HomeMy WebLinkAbout01-23-07 (2)
,--
; EV~ 1500 EX (6~OO)
OFFICIAL USE ONLY
COMMONWEAL TH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG. PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
~L
COUNTY CODE
-9L l1~Q___
YEAR NUMBER
DECEDENTS NAME (LAST. FIRST. AND MIDDLE INITIAL)
Devlin Carol
DATE OF DEATH (MM~DD~YEAR) DATE OF BIRTH (MM-DD-YEAR)
A
SOCIAL SECURITY NUMBER
195-38-0174
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
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C
11/2/2006 7/31/1948
(IF APPLICABLE) SURVIVING SPOUSE.S NAME (LAST. FIRST. AND MIDDLE INITIAL)
Michael B. Devlin
[X] , Original Retum
D 4 Limited Estate
D 6 Decedent Died Testate (Attach copy of Will)
D 9 Litigation Proceeds Received
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
W
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164-38-8267
D 2. Supplemental Return D 3. Remainder Retum (date of deanl prior to 12~13~82)
D 4a. Future Interest Compromise (date of death after 12~12~82) D 5 Federal Estate Tax Return Required
D 7. Decedent Maintained a Living Trust (Attach copy of Trust) _ 8 Total Number of Safe Deposit Boxes
D 10. Spousal Poverty Credit (dal' of d'a1h b,'w"," '2~31~91 aod '~1~95) D 11 Election to tax under Sec 9113(A) (AII"hS,h 0)
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
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en
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Michael B. Devlin
FIRM NAME (If Applicable)
6 Stonehedge Way
Carlisle, PA 17015
TELEPHONE NUMBER
717-249-3414
1 Real Estate (Schedule A)
(1)
o
OFFICIAL USE ONLY
2. Stocks and Bonds (Schedule B)
(2)
o
f~l
c;::'~
c:::~
--'
'--
:::':".
~-,....
3 Closely Held Corporation. Partnership or Sole-Proprietorship (3)
4 Mortgages & Notes Receivable (Schedule D) (4)
5. Cash. Bank Deposits & Miscellaneous Personal Property
(Schedule E) (5)
Z 6. Jointly Ol'ffled Property (Schedule F) (6)
0 o Separate Billing Requested
i=
:s 7 Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
::> (Schedule G or L)
l-
ii: 8 Total Gross Assets (total Lines 1-7)
<(
()
UJ 9. Funeral Expenses & Administrative Costs (Schedule H) (9)
0::
10. Debts of Decedent. Mortgage Liabilities. & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
o
o
N
W
91,469
o
:!::'n
1,786,586
t..O
(...)
C)
1,878,055
(8)
24,759
692
(11)
(12)
(13)
(14)
25,451
1,852,604
10,388
13 Charitable and Governmental Bequests/Sec 9113 Trusts for -Mllch an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
1,842,216
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15 Amount of Line 14 taxable at the spousal tax 1,793,736 L(15)
z rate, or transfers under Sec. 9116 (a)(12) x .0
0
i= 16 Amount of Line 14 taxable at lineal rate 6,925 x .0 ~(16)
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I-
::> 0
a.. 17 Amount of Line 14 taxable at sibling rate x .12 (17)
:E
0 41,556
U 18 Amount of Line 14 taxable at collateral rate x 15 (18)
X
<( Tax Due
I- 19 (19)
o
312
o
20
D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
6,233
6,545
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
3W4645 1 000
Decedent's Complete Address:
I 8-TREET ADDRESS
'6 Stonehed e Wa
I CITY
Carlisle
STATE
PA
'" ==1
170~
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
6,545
o
o
327
3 Interest/Penalty if applicable
D Interest
E Penalty
Total Credits (A + B + C) (2)
327
o
o
Total Interest/Penalty (D + E) (3)
o
4. 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 (4)
o
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
6,218
A Enter the interest on the tax due. (5A)
o
B. Enter the total of Line 5 + 5A This is the BALANCE DUE. (5B)
Make Check to: REGISTER OF
6,218
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
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; or ... . . . . . . . . . . . . . . . . . . . . .
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? . . . . . . . . . . . . . . . . . . . . . . . . . . " D
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? D
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. [XJ 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.
Yes
No
~
~
[XJ
D
D
D
D
~
~
[Jg
Under penalties of perjury, I declare that I have exammed this return, Including accompanying schedules and statements, and to the best of my knowledge and belief, it IS true, correct and complete
Declaration of prep rer other an th personal representative IS based on afl information of which preparer has any knowledge
ISLE FOR FILING RETURN
6 Stonehedge Way
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
Carlisle, PA 17015
DATE
ADDRESS
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 99916 (a) (1.1) (i)J
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 PS 89116 (a) (1 1) (Ii)]
The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even If
the surviVing spouse is the only beneficiary
For dates of death on or after July 1. 2000
The tax rate imposed on the net value of transfers from a deceased child 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 PS 89116(a)(1.2)J
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 89116(12) [72 PS 9 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 PS 8 9116(a)(1. 3)]. A sibling IS defined, under Section 9102, as an
individual who has at least one parent In common Wlth the decedent, whether by blood or adoption
3W4646 1 000
REI(-1~08 EX + (6-98)
. .
