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Home My WebLink About04-1094Estate of also known as Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Louise E. Garrett , Deceased Socia~ Security No. 192-30-0094 Diane L. Weary Petitioner(s), who is/are 18 years of age or older, apply(les) for: (COMPLETE 'A' or 'B' BELOW:) A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut r ix the Decedent, dated 11/21/1997 and codicil(s) dated None named in the last Will of State relevant circumstances, e.g. renunciation, death of executor, e~. - r-Fxcent as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of:~ documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: B. Grant of Letters of Administration (ct.a,; d.b.n.c.ta; pendente lite; durante absentia; dUO'rite minoritate) Petitioner(s) offer a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence I Daughter 2815 W. Rose,arden Blvd Mechanicsbr~ Son 232 Hermann St., San Francisco, CA Daughter 2243 Avena Lane, Coto D Caza, CA Diane L. Weary Robert K. Garrett Nicole Markham (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his/her last family or principal residence at 1913 Princeton Avenue, Cam[3 Hill Borough, Camp Hill, PA (list street, number, and municipality) Decedent, then 78 years of age, died 11/16/2004 at Carlisle, PA Decedent at death owned property with estimated values as follows: (if domiciled in PA) All personal property (if not domiciled in PA) Personal property in Pennsylvania (If not domiciled in PA) Personal property in County Value of real estate in Pennsylvania 17011 (Location) $ 80,000.00 105,000.00 situated as follows: 1913 Princeton Avenue, Camp Hill Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersi,qned: I ~'~ (I Signature T},ped or printed name and residence Diane L. Weary 2815 W. Rosegarden Blvd., Mechanicsburs, PA 17055 Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, [nc, Form RW- 1 (1991) Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer ther~state ac(cording t~ law. Swornto or affirmed and subscribed;~.~ ~. Diane L~-~eary ~' ~~ before me this~ day' of ~/ NO. Estateof Louise E. Garrett Social Securit7 No: 192- 30- 0094 AND NOW, Date of Death: 11/16/2004 Deceased , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before n~e, IT IS DECREED that Letters [] Testamentary [] Of Administration (c.t.a.; d.b.n.c.ta.; pendente lite; durante absentia; durante minoritate) are hereby granted to Diane L. Weary in the above estate and that the instrument(s) dated 11/21/1997 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters ........... Short Certificate(s) Renunciation ........ Affidavits ( ) Extra Pages ( ~ Codicil .......... JCP Fee .......... Inventory .......... Other .......... TOTAL ......... Attorney: Michael L. Ban~s I.D. No: 41263 Address: 429 South 18th Street Camp Hill, PA 17011 Telephone: 717/730-7310 Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software on¥ CPSystems, Inc. Form RW-1 (1991j This is to ccrdfy that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fec for this certificate, $2.00 P 10688062 No. Local Registrar ~Ox/1 9 20B4 Date Louise E. Garrett ~l - o4 - Ioq4 CERTIFICATE OF DEATH 78 ; . Cumberland Carlisle Carlisle Hospital J ~'~'~'~* ~'"'m glster~ Harrisburg Hospi 4 1913 Princeton Avenue Camp Hill, Pa 17011 'r~c~V Cumberland ,,-,~? ,T.(~,~.~.~ Camp Hill ~ ovember 19,2004 Hollinger Crematory Mt Holly Springs,Pa WILL OF LOUISE E. GARRETT I, LOUISE E. GARRETT, of Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I. I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, and any and all taxes and assessments imposed by any governmental body as a result of my death, whether on property passing under this will or otherwise, shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ITEM II. I hereby give, devise, and bequeath the following specific bequests: A. The sum of $35,000.00 to my daughter, NICOLE MARKHAM. ,- B. All shares of stock that I own in excess of 112 shares in any one : company shall be split evenly among my three children, DIANE WEARY, NICOLE MARKHAM, and ROBERT GARRETT, in kind. ' C. All shares of stock that I own in excess of 50 shares in any one company and less than 112 shares shall be split evenly between my daughter, DIANE WEARY, and my son, ROBERT GARRETT, and shall be distributed in kind. D. All shares of stock that I own in any one company that is 50 shares or less shall be divided evenly between my daughter, DIANE WEARY, and my son, ROBERT GARRETT, and is to be distributed either in kind or to be sold in accordance with their respective wishes. E. To my daughter, DIANE WEARY, I give, devise, and bequeath my automobile. ITEM III. I give, devise, and bequeath ail the rest, residue, and remainder of my possessions and estate of every nature and wherever situate shall be divided evenly between my daughter, DIANE WEARY, and my son, ROBERT GARRETT, provided they survive my death by thirty (30) days. ITEM IV. I appoint my daughter, DIANE WEARY, executrix of this my last will. Should my said daughter predecease me or otherwise fail to qualify or cease to serve as executrix of this my last will, I appoint my son, ROBERT GARRETT, executor of this my last will. ITEM V. In addition to the other powers and authorities granted to my personal representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby give to my personai representatives the following powers and authorities effective without court approval and until actual distribution of all property: to compromise any claim or controversy; to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as my personal representatives may determine and at vaiuations finally to be fixed by them; to invest in all forms of property, including any stock or other securities in any corporate fiduciary or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my personal representatives deem proper, without regard to any principle of risk or diversification; to 2 retain any or all assets of my estate, real or personal, without regard to any principle of risk or diversification; to sell at public or private sale, to exchange, or to lease for any period of time, any real or personal property and to give options for sales, exchanges, or leases, for such prices and upon such terms or conditions as my personal representatives deem proper; and to allocate receipts and expenses to principal or income or partly to each as my personal representatives deem proper in their sole discretion. ITEM VI. I direct that my personal representatives and fiduciaries shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand this o,~ ?,~7 day of ,1997. LOUISE E. GARRETT 3 The preceding instrumem, consisting of this and THREE other typewritten pages, each identified by the signature of the testatrix was on the date thereof signed, published, and declared by LOUISE E. GARRETT, the testatrix therein named, as and for her last will, in the presence of us, who at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. 4 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ) ( SS: ) The undersigned, being the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, does hereby acknowledge that I signed and executed the foregoing instrument as my last will, that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me by the.~e.stglr~ g~a~med above thi~:~/day-of'TJ~, 1997. Notary Publi~l ' no'r~,l~l~ ~r.~,t l Low~. AIb~ Tw~., ~b~ ~., PA ] CO~ON~ALTH OF PE~SYLVANIA ) ( SS: ) Sworn or affirmed to and acknowledge¢ before, me this 0~-/ d~y of/~L¢~/~/ff1997. t~ alan t~., ~ ~., 5 COUNTY OF CUMBERLAND names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the testatrix sign and execute the instrument as her last will; that she signed it willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the will as witnesses; and that to the best of our knowledge, the testatrix was at that time 18 or more years of age, of sound mind, and under no constraint or undue influence. CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Will No.: To the Register: LOUISE E. GARRETT November 16, 2004 21-04-1094 Admin. No: I certify that notice of beneficial interest. (estate administration) required by Rule 5.6(a) of the Orphans Court Rules was served on or mmled to the following beneficiaries of the above-captioned estate on December 8, 2004: NAME Diane L. Weary Robert K. Garrett Nicole Markham ADDRESS 2815 W. Rosegarden Blvd., Mechanicsburg, PA 17055 232 Hermann Street, San Francisco, CA 94110 2243 Avena Lane, Coto D Caza, CA 92679 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: none. Date: (717) 730-7310 Capacity: 17011 Counsel for Personal Representative f\ f,rb REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT REV-1500 EX + (6-00) OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 *' FILE NUMBER II 04 1094 ____ NUMBER QQUNTY CODE _ _ YF_~B DECEDENT'S NAME (LAST, FIRST. AND MIDDLE INITIAL) : Garrett, Louise E. I DATE OF DEATH (MM-OO-YEAR)-- SOCIAL SECURITY NUMBER I- Z W C w o w C T DilTEOF iliRTH(MM-DO-:YEAR) · 11-16-2004 01-19-1926 I(IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST. FIRSTAND-MI-DDLEINiTI~----- -- REGISTER OF WILLS SOCIAL SECURITY NUMBER I .I 3. Remainder Return (date of death prior 1012-13-82) .?5J 1. Original Return 2. Supplemental Return W 0- ::.:::$00 u"'''' w"u :coo u"'.J .... .. " 4a. Future Interest Compromise (date of death after 12-12-<12) 7. Decedent Maintained a Living Trust (Attach copy of Trust) 10 Spousal Pover:tY. Credit (date of death between . 12-31-91 and 1-1-95) THIS'SECTION MUSTBE'COr.PLETEO:-Aa CORReSPONOENCEANO,COIllFlDENTlALTi!J(!IIlFORMATlON'SHOULO BE DIRECTED. TO: NAME I COMPLETE MAILING ADDRESS Michael L. Bangs____1 FIRM NAME (If applicable) 4. Limited Estate 5. Federal Estate Tax Return Required Ii] 6. Decedent Died Testate (Attach copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes [l 11. Election to tax under Sec. 9113(A) (Attacl1 Sch 0) 0- Z W C Z o .. (I) w '" '" o u 429 South 18th Street Camp Hill, PA 17011 TELEPHONE NUMBER 717/730-7310 1. Real Estate (Schedule A) (1) (2) (3) (4) (5) (6) (7) 113,478.74 None None 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) [J Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) Separate Billing Requested 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) None 482.82 -.