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Home My WebLink About97-00121 PETITION H)R PIWIlA 1'1<: llnd GRANT OF LETTERS 01/- _9'7. -l~' J:.:f/a/(' of ..__.._.1\nnIL.G. _W<lgn<.'r also k I/O WI! as _.__.. . No. ')1': ,,-__._..._.____.__. Register of Wilh for the .--------~..-- ....-.. /)(,(,(,lIsed. ('"unty ofCumbeJ::~.ancL_.. in the Social S(,cllrlty No.._l.89,,,,-0,9~0.3.6.4_._..____._ Conllnonweulth of Pennsylvunla The petition of the undersigued respeclfully represents tlllll: Your petitioncrlXl, who is/,lIo<lR year\ of age g oldll al! II\e6xecuL9..L.._._..__.._.___ n~ed in the last will of the ahove decI'denl. dated ~___S.~.9._ et...___..___._____.___....____._.___, 19~ and eodlcll(s) duted _._.._...._[\Qfllf_ .._.......__~________.~.__.__,_________..__._~_ Husj:lan..!iL!l~!"es_:L..:=-lIa.5J.!~~y:::~}io ...I:I-'!-s Jiixec-S!tor-;-aIect !:I_aY~~!::I!::I~" hHUl' rdC~'ill\t dn.'1Ull\lIlnl\1:i, (.'.~, fl'lIum:iutirm, death Illl'\C\:ulor, etc,) Cumberland Decendclll was domiciled at death in !:1E~r A~1~.!!_TW1_I'J...I...._.._ ~ounty, Pennsylvania, Wllh h.e.L_ last family or principlIl residence at ...lOQ.....Mt ,.._L.~n Dq, ve .___. Mechanicsl2lil:~ PA 17 P 5 5 (I1~l ~lrl'C"I, numher and mlllll,:ipllliIY) Deeendent. then -1Q_._ years of age, died __!?,anuarY_12 . 1997_, at--East_b.nns.l:l.or.Q...'r.Q.\ms.hip--<.-.C~9untv , P.:-. .. Escept a.s folloll's, lkcedenl did nOI marry. was notllivorced and did not have a child born or adopted uftcr esecution of Ihe will ofl'eT~i1 for probute; was not the victim of a ~iIling and was never adjudicated incompetent: ___..-N.olla,__ Deccndcnl at death owned property with estimated values as follows: (If domiciled in I'u.) All personal property (If not domiciled in I'a;) Personal property in Pennsylvania (If not domicilcd in Pa.) Personal property in County Vulue l,f renll,;'sunc in P('nnsyl\'ania situatcd as follows: _ 83,000.00 $ $ $ $. ( WHEREFORE. petitionerl'IJ respectfully request(s) the probate of the last will llOO<~ presenled herewith and the grant of Ietlers Testamentary IIll'rOIl. 11C\lamCmuw adminl\lr,lliol1 ~'.l.a.; adminislratlon d.b,n,c.1.0,) PNC BANK, N.A. , ~ ~'""' " .:.. , .. :a:; := ~r. -.< .. ". Z::: " .. :s ': -l~~;;r' '-'--( Vice- Pr~sicjeni::& Trust Officer ..PJi~aM.k~14 ..A2.42. r" r 1 i.s.l.e. Pi k" PO Rcw 308 Camp ~ilL_YA .17061-0308 ~j '-7-- . ---_..~_.__. .-. ---,---~-.._- OATH Of- PERSONAL REPRESENTATIVE COMMONWEAI.TU OF PENNSYl.VANIA I 'S COl:NH OF SLJ!I?~~.~~_~!2.........____ f:;' lilt' pl'lition~rtl1 ab<l'c.narlled ,I<eurls) or affirm(sl thut tile statements in the foregoing petition are tl'lll..' atlllI.:Orr~l'l 10 till' Ill':--I ullbe ~llow1l'dgL' anu belkf of petilinl1cr(14 anu thaI as personal represen4 tUIlVl'Q() ,)1' [he abo\'l' dCL'l'dCllt pL'lil1DI1Cr(,,) will well and truly administer the estate according to low. Swnl'll In or arnrllll'u and hcl'orc 1l1c' Ill" . 6th r'eb- . ._a mo:-,-"Q'C::Z~~;" ,.. '. . R~ P I) ~1, f^,t", 15" ../57" I::i.. .,uh~cribl'd __ da\ nf IY.97_ I ~~i"'<&4------_._- ~ ~ \;ffe~ !'.i:~iI(reii.f'~T_;-_uiI.t_o rn ci r I f't'!c;_ !3C\DK,_t't.I\_.________ ~ l .--_.______. 3: N('l!.is{cf' No. 21-97-121 Estate of _ , Deceased Anna G. ....II'i:L<Ul8r DECREE 010' PROBATE AND GRANT OF LETTERS AND NOW ______~EB._~__.____l9_..~J_., in consideralion of the petition on the reverse side hereof, satisfactory proof having been presented before Ole, IT IS DECREED that the instrument(,) daled_.______OctoQIi'r 10 , 1994 deserihed therein be admitted to probate and flied or record as the last will of -- Anna G-,~~ner 'restamentarv and Letters are hereby granted to . - !~ Bank, N.A. ------....----- . ~I\~.i.~~~- fi 1 ke~Is"r-;;-r WIII'/:i...-l!8, ~ ,~.r\ FEES Probate, Letters, Etc. ,. . .."" $ 200.09... Short Certlficate3( )... $-!i-..Q.O... Renunciation ...".,........, $ K'-pages . ____ $ 21.00 JCP TOTAL _ L23~:88 Flied .".,... rJ::~, . .7 1.19n.. . . .. .. . .. James D. Bogar, Esquire 19475 . .~ TTORNEY ([Jur', Ct. ;, D. No,) 1 W, Main St.. Shiremanstown, PA 1701 ADDRESS (717) 737-8761 PHONE ~~ ~ :0::0 'l'~ cr ~U.Q (~ ..,., :.\1 \':' 83 , .. I . ('I 0'1 ...-': (~- , c' 31 :.':/ . , ,'f) . (,; N 15 So ;g~ 0 ...J . l \ mc4~~ t.\lw, h, Bc,,J. -;;1, - Je JJ? !!' '! II' , , 1:1 ' I':' i" ':1 ' , , , ' ; 1\ I 'i," 'I , 'i ::,':III! III ! I" 1 i ',::: I : : (! i i Ii; d' j i I II ' :' "I I I ,i 1 ) I 1 ; i :' J I 1'1, ," " 'II i'III,I';l :,1,1' ,t" ' i I I I, F II I I "1,1:1: Ij, I; " I , I "1" ,II ,: "i , PI" : I;,;, " I'" I ' II' '1'1: i "I, I, I I Ii ,I' ". ' : " 1,1 " ,I ;Iil: 'I: 11'111':'::1:11"11'1': w:: 'I II" I,ll/ 'I"!II\II'II;':II! i'I'I!;:II';:":: ,,' , II,' I rl ill Hi: 'I'~II illil!'::II: I~i I II : III'! : I 11\,: i I; :,,11 P : I, , "~I, ! 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I : I,. 'i. ',~ , , I' li'i I',. 1,-1 I' !',; i.-" "I" 1,1'1 !i ",'; I I I' I '! ':11 I I '"" ; :_1 I:' Iii ; i i , 'I I I' F " : , I' ,!' II i li-<' "I ' i ":" "it',' ':;,,1 ' I,' "I' , '! "I I :,:' , '0 1.0 0'1 - tts: .. "10; M\ij l"'1 {{}\,t"' ,) . \) .::: Q,. I d ~:~-" , If' C) " ,~ "1 U ':'1 U ftl r- -to' '\I .; I-I 8'/1>> , tii ~&!. P\ c,~ a: d e w ~ g ~ 'ifl!:5 ~ ., . O::l ~ '1 ~ID ~~ , . ~ ~ti~ffit; -.... :i , \ . ..... ~ ~8~~~. 