HomeMy WebLinkAbout07-10-13 J 1505611180
REV-1500 IX��-������
OFFlCIAI USE ONLV
PADeparimentofRevenue P���SylVania
oes.ve.m+ror��we CounlyCodeYear FileNumher
BureauoflndivitlualTwces INHERITANCETAXRETURN
PO BOX 280601 /
Harrisbum,PA 17128-0601 RESIDENT DECEDENT � � / � /� �
ENTER DECEDENT INFORMATION BELOW
Socfal Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
12202012 07091939
Decedent's Last Name Suffix DecedenPs First Name MI
WALTERS LAftRY L
(If Applieable)Enter Surviving Spouse's Infom�ation Be�ow
Spouse's Last Name S�x Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
flLL IN APPROPPoATE BOXES BELOW ,
� 1.Chiglnal Retum ' Q 2.Supplementel Refum Q 3.Remainder Retum(Date of Death
Prbrto 124382)
Q 4.Limited Estete Q 4a.Future Interest ComproMSe(date of Q 5.Fedeial Estete Tex Refum Requlre0
death eRer 1242-82)
� 6.DecedeM Died Testete Q 7.Oecedent MaMrtained e Living Trust 0 8,Total Number of Safe Deposit Boxes
(Attech Copy o(Wil� (Atlech Copy W TrusQ
Q 9.LXgatbn Pmaeds Received Q 10.Spousal Poverty Credd(Date M DeaM Q 11.Ekctim to Tax under Sec.9113(A)
BeN+een 12J131 end 1-1-9a� (Atlach Schedule O)
CORRESPONDENT-TXIS SECTION MUS7 BE COMPLETED.ALL CORRESPONOENCE AND CONFIDENML 7AX INFOIiMATION SHOULD BE DIRECTED TU
Name Daylime Telephone Number
ROBERT G . FREY 7172 5838 � �
� � � m
� @EG�ER OF Vg1,�,5 USEjJN�L'Y
W � •-- U� ^^7
m = c� � c
First Line of Address � D' r ~ m m
D Z � � ''�7` �
5 S . HANOVER ST. � � � ° �
o � o � T T
Second llne of Address n O -r� � —
. O C �--� — n
• � � r m
� o
City or Post OHice State ZIP Code � � oATE F][ED �
CARLISLE PA 17013
covespondent'se.mailaddress: RFREYaFREYTILEY. COM
Under peneflies of pe�jury,I dedare Ihat I have exemined Nis retum,indud'mg exomparrying schedules and shatemeMS,end to Ihe besf of rtry knwAedge end hefief,
distrue con and kta.Declareflonaf re rerolherthenihe rsonalre resenleliveisba5edoneRinfarmaliondvfikh re rarhssan ktroMed a.
SIGNA PERS N ONSIB E FO G RETURN DA .
7 �3
ADDRE55
5 SO TH HANOVER STREET CARLISLE PA 17013
SI NA RE OF PREPARE ^ ER TIiqN PR SEMATiVE � pq �
Y��r�� 6
A RESS
58D MOUNTAIN ROAD, BOIL NG SPRINGS, PA 17007
PLEASE USE ORI6INAL FORM ONLV _
Side 1
L 1505611180 150561118D J ` �
1�`
J 1505611280
REV-1500 EX(FI)
DecedenYS Social Security Number
occedem•sName: LARRY L WALTERS
RECAPITULATION . �
�. Reai es�ace�sa,eduie n�.. ... ... ... ... .. . ... ... .. . ..... .. . .. ... .. i. N 0 N E
2 Staks arM Bonds(Schedule B). .. .. ..:.. .. . .. .. ... .. .. . .. .. .. . .. .. 2 N 0 N E �
3. Closely Held Corporetion,Partnership or Sole-Proprietorship(Sehedule C). .. 3. N 0 N E
4. Nbrtgages and Notes ReceWable(Schedule D). . .. . .. ... ... ... ... .. . .. a. N 0 N E '
� 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E).. .. S. 14 8 7 5. 0 0
6. Jointly Owrred Property(Schedule� �Separate Billing Requested.:. .... 6. � 7115 0 . 0�
7. IMer-V'rvos Transfers&Miscellaneous Nor�Probate Property
(Schedule G) �Separate Bflling Requested.. ... .. 7. 3 2 2 2 O 5. O O
8. TofalGrossAssets(tWalLineslthrouqh�. .. .. ... .. ... 8 408230 . 00
. 9. FurrerelExpensesandAdministretiveCosts(Schedulel-�..... .. . .. . .. ... 9. 25377 . �0
10. Debts ot Decedern, Mortgage Liabilities and Liens(Schedule I). .. .. ... .. .. 10. 16883.00
11. TotalDeductlons(totalLines9and10)... .. .. . .. .. ... .. .. . .. ..... .. 11. 42260 . 00
t2 NetVa�ueolEswte(LineeminusLinell).. . .. .. ..... .. . .. .. ... .. ... 12. 365970 .00
13. Charitable and Govemmental Bequests/Sec 9113 Trusts for which
an elect(on to tax has not been made(Schedule J)... .. ... .. .. . .. .. ... ..13. 0 .�0
t4. Net Value subiect to Tox(�ine�2 minus Line 131.. . .. ... ... .. 14 365970. 00
TAX CALCULATION-SEE INSTRUCTIONS POR APPLICABLE RATES
15.Amourd of Line 14 ta�rable at ,
the spousal tax rete,or
transfers under Sec.9116 .
