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02-14-13 (3)
,. r 1505610140 REV-1500 EX (01-10) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number Po Box 28oso1 INHERITANCE TAX RETURN Hamsburg, PA 17128-0601 RESIDENT DECEDENT 2 1 1 2 0 9 6 9 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY Decedent's Last Name Suffix Decedent's First Name MI F I S H E L K A T H R Y N W (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW Q 1.Original Retum ~ 2. Supplemental Retum ~ 3. Remainder Retum (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Retum Required death after 12-12-82) QX s. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax~fder Sec. ~'}13(A) between 12-31-91 and 1-1-95) ttach Sch. ~ ~ Cr1 CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TA~fIF NATION ~ULD ~ D~ CTED T0: Name Dayti~ T~e~ne I~ber ~ ~ M A R C U S A M c K N I G H T I I I 7~~ 4.~9 ~ 5 3 First line of address I R W I N & Second line of address 6 0 W E S T City or Post Office C A R L I S L E M c K N I G H T P C• P O M F R E T S T R E E T State ZIP Code ~~- ~ iaECLI~TF~OF WILlS USL~O ~ ~ ~ ~ • ~ C.J ~ f°xi DATE FILED P A 1 7 0 1 3 Correspondent's a-mail address: Under penalties of pery"ury, I declare that 1 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. SIGNAj~RE OF PERSON SP, ON,SIBLE F~NG RETURN D TE / Ll~1.vJ `~GI/rti ~ 1 ~ f ADDRESS 412 DARL A MECHANICSBURG PA 17055 SIGNATURE P TH ~ EPRESENTATNE DATE ~ ADDRESS 7'h • °"~d r..3 60 WEST P T ~ CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610140 1505610140 J~ a 150561U240 REV-1500 EX Decedent's Social Security Number Decedent's Name: KATHRYN W• FISHEL RECAPITULATION 1. Real Estate (Schedule A) ........................:.................. 1 4 4 5 6 3. 0 3 2. Stocks and Bonds (Schedule B) ...................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. • 4. Mortgages and Notes Receivable (Schedule D) .......................... 4. • 0 . 0 0 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. 3 9 2 3. 0 1 7. Inter-Vivos Transfers 8 Miscellaneous N n-Probate Property Re uested arate Billin ~ S 7 5 3 2 1 3 1. 6 7 ....... g q ep (Schedule G) . 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 5 8 0 6 1 ? . 7 1 9. .................. Funeral Expenses and Administrative Costs (Schedule H) 9. 2 3 6 2 9. 3 8 10. 9 9 ) ....... Debts of Decedent, Mort a e Liabilities, and Liens (Schedule I ...... 10. 1 3 . 6 8 11. Total iDeductions (total Lines 9 and 10) ......................... ...... 11. 2 3 6 4 3. 0 6 12. ,, Net Value of Estate (Line 8 minus Line 11) ...................... ...... 12• 5 5 6 9 7 4 . 6 5 13. Charitable and Governmental BequestslSec 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. 5 5 6 9 7 4 . 6 5 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 0 0 0 15 0. 0 0 . (a)(1.2) X .0 . 16. Amount of Line 14 taxable 6 5 5 6 9 7 4 5 16 2 5 0 6 3. 8 6 . at lineal rate X .045 . 17. Amount of Line 14 taxable 0 0 0 17 0 • 0 0 at sibling rate X .12 . 18. Amount of Line 14 taxable 0 0 0 18 0 . 0 0 at collateral rate X .15 . 19 2 5 0 6 3. 8 6 19. TAX DUE ............................................... ....... . 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 1505610240 Side 2 0 1505610240 J Continuation of REV-1500 Inheritance Tax Return Resident Decedent KATHRYN W. FISHEL 21 12 0969 Decedent's Name Page 1 File Number Correspondents Name Daytime Telephone Number MA R C U S A Mc K N I GH T I I I 7 1 7 2 4 9 2 3 5 3 First line of address I R W I N & M c K N I G H T P C. Second line of address 6 0 W E S T P O M F R E T S T R E E T City or Post Office State ZIP Code C A R L I S L E P A 1 7 0 1 3 Correspondent's e-mail address: unaer penalties or perjury, I declare that I have examined this return, including acxompanying schedules and statements, and to the best of my knowledge and belief, it is tru correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIG OF PERS P LE FOR FILING RETURN DATE ~o ~3 ADDRESS 715 ALBERTA AVENUE MECHANICSBURG PA 17050 REV-1500 EX Page 3 decedent's Complete Address: File Number 21 12 0969 DECEDENTS NAME KATHRYN W. FISHEL STREET ADDRESS 5225 WILSON LANE CITY MECHANICSBURG STATE PA Zip 17055 Tax Payments and Credits: ~ • Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments 19, 700.00 B. Discount 1,095.97 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. (1) 25,063.86 Total Credits (A + B) (2) 20, 795.97 (3) (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 4,267.89 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• ...................................................................... ^ X^ b. retain the right to designate who shall use the property transferred or its income; ............................... ^ Q c. retain a reversionary interest; or ................................................................................................ ^ 0 d. receive the promise for life of either payments, benefits or care? ....................................................... ^ Q 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ^ 0 3. Did decedent own an "intrust for" orpayable-upon-death bank account or security at his or her death? ......... Q ^ 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)]. For dates of death on or after Jan.1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling isdefined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1503 EX + (6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER KATHRYN W. FISHEL 21 12 0969 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PUTNAM_INVESTMENTS 16,411.44 PUTNAM GROWTH & INCOME-A ACCOUNT NUMBER 0427792274 2. 402 SHARES,OF MANULIFE FINANCIAL STOCK` 4,466.22 402 X $11.11 PER SHARE _ $4,466.22 3. IMORGAN STANLEY SMITH BARNEY -INDIVIDUAL ACCOUNT#341908997-139 I 13,366.96 AMERICAN CAP INC BUILDER C 4. MORGAN STANLEY SMITH BARNEY -INDIVIDUAL ACCOUNT #341-908997-139 8,459.73 AMERICAN CAP WRLD GR & INC C 5. I54 SPARES OF METLIFE STOCK I 1,858.68 54 X $34.42 PER SHARE _ $1,858.68 TOTAL (Also enter on line 2, Recapitulation) I $ 44, 563 03 (If more space is needed, insert additional sheets of the same size) REV-1509 EX+ (01-10) • pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF: FILE NUMBER: KATHRYN W. FISHEL 21 12 0969 ff an asset was made 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) A. PAMELA VANKIRK ADDRESS 412 DARLA ROAD MECHANICSBURG, PA 17055 RELATIONSHIP TO DECEDENT DAUGHTER s. PATRICIA F. TAYLOR c. JOINTLY-OWNED PROPERTY: 715 ALBERTA AVENUE MECHANICSBURG, PA 17050 DAUGHTER ITEM NUMBER LETTER FOR JOINT 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 96 OF DECEDENT'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A. CITIZENS BANK 11,780.81 33.3 3,923.01 CHECKING ACCOUNT #6100681246 TOTAL (Also enter on Line 6, Recapitulation) I ~ 3,923.01 If more space is needed, use additional sheets of paper of the same size. REV-1510 EX+ (08-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER KATHRYN W. FISHEL _ 21 12 09F9 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 INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION pF APPUCne~El TAXABLE VALUE 1. OPPENHEIMER &_CO., INC. 7,964.65 100.00 7,964.65 IRA ACCOUNT #A87-0904685 BENEFICIARIES:.PAMELA VANKIRK/PATRICIATRYLOR 2. SUN LIFE FINANCIAL .80,105.71 100.00 80,105.71 POLICY #36-3600-010128 BENEFICIARIES: PAMELA VANKIRK/PATRICIA TAYLOR 3. DW$ SCUDDER INVESTMENTS-ACCOUNT #00426400281 14,840.18 100.00 14,840.18 DWS CORE EQUITY FUND-S 4. DWS SCUDDER INVESTMENTS-ACCOUNT #00005097760 36,655.62 100.00 36,655.62 DWS GNMA FUND-S 5. JOHN HANCOCK FUNDS -ACCOUNT #00004128487- 30,223.19 100.00 30,223.19 6. AMERICAN FUNDS -ACCOUNT #00059801.908 7,222.22 100.00 7,222.22 THE INCOME FUND OF AMERICA-A 7. MORGAN STANLEY SMITH BARNEY 4,181.76 100.00 4,181.76 ACCOUNT #341-899268-139 8. MORGAN STANLEY SMITH BARNEY 114,828.72 100.00 114,828.72 ACCOUNT #341-10168-139 9. MORGAN STANLEY SMITH BARNEY 129,595.18 100.00 129,595.18 ACCOUNT #341-10169-139 10. METLIFE INVESTORS USA 106,514.44 100.00 106,514.44 ANNUITY CONTRACT A2057105 BENEFICIARIES: PAMELA VANKIRK/PATRICIA TAYLOR 0.00 0.00 0.00 TOTAL (Also enter on Line 7, Recapitulation) ~ $ 532,131 67 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+ (10-09) • Pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER KATHRYN W. FISHEL 21 12 0969 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. MALPEZZI FUNERAL HOME 14,234.22 2. FLOWERS 291.50 B. 1. ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City Year(s) Commission Paid: State ZIP 2, Attorney Fees: IRWIN & McKNIGHT, P.C. 8,300.00 3. Family Exemption: (If decedents address is not the same as claimants, attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: REGISTER OF WILLS 123.50 5 Accountant Fees: 6. Tax Return PreparerFees: PATRICIA A. ROSENDALE, CPA 375.00 FINAL FIDUCIARY TAX RETURN 7. REGISTER OF WILLS -FILING FEE 30.00 8. THE SENTINEL -ESTATE NOTICE 200.16 9. CUMBERLAND LAW JOURNAL -ESTATE NOTICE 75.00 TOTAL (Also enter on Line 9, Recapitulation) ~ $ 23,629.38 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ (12-08) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, ~ LIENS ESTATE OF FILE NUMBER KATHRYN W. FISHEL 21 12 0969 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH CONTINUING CARE RX -MEDICAL 13.68 TOTAL (Also enter on Line 10, Recapitulation) I $ 13.68 If more space is needed, insert additional sheets of the same size, REV-1513 EX+ (01-10) Pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: KATHRY N W. FISHEL 21 12 0969 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [Indude outrtrg' ht spousal distributions and transfers under Sec. 91'6 (a) (1.2).] 70% REMAINDER 1. PAMELA F. VANKIRK Lineal 412 DARLA ROAD MECHANICSBURG, PA 17055 2. PATRICIA F. TAYLOR Lineal 715 ALBERTA AVENUE MECHANICSBURG, PA 17050 30% REMAINDER 3. JASON R. TAYLOR Lineal 110 W. GREEN STREET SHIREMANSTOWN, PA 17011 4. JENNA C. TAYLOR Lineal CARSON STREET PITTSBURGH, PA 5. CHRISTINE M. VANKIRK Lineal PITTSBURGH, PA ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ ~t more space is needed, use additional sheets of paper of the same size. LAST WILL AND TESTAMENT OF KATHRYN W. FISHEL I, KATHRYN W. FISHEL, of Shiremanstown, Cumberland County, Pennsylvania, being of sound mind, disposing memory and full legal age, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils heretofore made by me. ON_E: I direct my Co-Executrices to pay all of my .debts, funeral and administrative expenses as soon as convenient after my decease. Furthermore, I direct that all state, inheritance, succession and other death taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property composing of my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid by the Co- Executrices from my estate, and that none of the aforesaid taxes shall be prorated among those persons or entities named herein or otherwise beneficiaries hereunder . 1'V=O: My Co-Executrices may, at their discretion, compromise claims, borrow money, retain property for such length of time as they may deem proper; lease and sell property for such prices, on such terms, at public or private sales, as they may deem proper; and invest estate g4yy r '. a ~ property and income without restriction to legal investments unless otherwise provided hereunder. T~E_: I authorize and empower my Co-Executrices to sell any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at ublic P or private sale or sales and to give good and sufficient deeds and/or bills of sale therefore, in fee - - simple, as I could do if living. My Co-Executrices are authorized and empowered to engage in - - any business in which I may be engaged at my death, for such period of time after my death as seems expedient to said Co-Executrices. FOUR: I give, devise and bequeath all of my estate of every nature and wherever situate to my two (2) daughters, PAMELA F. VAN KIRK and PATR.ICIA F. TAYLOR, per stirpes. Should either daughter predecease me, then her share shall be distributed equally to her living issue. FI_: I nominate and appoint PAMELA F. VAN KIRK and PATRICIA F. TAYLOR to be the Co-Executrices of this my Last Will and Testament. SI_X: No person(s) shall benefit hereunder unless such beneficiary shall survive me by sixty (60) days. SEVEN: No Co-Executrix acting hereunder shall be required to post bond or enter security in this or any other jurisdiction. 2 .. .~ EI_ No beneficiary may assign, anticipate or pledge her or his interest in any income or principal held or distributable hereunder, and no beneficiary's creditors may levy, attach or otherwise reach any such interest. N=E: If any person entitled to share in any distribution under the terms of this my East Will and Testament becomes an adverse party in any proceeding ~to contest the probate of this - _ Last Will and Testament, such person shall forfeit his or her entire interest inherited hereunder - - and all provisions in favor of such person shall be declared void and of no effect. The share of such person so forfeited shall be distributed as part of the residue pursuant to Paragraph No. 4 hereof, as the case may be, except that if such person is entitled to share in the said residue, that interest shall be distributed proportionately to the other residuary beneficiaries. - T_ I hereby suggest that my personal representatives retain the services of Irwin & McKnight, P.C. as attorneys in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this / ~~ da of ~_ Y February 2011. ~ ~- ~' 1 (SEAL) THRYN W. FISHEL 3 Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will and Testament, in our presence, who, at her request, in her presence and in the presence of each other have hereunto set our names as subscribing witnesses. l~ ~ i~ - 4 ACKNOWLEDGMENT AND AFFIDAVIT WE, KATHRYN W. FISHEL, MARTHA L. NOEL and SHARON L. SCHWALM, the Testatrix and witnesses respectively, whose names are signed 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 that she had signed willingly, and that she - executed it as her free and voluntary act for the purpose herein expressed, and that each of the - witnesses, in the presence and hearing of the Testatrix, signed the Will as a witness and that to the best of their knowledge the Testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. f f~i.~ ~~~ YN . FISHEL c L. NOEL SHARON L. SCHWALM COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by KATHRYN W. FISHEL, the Testatrix herein, and subscribed and sworn to«before me by MARTHA L. NOEL and SHARON L. SCHWALM, witnesses, this // day of February 2011. (~ Notary No~riei s~ai a iNnCnight Al, No>~ry Pubik Carll~e 8om, Qunbetland County My Commission 6cp~es Oc~.10, 2013 . Member, Pennsvivanla Assodatlon ~ Nota~es 5 341-01o1~9-r39~ TsE FISHEL FAMILY IRREV`OC1~L8 TRUST .. TIiIS TRUST A~GRI~8~11TT is executed in triplicate on this day of ~?~ 1993, by and between GEORGE ~. FI38EL, by and thr qh~ s Attorney-in-Fact, Rath-ryn W. Fishel, aad R1°i~'I~RYN W. FISHEL, individually, now of 110 West Green Street, Shiremanstown, Cumberland County, Pennsylvania 17011 (herein cal~.ed nSefitlor~~~ or ~~ settlors ~~) and KATE~YN ~T. .FISE~~,, now of 110' West Green Street, Shiremanstown, Cumberland County. , Pennsylvania 1'011 {herein. called ^Trustee~^) . A8`I`ICLS I~. TRIIS'T ESTATE 1.01. Iaitial Priacipal. settlors, desiring to establish an irrevocable trust, do hereby irrevocably transfer, assign and deliver to the Trustee and its successors, and assign the assets listed on Schedule. A, attached hereto and made apart hereof. As further evidence of such assigntrtent, the settlors have executed or will execute or cause to be executed such other instruments as may be required for the purposes of completing the assignment or transfer of title to such pro}~er•'ty to the Trustee. The Trustee accepts such transfer and a.ssi;gx~;t to Ytst.lf as Trustee, az~d undertakes to ho~.d, manage, inve~~t and. reinvest the assts of this Trust, and to iiistribute the i~ico~cie and principal pf the Trust ~.n accordance with t12~ provisions. of this Agreement. 