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Carol A. Devlin
FILE NUMBER
21 06 1110
Include the proceeds of litigation and the date the proceeds were received by the estate
All property jointly-owned with the right of survivorship must be disclosed on Schedule F_
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1
1999 Toyota Avalon
7,150
2
American Home Bank - checking
9,229
3
Northwest Mutual - #5629301
CSV policy on surviving spouse
6,663
4
Northwestern Mutual # 5820210
CSV on surviving spouse
6,367
5
Northwestern Mutual # 6570450
CSV on surviving spouse
9,849
6
Northwestern Mutual # 6799906
CSV on surviving spouse
8,551
7
Northwestern Mutual # 6876259
CSV on surviving spouse
17,041
8
Northwestern Mutual # 7397774
CSV on surviving spouse
7,716
9
Northwestern Mutual # 8151624
CSV on surviving spouse
14,887
10
Northwestern Mutual # 8996001
CSV on surviving spouse
4,016
3W46AD 1 000
TOTAL fAlso enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
91,469
. .
REV-\S"0 EX. (6-98)
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Carol A. Devlin
FILE NUMBER
21 06 1110
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.
DESCRIPTON OF PROPERTY
ITEM It'ULOE HE NAME OF TI-E TRANSFEREE THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE
NUMBEF TI-E DATE OF TR.AJ\SFER ATTACH A COP'( OF THE DEED FOR REAL EST ATE VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1 Carol Devlin Revocable Trust
Residence (Wintergreen, VA) 850,000 100.0000 0 850,000
2 Carol Devlin Revocable Trust
Investments (see attached) 936,586 100.0000 0 936,586
TOT AL (Also enter on line 7, Recapitulation) $ 1,786 586
(If more space IS needed, Insert additional sheets of the same size)
3W46AF 1 000
REV.1511 EX + (12.99)
COMMONWEAL TH OF PENNSYL VANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Carol A. Devlin
FILE NUMBER
21 06 1110
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
DESCRIPTION
AMOUNT
A.
FUNERAL EXPENSES
1.
Cemetery lot
500
2
Funeral reception
4,325
Total from continuation schedules
13,304
B.
1.
ADMINISTRATIVE COSTS
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address
City
State
Zip
Year(s) Commission Paid
2. Attorney Fees
3.
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Michael Devlin
3,500
Street Address 6 Stonehedge Way
City Carlisle
State PA
Zip 17015
Relationship of Claimant to Decedent SPOUSE
4.
Probate Fees
630
5.
Accountant's Fees
2,500
6 Tax Return Preparer's Fees
7.
None
3W46AG 1.000
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$
24,759
Estate of: Carol A. Devlin
195-38-0174
Schedule H Part 1 (Page 2)
Item
No. Description
Amount
3 Grave Marker
1,000
4 Hoffman-Roth Funeral Horne
9,504
5 Travel - family members
2,800
Total (Carry forward to main schedule)
13,304
REV-~1::.12 EX + (12-03)
COMMONWEAL TH OF PENNSYL VANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Carol A. Devlin
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
21 06 1110
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
Community Life Team EMS
459
2
Medical expense
233
3W46AH 2 000
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
692
REV-1513 EX+ (9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Carol A. Devlin
NUMBER
I
1
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers
under Sec. 9116 (a) (1.2)J
Aimee Andyshak
3027 Tipperary Road
Northern Cambria, PA 15714
5.882% Residue: 3,463
2 Amber Andyshak
3027 Tipperary Road
Northern Cambria, PA 15714
5.882% Residue: 3,463
3 Ashley Andyshak
140 A Chambersburg Street
Gettysburg, PA 17325
5.882% Residue: 3,463
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
FILE NUMBER
21 06 1110
AMOUNT OR SHARE
OF ESTATE
Niece
Niece
Niece
