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Home My WebLink About05-04-06 (2) ~ \, ---I 15056051058 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 Number Date of Death OFFICIAL USE ONLY .~~.~.~.o/..g~de . Year INHERITANCE TAX RETURN RESIDENT DECEDENT File Number 21 05 .1094 Date of Birth 12/12/2005 12/04/1927 Decedent's Last Name Suffix Decedent's First Name MI SHIPMAN SHIRLEY G (If Applicable) Enter Surviving Spouse's Information Below Last Name Suffix First Name MI ?P?~~~'~...~?~.i~.~..?~.~.~r..i~y'..~.~.~~.~.r. THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ta) 1. Original Return C> 2. Supplemental Return c=> 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required C) CJ 4a. Future Interest Compromise (date of death after 12-12-82) C) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) c:.:J 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 DIREG--l~ TO: Name Daytime Telephon~ Number (.; , :..-") ........j...;.... : (717) 737-3405 . '. .~~: 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes 4. Limited Estate C) ;te) C:) 1... .; REGISTER OF WILLS pSE ON4Y -] ,~ .-----..-..~~(J... =~=~K==~" ..., \ I (" First line of address -'J 2109 MARKET STREET Second line of address 1"'.) or Post Office State 21 P Code DATE FILED 17011 Correspondent's e-mail address:TFLOWER@SFL-LAW.COM Under penalties of perjury, I declare that I have examined this retum, 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 ATURE OF PERSON SPO IBLE F FILING RETURN DATE , ~C - DATE S"-~-Ob ADDRESS SAlOIS, FLOWER & L1NDSA Y, 2109 MARKET ST., CAMP HILL, PA 17011 PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051058 15056051058 ---.J ,,\.ii '^'il!' \} \ . ./ ('J. 00 q, I('~ ~ '\J :\ \ tI --> 'V\ b-IJ ~ ~~~ (( 1> " ---I 15056052059 REV-1500 EX Decedent's Social Security Number ,........ . ...-...............................................-.................... .....".. .....,............... . Decedent's Name: SHIRLEY G SHIPMAN : 125-20-2969 RECAPITULATION 1. Real estate (Schedule A). '" . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. y_~~.<>__..._.;,_~_'\'....,~}.""""..".~__.;.h~~..''''.._..'''~..',..,.w~_>_.PN>...___;M~.o.-..;.........._"""-<>Ao.""'....." 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2.! 238,448.01 lINMIJ'''''.._NN'''''_....___._........_N''''._M>.Nu#J.".-H~."__-H"...--<J,,.__~VIII.'...,..N'..,U'''...,J<.v..~.....w_~.;w.....~ . . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3. . . . . ~._..t"........,_....~.~_"~~_"N"'''~~.Mh~;.-^._MiNW''l'''.___~.u..''''''''~~_.-....H.._.....,.,..._"'U....N"_'''NN..~ 4. Mortgages & Notes Receivable (Schedule D). . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. ~'~-----"~_...w~..........",,",,-,_,.) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5.' 148,393.40 : ;..u.'UNI."""'"'~",N...v"'JV"'__-"-_"_'N_~.N.NNJWw'.~_-I__""'W'''''N~N.~_; 6. Jointly Owned Property (Schedule F) c=> Separate Billing Requested . . . . . .. 6.! f..,...._...,......._-_NoNNI,"""^"_.._~.-N_~Nv.......-...."'^""'~"""AM""N..~N~____.,: 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c=; Separate Billing Requested.. . . . . .. 7. 88,486.59 : . . r~"W'~~..-N.<._..I.A>NN<,,~~'~""'~"-'--N~.J.-..'J_~_.....oJ_'__...,JU'^""'"~"'...,~'^"""^":.n__~,.: 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8.' 475,328.00 : ~-._..........._~"......,\~~......."""""v......",.~^.........._................~__,\",,,,_,: 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9.' 23,770.33 · ~U.........-.........''''...........W.,............_-..,N'N~..'''"....._.#M"~_..UN~U,.~...~~_.......-....N..No.._UA.."......N<;,......--.........."'...~ 1 O. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . . . . . 10. 10,4 70.83 : ~'''-.~'..d~.''..'.....'''''N.....,''''U'-'-'~...,'h#;..''~h'''_'''.,..'........N'''*..h..,""-,....u_'_",...uh_."'....<...____~_____N.wN._'^""; 11. Total Deductions (total Lines 9 & 10). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 11. i 34,241.16 1 ~...,.NININN>N.--.-N"'...,"'.....".____-MA.v.N~.."