0 . t'-. ~ cr .~ r:G 8cn~~Z I ~ .\) ?; .- . - .- -_..-- . ~m~~~ \ (\ 13~~ ~ ~.,~ ~ ., ijj ~. ,.J . .. " ,. - ~ r ,- . LAST WILL AND TESTAMENT OF' ANNA G. WAGNER I, ANNA G. WAGNER, of Upper Allen Town- ship, Cumberland County, Pennsylvania, make, publish and declare this as and for my Last Will and Testa- ment, hereby revoking all other Wills and Codicils heretofore made by me. FIRST: I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon, unto my husband, JAMES L. WAGNER, provided he survives me by sixty (60) days. SECOND: Should my husband, JAMES L. WAGNER, predecease me or die on or before the sixty-first (6lst) day following my death, I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of . appointment and together with any insurance policies thereon, as follows: A. I give and bequeath the sum of One Hundred and No/IOO ($100.00) Dollars to the SHHINERS HOSPITALS FOR CRIPPLED CHILDREN - "100 Million Dollar Club", of Harrisburg, Pennsyl- . vama. B. I give and bequeath the sum of Five Thousand and No/lOa ($5,000.00) Dollars to BARBARA KUHN, RD. No.2, Box 99, Mt. View Road, Shermansdale, Pennsylvania. C. I give and beqneath the sum of Five Thousand and No/lOa ($5,000.00) Dollars to my sister-in-law, ALICE A. HAGER, of 2119 Floyd Avenue, Apartment 2, Iowa Falls, Iowa, if living. D. I give and bequeath the balance of the said rest, residue and remainder of my estate as follows: 1. Ten (10%) percent thereof unto the AMERICAN CANCER SOCIETY, PENNSYLVANIA 2 FOR CRIPPLED CHILDREN, a corporation, for the uses and benefit of the Orthopedic Hospital, Phila- delphia Unit, located at 8400 Roosevelt Boulevard, Philadelphia, Pennsylvania, owned, operated and maintained by the said corporation. This bequest shall be known as the "James L. and Anna G. Wagner Fund." THIRD: Should any individuals named in Clause SECOND herein predecease me, I direct that the bequests made to them be divided proportionally among the residuary beneficiaries named in Clause SECOND, Subparagraph D of this, my Last Will and Testament. FQURT}I: In addition to all powers granted to them by law and by other provisions of this Will, I give the fiduciaries acting hereunder the following powers, applicable to all property, exercisable without court approval and effective until actual distribution of 4 all property: (A) To sell at public or private sale, or to lease, for any period of time, any real or personal pro- perty and to give options for sales, exchanges or leases, for such prices and upon such terms (including credit, with or without security) or conditions as are deemed proper. This includes the power to give legally sufficient instruments for transfer of the pro- perty and to receive the proceeds of any disposition of it. (B) To partition, subdivide, or improve real estate and to enter into agreements concerning the partition, subdivision, improvement, zoning or manage- ment of real estate and to impose or extinguish restrictions on real estate. (C) To compromise any claim or controversy and to abandon any property which is of little or no value. (D) To invest in all forms of property, including stocks, common trust funds and mortgage investment funds, without restriction to investments 5 authorized for Pennsylvania fiduciaries, as are deemed proper, without regard to any principle of diversifica.. tion, risk or productivity. (E) rro exercise any option, right or privilege granted in insurance policies or in other investments. (F) 'ro exercise any election or privilege given by the Federal and other tax laws, including, but not necessarily being limited to, personal income, gift and estate or inheritance tax laws. (G) To make distributions to my herein named beneficiaries in cash or in kind or partly in each. (H) To borrow money from themselves or others in order to pay debts, taxes, or estate or trust administration expenses, to protect or improve any property held under my will, and for investment pur- poses. (I) rfo select a mode of payment under any qualified retirement plan (pension plan, profit sharing plan, employee stock ownership plan, or any other type of qualified plan) to the extent the plan or the 6 law permits them to do so, and to exercise any other rights which they may have under the plan, in what- ever manner they consider advisable. ElFrH: I direct that all inheritance, estate, transfer, succession and death taxes, of any kind what- soever, which may be payable by reason of my death, whether or not with respect to property passing under this Will, shall be paid out of the principal of my resi- duary estate. SIXTH: I nominate and appoint my husband, JAMES L. WAGNER, Executor of this, my Last Will and Testament. In the event of the death, resignation or inability to serve for any reason whatsoever of the said tJAMES L. WAGNER, I nominate and appoint PNC BANK, of Camp Hill, Pennsylvania, Executor of this, my Last Will and rrestament. I direct that my Executor, and his successors, shall