3,463
3,463
3,463
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
1
2
3
4
B CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1
Todd Baird Lindsay Foundation
POBox 274, Carlisle, PA 17013
2
CARC - Project Share
5 N Orange St, Carlilse, PA 17013
3W46AI 1 000
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
(If more space IS needed, Insert additional sheets of the same size)
$
3,463
1,731
10,388
Estate of: Carol A. Devlin
195-38-0174
Schedule J Part 1 (Page 2)
Item
No. Description
Relation
Amount
4 Helen Andyshak
POBox 62
Heilwood, PA 15745
11.763% Residue: 6,925
Mother
6,925
5 Brandon Devlin
206 Hilltop Avenue
Garner, NC 27529
5.882% Residue: 3,463
Nephew
3,463
6 Colin Devlin
1112 Bynum Street
Wilson, NC 27893
5.882% Residue: 3,463
Nephew
3,463
7 Michael B. Devlin
6 Stonehedge Way
Carlisle, PA 17015
General Bequests: 1,793,736
Surviving Spouse
1,793,736
8 Lara Hayworth
1505 Debbs Lane
Chesapeake, VA 23320
5.882% Residue: 3,463
Niece
3,463
9 Chris Kaufman
8299 Clover Ridge Drive
Erie, PA 16509
5.882% Residue: 3,463
Nephew
3,463
10 Craig Kaufman
11813 Cherrywood Drive
Locust Grove, VA 22508
5.882% Residue: 3,463
Nephew
3,463
11 Matthew Kaufman
1310 S Mt Joy Street
Elizabethtown, PA 17022
5.882% Residue: 3,463
Nephew
3,463
Estate of: Carol A. Devlin
Item
No. Description
12 Mike Kaufman
5709 Timber Creek Drive
Erie, PA 16509
5.882% Residue: 3,463
13 Brett Milanese
201 Wakefield Drive
Charlotte, NC 28209
5.882% Residue: 3,463
14 Ryan Milanese
POBox 1845
Welcome, NC 27374
5.882% Residue: 3,463
Schedule J Part 1 (Page 3)
Nephew
Nephew
Niece
195-38-0174
Relation
Amount
3,463
3,463
3,463
Estate of: Carol A. Devlin
Item
No.
3
4
195-38-0174
Schedule J Part 2 (Page 2)
Description
Amount
St Jude's Childrens Researach
Hospital
501 St Jude PI, Memphis, TN 38105
1,731
St Patrick Church
140 E Pomfret St, Carlisle, PA
17013
3,463
AMERICAr~
H6MEBANkNA
Amencan Way Corporate Center
3840 Hempland Road
Mountville, PA 17554
Phone (717) 285-6400
(877) BANKAHB (226-5242)
CAROL A DEVLIN
6 STONEHEDGE WAY
CARLISLE PA 17015-9115
11111111111111111111111111111111111111111.1,11111111111111"II
www.bankahb.com
FrM
1
*** CHECKING *** MONEY MARKET BEGINNING
ACCOUNT NUMBER 0000102350
PREVIOUS STATEMENT BALANCE AS OF 10/20/06 ..... ... '" ......... ....
PLUS 1 DEPOSITS AND OTHER CREDITS .. ........... """
LESS 2 CHECKS AND OTHER DEBITS ..... ..... """'" ...
CURRENT STATEMENT BALANCE AS OF 11/20/06 .............. ...........
NUMBER OF DAYS IN THIS STATEMENT PERIOD 31
STATEMENT DATE
11/20/06
0000102350
ACCOUNT NO.
CYCLE-020
RATE 3.15000
!~~i:~
5.114.47
4.134.62
'\
*** CHECK TRANSACTIONS ***
SERIAL DATE AMOUNT 1
1016 11/15 1.276.92 I
DATE
-----------------------------------------------------------------------------------
AMOUNT
SERIAL
-----------------------------------------------------------------------------------
*** CHECKING ACCOUNT TRANSACTIONS ***
DATE DESCRIPTION
11/09 AC-CITICARD PAYMENT-CHECK PYMT
CK-0000I015
11/20 INTEREST PAYMENT
DEBITS l
3.837.55
CREDITS
20.06
*** BALANCE BY DATE ***
10/20 9.229.03 11/09
5.391.48 11/15
-----------------------------------------------------------------------------------
4.134.62
4.114.56 11/20
PAYER FEDERAL ID NUMBER.................
INTEREST PAID YEAR TO DATE..............
THIS STATEMENT OVERDRAFT CHARGES........
THIS STATEMENT RETURNED ITEM CHARGES....
YEAR TO DATE OVERDRAFT CHARGES..... .....
YEAR TO DATE RETURNED ITEM CHARGES......
23-3087841
690.20
.00
.00
.00
.00
----------------------------------------------------
*** INTEREST EARNED THIS STATEMENT PERIOD
DAYS IN PERIOD .........................
INTEREST EARNED ........................
ANNUAL PERCENTAGE YIELD EARNED (APY) ....
