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Home My WebLink About05-12-15� rt DECEDENT'S ESTATE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION C —� 1 ESTATE OF James R. Beistline , DECEASE`D 3 t No. 21-13-0442 PETITION FOR ADJUDICATION / STATEMENT OF PROPOSED DISTRIBUTION PURSUANT TO Pa. O.C. Rule 6.9 4 q , l0ga 13 !^J rn � r"n v- rn This form may be used in all cases involving the Audit of the Account of a Decedent's Estate. If space is insufficient, riders may be attached. Attach the spouse's election, if any; the papers required under items 8-19 inclusive; and any instrument pertinent to the adjudication. INCL UDE ATTACHMENTS AT THE BACK OF THIS FORM. Name of Counsel: Richard C. Snelbaker Supreme Court I.D. No.: 6355 Name of Law Firm: Snelbaker & Brenneman, P.C. Address: 44 West Main Street, Mechanicsburg, PA 17055 Telephone. 717-697-8528 Fax: 717-697-7681 Form OC -0/ rev. /0.!3.06 Page 1 of 10 Estate of James R. Beistline 1. Name(s) and address(es) of Petitioner(s): Name: Andrew Motter, Executor Address: 104 East Simpson Street Mechanicsburg, PA 17055 Identify any executors or administrators who have not joined in the Petition for Adjudication and Statement of Proposed Distribution and state reason: None Deceased Is this the first accounting by this fiduciary? ..................... 91 Yes F] No If not, identify prior accountings, the accounting periods covered, and the date of adjudication of the prior accounting. 2. Decedent died on 11/21/2012 R1 Letters Testamentary or [7 Letters of Administration were granted to Petitioner(s) on April 18. 2013 Date of Will (if applicable): 07/19/2012 Date(s) of Codicil(s) (if applicable): N/A Date of probate (if different from date Letters granted): same as above Was a bond required? E]Yes 0 No If yes, state amount: Are proofs of advertising of the grant of Letters attached? ......... 0 Yes El No Dates of advertising of the grant of Letters: Cumberland Law Journal, August 15, 22, 29, 2014, The Sentinel, August 17, 24, 31, 2014 Foran OC -01 rev. 10. 13.06 Page 2 of 10 Estate of James R. Beistline Deceased 3. Was decedent survived by a spouse? ............................. 0 Yes [:1 No If yes, name of the surviving spouse: Barbara S. Beistline 4. Has the surviving spouse filed to take an elective share? ............. DYes ✓' No (See Section 2201 et se of the Probate, Estates and Fiduciaries Code) If yes, date of election: 5. In the case of an intestacy, state the names of the decedent's surviving children or surviving issue of deceased children (if none, so state): N/A 6. Did decedent marry after execution of Will or Codicil(s)? ........... 0 Yes 0 No Were any children born to decedent after execution of Will or Codicil(s)?........................................... El Yes Qo N If yes, give names and dates of birth: Name: Date of Birth: 7. If required by the Medical Assistance Estate Recovery Act, 62 P.S. § 1412, was a request for a statement of claim sent to the Department of Public Welfare? .............................. .Yes 0 No Form OC -01 rev. 10, 13.06 Page 3 of 10 Estate of James R. Beistline Deceased Written notice of the Audit as required by Pa. O.C. Rules 6.3, 6.7 and 6.8 has been or will be given to all parties in interest listed in item 9 below, all unpaid creditors and all claimants listed in item 10 below. In addition, notice of any questions requiring Adjudication as discussed in item 14 below has been or will be given to all persons affected thereby. A. If Notice has been given, attach a copy of the Notice as well as a list of the names and addresses of the parties receiving such Notice. B. If Notice is yet to be given, a copy of the Notice as well as a list of the names and addresses of the parties receiving such Notice shall be submitted at the Audit together with a statement executed by a Petitioner or counsel certifying that such notice has been given. C. If any person entitled to Notice is not sui juris (e.g., minors or incapacitated persons), Notice of the Audit has been or will be given to the appropriate representative on such party's behalf as required by Pa. O.C. Rule 5.2. D. If any charitable interest is involved, Notice of the Audit has been or will also be given to the Attorney General as required under Pa. O.C. Rule 5.5. In addition, the Attorney General's clearance certificate (or proof of service of Notice and a copy of such Notice) must be submitted herewith or at the Audit. 