not be required to post security or a bond for the performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testa- 7 c ~IQtL..9LllQ~I&....h6 (a) Name of Decedent: Anna G. Wagner Date ot Death: January 12, ::'997 Will No. 1997-00121 Admin. No. To the Register: I certify that notice of beneficial intereat required by Rule 5.6 (a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on March 14, 1997: l:iAU Address Shriners Hospitals for Children "100 Million Dollar Club" c/o Zembo Temple 2801 N. 3rd street Harrisburg, PA 17110 Barbara Kuhn R. D. 2, Box 99 Mt. View Road Shermansdale, PA 17090 Shriners Hospitals for Children Burns Centers 2119 Floyd Avenue, Apt. 2 Iowa Falls, Iowa 83402 Route 422 and Sipe Avenue P.O. Box 416 Hershey, PA 17033 c/o Zembo Temple 2801 N. 3rd street Harrisburg, PA 17110 Alica A. Hagar American Cancer Society, pennsylvania Division, Ino. Shriners Hospitals for Children orthopedic Hospital Philadelphia Unit 8400 Roosevelt Boulevard philadelphia, PA 19152-1299 Notice has now been given to all persons entitled thereto under Rule 5.6 (a) except: Date: Ma~h 14, 1997 ,,- ~. ~-:-' r-:f 0 aI', Esquire D..!',' ':fn: ~- 1 West Ma Street [,;: Bogar & Sheely 0, Shiremanstown, PA 17011 - (717) 737-8761 ~ Capao.i ty: -- Personal Representative :!i.- ,.. X Counsel for Personal :~,I .1:' (.l ~;f 1- .:..'" Representative <llCC a: P'> ~::l UU l'NH"'R'TANCE 'fAX RETURNJFOR DATES OF DEATH AFTER 12131191 ". CftECK ftERE IF A SPOUSAl. . RESIDENT DECEDENT P'<?.'-'E.!l-"'~_2RE(JI!-'~2UI.'!1_~(J[L___ C0MMONWEAL1HOf PI.NNSY<.VANIA (TO BE FILED IN DUPLICATE FII.ENUMBER lIEPARTM'NTOf R'V'Nur 21 97 0121 "ARRIS~~~~.':~~~~"-1I601 . ~IT_H R.~_G.I_~!~,!g~_!'!.ILl:~) COUNTY CODE YEAR N-YM~ER DECEDENT'S NAME (LAST, FIHST, ANIl MIIlDITIN.ITlAi:)---. '-'--'''-J'Df:CiIlENT'S COMPI.ETE ADDRESS-- .. \'lJIllNER, ANNA G. MI~SSIAli VILI.AGE 100 M1', lI.I..LF.N DRIVE SOCIAL SECURllY NUMBIi::bIlATECiFOiillti-'[ IJ-Al'E"cifCiiiini:j- MF.niANICSBURG, PA 17055 DECEDENT 189-09-0364 ~1/.GL~l__. J:ll~!Ji}_B2_~_ ~lIlt~ CUMBERIAND <.l)tM!'Y "RST ~~o^M:61;1.'~~:Y:~I.: "pnO'; ',; NAM . (LA'''. ] SOCIAL SECUHllY NUMBER J AMOUNT RECEIVED (~JEE INSTRUCTIONS) 1, Original Roturrl ---~~---lJ"~.-SUrplorn(Jntal R~h;~---- ------03- RonlRlndor RollIlIl ----.-- 05 o 4n. FuhUo InlorCl9t Comptomlf1o (lor datos 01 doal" 8110r 12~12-A2) Docodonl Diad Tostata g] 7. Decodont Maintained fl Living Trust (Mach copy 01 Will) (AUach copy 01 Trusl) 'AUi'CdARI:S~oNO"r.eeA"OI(:l()NFIDeNtll\ui'.. xlHFdAM . tIONsflOUuOBltOIRl!CTEl)tO:i", -. . .... ........-...-... ...........-....- NAME COMPLETE MAILING ADDRESS LINDA J. WNDBERG PNC BlINK, N. A. TELEPHONE NUM8ER 4242 CARLISLE PI,K.E: ro BOX 717 730-2265 CAMP HILJ.. PA 1.'1001-0308 1. Real Estale (Sclledulo A) ( 1 ) None 2. Slack' and Bondo (ScllOdule B) (2). 80 ,417.8'1 3. Closely Held Sloek/Parll1e,ship Inlereal (Seh. C) ( 3 ) __ NonE! 4. MOllgagea and Noles Receivable (Schedule 01 ( 4 ) None 5. Casll, Bank Deposlls & Miscellaneous Peraonal (5) 15,450.39 PlOperty (Schedula E) 6. Jointly Owned Property (Schedule F) 7. Tran.fara (Schadule 0) (Schedula L) 6, Tolal Gross Assets (Iolal L1no91~7) 9. Funeral Expenses, Admlnlstratlvo Costs, Miscellaneous Expensos (Schedule H) 10. Debl.. Mortgaga L1ablllllas, Liens (Sclledule I) 11. TOlal Daducllons (Iolal Lines 9 & 10) 12, Nel V.lua of E.tale (I.Ine 6 mlnu. Line 11) 13. Charllable and Govarnmenlal Bequesl. (Schodula J) 14. 15. Spau..' Transfers (for datu of dBlIlh alter 6-30.114), SQ. Inslructionsfor ApphcablePercantllgeon Page 2. (Includo values from Schadultl K or Schedulo M.l 16. Amount 01 Une 14 taxablo at 6% rate (Include valuas from Scllodule K or Schedule M,) 17. Amount 01 Line 101 ts)(nblEJ fit 15% rato (Include values trom Schodulo K or Schodulo M,) 18, Principal tax due (Add lax frorn Uno~ 15, 16 Ellld 17.) 19. Credltn Spousal f'uvfllly erathl Prlot Paymonls Dincounl _.__+_ 1,425.00+ 75.00. 20. If Line 191s realer thnnltno 18, onlor lho cliHorollco on LillO 20, This lslho OVERPAVMENT, IIIIiQII'~''''IfI'Ol/aftt.quelrllng. refund Olvour ovorPaYinorrt. I 21. If Une 18 19 greater than L1no 19, onlOl 1110 dlflmoncfI on lIno 21. Tills I~ 1110 TAX DUE. A, Enter the lntmest on Iho bnlallco duo on Lino 21A, B. Enter the tolal a/Line Z1 and 2'IA on lIno 218. This if! \110 BALANCE DUE. Mako Check Pay-abl. to: R.qt.'.' 01 Wills, A.g.n'__ q,', 11' il,! ,1,II'II';II:I,!'1!!I,''1I'!''''''';...' I'....'..' "BE SURE TO ANSWER ALL QUESTIO~ ON PAGE,2 AND TO I\ECHEC.K,MATH '....I',....,J'i' :"','" .'1 'j."., , ,'. n r pe;~'~llje9 orpe;:ilii)':T doclare that IlltWO f1XWlllnnc11tlls rntllrrl. Illdudinq accompnflylnq sdwdulo$ and slntern:lnlfl, and to tho best 01 my knowl6dQ~ and be110f Ills truo, correct and complolo, I doclmo ltHll nil tOill wilolo !HW bHun ruportod III law m.ukol vohlo Doclmollon 0/ propalOt otllOr lhan tho pomonal ropresentatlve Is based on alllll/ormAllon of which pl(Ir:.!.~~~~S ;lI1Y_~:~~J,~j~~~.___...~_~_..___._,_ 5~ U i;J:o{f.A NA e'N[oIfJltH'RlluNUHf:llHlN /1!lLJlH';', [JATf: P'!: See Schedule attached ~\,'h"l____ ;;;^TUR!;OFf'R[f'AnER~ ~;;.