..........N~......,........N"N>NN.,UV.....MNNN""'""'...,"'...........".N......''''.'''...-__...'.................._.N~"""'.,.: . . 12. Net Value of Estate (Line 8 minus Line 11) . ............... .... ..... ... .. 12. : 441,086.84 . 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which '_.mm.......w_...~'_m_=--..=~m......N.........._u......Nmmu_.m...-N.W~.WN...'Mm..m~u..'......~..,w~...uNNn.'N,........."..A.VI.....W...,..: an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. . 0.00 . . t..A...U.....N>N...._..."'#o'....NMA>....A....N.,~.......MM"-".._....,,_..."'....u........A.'W"IW'...--...-NW~........................~.."'-..........."""............N......,_...,..NU...,.."""...W 14. Net Value Subject to Tax (Line 12 minus Line 13) .... . . . . . . . . . . . . . . . . . . . . 14. i 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 taxable at lineal rate X.O 45 441,086.84 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 441,086.84 : 15. 16. 19,848.91 17. 18. 19. TAX DUE. . . . .. ... . . . . .. . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ,e> L 15056052059 Side 2 15056052059 --.J 'l '" REV-1500 EX Page 3 Decedent's Complete Address: File Number f21l ,051 r1094--#^"^'~----~'-------i L_~~~~l ~ ~ . ""-_......~ ,.- .....~~_."""'".. ...... '_-......"<...w....'^"~.w."".........,..."......_..__..~..._~..w.....,...,...v..........,u........,..__-..-N_............. DECEDENTS NAME DECEDENTS SOCIAL SECURITY NUMBER SHIRLEY G SHIPMAN 125-20-2969 STREET ADDRESS MESSIAH VILLAGE 100 MT. ALLEN ROAD CITY I STATE I ZIP MECHANICSBURG PA 17055 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 19,848.91 19,500.00 992.45 Total Credits (A + B + C ) (2) 20,492.45 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( 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) 0.00 643.54 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5) (5A) (58) 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 00 b. retain the right to designate who shall use the property transferred or its income; ............................................ D 00 c. retain a reversionary interest; or.............................. .................. .............. .......................................... .................. D [i] d. receive the promise for life of either payments, benefits or care? ...................................................................... D [KJ 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? ............................ ............ ....................... ............ .................................. ........... ~ 0 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 P.S. 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. "\ . REV-1503 EX+ (6_98* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF SHIRLEY G. SHIPMAN FILE NUMBER 21-05-1094 All property jointly-owned with right of survivorship must be disclosed on Schedule F. VALUE AT DATE OF DEATH ITEM NUMBER 1 . DESCRIPTION 755.992 VANGUARD 500 INDEX FUND INVESTOR SHARES @ 116.54 1,970.218 VANGUARD WINDSOR II FUND INVESTOR SHARES @ 32.59 2. 3. 3,337.284 VANGUARD ASSET ALLOCATION FUND INVESTOR SHARES @ 25.81 88,103.31 64,209.40 TOTAL (Also enter on line 2, Recapitulation) (If more space is needed, insert additional sheets of the same size) 238,448.01 '" . Vanguard@ February 3, 2006 P.O. Box 2600 Valley Forge, PA 19482-2600 SAlOIS, FLOWER & LINDSAY ATTN: THOMAS E FLOWER 2109 MARKET ST CAMP HILL PA 17011 www.vanguard.com Estate of Shirley G. Shipman Dear Mr. Flower: We are responding to your letter requesting the value of the following account. Please convey our sincere condolences to the family of Ms. Shirley Shipman for their loss. As of December 12, 2005, the number of shares, the price per share, and the value of the account were as follows: Name, , Funct#,,: , Susan C. Kar-Guardian Account Shares Pric Accrued Value Dividends anguard 500 Index 0040- 755.992 $116.54 $88,103.31 Fund Investor Shares 09901718175 anguard Windsor II 0073- 1,970.218 $32.59 $64,209.40 Fund Investor Shares 09901718175 ang uard Asset 0078- 1I0cation Fund Investor 09901718175 3,337.284 $25.81 $86,135.30 Shares If you have any questions, please contact your Voyager Service Team at 800-284-7245. Voyager's business hours are Monday through Friday from 8 a.m. to 10 p.m. and on Saturday from 9 a.m. to 4 p.m., Eastern time. One of our dedicated Voyager associates will be pleased to assist you. Sincerely, ~lU.ku~. Adrienne Acheson Reg isteredRepres,entative I. . ~ ,,,I Correspondence Number 20043156 ; .. -..