(a)(t2)X.0 0 15. 0 . 00
16.Amourd of Llne 14 ta�ble
at�inea�ratex.o 45 365970 . 00 �s. 16468 . 65
1z anount a�ine ta
ta�cable at sibling rate X it p�7 17. 0 .��
18.Amourrt of Lirre 14 taxable�
atcol�atera�rateX #QA �e. 0 . 00
�s. raxouE. .. .. ... .. .. . .. .. ... .. ... .. .. . .. .. ... .. .. . .. .. .. . .. .. .. is. 16468 . 65
20. FlLL IN THE BOX IF YOU ARE REQUESTN6 A REFUND OF AN OVERPAYMENT �
Side 2
L 1505611280 1505611280 J
REV-15oo EX(F� Pege 3 Fl�e Number 161-32-5130
DecedenYs Complete Address: zi-i2-�3ao
DECEDENT'S NAME
LARRY L WALTERS
STREETADDRESS
2 MILL ROAD
GTY STATE LP
CARUSLE PA 17013
Tax Payments and Credits:
1. Tax Due(Page 2, Une 19) (t) 16468.65
2. Gedits/PaymeNs
0. Prlor Payments 20000.00
e. DiuouM 823.43
Total Credits(A+g) (7J 20823.43
3. Inlerest
(3)
4. If Line 2 Is greater than Line� +une 3,enter the difference.This is the OVERPAYMEN7.
Ft�l In boa on Pape 2,Line 20 to roquest a roNnd. (4) 4354.78
5. If Line i +��3 is greater than Line 2, erder the dif(erence.This is the TAX DUE. (� 0.00
Make check payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Dkl deeedent make a transfer and: Yes No
a. retain the use or income of the property transferted....................................................................................... ❑ �
b. retain the rigM to designate who shall use the property transterted or its income.....................:................... � �
e. retain a reversionary Irderest.......................................................................................................................... ❑ �
d. receive the promise for life of eHher paymeMS,benefits a care9................................................................... � �
2. If deffih occurted after Dec. 12, 1982,did decedent trensfer property wlthin one year of death
wtthout recelving adeqvate consideratlon7.......................................................................................................... ❑ �
3. Did decederd own an"in trust for or paya6le-upon-0ealh bank acmurd or security at his or her deathT............ � �
4. Did decedent own an IndiNdual retirement aceount,annuRy or other rmn-probate property,which
contains a benefieiary designation7.................................................................................................................... � ❑
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on w after July t, 1994,and before Jan. �,1995,the tax rate imposed on the net value of trensfers to or for the use of the surviving
spouse is 3 percent(72 P.S.§91�6(a)(1.1)f)1•
For dates of death on or after Jan. 1, 1995,the Wx rate imposed on the net ralue of trensfers to or for the use of the surviving spouse is 0 pereent
[72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a trerefer to a suMWng spouse from tax,arW the statutory requlremerrts for disclosure of
assets and filing a tax retum are still appllpble even if the surviving spouse is tha only ben�ciary.
For dates of death on or after July 1,2000:
• The tax rate tmposed on the net value of transTers from a deceased ehild 21 years of age or younger at death to or for the use of a retural pareM,an
adoptHe parerR or a steppareM of the child is 0 peroerrt[72 P.S.§9116(a)(1.2)].
• The Faz rate inposed on the nM value of transfers to w fa the use o(fhe decedenPs lineal benefidaries is 4.5 percent except as noted in[/2 P.S.§9116(a)(1)�.