---~~~~'''--'--''.'--~'''---'------------''--~--'------ [JATE RfV-t::.oo [)(t (H141 CHECK APPRO. PRIATE BLOCKS 04, [He L1mltod E.lale CORRES- PONDENT RECAPIT- ULATION TAX COMPUTA- TION 1.1.1 1.'_,' I , ,'" c (!urnoltunjdfl.\thprlll,lu12-ll-ft2f Fodor"l EstRto Tllx Holum RoqlJlrod o 8. Total NumbOl of 5alo Oopoflll BO)(WI 308 (6 ) (7), None 0.00 (8 ). 95,868.26 (e) 10,206.73 (101 4,152.68 14,359.4~_ 81,508.85 71,508.85__ (11) (12) (13) (14) 10,000.00 (15) . . (16) 0.00. .06 0.00 (17) 10,000.00. .15 1,500.00 . (18) 1,500.00 InlOl091 (19) (20) lL500,00 (21) (21A) (~IB) 0.00 0.00 0.00 PA ISOO1 N1Tflfi19 PNC_~--,-_!'l~A~_ 4242 ~ISLE PI}<E PO BOX CAMP IULJ.,. PA 17001-0308 308 COPY(I"llt Forms SofhYIl!lj Only, 1994 NlIl(;fl, I,ll;. N94PAO(l1 LAST WILL AND TESTAMENT OF ANNA G. WAGNER I, ANNA G. WAGNER, of Upper Allen Town- ship, Cumberland County, Pennsylvania, make, publish and declare this as and for my Last Will and Testa- ment, hereby revoking all other Wills and Codicils heretofore made by me. FIRST: I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon, unto my husband, JAMES L. WAGNER, provided he survives me by sixty (60) days. SECOND.: Should my husband, JAMES L. WAGNER, predecease me or die on or before the sixty-first (61st) day following my death, I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over w hieh I hold power of . I \ ~\"~ .,\ 1'-'"'" '~,\- , " ", " , .. ~ ' ., . .. ': ,< appointment and together with any insurance policies thereon, as follows: A. I give and bequeath the sum of One Hundred and No/100 ($100.00) Dollars to the SHRINERS HOSPITALS FOR CRIPPLED CHILDREN - "100 Million Dollar Club", of Harrisburg, Pennsyl- vania. :1 I B. I give and bequeath the sum of Five Thousand and No/IOO ($5,000.00) Dollars to BARBARA KUHN, R.D. No.2, Box 99, Mt. View Road, Shermansdale, Pennsylvania. C. I give and bequeath the sum of Five Thousand and No/lOa ($5,000.00) Dollars to my sister-in-law, ALICE A. HAGER, of 2119 Floyd Avenue, Apartment 2, Iowa Falls, Iowa, if living. D. I give and bequeath the balance of the said rest, residue and remainder of my estate as follows: I 'I I I \1 -, ! I i \ , [ . 'I 1. Ten (10%) percent thereof unto the AMERICAN CANCER SOCIETY, PENNSYLVANIA 2 ~',..\, "..'''''' FOR CRIPPLED CHILDREN, a corporation, for the uses and benefit of the Orthopedic Hospital, Phila- delphia Unit, located at 8400 Roosevelt Boulevard, Philadelphia, Pennsylvania, owned, operated and maintained by the said corporation. This bequest shall be known as the "James L. and Anna G. Wagner Fund." .THIRD: Should any individuals named in Clause SECOND herein predecease me, I direct that the bequests made to them be divided proportionally among the residuary beneficiaries named in Clause SECOND, Subparagraph D of this, my Last Will and Testament. FOURTH: In addition to all powers granted to them by law and by other provisions of this Will, I give the fiduciaries acting hereunder the following powers, applicable to all property, exercisable without court approval and effective until actual distribution of 4 , ,r.~: f..$.f!4t.~;tll;i( i\','_" Ii :1',1\.':i~.':>.'~'''' P, ,_' ,I ".~,,,, j;.: ' ~I:\)"'"-,\,, 1./1 -~~':r..,t3"" .f.,. " ~.. t .,1 " H -,. ' "~ ( all property: (A) To sell at public or private sale, or to lease, for any period of time, any real or personal pro~ perty and to give options for sales, exchanges or leases, for such prices and upon such terms (including credit, with or without security) or conditions as are deemed proper. This includes the power to give legally sufficient instruments for transfer of the pro- perty and to receive the proceeds of any disposition of it. (B) To partition, subdivide, or improve real estate and to enter into agreements concerning the partition, subdivision, improvement, zoning or manage- ment of real estate and to impose or extinguish restrictions on real estate. (C) To compromise any claim or controversy and to abandon any property which is of little or no value. (D) To invest in all forms of property, including stocks, common trust funds and mortgage investment funds, without restriction to investments 5 ,. " d. , . . ..'" authorized for Pennsylvania fiduciaries, as are deemed proper, without regard to any principle of diversificaM tion, risk or productivity. (E) To exercise any option, right or privilege granted in insurance policies or in other investments. (F) To exercise any election or privilege given by the Federal and other tax laws, including, but not necessarily being limited to, personal income, gift and estate or inheritance tax laws. (G) 1'0 make distributions to my herein named beneficiaries in cash or in kind or partly in each. (H) To borrow money from themselves or others in order to pay debts, taxes, or estate" or trust administration expenses, to protect or improve any property held under my will, and for investment purM poses. (1) To select a mode of payment under any qualified retirement plan (pension plan, profit sharing plan, employee stock ownership plan, or any other type of qualified plan) to the extent the plan or the 6 ..'