1.02. Add~.~tionai Pr.~~.eitsai... The settlors and any other person or perso~,5, with tli,e consent of the Trustee, shall have the right at any time to s~a~.~e add~it3-ons to the corpus o~f this Tnist or any share thereof' hereby established: All such additYOns shall be hell]., governed, and distributed by the Trustee in accordance with . the terms and conditions of this Agreement. ARTICLB II. IRREVOCABILITY OF C'RUE'T 2.01. Irrevocability. settlors have been advised of the consequences of an irrevocable trust an~1 hereby declare that this Trust shall be irrevocable and. shall not be altered, amended,. revolved, or terminated by settlors or any other person or persons. ARTICLE III. LIFE INSURANCE POLICI$5 3.01. General Provi.sion$ . If any insurance policies are transferred into this Trust, the Trustee shall be vested with all right, title, and interest in and to the transferred policies o~f insurance, and is authorized and empowered to exercise and en~'ay, ~.: 3g-I~o~ of ~9-i39 for the purposes of the Trust herein created and as absolu of such policies of insurance, all the to owner and privileges under such options, benefits,. rights upon and to pledge them for alloan or 1•oans in ~ he right to borrow rights, title, and interest in and to the above Stat ee takes ali policies subject to an. ~ insurance and as s i y pr=off' sPli~t -dollar life insurance agreement 'grnments, which may be in effect. ~t the time of transfer The insurance companies which have issued ' authoriz.ec~ and directed to re ~ Policies are hereby of such cognize the T=v.stee as absolute owner policies of insurance and as fully entitled to all options, rights, privileges:, and int°erests~ t~der such receipts, releases, and other instruments executed by the Truste in connection with. such Policies° shall be bindin u e interested in this Trust. The set:tlors hereh r e1 n 1 petSans rights, title, interest and y quish all w~.ich Settlors ma . powers in such policies o~f .i~nsura~e y own and which rights, title, ~.nterest and powers are not as~s.iQnable, and will, at the re execute all other instruments rreascniabl request of the Trustee, this relinquishment. y Quired to effectuate ~ . 0 2 . PSy3~t~t~ of Framium~s . Tie Trustee shall be under no obligation to pay the prpmi ~s whi~..~ . become due and under the Y payable prov1slons of any policy of insurance which may be transferred or assigned to this Trust., or to make certain that such Premiums are pas d by the transferor of such, policy, or to go~tify any persons of the nonpayment of such pr.~.~s., ate, the TY-~;stee shal•1 be under no responsibilitYi or liability of any kind in case such premiums are nat paid, except the T~rtistee shall apply any dividends~~ received on such policies to the thereon.. Payment of premiums ~Tpon notice at any time during the continuance of this. Trust that the pren~iuMS due upon such policies are in default, or that premiums which will become due will not be transferor or by any other paid, either bry the person, the Trustee, within its sole disCretio~n, may aprply any cash va.lue~s a:t~ributable to such policy to tl~e purchase o€ paid ~up~ insurance; .o~c ~of extended insu;rance~, or ~Y box'row upon such pool i c y for the payment of they- eon, or may aGCept the cash va~:ues o f such premiums dine. policy's forfeiture. pal 1cY upon they In the event tr3at the: ~rus tee receives the cash value of such policy upon its for€.eiture for nan a p. Yment of pre~niurns, the anbount received shall be added to the corpus of this Trust, and shall he administered according to the terms of this Agreetsent . If the i~sur~ed under such policies of insurance, becos-es totally and• permanently disabled within the meaning of any policies and because thereof the payment of .premiums, or any of them, shall duz'inq.the pendency of such disability, be waived, the trustee, upon receipt. of such knowledge; shall promptiy notify the insurance company which ~ha~s issued such polices, and shall tape any and all steps n~e~ces~sary to make such waiver of premium provision effecti~re. 2 3 410 - O ~ b`~- ~ 39 3.03. ~u.ties of Trustee With R~•ard to Life Iasur Policies . The Trustee shall be under r~o ~obli ~a. mace what eev r, except with respect to the safe~kee~ in of tion or duty of insurance and the duty to receive such stets as ma u bepolicies them in accordance with the requirements of this T 1s paid to companies issuing such t• by the such Policies, and to hold, ma.z~age and disburse proceeds subject to the terms of this Agreement. Upon the death of the insured, the This tee shall make reasonable of fo carry out the provisions of thin Agreement, includingts~e mair~tenana~e or defense of any suit shall be under no duty to maintainporvent,er h~ta ea ' the Trustee unless its expenses, including counsel fees and costs, haveation advanced or .guaranteed in an amount and in a mann,ex reaso been satisfactory to the Trustee. The Trustee Wray. r-epay any advances mace by i t or reimburs e~ i is el f for any such fees and cos is from an. corpus or income of this TrEls~t , 1' ARTICLE IV`. TRUST DIS~RIH~t'I011T~ 4 ; 0~._• Trust Priaciaai . ~'he entire co includ3aq the assets initially tran.,sferre ~utn © this s Trust subsequent additions to this ~i~:is t, and the. proceeds of any ,sale, exchange. or investment of such Trust. assets, s~ha.l.l 3~e used for the purpoees herein contained. 4 - 02 • ~acome Distr~,bution. I~urinq the lifetime of KA~RY~ W• ~L, •the Trustee shall distribute all of the net incoiae of the trust to, or for the benefit of, KA'~'HRYA7 yQ, FIBHBL for and during the remainder of her life, FISH~L should be admitted into a long term are facil~it~RYfl~T ~~ period of time, greater than thirty (3Q) da .s, ~' or a shah. discontinue distribution of all income,yand s all accuutu,late any and all of pthe net income o€ the trust, and: shall add such net income to the rincipal of the trust. The Trustee shall make no di s tril~uti.on of principa 1 to., or for the ~bene:f i t ~of , either or both of the S~ettlo=s . 4.03 ~. Princitaal Distributions . IIpon the death of RAT~YN W. FIS~EL, the Trust shall t'eiminate. ~Tpon termination, the remaining trust estate shall be: distributed 'as follows: (A) Thirty percent (30~) of the remaining trust estate shall b~e divide,,d into separate and equal shares, ar~d one such share shall be distributed to each of the Settlors ~ grandchi.laren, per sti If any of the Settlors ~ grandchildren predecease the teYminationeof this Trust, the predeceased grandchild~s share shall be distributed equally to the predeceased gra~ndchi.~d~s issue, per s~irpes, provided that if any of Settlors ~ grandchildren predecease the termination of this Trust without leavlnq issue, then such predecea-sed ~grandchild~ s sl2are shall be distributed equally to 3 3~(~ (61(e9~i3 q Settlors remaining grandchildren, per stirpes. ($) S~e~renty percent (70~) of the remaining trust estate shall be divided into separate and equal shares, and one such share shall be distributed to each of the Settlors' children, P3~cMFT,A F. VA~y' RIRR and PATRIC,IA.g. TAYLOR, per stirpes. If any of the Settlors' children predecease the termination of this Trust, the. predeceased child~s share shall be distribtite~d eq~zally to the predeceased c-hild's issue, pei stirpes, pravia~,ed that i€ any of ~ettiors children predecease the termination of this Trust without leaving issue, then such pre~de~ceased child r s s~iare shall be. distributed equally to Settlors' remaining issue, per' st~.rges-. 4.04. C~eaeral Power of ..~nt~en:t. settiore!~ children, PAM$~A F. VAST &~R and PATRICIA F. 