9. List all parties (charitable and non -charitable) of whom Petitioner(s) has/have notice or knowledge, having or claiming any interest in the estate as beneficiaries under the Will or Codicil(s) or as intestate heirs if there is a complete or partial intestacy: A. State each party's relationship to the decedent and the nature of each party's interest(s): Name and Address of Each Party in Interest I Relationship and Estate of Barbara S. Beistline C/O Andrew Motter, Executor 104 East Simpson Street Mechanicsburg, PA 17055 Surviving Spouse (Barbara died on 3/22/2013) 100% Interest Form OC -0I rev. 10.13.06 Page 4 of 10 Estate of James R. Beistline Deceased B. Identify each party who is not sui juris (e.g., minors or incapacitated persons). For each such party, give date of birth, the name of each Guardian and how each Guardian was appointed. If no Guardian has been appointed, identify the next of kin of such party, giving the name, address and relationship of each. N/A C. State why a Petition for Guardian/Trustee Ad Litem has or has not been filed for this Audit (see Pa. O. C. Rule 12.4). D. If distribution is to be made to the personal representative of a deceased party, state date of death, date and place of grant of Letters and type of Letters granted. Estate of Barbara S. Beistline, date of death 3/22/2013, Letters Testamentary granted on April 18, 2013 by the Cumberland County Register of Wills to Andrew Motter, Executor Form OC -01 rev. /0. 13.06 Page 5 of 10 Estate of James R. Beistline , Deceased 10. Other than the claim for the family exemption, list the names of all known claimants and the amount of their claims and state whether each claim is admitted. Name and Address of Each Claimant Amount of Claim Claim Will Claim Admitted? Be Paid In Full? Andrew Motter 6,576.71 Oyes Ej Yes 104 East Simpson Street ONo 0 No Mechanicsburg, PA 17055 PSECU, Attention: Collection 12,331.01 Wes ONo El Yes ONo Department/Account Services 1 Credit Union Place Harrisburg, PA 17110 E]Yes El Yes ONo O No DYes 0 Yes ONo El No If the estate is insolvent, attach a schedule setting forth the order of preference under 20 Pa.C.S. § 3392 and the proposed payments. 11. Was family exemption claimed? ................................ DYes O✓. No Was family exemption allowed? ................................ MYes ONo Family exemption claimant's name and relationship: Name: Form OC -01 rev. 10. 13.06 Relationship: Page 6 of 10 Estate of James R. Beistline Deceased 12. The amount of Pennsylvania Transfer Inheritance Tax and additional Pennsylvania Estate Tax paid, the date(s) of payment(s), and the interest(s) upon which paid, are as follows: Date Payment Interest $0.00 - Insolvent Estate 13. On the date of death, was the decedent a fiduciary (personal representative, trustee, guardian, agent under power of attorney) or surety on the bond of a fiduciary? ................... Yes 2 No If yes, provide the name of the estate, indicate whether an account has been filed and confirmed absolutely and all awards performed, or, in the alternative, how the decedent's estate will be discharged for the decedent's fiduciary administration of the estate. 14. A. Describe in detail any questions requiring adjudication and state the position of the Petitioner(s) as to each question: N/A B. Has notice of the question requiring adjudication been given to the parties identified in Paragraph 9 above? .................. 0 Yes 0 No 15. If Petitioner(s) has/have knowledge that a share has been assigned, renounced, disclaimed or attached, provide a copy of the assignment, renunciation, disclaimer or attachment, together with any relevant supporting documentation. Form OC -0I rev. /0. 13.06 Page 7 of 10 Estate of James R. Beistline Deceased 16. Had the decedent been adjudicated an incapacitated person. M Yes 0 No If yes, attach a copy of the Order if available; otherwise state the Court, term, number, date, and name of Hearing Judge. 17. A. List or attach a separate list of additional receipts and disbursements since the closing date of the Account. None B. Has notice of the additional receipts and disbursements been given to the parties identified in Paragraph 9 above? ............. 