--.-.--- -- .-.- :._ I....') Ir .'. (~:t'(; f '- t ;~I.. ._""". ;_" -.,'..'.. ~"".....- ~ REV-150B EX+ (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF SHIRLEY G. SHIPMAN FILE NUMBER 21-05-1094 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. MEMBERS 1ST FCU SAVINGS ACCT #83327-00 (PRINCIPAL -101.19; ACC INT - 0.03) 2. MEMBERS 1 ST FCU C/O #83327-40 (PRINCIPAL - 11,320.48; ACC INT - 14.23) 3. MEMBERS 1ST FCU C/O #83327-41 (PRINCIPAL - 27,640.73; ACC INT - 34.74) 4. MEMBERS 1ST FCU C/O #83327-42 (PRINCIPAL - 27,640.73; ACC INT - 34.74) 5. MEMBERS 1ST FCU C/O #83327-43 (PRINCIPAL - 27,640.73; ACC INT - 34.74) 6. MEMBERS 1ST FCU C/O #83327-44 (PRINCIPAL - 27,640.73; ACC INT - 34.74) 7. PNC BANK SAVINGS ACCT #5003800321 8. PNC BANK CHECKING ACCT #5070084863 10,581.25 plus ace. int. 0.94 9. PNC BANK C/O #31700237363 3,067.60 plus ace. int. 12.49 10. PNC BANK C/O #31900248389 3,067.60 plus ace. int. 12.49 11. PNC BANK C/O #31100248843 3,067.60 plus ace. int. 12.49 12. PNC BANK C/O #31100248844 3,067.60 plus ace. int. 12.49 13. PNC BANK C/O #31100248845 3,067.60 plus ace. int. 12.49 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 148,393.40 \- REGULAR SAVINGS ACCOUNT: Account Number/ Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Estate of: SHIRLEY G. SHIPMAN Date of Death: December 12,2005 Social Security Number: 125-20-2969 fvl~ MEMBERS 1st FEDERAL CREDIT UNION 83327 -00 04/29/1987 $101.19 $.03 $101.22 None 83327 -40 12/11/2004 $11,320.48 $14.23 $11,334.71 None 83327 -41 12/11./2004 $27,640.73 $34.74 $27,675.47 None 83327 -42 12/11/2004 $27,640.73 $34.74 $27,675.47 None 83327 -43 12/11/2004 $27,640.73 $34.74 $27,675.47 None 83327 -jl2 'it{, 12/11/2004 $27,640.73 $34.74 . $27,675.47 None ~s ?;RAL CREDIT UNION Denise A. Wolfe ~ Insurance Services Supervisor February 10, 2006 5000 Louise Drive · PO. Box 40 · Mechanicsburg, Pennsylvania 17055 · (717) 697-1161 · www.memberslst.org rIH~-LU C.XJIULJ o PNCBAN< March 29,2006 Sara Ensinger Attorney at Law 2109 Market St. Camp Hill, PA 17011 scp RE: Estate of Shirley G Shipman (Deceased) SSN: 125-20-2969 DOD: 12-12-2005 Dear Ms. Ensinger; In response to your request for Date of Death balances for the customer noted above, our records show the following: Certificate of Deposit Account #31700247363 Established 10-07-2004 SHIRLEY G Sl-IIPMAN DOD balance: $3,067_70 + $12.49 accrued interest Account #31900248389 Established 10-07-2004 SHIRLEY G SHIPMAN DOD balance: $3J067.70 + $12.49 accrued interest Account #31100248843 Established 10-07-2004 SHIRLEY G SHIPMAN DOD balance: $3J067.70 + $12.49 accrued interest Account #31100248844 Established 10-07-2004 SHIRLEY G SHIPMAN DOD balance: $3,067.70 + $12.49 accrued interest Account #31100248845 Established 10-07-2004 SHIRLEY G SHIPMAN DOD balance: $3~067_70 + $12_49 accrued interest Page 1 of2 Checking Account Acconnt#5070084863 Established 01-01-1979 SHIRLEY SHIPMAN DOD balance: $10,581-25 + $0.94 accrued interest Savings ACCollnt Account #5003800321 Established 05-31-2001 SHIRLEY G SHIPMAN DOD balance: $272.95 + $0.00 accrued interest Please note that this office only provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings accounts). We do not process any financial transactions or provide statements. If you need assistance with any of these items, please call 1-888~PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, ~;1_~ Erica L Schlegel 1-800-762-1775 P7 -PFSC-04-F 500 First Ave. Pittsbutgh P A 15219 Member FOle Page 2 of2 TnTr'l1 0 (";l'J REV-1510 EX+ (6-98* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF SHIRLEY G. SHIPMAN FILE NUMBER 21-05-1094 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. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND . THE DATE OF TRANSFER. ATTACH A COpy OF THE DEED FOR REAL ESTATE. DATE OF DEATH % OF DECO'S EXCLUSION VALUE OF ASSET INTEREST (IF APPLICABLE) 1. ANNUITY CONTRACT # 81328-21-91 MONY 2. ANNUITY CONTRACT # A637089384A AlG, Sun America 3. ANNUITY CONTRACT # 80022452 Thrivent Lutheran (IRA) TOTAL (Also enter on line 7 Recapitulation) (If more space is needed, insert additional sheets of the same size) '- -/ /* ~cY _ ~c """ In/""f\A\ 1h1t.)~~ ~~ An AXA Financial Company MONY Life Insurance Company of America P.O. Box 4720 Syracuse, New York 13221 (315) 477-3000 February 14,2006 Thomas Flower 2109 Market St Camp Hill, Pa 17011 Re: Contract/Policy - B 1328-21-91 and 1197-02-17 Annuitant/Insured - Shirley Shipman Dear Mr. Flower: On behalf of MaNY Life Insurance Company of America, please accept my heartfelt condolences upon the death of your client. I will be assisting you personally throughout the claim process and have enclosed the forms and a list of documents we will need to expedite processing of the claim. Please be assured I am here to help if you need assistance in completing the forms or if you have any questions throughout the claim process. .If D /3dr-dl4ll - ~nltlr Children .of Mrs. Shirley G Shipman to share alike is the beneficiary on ?18-21-9l Susan Kar, Son, D Richard Shipman, Son, Jeffe . -n : ene lsted on policy 1197-02-17. The approximate amount payabl on B1328- - 1S $34,949.08, of which $17,591.20 is taxable. The approximate amount paya e - 2-17' being calculated and the options available are listed below. The beneficiaries may want 0 consult with a tax advisor to determine which option is best for them: f //'17\&J 17 _~ ~ltlia.- 1. Electing an Installment or Life Option can spread the taxable amount out. To obtain election forms or for more information about these payment options, please call toll free at 1- 800-326-6744. Please note: If a Settl~11l.~~!9ptiop. is elected, it must be elected within 30 days of the date we "received due proof of death (the Death Certificate). 2. Immediate Payment Option: · Proceeds are immediately made available by means of an interest-bearing checking account. Please submit the following forms and documents to my attention at MaNY Life Insurance Company of America, PO Box 4720, Mail Drop 32-52, Syracuse, NY 13221. . The enclosed Request for Payment of Benefits form #03582. . Certified copy of the Annuitant's Death Certificate. . The original Contract, if available. . The enclosed Federal Income Tax Statement of Elections form #11363. Cat. #134228 (9/04) ,.......J. Y Thrivent Financial for Lutherans™ Death Benefit Information Mpls Settlement Option Contract: 50022452 Deceased: Shirley G Shipman Date of Death: 12/12/2005 Date Prepared: 03/04/2006 Claim Number; 363003 Death Benefit Cost Basis Taxable Gain $ $ 0.00 44,387.53 Total Death Benefit $ 44,387.53 Beneficiary Designation Primary: Susan Colleen Kar, Children Born/Adopted, Jeffrey Paul Shipman, Children Born/Adopted, David Richard Shipman, Children Born/Adopted Special Messages 1. IMPORTANT TAX REQUIREMENTS: Each beneficiary will be subject to federal income tax withholding for their share of the taxable gain. Each beneficiary needs to complete the substitute W-4P section on the Claimant's Statement. If NO withholding is desired, the first section in the substitute W-4P should be checked. If the beneficiary DOES want withholding, the appropriate section should be completed. 2. To assist the beneficiary in selecting a distribution method, you should refer to Income Tax Chart No.1. This chart can be printed from InfoSource, Customer Service, Claims, Death Claims Tax Charts. 