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Home My WebLink About03-12-07 --1 15056051047 REV-1500 EX (06-05) PA Department of Revenue '* Bureau of Individual Taxes .. PO BOX 280601 Harrisburg. PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Securi Number Date of Death OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT Date of Birth Decedent's Last Name Suffix Decedent's First Name MI (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW _ 1. Original Return C) 4. Limited Estate C) 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required C) 2. Supplemental Return C) C) C) 4a. Future Interest Compromise (date of death after 12-12-82) C) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) C) 10. Spousal Poverty Credit (date of death C) 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes - REGISTERef.1WILLS uSe.~NLY . ".CJ "'~:,:\. "C' :~ -u N f',) ..r:- ef) M Correspondent's e-mail address: LMpJ.ootL"I@ 1iLJJ..I'.{)m Under penalties of pe~ury. I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief. it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIG~.WURE OF PERSON RESPONSIBLE FOR FILING RETURN ~~"' r: "tn/J.J.tonL ADDR~ aO.] w. J:/mwoCKl.- Arb. Mechardc.6Nu7J B+ 170S5-ild~ SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE -- {J DATE ~/d/07 I DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051047 15056051047 ---I Ci ...J REV-1500 EX Decedent's Name: W/! Ii Ii..fYl RECAPITULATION 15056052048 1. Real estate (Schedule A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3. 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 6. Jointly Owned Property (Schedule F) <:::) Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) <:::) Separate Billing Requested.. . . . . .. 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10)................................... 11. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) .. . . . . . . . . . . . . . . . . . '.' . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line .13) .. ... . . .. .. . . .. .. . . .. . . .. 14. TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 16. Amount of Line 14 ~r~able at lineal rate X.O!f1> 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X. 15 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . 19. Decedent's Social Security Number 15. 16. 17. 18. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 15056052048 Side 2 c::> 15056052048 ...J REV-150G,EX Page,3 Decedent's Complete Address: DECEDENT'S NAME ________WdLU!I!l6:._Tt-t'YJf2-1 ~_____ _ . _____ STREET ADDRESS .____.il08__ht. fi"1!Y1~_dy'~. __ _______ File Number d I 0(, 07'1d.- Me.~i -----~STATE- ----------- --r ZIP- m___ - i /7055- 12 CITY Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) f /,10j.S7 , Total Credits ( A + 8 + C ) (2) 3. Interest/Penally if applicable D. Interest E. Penally Total Interest/Penally ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. f, I 803.57 , 8. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5) (SA) (58) fl. J' 08.57 I A. Enter the interest on the tax due. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING 'AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;.......................................................................................... D ~ b. retain the right to designate who shall use the property transferred or its income; ............................................ D ~ c. retain a reversionary interest; or......................................................................................................................... D ~ d. receive the promise for life of either payments, bene~ts or care? ...................................................................... D ~ 2. If death occurred after December 12, 1982, did aecedent 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? ........................................................................................................................ 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. 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 three (3) percent [72 P.S. 99116 (a) (1.1) (i)). 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 zero (0) percent [72 P.S. 99116 (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 zero (0) percent [72 P.S. 99116(a)(1.2)). The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 PS. 99116(1.2) [72 P.S. 99116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 99116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. -'~~.."" '*' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER W'dliarn G. TUHfle." .;JI ()~ 07tj:J.. 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. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH tlJ fnrnu-(..(L.. Bank: a ftJ I Pa:JGfvn st:. Harf"'7'6'bur(p JOA- /7/11 Tlm~ Depo.sd- Auptq)t M-OOOO0034}JQlf / /0; QtJ'I.07 .2. Pah-ioltr-Aluvs 7(efu.htL f dO. SO do FuUrtu .Iht.l;me. TV...Jt, KePurvA.. I ~ f d.:J.~ tJo TOTAL (Also enter on lineS, Recapitulation) $ /~ 751..3 7 (If more space is needed, insert additional sheets of the same size) _~E c:l1 ()~ ()79~ COl1Jl1Jerce eBank America's Most Convenient Bank@ 1-888-937-0004 commercepc.com Balance information reflects fransactions through 6:00 PM on that business day_ Some deposits may not be available for immediate w~hdrawal. Checks and other items are received for deposit subject to the provisions of the Uniform Commercial Code or any applicable collection agreement 043!3.08 10/02/06 G007 ,"",~..-. ~ 'I,-.w .:iUCIC:QH '-'~'. II tTIIt"'.t'l,\1 tAl L.L! t~ I I MUr;:Hv,IHL 16=40 ",.." i':Lr $10,909.07 SIMPSON FERRY OFFICE BR-17-HB (2/06) REV.l5iJ9 EX. (1.97) SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNS\ ~ VANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Wi/fluY/ if. Ttntp{u , If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. FILE NUMBER ;J I Ofp 07 tj:J- SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. L Y I')I\~ T. MtJJ..ootL 80a If/. EllYUuocxL Avt,;. MuhP.nUS~1 PA- 17055-'1ld~ 7J~ B. c. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. I~ 7/'f/O'l tPfhmu-c.e.. &nt::. A ct:.ou.nr iJ:. 30/~.5 7 ;- Jt~OOO. dO SO~ f .Jq 000.00 .:l. A. ,. 3 /Ir, jf) i &miN.rCL.- lJ/I.r)K. ~'Jk fIa()513Iilft,'11 t ~4(1 JOS. Z(o 5D% f I~I 05;)..1p3 TOT At (Also enter on line 6, Recapitulation) $ 8.JJ (JSJ-. 1,3 (If more space is needed, insert additional sheets of the same size) ~F .-.------.-________...a.L~~1L19 ..1- CHECKING COMMEI;ICE BANK, N.A. CAMP HILL, PA WE CREDIT YOUR ACCOUNT FOR THE REASON INDIC TED BELOW: T ra n S Fe r fro yY\ CD 30 llo 57 I L 'l n (\ e. -r \'Y\ a.. h 0'00 I: 50 2 311'0 ~B 1.,1: DATE: A-23 10103 AMOUNT 0,00 00 ~\ > Q C <.. D u ... ~ 2 c: '-'UI I II I le;;I "e;; "Bank 3801 Paxton Street Harrisburg PA 17111 888-937 -0004 ~ ell Ofp F ()7'1;J- STATEHENT DATE 0513187641 ACCOUNT NO. WILLIAM G TEMPLE LYNNE T MAHOOD C/O LYNNE MAHOOD 303 W ELMWOOD AVE MECHANICSBURG, PA 17055 *** BALANCE BY DATE.**:!'._.. __. '_~_~_'_. 08/08 23 I 988.23 (OJl/19.. 24.{105. 2€ij 08/31 09/05 65 I 921. 83 ~(j6-----gS ;~g-~5~.10 25 I 921. 