***
31
20.06
3.20%
- - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --
AS OF SEPTEMBER 1. 2006. AMERICAN HOME BANK WILL NO
LONGER BE OFFERING TELEPHONE BANKING. WE INVITE YOU TO
TRY OUR FREE ONLINE BANKING AT WWW.BANKAHB.COM.
TO REPORT A LOST OR STOLEN DEBIT CARD.
PLEASE CALL 1-800-523-4175.
NOTE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION
9N~M:ubW.
GORDON REi;:;TPJJ
r; 1"'::( irn(,:, f.,: f 1!n !Ic-n <~ F~ ppr;l'-:\l:-!1.ut:,,!(,
f\f-V~(\,'; (d-'; r O;"T~
f)~)li(:"/i..)l;'~T~l; :~::'(':!{:P"~ D('PU(~ii:C '"
January 16, :>001
Michael B Devlin
6 Stonehedge Way
Carlisle PAl 7013
RE Michael B Devlin Policies ~6:>9301 5820210 6)70450 6799906
6816259 7397774 8151624 89%001
Dear Mr. Devlin
Our condolences on the passing of your wife, Carol. As of November) lOOt), thi:
interpolated tenninal values of the policies listed above are:
Policy
5629301
5820210
6570450
6799906
6876259
7397774
8151624
8996001
Insured
Michael H D.:vlin
Michael 8 Devlin
Michael n Devlin
Michael B Ikvlin
Michael IS rkvlin
Michael IS Ikvlin
Michael IS Devlin
Michael IS D('vlin
Interpolated Ji:.rrn Res(~ve
$6,667.8{)
$6,367 'r>
$9,84R ':,(J
$8,550X';
$ I 7,0.109D
$1,116.-:1
$14,88696
$4,01~ j:j
While we are happy to provide this illfonnation for you, Northwestf:m i'Vi nllla! is not in R
position to advise you on tax matter~;. Voie feel it is important that Ollr poiicynwIlns
discuss these issu(:s with an attomey. accountant or the IRS.
Ifl can be of further assistance to you, please call me at (800) 388 8 r.n
Sincerely,
~ ~ei4ta4
Gordon Reistad
Enclosure: IRS 71) hJIms
cc Donald E Fa.dor, CLU. n 7-n8 6868
POBox 1751' HanishurgPA 11105 O()j'j'l"l4)
Tr12 Nonnwpstf'rn MutLJitl Liff' i I~,ur -'nCf> Con !jJitny I?D) OI';t \}J,~" ; 1(1<:,in !\Venue, MdW"tJkpe, Wisconsin I; ~7{J~J 414 7 ,r i, 1 11 l; 0'1 ~ ';~! u;u;
Carol Devlin T/A
CUSIP SECURITY # UNITS UNIT COST VALUE
04314H204 ARTISAN INTL FUND 1270.152 29.55 37,533
105320107 BRANDYWINE FUND 937.3 33.21 31,128
108747502 BRIDGEWA Y BLUE CHIP 35 IND 6274.04 7.93 49,753
220378EF6 CORRY PENN PA 3.25% 12/15/07 20000 99.64 19,928
23339C206 DWS EQUITY 500 INDEX 1001.382 155.05 155,264
23339E723 DWS SIT MUNIINSTL BD 1414.721 10.3 14,572
239080401 DAVIS NY VENTURE FD INC 1996.689 37.45 74,776
41014V869 JOHN HANCOCK SMALL CAP IND 979.244 12.52 12,260
411511306 HARBOR INTL FUND 421.05 60.16 25,330
45383QBFO INDEPENDENT BK 4.15% 7/31/07 20,000.0000 99.11 19,822
459200101 IBM COM 400 91.68 36,672
489645MP3 KENNETT SQ PA 3% 2/15/08 10,000.0000 99.12 9,912
548174CE9 LACKAWANNA PA SWR 3% 9/15/08 10,000.0000 98.86 9,886
55261F104 M & T BK CORP COM 68.0000 120.41 8,188
581291BZ3 MCKEAN CNTY PA 3.5% 11/1/11 20,000.0000 100.41 20,082
595679BU4 MIDDLE BUCKS PA 3.4% 2/15/09 20,000.0000 99.65 19,930
627196AVO MURRYSVILLE PA 3.55% 11/1/106 20,000.0000 100.52 20,103
687380105 ORRSTOWN FINL SVCS INC COM 235.0000 37.75 8,871
696420JL3 PALISADES PA 2.9% 9/1/2010 10,000.0000 96.81 9,681
721279EM5 PIKE CNTY PA 3.3% 10/01/2009 10,000.0000 99.18 9,918
857322V A6 PA ST PUB SCH 3% 11/01/10 10,000.0000 97.25 9,725
884116203 THIRD AVE SMALL CAP VALUE FD 2342.138 26.19 61,341
92204L203 VANGUARD PA TAX FREE 51,031.3300 1.00 51,031
92204L302 VANG PA TAX FREE L T ADMIRAL 3190.416 11.41 36,403
922908835 VANG MID CAP IDX INSTL 6465.659 19.22 124,270
922908876 VANGUARD SM CAP INDEX FD 592.534 31.48 18,653
94904P203 WEITZ VALUE FUND 788.471 40.24 31,728
959886CU4 W. WESTMORLAND PA 310/15/09 10,000.0000 98.26 9,826
936,586
SUMMARY OF SALIENT FEATURES
Subject Address 330 Deer Spnngs POint
Legal Description Lot 109 Deer Springs Section, Mountain SID 13-A, Wintergreen
City Wmtergreen
County Nelson
Stale VA
Zip Code 22958
Census Tracl 120086.9502 00
Map Relerence 16820
Sale Pnce I NJA
Date oj Sale NJA
Borrower Mike Devlin
Lender Mike Devlin