0 Yes 0 No 18. If a reserve is requested, state amount and purpose. Amount: 222.38 Purpose: Filing fees for Final Accounting and certified mail costs If a reserve is requested for counsel fees, has notice of the amount of fees to be paid from the reserve been given to the parties in interest? ........................................ {]Yes No If so, attach a copy of the notice. 19. Is the Court being asked to direct the filing of a Schedule of Distribution? .......................... E]Yes ONo As to real estate only? ........................................ DYes ❑✓ No Form OC -01 rev. 10. 13.06 Page 8 of 10 Estate of James R. Beistline Deceased Wherefore, your Petitioner(s) ask(s) that distribution be awarded to the parties entitled and suggest(s) that the distributive shares of income and principal (residuary shares being stated in proportions, not amounts) are as follows: A. Income: Proposed Disiributee(s) See Accounting B. Principal: Proposed Distributee(s) See Accounting Amount/Proportion Amount/Proportion Submitted By: (All petitioners must sign. Add additional lines if necessary): /L Of'�' Name of Petitioner: Andrew Motter, Executor Name of Petitioner: Form oc-ni rev. /0. 13.06 Page 9 of 10 Estate of James R. Beistline Verification of Petitioner (Verification must be by at least one petitioner.) Deceased The undersigned hereby verifies X [that hel.she he is li,1e Executor of the above-named name of corporalia, Estate of James R. Beistline and] that the facts set forth in the foregoing Petition for Adjudication / Statement of Proposed Distribution which are within the personal knowledge of the Petitioner are true, and as to facts based on the information of others, the Petitioner, after diligent inquiry, believes them to be true; and that any false statements herein are made subject to the penalties of 18 Pa. C.S. § 4904 (relating to unsworn falsification to authorities). * Corporate petitioners must complete bracketed information. Certification of Counsel The undersigned counsel hereby certifies that the foregoing Petition for Adjudication/ Statement of Proposed Distribution is a true and accurate reproduction of the form Petition authorized by the Supreme Court, and that no changes to the form have been made beyond the responses herein. Form OC -01 rev. 10. 13.06 Signature of Counsel for Petitioner Page 10 of 10 PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16, 1929), P. L.1784 COMMONWEALTH OF PENNSYLVANIA : ss. COUNTY OF CUMBERLAND Lisa Marie Coyne, Esquire, Editor of the Cumberland Law Journal, of the County and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid, was established January 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly issued weekly in the said County, and that the printed notice or publication attached hereto is exactly the same as was printed in the regular editions and issues of the said Cumberland Law Journal on the following dates, viz: August 15, August 22 and August 29, 2014 Affiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. Beistline, James R., dec'd. Late of Mechanicsburg Borough. Executor: Andrew Metter, 104 East Simpson Street, Mechanics- burg, PA 17055. Attorneys: Snelbaker & Brenne- man P.(,., 44 West Main Street, P.O. Box 318, Mechanicsburg, PA 17055--0318. Alvv ULisa Marie Coyne, Editor SWORN TO AND SUBSCRIBED before me this 29 day of August, 2014 Notary COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL DEBORAH A COLLINS Notary Public CARLISLE BORO., CUMBERLAND) :CNTY My Commission Expires Apr 28, 2018 PROOF OF PUBLICATION State of Pennsylvania, County of Cumberland Cathy Clark., Advertising Director, of The Sentinel, of the County and State aforesaid, being duly sworn, deposes and says that THE SENTINEL, a newspaper of general circulation in the Borough of Carlisle, County and State aforesaid, was established December 13th, 1881, since which date THE SENTINEL has been regularly issued in said County, and that the printed notice or publication attached hereto is exactly the same as was printed and published in the regular editions and issues of August 17, 2014 and August 24, 2014 and August 31, 2014. COPY OF NOTICE -OF PUBLICATION EXECUTOR'S NOTICE Letters Testamentary on