Income") and principal in the manner set forth below. The Trustees shall distribute the I ~ ncome and principal as follows: (A) During the lifetime of my husband, RICHARD M. III BARNES, if he survives me, the Trustee shall pay the Income i ,~ I~, quarter-annually to him o:r for his benefit and may expend in addition such sums from principal as the Corporate Trustee ~~ considers advisable, in view of other readily available funds of '~ which 1.he Trustee has knowledge, to provide for his welfare and comfortable support. it (B) The Trustees shall also pay to my husband such portions of the principal as my husband requests in writing, not: to exceed in any one calendar year on a noncumulative basis (i) I if he dies before December. 1, FIVE THOUSAND ($5,000) DOLLARS, oz' 2 I (ii) if he is living on December 1, the greater of FIVE THOUSAND ($5,000) DOLLARS or five 5o er cent of the ( ) a r c_ a p gg g to value of Ili the principal as of December 1. a (C) Upon the death of my husband, the trust shall terminate and be distributed, or if he has not survived me, my estate shalll be distributed, in equal shares to my children, '~ CYNTHIA B. VRIENS, S. JEFFREY BARNES and GRETCHEN L. BARNES. In the event that a child has not survived my husband and me, but is survived by a spouse who has not remarried, the share of such child shall be distributed to his or her surviving spouse. If a spouse of any child who predeceases my husband and me has remar=Tied, his or her share shall be distributed to my deceased child"s then living issue, per stirpes, subject to the minorit~~ provisions hereinafter set forth. If any child of mine should not be living at the time of such termination without a spouse or issue surviving, his or her share shall be distributed to my then I' livi_nq issue, per stirpes, subject to the minority provisions ', hereinafter set forth. In the distributicn of my estate adoptec~ 3 ~ ~' issue shall be treated as the natural children of their adoptive ~'~ parent. (D) If, on the termination of any foregoing trust, a share of principal is directed to be paid to any person who is then under the age of twenty-one (21) years, such share shall rrot be paid out, but shall be retained by the corporate Trustee in a separate trust. Until he or she attains such age, the Trustee shall pay to said person or expend for his or her benefit so much of the Income and principal as the Trustee considers advisable and shall add the rest of. the Income to principal and invest it. ~, When. said person attains such age, the principal shall be paid to ~' him or her. If he or she dies before such time, the principal li I ~; shall be distributed, outright or in trust, as he or she directs ~ i II by specific reference to this paragraph in his or her Will, and. i !~ any unappointed portion shall be paid to the persons entitl ~ ed to , II his or her estate. !i (E) Income allocated to a minor may be expended !, for his or her benefit or may be paid to his or her natural guardian, to the guardian of his or her person or estate or to a I 4 Custodian for him or her under an appropriate Uniform Gifts or ij Transf=ers to Minors Act, without liability on the part of the Trustee to see to the application thereof. The Trustee may also deposit amounts in an interest-bearing account in t:he minor's name in its own banking department or elsewhere and may pay a reasonable allowance to the minor. (F) The interest of any beneficiary, including a remainderman, in Income or principal shall not: be subject to assignment, alienation, pledge, attachment or claims of creditors while the funds are in the hands of the Trustee, but. this sentence shall not restrict the exercise of any power of withdrawal or appointment hereinbefore granted. (G) Except as may be otherwise specifically II hereinbefore provided, on the death of a beneficiar y, any Income accrued or received after the last regular Income a ent da i p Ym to !' shall be treated as accruing after the benefic_iary's death. All stock dividends in shares of the distributing corporation are principal. 