Darryl, again I am not able to reproduce the issue. I've placed couple points all over the world in RD_New projection. Saved it as layer package. Open default map, opened layer package and notes are placed exactly where they suppose to be. If you do precise placement (zoomed pretty closely), you'd need to go to the same extent to see exact placement for notes. If you zoomed out a little bit, graphics on screen (especially pushpins) may seem to be offset a little bit.