the Estate of JAMES R. BEISTLINE deceased, late of the Borough of Mechanicsburg, Cumberland County, Pennsylvania, have ben'grantLdto the urfdersigned. All persons. knowing ifiernselves to be indebted to said Estate will make Payment immediately, and those having claims will present them for settlement to: Andrew Molter 104 East Simpson Street Mechanicsburg,. PA 17055 Executor SNELBAKER A BRENNEMAN. P.C. 44 West Main Street P.O. Box 31.8 . Mechanicsburg; PA 17055-0318 Attorneys Affiant further deposes that he/she is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statement as to time, place and character of publication are true. Sworn to and subscribed before me this 4 QCs % (au ci. &nimlyc 'La -- A Nota tJy Public My commission expires: INANIA r p7t'ariai SeEll Betbany P -q. Hoitry NO-UIrY Public CZ;J;sie B01-01 CUIrberlanri counW My ComriSSIOLExVims Se". 26, 20 1 5 f,�S•PdIP C-jjj Cc IIE S •� pennsylvania DEPARTMENT OF PUBLIC WELFARE April 24, 2013 SNELBAKER & BRENNEMAN P C RICHARD C SNELBAKER ESQUIRE 44 W MAIN ST MECHANICSBURG PA 17055 Re: James Beistline SSN: ###-##-1541 Dear Attorney Snelbaker: Pursuant to your letter dated April 09, 2013, the Department's, Estate Recovery Program, has reviewed'the information you provided regarding the above -referenced individual. It has been determined that this individual did not receive any type of assistance during the questioned period. Therefore, according to the information you provided, the Department's Estate Recovery Program will not seek any recovery from this estate. If your client applied for Medical Assistance and had an application and/or hearing pending at the time of death, please advise us and provide any additional information that may affect a recovery by our Department. Thank you for your cooperation in this matter. If you have any questions, please contact me. Sincerely Vince A. Porter Recovery Section Manager (717)772-6604 Bureau of Program Integrity I Division of Third Party Liability I Recovery Section PO Box 8486 1 Harrisburg, Pennsylvania 17105-8486 KEITH O. BRENNEMAN RICHARD C. SNELBAKER- OF COUNSEL SNELBAKER 8 BRENNEMAN, P.C. A PROFESSIONAL CORPORATION ATTORNEYS AT LAW 44 WEST MAIN STREET MECHANICSBURG, PENNSYLVANIA 17055 717-697-8528 May 12, 2015 P. O. BOX 318 FACSIMILE (717) 697-7681 TO: PSECU Attention: Collection Department/Account Services 1 Credit Union Place Harrisburg, PA 17110 {Certified Mail No. 7010 1670 0001 0650 33571 Andrew Motter 104 East Simpson Street Mechanicsburg, PA 17055 Estate of Barbara S. Beistline C/O Andrew Motter, Executor 104 East Simpson Street Mechanicsburg, PA 17055 Re: Estate of .James R. Beistline, Deceased Estate No. 21-13-0442 NOTICE `I'O PARTIES IN INTEREST The undersigned, as Attorney for Andrew Motter, Executor of the Estate and under the Last Will and Testament of James R. Beistline, Deceased, hereby gives notice to each of the above named persons pursuant to Rule 6.3 of the Pennsylvania Supreme Court Orphans' Court rules as follows: 1. He has filed this date in the office of the Clerk of Orphans' Court and Register of Wills of Cumberland County, Pennsylvania, at Carlisle, PA, the First and Final Account of his administrationn as such Executor and the Petition for Adjudication, true copies of which are enclosed herewith. SNELBAKER 8 BRENNEMAN, P.C. Estate of James R. Beistline, Deceased May 12, 2015 Page 2 2. Said Account will be presented to a judge of the Orphans' Court Division of the Cumberland County Court. of Common Pleas at the Cumberland County Court House, 1 Court House Square, Carlisle, PA 17013, on June 16, 2015 at 9:30 o'clock A.M., prevailing time, at which time said Account will be confirmed unless written objections are filed prior thereto. 