----- 8,679.88 - - -------- 385,815.63 z o i= j ::J l- ii: <( o w a: (8) 508,457.07 (9) (10) 13,915.03 3,929.55 11. Total Deductions (total Lines 9 & 10) (11) 17,844.58 490,612.49 12. Net Value of Estate (Line 8 minus Line 11) (12) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (13) 0.00 (14) 490,612.49 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 (15) or transfers under Sec. 9116(a)(1.2) z 0 (16) i= 16.Amount of Line 14 taxable at lineai rate 490,612.49 x .045 <( I- ::J a.. 17.Amount of Line 14 taxable at sibling rate 0.00 x .12 (17) ::E 0 0 18. Amount of Line 14 taxable at collateral rate 0.00 .15 (18) >< x ~ 19. Tax Due (19) 0.00 22,077 .56 0.00 0.00 22,077.56 20. D CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Copyright 2002 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00: v Decedent's Complete Address: STREET ADDRESS 1913 Princeton Avenue --I STATE P AflP u'';-i011 CITY Camp Hill Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 22,077.56 0.00 Total Credits (A + B + C) (2) 0.00 3. InteresUPenalty if applicable D. Interest E. Penalty TotallnteresUPenalty (D + E) (3) 4. If Line 2 Is greater than Line 1 + Line 3, enter the difference. This is thfOVERPA YMENT. (4) Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (5B) 22,077 .56 22,077 .56 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: a. retain the use or income of the property transferred;..... ......................................... b. retain the right to designate who shall use the property transferred or its income;.... c. retain a reversionary interest; Dr......................... ..................................................... .............. d. receive the promise for life of either payments, benefits or care?......................................................... 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?......................... ................... ................................... ................ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.. 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?............. ................ ................_...... I IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of whi91 preparer has any knowledge._ SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS iane L. Weary \, t Yes No Il 1-. I' DATE 2815 W. Rosegarden Mechanicsburg, PA 17055 Ild)/b~' DATE FILING RETU~~-- ADDRESS ADDRESS DATE 429 South 18th Street Camp Hill, PA 17011 .:-; 6\ For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. ~9116 (a) (1.1) (i)J. For dates of death on or after January 1, 1995, the tax rate imposed on the net vaiue of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)]. The statutedoes 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 twenty-one 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% [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%, 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% [72 P.S. ~9116 (a) (1.3)J. A sibling is defined under Section 9102, as an individual who has at ieast one parent in common with the decedent, whether by blood or adoption. Rev-1502 EX+ {6-9B} *' SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Garrett, Louise E. FILE NUMBER 21-04-1094 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or selt, both having reasonable knowledge of the relevant facts Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 1913 Princeton Avenue, Camp Hill. Sold on March 31, 2005 (see copy of settlement sheet attached). 113,478.74 TOTAL (Also enter on Line 1, Recapitulation) 113,478.74 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 6-98) \' - ,2502-0265 .,r A. B. TYPE OF LOAN: U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1.oFHA 2.QFmHA 3. OOCONV. UNINS. 4.DVA 5.DcONV.INS. 6. FILE NUMBER: 17. LOAN NUMBER: SETTLEMENT STATEMENT MINICK.JASON 0079426094 8. MORTGAGE INS CASE NUMBER: OLD MORTGAGE INS CASE NUMBER 699/F/5.375% SKS C. NOTE: This fonn is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked 7POCr were paid outside the closing; they are shown here for informational purposes and are not included in the totals. 1.0 '19' (MIN1CK.JASON.PFDlMINtCKJASON/5) D. NAME, AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: JASON C. MINICK and ESTATE OF LOUISE E. GARRETT IRWIN MORTGAGE CORPORATION ERIN E. LUBOLD 1913 PRINCETON AVENUE CAMP HILL, PA 17011 G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 25-1857112 I. SETTLEMENT DATE 1913 PRINCETON AVENUE Midstate Abstract Company CAMP HiLL, PA 17011 March 31,2005 Cumberland County, Pennsylvania PLACE OF SETTLEMENT 2331 Mar1<et Street Camp Hili, PA 17011 J. SUMMARY OF BORROWER'S TRANSACTiON K. SUMMARY OF SELLER'S TRANSACTION 100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: 101. Contract Sales Price 124 900.00 401. Contract Sales Price 124900.00 102. Personal Prooertv 402. Personal Propertv 103. Setllement Charoes to Borrower (Line 1400\ 4 175.84 403. 104. 404. 105. 405. Adiustments For Items Paid Bv Seller in advance Adjustments For /fems Paid By Seller in advance 106. Citvrrown Taxes to 406. CitvlTown Taxes to 107. County Taxes 03/31/05 to 01/01/06 333.84 407. County Taxes 03/31/05 to 01/01/06 333.84 108. School Taxes 03/31/05 to 07/01/05 328.15 408. School Taxes 03/31/05 to 07/01/05 328.15 109. SEWER 03/31/05 to 07/01105 30.50 409. SEWER 03/31/05 to 07/01/05 30.50 110. REFUSE - APRIUMA Y/JUNE 40.74 410. REFUSE - APRIUMA Y/JUNE 40.74 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 129,809.07 420. GROSS AMOUNT DUE TO SELLER 125,633.23 200, AMOUNTS PAID BY ORIN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Denosil or earnest monev 1 500.00 501. Excess Deposit (See Instructions\ 202. Principal Amount of New Loan(s 124 900.00 502. Settlement Charoes to Selier (Line 1400\ 10,996.44 203. Existina 10an(s) taken subiect to 603. Exlsllno loan(s) taken subiect to 204. 504. Payoff of first Mortgage 205. 505. Payoff of second Mortoaoe 206. 506. 207. 507. (Deposit disb. as proceeds) 208. 508. 209. SELLER ASSISTANCE 1,008.05 509. SELLER ASSISTANCE 1,008.05 Adiustments For Items Unnaid Bv Seller Adiustments For Items Unoaid Bv Seller 210. Citvffown Taxes to 510. CitvlTown Taxes to 211. County Taxes to 511. County Taxes 10 212. Schooi Taxes to 512. School Taxes to 213. CREDIT FOR HOME INSPECTION 150.00 513. CREDIT FOR HOME INSPECTION 150.00 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER 127,558.05 520. TOTAL REDUCTION AMOUNT DUE SELLER 12,154.49 300. CASH AT SETTLEMENt FROMITO BORROWER: 600. CASH AT SETTLEMENT TOIFROM SELLER: 301. Gross Amount Due From Borrower (Une 120) 129 809.07 601. Gross Amount Due To Selier (Line 420) 125633.23 302. Less Amount Paid BylFor Borrower tLine 22m ( 127,558.05) 602. Less Reductions Due Selier tLine 5201 ( 12,154.49 303. CASH! X FROM)! TO) BORROWER 2,251.02 603. CASH! X TO)( FROM) SELLER 113,478.74 OMB NO ........ . t of a completed copy of pages 1&2 of this statement & any attachments referred to herein. Iier . ~ r<:E'C . "'~9" ~ . L. SETTLEMENT CHARGES 700. TOTAL COMMISSION Based on Price $ I1iJ % 7374.00 PAID FROM PAID fROM Division of Commission" ffine 7001 8S Follows: BORROWER'S SELLER'S 701. $ 3.712.00 10 CENTURY 21 PISCIONERI REALTY. INC. FUNDS AT FUNDS AT 702. $ 3.662.00 to ERA-NRT. INC. SETTLEMENT SETILEMENT 703. Commission Paid at Settlement 7,374.00 704. to 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Onainat;on Fee % to 802. Loan Discount % to 803. Appraisal Fee to ERIK JON REISSER 300.00 804. Credil Report to CBCCOMPANiES 29.90 805. Tf<< RELATED SERVICE FEE to LERETA 71.00 806. FLOOD DETERMINATION FEE to FIRST AMERICAN FLOOD DATA SERVo 7.50 807. FLOOD ZONE FEE (LIFE OF LOAN) to FIRS:r AMERICAN FLOOD DATA SERVo 2.50 808. DOCUMENT PREPARATION FEE to IRWIN MORTGAGE CORPORATION 300.00 809. UNDERWRITING FEE to IRWIN MORTGAGE CORPORATION 300.00 810. INSURANCE TRACKING to ZC SiI ERLING 7.00 811. MERS REGISTRATION FEE to MERS 3.95 812. COURIER FEE to IRWIN MORTGAGE CORPORATION 25.00 813. 814. 815. 816. 817. 818. 819. 820. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From 03/31/05 to 04/01105 @ $ 18.390000/day ( 1 days %) 18.39 902. Mortaane Insurance Premium for months to 903. Hazard Insurance Premium for 1.0vears to NATIONWIDE INSURANCE POC $359.00b 904. 905. 1000. RESERVES DEPOSITED WITH LENDER . 1001. Hazard Insurance 2,000 months <'<'D $ 29.91oe, month 59.82 1002. Mortnane Insurance mohths @ $ 44.76 ner month 1003. CitvlTown Taxes months <'<'D $ per month 1004. Countv Taxes 2.000 months $ 36.79 oer month 73.58 1005. School Taxes 10.000 months $ 106.32 per month 1.063.20 1006. month. $ ner month 1007. month' ~ nR, mnnth 1008. AGGREGATE ADJUSTMENT months S oer month -266.80 1100. TITLE CHARGES 1101. Settlement or Closinn Fee to 1102. Abstract or Tille Search to 1103. Title Examination . to 1104 Title Insurance Binder to 1105. Electronic Document PreD. to Midstate Abstract Comoanv 50.00 1106. Closinn SeNice Letter to Midstate Abstract Comoanv 35.00 1107. Attorney's Fees to (includes above item numbers: ) 1108. Title Insurance to MIDST ATE ABSTRACT 983.75 (includes ebove item numbers.1102. 11038. 1104 ) 1109. Lender's Coveraoe $ 124,900.00 1110. Owner's Coverage $ 124,900.00 983.75 1111. Ends 100.300,8.1.1020 to Midst~te Abstract Company 200.00 1112. Notary Fee to. Mids\~te Abstract Company. 10.00 1113. Notarv Fee to Midst~te Abstract Compa'nv 5.00 1114. SERVICE FEE 10 CENl'URY 21 PISCIONERI 195.00 1115. TRANSACTION FEE to ERA-NRT. INC. 125.00 1116. AON WARRANTY to AON HOME WARRANTY SERVICES, INC. 409.00 1117. SEWER - JAN TO JUNE 2005 to CAMP HILL BOROUGH AUTHORITY ACCT. #0965 60.00 1118. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees: Deed $ 39.50; Mort9age $ 71.50; Releases $ 111.00 1202. Citv/<"ountvTax/Stamns: Deed 1 249.00' Mortaaae 1.249.00 1203. Stale Tax/Stamps: Deed 1 249.00; Mortoaoe 1,249.00 1204. 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. SUNev to 1302. Pest rnsoection 10 BIECi'iLER & TILLERY INC. POC $35.00b 1303. HOME INSPECTIONIRADON TEST to BIECI LER & TILLERY INC. POC $370.00b 1304. 2005 COUNTYIBORO Tf<<ES to JANE L. MILLER Tf<< COLLECTOR 01-22-0536-329 441.49 1305. RADON MITIGATION to ENVI OQUEST 680.00 1400. TOTAL SETTLEMENT CHARGES'TEnter on Llnes'103, Section J and 502, Section K\ ....., 4.175.84 10,996.44 By"'"'" p.,. 1 of IN, "".moo'.1he ",ooto'" ""'OV<edg. _tpt of. ""mp'"'' copy of p.,. 2 or"", two p.,. .tetem'l1 a * - Seller Assistance Midstate Ab~ct Com an p y Settlement Agent Certified to be a true copy. I M1NlCX.JASON I MINICK-JASON I ~) Rev-1508 EX+ (6-98) *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONINEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Garrett, Louise E. FILE NUMBER 21-04-1094 Include the proceeds of litigation and the date the proceeds were received by the estate All property jolntly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Refund from BC/BS of unused premium 475.70 2 Refund from Verizon 1.30 3 Dividend from NiSource 1.61 4 Refund - Refund of overpayment from UGI 4.21 TOTAL (Also enter on Line 5, Recapitulation) 482.82 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev.1509 EX+ (6-98) *' SCHEDULE F JOINTL V-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Garrett, Louise E. FILE NUMBER 21-04-1094 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME A. Diane L. Weary ADDRESS RELATIONSHIP TO DECEDENT Daughter 2815 Rosegarden Blv Mechanicsburg, PA 17055 B. Robert K. Garrett 232 Hermann St. San Francisco, CA 94110 Son C. JOINTLY OWNED PROPERTY: DESCRIPTION OF PROPERTY %OF DATE OF DEATH LETTER DATE ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT NUMBER OR SIMIlAR IDENTIFYING NUMBER. ATTACH DEED FOR VALUE OF ASSET INTEREST DECEDENT'S INTEREST JOINTLY-HELD REAL ESTATE. 