83 09/01 PAYER FEDERAL ID NUMBER INTEREST PAID YEAR TO DATE 23-2324730 16.01 ---------------------------------------------------- CYCLE-002 26,895.83 *** INTEREST EARNED THIS STATEMENT PERIOD DAYS IN PERIOD ......................... INTEREST EARNED. ........ ............... ANNUAL PERCENTAGE YIELD EARNED (APY).... *** 29 3.27 0.15% ---------------------------------------------------- NnTF' C:::FF RFVFRC:::F C:::lnF FOR IMPORTANT INFORMATION Mp.mhp.r FDIC <~I= ~~~~9,L Page: 1 Document Name: untitleci. CIDICU F1fID CUSTOMER NAME M.:4.ILING ADDRESS IvIAILING ADDRESS CITY .1\..ND STATE SSN / Tl\J{ ID HONE PHONE PLACE OF 1il0RK CI DISPLAY CUSTOMER BANK 0184 ) LYNNE T *MAHOOD LINE 1 303 W ELMWOOD AVE LINE 2 MECHANICSBURG PA 172486529 S BIRTH DATE 717-766-8055 DAY PHONE 17055 03 06/30/55 LAST MAINT 09/18/00 717-697-2362 OFFICER NOTAVAIL DUE DATE EXPIRATION ~R:4.CKING MESSAGE NONE 1. SECONDARY OWNER CK 50 PLUS CLUB 0000000513187641 9,742.80 - .. 3 < SECONDARY OWNER TD 18 MO. PROMO CD 0000000000301657 J.ta> 40,000.00 11, cd () - ~ ~ --- ( 0 0 0 0 0 0 0 0 0 ) ACCESS SELECTED RELATIONSHIPS I Y ) ACCESS SELECTED RELATIONSHIPS IF MORE TKA.N ONE RELATIONSHIP IS TO BE ACCESSED, ENTER IN THE SELECTED ORDER. ~ej-tI 0\ -,tL tS. ~ \P'" ^t'OU-" ., \S 0 ~ t, ().Y' ,-trY1'\. 1\"l rY 'oll' cr rvP uJi~J ~ Date: 1/4/2005 Time: 04:12:36 ~--~-------------------_._-~_._-------_.._--_._-~_.-.---~--_. REV:"" EX, .'''.99'. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ,;/1 tk 07'1~ Debts of decedent must be reported on Schedule 1. ITEM NUMBER A. FUNERAL EXPENSES: DESCRIPTION 1. .A1 yer.s - Harne.r nu,eraJ Horne., th"'31Ln "5t Open;~ / el()~""'J t!ilurcJ. }='Io ri 5f; /VUnisftr B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/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 Street Address City State _ Zip Relationship of Claimant to Decedent 4. Probate Fees Gn:t.nt uP Le.H~ 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. MdJI }J{)+i~ OF RsWe- Adfhini~'Qn EshJ-e- N~-h'~ - t.IJ.r-liSIe. 5e.nhn~ i. AMOUNT f /Of,.5i f 50.00 l' :Jo.I)O 4 7/.00 f 100.00 o o o ! 87,OtJ (/ o t q.;;g 1107. q'l TOTAL (Also enter on line 9, Recapitulation) $ 35/. KS (If more space is needed, insert additional sheets of the same size) REV:1512 EX+ (12-03) . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF h//I!ltl.n1 G. Timflu ITEM NUMBER 1. FILE NUMBER dl{ O(p 07'1"- Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. VALUE AT DATE DESCRIPTION OF DEATH Alert Phar~ S'erdce..5 t ~CltQ.5:J- d. Mess/oJ, Yl! (IJ-j ~ f -1 q~(, .:;'0 TOTAL (Also enter on line 10, Recapitulation) $ ~,/ 7;J. . 7::L (If more space is needed, insert additional sheets of the same size) ~x _ ..-':1L..q~___q79~ ** ACTIVITY FOR TEMPLE, WILLIAM -TEMPW - -70608 08/07/06 7121637 14 NAMENDA 10MG 01 18.05 .00 18.( 08/07/06 7121638 28 MUCINEX 600MG 01 * 14 .32 .00 14.2 08/07/06 7121639 7 LIPITOR 10 MG TAB 01 11.20 .00 11.~ 08/07/06 7121640 7 DILTIAZEM HCL 120 01 5.10 .00 5. J 08/07/06 7121641 7 CITALOPRAM HBR 20 01 3.75 .00 3.~ 08/07/06 7121642 7 ASPIR-LOW 81MG EC 01 * 2.43 .00 2.4 08/07/06 7121643 7 ARICEPT 10MG 01 19.79 .00 19. ~ 08/07/06 7121644 4 AMIODARONE 200 MG 01 3.56 .00 3. ~ 08/17/06 7121637 60 NAMENDA 10MG 01 69.14 .00 69. : 08/17/06 7121638 120 MUCINEX 600MG 01 * 53.48 .00 53.~ 08/17/06 7121640 30 DILTIAZEM HCL 120 01 13.63 .00 13. f 08/17/06 7121642 30 ASPIR-LOW 81MG EC 01 * 2.53 .00 2 . ~ 08/17/06 4079859 120 GUAIFENESIN W/COD 01 * 1. 73 .00 1." 08/21/06 2024519 30 MORPHINE SULF 20M 01 7.81 .00 7. ! -'--""-""-- i Previous Balance Charges this month __ u.