3. You have the right to file written objections to said Account prior to the confirmation as scheduled above. Very truly yours, 9'(��"'Snelbaker Ri h RCS:sks Enclosures 20 Pa. C.S.A. Sec. 3392 §3392. Classification and order of payment. If the applicable assets of the estate are insufficient to pay all proper charges and claims in full, the personal representative, subject to any preference given by law to claims due the United States, shall pay them in the following order, without priority as between claims of the same class: (1) The costs of administration. (2) The family exemption. (3) The costs of the decedent's funeral and burial, and the costs of medicines furnished to him within six months of his death, of medical or nursing services performed for him within that time, of hospital services including maintenance provided him within that time, of services provided under the saedical assistance program provided within that time and of services performed for him by any of his employees within that time. (4) The cost of a gravemarker. (5) Rents for the occupancy of the decedent's residence for six months immediately prior to his death. (5.1) Claims by the Commonwealth and the political subdivisions of the Commonwealth. (6) All other claims. (Feb. 21, 2006, P.L.45, No.17, eff. imd.) 2006 Amendment. Section 2 of Act 17 provided that Act 17 shall apply to the estate of a decedent who dies on or after the effective date of Act 17. Cross References. Section 3392 is referred to in section 7755 of this title. LAW OFFICES SNELBAKER & BRENNEMAN, P.C. � N,16q, i3 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA. ORPHANS' COURT DIVISION FILE NO: 21-13-0442 FIRST AND FINAL ACCOUNT OF Andrew Motter, Executor For ESTATE OF JAMES R. BEISTLINE Social Security #: Tax ID #: Date of Death: Date of Incapacity, if any: Date of Executor Appointment: Date of First Complete Advertisement: Accounting for the period: 198-30-1541 90-6241227 November 21, 2012 None April 18, 2013 August 15, 2014 November 21, 2012 May 1, 2015 Purpose of Account: Andrew Motter,. Executor offers this Account to acquaint interested parties with the transactions that have occurred during his Administration. It is important that the Account be carefully examined. Requests for additional information, questions or objections can be discussed with: Richard C. Snelbaker Snelbaker & Brenneman, P.C. 44 West Main Street Mechanicsburg, PA 17055 Phone #: 717-697-8528 Supreme Court I.D. No: 06355 Page 1 o M c7. ) CO � SUMMARY OF ACCOUNT PRINCIPAL | |Receipts NM 3 Less Disbursements/Claimspaid or tobapaid upon confirmation of account: 4 $4]3 Class (1)Claims: 3 $4.104.13 Balance before Distributions Class (2)Claims 3 $0.00 4 Class (3)Claims 3 $0.00 Class (4) Claims 3 $0.00 Listing of Unpaid Creditors Class (5)Claims 3 $0.00 5 Class (5.1)Claims 3 $0.08 Class (6) Claims 4 Balance before Distributions � Distributions hoBeneficiaries 4 � Principal Balance nnHand For Information: Investments Made 4 Changes in Holdings 4 HW*]NFZ Receipts 4 $4]3 Less Disbursements 4 Balance before Distributions Distributions baBeneficiaries 4 Income Balance onHand ' COMBINED BALANCE DNHAND Listing of Unpaid Creditors 5 Listing ofPersons Interested inDistribution 5 Estate Affidavit Page LAW OFFICES swsLo^xsn& BRENNEMAN, P.C. 1.1 LAW OFFICES SNELBAKER & BRENNEMAN, P.C. PRINCIPAL RECEIPTS Assets Listed on Inventory per copy attached: $4,100.00 (Valued as of Date of Death) ADJUSTMENTS TO INVENTORY 0.00 SUBSEQUENT RECEIPTS 0.00 TOTAL PRINCIPAL RECEIPTS $4,100.00 DISBURSEMENTS OF PRINCIPAL There are insufficient funds to pay all claimants/creditors; therefore the proposed payments and disbursements are based upon the parameters as provided in 20 Pa.C.S.A. § 3392 CLASS (1) CLAIMS - COSTS OF ADMINISTRATION The following items are to be paid upon confirmation of the accounting: "** Snelbaker & Brenneman, P.C., costs advanced 440.90 a. Register of Wills, probate fee 113.50 b. Register of Wills, short certificates 15.00 c. The Sentinel, advertising Executor's Notice 222.40 d. Cumberland Law Journal, advertising 75.00 Executor's Notice e. Register of Wills, additional probate fee 15.00 *" Snelbaker & Brenneman, P.C., attorney fees 1,100.00 "* * Andrew Motter, partial payment for balance of secured auto loan 2,340.85 paid with personal funds to PSECU in the amount of $6,576.71 Reserve for filing fees for Final Accounting and 222.38 certified mail costs TOTAL CLASS (1) CLAIMS TO BE PAID: $ 4,104.13 CLASS (2) CLAIMS - FAMILY EXEMPTION NONE $0.00 CLASS (3) CLAIMS - COST OF FUNERAL AND BURIAL AND THE COSTS OF MEDICINES FURNISHED WITHIN SIX MONTHS OF DEATH NONE $0.00 CLASS (4) CLAIMS - COSTS OF GRAVE MARKER NONE CLASS (5) CLAIMS - RENTS FOR OCCUPANCY OF THE DECEDENT'S RESIDENCE NONE $0.00 CLASS (5.1) CLAIMS - CLAIMS BY THE COMMONWEALTH AND THE POLITICAL