1 AB 12/30/2002 PNC Bank - Senior Checking Plan 26.039.64 33.333% 8.679.88 Account 51400022685 TOTAL (Also enter on Line 6, Recapitulation) 8.679.88 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev 6-98) JAN-24-2005 18:31 PNCBANK 412 768 3458 P.01/01 0PNCBAN< January 25,2005 Michael Bangs Attorney at Law 429 S 1811I St. Camp Hill, P A 17011 RE: Estate of Louise Garrett (Deceased) SSN: 192-30-0094 DOD: 11-16-2004 scp Dear Mr. Bangs: In response to your request for Date of Death balances for the customer noted above, our records show the following: Checking Account Account #5140022685 Established 12-30-2002 LOUISE GARRETT DIANE L WEARY ROBERT K GARRETI DOD balance: $26,039.64 Non interest bearing account Please note that this office only provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings accounts). We do Dot process Any financlAl trans.ctions or provide ltatements. If you need assistance with any of these items, please call1-888.PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, ~~.~ Erica L Schlegel 1-800-762-1775 P7-PFSC-04-F 500 First Ave. Pittsbwgh PAl 5219 Member FDIC TOTAL P.01 Rev-1510 EX+ (6-98) *' SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Garrett, Louise E. FILE NUMBER 21-04-1094 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECO'S TAXABLE EXCLUSION NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE THE DATE OF TRANSFER ATTACH A COPY OF THE DEED FOR REAL ESTATE. 1 Transamerica Life and Annuity - Annuity No. 12.875.51 100% 12.875.51 26657067 2 Wachovia Bank, N.A. - IRA Account 22.442.61 100% 22.442.61 #257020050262514 3 Waypoint Account 1003024278 DD * 61,138.90 33% 21.046.30 4 PSECU Various accounts * 180,902.97 33% 60.300.99 5 Waypoint Account 500031533 DD* 802.56 33% 267.52 6 Waypoing CD 1000013041 25.110.65 100% 25.110.65 7 Waypoint Savings Account 57000325* 546.19 33% 182.06 8 Weary Family Irrevocable Trust * 243.589.99 100% 243.589.99 *See sheet attached TOTAL (Also enter on Line 7, Recapitulation) 385.815.63 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) ESTATE OF LOUISE E. GARRETT CONTINUATION OF SCHEDULE G FILE 21-04-1094 Item Number 3. On 4/6/04, Waypoint Account 1003024278DD was closed out. Decedent's interest in the account was gifted to her son Robert K. Garrett and her daughter, Diane L. Weary. Decedent was the owner of one-third of the account which is subject to tax. 4. Decedent was the joint owner of several PSECU accounts which totaled $180,902.97 at the time of closeout of the accounts on 6/25/04. Decedent gifted her portion of the accounts to her son Robert K. Garrett and daughter Diane L. Weary. Decedent was a one-third owner ofthe accounts which are subject to tax. 5. One 4/6/04, Waypoint Account 50003l533DD was closed out. Decedent's interest in the account was gifted to her son Robert K. Garrett and her daughter Diane L. Weary. Decedent was the owner of one-third of the account which is subject to tax. 7. On 4/6/04, Waypoint Account 57000325 SV was closed out. Decedent's interest in the account was gifted to her son Robert K. Garrett and her daughter Diane L. Weary. Decedent was the owner of one-third of the account which is subject to tax. 8. The Weary Family Irrevocable Trust was owned entirely by the Decedent and therefore the total amount is subject to tax. PSE"" the financial link TM December 15, 2004 Account # 8005515864 MICHAEL L BANGS 429 SOUTH 18TH STREET CAMP HILL, P A 17011 Dear MR BANGS: The following is the status of LOUISE E GARRETT's account with PSECU as of the date of closing August 24, 2004. Joint Owner's Name ROBERT K GARRETT, DIANE L WEARY ADDDED 07.07.2003 AS JOINT TENANTS W/ROS 1 I .16.2004 07.19.1926 Date of Death Date of Birth Share Description Open date Balance Accrued Dividend SOl Regular Shares 03.05.1987 $ 5.19 $0.00 S 03 Christmas Shares 0.96 0.00 S 04 Checking Shares 9.22 0.00 S 07 Money Market Shares 03.30.2000 104.66 0.00 S 53 12 Month Certificate Shares* 11.29.2000 0.00 0.00 *Closed 06.25.2004 On June 25, 2004, the following was done: the S53 Certificate was closed and $28,314.15 was transferred to S4 Checking; $94,929.98 from S7 Money Market to 54 Checking; $1,948.70 from S3 Christmas to S4 Checking; $377.42 from SI Regular Shares to S4 Checking. The balance in checking on that date was $55,332.72. We then disbursed a check for $180,902.97 payable to Robert K. Garrett and Diane Weary. The dividend earned from January 1,2004 through the date of closing was $771.77. The decedent had no loans with us. We do not have safe deposit boxes for our members. If you have any questions, please call 234-8484 in Harrisburg or our toll-free number, (800) 237-7328. At the menu prompt, enter 6 and then extension 2227. Meacie Fairfa Member Service Representative Finance Support Unit PENNSYLVANIA STATE EMPLOYEES CREDIT UNION Main Address: 1 Credit Union Place, Harrisburg. PA 17110-2990. (717) 234-8484. (800) 237-7328 Mailing Address: P.O. Box 67013. Harrisburg, PA 17106-7013. (717) 777-2100 (TOO)' (800) 472-1967 (TOO) Web Address: www.psecu.com Savings federally Insured up to $100,000 by the National Credit Union AdministratIon. '" WayRqipJ January 3, 2005 Bangs Law Office 429 S 18th St Camp Hill Pa 17011 Re: Estate of Louise E Garrett Date of Death: 11-16-04 Social Security #: 192-30-0094 Michael L. Bangs: 1 am responding to your letter on December 30, 2004 reguarding infonnation on the closed accounts for Louise E Garrett. The following is the infonnation that you requested: Acct# Close-out Balance Date Names on Accounts opened 570000325 SV 546.19 040604 Louise E Garrett 11 /13 /95 Robert Garrett Diane L Weary 500031533 DD 802.56 040604 Louise E Garrett 03/24/94 Robert Garrett Diane L Weary 1003024278 DD 63138.90 040604 Louise E Garrett 03/13/00 Robert Garrett Diane L Weary 1000013041 CD 25110.65 012004 Louise E Garrett 03/13/00 ~01J1M Erin E Watts P.O. Box 1711. HARRISBURG. PENNSYlVANIA 17105-/7/1 Toll Free 1-866-WAYPOINT (1-866-929-7646)' IN YORK AREA 717/815-4500 . www.waypointbank.com .. ..~"'''' .i u~u d - n:rf . i'J.A -i' ; 11 T/" l?i ,t,.....' . WACHOVIA Reference !D: 1090372 Wachovia Bank N.A. Balance Confinnalion Services POBox 40028 Roanoke, VA 24022-7313 December 24, 2004 MICHAEL L BANGS ATTORNEY AT LAW 429 SOUTH 18TH STREET CAMP HILL, PA 17011 SUBJECT: Verification I Confirmation of Account and Balance Information provided for: Customer: LOUISE E GARRETT (SSN# 192-30-0094) Date of Death: November 16, 2004 Deposit Account Information Account Type Account Number Date of Death Balance Average Balance" Date Opened Maturity Interest Accrued YTD Date Date Rate Interest Interesl Paid Closed IRA 257020050262514 LEGAL TITLE: LOUISE E. GARRETT $22,442.61 10/1911999 $38,49 $804.05 \ 113012004 For Beneficiary Claim Form information, please call 1(800)669.2136. . Due to system limitations) we can only provide a twelve month average balance on depository aCCQunts. Other Account Information Account Type Account Number Date of Balance Date Opened Dale Closed Ledger Collected ANNUITY T AFS 127339551 11128/2000 LEGAL TITLE: LOUISE E. GARRETT TRANSAMERlCA . For information regarding annuities, please call 800-258.4260 ANNUITY T AFS 126657067 LEGAL TITLE: LOUISE E. GARRETT TRANSAMERlCA. For information regarding annuities, please call 800.258.4260 OPEN DATE IS UNAVAILABLE 0000 000614 . ~~ WACHOVIA Reference lD, \ 090372 No Safe Deposit Box found for customer. CAP, BROKERAGE and SELF-DIRECTED IRA ACCOUNTS HAVE BEEN CONVERTED TO W ACHOVIA SECURITIES. YOUR REQUEST HAS BEEN FORWARDED FOR PROCESSING and WILL BE MAILED UNDER SEP ARA TE COVER. FOR QUESTIONS REGARDING CAP, BROKERAGE, or SELF-DIRECTED IRA ACCOUNTS PLEASE CALL W ACHOVIA SECURITIES at 1-866-874-2717. " Dale of dealh balance does nOl include accrued inleresl. " If dale of death OCCUTTS on a weekend or a holiday, dale of dealh balance does nol include any transaclions thaI were adedUringoa:li~~ eresa Bennett Servicenler Associale Phone: (540)563-7323 ll; tb 0000 000614 '~~~~A ~ ICk4L / /!u!;)vl f;J d~Ae Transarnerica Life Insurance and Annuity Company Home Office: Charlotte, North Carolina Administrative Office: 4333 Edgewood Road NE PO Box 3183 Cedar Rapids, Iowa 52406-3183 December 16, 2004 Bangs Law Office Attn: Michael L Bangs 429 South 18th Street Camp Hill, PA 17011 RE: Annuity Number(s) 26657067 Dear Michael L Bangs: Thank you for the recent inquiry on the above listed qualified annuity for Louise E Garrett (deceased). As of November 16, 2004, the date of death, the full-accumulated value was $12,875.51. Our records indicate the following beneficiary information for this annuity: Primary Beneficiary(-ies) : Robert Garrett Diane Weary Nicole Markham Contingent Beneficiary(-ies): None Listed Our records indicate this was processed as a death claim on November 29, 2004 for $12,889.07 and paid to the named beneficiaries. Transamerica Life Insurance and Annuity Company is a member of the Insurance Marketplace Standards Association (IMSA), an organization committed to high ethical marketplace standards in the sale and service of individual life insurance and annuities. Member of the .EGON. Group . If you have any questions or concerns, you may call our customer service line. Our toll free customer service line, 1-800-553-5957, is available Central Time from 7:00 AM to 5:30 PM Monday-Thursday and Friday 7:00 AM to 4:30 PM. Sincerely, ~~ ~ Customer Care Groupjsmf Transamerica Life Insurance and Annuity Company ,,23 2B04 14:00 FR R W BAIRD PLAZA ~~i -~'" \:.,< ~~~ ~!:~ /lIo>O or;;" ~O! ~~Q .""',,, i~~ ~~" ~~~ \ll:DO ~1Jl:D "'~~ h~ "'i"z '" 8 ~~?i ~z~ mgc ~zi; ~- "'cz ~~Q ",,,,0 oe~ ;;~Q mt';O ~8~ Ill",,>> g~:D ~;,,~ dg ~:o~ !S!Rfi ;:;"'~ ~:D"" <c~ '"g~ rn", !i !- ~~ <'" "," ...,1l ~~ ~l;l ~8 ...,~ 0" ~g ;c'" d ~" ;;!l ft", ~~ ~!!: ...,m zj:i !;~ mZ n z,; ~2 eo> "'c g! 0" /!;?i n g~ :i~ :..~ ",m mOl ~Pl ~fjj "'~ m 816 480 4250 TO 917177307374 C:=EO;oGl<Jl )> 'Doc'<' o~zm!;la; "'l:em!l! a, O-<=E~ ~ 53~!!'^ 0 .;j~s:iGl .~!<""~ .~-8;o , :e ~ , ;O:::!=l ~mQo -lm :ern c: ~ M. ~ -.... " ~_QtI:lg)-...JQV\.~N'" ;!- " " i l:ltnt-"''''~-51l!l1~ ...gJl!iS8~15N15Il1~t; , <-<Sll'O:t:J:Cl8"t;ltDi'l: '" "'(lit') ~\llmmOx!ii'll iI: ~~~~1GU'"t;lIl!::l~ ! ~UU~~iUn i '" " I' .......~ ~ N ~~.l .. _..l'Jt~",..Qlm- ~~~~~~n~~~~p !!l",~88;:!8g:g;;Hl~!l. ~~~!'='~~!V~~So1~" ~&U!!~~UU ~ l\. " :ll, :J::l0- 1~!i!O oI>Glol>lJl "ii:O ~!:: a. '" ~ a: s: ,. III It - ~ ~ ~~ "Ir t- ~a i'~ cr- or ~ .~ r.o ...... ~i ;,;~ P.02 a. ~ CXl a. '" ... o ~ ~ :;, .... '" ~ ~ - ~ ~ > ii: , :: ~ :xl -< ." ,.. !!: jj :xl -l ::Xl C ~ )> 08 'tlc; <D::J :.1- i~ _.0 =~ COO" (/) 0 o " i THE WEARY FAMILY IRREVOCABLE TRUST THIS TRUST AGREEMENT is executed in triplicate on this.l3 day of July, 2004, by and between LOUISE E. GARRETT, now of 1913 Princeton Avenue, Camp Hill, Cumberland County, Pennsylvania 17055, by and through my attorney-in-fact, DIANE WEARY, now of2815 West Rose Garden Boulevard, Cumberland County, Pennsylvania 17055 (hereinafter called "Settlor") and DIANE WEARY, now of28l5 West Rose Garden Boulevard, Cumberland County, Pennsylvania 17055, and ROBERT GARRETT, now of 232 Hermann Street, San Francisco, California 94117 (hereinafter called "Trustees" or "Co-Trustees"). ARTICLE I. TRUST ESTATE 1.01. Initial Principal. Settlor, desiring to establish an irrevocable trust, does hereby irrevocably transfer, assign and deliver to the Trustees and their successors, and assigns the assets listed (,m Schedule A, attached hereto and made a part hereof. As further evidence of such assignment, the Settlor has 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 oftitle to such property to the Trustees. The Trustees accept such transfer and assignment to themselves as Trustees, and undertake to hold, manage, invest and reinvest the assets of this Trust, and to distribute the income and principal of the Trust in accordance with the provisions of this Agreement. 