____...___,.__ Finance Charge 152.03 LEGEND _.EO~RHQNTl:J: TOTAL CHARGES 74.49 NON-LEGEND .J~'QR.MONTH . Total Payment & Credits , '" C't .00 ~. .TO"1"o4" TAl( _."~ -.----.-,'.-- .---- ----.------------ -~--'-.---_.~-----_._. ~ -- ~---_..------ - -- ---.---_. ______________..u________.__________ ___________._." ."..~...________.____ .00 226.52 .00 226.52 .00 ~ ~ + + FOR ALL PHARMACY RELATED INQUIRES PLEASE CALL Alert Pharmacy Services, Inc at 1-800-266-9954 Statement TenninolllgY .<>n reverse ) J ! ) ) J ) , f ) UJ ~ li ::i ~ :;::1 'E ~ = E ~~ "- ~ ~ ~ <U '; ~~ Q J~ } Q , ,~r )/ 0" ()79~ Q Q .,e t-- t--.. M 5 QQ QN M.,e t--~ ~~ MM .~ r ~..( ,~.' ~'- wQ ::IN O.,e I-~ ZQ'\ ::I~ ~Gf'l ~ ..J ;!: o I- Q ~ \C t-- ~ M o N ~Q a::Q ~= o QQ QN r-=M Q'\ t-- Q ~ \C ~ Q ~ \C M N QQ ~~ ~~ \C In Q f'!f'! ~~ N o OlQ a::Q ~= o o coQ a::Q ~= o ~ > Q i::loi N ~ ~ ~ < ~ ...:l "; ~ oj< ~ ~ : z ~ ~- ~ -00 ~ =~ ~i::loi ';~ ;;=1 .5 'Q~U ~~SS~~ Z~'f>8 oj<-.In~~ : ~~P:;;=I ~~i::loii::loi o "'Q a::Q ~= o I-Q ZN w.,e a::~ g;Q'\ ()~ \C Q -. Q ~ 00 Q 'It: 1-00 ZQ ~\C 1i5Q W t-- a:: \C \C QQ -. -. ~~ NN -. -. 00 00 QQ /-.-- ',- }\ a. g~ u.Z ..... o l:: '" eo; ..c: ..... l:: ~ e ;>.. eo; Co ..c: CJ :c ~ ~ ...:l s.. i::loi.8 ~~ ~ ~ ~8 CJ ~ eo; l:: ~ 0 <"2 - ~ ...:l ~ ::3 ~ ~l: .;>.. _ eo; ~ e ~ LlJ Oil ::2: ;; <(..c: Z ~ I- CJ Z l:: LlJ ~ 0-= (f):;f. w;.. 0:::< = o ;>.. .:.: l:: eo; ..c: Eo- = o ;;.- .:.: l:: eo; ..c: Eo- a; ..... 0: "0 ~ "0 ~ ..c: ..... e- N N 00 I <::> 0'\ r-- = '" ~ CJ ";; s.. ~ en eo; CJ '" '-i: o ..... ;>.. ';:; CJ ~ s.. "0 e ~ ..c: ..... '" '" ~ s.. "0 "0 eo; ~ '" 0: ~ C. ;>.. .Q "0 ~ ;.. "Q:i CJ ~ s.. l:: ~ ~ .Q :c s.. = o ;>.. ..... = o .Q 0: '" l:: s.. ~ CJ l:: o CJ s.. o '" l:: o ::: '" ~ = 0- ;>.. l:: 0: ~ ;.. 0: ..c: = o ;>.. '- REV-1513 EX+ (9-00) . '. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF J. /'/1' G"T:: WI 14J?1 . IUhp/v FILE NUMBER .,;)1 0(, 07tj ~ 1. RELATIONSHIP TO DECEDENT NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Lynne. T. /IIlILhood- ~h-te.r 30,3 W. ~/tntv~od. A-v~. Mechu>lC.5b~1 pA 17055'-'tI~~ AMOUNT OR SHARE OF ESTATE NUMBER I /00% 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. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1, TOTAL OF PART II - 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) _t I 2 n~O 1lLast Mill aub Qr~stattt~nl}j~ 2~~8 ~ _, ....'-""~ II f .".:)t= ~:J ~j~ .J> OF ;--i -:J I CJ WILLIAM G. TEMPLE G.) CJ1 N I, WILLIAM G. TEMPLE, a citizen of the United states, and a resident of Pinellas County, Florida, being of sound and disposing mind and memory, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any other Wills and Codicils by me at any time heretofore made. ,FIRST: I ,direct that all my legal debts and liabilities, including funeral expenses, be paid out of my estate as soon as practicable aftermydeath,-provided that such debts and liabilities should first be paid out of the assets of my Living Trust as described herein below, if such Trust is in existence at the time of my death. Such debts and liabilities shall be paid out of my estate only to the extent that the'assets of my Trust are insufficient to pay the same. SECOND: I devise certain personal property to my beneficiaries in accordance with a list which I shall draft and sign after the execution of this Will. Such separate instrument is made in accordance with Florida Statute 732.515 and is intended by me 1:0 be a ,complete and ;final disposition of the property named in such separate instrument to my beneficiaries. If no such list can be found as of thirty (30) days after the PAGE ONE OF A SIX PAGE WILL JI~L u I 1 ~ - ~ , (.