SUBDIVISIONS OF THE COMMONWEALTH NONE $0.00 Page 3 LAW OFFICES SNELBAKER & BRENNEMAN, P.C. CLASS (6) CLAIMS - ALL OTHER CLAIMS PSECU, unsecured loan ending in #821-1 in the amount $0.00 of $12,331.01, which will not be paid due to insufficient funds DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES NONE $0.00 PRINCIPAL BALANCE ON HAND Cash Automobile Less expenses to be paid subsequent to confirmation of First and Final Account as as listed on page 3 & 4 of accounting TOTAL PRINCIPAL BALANCE ON HAND INFORMATION SCHEDULES PRINCIPAL INVESTMENTS MADE NONE NONE CHANGES IN PRINCIPAL HOLDINGS RECEIPTS OF INCOME FIDUCIARY VALUE AT ACQUISITION 5/1/2015 VALUE $ 4,104.13 $0.00 $0.00 $ 4,100.00 $ (4,104.13) $0.00 $ 4,100.00 $0.00 $0.00 3/27/2015 Belco Community Credit Union, interest on estate checking account $ 4.13 $ 4.13 DISBURSEMENTS OF INCOME NONE $0.00 DISBURSEMENTS OF INCOME TO BENEFICIARIES NONE Page 4 Ma LAW OFFICES SNELBAKER & BRENNEMAN, P.C. * UNPAID CREDITORS: 1. Andrew Motter 104 East Simpson Street Mechanicsburg, PA 17055 Class 1 claim for balance of unpaid secured auto loan $ 4,235.86 2. PSECU Attention: Collection Department / Account Services 1 Credit Union Place Harrisburg, PA 17110 Class 6 claim for unsecured loan ending in #82L1 $ 12,331.01 ** PERSONS INTERESTED IN DISTRIBUTION OF ESTATE: 1. Estate of Barbara S. Beistline C/O Andrew Motter, Executor 104 East Simpson Street Mechanicsburg, PA 17055 Page 5 $0.00 LAW OFFICES SNELBAKER & BRENNEMAN, P.C. COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF CUMBERLAND SS. Andrew Motter, being duly sworn according to law deposes and says: that he is the Executor of the Estate of James R. Beistline, Deceased; that he is the Accountant herein; that the foregoing is a true and complete accounting of his administration of said Estate; that the attached list or or schedule [*] contains the names, addresses,and amounts due unpaid creditors who have given proper notice of their claims; that the attached list or schedule [" ] contains the names and addresses of all persons interested in the distribution of said Estate; and that the facts set forth herein are true and correct to th best of his knowledge, information and belief. Andrew Motter, Executor Sworn to and subscribed before me this I J - day of Vk0/ 2015 COMMONWEALTH OF PENNSYLVANIA Notarial Seal Sandra K. Showers, Notary Public Mechanicsburg Boro, Cumberland County My Commission bivires Nov. 22, 2015 MEMBER; FENMYLVANLA ASSOaAlION OF NOTARI Page 6 COPY AMENDED INVENTORY REGISTER OF WILLS OF Cumberland COMMONWEALTH OF PENNSYLVANIA 1 SS COUNTY OF Cumberland J Andrew Motter, Executor COUNTY, PENNSYLVANIA File Number 21-13-0442 Personal Representative(s) of the Estate of James R. Beistline deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the personal assets wherever situate and all ofthe real estate 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, d that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorand at the end of this inventory. j ^I r ' verify that the statements made in this Inven- tory are true and correct. I understand that false state- ments herein are made subject to the penalties of Andrew Motter., Executor 18 Pa.C.S. § 4904 relating to unsworn falsification to -I_U4 Tast Simpson 5tree authorities. Mechanicsburg, PA 17055 Attorney -- (Name) Richard C. Snelbaker (Supreme C(nrrt LD. No.) 6355 (Address) Snelbaker & Brenneman, P.C., 44 West Main Street, Mechanicsburg, PA 17055 (Telephone) 717-697-8528 DATE OF DEATH LAST RESIDENCE I DECEDENT'S SOC. SEC. NO. 1 1/21/2012 1 55 East Main Street, Mechanicsburg Boro.,Mechanicsburg, PA 17055 198-30-1541 FIGURES MUST BE TOTALED 1. 2000 Lincoln Towncar, sale value (Attach additional streets as needed) 4,100.00 TOTAL: 1 4,100.00 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative include the value of each item, but such figures should not be extended into the total of the Inventory. (See 20 Pa. C.S. § 330/(6)) Form RPF -09 rev. 10. 13.06 C i_L. •c:3_ il- _ (Attach additional streets as needed) 4,100.00 TOTAL: 1 4,100.00 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative include the value of each item, but such figures should not be extended into the total of the Inventory. (See 20 Pa. C.S. § 330/(6)) Form RPF -09 rev. 10. 13.06