3. Contract S0022452 had Check# 7504250559 mailed after the date of death and is uncashed. Thrivent Financial for Lutherans will void this check. AIG Life Companies (U.S.) AIG LIFE INSURANCE COMPANY AMERICAN INTERNATIONAL LIFE ASSURANCE COMPANY OF NEWYORK A Member of American International Group, Inc. April 3, 2006 Law Offices Saidis, Flower & Lindsey Attn: Thomas E. Flower 2109 Market Street Camp Hill, P A 17011 Re: Deceased: Contract #: Shirley Shipman A637089384A Dear Mr. Flower: Thank you for your recent inquiry regarding the referenced annuity contract( s). It is our pleasure to be of service to you. The val~e of the contract as of December 12, 2005 was $9,149.98. We hope this information is helpful; however, should you have additional questions or require further assistance, please feel free to contact our .Client Care Center by using our toll free number of 1-800-233-2947. s~. . _ Becki Galaviz M Claims Department Annuity Administration P.O. Box 15403 · Amarillo, TX 79105-5403 · 800.233.2947 REV-1511 EX+ (12-99). COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-05-1094 ESTATE OF SHIRLEY G. SHIPMAN ITEM NUMBER A. B. 1. 2. Debts of decedent must be reported on Schedule 1. DESCRIPTION AMOUNT 1. FUNERAL.EXPENSI;S; COCKLIN FUNERAL HOME, PROFESSIONAL SERVICE~ CASKET (2.445.00) AND VAULT ,100.00) DEATH CERTIFICATES AND OBITUARIES CLERGY HONORARIUM (150.00) AND ORGANIST (100.00) GRAVE OPENING, LABOR (450.00) AND EQUIPMENT (120.00) FUNERAL DIRECTOR, MILEAGE SUNBURY MONUMENT WORKS, MEMORIAL STONE AND ENGRAVING ADMINISTRATIVE COSTS: 2. 3. 4. 5. 6. 7. 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: Attorney Fees 12,500.00 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 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. PUBLISH EXECUTOR'S NOTICES - SENTINEL (166.07), C~~B.LAVV JRNL. (75) 8. SHORT CERTIFICATES 9. PNC BANK, CHECK PRINTING FEE TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) 23,770.33 . REV-l512 EX+ (12-ll3) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF SHIRLEY G. SHIPMAN FILE NUMBER 21-05-1094 Report debts Incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. ALERT PHARMACY SERVICES 85.94 3. MESSIAH VILLAGE, NURSING ROOM & BOARD PA DEPT OF REVENUE, 2005 INCOME TAX 10,132.12 252.77 2. TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) 10,470.83 . REV-1513 EX+ (9'()O) .- COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF SHIRLEY G. SHIPMAN NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec.911{3{~L(1~?)L. 1. SUSAN C. KAR, 17 Buck Drive, Carlisle, PA 17013 2. D. RICHARD SHIPMAN, 313 Sample Bridge Rd, Mechanicsburg, PA 3. JEFFREY P. SHIPMAN, 538 Mountain Road, Boiling Springs, PA 17007 FILE NUMBER 21-05-1094 AMOUNT OR SHARE OF ESTATE RELATIONSHIP TO DECEDENT Do Not List Trustee(s) DAUGHTER 0.33 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 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) . LAST WILL AND TESTAMENT OF SHIRLEY G. SHIPMAN I, SHIRLEY G. SHIPMAN, of 19 Chestnut Drive, Carlisle, Cumberland County, Pennsylvania, declare this instrument to be my Last Will and Testament, in manner and form following: 1. I hereby expressly revoke all Wills and Codicils heretofore made by me. 2. I hereby direct my Executor to pay all my just debts, fu- neral and administrative expenses out of my estate, as soon as practicable after my death. 3. I direct that all taxes which may be assessed in conse- quence of my death of whatever nature and by whatever jurisdiction imposed shall be paid out of my estate as a part of the administra- tion of my estate. My Executor shall have no duty or obligation to obtain reimbursement for any such tax paid by my Executor even though on proceeds of insurance or other property not passing under this Will. 4. I give and bequeath those items of my personal property set forth on a separate, unsigned memorandum which it is my intention to prepare and place with this Will, to those persons whose names are set forth on the said memorandum opposite the name of the item, provided they survive my death. Should such a memorandum not be found with my Will, it shall be conclus~ presumed that I did not prepare one, and the provisions of this paragraph shall be null and void. 5. I give, devise and bequeath the remainder of my estate, of whatever nature and wherever situated, to my children, Susan C. Kar, D. Richard Shipman and Jeffrey P. Shipman, provided that the share of any child who predeceases me or dies on or before the thirtieth (30th) day following my death shall be distributed to his or he issue, per stirpes, living on the thirty-first (31st) day following my death; and in default of any such then-living issue, such share shall be di- vided equally among my other children. 