Size (Square Feet) 2,448
Price per Square Foot I
Location Wintergreen
Age 1
Condition Good
lotalRooms 8
Bedrooms 5
8aths 45
Appraiser Sean B. McCoy, RAA
Date 01 Appraised Value November 22, 2006
Final Estimate 01 Value $ 850,000
Form SSO - "WmTOTAl" appraisal soMware by a la mode, inc. - 1.800.AlAMODE
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REVOCABLE TRUST AGREEMENT
THE CAROL A. DEVLIN REVOCABLE TRUST
~
THIS AGREEMENT is made and entered into this 't8 day of January, 2004,
by and between CAROL A. DEVLIN, of South Middleton Township, Cumberland County,
Pennsylvania, as Settlor (the "Settlor"), and LETORT MANAGEMENT & TRUST COMPANY, a
Pennsylvania trust company with offices in Camp Hill, Pennsylvania, as Trustee (the "Trustee").
WIT N E SSE T H:
WHEREAS, the Settlor may be desirous in the future of placing the active
management and control of certain property in the hands of the Trustee.
NOW, THEREFORE, for and in consideration of their mutual covenants and
promises, the Settlor and Trustee agree as follows:
ARTICLE ONE
TRUST ASSETS
S1.1 The Settlor, or any other party or person, may from time to time make
policies of insurance on the Settlor's life, individual retirement account benefits, and/or qualified
or non-qualified retirement plan benefits payable to the Trustee, or may transfer assets to the
Trustee, subject to the terms of this Agreement, by inter vivos grant or by Will. The trust assets
shall include the proceeds of all insurance policies payable to the Trustee and all such other
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benefits or added assets (collectivelY the "Trust Assets"), which shall be held, administered,
distributed and governed by the Trustee, IN TRUST NEVERTHELESS, in accordance with the
provisions of this instrument and any amendments hereto.
92.1 During the Settlor's liletime, the Trustee shall have, hold, manage, invest
ARTICLE TWO
DURING THE SETTLOR'S LIFETIME
and reinvest the Trust Assets, collect the income, and
~2.1.1 The Trustee shall payor apply the entire net income as
the Settlor may from time to time direct. The Trustee shall also pay to the
Settlor such sums from or portions of the principal of the trust as the
Settlor may from time to time request from the Trustee during the
Settlor's lifetime.
~2.1.2 The Trustee shall pay and use such portion or all of the
income and principal of the Trust Assets as the Trustee, in the Trustee's
sole discretion, shall deem necessary from time to time to provide for the
proper maintenance, support, medical, hospital, nursing or nursing home
care of the Settlor and of the Settlor's husband, MICHAEL B. DEVLIN
(the "Settlor's Husband").
93.1 Upon the death 01 the Settlor, the Trustee shall divide and distribute the
ARTICLE THREE
UPON THE SETTLOR'S DEATH
balance of the Trust Assets as follows:
~3.1.1 _ If the Settlor's Husband survives the Settlor, the.
Trustee shall distribute the Trust Assets to the Settlor's Husband.
~3.1.2 If the Settlor's Husband does not survive the Settlor,
the Trustee shall distribute the Trust Assets to the then serving Trustee of
the Mike and Carol Devlin Charitable Trust created under the terms of the
Will of the survivor of the Settlor and the Settlor's Husband, if it is then in
existence, to be distributed under the terms thereof. If such Charitable
Trust is not then in existence, the Trustee shall distribute such assets to
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one or more organizations described in Section 2055(a) of the Internal
Revenue Code in such proportions as the Trustee shall select in the
Trustee's sole discretion, taking into consideration the charitable interests
of the Settlor reflected by any written memoranda and by the Settlor's
other charitable contributions.