. -~ _ ---j -'. . " law permits them to do so, and to exercise any other rights which they may have under the plan, in what- ever manner they consider advisable. FIITH.: I direct that all inheritance, estate, transfer, succession and death taxes, of any kind what- soever, which may be payable by reason of my death, whether or not with respect to property passing under this Will, shall be paid out of the principal of my resi- duary estate. SIX'111: I nominate and appoint my husba.nd, JAMES L. WAGNER, Executor of this, my Last Will and Testament. In the event of the death, resignation or inability to serve for any reason whatsoever of the said JAMES L. WAGNER, I nominate and appoint PNC BANK, of Camp Hill, Pennsylvania, Executor of this, my Last Will and Testament. I direct that my Executor, and his successors, shall not be required to post security or a bond for the performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testa- 7 . " . . "-:-:.~,:." "J ~ .., " , .'~ '1 TilE F I HS r IW1K ANIl TlUlST Cm\I'ANY THIIST AGHE01Un III >:......." I-~.. \ f \.,. ,~j~ll \. )I[!. ":"\ "~>Lr L This THlIST 1s estalll ished betweon The Fir"t Bank and Trust Company as Trustee and the undol'signed as settlors. The sett10rs hereby grant and convey to the Trustee all right, title and interest in the cash amount indicated below and to any other assets or 1 tabi 1 ities set forth on Schedule "A". which lIlay be attached to and made a part of this agreement. In managing these and any other assets subsequently transferred to this TRUST. the Trustee is charged with the following duties: keep the assets safely; use tile care and attention which a reasonable prudent man WOUld devote to the management of his own financ'la1 affairs considering the economic conditions of the time. advise the settlors monthly of the past month's transactions and the valuation of assets held at month end. and annually of any necessary information for the preparation of the sett10rs' tax returns; transfer the net income each month to the principal of the TRUST for reinvestment, to or for the use of the settlors, to the settlors' checking account as indicated below. In addition to those powers granted by law, the Trustee may exercise the fo 11 ow; ng powers in order to perform the above duti es ; rece i ve proceed s from the sale. maturity. call or conversion of TRUST assets; invest in and buy or sell assets (including real or personal property, mutual funds. and obligations, deposit accounts with The First [lank and Trust Company and stock of its holding company PNC Financial Corp) subject to the settlors guidelines indicated be10\~; borrow money at reasonable rates and pledge TRUST assets as collateral should it be prudent to do so. pay any necessary expenses. including reasonable Trustee's compensation. allocate transactions between income and principal as the Trustee deems best. and handle routine matters according to the Trustee's best judgment. including but not 1 imited to making timely exchange of temporary issues for permanent, executing proxies or voting shares, buying or selling fractional shares. and exercising holding or selling warrants representing rights received in corporate recapitalizations or reorganizations. The settlors may alter or amend this TIlUST in any way provided that such change does not result in making the TRUST irrevocable or creating dispositive provisions to take effect at or after the sett101's death. .. The settlors may add to or withdra\~ frolll the THUST'S income or principal at any time, 'subject only to providfn\) reasonable notice. Iho mUST shall terminate upon the death of the last to survive with principal and undistributed incollle being paid into the survivol"S estate. Tho Trustoe lIIay exp(!nd THUST incomo or principal in behalf of the settlors at their direction Ot' in behalf of any nallled beneficial'y to the extent of their beneficial interest. Only the settlors shall have the power to assign or encumber their interest in the mUST or otller'wise cause its assets to become liable for the payment of a beneficiary's personal obl igation or debt. The Trustee is responsible for losses caused by its gross negl igence but not for other losses such as, but not lilllited to, those created by fluctuation in market valuations. The'Trustee is not required to account to anyone, except as described above, unless expressly directed in writing by the settlors or their personal representative. EHher porty lIIay terminat.e this THUST at ony timo, subject only to providing reasonable notice. INVESTMENT GUIDELINES __Taxable bonds _Common stocks . Tax exelllpt bonds ~~Trustee's discretion ~ reinvestment WITIAL CASU DEPOSIT $ /; f INCOME TRANSFER JAMES L. WAGNER Name J 'I J.. () (- (.() In Social Security Number _.To checki ng AIC To address shown .--- -../;,~?v' -? f. /969 Date oJ~::~;:/~t4"k' i-~ S i(rii rn- ""' /! ~ J 5d~Cwk $/' b!j~1i St eet,~dd ess II . v _11&. " butt' F71.ll/tJ$::; Ci ty, State,. Zi-p-:::tOcle / d"-I~-';;; ty);<-p ~ Signature () " ANNA G. WAGNER Name /J'7- 07.. CU?I/ Social Security Number .