-::.:..;. c:...,-" i,.J .~ -~.~i --1'/ :'~:::J _~l :",,:) -:. l ~ i' I __:--. .':1 . -) ___ n -) date of my death, then all personal property which I own at the time of my death shall become a part of the residue of my estate and pass according to the residuary clause of this, my Last Will and Testament. THIRD: All the rest, residue and remainder of my estate, both real, personal and mixed property, of every kind and nature and wheresoever situate, of which I may own or have the right to dispose of at the time of my death or thereafter, including the proceeds of any insurance on my life payable to my estate or Personal Representative, and including any Powers of Appointment in my favor, I give, devise and appoint to that REVOCABLE LIVING TRUST, dated <o~~ JL / D , 1993, of which my wife and I are the Grantors, to be disposed of in accordance with the terms of said Trust and any Amendments thereto executed by me at any time prior to the execution of this Will. FOURTH: In the event that the aforesaid Trust is not in existence, or is, for any reason, unable to receive any assets passing under this, my Last Will and Testament, then I give, devise and appoint all the rest, residue and remainder of my estate, of whatever kind or nature and wheresoever situate, which I may own or have the right to dispose of at the time of my death or thereafter, including the proceeds of any insurance payable to my Personal Representative and including any powers of appointment in my favor, I give, devise and appoint to the beneficiaries of said Trust, in strict accordance with PAGE TWO OF A SIX PAGE WILL /~7/t: dispositive provisions of such Trust, and any Amendments thereto executed by me at any time prior to the execution of this Will. FIFTH: If my wife, MILDRED M. TEMPLE, should die with me in a common accident or under circumstances which make it difficult to determine which of us survived the other, then it is to be presumed that I survived my wife and the administration of this estate is to be in accordance with that presumption. If any beneficiary named herein, other than my wife, fails to survive me for a period of ninety (90) days, then it shall be presumed that for the purposes of this, my Last Will and Testament, that such beneficiary predeceased me and the disposition of the assets in my estate shall be made in accordance with such presumption. SIXTH: If, at the time of my death, I own any property jointly with any other person or persons, as tenants by the entirety, as joint tenants with right of survivorship, or which is payable to either Co-owner or the survivor of them, then it shall be conclusively presumed that such property was owned jointly and such property shall pass to such person or persons as a result of their survivorship, and shall not be considered a portion of my probate estate. SEVENTH: I make, nominate and appoint my wife, MILDRED M. TEMPLE, as Personal Representative of this my Last Will and Testament. I request that my Personal Representative serve without bond and I expressly give and grant unto my Personal PAGE THREE OF A SIX PAGE WILL ~~ if Representative full power and authority to sell any or all of the assets of my estate without notice and without order of any Court. In the event she does not survive me, or in the event for any reason she does not qualify as Personal Representative of this Will, or