1.02. Additional Principal. The Settlor and any other person or persons, with the consent of the Trustees, shall have the right at any time to make additions to the corpus of this Trust or any share thereof hereby established, All such additions shall be held, governed, and distributed by the Trustees in accordance with the terms and conditions of this Agreement. The Trustee, in its sole discretion, may require, as a prerequisite to accepting property, that the transferring party provide evidence satisfactory to the Trustee that (i) the property is not contaminated by any hazardous or toxic materials or substances; and (ii) the property is not being used and has never been used for any activities directly or indirectly involving the generation, use, treatment, storage, disposal, release or discharge of any hazardous or toxic materials or substances. 1.03. Disclaimer. The Trustee shall have the right to disclaim, in whole or in part, prior to its acceptance by the Trustee, any interests in property for any reason, including but not limited to a concern that such property could cause potential liability under any federal, state, or local environmental law. ARTICLE II. IRREVOCABILITY OF TRUST 2.01. Irrevocabilitv. Settlor has been advised of the consequences of an irrevocable trust and hereby declares that this Trust shall be irrevocable and shall not be altered, amended, revoked, or terminated by Settlor or any other person or persons. ARTICLE III. LIFE INSURANCE POLICIES 3.01. General Provisions. If any insurance policies are transferred into this Trust, the Trustees shall be vested with all right, title, and interest in and to the transferred policies of insurance, and are authorized and empowered to exercise and enjoy, for the purposes of the Trust herein created and as absolute owners of such policies of insurance, all the options, benefits, rights and privileges under such policies, including the right to borrow upon and to pledge them for a loan or loans. The Trustees take all rights, title, and interest in and to the above-stated insurance policies subject to any prior split-dollar life insurance agreement and assignments, which may be in effect at the time oftransfer. The insurance companies which have issued policies are hereby authorized and directed to recognize the Trustees as absolute owners of such policies of insurance and as fully entitled to all options, rights, privileges, and interests under such policies, and any receipts, releases, and other instruments executed by the Trustees in connection with such policies shall be binding upon all persons interested in this Trust. The Settlor hereby relinquishes all rights, title, interest and powers in such policies of insurance which Settlor may own and which rights, title, interest and powers are not assignable, and will, at the request of the Trustees, execute all other instruments reasonably required to effectuate this relinquishment. 3.02. Pavment of Premiums. The Trustees shall be under no obligation to pay the premiums which may become due and payable under the provisions of any policy of insurance which may be transferred or assigned to this Trust, or to make certain that such premiums are paid by the transferor of such policy, or to notify any persons of the nonpayment of such premiums, and the Trustees shall be under no responsibility or liability of any kind in case such premiums are not paid, except the Trustees shall apply any dividends received on such policies to the payment of premiums thereon. Upon notice at any time during the continuance of this Trust that the premiums due upon such policies are in default, or that premiums which will become due will not be paid, either by the transferor or by any other person, the Trustees, within their sole discretion, may apply any cash values attributable to such policy to the purchase of paid-up insurance or of extended insurance, or may borrow upon such policy for the payment of premiums due thereon, or may accept the cash values of such policy upon the policy's forfeiture. In the event that the Trustees receive the cash value of such policy upon its forfeiture for nonpayment of premiums, the amount received shall be added to the corpus of this Trust, and shall be administered according to the terms of this Agreement. Ifthe insured under such policies ofinsurance, becomes totally and permanently disabled within the meaning of any policies and because thereof the payment of premiums, or any of them, shall during the pendency of such disability, be waived, the Trustees, upon receipt of such knowledge, shall 2 promptly notify the insurance company which has issued such policies, and shall take any and all steps necessary to make such waiver of premium provision effective. 3.03. Duties of Trustees With Re~ard to Life Insurance Policies. The Trustees shall be under no obligation or duty whatever except with respect to the safekeeping of such policies of insurance and the duty to receive such sums as may be paid to them, in accordance with the requirements of this Trust, by the companies issuing such policies, and to hold, manage and disburse such proceeds subject to the terms of this Agreement. Upon the death of the insured, the Trustees shaIl make reasonable efforts to carry out the provisions of this Agreement, including the maintenance or defense of any suit, provided, however, the Trustees shaIl be under no duty to maintain or enter into any litigation unless its expenses, including counsel fees and costs, have been advanced or guaranteed in an amount and in a manner reasonably satisfactory to the Trustees. The Trustees may repay any advances made by them or reimburse themselves for any such fees and costs from any corpus or income of this Trust. ARTICLE IV. TRUST DISTRIBUTIONS 4.01. Trust Principal. The entire corpus of this Trust, including the assets initially transferred to this Trust, subsequent additions to this Trust, and the proceeds of any sale, exchange or investment of such Trust assets, shaIl be used for the purposes herein contained. 4.02. Income Distribution. During the Settlor's lifetime, the Trustees shall distribute all of the net income of the trust to, or for the benefit of, LOUISE E. GARRETT. The Trustees shaIl make no distributions of principal to LOUISE E. GARRETT. Upon the admission of LOUISE E. GARRETT to a long term care facility for a period oftime in excess ofthirty (30) days, the Trustee shaIl cease the distribution of income and shall accumulate the income to the principal of the Trust. 4.03. Principal Distributions. Upon the death of the Settlor, the Trust shall terminate. Upon termination, the remaining trust estate shall be divided into separate and equal shares and one such share shall be distributed to each of the Settlor's children, DIANE WEARY and ROBERT K. GARRETT, per stirpes. If either of the Settlor's children predecease the termination of this Trust without surviving issue, then the predeceased child's share shall be distributed to the other child of the Settlor, per stirpes. 4.04. General Power of Appointment. Settlor's children, DIANE WEARY and ROBERT K. GARRETT, are hereby granted the general power to appoint some or all of the principal of this Trust to themselves, their estates, their creditors, the creditors of their estates, in such proportions and upon such terms (in trust, outright gifts, or in any other manner) as they jointly or individually deem advisable. This power shall not be exercisable under their Wills and shall terminate upon the death of the Settlor. If Settlor's children fail, either in whole or in part, to exercise this general power of appointment herein granted, the unappointed principal shall continue in trust and shall be administered according to the terms of this Trust. Upon the death, resignation, removal or incapacity of Settlor's children, DIANE WEARY and ROBERT K. GARRETT, the 3 survivor of them shall exercise the general power of appointment under this provision. Prior to the exercise of the General Power of Appointment by DIANE WEARY and ROBERT K. GARRETT, or either of them, DIANE WEARY or ROBERT K. GARRETT shall provide a written notice of the intent to exercise this power to the then-current Trustees. The Trustees shall inform the Settlor of the intent to exercise this General Power of Appointment. For a period often (1 0) days, the Settlor may veto the proposed exercise of the General Power of Appointment. After the ten (10) day period expires, the proposed exercise of the General Power of Appointment shall take effect unless the Trustees have received written veto from the Settlor. ARTICLE V. POWERS OF TRUSTEES 5.01. General Powers. In addition to such other powers and duties as may have been granted elsewhere in this Trust, but subject to any limitations contained elsewhere in this Trust, the Trustees shall have the following powers and duties: A. In the management, care and disposition ofthis Trust, the Trustees shall have the power to do all things and to execute such deeds, instruments, and other documents as may be deemed necessary and proper, including the following powers, all of which may be exercised without order of or report to any court: (I) To sell, exchange, or otherwise dispose of any property, real, personal or mixed, wheresoever located, at any time held or acquired hereunder, at public or private;: salt:, for cash or on tenns as may be detemlined by the Trustees, without advertisement, including the right to lease for any term notwithstanding the period of the Trust, and to grant options, including an option for a period beyond the duration of the Trust. (2) To invest all monies in such stocks, bonds, securities, investment companies or trust shares, mortgages, notes, choses in action, real estate, improvements thereon, and other property as the Trustees may deem best, without regard to any law now or hereafter in force limiting investments of fiduciaries.. (3) To retain for investment any property deposited with the Trustees hereunder. (4) To vote in person or by proxy any corporate stock or other security and to agree to or take any other action in regard to any reorganization, merger, consolidation, liquidation, bankruptcy or other procedure or proceedings affecting any stock, bond, note or other security held by this Trust. (5) To use lawyers, real estate brokers, accountants and any other agents, if such employment is deemed necessary or desirable, and to pay reasonable compensation for their services. 