~ P.t~~h Attest: W\.., ~H ONLY YOUR ATTORNEY CAN PROVIDE LEGAL ADVICE ... '".....__~ __. ......n.... r .< ......._ .~_. --__.________ I I ." \ . \~ \ I 1 I \ \ , , . .. " , , " . t I I l \ \ I I I I ~ ~ .... <( ~~ "'if ~~ l2d ~ , ~ ~ ~ ~ '11' Il. I: .-"I,omu: 0/ ;:I'r cf Will" j" . 'n" ~~""I c;( CU' ~ (/l ;:J o ::t: E-<E-< :z:p:: ~;:J l?0 ":U (/l)< 0"1 f.o~ E--i ~ ....:i:z: 0 H:::> r-.. :3:0 ,.., UE-< ~~~P: ~~~~ (/l~ZH He~..:I ~B Ul5 II:) ':, :'! 8- ~dV L6. Ol!l~,~ '.... "..,,..'~-;u 'ltJ - . . = 1 = E -: : . "': :!: "1 ~ =: -= - ~ ~ - ,.., ... I'l " I'l 0' r) ~ tl .. Q I" .. , ~ 'if j:w -1 ,," . ot'" t"''' J,' I ' .f. rt:. \ . ) "," 41<' . , " L..., ,,' ~. I' " ' , ~.' . !.. II \ IQ ". ;.. '! '\ \, '. ,'.," l, , i' " ~:', IV ,{-' \" , " , - ~ ,,, , ~. .4iJ l I j~,. 1\, I 'i. ~. ",.' " ~'--' .....JP~ ~-;'~ '.---~-.--..~...,. ~ - '......1' 1'''', /5~!j'l-1(1 COMMONWEALTH OF PENNSVLVANIA DEPARTMENT OF REVENUE IUREAU OF INDIVIUUAL TAKES INHERITANC[ 'AK DIVISION IK:PT. tl0601 ItARAltaUAG, PA 17128-0'01 NOTICE OF INHERITANCE TAK APPRAISE"ENT, ALLOWANCE OR DiSALLOWANCE OF DEDUCTIONS AND ASSESS"ENT Of TAK DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-12-98 WAGNE~ 01-12"97 21 97..0121 CUMBERLAND 101 [~~-~~~===:~=~ =3 MAKE CHECK PAVABLE AND REMIT PAVMENT TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 CUT ALONO THIS LINE ~ RETAIN LOWER PORTIClN FOR YOUR RECORDS ~ Rifv:is'4-j"EX--AFP--foii:9;"j"Nor-icE-"oF"i"NHER-ifANcE-;rAx-i\-PPRi\"iiiEi1ENT~--AL1-OWAiiC!-CiR--"-----"------"- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ANNA G FILE NO. 21 97-0121 ACN 101 APPROVED DEDUCTIONS AND EXEMPTIONS: 10,206.73 . 9. funeral Expf'n...IA,dll. COltl/Hile. Expan... (Schedul. H) (,) 10. Dobh/"ortgoUe Llobllltio./Llo". ISohodulo II 110) 4,152,68 11, Total Daductlc.n. (11) 12. W.t Value of hw Return (12) 15. Charitable/Goy.rnllent.1 Bequ..ts; Non-elected 9115 Trult. (Schedule J) (15) _ 14. Not Vol... of E.lot. Subjoot to Tox (14) NOTE: If an assessment wati iSlued previously, lines 14, 15 and/or 16, 17 and 18 reflect figures thMt include the total of ~" returns assessed to date. ASSESSMENT OF TAX: 15, Altount of L In. 14 at Spou,.l rat. US) U. Allount of Lina 14 hxabla .t Lin..lICh.. A rat. (16) 17. AMount of Lin. 14 taxabl. .t Collatera1/Cl... 8 r.t. (17) la. Principal Tax Du. TAX CREDITS: FAY"ENT DATE 04-07-97' LINDA J LUNDBERG PNC BANK NA PO BOX 308 CAMP HIll PA 17001 ESTATE OF WAGNER TAK RETURN WAS, I X I ACCEPTED AS fiLED RESERVATION CONCERNING FUTURE INTEREST " SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. b.l E st.... I Sch.duh A) 2. stockll and Bonda (Schedul. B) S. Clo.~ly H.ld stock/Partnership Int.re.t (Schadule C) ~. HortQagal/Not.. R.c.ivable (Schedula D) S. Cash/Bank D.poI.Us/Hho. Parllonal Property (Sohedul. E) 6. Jointly Owned P~op.rty (Schedul. f) 7. Tran.farl (Sohedule 0) 8. Total A...t. RECEIPT NU"BE R AA185364 DISCOUNT 1+) INTEREST/PEN PAID (-I 75.00 I CHANGED III ,00 121 80.417.87 (3)- .00 (4) .00 IS) 15.450.39 161_ .00 171 . 00 (8) .OOK'OO, .00 X .06, 10,000.00 K .15,_ 1181 A"OUNT PAID 1.425.00 TOTAL TAX CREDIT ---- BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE , .' -- .U.U4f U", llt,'" ANNA o DATE 01-12-98 NOTE: To in sur. prope,. oredit to your .ccount, IUbMit the upper portion of this forR with your tax pay.ant. 95,868.26 14 . 3~9 !t.l 81. 508.85 71,508.85 10,000.00 will .00 .00 1.500.00 1,500.00 1,500.00 .00 .00 ------- .00 1 . IF PAID AFTER DATE INDICATED, SEE BEVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN .1, NO PAY"ENT IS REQUIRED. IF TOTAL DUE IS REflECTED AS A "CREDIT" ICRI, YOlI "AY BE DUE ~ REFUND. SI., REVERSE SIDE Of THIS fOR" FOR INSTRUCTIONS.) RESERvATION' E.t.t.. .1 dIC.dtn\l d.ln. .n " b.l.r. Dac..b.r lZ, 1..2 .- If .n. lutu" I.t.r..t In th. ..tot. It tron.l.rred In p......loo " onj....nt t, elm. (noll.tor." b.n.f1,lorl.. .1 th. d.....nt .I\or th' ..plr.\loo .1 on. ....t. lor 111. or lor ..m, th. c....n"'l\h hor.b. "p".... romv" th. right t. "prol.. ond ...... ,ron.lor Inherit""'. T.... at thl lawful CiIl.. e (eoUatarl'll) rat. on IlM ,uch fuhlr. Inttrut. PURPOSE Of NOTICE I To f~lfill th. rlqUlr...nt. of Slctlon l14G of the Inherltanol and E,tete TalC Act, Act 21 of 1995. (72 p,S. SloUon 1JI140), O.tooh th. top pnr\l.n 01 thl. .,\Ic. .nd .vb.lt with ..ur p....nt t, th. R..,..., ,f Will. prln'" on th. rav'''O .lcle. --Hake chick or .0n1Y ord.r plJyable to 1 REGISTER OF MILLS, "GENT PAVHEHT: REfUND (tRl I , "fund ,f 0 'OK cr.dlt, ""Ich w.. not roqu..t.. ,n tho 10' ..turn, .., '0 ".....tod b, co.plotl.. .n -,..lIoo\lon for Refllnd ~f Plnn.."lvanla Inheritance and E.tat. Tax" o.~E\l'-13n). Appl1catlon. nr. IIvlIUabll I\t tha affic, of tha RIUI_t.r of Will., any of thl 21 R,vlnu. nlltrlct OHlc.., or by call1nlll tho .peela1 Z4~hour Im.wadng Itrvle. nwhlr. for for.. nrdldng1 In punnlylvanh 1-800-362-21)50, outside penn.vl"anllll nnd within 10cn1 tlnrrlsburQ aren (117) 787"BG94, lOOt (711) n'/.