• l'he tax rete imposed on the net value of transfers to or for the use of the decedeM's siblings is 12 percent[72 P.S.§9116(a)(1.3)�.A sibling is
d�rred,under Section 9102,as an ind'rvldual who has at least w�e parent In common wtth the decedent,vfiether by btood or adoptbn.
REV•1508EX�(11-10) SCHEDULE E �
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENTOFREVENUE pERSONAL PROPERTY
INMERRANCE TAX RETURN
RE9DENT DECEDEM
ESTATE OF: FILE NUMBER:
Larrv L WaRers 21 12 1340
Include the proceeds of Iltigffiion and the date the prxeeds were received by the estate.
All propeRyjoiMlyowned wkh right of survivorship must bo disolosed on Schedule F.
ITEM - VALUE AT DATE
NUMBER DESCRIPTION
OF DEATH
1 Members 1st Account No. 424600-00 5
2 Members 1st Account No.424600-11 12,604
3 Homeowners Insurance refund ���
4 Cash �Q�
5 United HeaRhcare refund 154
6 Personal property sold 100
7 FIAA card services refund 2�
8 FIAA card services refund 2�
9 Autoinsurance refund 265
10 Telephone refund 29
11 Federal income tax return refund 1,453
TOTAL(Also enter on line 5, RecapRulation) $ 14,875
If more space is needed,use additional sheets of paper of the same size.
REV-i5W IX.(07-1�
pennsylvania SCHEDULE F
DFPARTMENT OF REVENUE
JOINTLY-OWNED PROPERTY
INHERRANCETA%REfURN
RESIDENT DECmQJT •
ES7ATE OF. FILE NUMBER:
Larrv L Watters 21-12-1340
It an asset be¢amejointlyowned wRhin one year of tho deoedent's date o}death, k must be repoRed on Schedule G.
SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TOOECEDENT
A Lisa Peabody 580 MOUNTAIN ROAD Daughter
BOILING SPRINGS, PA 17007
B.
C.
JOINTLY OWNED PROPERTY: '
�rrea onre DESCRIPTION OF PROPERTY w oF onre oF oennn+
ITEM FORJOIM MADE INQUDENAMEOFFINANGALINSTRUTIONANDfl4NKACWUMNUA�EEROR$IMILAR DATEOFDEATH DEGmENf' VALUEOF
NUMBER 7�nrri �arrt IpFMIFYINGNUMBER.ATfACHDEFDFORJ0INRYHBDRFI�LESTATE. VnLUEOFn55E7 IMQtesi OECmEr777'SItaTERESf
� A ��� 2 Mill Road, Carlisle, Pennsylvania, assessed value attached 14z 300.00 50.00% 71,150.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
TOTAL(Also enter on Line 6, Recapitulation) S 71 150.00
If more space is needed,use addRional sheets of paper of the same size.
REV-1510EX+(08-09) SCHEDULE G
pennsylvania lNTER-VIVOS TRANSFERS &
DEPAHTMENfOFREVENUE
RESDENTDECmQJT R" MISC. NON-PROBATE PROPERTY
ESTATE OF � FILE NUMBER
La_rry L Watters 21 12 1340
Thrs schedute must be completed and filed U ihe ansvrer to eny of questions 1 ihmugh 4 on paga three of the REV-1500 is yes,
DESCRIPTION OF PROPERTY
ITEM WCLUpETMEn,wEOFTHETRWSFptEE,T�pRRElAT10N9pPTO0ECEDE1vfAND DATEOFDEATH %OFDECD'S EXCLUSION TAXABLE
NUMBER TNEMTEOFTR�NSFER.�RAq1ACOPYOFTIEDFEOPoRRFALEST�TE. VALUEOFASSET INTEREST "O�E� VALUE
1. Orrstown Bank IRA, acct. 11012005732 124,077 100.00% 0 124,077
2. Orrstown Bank IRA acct PNG001434 198,128 100.00% 0 1gg,12g
0
0
0
0
0
0
0
0
0
0
0
0
0
0
, 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
• 0
0
0
0
TOTAL Also enter on Line 7 Reca itulation E 322 205
If more space is needed, use additional sheets of paper of the same size.
REV-1511 EX+(1609)
pennsylvania SCHEDULE H �
OEPAFi7MQ1iOFREVENUE FUNERAL EXPENSES AND �
RESDEMCDEC�INT R" ADMINISTRATNECOSTS
ESTATE Of FILE NUMBER
Larrv l Watters 21-12 1340
DeoedeM's debts must be repoRed on Schedule t.