1 ... 6. If, at the time of my death, the law requires the appoint- ment of a Trustee to administer the share of a minor beneficiary of my estate, f nominate and appoint my brother-in-law, William R. McCurdy, as Trustee of the share of any beneficiary hereunder who may be under a minor at the time of my death. The income and/or principal of said trust may be accumulated or expended for the maintenance, education and support of such beneficiary as my Trustee in its sole discretion may determine; and my Trustee, in the expenditure of income and/or principal for such purposes, may, at its discretion, apply the same directly or pay the same to any person having the care or control of said beneficiary or with whom the beneficiary resides, without duty on the part of the Trustee to su- pervise or inquire into the application of the funds by any person to whom payment is so made. The balance of such income and/or prin- cipal shall be paid to such beneficiary upon reaching the age of twenty-two (22) years, rather than the age of attaining majority, or to such beneficiary's estate in the event of death prior thereto. 7. I nominate and appoint my brother-in-law, William R. McCurdy, as Executor of this my Last Will and Testament; and as substitute Executrix I nominate and appoint my daughter, Susan C. Kar. I further provide that my personal representative and Trustee shall not be required to file any bond or other security in any juris- diction to secure the faithful performance of his or her duties nor be required to obtain any order or approval of any Court for the exercise of any power or discretion set forth in this Will. 8. In addition to the powers conferred by case law, by statute and by other provisions of this Last Will and Testament, my personal representative, Trustee, and any successors in those capacities shall have the following discietionary powers applicable to all real and personal property held by them, which powers shall be effective without Order of any Court and which shall exist and continue until the time of actual distribution: A. To retain any property of any nature re- ceived by them for whatever period they shall deem advisable; B. To invest and reinvest all or any part of the assets of my Estate without regard to statutes 2 - ----~._.__. --~-------------------------- ~~ . t. limiting the property which a fiduciary may pur- chase; C. To sell, transfer, exchange or otherwise dispose of, any part of the assets of my Estate, for cash or on terms, publicly or privately, or to lease, without liability on the purchasers to see to the application of the proceeds, and to give options for these purchases without the obligation to repudiate them in favor of a higher offer; D. To execute and deliver any deeds, leases, assignments or other instruments as may be neces- sary to carry out the provisions of this Will; E. To borrow money, if necessary to facili- tate the administration and closing of my Estate, including the right to borrow money from any bank, and to mortgage or pledge any asset of the estate as security; F. To loan to, and to purchase assets from, my estate, even if they or either of them are also acting as Executor thereof. G. To assume continuance of the status of any beneficiary with regard to death, marriage, di- vorce,__ illness, incapacity and similar incidents or matters in the absence of information deemed--reli- able without liability for disbursements made on such assumption; H. To make any distribution hereunder either in kind or in money, or partially in kind and par- tially in money, considering of course the reason- able wishes of the beneficiary. Distribution in kind shall be made at the appraised value of the prop- erty distributed, as it is set forth