ARTICLE FOUR
APPOINTMENT OF FIDUCIARIES
whatsoever, without court approval. If LETORT MANAGEMENT & TRUST COMPANY is
54.1 Any Trustee hereunder may resign at any time, for any reason
unable or unwilling to act or continue to act, for any reason whatsoever, the Selllor appoints the
Settlor's Husband, MICHAEL B. DEVLIN, as successor Trustee. If the Sellior's Husband Is
unable or unwilling to act or continue to act, for any reason whatsoever, such person(s) or
institution(s) as the Settlor's Husband shall designate in an inter vivos or testamentary writing
shall be appointed as successor Trustee.
94.2 AIi references herein to the "Trustee" shali mean the originaliy appointed
Trustee or the successor Trustee, as the case may be.
95.1 No fiduciary under this Agreement shali be required to give bond or other
ARTICLE FIVE
POWERS OF FIDUCIARIES
security for the faithful performance of the fiduciary's duties.
95.2 Any such fiduciary shali have the foliowing powers, in addition to those
given by law:
55.2.1 To invest in, accept and retain any real or personal
property, including stock of a corporate fiduciary or its holding company,
without restriction to legal investments;
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. .
95.2.2 To sell, exchange, partition or lease for any period of
time any real or personal property and to give options therefor for cash or
credit, with or without security;
95.2.3 To borrow money from any person including any
fiduciary acting hereunder, and to mortgage or pledge any real or
personal property;
95.2.4 To hold shares of stock or other securities in nominee
registration form, including that of a clearing corporation or depository, or
in book entry form or unregistered or in such other form as will pass by
delivery;
95.2.5 To make distributions in cash, or in kind at current
values, or partly in each, allocating specific assets to particular
distributees on a non-pro rata basis, and for such purposes to make
reasonable determinations of current values;
95.2.6 To terminate any trust created herein, the principal of
which is or becomes too small in the Trustee's discretion to make the
establishment or continuance of the trust advisable, and to make
immediate distribution of the then remaining trust property to the
beneficiary then entitled to the income of the trust property or, if there is
more than one beneficiary, to the beneficiaries then entitled to the income
of the trust property, in proportion to their respective interests therein or,
if such interests are not defined, in equal shares to such beneficiaries.
The receipts and releases of the distributees will terminate absolutely the
right of all persons who might otherwise have a future interest in the trust,
whether vested or contingent, without notice to them and without the
necessity of filing an account in any court;
95.2.7 To execute any agreement relating to the disposition or
redemption of any business interest that may be a part of the trust estate,
whether the same involves a proprietary interest, a partnership interest or
stock in a closely held corporation;
95.2.8 To operate or arrange for the operation of any
business interest held hereunder, and to join or become a party to, or to
oppose, any reorganization, readjustment, foreclosure, merger, voting
trust, dissolution, consolidation or exchange relating to any such business
interest;
~5.2.9 To engage in litigation and compromise, arbitrate or
abandon claims;
(AS07179}
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85.2.10 To determine the apportionment of receipts and
expenses, including extraordinary cash dividends, stock dividends,
capital-gain dividends of regulated investment companies and proceeds
and expenses of the sale of unproductive real estate, between income
and principal, such apportionment to be made so as to balance fairly the
interests of any income beneficiary and the remaindermen;
S5.2.11 To make elections, decisions, concessions and
settlements in connection with all income, estate, inheritance, gift or other
tax returns and the payment of such taxes, without obligation to adjust
the distributive share of income or principal of any person thereby
affected;
ARTICLE SIX
PROVISION FOR TAXES, DEBTS AND EXPENSES
expenses of her last illness, funeral, burial and administrative expenses of her estate and
86.1 The Trustee may pay any of the Settlor's legally enforceable debts, any
estate taxes, inheritance taxes, transfer taxes and other taxes of a similar nature payable by
reason of the Settlo~s death to any government or subdivision thereof upon or with respect to
any property subject to any such tax, and any penalties thereon, or any portion thereof, in the
Trustee's sole discretion, without reimbursement, out of the principal of that portion of Trust
Assets disposed of by of Article Three hereof.
ARTICLE SEVEN
REVOCABILITY
alter or revoke this instrument in whole or in part; provided, however, that the duties, powers,
S7.1 The Settlor may, by instrument in writing delivered to the Trustee, modify,
compensation and liability of the Trustee shall not be changed without the written consent of the
Trustee.