5 FOURTH: (A) The Trustees shall have the follow:~ng powers, in addition to those granted by law: to accept assets in kind in distribution from my estate or elsewhere; to collects proceeds of insurance on my life and to use such proceeds to puz-chase assets from my estate or to make loans to my estate; to retrain assets in kind or to sell the same; to invest in any kir.~d of ~>roperty without regard to any statutory limitations; to retain policies of life insurance, to pay premiums thereon from income or I~ principal and to exercise all rights of ownership th.ereover; to pledge,, exchange or mortgage real or personal property and to ii ~, lease the same for terms exceeding the term of the trust; to give ~ or exercise options for sales, leases and exchanges; to borrow money; to compromise claims; to vote shares of corporate stock, j in person or by proxy, in favor of or against mana ement g I ~~~ proposals; to carry securities in the name of a nominee, I including that of a clearing corporation or depository, or in 'I book er..try form or unregistered or in such other form as will_ ~,' pass by delivery; to allocate realized capital gains to income cr principal; and to make division or distribution either in cash or 6 I in kind, allocating to each share identical cr different kinds ofd or interests in property and property having different bases for Federal income tax purposes. (B) While observing its primary responsibility to act ~~ I' in the best interests of the beneficiaries, the corporate Trustee ~~ ~I~ is aut..:~rized to deal with its entire banking institution and its ,I j affiliates on the same basis as with unrelated institutions. By way of illustration and not limi tation, the Trustee may invest in I ~~ j interest-bearing accounts in or certificates of deposit issued by; its banking department, in shares of registered investment companies for which the Trustee or an affiliate per:Eorms services for a fee, whether as custodian, transfer agent, in~~estment ~I advisor or otherwise, or in securities underwritten by syndicates of which the Trustee is a member, but not if purchased from the ~ 1 Trustee; may borrow money from its banking deb>artment; may retain ' shares of its corporate stock or that of any company having I control over it, but the Trustee shall not review said stock for investment purposes and shall sell, purchase or vote said stock only as directed by an adult Income beneficiary of the trust in 7 tr 'i i it I j it which it is held; and may execute purchases and sales through .its ~~ affiliated brokerage service at the affiliate' E s regular II I institutional rates so long as that service provides competiti•Je execution. Any broker or dealer executing transactions on behalf of the trust may receive commissions that are reasonable in relat=ion to the value of the brokerage and/or research service: provided. The term "affiliate" shall include a subsidiary of t:he Trustee cr of an affiliate. I (C) The corporate Trustee may resign at any time, without stating cause, by petitioning a court of competent jurisc'.iction to designate and appoint a successor corporate Trustee. In the case of the merger or consolsidation of the Trustee, the resultant company shall become successor Trustee '! hereunder without notice to any party. II (D) The Trustee shall be entitled to receive I compensation for its services hereunder in accordance with its I schedule in effect when the servi ces are performed. ~I 8 FIFTH: I appoint RICHARD M. BARNES as my Executor and gig=e to him as Executor the same powers as are given to the Trustee~~ under Article Fourth above and also the power to file an Y qualified disclaimer I could have filed if living. In the evert that h.e is unable or unwilling to serve, I appoint S. JEFFREY BARNES as Executor, and in the event that he .is unable or unwilling to serve, I appoint LAWRENCE M. KNAI?P as Executor. No bond or other security shall be required of any fiduciary hereunder in any jurisdiction. SIXTH: I realize that fiduciaries are given discretion by law to make various elections which affect the income and ii transfer taxes payable by estates, trusts and beneficiaries, as I well as the relative shares of beneficiaries, such as taking ~~' administration expenses as deductions for either estate or incorleli ~; tax purposes, selecting options for the payment of employee deat.h~ !. I benefits, electing to take