'i'A~, are hereb y granted the general power .to~ .appoint some or all o~ the principal of this Trust to themselves or their estates, nr any other individual, in such proportions and upon such terns (in trust, outright gifts,. or in any other manner) as they jointly dee~a. advisable. The authority under this general po~+rer of appointment shall only .b,e exercisable upon the consent, in writing, by all of the Settlors' children, w~. ~ regard to the teens , conditions , -and amount o~f the appointment. This power shall not be~ exercisable under their Wills. If Settlors' children fail, e~.ther in whole or in part, to e~erci.se this general power of appointment her-e-in granted, the unappointed prine~.pal shall continue in trust and skull be administered according to the terms of this. Trust. Upon the death, resignation, r..ei~oval. or incapacity of one of the Settlors' children, then the remaini.nq child shall exercise the general power o f appointment unde~r~ this provision.. 4..05. Broad , SneQial Power of A~~irttment.. KA~RyN W. FISHEL is hereby granted the special power to appoint, at any time and from time to t3~ae, the principal of this Trust i,n ~irhole or in part and in any° manner and ~ in suoh proportions. as she- deems a~dvi.s~able to ~honcteeer she desires . This peer shall not be. exercisable under her Trill. This special. power of appointment does not grant to RAT,~RYN W. gIS'HEL. the power to appo~~int the principal of this Trust to herself, her estate, her creditors or the creditors of her estate. If I~'A~'HRY11~ ~P. FIB~H$L fails, either in whole or in part, to exercise thisspecial power of appointment herein granted, the unappoin.ted principal shall continue in trust and shall be administered according to the ter~as of~ this Trust. ARTICLE V . POWERS O'F TitUSTEE 5.01. Gene~cal Powers . In addition to such other powers and duties as nay have been. granted elsewhere in this Trust, but subject to any lin7i ta~tions contained elsewhere ~.n this Trust, the Trustee shall have the following powers and duties: 4 34l-oiotl~9~~39 account o€ any payment made by it pursuant to the provisions hereof. 2N ~9'ITN$S3 ~gggaF, the Set-tlors and Trustee have hereunto set their hans~s and seals as of the day and year first above-writt.eA,, r (/'~J~~ ~____'',..-~x,% ,~~ :' ~~,~~~ pia..-c srAr,~ ). G~ORG]3 ti . ICI SHSL,~ bY' aad through hi8~ attorney- ~.n-fact, KAq'HR~tlif ~R. FIgSEL, 3$~'TLOR ~~' ~~ ~ ~~~ ~5~., COI~+lO11T~T8~7~ OF ~~s•YL~14~T~; SS COD1'~'3'3C OF .. - ~' On th•' ` is, the O_ daX o~~ 19.93, before .tee, a I~ota~ty ~ubl..ic,. the ~de~signed o~~fic~er, ~.~ersona~ll~ appeared ~Ol~~g. ~ • FI~SHBL~ by aad th~o~gh his at~QrneY• ia~-fact, .Ii~A'rSR~T ~: F33HgL, and. RAR~$RY,I~ ~. FI~3~EL, his wife, known to me Eor satisfactorily proven) tb h~e the persons whose names are subscribed to the within Trust Agreement, ar~d aeknowle~iged that they executed the same for the purposes therein contained. IN 'q'P=Z'N.RSS. T~R$QF, I have set my hand and offic~.al ~~-~'~ ..~~ ~~ .. - ~~- . ,~: ~ ccomma gsion Expires . ~~•~ t.~da~Lee~s, No~~yPubfc , .. [~Y Can Dd g~ 15 . , ..- ~ ~ ; the farec~oing Trt~.s.t Agreement was delivered, h eby accepted., at ~~~L~nJ~ P~ennsylvaui~a, on ~, 199_ . 1 ~. ,~,~ ~ (3E~lL] RATHR ~P. FI38BL, TRU3TF~ 12 .~,. II~II~IIINI~nwA~YAIN~~III ,. e~ ao .a~ ;Q~~ . I :. . .~ `~ ~ .~ ~ ~ ii • , ~ ~. • d' CO (h .. ~ .brO'; ' . ~•: c '. , , '~ d - ~ _ t. j:. ,.. ~~~ - i. '' ~ _ _ ~ - ~. 1. i, ~ C• ~ ~ ^ - '' ~ ~ _ _ ,: '' ~~ o (,~ f.: r• . _. ~ (~~ .~ r V. z s.E - O ~ ~ +/ ~- ~ ; N N~tn :p:C ~ =++.(0 ' ~ O, ~.. 1_ 1 _. :~ Z ..... __ .. .. . _' ~ . ~ : ~ W . _ ,_ , :: ~ ~ _ - . : a' ~~.j- _- ;. • ~ a- -- :.. . ... . ~. 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N N ;~.• A O ~;' _'> O O p ~p O O O W~ C aNy~oc`a'. o-`-c~~~ va-~ ~, o=~E: c~a=~ ate- LLB: O O~, ~ ~ O t o. ~ c ~ n. c E c :~ •~ ~c U~~.::.~_-. 2~~ ~ N'~ ~ 'p ~- s C. ` ' N r Oz•7`O.~ N`mEE~= ~mEo:~ M W *_'' V ~'-' ~yo~~~~v E ~» ~:~ ~ O V y C Nc~Ev~c°~ .. Oui~ v 3~3 ~•:~_: .~ ~. , :~ ,o ~W ;.~ ~ ~. ,- ,, OC ~' D , ~' $ , ~'`_ ,~~ v ~a , , "O ., ~~ I ,'~ ivu ~.. 111JLV11Val 111VGJ ~ 1Y1Q11uul1G I'111L111fv:1Cll l.UrpUTaAOII JTDCK - Yahoo... http://finance.yahoo.com/q/hp?s=MFC&a=07&b=21&c=2012&d=07... t ~~ Hi, Karen Sign Out Hey Mail 5 My Y! Yahool Search __ , Search:Web ; ~ HOME INVESTING NEWS PERSONAL FlNANCE MY PORTFOLIOS EXCLUSNES ' ~ GetQuotesJ Finance Search Mon, Nov 19, 2012, 3:17pm EST- US Markets cbse in 43 mins __ __ _ _ Dow 11.42% Nasdaq 11.87% No platfomt tees. Ttadelreefar60days. E'°TRADE' wowettrad, p OPEN AN accoulur E~kTRRDE SECURITI[S lLC Manulife Financial Corporation (MFC) -NYSE Add to Portfolio Like i 39 __ 7 2 ^ 07 • 0.18 (1.51 %~ 3:17PM EST -Nasdaq Real Time Price Historical Prices Set Date Range (~~ Daily Start Date: Aug i 11 '~ 012 Eg. Jan 1, 2010 C'~ Weekly End Date: Aug ~, 21 ~ 012 (~'} Monthly Dividends Only Get~Pnces Prices Date Aug 21, 2012 f8iDownload to Spreadsheet Currency in USD. Open High Low Close 11.37 11.48 11.19 11.23 ` Cbse price adjusted for dividends artd splits. r =~--- Get Historical Prices for: - ', c. F , AdChoices First ~ Previous ~ Next ~ Last Volume Adj Close` 1,828,100 11.11 First ~ Previous ~ Next ~ Last ~__ ..-,.-::-.~r, d. Upgrade to the fasfier, safer Firefox. Optimized for Yahoo! Copyright ®2012 Yahoo! Inc. All rights reserved. Privacy Policy -About Our Ads -Terms of Service - CopyrighUlP Policy -Send Feedback - Yah001 -ABC N@W S NetW Ofk Quotes are real-time for NASDAQ, NYSE, and NYSE MKT. 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' - . -. ~ ~ ~ ~~ ~~ ~; ;a One Citizens Drive ~ 2 ROP 11 Riverside, RI 02915 December 12, 2012 ~ ~ Law Offices Irwin & McKnight PC RUVi~ ~ iVicKNiGH West Pomfret Professional Building ~~~ ~~F~~~~ 60 West Pomfret Street Carlisle PA 17013-3222 Estate of KATHRYN W FISHEL Date of Death: Aug 21, 2012 SSN: 187-16-6538 Dear Sir/Madam: In accordance with your request, the attached information sheet has been provided in the above decedent's name as of his/her date of death. Per your request there was no change in ownership within one year prior to date of death. For Installment Loans or Line of Credit accounts, contact our Loan Department at 1-800-708-6680. For all other inquiries, please ca11877-579-2667 option 2. Sincerely'; Vim" .-- i v; 4~` Lisa Drainville Decedent Account Processing REF#: 572686 T~ Citizens Bank Account Number 6100681246 Account Title KATHRYN W FISHEL/PAMELA VANKIRK/PATRICIA FTAYLOR Date Opened 6/6/ 1966 Account Type Checking Principal Balance as of DOD $11780.81 Interest from Last Posting to DOD $ .00 Account Balance as of DOD $11780.81 YTD Interest to DOD $ .00 ` ppE ][~ Oppenheimer & Co. Inc. 1015 Mumma Road Wormleysburg, PA 17043 Phone 717-763-8200 Fax 717-763-1765 Toll Free 800-722-2294 Transacts Business on all Principal Exchanges February 6, 2013 ,. ,, u_- j .~:,}- ~ 31k~~ ~ 8 ~~ ~' Irwin & McKnight, P.C. West Pomfret Professional Building ~~ ~• p~ ~ F-~ ~3 ~~ 60 West Pomfret Street Carlisle, PA 17013 `~t~IiY ~ Ivlc~~(~ilGi~ a ; h~`r~l ~~~.~~~~~ RE: Acct #A87-09046.85 Kathryn W. Fishel (deed) IRA Dear Sir or Madam: Please find below the date of death valuation for August 21, 2012 for the above-referenced account. Securi Price Value Putnam Growth & 14.17 $7,456.52 Income Fund Class A Advantage Bank Deposit 1.00 $267.96 Advantage Primary Liquidity 1.00 $240.17 Total Value $7,964.65 Should you require any further information, please do not hesitate to call. Sincerely, C Micha 1 G. Crouse Financial Advisor MGC/hk This report is for illustration purposes only it is not and should not be construed as a substitute for your Op~lenr.e,r;~ur & Co. Inc. account statement or Form 1099 and should not i1r1 ~e;;.;;~ u,~an ?or tax reporting purposes. fvlarket prices reflected are as of ~~~21, 1~_ and are from sources believed to be reliable but are not warranted by us as to accuracy or completeness nor do they represen? guaranteed markets for the securities. This information is subject to change. Commissions, sales charges or deferred charges might apply if the acrount were to be immediately liquidated Oppenheimer & Co. -nc., nor any of its employees or affiliates does not offer legal or tax advice. From: yLr. vvv-. .. ..