in the inheri- tance tax return filed in my Estate; I. To exercise any subscription right in con- nection with any security held hereunder, to con- 3 . '- sent to or participate in any recapitalization, reor- ganization, consolidation or merger of any corpo- ration, company or association, the securities of which may be held hereunder; and to delegate au- thority with respect thereto, to deposit invest- ments under agreements, to pay assessments, and generally to exercise all rights of investors; J. To continue in any partnership, joint ven- ture, joint ownership or other business enterprise of which I am a part at the time of my death; K. To compromise claims; L. To continue for whatever period of time my personal representative shall deem necessary any ownership as a tenant in common or as a part- ner, in real estate or other property and to act as I would have done had I been Jiving; M. To do all other acts in his/her or their judgment necessary or desirable for the proper management, investment and distribution of the assets of my Estate. N. In the event that any person shall have died at the same time as I did, or in a common dis- aster with me, or under circumstances that it is difficult or impossible to determine who died first, shall be deemed by my Executor to have prede- ceased me. 9. All income or principal held for the use and benefit of the beneficiaries of this Estate shall not be in any way or manner sub- ject to anticipation, assignment, pledge, sale or transfer, no shall any such interest, while in the possession of the Trustees, be liable for or subject to the debts, contracts, obligations, liabilities or torts of any beneficiary, or to attachments, executions or seques- trations under process of law. If any beneficiary of the Estate shall, in the sole opinion of my personal representative, be or become mentally or physically inca- 4 . . pacitated, by reason of illness, accident, minority or other circum- stance, my personal representative may apply either income or principal for the support and welfare of such beneficiary directly or to the person who has the care and control of such beneficiary, without the intervention of any Guardian and without obligation to supervise application of said amounts in any way. IN WITNESS WHEREOF, 1 have hereunto set my hand and seal this 26th day of June, 1990. .d~ .,)J.~;t~"VJau--(SEAL) S ' ley G. Shlpm n --1)J), (1;1 o1f~ u ~ I~. '---[ . -h\ 06j;;j)~ - 0-----------::::;------ COMMONWEALTH OF PENNSYLVANIA . SS. COUNTY OF CUMBERLAND I, SHIRLEY G. SHIPMAN, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified accord- ing to law, do hereby acknowledge that 1 signed and executed the in- strument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein ex- pressed. Sworn or affirmed to and acknowledged before me, by SHIRLEY G. SHIPMAN, Testatrix, this 26th day of June, 1990. ~~Mtst~~U~-- r;::k",,,,' ..) ! ,/) ~ I I} c , .' <J I I L '. "' 1 ..-1. tip r ---' ~L-LJ ~, ).' f ifffrAR(ACSEAl .- _..:-- LAURA ~. BISTllNE, Notary PUblic Ca~11~le, Cumberland County 5 1"1)' Comm1S51on Expires MarCh 26. 1993 ., , .. COMMONWEALTH OF PENNSYLVANIA . SS. COUNTY OF CUMBERLAND We, Roger M. Morgenthal and Janice E. Hertzler, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testatrix, SHIRLEY G. SHIPMAN, sign and exe- cute the instrument as his/her Last Will; that he/she signed will- ingly and that he/she executed it as his/her free and voluntary act for the purposes therein expressed; that each of us in the sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me by Roger M. Morgenthal and Janice E. Hertzler, witnesses, this 26th day of --/J, p1" ii, 1 9 8 9 . ~ -::r~~JL/14$0/1--- . U Roger M. Morgenthal C-' r\ . 7 I "'\ ~n ~' ? ~" VV'Y1 \ ~' - N 'T--1../ --~------------ ------ C7 Janice E. Hertzler ~....~ {]I jjif;' 7 ..,,-.:..' --:1 I / __ "~K~~/L,.~LL-~l~~~./ ~L:~'~ NOTARIAL SEAL LAURA A. BISTLINE. Notary Public Carlisle, Cumberland County My Commission Expires March 26, 1993! 