qualified terminable interests as part! II of the marital deduction, selecting alternate valuation dates, postponing the payment of taxes, filing joint .income tax or gift 9 I -~~~~ tax returns, allocating any exemption from generation-skipping ii transfer tax, filing estimated income tax returns and making payment thereon and effecting a redemption of corporate stock. The decisions made by my fiduciaries in any of these matters shall be binding upon, and not subject to question by, any affected persons. I rely upon my fiduciaries to take into consideration the total income and transfer taxes payable by reason of their decisions, including those payable by my survivors, and they are authorized in their d_iscret:ion, but not it required, to make adjustments between income and principal as a I result thereof. They are specifically authorized to file a joint ~~ income tax return ii with my husband for any period during which such a return is permitted, without re uirin hi q g m to sign an !~ indemnification agreement. ~, i SEVENTH: I appoint NATIONAL CITY BANK, Pittsburgh, Pennsylvania, guardian of the estate of any minor receiving any !~ sums of money, real property or other intangible personal property free of trust by reason of my death, if such property is' 10 ~, i i II in excess of the amount which may be paid to the natural guardian; and I authorize said guardian, in his sole discretion and without order of court, to retain such property in kind or to sell the same, giving good title to any real. estate, to inves~ and reinvest without being limited to "legal" investments and to use both income and principal for the minor's welfare, comfortable support and education, including college expenses. EIGHTH: I direct that all estate, inheritance and other taxes in the nature thereof, together with any interest and j, penalties thereon, becoming a able because of m P Y y death with ~~~, ~ respect to the property constituting my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid from the principal of my residuary estate, ~,i and no person receiving or having a beneficial interest in an~~ such property, whether under this Will or otherwise, shall at any ~~' time be required to contribute to or refund any part thereof; i PROVIDED, however, that this direction shall not apply to the taxes on any property included in my estate solely because of a ~I 11 i l.__ !. ~; "',~ power of appointment thereover which ~~ Iii exercised or on any qualified termina IN WITNESS WHEREOF, I have hereu _~ n this ~ ~ day of Y.~:lr•~y:~,1°r-.~~; _ ~ i~ ~~~ ~~ ~ f,~ j ~)~ ti ~~ ~ .~~~~- ~ SEAL ) Signed, sealed, published and declared by ELIZABETH R. BARNES, the Testatrix above named, as and for her Will, in the presence of us, who, at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses hereto. ,.. ~~~ ~~ ~~ ~~ b r~ 12 COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF ALLEGHENY ) We, ELIZABETH R. BARNES, the Testatrix, and fc=zr.?~~- if ~~r~r~ i< ~ ~~ and .~~r~Sr"-~~-~~, ~ ~~ -r c~is~ the witnesses `whose names are subscribed to the foregoing -~ 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 it 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 witnesses and that to the best of their knowledge t=he testatrix was at that time 18 or more years of age, of sound m~_nd and under no constraint or undue influence. '~~e~tatrix ~, °- l „ _ _~ Witness ~ ,~ Uk.J CL~t,,~-t- ~ ~ .~y ~ u-;~ r, ~ Witness Subscribed, ELIZABETH R. BARD before me by _ day of sworn to and acknowledged before me by ~S, the testatrix, and subscribed and sworn to ~-~ j~ ~ ~~. f-.~- ~~ .~ c"~ f ~,~ f" and ~ ~ ~ ~~~ fl~~ witnesses, this ~ ~~~~ -~-~ z-- 19 9 8 . Lr~1 `~ I; Notary Public ~.` 1 3 Notarial Seal Lawrence M Knapp, Notary Public Pittsburgh, Allegheny County ' My Comm(ssion Expires Jan. 14, 2002 Member, PennsyWania A,;;ocia'ion of Notaries © jrl~l DC~11A _ACCOT.INT NU. ACCOJNT 'PYFE 9843119125 M&T CLASSIC CHECKING W/INTEREST 00 0 04345M NM 017 ELIZABETH R BARNES 14 EAST HARMON DR CARLISLE PA 17015 INTEREST PAID YEAR TO DATE 1.25 Trrr~rrTrm ([TrnanRTT[> STATEMENT FERIQII PAGE JUL.21-AUG.20,2010 1 OF 2 STONEHEDGE BEGINNING BALANCE DLF03IT5 & aTFLER ADDITIONS CHECKS PAID D'i`HPR SUBTRACTTONS CLFR:&ENT I23TE`RES" PI? $NDIN6 $ALANCE NO_ AMOUNT NO. AMOUNT NO. ANOUNT 7,866.86 4 17,675.28 2 630.00 13 11,299.37 0.06 13,612.83 T rrllrTTTT TrT Tr)T m[r PO(aTF.NG DATE - TRANSACTION DESCRIPTION L3EP0$ITS; INTEREST & OTHER ADDITIONS C1-IECKS & OT73F;R SUBTRACPTONS DAILY - BALANCE 07-21-10 BEGINNING BALANCE $7,866.86 07-30-10 BENEFIT PAYMENTS PENSIONS 2,472.3 10,339.21 OB-03-10 US TREASURY 303 SOC SEC 1,193.D0 11,532.21 08-OS-10 WEB PMT Continuing Care RX 576.99 OB-OS-10 WEB PMT BANK OF AMERICA 226.32 08-OS-10 WEB PMT VERIZON 65.29 OB-OS-10 WEB PMT Anglican Diocese of Pitt 59.42 10,604.19 OB-06-10 WEB PMT Continuing Care RX 313.38 OB-06-10 WEB PMT West Shore Endoscopy Cen 106.76 OB-06-10 WEB PMT Hampden Physician Associ 39 97. OB-06-10 WEB PMT Capital Anesthesia 3.99 10,140.09 08-10-10 REVERSE DIRECT DEPOSIT 1,193.00. 8,947.09 OB-11-10 WEB PMT Bethany Skilled Nursing 6,589.50• 08-11-10 WEB PMT Bethany West Apartments 1,912.75 08-11-10 CHECK NUMBER 0256 490.00 45.16- 06-16-10 DEPOSIT 1,009.93 08-16-10 CHECK NUMBER 0257 140.00 824.77 08-18-10 JANNEYMONTGOMERY CREDIT 13,000.00 13,824.77 OB-19-10 WEB PMT WSEMS 196.20 08-19-10 WEB PMT Pinnacle Health Med Svcs 15.80 13,612.77 OB-20-10 INTEREST PAYMENT 0 06 . 13,612.83 ENDING BALANCE $13,612.83 CHECKS FRID StY 256 08-11-1D 490.00 257 08-16-10 140.06 rtnn~ri_vr+.n.~A 1nrltK.l. IP,nl.r_ i~nA~ INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND ~ FILE NO Po eox zeo6ol '~ TAXPAYER RESPONSE ACN HARRISBURG PA 17128-0601 DATE REV-1543 EX 0.FP (08-OB) ' 21 10-1049 10170020 12-13-2010 S J BARNES _~~~~ ~z , , „~ ~4 EH~sT HI>4Rr~•oN ~r2cvE Cr~,Qu ~~~ P,4 17~r ~' EST. OF ELIZABETH J BARNES SSN 172-26-4029 DATE OF DEATH 07-30-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE: CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. DOLLAR BANK provided the Department with the information below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-named decedent, you were a .i oint owner/beneficiary of this account. If you feel the information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of .c^n Sylvania. Please call :717) 787-9327 w.ith..questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 10665637599 Date 01-22-2002 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $` 6 ~ 045.52 payment to the Register of Wills. Make check payable to "Re g:i ster of Wills, Agent". Percent Taxable X 50.000 S` 3 ~ 022.76 NOTE: If tax payments are made within three Amount Subject to Tax months of the decedent's date of death, Tax Rate ~( 1rj deduct a 5 percent discount on the tax due. Potential Tax Due $ 453.41 Any Inheritance Tax due will become delinquent nine months after the date of death. PART TAXPAYER RESPONSE 'FAILURE'.~~0 FtESP.ON#3~lIl .E~ULT At+l fl FICIAL 1~AX ASSES5I~EN:T A. ^ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain C H E C K a discount or avoid interest, or check box "A" and return this notice to the Register of O N E Wills and an official assessment will be issued by the PA Department of Revenue. BLOC K ~ g, ~y~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y J~ to be filed by the estate representative. C. ~ The above informs ion is incorrte~ct and/or debts and deductions were paid.. Complete PART 2~ and/or PART ~ below. PART if indicating a different relationship to decedent: tax rate, please state ~~ °°' W "~ 'a ~ - OFF,~CIAL US ~NLY ~ ~ AAF TAX R \~; PA DEPARTMENT OF REVENUE ETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 1 2. Account Balance 2 $ ~~ 2 3. Percent Taxable 3 X ~ 3 4. Amount Subject to Tax 4 +fi 4 ~ 5. Debts and Deductions 5 - ~ - ~ -. ._ .. 6. Amount Taxable 6 $ -6 7. Tax Rate 7 X :~ ~ .- 8. Tax Due g PART DEBTS AND DEDUCTIONS CLAIMED S^ DATE PAID PAYEE DESCRIPTION AMI'iIIAIT OwTn Under penalties of perjury, I declare that the facts I have reported a~b7ove are true,/c,,~orrect and complete to the best of my knowledge and belief. HOME C /~~ ) ~~'~~W ~ ~~~ WORK C "7t7 ~ ZZ(~-b~Z/ ~Cr3i.~ (2-31~"-l0 TAXP,~„ ". S~NATURE TELEPHONE NUMBER DATE •~• ~ ~~-~~~~~ ~~, ~i,~n ~ yr iax l.OmpULatlOn) $ The right choice for the long term° American Funds® PO Box 2560 Norfolk VA 23501-2560 AT 01 250826 16621H931 A**3DGT ~Illilllln~nl~~llll11111111~I~I l~ll~l~l llll~ll~nl~lrlil~~~ll~ CB&T CUST IRA/ROLLOVER ELIZABETH R BARNES/DEC'D 5225 WILSON LN APT 1101 MECHANICSBURG PA 17055-6664 Year-End Statement Page I of 4 December 31, 2010 Your t3nandal advisex' MCANDREWS/PASTIN (412) 562-7936 JANNEY MONTGOMERY SCOTT LLC 600 GRANT ST STE 3100 PITTSBURGH PA 15219-2709 Best wishes for the New Year For more account information ...................................................................................................... ................................................................................................... This statement shows your complete account activity for 2010. ^ Call dour financial adviser We recommend you keep it for your tax records. See our online ^ Automated information and services Tax Center for tax forms, interactive worksheets, average cost Website - americanfunds.com information, and more. You can also go online to make your American FundsLine ° - 800/325-3590 IRA contributions. Visit us at americanfunds.com/taxes. ^ Personal assistance - 8 a.m. to 8 p.m. Eastern time M-F Guide to market recoveries Shareholder Services - 800/421-0160 A look back at several signrficant market declines -and their subsequent recoveries -can offer useful perspective for today. =_ Visit americanfunds.com/recoveries to access our tools and resources. Year-end summary Reinvested Change in ~_ Value on dividends and account Value an Ending ....._...... 17,/31/09 + Additions + capital gains - Withdrawals +/- value 17/31/10 share balance .............................................................................................................................. CBdtT CUST IItA/ROII.OVER ............................................................. ELIZABETH R BARNES/DEC'D American Funds Money Market Fund-A Account # $130,670.43 American Funds Money Market Fund-A Account # f#~761UD $0.00 American Funds Money Market Fund-A Account # 8515'ltit2 $0.00 American Funds Money Market Fund-A Account # 85fi16t19 $0.00 Totals 5130,670.43 $0.00 $0.00 -$130,670.43 $0.00 $0.00 $43,556.81 $0.0(1 -$43,556.81 $0.00 $0.00 $43.556.81 $0.00 -$43,556.81 $0_(~ $p.00 $43,556.81 $0.00 -$43,556.81 $0.00 $0.00 5130,670.43 .~u.0o -5261,340.86 Se.OO So.Oo 0.000 0.000 0.000 0.000 ncs..vnm•.oas~esaooan3za~.az~.cr+sacsox.nrvMCn........~i___.oiveisivz/sir¢ioo ~ 250826/000000 t~ O .~ ro .-i ro a) +-~ ro +~ W ~n~.cmo 0 O O U N +~ ~--i ,-~ 0 ~ O U ?i G i ro 1 O . r{ ~, a) ?-I ~ N • • O N O 6l ro I D ul r1 O N +~ -r ro 3-i W [~ Q) I >, ~ ~ O O U Sa O ~r 4-a ~ rI [~ ~ ~ ~ U U a +~ .~ cis O ~ o -~ rn ,n ~ cll Q. 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BARNES ACCOUNT NO. 16-75-010-9427097 WAIVER OF ACCOUNT RECEIPT RELEASE AND INDEMNIFICATION AGREEMENT The circumstances leading to the execution of this Waiver, Receipt, Release and Indemnification Agreement ("Agreement") are as follows: 1. WHEREAS, Richard M. Barnes, as Grantor, created a trust (the "Barnes Trust") for the primary benefit of Elizabeth R. Barnes, Grantor's wife, under the terms of his Last Will and Testament dated September 27, 1998 (the "Will"), a copy of which is attached hereto as Exhibit A; 2. WHEREAS, National City Bank served as the original trustee of the I3arnes Trust; 3. WHEREAS, PNC Bank, National Association ("PNC") as successor to National City Bank, is the acting trustee ("the Trustee") of the Barnes Trust; 4. WHEREAS, Elizabeth R. Barnes died on July 30, 2010, and under the terms of the Barnes Trust as set forth in the Will, the Barnes Trust terminated upon her death; 5. WHEREAS, under the terms of the 'Barnes Trust as set forth in the Will, Grantor's children, Cynthia B. Vriens, S. Jeffrey Barnes, and Gretchen L. Barnes (together, the "Beneficiaries") are the remainder beneficiaries that are each entitled to the final distribution of the remaining assets held in the Barnes Trust in equal shares; 6. WHEREAS, the Beneficiaries have requested that the Trustee distribute the Barnes Trust assets to the Beneficiaries without the preparation, filing, audit and adjudication of an account of the Trustee's administration of the Barnes Trust with a court of competent jurisdiction (the "Court"), and the Trustee has agreed to do so, provided that the Beneficiaries waive the filing with and auditing of an account of the Trustee's administration of the Trust with the Court and release and agree to indemnify the Trustee from any and all claims and liabilities relating in any way to its administration of the Barnes Trust; 7. WHEREAS, each of the Beneficiaries has been offered the opportunity to review the terms of the Barnes Trust as set forth in the Will, together with the books and records of the Barnes Trust and any statements which the Trustee has either provided, or offered to provide, and based upon the examination of each of the undersigned, or on his or her decision not to make such an examination, each of the undersigned is satisfied that he or she has sufficient information to make an informed decision in waiving his or her right to a court accounting and approving the administration of the Barnes Trust, including, but not limited to, the overall investment strategy of Trustee and all decisions made and actions taken or not taken with regard to the administration of the Barnes Trust; and a+~ -1~ ~~~1 8. WHEREAS, each of the undersigned desires to approve the termination and distribution of the Barnes Trust to the Beneficiaries and to settle the Trustee's administration of the Barnes Trust on an informal basis without having an accounting filed with the Court, without an accounting being prepared in the form used for filing with the Court and without Court approval of the distribution of the Barnes Trust; and each of the undersigned has been informed that he or she is entitled to an accounting, to the filing of such accounting with the Court and such Court approval. NOW THEREFORE, in consideration of the foregoing and intending to be legally bound, each of the undersigned Beneficiaries hereby: 1. Represents and warrants that he or she has read and understands the terms of the Barnes Trust as set forth in the Will and this Agreement and that the facts set forth above are true and correct. 2. Waives the preparation and filing of any accounting of the administration of the Barnes Trust with the Court. 3. (a) Declares that he or she has been offered the opportunity to review the terms of the Barnes Trust as set forth in the Will, the books and records of the Barnes Trust and any periodic statements and based upon an examination (or on his or her decision not to make such an examination), the undersigned is satisfied that he or she has sufficient information to make an informed waiver of his or her right to a formal accounting with the Court. (b) Accepts those books, records and statements and approves them, whether examined or not, as if they had been duly stated in the form of an accounting and filed with and audited, adjudicated and confirmed absolutely by the Court. (c) Waives the preparation, filing and auditing of an accounting of the Trustee's administration of the Barnes Trust in the Court and agrees that the Court may by its decree confirm an accounting prepared on the basis of the above statements as a complete and full accounting of its administration of the Barnes Trust should the Trustee decide to file such an accounting at a future date. 4. Acknowledges that (a) he or she has examined the attached closing statement for the Barnes Trust, including the most recent disclosure of expense ratios available for any affiliated fund in which the Barnes Trust may have been invested, and finds it to be true and correct in all particulars; and (b) that all fees paid to the Trustee, any of its affiliates or any unrelated third parties, for services, as reflected in the account statements, were properly paid. 5. Approves the distribution of the Barnes Trust assets delineated on the attached schedule and, effective upon delivery of such assets to the Beneficiaries, each undersigned Beneficiary acknowledges receipt of such property. -2- 6. Releases, and agrees to indemnify and hold PNC, in its corporate capacity and as the Trustee, harmless from and against any and all losses, claims, demands, surcharges, causes of action, costs and expenses (including legal fees, costs and expenses), which may arise from its administration of the Barnes Trust, including, but not limited to, the compensation paid to PNC and/or any of its affiliates, the overall investment strategy of the Trustee, ail decisions made and actions taken or not taken with regard to the administration or investment of the Barnes Trust, and the Trustee's distribution of the assets to the Beneficiaries in accordance with this Agreement; provided, however, that the agreement of each of the undersigned Beneficiaries executing this Agreement in a fiduciary capacity as the trustee of a Beneficiary trust to indemnify and hold PNC harmless shall be limited to funds held in such Beneficiary trust at the time a claim for indemnification is made. 7. Agrees to refund to the Trustee any amount which may at any time be determined to have been an erroneous distribution to him or her regardless of the cause of such erroneous distribution, even if attributable to negligence, agrees that any period for the limitation of actions for the collection of any erroneous distribution shall commence only at such time as the Trustee shall have obtained actual knowledge of such erroneous distribution and that in no event. shall the period for collection of any erroneous distribution be less than two years after the actual discovery by the Trustee; provided, however, that the agreement of each of the undersigned Beneficiaries executing this Agreement in a fiduciary capacity as the trustee of a Beneficiary trust to,refund such amount to the Trustee shall be limited to fiends held in such Beneficiary trust at the time a claim for refund is made. 8. Declares it to be his or her intention that this Agreement shall be governed by the laws of the Commonwealth of Pennsylvania and that an Orphans' Court Division of the Court of Common Pleas of an appropriate County in Pennsylvania shall have the exclusive jurisdiction over all suits regarding the c;nforcement of this Agreement and specifically submits to the jurisdiction of such Court. 9. Declares that this Agreement shall be legally binding as an agreement under seal upon him or her (whether or not this Agreement is signed by all of the parties listed below) and upon his or her heirs, personal representatives and assigns. 10. Agrees to act as a virtual representative pursuant to 20 Pa. C.S. § 7723 of (a) all minor, unborn, unknown or unascertained members of each class of trust beneficiaries of which he or she is a member; (b) all potential appointees of any power of appointment he or she holds; and (c) his or her minor and unborn descendants. 11. Specifically waives the statutory sixty (60) day notice of his or- her designation as a virtual representative as set forth in the preceding paragraph and waives his or her right to decline such designation. 12. Agrees that the Trustee, in its discretion, may decide whether or not to forgo its right to file an account of its administration for audit by the Court and transfer assets of the Barnes Trust to the Beneficiaries if this Agreement is not signed by all Beneficiaries. -3- 13. Understands that this Agreement may affect his or her legal rights and acknowledges that he or she has either consulted with an attorney or has affirmatively chosen to execute this Agreement without consulting an attorney. 14. This Agreement may be executed in any number of counterparts, each of which shall be deemed to be an original but all of which together shall constitute one and the same instrument. IN WITNESS WHEREOF, the undersigned have hereunto set his or :her hand and seal on the dates set forth below their signature. WITNESS: BENEFICIARIES: Cynthia B. Vriens Dated: , 2011 Dated: WITNESS: Dated: i~ [ ~-- l r , 2011 WITNESS: Dated: 2011 S.. Jeffrey Barn~~ Dated: ~t~ f L ~ ~ , 2011 Gretchen L. Barnes 2011 Dated: 2011 PNC Bank, National Association, Trustee of the Barnes Trust, in its fiduciary capacity and not its corporate capacity -4- U Z r- r L Q .` N r r ~ ~~ ~ M ~~ O w ~ O Y o °o L D ( Q O CC G d w R Q ~ O) O) O> ~F 3 O O C ~ ~ ~ Q r ~ ~ O~> 69 V3 b4 Y L C . •+ ` 0 V rn o a d x ° ' o ~ ~ r ... ~, ~ o 0 R ~ ~ 0 ~ ~ ~ ~ ~ ~; N N v3 its ea C ' ++ ' d ° o N £ ° W 0 v C R r rn ~ C ~ Z 'D ~ ~ ~ Z ~ LlJ ~ ~ Y ~ Q m ca ~ a o ~ ~ ~ ~ ~ ~, v ~ ~ Q Z ~ • ~ ~ ~ ' 3 ~ w ~ ~ tl Z ~ o ~ Q ~ m `~ O F- w • ~+ a y ~ .i U ~ • d N w • ~ E ^ 3 Z 'L O ~ w ~ V N _ 2 d • Q ~ ~ O ° U ~ v U ~ Q cn ~ N •-- ~ ~ N m o ~ r- d o n M O O 0 N V O 0 r u a~ E Z U Q Z LL N N a~ m m a Z' a~ C7