ITEM
NUMBER DESCRIPTION
AMOUNT
A. FUNERAL EXPENSES:
t. Baughman Memorial 195
2. Hoffman Roth Funeral Home 12,461
B. ADMINISTRATIVECOSTS:
1. Personal Representative Commissions: �,$00
Nama(s)of Personal Representetive(s) Lisa Peabodv
SlieetAddress 580 Mountain Road �
city Boilinq Sprinqs sce�e PA LP 17007
Year(s)CommtssionPeid; 2013
2 AttomayFees: 4,500
3. Femih Exemplion:Q(Eacedent's address is not ihe same as ciaimam's,ettach e:planetion.)
Claimanl
Street Address
��N Stete 9P
Relatiorrship of Clalmanl to DeceAent
4. Pro6ate Fees: 477
5. Accourrtent Fees:
6. Tex Retum Preparer Feas: � '
7. Advertising in CumbeAand Law Journal 75
8. AdveRising in the Sentinel �gg
TOTAL(Also enter on Line 9, Reca itulation E 25 377
If more space is needed,use additional sheets of paper of the same size.
REV-0512IX�(12-OB)
pennsylvania SCHEDULE I
DEPARTMINf OF REVENUE
iNHeRirnraeernxReruaN DEBTS OF DECEDENT,
RESIDENTDECEDENT MORTGAGE LIABILITIES 8 LIENS .
ESTATE OF FILE NUMBER
LarrV L Watters 21 12 1340
Report debta Ineum�M bythe decedent prlor W deaN that remained unpald at the date at deaM,Irrcludinp unrelmbu�sed mediwl expanses.
��M VALUE AT DA7E
NUMBER DESCRIPTION
OF DEATH
1. •
Members 1st Visa Account No. 4672090000435586 37
2. Final PPL bill 55
3. Green Ridge Village 16,791
TOTAL(Also enter on Line 10, Recapftulation) E 16,883
If more space's neeEed,inseA edditronal sheets olihe same size.
REV-0513 EX+(07-10)
pennsylvania SCHEDULE J
OEPARTMINf OF REVBJUE
IMiQtRMICETA%RENRN BENEFICIARIES
RE9DENT DECmINf ' �
ES7ATE OF: FILE NUMBER:
Lar L Walters 21-12-1340
RElAT10NSF9PTODECmENf PMOUNTORSHARE
NUMBER NAME AND ADDRESS OF PERSON(5)RECENING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS Qnclude oWAght spousal distributians entl trarriers under
Sec.9716(e)(1.2).�
� Lisa Peabody �
, 580 MOUNTAIN ROAD, BOILING SPRINGS, PA 17007 Daughter 100%of remainder
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHONM ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIAIE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL qSTRIBU710NS UNDER SECTION 9113 FOR WHICH AN ELECTON TO TAX IS NOT TAKEN:
1.
B. CHARITABLEANDGOVERNMEN7ALDIS7F21BUTIONS:
1.
TO7AL OF PART II—ENiER TOTAL NON-TAXABLE DISTiIBUTONS ON UNE 13 OF REV-1500 CAVER SFiEET. S O.00
If more space is needeC,use addNional shee6 of peper o(tha same s¢e.
St
�
MEMBERS 1S�
FEDSRALCREDIT UNfON
SAVINGS ACCOUNT:
Account Number/Suffix 424460-00
Date Account Established � 07/07/2011
Principal Balance at Date of Death $5.00
Accrued Interest to Date of Death $.OS
. Total Principal and Accrued Interest ; $5.05 , �
NAme of Joint Owner - ' - - � None� � � , �
CHECKING ACCOUNT: ,
Account Number/Suffix 4 2446 0-1 7
Date Account Established 07/07/2011
Principal Balance at Date of Death $12,602.95
Accrued Interest to Date of Death $]3
Total Principal and Accrued Interest $12,603.68 _ -
Name of Joint Owner None
VISA ACCOUNT:
Account Number 4672090000435586'
Date Account Established 07/08/2011
Principal Balance at Date of Death $36.88
Name of Joint Cardholder . None
`CONTRACTUAL PLEDGE OF SHARES. �
- MB RS�1FE�CR�DITU_r}fyn � , <
\.X Rtl 1��Li4 IVz
� -� -a Ile A.Kline -
Lending Insurance Support Specialist
January 9,2013
Estate of:�LARRY WALTERS � �
Date of Death:-12I2012012 — — -� - �. �
Social Security Number: 16732-5130
5000 Louise Drive • P.O. Box 40 • Mechanicsburg,Pennsylvania 17055 • (800) 283-2328 • www.memberslstarg
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JRN-10-2013(THU) 1A; 32 ORRSTOWN BRIdK (FRX)7172d98010 P. 003/007
�
C,�RRSTO�v1v
Barn�.