{A507179}
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the Internal Revenue Code of 1986, as amended from time to time, or the corresponding
98.1 As used in this Agreement, the term "Internal Revenue Code" shall mean
ARTICLE EIGHT
MISCELLANEOUS PROVISIONS
provision of subsequent law.
that it is impossible to determine which survived, it shall be conclusively presumed and this
98.2 If the Settlor's Husband and the Settlor die under such circumstances
Agreement shall be construed as if the Settlor's Husband had predeceased the Settlor.
benefit of any beneficiary who is under (a) twenty-five (25) years of age, or (b) a legal disability
98.3 Whenever the Trustee is directed to distribute property to or for the
or otherwise suffers from an illness or mental or physical disability that would make distribution
directly to such beneficiary Inappropriate (as determined in the Trustee's sole discretion
exercised in good faith), the Trustee may distribute such property to the person who has
custody of such beneficiary, may apply such property for the benefit of such beneficiary, may
distribute such property to a custodian for such beneficiary, whether then serving or selected
and appointed by the Trustee (including the Trustee), under any applicable Uniform Transfers
to Minors Act or Uniform Gifts to Minors Act, may distribute such property directly to such
beneficiary's estate, or may distribute such property directly to such beneficiary (except if any of
the conditions hereinbefore described in (b) apply), without liability on the part of the Trustee to
see to the application of such property. This provision shall not In any way operate to suspend
such beneficiary's absolute ownership of such property or to prevent the absolute vesting
thereof in such beneficiary.
(A507179}
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S8.4 Except as otherwise may be provided in this Agreement, during the
continuance of any of the trusts created hereunder and thereafter until the property is
distributed to and received by any beneficiary hereunder, the principal sums thus held in trust
for any beneficiary, respeciively, and the income thereof shall not be subject to or liable for any
contracts, debts, engagements, liabilities or torts of such beneficiary noW or hereafter made,
contracted, incurred or committed, but shall be absolutely free from the same, and such
beneficiary shall have no power to sell, assign or encumber all or any part of the principal sums
or such beneficiary's interest therein, respectivelY, or the income thereof, or to anticipate the
income.
S8.5 A corporate fiduciary shall be entitled to receive compensation for its
services hereunder in accordance with its schedule in effect when the services are performed,
but not in eXcess of such compensation as would be approved by a court of competent
jurisdiction. An individual fiduciary shall be entitled to receive reasonable compensation for
such fiduciary's services hereunder.
S8.6 This instrument and any trust created hereunder shall be governed by the
laws of Pennsylvania and shall have its situs in Cumberland County, Pennsylvania.
[THE BALANCE OF THIS PAGE HAS BEEN lEFT INTENTIONAllY BLANK]
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IN WITNESS WHEREOF, the Settlor and the Trustee have hereunto affixed their
hands and seals and/or caused this instrument to be duly executed on the date and year first
written above.
WITNESS:
SETTLOR:
c:JC:/'t>F#-'
/
C!-!lidt( (J) ~
Carol A.. Devlin ~
ATTEST:
TRUSTEE:
_~f,{)~
LETORT MANAGEMENT & TRUST
COMPANY
{A507179)
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THE CAROL A. DEVLIN REVOCABLE TRUST
SCHEDULE A
WITNESS:
SETTLOR:
/~~4
CLru# 0 ~
Carol A. Devlin
ATTEST:
TRUSTEE:
~r;o~
LETORT MANAGEMENT & TRUST
COMPANY
B~~~~~~
Title:
{A507179}
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COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF CUMBERLAND
On this, the )..6 ~ day of January, 2004, before me, a notary public, the
undersigned officer, personally appeared CAROL A. DEVLIN, known to me (or satisfactorily
proven) to be the person whose name is subscribed to the within instrument, and
acknowledged that she executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
(SEAL)
Notarial Seal d
Kathy J. Weidner, Notary Public
Carlisle Boro, Cumberland County
My Commission Expires June 28, 2005
Member, Pennsylvania Association ot Notanes
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COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF CUMBERLAND
On this Z~~ay of January, 2004, before me, a Notary Public, the
undersigned officer, personally appeared ~ y/~..5 J)/p rr>-1r-1J ,who acknowledged
himse /herself to e the {! ()O of LETORT MANAGEMENT & TRUST
COMPANY, and that he/she as such officer, being authorized to do so, executed the foregoing
instrument for the purposes therein contained by signing the name of said LETORT
MANAGEMENT & TRUST COMPANY by himsele9s such officer
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
~J-"~{)~
Notary P~ .' .....
My Commission Expires 'NOTARIAlSfAC/'
KATIE E. CLARf(f', NQTARYPlIBUG.
lOWER ALLEN 'TWp,CUMBERlANDCO.
MY COMMISSION EXPIRES NOV7 2005
(SEAL)
{A507179}
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COpy
AMENDMENT OF AGREEMENT OF TRUST
THIS AGREEMENT is made and executed this 31st day of October, 2006, by and
between CAROL A. DEVLIN, of South Middleton Township, Cumberland County, Pennsylvania,
as Settlor (the "Settlor"), and LETORT MANAGEMENT & TRUST COMPANY, a Pennsylvania
trust company with offices in Camp Hill, Pennsylvania, as Trustee (the "Trustee").