-?2~2 (Htllllrlnu IIlPalrlld Only). l.n~ plldY In lnterellt not llI,tl,Hed with the IIIpprllls..ant, "lloWllnc' or diullowanca of deductlQn., or 11IS......nt of tal< (Including discount or Interellt) IlIJl shown Gn this Notloe IIU.t abject withIn shch' (60) dl~s of rftlc:elpt \'If thll MoUct bYl _Mwrltten protISt to thifl PA llllpart.ent of R.venue, 80ard of ApptUlls, Oept. 2&10l1, IlntrhburQ, Ill. --1I111ct;lan to hnvlI the anthr deter.tnad nt audit of the account of thll personal repre..ntative. "flppeal ta th. Orphan.' Court. 171'/.8-1021, OR OR oaJf.CTlONSI l.DHIN ISTRl.TlIIE CORREC1IOHS I fnc1\J!l1 error. dhea"erlld on thIs a,,~u"llnt .hould be lIddrused In ...rlUng tal PA ClIpert.ent of Re"enuo, Bureau of Indlvhtue1 Taxal, AllNI Post Allllu.ant RIl"I.w Unit, nap\. 2806D1, tlarrhburg, PA 11128-0601 phon" (117) 181M6S05. Se. peg. S of thll booklet "lnltructions for tnheritfml'l" Till< Return for I Resident Oeced"nt" (RE\I"IS0Ufar fin el<planat1on of adalnlstrl'ltlvillY correctable IIrror.. II on, to, duo I. pold wlth'n thr" '" ool..,dor ....th. .Hor tho doc..ont'. ...th, . fl.. por..n' ""' "IO,unt .f the tlllX paid Is ,11o'Wed. The 1S;': t.~ aMutv nan-pllrtll:ll~etlcm penalty Is coaputed on the totfll of the tnl< and inhr..t auened, tlI'ld not plld before JMuarlf 16, 1'96, the Hr.t da~ flft.,- the end of the tel( um..h' period. Thlll non~pl!lrtlclPllltlon p.nolt. I. "p..l.bl. In tho .... .onn" ond 'n 'ho tho .... tI.. p.r1od .. you would .p...l tho to> .nd lnt".., thlt hu b..n fIlI..ued a. IndIcated on this notice. lnterut it Chllfg.d ~glnnlnll ~it" first day of dIlllnqutnC~, or nln. (9) eonthl and 0"", (1) day fro. the date of ...th, '0 tho dot. .f p.,,"'\. T.... whl.h b.o_ ...1I....ont ..IM' Jonu'" I, 19" .oor Intor..t ., tho roto of .b (6;0 ptfCllnt par fiMUIl ollloulated at II dslhl r~t. of ,OOOI6~, All tenl whloh beea.. delinquent on and Ifter JlIl"lUer~ I, 1982 wIll bel" Interut lilt II rate whleh ,.,Ill "'lIr'! frO. (:shndar ~ur to ca10ndar yellr wlth tMt rate l!IMouncld by U... Pl. napnrt_v,t of Rev.nuI, The appllcablfl lnterut ratu for 19ft2 through 1998 are: '!!!r Int.re.t Rate DailY lnhrut Factor !!!l' ~nt..r..t Rat! Dally Int.r.lt Factor 1982 20:< ,00054& 1917 'X .000241 1911 16:< .000456 1981~1991 11;( .000301 1984 11X .000301 1992 .X ,000241 19B5 ax .00035& 199!-1994t 7'1. ,000192 19&6 lOX ,000?74 199~.1'9B 91: ,000247 nlnterllt I. ClftlCilllated u folloMII INTERE.ST . IALANC'~ OF TAX UNPAID X NUKIER OF DAYS DELINQUENT X DAILY INTEREST FACTOR MMl.nY K\ltlce i..~ "fter'the hI( beco.tIl dellnqlKll"1t will r4lflect en Interut cftlculatlon to fift.en (15) dIY' beYond the date af the I.......nt. 1f pay..nt i. .... .fter the lntere.t COllPutation date IhoWn on thl MCItlot, l!Iddltlonal lnhrut ......t be cnlr.ullbted. OlSCOlmTl PENAL TV I INTEREST I FlJl1crul Expcnscs 4/16/97 Gingrich Mcmoriuls- I ,cvclund clean monumcnt $ 200.00 $ 200.00 Administration Expenses 3/28/97 Bogar & Sheeley - Reimburscmcnt for Probatc costs $232.00 Lcgal Advcrtising m.23 $ 365.23 3/31/97 I'NC Bank, NA, Trustcc under dccd of trust of Jamcs I.. & Anna (I. Wagncr dtd 6/26/89 - Trustccs compcnsation 166.68 4/16/97 EYP Systcms - Fcc for datc of dcath vallmtion 10.50 4117/97 Cumbcrland County Tax Collcctor - 1997 per capita tax 9.80 9/8/97 Registcr of Wills - 2 Short ccrli ficutes 6.00 9/19/97 Mcdi-Claim - Fec for cstate medll:al claim ii1ing 140.00 10/3/97 John Michalski - Jcwelry appraisal 75.00 10/3/97 Faccts - Jcwclry appraisal 200.00 10/9/97 Linda Lundbcrg - Rcimbursemcnt PA Inheritancc tax filing fcc 15,00 2/11/98 Registcr of Wills - Fcc for filing Invcntory . 10.00 2/11/98 Claudc C. Wolfe & Assocs. - Auctionccr's commission on salc ofjcwclry 205.10 Rescrvc for filing costs 250.00 1,453.31 Federal and State '1Ml:li 4/7/97 Rcgistcr of Wills, Agcnt - I' A Inhcritancc tax $1,500.00 less 5% discount $75.00 $1,425.00 Rcscrve for 1997 fiduciary incomc tux 1.000.00 2,425.00 El:cs and Commissions 1/15/98 PNC Bank NA - Exccutor's compensation $4,725.00 2/11/98 Jamcs D. Bogar. Esquirc - Attorncy's' compcnsation 4.725.00 9,450.00 Total Principal Disburscments $~ 4 . D1STllllilll1U.lliLUl" l'RINl'il~J:U_Ul':NEFK'It\Rl.l.ili TO: Shrincrs Ilospitllls f(l\' Cripplcd Chlldrcn "100 Million Dollar Cluh" 111 sutisnlction or Itcl11 Sccond(.'\) 3/19/98 TO: 3/19/98 TO: 3/19/98 CASII Barhura Kuhn, In slltisfllCtion or ItCI11 Sccond(B) CASH Alicc A. Hugcr. In satisraction orltcm Sccond(C) CASH Total Distributions or Principal to Bcncficiarics PRINCIPAL BALANCE ON HANI) 3/19/98 Invested Cash Total RECEIPTS OF INCOME Interest 6/10/97 6/10/97 Metlire - Intercst on policy #325712213 Metlife - Intercst on policy # 128996519 Compass Cupital Money Ivlarkct. Scrvicc Class Fund 110& Interest 11'0111 2/3/97 tn5/1/97 Compass Capital U. S, Trcusury Money Market, Scrvicc Class Fund 1109 Intercst from 411/97 to 3/3/98 5 $ &.99 8.49 98,70 . 3,510.39 $ 100.00 5.000.00 5.000.00 $!,Q, I QO,PQ Fiduciary Acquisition Value $60.976.81 $~q.9?~.8J $ 3,626.57 STATUS REPORT UNDER RULE 6.12 - .. ---'- Name of Decedent. I ~~~I>, c,- W\'>,6-~L-L ~I,. '4I'\--~C:::' Date of Deathl I Y',.2- (; 7 --- Will No. ''\'''1-00\\0.-\ Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estatel 1. State whether administration of the estate is complete I Yes__*- No__..