ATi aditioa ofExceUence
Sharoholder Da[e Range
Accoun[No. 13012005732 As of: 12/20/2012 �:�
ORRSTOWN BANK C/F � �
LARRY L WALTERS IRA -�;Set;,Dates•.�
560 MOVNTAfN RD
80ILING SPRINGS,PA 1700>
Aeeount Belaaces 8 Rerum to.Men�
� SettlOdUnsettled 7oWl Cos 7otal
Fund roame Shares Sha Share Price BaSis* Value
ForwarG US Government Mone -Ins[I[utlonal 1,B10,M14 .0001,810.440 1.D0 $1,B1�.M1 '
forward Income&Grow[h Allocation- B4OOi.729 .0�08,001.7z $15.29 g122,2Gb.a2
[nstl�utlonal
- otBi 5124 076.86
"The tost basls Is only being calculated and reported on covere0 shares.Any shares acquired prlor to �
January 1,2012 dre not consldcred coveretl shareS and arc not included in thi5 Flgurc.
Snapshot of: 7Rht2 -Premler Income&Growfh
Objective/SSraeegy: Seeks high current Income&some capital appreclatlon.
UNDERLYINGFUND GERCENT MONEY MANAGER
Commoditv Lono/Short 2.6 Fonvard Mana emrnL San
Str3Ceov Func1 Franric o, q
The fund Seeks exposure to the tommodlry markets and retumS Cha[
Corcespond co the Credit Sui55e Momentum and Volatility Enhance0
„N. t Re2urn Scrategy Index (CS MOVERS Intlex), whlch caplralizes on
�.��t���� commodlry fuwres price momenCUm.The fund seeks long•term Coral
retum.
FM Caroor�ta Daht�und 20.4 SW nsse[Manaaement. Newoorc
6each, CA
The fund Inves[s in foreign Currencles from developed and Cmerging
marke[countries and secks to offer expoSUYe[o euro-and U.S.-dollar-
denominated Flxed-income securlCles of non-U.S. issuers antl derlvacives.
Portfolio duration wlll Lyplcally be within a range of plus or minus three
years of the benchmark.The fund 5eeks to achleve high total return
(C2p1[al appreciation and in[ome7.
E�rrrnA�eA Mar_k .etPlus b Ferward Manaaement. San
F m Francisco. CA
The fund's investmenC SCrategy seeks to exceed the total recum of the �
Russell•2500 lndex�y invescing in struccureC products with economlc
charac[eristics similar to common scocks of small and medlum
capitalizaCiOn equl[Ies,and is augment8d wlth a s[2tegy that inve5[S In .
hlgh qUallty, short duration bonCS.The fund seek5 Capltal growtA.
Fron I r Stratmv FunA 1.4 F�rward MAnaUem �L San
Risk Level Fr� Is o, A
The fund Invests in securitles Chat approximate the MSCI Frontler
,,, ' , , Markets Index, whlch conslscs of 25 countrles In flve regions--Eastern
� � Europe,�Amerlcas, Middle East, Asi�'and�Afrlca'.The'fuod�seeks Capltal ' '
growch.
Hlah YnIA Aond FunC 8.8 First Wes[ern Inveshnent
Manaaement Los Anaelas. and
Denvec [O
The fund iM25ts In lowcr-ratetl bonds of companles whose prospetCS are �
JAN-10-2013(THU) 1a: 33 ORRSTOWN BANK (FAX)7172d98010 P. 00d/007
stable or improving and whose bonds ofFer an att2ctive yield. PorCF011o
, duratlon wlll nortnally be wifhln a range of plus or minas 20%of the
funtl's benchmark.The fund seeks high curtent Income.
Tnternatlonal Dividend SR.6 Forward Ma�aaement. Sart
Fund . Fr+n �is o. .A
The fund seeks to achleve long-[erm capital apqr¢clatlon and income by
investang In�dlvldend-paying companles loca[ed oucside of the U.S.,
Invescing in stocks with higher-relative dividend yields, dlvldend growth
pocential and antiClpated Smck prire appreCiatlon. Portfollo duration is
� normally one to flve years.