4 (6) To compromise, settle or adjust any claim or demand by or against the Trust and to agree to any rescission or modification of any contact or agreement affecting the Trust. (7) To renew any indebtedness, as well as to borrow money, and to secure the same by mortgaging, pledging or conveying any property of the Trust, including the power to borrow from the Trustees (in the Trustees' individual capacity) at a reasonable rate of interest. (8) To retain any business interest transferred to the trustee, as shareholder, security holder, creditor, partner or otherwise, for any period of time whatsoever, even though the interest may constitute all or a large portion of the trust principal; to comply with the provisions of any agreement restricting transfer of the interest; to participate in the conduct of the related business or rely upon others to do so, and to take or delegate to others discretionary power to take any action with respect to its management and affairs which an individual could take as outright owner of the business or the business interest, including the voting of stock (by separate trust or otherwise regardless of whether that separate trust will extend for a term within or beyond the term of the trust) and the determination of all questions of policy; to execute and amend partnership agreements; to participate in any incorporation, reorganization, merger, consolidation, sale of assets, recapitalization, liquidation or dissolution of the business, or any change in its nature, or in any buy-sell, stock restriction, or stock redemption agreements; to invest in additional stock or securities of, or make secured, unsecured, or subordinated loans to, the business with trust funds; to take all appropriate actions to prevent identify, or respond to actual or threatened violations of any environmental law or regulation thereunder; to elect or employ with compensation, as directors, officers, employees, or agents of the business, any persons, including a trustee of any trust held under this instrument, or any director, officer, employee, or agent of a corporate trustee of any trust held under this instrument, without adversely affecting the compensation to which that trustee would otherwise be entitled; to rely upon reports of certified public accountants as to the operations and financial condition of the business, without independent investigation; to deal with and act for the business in any capacity (including in the case of a corporate trustee any banking or trust capacity and the loaning of money out of the trustee's own funds) and to be compensated therefor; and to sell or liquidate the business or any interest in the business. (9) To register any stock, bond or other security in the name of a nominee, without the addition of words indicating that such security is held in a fiduciary capacity, but accurate records shall be maintained showing that the stock, bond or other security is a trust asset and the Trustees shall be responsible for the acts of the nominee. (10) To set aside as a separate trust, to be held and administered upon the 5 same terms as those governing the remaining trust property, any interests in property, for any reason, including but not limited to a concern that such property could cause potential liability under any federal, state, or local environmental law. B. Whenever the Trustees are directed to distribute any trust principal in fee simple to a person who is then under twenty-one (21) years of age, the Trustees shall be authorized to hold such property in trust for such person until he becomes twenty-one (21) years of age, and in the meantime shall use such part of the income and the principal of the trust as the Trustees may deem necessary to provide for the proper support and education of such person in the standard ofliving to which he has become accustomed. If such person should die before becoming twenty-one (21) years of age, the property then remaining in trust shall be distributed to the personal representative of such person's estate. C. In making distributions from the Trust to or for the benefit of any minor or other person under a legal disability, the Trustees need not require the appointment of a guardian, but shall be authorized to payor deliver the distribution to the custodian of such person, to payor deliver the distribution to such person without the intervention of a guardian, to payor deliver the distribution to the legal guardian of such person if a guardian has already been appointed, or to use the distribution for the benefit of such person. D. In the distribution of the Trust and any division into separate trusts and shares, the Trustees shall be authorized to make the distribution and division in money or in kind or in both, regardless of the basis for income tax purposes of any property distributed or divided in kind, and the distribution and division made and the values established by the Trustees shall be binding and conclusive on all persons taking hereunder. The Trustees may in making such distribution or division allot undivided interests in the same property to several trusts or shares. E. If at any time after Settlor's death the total fair market value of the assets of any trust established or to be established hereunder is so small that the corporate Trustee's annual fee for administering the trust would be equal to or less than the minimum annual fee set forth in the Trustee's regularly published fee schedule, then the Trustees in their discretion shall be authorized to terminate such trust or to decide not to establish such trust, and in such event the property then held in or to be distributed to such trust shall be distributed to the persons who are then or would be entitled to the income of such trust. If the amount of income to be received by such persons is to be determined in the discretion of the Trustees, then the Trustees shall distribute the property among such of the persons to whom the Trustees are authorized to distribute income, and in such proportions, as the Trustees in their discretion shall determine. F. The Trustees shall be authorized to lend or borrow, including the right to lend to or borrow from the Settlor's estate, at an adequate rate of interest and with adequate security and upon such terms and conditions as the Trustees shall deem fair and equitable. G. The Trustees shall be authorized to sell or purchase, at the fair market value as determined by the Trustees, any property to or from Settlor's estate, the estate of Settlor's spouse, or 6 any trust created by Settlor or Settlor's spouse during life or by will, even though the same person or corporation may be acting as executor of Settlor's estate or the estate of Settlor's spouse or as trustee of any other such trusts and as the Trustee of this Trust. H. The Trustees shall have discretion to determine whether items should be charged or credited to income or principal or allocated between income and principal as the Trustees may deem equitable and fair under all the circumstances, including the power to amortize or fail to amortize any part or all of any premium or discount, to treat any part or all of the profit resulting from the maturity or sale of any asset, whether purchased at a premium or at a discount, as income or principal or apportion the same between income and principal, to apportion the sales price of any asset between income and principal, to treat any dividend or other distribution on any investment as income or principal or to apportion the same between income or principal, to charge any expense against income or principal or apportion the same, and to provide or fail to provide a reasonable reserve against depreciation or obsolescence on any asset subject to depreciation or obsolescence, all as the Trustees may reasonably deem equitable and just under all of the circumstances. 1. The Trustees are hereby authorized and empowered to purchase such insurance policies as they deem appropriate. 5.02. V otim! bv Trustees. When the authority and power under this Trust is vested in two (2) or more Trustees or Co-Trustees, the authority and power under this Trust or granted by law shall be vested in, and exercised by, each of the Trustees individually or all of the Trustees jointly, such that each Trustee may act independently, or the trustees may act jointly, in the administration or under the terms of the Trust agreement. 5.03. Trustees Power to Deal with Environmental Hazards. The Trustee shall have the power to use and expend the trust income and principal to (i) conduct environmental assessments, audits, and site monitoring to determine compliance with any environmental law or regulation thereunder; (ii) take all appropriate remedial action to contain, clean up or remove any environmental hazard including a spill, release, discharge or contamination, either on its own accord or in response to an actual or threatened violation of any environmental law or regulation thereunder; (iii) institute legal proceedings concerning environmental hazards or contest or settle legal proceedings brought by any local, state, or federal agency concerned with environmental compliance, or by a private litigant; (iv) comply with any local, state or federal agency order or court order directing an assessment, abatement or cleanup of any environmental hazards; and (v) employ agents, consultants and legal counsel to assist or perform the above undertakings or actions. Any expenses incurred by the trustee under this paragraph may be charged against income or principal as the trustee shall determine. ARTICLE VI. SPENDTHRIFT PROVISION 6.01. General Provision. No beneficiary shall have the power to anticipate, encumber or transfer his interest in the Trust Estate in any manner other than by the valid exercise of a Power of 7 Appointment. No part of the Trust Estate shall be liable for or charged with any debts, contracts, liabilities or torts of a beneficiary or subject to seizure or other process by any creditor of a beneficiary. ARTICLE VII. CONSTRUCTION OF TRUST 7.01. Choice of Law. This Trust shall be administered and interpreted in accordance with the laws of the Commonwealth of Pennsylvania. 7.02. Code. Unless otherwise stated, all references in this Trust to section and chapter numbers are to those ofthe Internal Revenue Code of1986, as amended, or corresponding provisions of any subsequent federal tax laws applicable to this Trust. 7.03. Other Terms. Unless the context otherwise requires, the use of one or more genders in the text includes all other genders, and the use of either the singular or the plural in the text includes both the singular and the plural. 7.04. Captions. The captions set forth in this Agreement at the beginning of the various divisions hereof are for convenience of reference only and shall not be deemed to define or limit the provisions hereof or to affect in any way their construction and application. 