__ 2. If the answer is No, atate when the personal representative reasonably believes that the 4drninhtration will be complete I 3. If the answer to No. 1 is Yell, state the following I a. Did the personal representative file a final account with the Court? Yes~ No__. b. The separate Orphans' ((lllrt No. (if any) for the personal representative's account is: c, Did t.he personal representative state an account informally to the parties in interest? Yes No d, Copies of receIpts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. ~~L 9.~' 0).)'- ~~\O'l... ~~ .\ Signature~~ ~~ ::s- ~) 1J&..u.... Name (Please type or print) ~,.,,)l.. ~~ ~O 9"u'l- ~O? C~ "" ~ I...l.. ~ "t. \ '\ bC.1.::J? ~ D? Address l1.~ l ~ -k~~ Te 1. No. Datel \~\ ~l \s.':1- ("J ~- :' ",) ,,'-,1 \ 1..',,\ ., J ,-"){"- Capacity: '-b.._personaJ. Representative (HAH nmf/ AM3) _____Counsel for personal representative ~ Decadent's Complete Address: STREHT ADDRESS CITY Carlisle : STA TE I PA iZIP 17013 J 180 Easy Road lex Payments and Credits: 1. Tax Dua (paga 1 L1na 19) 2. Cradlls/Paymanls A. Spousal Poverty Cradll B. Prior Payments C, Discount (1) 0.00 Total Credlls (A + B + C) (2) (1,00 3, InteresVPenally If applicable D. Inlaraol E. Penally TotallnlerasVPenally (D + E) 4. If Line 21s greater than Une1 + Line 3. enter the difference, This Is thEOVERPAVMENT. Cheok box on Pege 1 Line 20 to requaata r.fund 5. If Line 1 + Line 31s grealer Ihan Line 2. anter the difference. This Is IheTAX DUE. A. Enter Ihe Inlerest on the tax due. B. Enter Ihe total of Line 5 + 5A. This is IheBALANCE DUE Make Check Payable 10: REGISTER OF WILLS, AGENT 1. Old decedent ma~,e a transfer and: a. retain the use or Income of the property transferred;..." ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,.,,..,,,,,,,..,'" b. retain the right to designate who shall use the properly transferred or Its Income;.",,,,,,,,,,.,,,,,,,,,..,,, ,",' c, retain a reversionary Interest; or..... ,.,'. .... ............,,,...,, .........",..... ...... "......""",....., """"". n',"""" ."'" d, receive th~ promise for life of either payrnents, benefits or cara?",,,,,,,,,,,,,,,,,,,,,,,,, """"""""""",,,,,,,,. 2, If death occurred after DAcember 12, 1982, did decedent transfer property wIthin one year of death without receiving adequate consideration? .,.., ,,,,,,..,,,,.,.,, .., ..",,,, "".,. ,.., ."" "...., ..., .., ... ... n .... ....".... ...... J. Old docedent own an "In trust for" or payable upon death bank account or security at his or her death?,,,.,,,,, 4. Old dec~dent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?".,.." ."",.", .."",...,n..., ,. ..,.......... ... ....., .............." .,. .."... ."......",.,.,... ,. ". PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "K" IN THE APPROPRIATE BI.OCKS '~ I o o r8I r8I r8I o IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART Of TIle RETURN, UndfH pllnaltles 01 perjury. I declllre Ihall have e~!lmlned Ihls rlIlufI'l. including Bccompanying schedules and slnlemllnls, and to lhe basi 01 my knowledgfl and bfllief, Ill. IllIll, COfrct\:1 'lilt! ~UlllfJijjtn 1I.Hilllill"lrl prepare.r olher l~l'ln I~e.person!ll ~epresenlllllve Ir,~.a~.adon.an InlormMlon 01 Wlil!lh preparcrhils any .knowl~dQe SIGNATURE OF PERSON RESPONSIBLE FOR FI1.ING RETURN ADDRESS 0",11' Al,Idrey G. Adams. / ,. ( L (,dce ,,_) C,,({) ))1.1.' SIGNATURE OF Pf~SON R~SPONSIBlE FOR riLING HE'fURN 180 Easy Road Carlisle, PA 17013 ADDRESS o^-H SIGNATURE OF PREPARER OTHER 'rIIAN REPRE~~NTATlVE ADDRESS HA'I Edward1.\ "'c1Jorj)p, F;S(IUh~~ J ;' 'I' E t 11 I S -~~~:~~<~; : ! :';.;;---'~i. ,,<:~~~~:,:~~!~6,:~~~:'::0..._~~C':;~:\,<~:l;~,"~~~'1it'C;)~ ~- For dates of dealh on or after July 1. 1994 and before January 1, 1995, the tax ralo imposed on Ihe net valua of Iran.fer. to or for th. lJ~n of Ihn surviving spousals 3% [72 P.S. ~9116 (a)(1.1) (i)J, For dales of death on or after January 1, '1995, the tax rate Imposed on the net value of transfers to or for lhe unft of tho ourv!v!i\g illUUUc. Is 0% 172 P.S. ~9116 (a) (1.1) (II)), The statutedoes not exemoJa trensfer 10 a surviving spouse from lax, ond tho Rlalutory rnqulremonl. Of dl."loou," of assets a.id filing a tax return are sllll applicable evon If the survivIng spouse Is tho only banaflalory. For datas of death on or after July 1,2000: The lax rate imposed en the net value of transfers from a deceased child twenty-ono years of HgO m younonr III dftAlh 10 or for Ihit ~hift t~f ft fitl!lHul parenl, an edopllve parent, or a stepparent of Iha child Is 0% [72 P,S, ~9116 (a) (1.211. The lax mle Imposed on the net value of transfers to or for the use of the decedenl's linoal hOfloflcltHlu!i 18: 4 ,f)ilh, flKtI.~pl JIM nfitnil in 12 I'.B ~!111 n 1.2) [72 PS ~9116 (a) (1)] The tax rate Imposed on the net value of transfers to or for tho use of U10 (tor.odont'!J ,;Ibll/l\ls I~t /i/" U / P}l GO 1 Hi (a) (1 :111 A .11011110 II; Iluli!\tJIl. under Section 9102. as an Individual who has alleast ana pamnl in common wllh Iho docudllnt, w!lnlllll! IIY Illood \if iidllpllOfi