having qualified shall fail for any reason to act, then and in such event, I hereby appoint my daughter, LYNNE T. MAHOOD, as Alternate Personal Representative of this my Last Will and Testament. EIGHTH: Without limitation of the powers bestowed on my Personal Representative by statute, common or general rules of law, I authorize and empower my Personal Representative in the administration of my estate at any time and in my Personal Representative's sole discretion to sell, mortgage, or otherwise encumber without notice and without order of court any assets of the estate including any real or personal property belonging to my estate and to settle any claims, either in favor of or against my estate, as to which my Personal Representative shall deem best to retain any stocks, bonds, notes, other securities and other property, real and personal, without liability for any decrease in value thereof, and to execute any and all proper and necessary deeds, conveyances and receipts. All powers bestowed on my Personal Representative shall be applicable to any successor Personal Representative, acting hereunder to the same extent as though expressly named herein. IN WITNESS WHEREOF, I, WILLIAM G. TEMPLE, have hereunto PAGE FOUR OF A SIX PAGE WILL //.J-z1 ;;:- /( v set my hand and seal in Pinellas County, Florida, this day of February A.D., 1993. ~" ~'//l- - ~/-L' ~ ~.-T~.-/ _ . ':b--J.-;>~-{; WILLIAM G. TEMPLE (SEAL) The foregoing instrument was on this JL) day of February A.D., 1993, signed, published and declared by WILLIAM G. TEMPLE to be his Last Will and Testament in the presence of each of us, who thereupon at his request and in his presence and in the presence of each other have hereunto subscribed our names as witnesses this day and year last above written. ~ residing in Palm Harbor, Florida (Yl...e..P..L ~ hJ n.~-o- res id i ng in Safety Harbor, Florida STATE OF FLORIDA COUNTY OF PINELLAS We, WILLIAM G. TEMPLE, the testator and Mark W. Brandt and Melissa H. Nelson , witnesses respectively, whose names are signed to the attached or foregoing instrument, having been sworn, declared to the undersigned officer that the testator, in the presence of witnesses, signed the instrument as his Last Will, and that each of the witnesses, in the presence of the testator and in the PAGE FIVE OF A SIX PAGE WILL I ~~I ..;/ v presence of each other, signed the Will as a witness. ,;?/~Y:/j-~~ ~~-7A 4L WILLIAM G. TEMPLE . ~ . Testator /U1~4 Witness fYl.JL~D ~ Witness STATE OF FLORIDA COUNTY OF PINELLAS The foregoing acknowledgment was acknowledged before me this ID+.bday of Februarv , 1993 by WILLIAM G. TEMPLE, the Testator and by Mark W. Brandt and Melissa H.Nelson , the witnesses, who are . personally known to me or have produced d Yl vet ~ II e..en~(" as identification and who did/did not take an oath. '-Cl~ '-1'f\ .~~ Notary Public My Commission Expires: OFFiCIAL NOTARY SEAL DAWN M MARVIN NOTARY PUBLIC STATE OF FLORIDA COMMiSSION NO. CC047126 MY COMMiSSION EXP. OCT. 20,1994 PAGE SIX OF A SIX PAGE WILL l?L ,~/ r .r4 1"'. ',p,j ;... '.Jj t ~ SL ~', " ..~~ I~ R ...., c.cKI . . t'J . oJ ~ ~ ~ ~' i ~.( ~~t '01< 1"1' o 0-. ':JIll ~" ~ t,) ~''3 .E a)'c ~ E-W '~ .::&.~ ~ ~~~ ~C") . F"" ? t.6 ,)11.n11'~D\ 12 "ii I_'~S ; 1IIJ i i,.1 ,... ,-,. .~ r" ~ " ,-, .'- ....,. .. ".." f'. . 1':'\ { .', I f,\,.PC '. " ". ' ~. \).:) L". '~~ CUi" ~ l~ -!~ ~.. ,. . ~ ~~~~..~ ~.~~~~~ .... ( " ... ~~. ~ ~~.\' ~~~~. .....~ ~ <:.:: ~ ""=u......... ~ ~ - - - - - - - - - - - - - - - - 1 ~ ", r 1 + (,',