7.05. Situs of Trust. The Trust shall have its legal situs in Cumberland County, Pennsylvania. ARTICLE VIII. COMPENSATION OF TRUSTEES AND APPOINTMENT OF SUCCESSOR TRUSTEES 8.01. Compensation. The Trustees shall receive as their compensation for the services performed hereunder that sum of money, based on an hourly charge or percentage rate, which the Trustees normally and customarily charge for performing similar services during the time which they perform these services. 8.02. Removal of Trustees. Settlor may remove the Trustees, or any of them, at any time or times, with or without cause, upon thirty (30) days written notice given to the current Trustees. Upon the death of the Settlor, a majority of the current income beneficiaries may remove the Trustees, or any of them, at any time or times, with or without cause, upon thirty (30) days written notice given to the current Trustees. Upon the removal ofthe Trustees, or any of them, a successor Trustee(s) shall be appointed in accordance with the terms set forth in Paragraph 8.03. 8.03. Appointment of Successor Trustees. The Trustees, or any of them, may resign at any time upon thirty (30) days written notice given to the Settlor if Settlor is living, or in the event of Settlor's death, upon thirty (30) days written notice given to the current income beneficiary or 8 beneficiaries (including a beneficiary's natural or legal guardian or legal representative), hereunder. Upon the death, resignation, removal or incapacity of the Trustees, or any of them, a successor trustee(s) may be appointed by the Settlor during Settlor's lifetime, or, after Settlor's death, by a majority of the current income beneficiaries. Notwithstanding the foregoing provisions respecting the appointment of a successor trustee(s), if and in the event that one Trustee shall die, resign, be removed, or be adjudicated incompetent, the remaining Trustee shall exercise the powers, and carry out the duties, of Trustee individually until such time as a successor trustee is appointed. Any successor trustee(s) shall be a financially sound and competent corporate trustee or issue of the Settlor or an individual selected by the Settlor or the then-current income beneficiaries. Any successor trustee(s) thus appointed, or, if the corporate trustee shall merge with or be consolidated with another corporate fiduciary, then such corporate fiduciary, shall succeed to all the duties and to all the powers, including discretionary powers, herein granted to the Trustees. 8.04. Exoneration of Trustee. No Trustee shall be liable for any loss or depreciation in value sustained by the Trust as a result of the Trustee retaining any property upon which there is later discovered to by hazardous materials or substances requiring remedial action pursuant to any federal, state, or local environmental law, unless the Trustee contributed to the loss or depreciation in value through willful default, willful misconduct, or gross negligence. 8.05. Indemnification of Trustee Upon Distribution. Notwithstanding any contrary provision in this Trust Agreement, the Trustee may withhold a distribution to a beneficiary until receiving from the beneficiary an indemnification an agreement in which the beneficiary agrees to indemnify the Trustee against any claims filed against the Trustee as an "owner" or "operator" under the Comprehensive Environmental Response, Compensation and Liability Act of 1980, as from time to time amended, or any regulation thereunder. ARTICLE IX. PERPETUITIES CLAUSE 9.01. General Provision. Notwithstanding anything to the contrary in this Trust, each disposition the Settlor has made here, legal or equitable, to the extent it can be referred in its postponement of becoming a vested interest to a duration measured by some life or lives in being at the time of Settlor's death is definitely to vest in interest, although not necessarily in possession, not later that twenty-one (21) years after such lives (and any period of gestation involved); or, to the extent it cannot be referred in any such postponement to such lives, is to so vest not later than twenty-one (21) years from the time of Settlor's death. ARTICLE X. ACQUISITION OF UNITED STATES TREASURY BONDS ELIGIBLE FOR TAX PAYMENT; PAYMENT OF TAXES, FUNERAL EXPENSES, AND EXPENSES OF ADMINISTRATION 10.01. Acquisition of Bonds. The Trustees may, at any time, without the prior approval or direction of the Settlor and whether or not the Settlor is able to manage Settlor's own affairs, acquire 9 United States Treasury Bonds selling at a discount, which bonds are redeemable at their par value plus accrued interest thereon for the purposes of applying the proceeds to the payment of the United States estate tax on the Settlor's estate; and the Trustees may borrow from any lender, including themselves, with or without security, to so acquire these bonds. 10.02. Payment of United States Estate Tax bv Bond Redemption. The Settlor directs that any United States Treasury Bonds which may be redeemed at their par value plus accrued interest thereon for the purpose of applying the proceeds to the payment ofthe United States estate tax imposed on the Settlor's estate, and which are held by the Trustees, shall, to the extent of the amount determined to be required for payment of the estate tax, be distributed to the legal representative ofthe Settlor's estate to be used by the legal representative ahead of any other assets and to the fullest extent possible to pay the estate tax. 10.03. Payment of Death Taxes and Other Estate Settlement Costs. After the Trustees have complied with paragraph 10.02, above, and ascertained from the legal representative that all such bonds have been redeemed in payment of the United States estate tax, the Trustees shall also ascertain from the legal representative whether the legal representative has sufficient assets to pay the remaining legacy, succession, inheritance, transfer, estate and other death taxes or duties (except the additional estate tax imposed by Section 2032(c), or corresponding provisions ofthe Internal Revenue Code of 1986 applicable to the Settlor's estate and imposing the tax) levied or assessed against the Settlor's estate (including all interest and penalties thereon), all of which taxes, interest and penalties are hereafter referred to as the death taxes, interest and penalties. If the legal representative advises the Trustees that insufficient funds exist to pay all the death taxes, interest and penalties, the Trustees shall then pay to the legal representative from the trust property, an amount equal to all the death taxes, interest and penalties in excess of the funds available to the legal representative for these purposes, which payments are to be made without apportionment. If the Executor of the Settlor's estate, in such Executor's sole discretion, shall determine that appropriate assets of Settlor's estate are not available in sufficient amount to pay (I) the Settlor's funer'!l expenses, and (2) expenses of administering the Settlor's estate, the Trustees shall, upon the request of the Executor of the Settlor's estate, contribute from the principal of the trust estate the amount of such deficiency; and in connection with any such action the Trustees shall rely upon the written statement of the Executor of the Settlor's estate as to the validity and correctness of the amounts of any such expenses, and shall furnish funds to such Executor so as to enable such Executor to discharge the same, or to discharge any part or all thereof itself by making payment directly to the person entitled or claiming to be entitled to receive payment thereof. No consideration need be required by the Trustees from the Executor of Settlor's estate for any disbursement made by the Trustees pursuant hereto, nor shall there be any obligation upon such Executor to repay to the Trustees any of the funds disbursed by them hereunder, and all amounts disbursed by the Trustees pursuant to the authority hereby conferred upon them shall be disbursed without any right in or duty upon the Trustees to seek or obtain contribution or reimbursement from any person or property on account of such payment. The Trustees shall not be responsible for the application of any funds delivered by them to the Executor ofthe Settlor's estate pursuant to the authority herein granted, nor 10 shall the Trustees be subject to liability to any beneficiary hereunder on account of any payment made by them pursuant to the provisions hereof. IN WITNESS WHEREOF, the Settlor and Trustees have hereunto set their hands and seals as of the day and year first above written. WITNESS: JiWMJi NlLtt[ LOUISE E. GARR her attorney-in-fac SETTLOR (SEAL) , by and through lANE WEARY, COMMONWEALTH OF PENNSYLVANIA COUNTYOF (ji11/)(XItU1d SS: On this, the ~ day of July, 2004, before me, a Notary Public, the undersigned officer, personally appeared LOUISE E. GARRETT, by and through her attorney-in-fact, DIANE WEARY, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within Trust Agreement, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have set my hand and official Seal. iUlfp2~j Q!{7f/I . Notary Public . My Commission Expires: 7 )3r) /01/ Notarial Seal MIChelle C. Martin, Notary Putilc Lower Allen Twp., Cumberland County My Commission ExPres J~ 30,2006 Member. Pennsylvania Assoc:iallon Of /IkIar1es 11 The foregoing Trust Agreement was delivered, and is hereby accepted, at Mechanicsburg, Pennsylvania, on July -p2; , 2004. w~lJ C1kt (SEAL) E The foregoing Trust Agreement was delivered, and is hereby accepted, at San Francisco, California, on July ,-+ ,2004. ~D~ WIT~ (SEAL) T, TRUSTEE / 12 SCHEDULE "A" SCHEDULE REFERRED TO IN THE ANNEXED TRUST AGREEMENT DATED: JULY _,2004 FROM LOUISE E. GARRETT, SETTLOR TO DIANE WEARY AND ROBERT GARRETT, TRUSTEES Property Description: 1. Investment Accounts identified as: 13 REV-llSl EX_ (12-99) . SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Garrett, Louise E. Debts of decedent must be reported on Schedule I. FILE NUMBER 21-04-1094 ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 5,702.26 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City State Zip - Year(s) Commission paid 2. Attorney's Fees 7,000.00 See continuation schedule(s) attached 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 278.00 See continuation schedule(s) attached 5. Accountant's Fees 355.00 See continuation schedule(s) attached 6. Tax Return Preparer's Fees 7. other Administrative Costs 579.77 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 13,915.03 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1502 EX+ (6-98) . SCHEDULE H-A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Garrett, Louise E. FILE NUMBER 21-04-1094 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Catalano's Inc. - Funeral Luncheon 441.26 2 Myers-Harner Funeral Home, Inc. 3.158.00 3 Rolling Green Cemetery Company 2.103.00 Subtotal 5.702.26 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) Rev-1502 EX+ (6-98) . SCHEDULE H-B2 ATTORNEY'S FEES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Garrett, Louise E. FILE NUMBER 21-04-1094 ITEM NUMBER DESCRIPTION AMOUNT 1 Michael L. Bangs, Esquire 7.000.00 Subtotal 7.000.