-- 01 / 2512013 -16:30 #237 P .001 / 001 'i~e~ ~, ~ Sun Life Assurance Company of Canada (U.S.) Sun ~~ P.O. Hoc 9133 Life FinanCl~l ® wenesl~ Hills, MA 02481-9133 TeL• 800-75~7Z16 Fax: 78 ] -30¢5383 January 25, 2013 Jennifer Conway - Morgaa StauIey Smith Barney LLC Via Fax: 717-730-1894 RE: Contract value Contract number: 36-3600-010128 ~n~Cs)= Fishel Family Irr Trust U/A Dtd 07/29/93 Dear Ms. Conway, Thank you for calling our G~tstomer Sertrice Center. As discgssed dYuing your call, we ate writing to eonfirtn the followsng inform~.tion about tbi~ Sua Life Financial annuity. The contract value as of August 21, 2012 was $80,105.71. If you have any questions, please call our Customer Service Center at 800-752-7216. Sincerely, Yvonne Hill ~A,nnuity Operations & Customer Service 86051818 ,: a~~ _~.' ~=z~..~ Sun Life Assurance Company of Canada ~U'.S.) . is a member of the Sun Iafe Financial grono of com~i~, Karen Noel From: Wolfgang, Raymond <rolfgang@jhnetwork.com> Sent: Thursday, September 13, 2012 2:17 PM To: Karen Noel Subject: RE: Kathryn Fishel Estate Hi Karen, Here are the date of death values for the accounts on Kathryn: ~DWS Scudder investments, 00426400281, $14,840.18 TY~S~' ~DWS Scudder Investments, 00005097760. $36,655.62 -fitus~ Putnam Investments, 00427792274, $ 16,411.44 i v~ dU~ ~G~ John Hancock Funds, 00004128487 30 223.19 -"I'Y V`~"~ ,$ , American Funds, 00059801908, $ 7,222.22 - ~ ~ (us~ If you need anything further, please let us know. Raymond F. Wolfgang Jr. 2431 N. 2nd Street Harrisburg, PA 17110 O- (717) 234-7607 F- (717) 234-7560 C- (717) 982-2022 Offering John Hancock Products, Registered Representative/Securities offered through Signator Investors, Inc. Member FINRA, SIPC. 1624 Hausman Road Allentown, PA 18104 (610) 530-2112 (800) 811-5400 From: Karen Noel [KNoel@irwinmcknight.com] Sent: Thursday, September 06, 2012 2:35 PM To: Wolfgang, Raymond Subject: Kathryn Fishel Estate Per our conversation this afternoon, please forward date of death valuations for all accounts held in the Kathryn W. Fishel Trust. If you have any questions, please do not hesitate to give me a call. Thank you. Karen Noel Irwin & McKnight, P.C. 60 West Pomfret Street Carlisle; PA 17013 tel: (717) 249-2353 urnam ` INVESTMENTS 2012 YEAR-TO-DATE STATEMENT 01/01/2012 - 06/30/2012 >07126 7613962 001 092033 OD6974775 KATHRYN W FISHEL 5225 WILSON LN APT 205 MECHANICSBURG PA 17055-6663 CONTACT INFORMATION INVESTMENTS: ACCO RAYMOND F WOLFGANG tnam Investmen SIGNATOR INVESTORS IN 1-800-225-1581 1-717-234-7607 putnamcym-~ ~~~~U~ ~1~~,~ ~cc o~ r,k YOUR PORTFOLIO VALUE as of 06/30/2012 Current quarter Year to date (04/01/2012-06/30/2012) (01/01/2012-06/30/2012) Beginning value ;16 , 657.67 ;14.605.33 Additions (+) 0.00 0 .00 Withdrawals (-) 0.00 0.00 Change ~n value (+/-) _ ;-941 .14 ;1 .111 .20 - - ...~'....._._._.. 's€¢... _.._ _.. 'i'•iiE's^ ~ ~ iii::€€."i''€€' ~~€~ " '`i~f ~==E~ ~='sE=~'"~ ~' ~ _€ ~_~ ~ '° ~ ~€' W_s~ ~€_:: == ~' =.; _' ~`~ M: "::~~_~€ ~~>r'.s~s~''€€ =' YOUR PORTFOLIO HISTORY $16,000 814,605 $15,716 s12,eoo ss.soo $6,400 $3,200 O 1 3 2011 O 30 2012 SUMMARY OF ACCOUNTS Account Beginning value Additions Change in value ~ Ending value Name ~ number (01/01/2012) withdrawals (+/-) (06/30/2012) KATHRYN W FISHEL INDIVIDUAL ACCOUNT 0427792274 PUTNAM GROWTH & INCOME-A $14 , 605 .33 $0.00 $1 , 1 1 1 .20 $15 , 716 .53 Value of Putnam portfolio ;14 , 605.33 60.00 ;1 , 111 .20 s 15 , 716.53 Adding to your Putnam account is now easier than ever. You can send money directly to Putnam using ~- your bank's electronic bill-pay system. For more information, go to putnam.com/checkfreeinvesting, or if you have a mobile device with the Microsoft Tag application (available at http://gettag.mobi), simply ~ scan this code. n ~ This is a summary of your year-to-date statement. Additional details follow and are available at the secure account section of putnam.com. ~: ~J 'C f a PAGE 1 OF 3 07126 7613962 074252 025105 00001/00002 r KATHRYN W FISHEL 2012 YEAR-TO-DATE STATEMENT 01/01/2012 - 06/30/2012 Summary of your Putnam accounts Beginning balance Exchanges Change Ending balance Fund name (as of 01/01/2012) Additions in/out Withdrawals in value (as of 06/30/2012) PUTNAM GROWTH & INCOME-A $14,605.33 $0.00 $0.00 $0.00 $1,111.20 $15,716.53 Total year to date ;14,605.33 ;0.00 ;0.00 ;O 00 ;111120 S15 716 53 Total this quarter ;16,657.67 ;0.00 ;0.00 ;0.00 -;941.14 515,716.53 Share Number Share Total Date Account activity detail Amount price of shares balance value 01/01/2012 Beginning Balance 12.690 1150 932 $14 605 33 03/13/2012 DIV REINVEST 0.043 $49.49 14.360 3.446 1154.378 06/13/2012 DIV REINVEST 0.043 49.64 13.050 3.804 1158.182 06/30/2012 Ending Balance 13.570 1.158.182 ;15.716.53 HISTORY OF YOUR INVESTMENT IN THIS ACCOUNT Initial amount + Additions + Exchanges - Withdrawals = Net amount + Change = Ending Balance invested on invested in value as of 10/31/1996 06/30/2012 ;5,000.00 ;5,000.00 ;0.00 ;0.00 ;10,000.00 ;5,716.53 ;15.716.53 Capital gains and dividends distributed in cash since initial investment ;0.00 Dividends This quarter Year to date $49.64 $99.13 Capital gains $0.00 $0.00 Total Income $49.64 $99.13 ~ e . ~. ~ Fund 5 years 10 years/life inception 1 year annualized annualized Fund name date NAV POP NAV POP NAV POP PUTNAM GROWTH & INCOME-A 11/06/1957 -1.56% -7.25% -3.99% -5.12°~ 2.88% 2.27% ' If "N/A" appears in any box, performance was either not available or not reported at the time this statement was produced, or the fund has not been in operation long enough for performance to be reported. See reverse for information on performance. PAGE 3 OF 3 07126 7613962 014253 025107 00002/00002 Quarterly Account Statement Apri11, 2012 through June 30, 2012 Your Portfolio Summary by Fund Name Total Share .Price Fund Name Shares Owned x on 06/30/2012 Non-Retireme~ DWS Managed Municipal Bond 2,762.994 $9.360 DWS GNMA Fund-S 678.561 $15.510 DWS Core Equity Fund-S 838.902 $16.970 $165.78 $25,861.62 $9.360 2,762.994 Total Portfolio Account Activity ^ Account Number 5097760 Fund Name DWS Managed Municipal Bond Fund-S Fund Number 2066 NA5DAQ SCMBX Cost Basis Method AVERAGE COST Trade Transaction Descri tion/ p Date Cost Basis Method DollarA.mount Beginning Balance on 04/01/2012 $25,695.84 04/2412012 Incame Div Cash $92.50 0584/2012 Income Div Cash $81,11 06J258012 Income Div Cash $97,96 INVESTMENTS Deutsche Bank Group Value on Cost Basis Cost Basis = 06/30/2012 Noncovered Shares Covered Shares $25,861.62 N/A N/A $10,524.48 N/A N/A $14,236.17 $18,001.79 $74,04 $50,622.27 Registered to: KATHRYN W FISHEL TR FISHEL FAMILY IRREVOCABLE U/A 07/29/93 Share-~°°"°"' Shares - Price = This Transaction $9.300 $0.000 0.000 $0.000 0.000 $0.000 0.000 Total Shares Owned 2,762994 2,762.994 2,762.994 2,762.994 Change in Value Ending Balance on 06/30/2012 ^ Account Number 5097760 Fund Name DW5 GNMA Fund-5 Fund Number 2393 NA5DAQ SGINX Cost Basis Method AVERAGE C05T Trade Transaction Descri Lion/ p Date Cost Basis Method Beginning Balance on 04/01/2012 04238012 Income Div 0.0624 Cash 05838012 Income Div 0.0624 Cash 06822012 Income Div 0.0625 Cash Registered to: KATHRYN W FISHEL TR FISHEL FAMILY IRREVOCABLE TRUST U/A 0789/93 Share Shares Total Shares DollarAmount - Price = This Transaction Owned $10,538.05 $15.530 678.561 $42.34 $0.000 0.000. 678.561 $42.34 $0.000 0.000 678.561 $42.41 $0.000 0.000 678.561 Change in Value -x13.57 ---- - ~ ---- - - -- ---- ~ - -- - -- -- - Ending Balance on 06/30/2012 510,524A8 $15.510 ~'`" ^ Account Number 426400281 Fund Name DWS Core Equity Fund-5 KATHRYN W FISHEL TR Fund Number 2064 FISHEL FAMILY IRREVOCABLE NASDAQ 5CDGX TRUST U/A 0729/93 Cost Basis Method AVERAGE COST ~~ ..- Trade Transaction Ducri Lion/ ~`~.. ~''~-,,,, Share - ~' Sharer Date Cost Basis Metho Dollar Amount 1 ~- -~~ - .-... ~-bracer This Transaction Beginning Balance on 04/01/2012 $15,191A9 $18.160 061222012 Income Reinvest 0.0471 $39.40 $16.650 2.366 Change in Value -$994.72 Ending Balance on 06/30/2012 $14,236.17 $16.970 Effective on February 1, 2012, DWS Growth & Income Fund was renamed DWS Core Equity Fund to better reflect its investment style. Not FDIC Insured • No Bank Guarantee • May Lose Value 678.561 Total Shares Owned 836.536 838.902 838.902 - - 3' T Page 2 of 6 0 IICT lVI/~R']~7A ClAl e . the future is yours Mutual Funds Operations John Hancock Signature Services, Inc. PO Box 55913 Boston, MA 02205-5913 RECIPIENT'S name, address and ZIP code AT001~~ 000026204 0 0570 1rcATHRYN W FISHEL TTEE FISHEL FAMILY TRUST 5225 WILSON LN APT 205 MECHANICSBURG PA 170 1099-DIV ~~i~~ OMB. No. 1545-0110 2017 Dividends & Distributions This is important tax information and is being furnished to the Internal Revenue Service (except as indicated). If you are required to file a return, a negligence penalty or other sanction may be imposed on you if this income is taxable and the IRS determines that it has not been reported. RECIPIENT'S identification number XXX-XX-6538 Payer: Fund name, 1a. Total 2a. Total 4. Federal fed. Id no. and ordinary 1 b. Qualified capital gain 3. Nondividend income tax 6. Foreign account number dividends dividends distributions distributions withheld tax paidt BOND A 1,453.03 0.00 24.59 0.00 0.00 0 00 04-2528977 . 0004128487 . TOTAL 1,453.03 0.00 24.59 0.00 0.00 0.00 of Ordinary Dividends (Column 1 a of 1099-DIV) Fund name from U S Government Obliaations* Direct * * Indirect* BOND A 2.59% 15.12% Department of the Treasury -Internal Revenue Service Please see reverse side for explanation of notations. Form 1099-DIV Page 1 of 1 ~'~ {'~ The.. right choice for the ong term® Arr~ercan Funds .~ PO' Box 2280 Norfolk VA 2~~'`~--~,.,,, ~~ AV 02 22218697H757 A**5DGT 1111 '111111'1'III'II'1111111'II'IIII1111111111111'II1~1111111 THRYN W FISHEL TTEE FISHEL IRREV TR DTD 07/29/1993 MAPLEWOOD ASSISTED LIVING 5225 WILSON LN #205 MECHANICSBURG PA 17055-fififi Personal rate of return now available Available now on .your quarterly statement and coming soon online, you can find your personal rates of return at the portfolio, account and fund levels, as well as historical results for all your funds, to better meet your investment needs. Learn more at americanfunds.com/statement. Understanding your portfolio value Your total portfolio value is a summary of all accounts, as detailed on the following pages, including funds you previously owned. Your withdrawals and fees consist of all deductions from your account, including annual fees, and any dividends and capital gains taken in cash. Quarterly Stafiement June 29, 2012 Page 1 of 3° Primary account number: 598Q1908 Since initial investment on Year-to-date since Ol/Ol/2003* 01/01/2012 Beginning value $5,812.61 $6,788.81 + Additions $0.00 $0.00 - Withdrawals and fees -$3,629.37 -$133.66 ...................................g......................-~-~---.................... +/- Investment ain/decline ...................................................................................... $4,848.60 .............................. .. . $376.69 Ending value as of 06/29/2012 $7,031.84 $7,031.84 *For accounts opened prior to 2003, an initial investment date of January 1, 2003 is used. More information is available at americanfunds.com/statement. Annualized since initial investment on oi/Ol/2003* 8.75% Year-to-date since 01/01/2012 5.59% 1-AF1-028582828-J90943 1972221/2 12 { i i I f ® Equity-income 100.00% 100.00% I i ~ I i I I ~ I i I How to contact us Through your financial adviser RAY WOLFGANG (717) 234-7607 SIGNATOR INVESTORS, INC. C/0 KEYSTONE FINANCIAL 1624 HAUSMAN RD ALLENTOWN PA 18104-9349 americanfunds.com FundsLine® 24-hour automated service 800/325-3590 Shareholder Services Representative 800/421-4225 (M-F 8 a.m. to 8 p.m. Eastern time) Mail American Funds Service Company PO Box 2280 Norfolk VA 23501-2280 Overnight courier American Funds Service Company 5300 Robin Hood Road Norfolk VA 23513-2430 Questions about your statement a mericanfunds.com/statement o. + 214 Senate Ave 7th Floor Camp Hill, PA 17011 tel 717 730 1800 fax 717 730 1894 toll free 800 237 1700 September 27, 2012 Irwin & McKnight , P.C. Attn: Marcus A. McKnight III West Pomfret Professional Building 60 West Pomfret Street Carlisle, Pa 17013 Re: Estate of Kathryn W. Fishel Dear Mr. McKnight, MorganStanley SmithBarney swy a.w T- r n .. ~~~~~ CEP 2.8 20~~ IRWIfV ~ McKiVIGHF I_AUU OFFICES As requested, I have enclosed a valuation for Kathryn Fishel's accounts with our Firm. Please be advised that the account registrations have not changed in the past 12 months; nor were any accounts closed. However, the first Trust account referenced below (341-010158-139) was never funded and is currently at a zero balance. The Fishel Family Trust owns an annuity with Sun Life with Kathryn Fishel as the annuitant. This policy was issued on 07/20/2000. I have informed them of Kathryn's passing and they are preparing the claim forms for the beneficiaries named in the contract. Account Re istration Account Number O enin Date Kathr n Fishel Ttee, Fishel Famil Irrev Trust U/A/D 7/29/1993 3.41=01©-1~9 07/05/2012 Kath n Fishel Ttee, Fishel Famil Irrev Trust U/A/D 7/29/1993 341-010168-139 ~' 07/12/2012 Kath n Fishel Ttee, Fishel Famil Irrev Trust U/A/D 7/29/1993 341-010169-139 / 07/12/2012 Kathr n Fishel Ttee, Fishel Famil Irrev Trust U/A/D 7/29/1993 341-899268-139 / 05/09/2001 Kathr n W. Fishel 341-908997-139 ~/ 05/02/2008 We will await further instruction from you anti the executrixes of Kathryn's estate on how you would like to proceed with the accounts. As always, please feel free to contact me at 717-730-1826 or at jennifer.s.conwa~morganstanlev com~om with any questions or concerns. Kindest R gards, Jenne er Con RP® Sr. Registered Associate Morgan Stanley Smith Barney LLC. Member SIPC. a Kathryn Fishel: Individual Account # 341-908997-139 Symbol/CUSIP Security Description Quantity Price ($) Market Value ($) r~ - Cash -57.11 1.00 -57.11 ~~'C~: CIBCX AMERICAN CAP INC BUILDER C 253.21 52.79 13,366.96 .._.~.~1~ ~ ~~~ 1 CWGCX AMERICAN CAP WRLD GR & INC C 240.47 35.18 8,459.73 ~5fi~~..~ TOTAL 21,769.58 ~ ../ Kathryn Fishel Trustee: Fishel Family Trust account # 341-899268-139 Symbol/CUSIP Security Description Quantity Price ($) Market Value ($) BDPS CITIBANK,N.A. 4,181.76 1.00 4,181.76 TOTAL $4,181.76 Kathryn Fishel Trustee: Fishel Family Trust account # 341-10168-139 Symbol/CUSIP Security Description Quantity Price ($) Market Value ($) - Cash 90.00 1.00 90.00 BDPS MORGAN STANLEY BANK N.A. 5,530.25 1.00 5,530.25 AHMIQ AMERICAN HOME MORTG INVT CORP 500.00 0.02 7.50 EVV EATON VANCE LTD DURATION FD 535.00 16.71 8,939.85 JPM.I JPMORGAN CHASE 8.625% SER J 200.00 26.41 5,282.00 NFJ NFJ DIVIDEND INT & PRE STRGY 200.00 17.30 3,460.00 JQC NUVEEN CREDIT STRAT INC FD 600.00 9.40 5,640.00 EHI WESTERN ASSET GLOBAL HIGH FD 1,307.31 13.78 18,014.73 CWGCX AMERICAN CAP WRLD GR & INC C 242.60 35.18 8,534.67 MIGFX MFS INVESTORS GROWTH STK A 578.08 17.48 10,104.84 PTTCX PIMCO TOTAL RETURN C 2,287.72 11.38 26,034.25 PUBCX PIMCO UNCONSTRAINED BD C 1,806.25 11.46 20,699.63 MER.M 06/15/2062 100.00 24.91 2,491.00 TOT AL $114,828.72 Unless otherwise indicated, this information is not intended to be a substitute for the official account statements that You receive from Us. This information is approximate and subject to adjustment, updating and correction and is for illustrative and general reference purposes only. We are not responsible for any clerical, computational or other inaccuracies, errors or omissions. We obtain market values and other data from various standard quotation services and other sources, which We believe to be reliable. However, We do not warrant or guarantee the accuracy or completeness of any such information. The values that You actually receive in the market for any investment may be higher or lower than the values reflected herein. To the extent there are any discrepancies between Your official account statement and this information, You should rely on the official account statement. This information should not be considered as the sole basis for any investment decision. The Bank Deposit Program (BDP) is a cash sweep feature whereby free credit balances are automatically deposited into deposit accounts established for clients by Morgan Stanley Smith Barney at two banks: Morgan Stanley Bank, N.A. and Morgan Stanley Private Bank, National Association (the Banks). Morgan Stanley Smith Barney is a registered broker-dealer, not a bank. Unless specifically disclosed in writing, investments and services offered through Morgan Stanley Smith Barney are not insured by the FDIC, are not deposits or other obligations of, or guaranteed by, the Banks and involve investment risks, including possible loss of principal amount invested. i ~usi ~~~d~ i Kathryn Fishel: 341-10169-139 Symbol/CUSIP Security Description Quantity Price ($) Market Value ($) - Cash 100 1.00 100.00 BDPS MORGAN STANLEY BANK N.A. 1895.84 1.00 1,895.84 BIV VANGUARD INTERMEDIATE TERM BND 272 88.82 24,159.04 BCBAX BLACKROCK CORE BOND PTF A 2,433.33 9.68 23,554.63 LSBDX LOOMIS SAYLES BOND INST 782.552 14.77 11,558.29 PTTAX PIMCO TOTAL RETURN A 2,067.77 11.38 23,531.22 ' PSHAX ~ PIMCO SHORT-TERM A 3,897.16 9.85 38,387.03 TPINX TEMPLETON GLOBAL BD FDA 485.54 13.20 6,409.13 - $129,595.18 Unless otherwise indicated, this information is not intended to be a substitute for the official account statements that You receive from Us. This information is approximate and subject to adjustment, updating and correction and is for illustrative and general reference purposes only. We are not Last Refreshed - 14:37 PM EDT, 10/01/2012 ~S~ Jan z9 Z813 17:46:89 MetLife -> +717Z496354 Page aez t~ MetLife Investors USA P.O. l3ox 14593 Des Moines IA 50306-3593 January 29, 2013 KAREN NOEL Copy to: Fax: 717-249-6354 RE. METLIFE INVESTORS USA INSURANCE COMPANY CONTRACT A205710i5 DECEASED KATHRYN W FISHEL Dear M s. Noel Thank you for your recent inquiry regarding the contract referenced above. Our records indicate that the date of death and the account value on that date are: Date of Death: 08/21/2012 Account Value: $106,514.44 If you have any questions, please contact your representative or call our Customer Service Center at 1-BDO-284-4536 Monday through Friday between 8:30 a.m. and 6:30 p.m., ET. Sincerely, Sorya Inthalangsy Annuity Representative -Post Issue Processing MetLife Annuity Operations and Services Help us stay connected: Please keep us updated with respect to all who are associated with this contract, including the owner. the annuitant, and any beneficiaries. Make sure that we have the following information for all persons or entities: name. address, phone number, date of birth. and social security or tax identification number. Changes may be submitted to the address provided above, by calling our Customer Service Center at the phone number provided above, or by contacting your Representative. ..~. ~~' f~ c'7 8 Market Plaza Way ~ Mechantcsburg, PA 17055 ~ • p ~~`''~ Phone: -697-4696 Michael J: Malpezzr, Owner FUNERAL HOME Jeremy ~J Shartzer, Funeral Director Ryle C. Knipe, Funeral Director STATEMENP OF FUNERAL GrOODS AND SERVICES SELECTED Charges are only for those items that you selected or that are required. If we are required by law or by a cemetery or crematory to use any items, we will explain the reason in writing below. If you selected a funeral that may require embalming, such as a funeral viewing, you may have to pay for embalming. You do not have to pay for embalm- ing you did not approve if you selected arrangements such as direct cremation or immediate burial. If we charged for embalming, we will plain why below. For the Service of rt''.e,' ~. •~! -~{•~' f ~'-.~ `'~.~~~ ~ Date of Death. •:~ G • ' % ?. ~: .- Chat$e t0: ' f~•,~'/c'~ 1riC'.~~ ~+:• r<.• :K. ~'~, .!'A/ls~ ~'•4•iF: /r (..,~~/ ,/' Name Address `City State A. CHARGE FOR SERVICES 3ELEGTED: Other clothing I. PROFESSIONAL SERVICES Services of Funeral Director/Staff ...... S ~;t/c.:!. Cremation um ................... S . Entbalmirlg .................... f rr~ .:'_ (Descripdo~ Other preparation of body ' ''~ OTHER s ~ = e S s r i ~a B S % ,:7 ~.~ ~~' MERCRANDIL4E SEiECI'BD " " " ' • • • • • • • • • SUB-TOTAL OF PROFESSIONAL SERVICES ..........Al S . 2. FACILITIES AND SERVICES C. SPECIAL CHARGES: ~ Use of faalities and services for gong ~ ~~ to viewing (Visitation/Wake) ......... S ~'i~ ` $ Q~llneral Home) Use of faalities and services R~~B ~ ~~ from for funeral ceremony ............ S 1l/:r ~- S Use of fadlities and services for (Funeral Home) Memorial Service ............... S ~ Immediate Burial ................. S Use of equipment and services Direct Cremation ................. S for graveside service ............. S ,/ r ~. S Other use of fadlities SUB-TOTAL OF SPECIAL (:BARGES ................C S D. CASH ADVANCED Opening Grave ................ . S =7 U 3U&TOTAL OF FACQTI~S/HQiIIPMEN'i' ...........A2 S Cemetery Equipmrnt .............. S 3. AUTOMOTIVE EQUIPMENT Lot and Deed ................... S Vehicle to transfer remains to Ftmetal Home Newspaper Notices-Lard ........... S ^r_ c>:~ ~, Lora! ......................... S~ Newspaper Notlces-Out-of-town ...... S l h Hearse (Casket Coach) Te ep one A Telegrams ............ S Local .........................5 •si' Airfare ........................5 a~BY~~B .............. S 'Z. u;J Limousine ~` Pallbearers ..................... S Local ......................... S Certified Copies of the Death ........ S . -^ - ; Fay car '""- Certificate . S ~ .r .. . . ............ Local .........................5 :: : : Police Escort S Flower car or floral disposition L l S ~ ~~f Flowers ........................ S ~ oca ......................... Vault Service Charge S .............. Lead car/clergy car , ~- S ] E.•° ---- C~ /.":..~: / ~ ._ ,, ,~ `" Local ......................... 'S~ S Car for pallbearers S Local .........................5 S Out of town transportation .......... S S S SUB-TOTAL OF ADVANCES .......................D S .~ ~•~5f .r SUB-TOTAL OF AUTOMOTIVE EQUipA~VT .........tii S ' We dtarge you for our seririces in obtaining: TOTAL OF PROFESSIONAL SERVICES, (specify cash adrrances that are »rarkad-up) FACIIITIDS AND AUTOMOTIVE _ .. ~~ ~'J.} ~v c5"~ . EQUIPMENT ...................................A S ~ ~ B. CHARGE FOR MERCBANDItSE SELE r ;r -- -- ' ' ` " ~ ~ OF CHARGES A. Professional Services, Fadlitles and Casket ............. ~ . •': '-t..... S , (Descriptiort~~. ~ .,~.'.:-/.:./~r.' ~. Equipmrnt, andAutomotive• • • • • • • • • Equipment . s.'~~r7f.. '~ -„ .x rrrr ..1 _ 1 B. Merchandise .................... S c ~ r`rJ,i ... Other Receptacle ................. S C. Speaal Charges . S l;Descriptiord y D. Cash Advances .................. S I '~ r .~ Outer burial container ......... ~_-"- _ . S •; ~•~, ... „ TOTAL OF ALL SECTIONS ........... ~; ............ S ~• iv.~ (Description) ~ r • ~ : r_ ~ i ~ r •PAH)~AT TIi11lE OF OR PRIOR TO r• y: _ _ ~/.- ~ 'ARRANGEbIENTS' ... 1...... ...........:..... S ' ~ . - ~^ Adcnowledgemrnt cards .... ..... S . BAiANCE DUE ............................. S ~ " ,:. . Register book(s) .........: ~,~,,•:.. ST ~ ' REASON FOR LTG ~' a r 7 U (,~ r ~~ / ~ ~ Memory folders ..........E ...... S / i ~iCr/ .%! <! /_ ~ f /a?..1.; ~ ~ f•f "' i/.~ru//rte ~ ! t Prayer cards ..........:......... S T k S B any law, cemetery, or crematory requircmrnts have required the purchase ~l/) of an of the items listed above the law or re uirem t i l d b l emporary grave mar er ............ y , q rn s exp a~rle e alw. ++ ~! , a ` ' '~ ~ Burial clothing .................. S , I ~(.. ti,:l,~ ~/. /~ / . ;:~ .~~a~r/'~ •-1. ~s i ,1i ~ ,+ :~ 7 "1 - I! I agree that I have examirud the items of goods and services selected above and found ~ . them to be correct and according to the arrangements I have requested. I adtnowledge receipt of a copy of this Statement of Funeral Goods and Services Se~cted. I represent t I have suffidrnt funds available for paylrreclt of the cash price for the goods ~ ~ ' ,~ and services selated. I also agree.. to make payment of S s,: ? within i 3 days. I agree to be jointly and severally liable with anyone else who signs below. A late dtarge of J ~'_7 '! per montlt amounting to J ~'. "f i per year will be applied to the unpaid balance beginning 7r_ days from the date of this agreement. I will also pay to the Funeral Director all reasonable costs paid by the Funeral Director to collect amounts I owe under this agreemrnt. Those costs may include attorneys' fees, cart[ cross and other costs. Any additional services or merchandise ordered or requested after the date of this agreemrnt will be considered part of this agreement and the cost thereof will be reflected on.the final bill or statement. (Seal) ~ /~"" / '.~~ : ;:~--. (Purdtaser) (Date) ~' .. (Seal) .. % .... ~`` , ~ y ~'`~r~l~/ ~ "'~,/' • ~ (Purchaser) / (Licensed Funeral Director) O Pennsylvania Funeral naeaors Assotiatla~ WHrI'E Funeral Dirccta YO.I.OW Fungal Dbectw PINK G~stana form -600 Revised 1/04 1,~5~ leg KATHRYN W FlSHEL Aooount flAarltet Vales Stock Price as of 1109 2 Toted Market Value 532.020 51,729.08 The aggregate amourrt pad to all Trust Berlefbiaries to this distributlon 18 $1.50,581,457.14. Investor ID 8067 7291 79~Y 2012 Dhri dead Summary Record Date Thal Trust lrrteret3ts .Dividend. per Trust irtberest Currerrt Distribution 11/09/2012 54.0000 50.74 5.98 Pt~able Date Tax Withheld Net Distribution Prior Year DisMtwtion 12/~a/2o12 So.oo S~.9B 539.9e Ttuat t3wtafloimy InRonttabott _ . You may purchase or.~sell your shares of Mett.if®, Inc. common stock An annual shareholders' meeting to elect members of ttte Bosrd of (represented by-`Trust Interests") held in_the MetLife.Policyholder Trust Directors of Metl.ife, ,Inc. and for- the transaction of otiter busilr~ess is (the `Trust")..froe: of .any :commissions or other-lees, under the MetLife expected to • be held on .or r.about April 23, 2013. The deadline -for Purchase and ~ Sale Program, as amended. A copy of the brochure submitting shareholder. proposals for consideration at this meeting is describing the- pprrogram.. - is . available. . on the Intemet . _ at. Noxember.,Zt3, .2012 A, copy of MetLife, ,int.'s annual report..and pr. • http://irtvesto[.metlife.com by selecting the- Shareholder Services -statement wUl tie- available tree of charms on or about::March 31, 2013, Information page, or b~ calling.the number listed_ aboire: You are.:permitted along. with other MetUfe, Inc. and Trust tilinga under federal securities ' to transfer your Trust ~ nterests .Drily ~iri the circumstancsrs described in the ' laws, .,(i) on he Internet at www.metlife.com by selecting About MetLite, brochure. You may also instrirlct 'thaf all (but note less 'than all) of your Corporate Qovernance, (ii) bywritingg to MetLifs, Inc., c% Computerohare shares of Mett.ife, Inc. common stock held by itte Trust be withdrawn from Shareowder Services LLC, PO Box 358447. Pittsburgh, PA 15252.8447, or . the Trust. Infomratiort.. regarding-your wiEhdrawal rights may be found in Cii) by calling the number listed above. These and other SEC .filings by • the-Purchase and-:Sale Program brochure or by,calling the number listed Meti.ife, Inc. and the Trust are also available on the Internet at above -;Metlife, Inc. amended the Purchase and Sala Program Procedures wwwsec.gov. • m :Oct!oiJef 2012. As a result, .,,,"~ - ~e:-lrn~r a~r~t- ~01~-fiax Irifoirrri~on - - - - _ . N e FORM 1089-DIV. U.S. TAX INFORMATION FOR 2012 ~ OMB NO.1545-pi10 DIVIDENDS/DISTRIBUTIONS COPY B .FOR RECIPIENT RECIPIENT'S TOTAL ORDINARY IDENTIFICATION NUMBER DMDENDS GIUAUFIED DMDENDS FED~tALIN00METAXWITFN4ELD BOX 1a BOX 1b ill ~ )~~ '~ •~ BAYER'S NAME. ~ PAYER'S FEDERAL IDENTIFlC~ITION NUMBER iCOMPUTERSHARE SHAREOWNER SERVICES LLC f 51-~i18967 AS CUSTODIAN OF THE METLIFE POLICYHOLDER TRUST SECURITY DESCRIPTION TO WHOM PAID TRUST INTERESTS KATHRYN. W FISHEL 110 W GREEN ST REPORTED BY SHIREMANSTOWN PA 17011-6517 Cp pP UpX 4 E g 10 PROVIDENCE, RI 02940-3010 IMPORTANT 2012 TAX INFORMATION- FOR INFORMATION. REGARDING THE ABOVE, CALL 1-800-B49-35r~3 This is important tax Information and is being famished to the Internal Revenue Service. M you are required to file a return, a negligence penalty or other sanction may be imposed on you if thla Income is taxable and the IRS determines that it has not been reported. Box 1 a -Shows total ordinary dividends that are taxable. Indude this amount on Ane 9a of Form 1040 or 1040A. Also, report it on Sdredute B (1040A or 1040), ff required. The amount shown may be dividends a corporeUon paid directly to you as a partidpent (or benefidary of a partid- pant) in an employee stock ownership plan (ESOP). Report it 8s a dividend on your Form 1040/1040A, but treat it as a plan distribution, not as Investment income, for any other purpose. Box 1b -Shows the portion of the amount in box ta, that may be eligible far the 15% or zero capital gains rates. See Form 1040/1040A instructions for how to determine this amount Report the eligible amount on line 9b, Form 1040 or 1040A. Box 4 -Shows backup wffhholding. A payer must backup withhold on certain paymerks ff you did not give your taxpayer IdenUUcaUon number to the payer. See Form W-9, Request for Tax- payer Identification Number and CertfficaUon, for information on backup withholding. Indude this amount on your income tax return as tax withheld. Nominees. If this form includes amounts belonging to another person, you are considered e nominee recipient You must file Fora 1098-DIV (with a Form 1096) with the IRS for each of the other owners to show their share of the income, and you must famish a Forn 1098-0IV to each. A husband or wife Is not required to file a nominee return to show amounts owned by the other. See the 2012 General Instrudions for Certain Information Returns. For account inquiries, you .may visit www:cpushaceownerservices.com or colt 1-800-649-3593. - When cotltacang us please have your Investor ID available; located in the upper right fiend corner of this document. a.au a aaau~va av~aa a a avv.s l a.av~• •a av, a11V. ~V1LLliV11 JWbl\ -7 LVVll ~ IQtt.VV: 1'... t nt~p:ii nnance.yanoo.corrv qi rip-is=ivt~ 1 csia=U' /rkb=l 1 tic=~u t ~aLa=U"/... ~, ~~ ~~ Get new Yahoot Mail apps Mail My Y! Yahoo! --~ Search , ~Search~Web _ .I I HOME INVESTING NEWS PERSONAL FlNANCE MY PORTFOLIOS EXCLUSNES r J .Get~Quotes,~ Finance Search Tfw, Feb 7, 2013, 12:38pm EST- US Markets cbse in 3 hrs and 22 miss Dow 10.69% Nasdaq •0.49% '~ ~ MET FREE'EDUCATiON: "j ~: _ _&LLRESEARCH _ MetLife, InC. (MET) -NYSE __ Add to Portfolio Like I ~ 71 36 ^ 88 • 0.69 (1.85%~ 12:39PM EST -Nasdaq Real Time Price .~ Historical Prices Get Historical Prices for: ~~ ~ i f «~: Adchoices Set Date Range r Daily Start Date: Aug ~ ~1 ~012 ~~ Eg. Jan 1, 2010 _.____~ L`___._.__~ I~_______~ ~ Weekly End Date: AugJ ~ 012 (J Monthly Q Dividends Only First ~ Previous ~ Next ~ Last Prices Date Open High Low Close Volume Adj Close' Aug 21, 2012 35.05 35.90 35.05 35.33 11,031,000 34.42 ' Cbse price ad~sted for dividends and splits. r"1DOWnlOad to Spreadsheet Currency in USD. First ~ Previous ~ Next ~ Last Copyright ®2013 Yahoo! Inc. All rights reserved. Privacy Poky -About Our Ads -Terms of Service - CopyrighUlP Policy -Send Feedback - Ya h001 -ABC N@W S NetW Ork Quotes are real-time for NASDAQ, NYSE, and NYSE MKT See also delay times for other exchanges. Atl information provided "as is" for informational purposes ony, not intended for Vading purposes or advice. Neither Yahoo! nor any of independent providers is liable for any informational errors, incompleteness, or delays, or for any actions taken in reliance on information contained herein. By accessing the Yahoo! site, you agree not to redisVibute the information found therein. Beal-Time continuous streaming quotes are available through our premium service. You may turn streaming quotes on or off. Fundamental company data provided by Capital IQ. Historical chart data and daily updates provided by Commodity Systems, Inc. (CSI). International historical chart data, daily updates, fund summary, fund performance, dividend data and Morningstar Index data provided by Morningstar, Inc. 1 of 1 2/7/2013 12:39 PM