Interna[lonal Real Es[ate .8 Fonvard Manaaement. San
Fund Franricm. CA
The fund emploYS a bottom-up approach W stock selection with
emphases on superior property locatlon and quality, strong prospec[s for
apprecia[ion in properCy rents and values, and management's[rack
record for adding value. Invests primarlly In hlgh-quality commerclal and
� resldential real estate[ompanles locatetl in Asia, Australla, Europe,
Canada and Latln amerlca.The fund seekS GoW I re[urn from both capital '
appretlatlon and current income.
• Invesrmenr Grade Fixed• 29.6 Pacifie investmenc Mananement
Income Fund somoanv, N woort Reach. CA
The fund invests in investmeno-grade,debt securities and other
ins[ruments that have slmllar economit characteristl¢to investment-
grade debt Securlties investing in U.S. corporate honds, U.S. Govemmenc
or agenry securitles,and mortgage-Cacked and 2sse[-boCked securities.
Portfolio du2tlon wlll typically be withln Cwo years of the fund'S
benchmark.The fund seeks generaclon of current income.
ManaaetlFucures 5.0 Forwarcl Manaoement San
Ftratenv Fiind Franr.lseo. CA
7he fund sceks exposure to Che fu[ures markets and gene�ally Inves¢ in
futures-related instrumen[s chac track[he performance of futures
cont2Cts included In[he Credit Svisse MWtI-Asse[Futures Strategy Index
(CSMF Index).The fund seeks long-term[o[al return.
Beal Estate Fund .5 Forward Mananem nt STn
Frandsw, CA
The fund investr in high quallry U.S. companie5 ezpetted[o generate
superior real esta[e drlven re[ums over longer tlme periods and fotuses
on real esia[e companies whlch [an be identified as h3ving attrattive
cash flow, assers and management characterls[Ics.The fund seeks
Income with capitai apPrecia[lon as a secondary goal.
SeIM EM Dividand Fund H.3 Forward Manaaemerrc. San
P2nci5[a CA
The fund invests In the securities of dividend-paying companies loca[ed
in emerging marke[countries and seeks Invesonents based on
funtlamen[al quali[y,dividend ylcld, diviAend grow[h po[entlal, valua[ion
and anticipated pACe appreciation.The fund seeks to achieve high toCal
re[urn through capital apDrecia[lon and current income.
SPDRfw S&P SOOt� FTF 2.4 SPDRhI SRP 500(d ETF TNSt
Ar=und Chac, before expenses,generally rorresponds to the prlce and
yield performance of the S&P 500 Index.7he S&P 500 Index is an
unmanage0 Index of S�D common s[acks chosen [o reFlett the IndustHes
In Che U.S. economy.
C�reteair Altemetives 5.0 ForwAr{�ManaaCm n[. San
m Franclsco. CA
The fund invests in altemative asset classes 5�ch as real estace-21a[ed
securities, commodlry-related secu�ties and tunencies,and other
Seturltles tha[exhibi[low his[oNCal correlations with global S[ock and
bontl markets.The fund Seeks co provide long•Cerm capltal appreciation
and income.
Invesdng Invoives risk, including posslble loss of principal. WhBn Investing in srnall cap stocks you may
notice greater fluctuaLlons In market value. By inveSCing In Internacional stocks, Including emerging
� ��� markets anE�f'rontler�markets;you may 6e sub�ecctocurrency Fluccuatlons�and pollticaland'economlc ' ' � �� � ��
instablllry. 8y investing in high yleid 6onds yau may be sub)etted co grea[er price volatlllty hasetl on
Fluccuations in i55uer and Credl[quality. When investing In bonds,you are SubJeCC, 6u[not limited to,
� [he Same InC0re5[rate, inflation and Cr@dlt Nsks associated wikh the Undfrlying bonds owned by Che .
Fund. Mortgage-backed sBCUrltles are subject[o prepayment and extension risk Bnd [herefore react
Cifferently to changes in In[erest rates than other bonGS. Small movemenCS In In[erest rates may
)RN-10-2013(THU) id: 33 ORRSTOWN BRNK (fRX)i172d98010 P. 005/007
puickly antl significan[ly reduce the value of certain mortgage•hackeG securicies.7�e Frontier Markcu
and Strategit Alterna[Ives Funds are non-diversifled funds. An Investor will indlrectly bear the expenses
of the fund?s undcrlying investrnents. in a0dlclon, the funG7s underiying Investments(such es
svuttured notes, deriva[IveS, r,pmmodicles and levered ETFS) wlll Involve heightened risks related co
Iiquidity, increased volatlllry, and unfavorable fluttuatlons In currency values.The un0erlying
IntemaUonal and real estate inve5tment5 of thc Frontier Markets and SCrategic Alternatives Funds mdy
also be suh�ecc ro economic or polldcal Insrablllry in the US and oCher coun[rles, creGi[risk and IntereSC
rate fluRUa[ions. "The Fund?s ac[ual allocations may differ due to marke[flucSUation5 and Other
factors. Forward htanagemenc has che discretlon to change che Funds7 allocaClons.
The FunCS'acfual allaatlons may Clffer due to market fluctuatlons and atl�er factors. ForwaN �
Management has rhe di:crefion to change the Funds'allocacion;. For a IisC of allaatlons current to Me
mos[recent month end, �ISIC www.fonvardinvesting.COm
NOT FDIC INSURED NO OANK GUARANTEE MAY LOSE Vn�UE
You sAOUId consi0er the inve5tmen[obJectives, �isks, charges and expenses of che Forward Funds
rarefully be/ore Invesdng. a prospeczus wifh this and orher Information may 6e o6wlned by calling
(800)882-9612 or by downloading on¢from www./oiwardinvesting.com. Itshould be read orefully
before investing.
Prlvacy Pollcy I ConW ct I Fonvard Funds are dlSrnDUCeO by atPS 01strlGUtors,lnc.
.. . . . . . . . . . . . . .... . . . . . . .. . . . . ... . . .
• JRN-10-2013(THU) IA: 3a ORRSTOWN BRNK (FAX)7172d98010 P. 006/007
Holdina� Irrvesior
larry L Walters Mrvon R Jaymes Combined Account Port/cllo
SBD Mounteln Road Ortstown FnanGal Advisors Date: 12/20I2012
Bolling Sprgs,Pq 1)007 427 Vlllage Drlve Creeted:01/10l2013
Carlisle,PA 17015
. ' 717-248-3737 •
Larry L Walters
Acct Name:IRA FBO LARRY L WALT6RS CETERA IfWSTMNT SVC AS CUST 5B0 MOUNTAIN f2D BOIIING SPRGS PA
'17007-9515
AcM No:PNG00i434 Acctrype:Thlyd Partyl�5 Custodlan ReUrement Account
Rep.No:BUG
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, ImoalorToWl: � 5198,�28.13
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JAN-10-2013(THU) 1d; ;5 ORRSTOWN BAIJK (FRX)7172d98010 P. 007/007
Moidinas by Investor
Larry L Walters Mrvon R Jaymes Combined Account Portfolio
560 Mountain Roed Orrstown Flnancial Advlsors Date: 12/20/2012
Boiling Sprgs, PA 17007 427 Vllago Drive Created:0111 0/2 0 1 3
Carllslo,PA 1�015
717-249-3737 .
Disclosure:
Reglatered Raprosonlatlw of and secun6ee oHerad Ihrough Coima AONsor Nenvorks LLC,memDar SIPC,Orrslavn Financlel Ad�lsors Is nol
efllllatod wIN Celera Advisor Nehwrlm LLC.Valuos aro as of�71202072 unleos otharwlee noied. We bolleve the sourcos�o bo rolWblo,how�wer,
the accuraey and complelenass of tho Intormatlon is nol guaranteed,as It Is a campllatlon ol lnlormatbn trom rarlous Maridal sources(mulual
funda,Cireci portldpatlon prograrrts,correspondent brokera,olc). In t�o ovcn[of any discrepancy,lhe spomor's valuatien ahall prevell.
Pertormance data quo�ed represenls pasl perfortnance and doas not guarantee fuWre resulls.The Invostmont roWm and prfnclpal of an Investrnent
wlll fiuctuale so thal an Investor's sharos when redeemed may be worlh more ar lesa than IMe orlginal cosL Tho valuas rcprosonted In thls report
may not reAec�iho truo orlglnal rost of Ihe Wienl's iniliel inuestmenL
For fee—based accounle only,lhe hguree may or may rrot ro0oetthe deduclion of investrnenl edvisory fees. If Ihe Invashnent Is being managed
fhrough e fee—Gased accounl or egreamunt,lho rawms may be reduced by Ihese eppllcebla advlsory fees. Refer lo your Advlsor'e Form AW,Pan
II.
Tha Informatlon wntalned In Nese reports is colleclad kom sowcee betleved�o be rella6le. Howover,you shoukl elways rely on your slalements
roeolvetl dlmdly from pmduct sponsors. If you have eny questlons regarding your roport,ploaso call your roprusonrativo.
The�oume dete kr Iha klbwing aaounts was provldod Gy Porshing: � . . . , .
PNG00'1434 � � � '
i
�ge 2 of 2
. �-..
219 Norih Harrover Sheet
. Carlisle,Penruylvanio 17013
� 717.243.4511
' foll hee 1.866.451.4511
��j2�,�__�� - 2 tax 717.243.3723
: v�
� !� FUNERAL HOME 6t CREMA?ORY, INC. ����}h.�
January 29, 2013
Lisa Peabody
580 Mountain Road
Boiling Springs, PA 17007
Statement of Funeral Expenses for: Larry L. Waiters
Date of Death: December 20, 2012 Account Id: 16749-307
PACKAGE:
Traditional Funeral Service
TRADITIONAL FUNERAL SERVICE PACKAGE $ 4,850.00
SubToWl: $ 4,850.00
MERCHANDISE:
Casket: 0akland $ 3,225.00
Outer Container: Continental $ 2,500.00
Sub ToWi: $ 5,725.00
TOTAL FUNERAL HOME CHARGES: $ 10,575.00
CASH ADVANCES:
Letort Cemetery $ 900.00
10 Certified Death Certificates at$6.00 each $ 60.00
Newspaper Notice-Sentinel $ 286.68
Newspaper Notice-Patriot $ 353.85
Clergy $ 100.00
Flowers $ 159.00
Additional Flowers $ 26.50
Sub Total: $ 1,886.03
Total Funeral Expense: S 12,461.03
Total Payments Made: $ 12,461.03
Payments Made:
FDLIC Check 192773 Jan 18, 2013 12,347.71
Estate Of Larry Wakers Check 96 Jan 29, 2013 113.32
Balance: S o.00
SERVING OUR COMMUNITY SINCE 1 9O7
� �(1�6-� � ���
�
Bau9hMan MeMOrial
/1 S Bedford SLreeL
CARLISIE. Vp i7B13
711-1/3-5/8A
TERIQNAII.U.� 71BfiB368
IERCHANi X; 5556B9815686 .
DISCOUER
Sp���t#12167
RRN�3B1618 BZB47 pUTH:01629B
JRN 16. 13 13aB8
TOTAL S195.00
LISA A iEABOD4
CUSi01ER COP4 i
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d.To sell at public or prtvate sale for cash or upon ccedit,or paztly(or cash and
partly on credi[,and upon such tetms and conditions as shall be deemed proper,any part
or parts of the vust estate,and no pumhaser at any such sale shall be bound to inquire
inro the expediency or propriery of any such sale or to see to the application of the .
. putchase money arising thereGom.
� e.To keep on hand and uninvested such moneys as may be deemed proper and
for such period as may be found expedient
f.To compromise,settle,or arbitra[e any claim or demand in favor oF or against
the Vust estate.
g.And authoriud in the discharge of fiduciary dufies,ro employ counsel and to
� detelmine a¢d to pay such counsel reasonable compensauon which shall be char8ed
� against the principai or income of the wst fund,and shall further be enutled to charge
against the principal or income such other reasonable expenses and chazges as may be
necessary and proper to incur for ihe pmper dischazge of fiduciary duues and for the
. propet management and administration of the trust esta[e•
h. In maldng any division of properry into shares for the purpose of any
disvibufion thereof dimcced by the provisions of the trust, to make such�division or ,
disvibutlon, either in cash or in kind,or partly in cash and partly in kind, as shall be
' deemed most ezpedient,and in maldng any div�sion or distribufion in ldnd may allot any
- specific security or property or any undivided interest cherein to any one or more oC such
s6ares,and to that end may appraise any or al�of the proper[y so co be allotted and the
judgment as m the pmpriety of such a1loUnent and as to the�elafive value for pulposes of �
distribufion of the securities or property so allotted shall be final and conclusive upon all
persons inte'esced in the trvst or in the division or disVibution thereof.
i. Aufiortzed[o regis[er any shares of stock or other assets oC any trust in[heir own
names or in the name of a nominee.
IN WITNESS WHERE�F.I ha�e hereunto set my hand and seal to ehis my Last`71'ill
and Testament wrieten on 2 pages,this 201° day oF July,2011.
� vYY�tJGCW�� (SEAL) ..
LpRR .WALTERS.
Signed, sealed,published and declared, by LARRl 1-. WALTERS,the Testator above .
request, and nf the prcsence of each othe�have�hereunto subscn'bed our names ascateest n'g �
witnesses. � .
�.
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