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B2 (Rev. 6-98) Rev-1502 EX+ (6-98) *' SCHEDULE H-B4 PROBATE FEES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Garrett, Louise E. FILE NUMBER 21-04-1094 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Register of Wills/Cumberland County - Probate Fees 278.00 Subtotal 278.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B4 (Rev. 6-98) Rev.1502 EX+ (6-98) *' SCHEDULE H-B5 ACCOUNTANT'S FEES continued COMMON\NEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Garrett, Louise E. FILE NUMBER 21-04-1094 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Boyer & Ritter - Accountant Fee 300.00 2 Expense - Tax Return Preparation 55.00 Subtotal 355.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduieH-B5 (Rev. 6-98) Rev-1502 EX+ (6-98) . SCHEDULE H-B7 OTHER ADMINISTRA TIVE COSTS continued COMMONIJIIEAL.TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Garrett, Louise E. FILE NUMBER 21-04-1094 ITEM NUMBER DESCRIPTION AMOUNT 1 Cumberland Law Journal 75.00 2 L.G. Connor Real Estate Appraisers, Ltd. 300.00 3 The Sentinel 129.77 4 Richard Woodard - Carpet cleaning costs for sale of house 75.00 Subtotal 579.77 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1512 EX+ (6-98) . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Garrett, Louise E. FILE NUMBER 21-04-1094 ESTATE OF Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1 Comcast Cable VALUE AT DATE OF DEATH 43.13 2 Gates, Halbruner & Hatch, P.C. 80.00 3 HCR Manor Care - Manor Care Carlisle 372 1.650.45 4 Health South Rehab 404.00 5 Health South Rehab 343.00 6 NeighborCare Pharmacy Services 231.27 7 PA American Water Co. -1/14/05 to 2/12/05 11.64 8 PA American Water Company -12/13/04 to 1/14/05 12.22 9 PA American Water Company - (2/12/05 to 3/10/05) 12.40 10 PA Department of Revenue - 2004 Individual Income Tax Due 266.00 11 PAWC - Final Water Bill 12.65 12 Penn National Insurance - Homeowners Insurance (quarterly installment) 63.00 13 Penn Waste, Inc. - Trash Removal and Recycling 40.74 14 Penn Waste Company - Trash service (April, May & June) 40.74 15 Pennsylvania American Water Company -10/13/04 to 12/13/04 29.73 16 PP&L Electric Company - 1/14/05 to 2/14/05 14.50 17 PP&L Electric Company -12/14/04 to 1/14/05 21.47 18 PP&L Electric - (2/14/05 to 3/16/05) 11.72 Total of Continuation Schedule(s) See attached page TOTAL (Also enter on Line 10, Recapitulation) 3,929.55 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) Rev-1512 EX+ (6-98) . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DeCEDENT Garrett, Louise E. FILE NUMBER 21-04-1094 ESTATE OF ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 19 PP&L Electric - Final Bill 10.58 20 PP&L Electric Utilities -10/14/04 to 12/14/04 29.51 21 UGI Company - 1/19/05 to 2/17/05 65.00 22 UGI Company - 12/17/04 to 1/19/05 141.00 23 UGI - (water heater plan maintenance) 47.50 24 UGI Gas - Services 10/18/04 to 11/18/04 201.96 25 UGI Corp Holding Co -11/18/04 to 12/17/04 86.27 26 Verizon - Services 11/8/04 to 12/10/04 59.07 TOTAL (Also enter on Line 10, Recapitulation) 3.929.55 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Scheduiel (Rev. 6-98) REV-1513 EX+ (9-00) *' SCHEDULE .. COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Garrett, Louise E. 21-04-1094 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) Do Not List Trusteels) I. TAXABLE DISTRIBUTIONS [include outright srrousal Clistributionsg and ransfers under Sec. 116(a)(1.2)] 1 Robert K. Garrett Son One-half of 232 Hermann Street residue San Francisco, CA 94110 2 Nicole Markham Daughter 35,000.00 2243 Avena Lane Trabuco Canyon, CA 92679 3 Diane L. Weary Daughter One-half of 2815 W. Rosegarden Blvd. residue Mechanicsburg, PA 17055 Total 35,000.00 Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleJ (Rev. 6-98) t' ~ \)--. "' ............. ~ ~ ~ ~ ~ '~ ~ WILL OF LOUISE E. GARRETT I, LOUISE E. GARRETT, of Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I. I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, and any and all taxes and assessments imposed by any governmental body as a result of my death, whether on property passing under this will or otherwise, shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ITEM II. I hereby give, devise, and bequeath the following specific bequests: A. The sum of$35,000.00 to my daughter, NICOLE MARKHAM. B. All shares of stock that I own in excess of 112 shares in anyone company shall be split evenly among my three children, DIANE WEARY, NICOLE MARKHAM, and ROBERT GARRETT, in kind. C. All shares of stock that I own in excess of 50 shares in anyone company and less than 112 shares shall be split evenly between my daughter, DIANE WEARY, and my son, ROBERT GARRETT, and shall be distributed in kind. D. All shares of stock that I own in anyone company that is 50 shares or less shall be divided evenly between my daughter, DIANE WEARY, and my son, 1 '" ~ ~ ........ "...... '1 ~ f': ~ ~ ~ ROBERT GARRETT, and is to be distributed either in kind or to be sold in accordance with their respective wishes. E. To my daughter, DIANE WEARY, I give, devise, and bequeath my automobile. ITEM III. I give, devise, and bequeath all the rest, residue, and remainder of my possessions and estate of every nature and wherever situate shall be divided evenly between my daughter, DIANE WEARY, and my son, ROBERT GARRETT, provided they survive my death by thirty (30) days. ITEM IV. I appoint my daughter, DIANE WEARY, executrix of this my last will. Should my said daughter predecease me or otherwise fail to qualify or cease to serve as executrix of this my last will, I appoint my son, ROBERT GARRETT, executor of this my last will. ITEM V. In addition to the other powers and authorities granted to my personal representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby give to my personal representatives the following powers and authorities effective without court approval and until actual distribution of all property: to compromise any claim or controversy; to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as my personal representatives may determine and at valuations finally to be fixed by them; to invest in all forms of property, including any stock or other securities in any corporate fiduciary or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my personal representatives deem proper, without regard to any principle of risk or diversification; to 2 retain any or all assets of my estate, real or personal, without regard to any principle of risk or diversification; to sell at public or private sale, to exchange, or to lease for any period of time, any real or personal property and to give options for sales, exchanges, or leases, for such prices and upon such terms or conditions as my personal representatives deem proper; and to allocate receipts and expenses to principal or income or partly to each as my personal representatives deem proper in their sole discretion. ITEM VI. I direct that my personal representatives and fiduciaries shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand this .:lId day of IIlr1~ ,1997. ,~J-Ul~-", ~ ~ LOUISE E. GARRETT 3 The preceding instrument, consisting of this and THREE other typewritten pages, each identified by the signature of the testatrix was on the date thereof signed, published, and declared by LOUISE E. GARRETT, the testatrix therein named, as and for her last will, in the presence of us, who at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. fvt,.i.~ !.&cy2 LV/A->~~ / 4 COMMONWEALTH OF PENNSYLVANIA ) ( SS: COUNTY OF CUMBERLAND ) The undersigned, being the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, does hereby acknowledge that I signed and executed the foregoing instrument as my last will, that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. :l17.u~~", ~ AJJ ~.J;tL Sworn or affirmed to and acknowledged before me by ~e~tNT...!J ~lI!?~d above thi / day of 11O/VIIUJlJlr , 1997. NOT Amid. &/!:Al WENDY S. CHESBRO, Hotory Publ1c Low.. AIle" Twp., Cumbetlolld Co., PI. My Comlllllllon Expires Mtzy 10, 1999 COMMONWEALTH OF PENNSYL VANIA COUNTY OF CUMBERLAND ) ( SS: ) WE, M ~~I L /3,4AJ 6S and LiNN GH ~ENFG"1.j) , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the testatrix sign and execute the instrument as her last will; that she signed it willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the will as witnesses; and that to the best of our knowledge, the testatrix was at that time 18 or more years of age, of sound mu,,1, """ "nde< no <on,_' '" ,,- in/l"""".~ ~ 7 r~ Sworn or affirmed to and acknowled~e9 b~~72.c;.. this d.-/ d y of/JdJltl fCA:..#ft 1997. Notary Publi NOT AIllId. SIAl WElo!DY-s. CHUIRO, NoIary ",*1Ic l...... ......11 Twp.. Cumb4otoftd 0.., 'A Mr CollItwlalon Expl_ /My 10. 1999 5 BANGS LAW OFFICE fWSOUTH ISlli STREET CAMPHILL,PA 17011 E-mail: mikebangs@verizon.net PHONE: 717-730-7310 FAX: 717-730-737f MICHAEL L. BANGS, Attorney-at-Law WENDY S. CHESBRO, Paralegal WILLIAM E. MILLER, JR. Of Counsel April 27, 2005 Glenda Farner Strasbaugh, Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, P A 17013 RE: Estate of Louise E. Garrett File No. 21-04-1094 Dear Mrs. Strasbaugh: Enclosed for filing as a part of the above-referenced estate please find the following: 1. The original and one copy of the Pennsylvania inheritance tax return; 2. The original inventory; 3. A check in the amount of $22,077.56 to pay the tax shown to be due; and 4. A check in the amount of$30.00 to pay the filing fee for these documents. Kindly file the inheritance tax return accordingly and return a paid receipt to me in the enclosed, stamped, pre-addressed envelope. If you have any questions or require anything further, please contact me directly. ~~ Michael L. Bangs wsc Enclosures cc: Mrs. Diane L. Weary c.r: ~~- ---=-~ UJ '" co <I: .z: lOO 1- ~ QI 'IJ '. co CCl....J- --0') CL.-.....J-I'-Tf") <I:-O(\UD-. .Q..:I:r"-- NO "l a. -g:g~; .=. :I: <I:o 'J: U Ln I- CXJ z am ~ f:R- q~S" 0 ~1: ~ ;; 0 ,~ ~~ ,."~,," { "II .11I C -= c CA u a - n ... .. ,fl.', v_:\ ..\ ._\ 11.:\ , 4 ~ .... (;.;1 - r.. r.. o ~ ... rsJ ~ Z <: = ~..., "..., 1;0 ~t- 00..., ~~ ..., < ..cf'3 ~= Q Q, 00 e "" " ~u ~ ~ <.;..., o .... n:l ..... rfJ n:l 'w ~ n:l 0 J:t:;..!:: ""I:: ..!:: ;:::I bDOn:l ]U~ rfJ ;;., c:r <'"\ ~t::IZJ- ..-- ;:::I n:l 0 IZJ 0 rfJ r-- ...u ;:::1- ~"'2.8<c @(<ltl'l< ~-::t "' ~hJO~ -o..oUrfJ ~ S n:l:'::: ~ ;:::I ~ ~ OUOU o I- Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of Louise E. Garrett No. 21-04-1094 , De'ceased Date of Death 11/16/2004 Social Security No. 192-30-0094 also known as Diane L. Weary --...---........ _..,_...._~._,._-_._._-_.__..._-_.._----_._----------- ---------..----- The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa, C. S. Section 4904 relating to unsworn falsification to authorities. tJ- llli Personal Representa e Attorn"" =;'~~B.ng. __ S"""ffi' Di.n~ ~i1.IU1.. - '_./"', .. I.D. No.: . _ Signature: . 