WIT N E SSE T H:
WHEREAS, the Settlor, as Settlor, and the Trustee, as Trustee, entered into an
Agreement of Trust dated January ,;{~'200,t(the "Trust Agreement"); and
WHEREAS, Article Seven of the Trust Agreement reserves to the Settlor the right to
modify, alter or revoke the Trust Agreement in whole or in part by instrument in writing delivered
to the Trustee.
NOW THEREFORE, the Settlor hereby amends the Trust Agreement to read as follows:
1. ARTICLE THREE of the Trust Agreement is hereby deleted and the following
new ARTICLE THREE is substituted therefore:
ARTICLE THREE
UPON THE SETTLOR'S DEATH
93.1 Upon the death of the Settlor, the Trustee shall divide and distribute the balance
of the Trust Assets as follows:
S3.1 ,1 If the Settlor's Husband survives the Settlor, the Trustee
shall distribute the Trust Assets to the Settlor's Husband.
(A857728: I)
S3.1.2 If the Settlor's Husband does not survive the Settlor, the
Trustee shall distribute the Trust Assets in equal shares to the following
of the Settlor's and the Settlor's Husband's nieces and nephews who
survive the Settlor:
S 3.1.2.1 Lara Hayworth;
S 3.1.2.2 Ryan Milanese;
S 3.1.2.3 Brett Milanese;
S 3.1.2.4 Brandon Devlin;
S 3.1.2.5 Colin Devlin;
9 3.1.2.6 Ashley Andyshak;
93.1.2.7 Amber Andyshak; f
93.1.2.8 Amie Andyshak;
\
93.1.2.9 Chris Kaufman; .~--
, '.
93.1.2.10 Craig Kaufman;
9 3.1.2.11 Matt Kaufman;
9 3.1.2.12 Mike Kaufman;
IN WITNESS WHEREOF, the Settlor and the Trustee have hereunto affixed their
hands and seals and/or caused this instrument to be duly executed on the date and year first
written above.
WITNESS:
SETTLOR:
~~~
caro~~ A^~~
ATTEST:
TRUSTEE:
fZfL 9PL--
LETORT MANAGEMENT & TRUST
COMPANY
B~~~~~~~'O~.-
Title: ..~~~
(A857728I }
. .
COMMONWEALTH OF PENNSYLVANIA
)
)
)
SS:
COUNTY OF DAUPHIN
On this, the 31 st day of October, 2006, before me, a notary public, the
undersigned officer, personally appeared CAROL A. DEVLIN, known to me (or satisfactorily
proven) to be the person whose name is subscribed to the within instrument, and
acknowledged that she executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
,
~ )-f. {kv.:.
Notary Public
My Commission Expires:
(SEAL)
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Marianne H. Acri, Notary Public
City of Harrisburg, Dauphln County
My Commission Expires June 10, 2010
(A8577281 )
< .
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF OAV'tffIN
)
)
)
SS:
.)JA- f
On this I day 0
Oc;hbu-
, 2006, before me, a Notary Public, the
undersigned officer, personally appeared G. fr\G4--tlt\ ~('hd~4'1e< , who acknowledged
himself/herself to be the f(u,'~+ of LETORT MANAGEMENT & TRUST
COMPANY, and that he/she as such officer, being authorized to do so, executed the foregoing
instrument for the purposes therein contained by signing the name of said LETORT
MANAGEMENT & TRUST COMPANY by himself/herself as such officer
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
~ 1-1. tf.uv,'
Notary Public
My Commission Expires:
(SEAL)
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Marianna H. Acrf, Notary Public
City of Harrisburg, Dauphln County
My Commission EXpIres June 10, 2010
(A857728! )
COMMONWEALTH OF PENNSYLVANIA
DEPAR, >'FNT OF REVENUE
· BUREAU [F INDIVIDUAL TAXES
DEPT 260601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
DEVLIN MICHAEL B
6 STONEHEDGE WAY
CARLISLE, PA 17015
-------- j'.Jld
ESTATE INFORMATION: SSN: 195-38-0174
FILE NUMBER: 2106-1110
DECEDENT NAME: DEVLIN CAROL A
DA TE OF PAYMENT: 01/23/2007
POSTMARK DATE: 01/23/2007
COUNTY: CUMBERLAND
DA TE OF DEATH: 11/02/2006
NO. CD 007729
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $ 6, 2 1 8.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 1671
SEAL
INITIALS: WZ
RECEIVED BY:
REGISTER OF WILLS
$ 6, 2 1 8.00
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS