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HomeMy WebLinkAbout12-26-12`' lYa, ~l6 ry 99 IN RE: IN THE COURT OF COMMON PLEAS OF ESTATE OF MERLE R. WILSON, CUMBERLAND COUNTY, PENNSYLVANIA Deceased ORPHANS COURT DIVISION NO. 2011-00513 FIRST AND FINAL ACCOUNT OF MICHELLE A. ISHIMARU, EXECUTRIX FOR ESTATE OF MERLE R. WILSON, DECEASED Respectfully submitted, LAW OFFICES OF CRAIG A. DIEHL Date: ~ By: Craig Diehl, Esquire Attorney I.D. No. 52801 3464 Trindle Road Camp Hill, PA 17011 Tel: (717) 763-7613 Fax: (717) 763-8293 Attorney for Estate n ~. ~ . 1 4 ~~ ~ ~~ ~ ^~ y ~'4.~ ~ h~v ~~ { ~. ,^ to C~ ~ n l . ~ ~+ ~ '4 .d ~ L . /'' ~ ~ .. ...i ~~ ..F ~ ~ ~ ....~ Z v..b 4.. ,...,~ ~''^ l f~a ~ C .~~ ~ • t sM ~~ ~ k`d IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA ORPHANS' COURT DIVISION FILE N0.2011-00513 FIRST AND FINAL ACCOUNT OF Michelle A. Ishimaru, Executrix For ESTATE OF Merle R. Wilson, Deceased Date of Death: Date of Incapacity, if any: Date of Executrix's Appointment: Date of First Complete Advertisement Accounting for the period: Apri17, 2011 None April 29, 2011 May 7, 2011 April 29, 2011 to November 30, 2012 Purpose of Account: Michelle A. Ishimaru, Executrix, offers this Account to acquaint interested parties with the transactions that have occurred during her administration. The account also indicates the proposed distribution of the estate. It is important that the account be carefully examined. Requests for additional information or questions or objections can be discussed with: Craig A. Diehl, Esquire, CPA Law Offices of Craig A. Diehl 3464 Trindle Road Camp Hill, Pennsylvania 17011 (717) 763-7613 I.D. No. 52801 SUMMARY OF ACCOUNT Proposed Distribution to Beneficiaries Receipts Net Gain on Sales or Disposition Less Disbursements: Debts of Decedent Funeral Expenses Administration Expenses Family Exemption Federal, State & Local Taxes Fees and Commissions Balance before Distributions Distributions to Beneficiaries Principal Balance on Hand nc~ci~~~ Less Disbursements Balance before Distributions COMBINED BALANCE ON HAND PAGES 11-12 $118,273.10 3-4 $140,390.89 5 $488.09 $140,878.98 6 $1,317.29 6 $868.15 6-7 $1,553.75 7 $0.00 7 $5,667.23 7 $12,245.49 $21,651.91 $119,227.07 8 $100.00 9 $119,127.07 10 $1,304.04 10 $2,158.01 10 -$853.97 10 $118,273.10 2 PRINCIPAL RECEIPTS Assets Listed in Inventory (Valued as of April 7, 2011 -Date of Death) Stocks US Savings Bond EE -Issuance Date June 1993 789.609 Shs. Prudential Jennison Utility Class A 519.352 Shs. DWS Healthcare Fund S Janus Account 480.102 Shs. Vanguard Windsor II Investor 514 Shs. Northrup Grumman Corporation Vanguard Money Market Fund 85 Shs. Huntington Ingalls 50 Shs. Computershare Tangible Personal Property Household Goods -Auction Proceeds Coin Collection Baseball Card Collection Orrstown Bank - checking account Insurance MetLife $4,823.35 Total Inventory Fiduciary Acquisition Value $1,016.80 $8,662.01 $13,700.51 $10,461.24 $13,250.82 $32,145.56 $41,459.87 $3,298.00 $3,174.50 $127,169.31 $159.00 $1,537.00 $542.15 $2,238.15 $5,543.13 3 $5,543.13 $4,823.35 $139,773.94 Receipts Subsequent to Inventory (Value When Received) 6/28/11 AARP -Health Refund 7/21/11 Pennsylvania Department of Revenue Property Tax Rebate 8/25/11 Henderson Funeral Home Refund of overpayment $16.95 $500.00 $100.00 $616.95 TOTAL PRINCIPAL RECEIPTS $140,390.89 4 GAINS OR LOSSES ON SALES OR OTHER DISPOSITIONS 5/20/11 $1,000.00 US Savings Bond EE Issuance Date -June 1993 Net Proceeds 1,043.22 Acquisition Value 1,016.80 6/28/11 789.609 Shs. Prudential Utility Class A Net Proceeds 8,456.71 Acquisition Value 8,662.01 7/27/11 Janus Account Net Proceeds 10,056.04 Acquisition Value 10,461.24 8/25/11 519.352 Shs. DWS Healthcare Fund S Net Proceeds 14,131.57 Acquisition Value 13,700.51 7/23/12 480.102 Shs. Vanguard Windsor II Investor Net Proceeds 13,975.47 Acquisition Value 13,250.82 7/23/12 Vanguard Money Market Fund Net Proceeds 41,476.15 Acquisition Value 41,459.87 7/31/12 514 Shs. Northrup Grumman Corporation Net Proceeds 32,891.28 Acquisition Value 32,145.56 8/6/12 85 Shs. Huntington Ingalls Net Proceeds 3,244.10 Acquisition Value 3,298.00 8/6/12 50 Shs. Prudential Compushare Net Proceeds 2,382.86 Acquisition Value 3,174.50 Total Gains and Losses Less Loss Net Gain Gain Loss $26.42 $431.06 $724.65 $16.28 $745.72 $205.30 $405.20 $53.90 $791.64 $1,944.13 $1,456.04 $488.09 5 $1,456.04 DISBURSEMENTS OF PRINCIPAL Debts of Decedent 5/20/11 Choice VISA Credit card bill $196.68 5/20/11 David L. Hartzok, OD FAAO Medical bill $25.00 5/20/11 Chambersburg Hospital Medical bill $25.08 5/20/11 AT&T Telephone bill $33.55 5/20/11 Express Scripts Pharmacy bill $19.98 5/20/11 Care First PHCY, SVCS, LLC Medical bill $155.26 6/2/11 West Shore EMS Chambersburg Ambulance bill $861.74 Funeral Expenses 6/2/11 Henderson Funeral Home Services $868.15 Administration Expenses 6/7/11 The Sentinel Estate advertisement $200.16 5/20/11 Cumberland Law Journal Estate Advertisement $75.00 7/24/12 Law Offices of Craig A. Diehl Reimbursement for certified mail DPW lett~ $5.59 7/24/12 Law Offices of Craig A. Diehl Reimbursement for Short Certificates $8.00 5/20/11 Cumberland County Register of Wills Probate fees $281.50 1 /4/ 12 Max Winn Auctions Auctioneer fee $15.90 6/9/11 Postmaster Postage for estate $17.60 1 /4/ 12 PK Choppers Clean out apartment $885.00 $1,317.29 $868.15 6 DISBURSEMENTS OF PRINCIPAL (cont'd) Administration Expenses 8/14/12 Cumberland County Register of Wills Additional Probate Fee $50.00 8/12/12 Cumberland County Register of Wills File Inheritance Tax Return $15.00 $1,553.75 Federal and State Taxes 1/4/12 Cumberland County Register of Wills PA Inheritance Tax $5,000.00 8/12/12 Cumberland County Register of Wills PA Inheritance Tax $667.23 $5,667.23 Fees and Commissions 7/24/12 Michelle Ishimaru Executrix compensation $6,800.00 7/24/12 Law. Offices of Craig A. Diehl Attorney's fees $5,445.49 $12,245.49 TOTAL DISBURSEMENTS OF PRINCIPAL $21,651.91 7 DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES To: Belinda M. Gordner, in satisfaction of gift under Article THIRD of Will 12/10/11 Cash $100.00 PRINCIPAL BALANCE ON HAND Cash FIDUCIARY VALUE AT ACQUISITION 12/5/2012 VALUE $119,127.07 $119,127.07 TOTAL PRINCIPAL BALANCE ON HAND $119,127.07 $119,127.07 RECEIPTS OF INCOME Dividends Computershare, common 6/16/2011 $257.00 10/12/2011 $257.00 12/16/2011 $257.00 5/3/2012 $257.00 7/11/2012 $203.54 $1,231.54 Prudential, common 12/16/2011 $72.50 TOTAL $1,304.04 DISBURSEMENTS TO BE PAID To be Paid: Law Offices of Craig A. Diehl Legal fees $1,654.51 To be Paid: Michelle Ishimaru Executrix fee $323.50 To be Paid: Cumberland County Register of Wills Filing Fee for First and Final Account $180.00 TOTAL DISBURSEMENTS OF INCOME $2,158.01 Balance before Distributions -$853.97 Principal Balance on Hand $119,127.07 COMBINED BALANCE ON HAND $118,273.10 10 PROPOSED DISTRIBUTION TO BENEFICIARIES The Personal Representative proposes distribution of the Balance for Distribution to the following heirs as described: Michelle Ishimaru 4100 Hambleton Avenue Louisville, OH 44641 Leslie Wilson 11905 Browns Road Church Road, VA 23833 Belinda Gordner 1205 State Route 254 Milville, PA 17846 Henry Wilson c/o Victor Wilson 19576 Wagon Trail Drive Noblesville, IN 46060 Victor Wilson 19576 Wagon Trail Drive Noblesville, IN 46060 2.667% of Residue 2.667% of Residue Specific Bequest of $100.00 2.0% of Residue In Trust 2.667% of Residue $3,154.33 $3,154.33 $0.00 $2,365.47 $3,154.33 Christopher Mayle 271 Kennedy Street Louisville, OH 44641 Evelyn Gordner 1205 State Route 254 Milville, PA 17846 Noah Wilson 19576 Wagon Trail Drive Noblesville, IN 46060 11.25% of Residue 11.25% of Residue In Trust 11.25% of Residue In Trust $13,305.58 $13,305.58 $13,305.58 Cassandra Wilson 11.25% of Residue $13,305.58 11905 Browns Road To be distributed pursuant to Church Road, VA 23833 Paragraph 5.02 of Last Will & Testament 11 Alicia Servey 446 Oliver Street Williamsport, PA 17701 Dawn Dillon 67 Candler Court Cameron, NC 28326 Les Wilson, Jr. 11905 Browns Road Church Road, VA 23833 Ryan Wilson 19576 Wagon Trail Drive Noblesville, IN 46060 11.25% of Residue $13,305.58 To be distributed pursuant to Paragraph 5.02 of Last Will & Testament 11.25% of Residue $13,305.58 11.25% of Residue $13,305.58 In Trust 11.25% of Residue $13,305.58 In Trust $ 118,273.10 12 COURT OF COMMON PLEAS OF CUMBERLAND COUNTY ORPHANS' COURT DIVISION IN THE MATTER OF MERLE R. WILSON ESTATE FIRST ACCOUNT OFMICHELLE ISHIMARU, EXECUTRIX UNDER THE WILL OF MERLE R. WILSON NUMBER 21 11 00513 NOTICE TO PARTIES IN INTEREST Notice is hereby given that the Executrix of the above-captioned Estate has filed a First Account and Statement of Proposed Distribution with the Clerk of the Orphans' Court of Cumberland County, Pennsylvania, and the Audit thereon shall be before the Court on the St" day of March, 2013, at 9:30 A.M., in Courtroom No. 1, Cumberland County Courthouse, One Courthouse Square, Carlisle, Pennsylvania 17013. If you have any objection to any transaction or matter involving the Estate, you must file with the Clerk of the Orphans' Court objections thereto in writing prior to Audit, or appear in person or by legal counsel and present your objections to the Court at Audit. If you fail to present objections, the Court may assume you have no objection to the Account and Statement of Proposed Distribution. You are not required to appear if you have no objections. A copy of the Account and Statement of Proposed Distribution is attached hereto; and if not attached, it is available for your examination at the Register of Wills Office, Cumberland County Courthouse. Respectfully submitted, LAW OFFICES OF CRAIG A. DIEHL Date: ~ .~:~ ~. ~ F, .. .., i. .~ ~.. .. •. ~.~ r h ~ .. .... .. ..~ 4y ~ ~.n .... ~+y ~ ~J r ,.a ~ ~ ',~ t 1...~ .'i.» ~y ` , ~ f e Ewa - --" _~ w ~ r JJ ,~+ ~» LY_. ~-, ~..A ~~~ L.-~--~ V ~"~1 ,/ e . 1,3,,5 ~-+.,,_} U ~• (' ` `w1J ~roi.a ~~ Y....~ ` ~-~ By: Craig A iehl, Esquire Attorney I.D. No. 52801 3464 Trindle Road Camp Hill, PA 17011 Tel: (717) 763-7613 Fax: (717) 763-8293 Attorney for Executrix I:~~CEI~ENT'S ESTATE CO[JRT OF C,'p1vINIOh' PLEAS OF CL11V1BERLAND COUNT~J, PrNNSYLVANIA ORPHANS' CC3URT DI~rISI~]N ESTATE ~F Iti'IERLE R. ~1VILSON Na. 2011-00 ~ 13 r _,~ „~ " ~1 ~ 1 ,~ ~ "w P~~ ~1 . ... s -r ..~ ~ - f,.,~ is . ' ~ _,. . ~ ,, • . ' • ,. a - , y _ ~_ ~. .. ,., n ', i . ~;~ DECEASED P'ETITIUIV FUR ADJUDICATIQN ~'~'A'i`E?IrIENT Q~' p~QppS~D DCSTRISt~TIC3N PCJ`IiSUANT TO Pa. Q.C. Rule fi.9 T~lais~.forrn may 6e used rn uIl cases irrvolvin~ the ~4udit of'the Account of'cr Decc~c~ent'.s E.s~tate. If .space is ins t fficient, r•idet~s rrza ~ ~ .. y ~e ulttrchec~. ~Ittrtch tdae spouse s election, if crnv; tdie papers recluirerl 1.rrrdeY iterrr.5~ t~-I9 inclusive; grid rxny instr~urrrent pertinent tCi the crr~ur~ic~rtion. I.~VCL ~ ODE .A 7'T_~ CJ~IrY,f~',~t'.TS A 7' THE B ~ ~'K OF TI~I~ FQRlt~ Name of Counsel: Craig A. Diehl, Esquire, CPq Supreme Court I.D. No.: 5280] Name of` Law Finn: La~~r Offices of Craig A. Diehl Address: ~=~~~ T'rindle Ro~id, ~.'arnp Hill, PA 1701 I Telephone: (717 763-7F ] 3 FaY:_~717~ 763-8283 Fcrr•rrr c3£'-n~ rt1~ in. r.~.s~~ Page 1 of 10 Estate of ?vTERLE R. WILSUN Deceased l . Names} and address(es) of Petitioner(s): ~,-~7le; Michelle A. lshitnaru .address. ~ 14C~ Hambletan Avenue Lauisvilie, OH 4641 Identify any executors or administrators t~rho have slot joined in the Petition f'or Adjudication and Statement of Proposed Distribution and state reasc7n: None Is this the first accounting by this fiduciary? ..................... ~ Yes ®No If not, identify prior accountings, the accounting periods covered, and the date of adjudication of the prior accounting. Z. Decedent died on Aril 7, ?4l 1 © Letters ~`estamentary nr ^ betters of Administration v~~ere granted to Petitioner(s) on April 29.2011 Date of t~'il1 (if up~liccrhle): tune 3, ?009 Date(s:) of Codicil{s} ~ifu~~~licuhlcj~: N1A Date of probate (if differej~t fi~Um Jule T,etrers ~r'unter.~): NIA VtTas a bond reQuired? ®Yes ~7] No If yes, state amount: Are proofs of advertising of the grant of Letters attached? ....... , . ~ yeS Dates of advertising cif the grant of Letters: May l ~, ?0, 27.20 ~ 1 ~ No FUr-rn UC-01 rer. 1(1-13.06 I'agC ~ Cif ~ ~ Estate cif MERLE R. Vt~1LS~N Deceased 3. V4~as decedent survived by a spouse? ............................. ^Yes ®No 1f yes, name of the sur~;~iving spouse: ~~`~ 4. Has the surviving spouse filed to take an elective share? ............. ^Yes ®Na (S~~e ~Sertrvrz ZZOI et sir-. of t1~e Prnhtit~.~, ES~lates rtnc~ Fic~uciuri~~s Code 5. if yes, date of election: ~`n In the case of an intestacy, state the names of the decedent's surviving children or surviving issue of deceased children ~if'rrnne, .5-o stal~~: ~!r A 6. Did decedent marry alter execution of Will or Codicils}7 .......... . Were any children born to decedent after execution of V~r'ill or Codicil(s)? ............... .......................... . rf yes, give names and dates of birth: ~~`amc: Date of birth: ^ YeS ^ 1WU ^Yes [,~ No 7. If required by the Medical Assistance 1•:state Recovery Act, 62 P. S. ~ 1412, vas a request for a statement of claim sent to tl~e Department of Public Welfare .............................. ©Yes ^ N~ Form OC-01 r~r. 10.13.fJh Page 3 of 1 ~ Estate of ~'~E~-E R• W1LSflN Deceased $. Written notice of the Audit as required by Pa. U.C. Rules 6.3, 6.7 and ~.$ has been or will be given to all parties in interest listed in item 9 below, all unpaid creditors and all claimants listed in item 1 Q below. In addition, notice of any questions requiring Adjudication as discussed in item l4 belotiv has been or will be given to all persons affected thereby. A. If Notice has been given, attach a copy of the Notice as well as a list of the names and addresses cif the parties receiving such ldotice. . B. if I~lotice is yet to be given, a copy of the Notice as well as a list of the names and addresses of the parties receiving such Notice shall be submitted at the Audit together with a statement executed by a Petitioner or counsel certifying that such notice has been given. C. If any person entitled to Notice is not .s~ai.jura:s (e,~., minors or incapacitated persons). Notice of the Audit. has been or will be given t.o the appropriate representative on such party'ss behalf as required by Pa. 4.C. Rule 5.2. ~. if any charitable interest is involved, Notice of the Audit leas been or aril( also be given to the Attorney General as required under Pa. a.C. Rule 5.5. In addition, the Attorney General's clearance certificate (or proof of service of Notice and a. copy of such Notice} must be submitted herewith or at the Audit. 9. List all parties (charitable anti non-charitable) of whom Petitioner(s~ has/have notice or knowledge, having or claiming any interest in the estate as beneficiaries under the ''dt~ill or Codicil(s) or as intestate heirs if there is a complete or partial intestacy; A. State each party's relationship to the decedent and the nature of each party's interest(s): .1'urne pnd Address ul Each rri I~rteresr ~ Rc larronship and C~ Michelle lshimaru 41 X01-lambleton Avenue Louisville, Qhio 44641 Leslie 1~'ilson 11905 frowns Road Church Road, ~A ?3533 ~;xecutrix/Daughter ~ 2.667% of Residue Son Z.b67~/~, of Residue Form OC.'-(11 rer. 1 X1.13. alb Page 4 of l U Estate of ~'ZER-I--E R. W'ILSpN Deceased :G`ame u+uladdress c~ Euc~h Parry iii lrrrerest I Retatrntuhi~arrrlComrrrents ifanb I Interest Belinda Crordner Daughter Specific Bequest of 12U5 State Route 254 $ 100.0(} Iblilville, PA 17~~~ Henry V~ilsan , Son 2.0°l0 of Residue in c/o victor 1~'4lilson Trust 1457G t~:'agan Trail Drive Nflblesvi(le, IN 4t;Ubp Please see attadlcd list for Lach Yariy in Interest. B. Identify cash party who is not sur juris (c.~., minors or incapai;itated persons}. Far each such party, give date of birth, the Warne of each Gtaard€an and how each Guardian was appointed, If no Guardian has been appointed, identify the next. of ktn ol'suc:h party, I;iving the Warne, address and relationship of each. C. State tivlty a Petition for Guat'dian/"I'rustee ~4d Litenz has or has not been filed for this Audit (see Prl. O.C. Rule 12.~~. D. tI` distribution is to be made to the personal representative of a deceased party, state date of death, date and place of grant of Letters and type ~f Letters granted. NrA f~~ortrt OC'-(11 rf'r. IC1.13.~16 Page 5 of 10 Name and address of Each Party in Interest Victor Wilson 1957E Wagon Trail Drive Noblesville, 1N 46061) 2.667°~o of Residue Christopher Mayle ?21 Kennedy Street Louisville, C~}H 4464 Evelyn Crordner 1205 State Route 2 54 Ititiilville, PA 17~4F~ Noah Wilson 19576 Wagon "frail Drive Noblesville, IN 46060 Cassandra Wilson 11905 Bra~~~ns Road Church Road, VA 23833 11.25°/a of Residue 1 l .25°% of Residue In Trust 11.25% of Residue In Trust 11.25 % of Residue To be distributed pursuant to Paragraph 5 , 02 ~f Last Will & Testament Alicia Servey 11.25°/U of Residue 446 sliver Street To be distributed pursuant to Williamsport, PA 17701 Paragraph 5.02 of Lafit Will & ~1'estament Da~4~~ Dillon 11.25°,~0 of Residue b7 Candler Court Cameron, NC 2$326 Les Wilson, Jr_ 11.25°io of Residue 11905 Brativns Road In Trust Church Raad, VA 23833 Ryan «'itson 11.25°~ir of Residue 195 76 V~'agon Trail Drive In Trust Noblesville, IN 46060 Estate of ?~'1ERLE R. WILSQN Deceased 10. Qtller than the Maim for the family exemption, list the names of all known claimants and , the amount of their claims and state whether each claim is admitted. All claims arc admitted and 1~•ill ire paid. :ti~art~e and address u/'Each Claimant ~nro~nr njClain~ t'luim lt~Ilt L'laim ~dmiued? I3e Paid In Fut!? ~Y~S ~ YES ~No ~ Na Yes ©Yes ~No ~No ^Yes ®Yes ~No ®No Yes ®Yes QNo ~ No if the estate is insolent, attach a schedule setting Earth the order of prefere~lce under 20 Pa.C.S. § X392 and the proposed payments. 1 1. t~~'as family exemption claimed? .................... . . . - - ....... ®Yes ~No b'o'as family exemption allowed? ................................ Yes ~No Family exemption claimant's name and relationship: ~:an:e. Rclc~~inrrshr~• rnr~t ac--r~l retie. lfl. f3-~6 Page 6 of 1 U Estate of MF,RLE R. '4'4'1LSUN Deceased l2. The amount of Pennsylvania Transfer Inheritance Tax and additional Pennsylvania Estate Tax paid, the dates} of payment~:s), and the interests} upon which paid, are as follows: Dare f'ay~1-renr hrrere.~r Ol 1a6i2t~ l2 S,OOO.t~O Entire Estate Obi' 13/2 1 ? 6~?.23 Entire Estate 13. Un the date of death, was the decedent a fiduciary (pers©nal representati~~e, trustee, };uardian, agent under power of attorney) or surety on the band of a fiduciary? .................. . ^ Yes Na if yes, provide the name of the estate,' indicate whether an account has been filed and confir~Tlcd absolutel}r and all av~fards performed, or, in the alternative, havtr the deccdc~nt's estate will be discharged far the decedent's fiduciary administration ul'the estate. 14. A. Describe in detail any questions requiring adjudication and state the position of the Petitioner(s) as to each question: ivnnc B. Has notice of the question requiring adjudication been given to the parties identified in Paragraph 9 ~ibc~ve`? ............... . . . ^ Yes ^ No 15. If Petitioner(s) hasihave knowledge that a share has been assigned, reclounced, disclaimed or attached, provide a copy of'the assignment, renunciation, disclaimer or attachment, together ~~'ith any relevant supporting documentation. Fnrnr t~C-[tl ~-~>ti. ~~?. r3.r« Page 7 of ~ ~} Estate of ;~~ERLE R. Vl'ILSQN Deceased 16. Had the decedent been adjudicated an incapacitated person? .......... ^Yes ^ No If yes, attach a copy of the Order if avai Table; otherv~•ise state the Court, term, number, date, and name of Hearing Judge. 17. A. List or attach a separate list of additions} receipts Ind disbursements since the closing dste of the Account. None B. Has notice of the additional receipts and disbursements been given to the parties identified in Paragraph 9 above? ............. ®Yes ^ No 1 ~. lfa reserve is requested, state amount and purpose. None. -~ntount: Purp~,te: If a reserve is requested for counsel fees, has notice of the amount of fees to be paid from the reserve been given to the parties in interest? ........................................ ®Yes ^Iti1o if so, attach a copy of the notice. l 4. Is the Court being asked to direct the filing of a Schedule of Distribution? .......................... ^Yes ^ No As to real estate only? ........................................ ^Yes ^ No ran„ nc-ni rPt~. io.e3.c~~ Page 8 of 10 Estate of Nf~.RLE I~. 1~ILS~N Deceased t~'herefortr, your Petitioner(s) askts~ that distributivn be awarded to the parties entitled and suggests}that the distributive shares of income and principal residuary shares being stated itl prc~portians, not amounts) are as fallow'S: Sec ~lttachc.d First & Final Account. ~1. Incorne: Prop c~sec111rsrrib u ree ts) I3. Principal: Pr-vposed Drstributee(sJ ,4 rrrnurtL'Prtl~rrf rnn ,~ rrroun L~ProPurlirrn Submitted Icy: (All pelitioraers must sign. ~cld additiancrl lines if nc>ces,5'ary~: Na e ofPetitioner: Michelle A. Ishirnaru Name of Petitioner: For~rr Ur'-o! r«~. 1(1. 13. f1G Page g of I ~ Estate flf M£RI-E ~• WIi.SON Verification of Petitioner tVeriiication must be by at least one petitioner.} The undersigned hereby verities * [that !1e'slre she is rate Executrix of the above-Warned name ofcar~orairan Estate Of Merle R. Wilson Deceased and] that the facts set Earth in the foregoing Petition for Adjudication / Statet~ent of Proposed Distribution which are within the personal knowledge of the Petitioner are true, and as to facts based on the information of others, the Petitioner, after diligent inquiry, believes than to he true; and that any false statements herein are made subject to the penalties of 1$ Pa. C.S. ~ 4904 (relating to unsworn falsification to authorities}. Signature of Petitioner '~ Corporate Fetitic~ners must c•arnplete bracketed i~tfortnalion. Certification of Counsel The undersigned counse( hereby certifies that the foregoing Petition far Adjudication/ Statement of Fr©posed Distribution is a true and accurate reproduction of the farm Petition authorized by the Supreme Court, and that no changes to the form have been made beyond the ~.. respo~es herein. ~...,, ,; .,, ~ ~ ~ :. • ~ ~.,. ~- _ t ~,. ~ '~ ~., '~' U Signature- f counse! for Petitioner Cr~i~ A_ Diehl, L•sgtitirc, CPA Page 1 D of 10