6 I Signature: Firm: Address: 429 South 18th Street Camp Hill, PA 17011 717/730-7310 Address: Dated: 2815 W. Rosegarden Mechanicsburg, PA 17055 717/790-0778 4-27-00 Telephone: Telephone: -, '., Personal Property Cash............................................................................................... Miscellaneous Property................................................................ Stocks/Listed ................................................................................. Stocks/Closely Held...................................................................... Bonds............................................................................................. Partnerships and Sole Proprietorships ..................................... Mortgages and Notes Receivable............................................... 482.82 r"'4 ....,..; .." Total Personal Property......................................... 482.82 Total Real Property................................................ 113,478.74 Total Personal and Real Property......................... 113,961.561 Total Out-of-State Real Property.......................... .J::. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96i RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT BANGS MICHAEL l 429 S. 18TH STREET CAMP Hill, PA 17011 ___n___ fold ESTATE INFORMATION: SSN: 192-30-0094 FILE NUMBER: 2104-1094 DECEDENT NAME: GARRETT LOUISE E DATE OF PAYMENT: 04/28/2005 POSTMARK DATE: 04/27/2005 COUNTY: CUMBERLAND DATE OF DEATH: 11/16/2004 NO. CD 005266 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $22,077.56 I I I I I I I I TOTAL AMOUNT PAID: $22,077.56 REMARKS: CHECK#1022 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WillS . . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 OFFICIAL USE ONLY REV -1500 INHERITANCE 21-02-1094 TAX RETURN RESIDENT DECEDENT w <0: ~t::U) 0"''' wo.o ,,00 0"'--' o."' o. <0: I- Z W C W U W C DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SHIELDS, OTHO O. DATE OF DEATH (MM-DD-YY) 10/24/2002 (IF APPLICABLE) SURVIVING SPOUSE'S NAME Shields, Ma R. COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 189-18-6275 THIS MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 211-52-2850 D 3. Remainder Return D 5. Fed. Est. Tax Return Req'd 0_ 8. Total number of SOB's z o i= <C ...J :::l !:: a. <C U W 0:: 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3.Closety Held Corporation, Partnership or Sole-Prop. 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Misc. Personal Prop.(Sch.E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Misc. Non-Propate Prop. 8. Total Gross Assets (total lines 1-7) 9. Funeral Expenses & Administration Costs (Sch H) 10. Debts of Decedent, Mortgage liabilities, & Liens 11. Total Deductions (total lines 9&10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (13) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amnt of Line 14 taxable at the spousal rate, or transfers under Sec.9116(a){1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 10 W. Pomfret St. Carlisle, PA 17013 $0.00 $0.00 $0.00 $0.00 $0.00 (1) $0.00 (2) $0.00 (3) (4) $0.00 (5) $3,985.16 (6) $0.00 (7) $6,969.66 (8) (9) (10) (11) (12) DATE OF BIRTH (MM-DD-YY) 6/3/1921 >- z w o z o o. rJ) w '" '" o o o 2. Supplemental Return 4. Limited Estate 0 4a. Future interest Compromise 6. Decedent Died Testate 0 7. Decedent had Living Trust 9. Lit'g'tion Proceeds Rec'd 1 Q. Spousal Poverty Credit :tl'Ilss!ii~~I\I::IS:RE!il!iii~:::iijj~!iitl:E:' NAME, Patricia R. Brown, Esquire FIRM NAME, Salzmann Hughes, P.C. TELEPHONE NUMBER 717249-3024 z o >= <0: >- ::> Q. :l! o o >< <0: >- $10,955 $0.00 $0 $0 x.o_ x.045 x.12 x.15 OFFICIAL USE ONLY $10,954.82 $0.00 $10,954.82 $10,954.82 (15) (16) (17) (18) (19) Decedent's Complete Address: STREET ADDRESS 415 E. Old York Road CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1 Tax Due 2. Credits/Payments A Spousal Poverty Credit B. Prior Payments C. Discounts (1) Total Credits (A+B+C) (2) 3 InteresUPenalty if applicable D. Interest E. Penalty 4. TolallnterestlPentalty (D+E) If Line 2 is greater than Line 1 + line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (3) (4) 5. (5) (5A) (5B) If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check to: REGISTER OF AGENT $0.00 $0.00 $0.00 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: yes no a. retain the use or income of the property transferred: b retain the right to designate who shall use the property transerred or its income: D D D D D D !2:J c, retain a reversionary interest: or d, retain the promise for life of either payments or care? 2 If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 4 Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary disignation? !2:J !2:J !2:J !2:J !2:J !2:J D IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Declaration of oreparer other than lhe personal representative is based on all information of which pre parer has any knowledqe SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete DATE ADDR\ES~ _ _. . '-f~"1'? ~ SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ) 0 Vv-<. d f) oy">-'-f.-'-<. 1- .&:-f ADDRESS p.., U,,,< L J'\ Lc , 1701 -" DATE 10 /v3/0)- For dates of death on or after January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S Sec. 911fil:.\11 1\1;;\1 The statute does not exempt a transfer to a surviving spouse from t ax, and the statutory requirements for disclosure ofassels andf ilingataxretl For dates of death on or after July 1, 1994 and before January 1, 1995. the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72P.S Sec. 9116(a}(1, l)(I}] onlybeneficrary For dales of death on or after July 1,2000 NAPD The tax rate imposed on the nel value of transfers from adeseased childtwenty-oneyearsofageoryoungeratdeathtoorfortheuseofanatur or a stepparent of the child is 0% [72 PS. Sec. 9116(a)(1.2)] The tax rate imposed on the net value of lransfers to or for the use of lhe decedent's lineal beneficiaries is 45%, except as noted in 72 PS Sec The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 PS. Sec.9116(a}(13}] A sibling is defir :J Ars, individual who has at least one parent in common with the decedent, whether by blood or adoption th, - SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANIOUS PERSONAL PROPERTY ESTATE OF FILE NUMBER SHIELDS, OTHO O. 2 I -002-1 094 (Ail property Jointly-owned with Right of Survivorship must be disclosed on Schedule F) ITEM DESCRIPTION NUMBER VALUE AT DATE OF DEATH Equiserve - Prudential Acct #3976-7970 $3,985.16 2 134 Shares@29.74pershare 3 4 5 6 7 TOTAL (also on line 5, Recapitulation) $3,985.16 SCHEDULE G TANSFERS ESTATE OF 21-02-1094 SHIELDS, OTHO O. This schedule to be completed and filed if the answer ofthe question on the reverse of the cover is yes. ITEM DESCRIPTION EXCLUSION TOTAL VALUE DECD.% DOLLAR VALUE NUMBER OF ASSET INT OF DECD. INT I Prudential Financial Acct # IRA 100.0% $6,969.66 AAC - R69117-I7 2 TOTAL (also on line 7, Recapitulation) $6,969.66 SCHEDULE J BENEFICIARIES ESTATE OF 21-02-1094 ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE NUMBER OF ESTATE I Mary R. Shields Wife 100% 415 E. Old York Road, Carlisle, PA 17013 2 3 4 SHIELDS, OTHO O. ITEM NAME AND ADDRESS OF BENEFICIARY NUMBER AMOUNT OR SHARE OF ESTATE B. Charitable and Governmental Bequests: TOTAL CHAR1T ABLE AND GOVERNMENTAL BEQUESTS (also enter on line 13, Recapitulation) $0 INRE: ) IN THE COURT OF COMMON PLEAS OF ) CUMBERLAND COUNTY, ) PENNSYLVANIA ) ) ORPHANS' COURT DIVISION ) ) NO. 21-04-1094 ESTATE OF LOUISE E. GARRETT Deceased RECEIPT AND RELEASE ,...., I, DIANE L. WEARY, the undersigned, being a beneficiary under the Estaty of L~se E. Garrett, deceased, do hereby: 2 " /~ " :7ro c-: '~. ) ,0_,) CJ 1. State and acknowledge that I am an adult individual; 2. Waive the filing of an Account or Schedule of Distribution by the per$'oiJ.'a1 -.,) c,:> en representative of the Estate; 3. Acknowledge that I have received all sums of money to which 1 am entitled as a beneficiary of the Estate of Louise E. Garrett; 4. To the extent of said distribution, release DIANE L. WEARY, Executrix, of the Estate of Louise E. Garrett, and her heirs and personal representatives, from all liabilities, whether due to her negligence or otherwise, which she may have by reason of her administration of the Estate; 5. Agree to refund to the Estate and to the said DIANE L. WEARY, Executrix, any portion of the distribution to which I am not properly entitled, and, to the extent of said distribution, to indemnify her and the Estate for claims made against her and to reimburse her and the Estate all expenses and costs incurred in connection with any such claim; and 6. Declare that this instrument shall be legally binding upon me, my personal representatives, and assigns. V> -r:> . .- '-1'1 I C) ,(~ '.J , C:J ;;"1- o . r:-) ':-:~l Tl .: c-s r-n .J "1 IN WITNESS WHEREOF, I have hereunto set my hand and seal this :J.. day of A erst ,2005. (SEAL) COMMONWEALTH OF PENNSYLVANIA ) ( SS: COUNTY OF CUMBERLAND fl.' ) On this, the Z day 0 L , 2005, before me, the undersigned officer, personally appeared D NE L. WEARY, known to me (or satisfactorily proven) to be the person whose name is sub ribed to the within instrument and acknowledged that she executed same for the purposes therein contained. IN WITNESS WHEREOF, I~~. e eunt serrr ?and and official seal. . J L/WI)o . N tary Publi NOTARlAi. SEi\l WENDY S. CHESBRO. Nol'~ry PubIlc Lower Allen TIIij)., Cumbelland CountY My Commls8ion ExpIres May 10. 200'1 REGISTER OF WILLS OF CUMBERLAND COUNTY REPORT OF STATUS OF ADMINISTRATION (For Resident Decedents Dying after July 1, 1984) ESTATE NO. 21- 04 -1094 Name of Decedent: Social Security No.: LOUISE E. GARRETT 192-30-0094 Date of Death: November 16,2004 Name of Personal Representative: Diane L. Weary Capacity (check one) Executors Administrator x Administrator c.t.a. Administrator d. b.n. Is the administration of the estate complete? Yes_X_ No If "Yes", how was the administration ended? (check one) By court accounting By account stated to parties in interest X Did the parties release the personal representatives? Yes Other (explain) Total amount paid to date to creditors and for funeral and $41,085.11 administrative expenses Total value of distributions to date to beneficiaries $94,194.19 If administration is not complete, estimated value of assets $ still in administration L. ( NOTE: This status report is due no later than the due date for filing of the Pennsylvania inh&!"itance tax return or, if no inheritance tax return is required, nine (9) months after the date=of death; if the administration of the estate has not been concluded, a summary report shaD.:be fil~ annually thereafter until the administration is complete. LL C.,'I L'.. t: . c_, I ce,fti,fy ~der penalty of perjury that the foregoing information is correct to the best of my kno.wledge, information and belief. r /.-. , . L\.' [~. r\ (1 ~~.~ C. Da~J ~ 1~1{i~- I ~