6 'f-l (;J -.J 15056051058 REV-1500 EX (06-05) PA Department of Revenue '* Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMAT.ION BELOW Social Number Date of Death OFFICIAL USE ONLY g~~~.o/.g?de Year INHERITANCE TAX RETURN RESIDENT DECEDENT Date of Birth 09/16/2005 08/16/1949 Decedent's Last Name Suffix File Number 21 10869 05 CINDY Decedent's First Name M WISE (If Applicable) Enter Surviving Spouse's Information Below Last Name Suffix MI Spouse's So?ial Security Number ,SPo.~.~e's.. Fir~.!...~.~.f!.l.~........ ...... ..................... .. MI ;...,....... THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS <=:> 4a. Future Interest Compromise (date of death after 12-12-82) CJ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Depo~t~oxes (Attach Copy of Trust) r :-.1 t .; ~ 10. Spousal Poverty Credit (date of death C> 11. Election to tax ~er 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 DIRECT€o TO: ' : Name '~~y'!i.f!.l.~...!.~.I~P~.?~.~..~~'.!.l.~r~. ..................:............ FILL IN APPROPRIATE OVALS BELOW ~:> 1. Original Return c::> 2. Supplemental Return C) 4. Limited Estate caJ 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received ~ First line of address 2109 MARKET STREET Second line of address or Post Office State ZIP Code 1 7011 Correspondent's e-mail address:tflower@sfl-Iaw.com c:> 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required C> i (717) 737-3405 ~.. --." -, ~i ., :) '::.. 'C) .! ',__-J C-, .--.., ~4 ',I ::J .' r-) .-," \::,;, '-J ..--~,'] I 'h.h._.. .. .... .....h............_ ... .,...::::;, IREGISTER.'oF W~qi USE ON~ .~ I '1 r-.) i i L.._.__.__..__,!!ATE.!'L~______..._.._.J Under penalties of perjury, 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 nd mplete. Declaration of preparer other than the personal representative is based on all information of which pre parer has any knowledge. SIGNATUR P SQN NSIBLE R FILING RETURN DATE ADDRESS SAlOIS, FLOWER & LINDSAY, 2109 MARKET ST., CAMP HILL, PA 17011 PLEASE USE ORIGINAL FORM ONLY L 15056051058 Side 1 DATE '/-rZ-f) 15056051058 --.J ~~ ~,~ ~ ~ ~ ~ Q ~.~ .. .i:}, \ ~ fC~ a '"':I-. \() Co , '> ~ <':)..... \C) ,. ~ . ---I 15056052059 REV-1500 EX ~,~,~~~~~~.'~",~,?,~i,~,I",~~,~~,~io/,~.~~,~.~~""", Decedent's Name: CINDY M WISE i 191-40-8938 I RECAPITULATION 1. Real estate (Schedule A). .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 136,380.00 : , ' , . r....~_...-<<<.-"'*"'_;~~_,.._;r.-,,.."'............"'''''~/'''-.''"'._'''...''''''''.~.-..;.,AN-'^"''''"''.fu;..'''''b..........-_~~h-,._.~ 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 38,189.83 : . ' ~'N'_'J;U""'''''_U__'''__''''''__''''N",",.,,...........__'UN.'''''J~U~-''''-J>W''''''';''W'''''.,N_.N....._~.~ 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3. . ' . ' . ' . ' . ' , . . ' . . r_""'.....'.....................MMIoN.MU...'N.VA~..N~......'_..,.~,.~~'.--.,.._~"'.k----U'_N".........--.._W_..U{ i 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. I ~"'_~""""""""""~IAN'.__~.-b"'N.MM_-""",....____~__...-.......,_~{ 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 25,586.33 ' t'...."""___NNNW'NNN.N;N...W........._"'_'NNN.......W._.~"N.,,_~~....'."H'NN....-__-'"''''''''--'''''""",-"",,,,W,AI'UO_U: 6. Jointly Owned Property (Schedule F) c::> Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c::> Separate Billing Requested.. . . . . .. 7. 168.20 : . ' , ' f......,...._....~_..._N.....~~~....__........~...,..w^""'_.__W'Ho~ , ' ~.N"_M#~~~_./'~__..^"'~~n.."'N..~_,...MII.-.u'-."-.h'..Ji.'''''''_''''"''N: 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. i 200,324.36 : __...w,>W"_....""...,.......'7"_..__~_..-:'>'.........~~.....-w<...."'" 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9. 24,679.40 ; , ' >"N_.UNoNU_U~....T4W..~..-u~_.N~N~J..U......~.r.--...~~....,~....._--...u_~u.ru'^'lNN.u<NU,,^"W.V.U'Y_;'V"MNT~;,MUUoU.'_: 1 O. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . . . . . 10. · 113,471.63 ' ~^""""'"""~~~"...W~^--UU.i.l'..H'.,"-'""'''..~U~J:.,'.~d''''d.~V~.'~J;.-''.'J'J'---..~/.~..._.........c~._...('^""""-__-.."'J...~M.;U.;""'O'.....".: 11. Total Deductions (total Lines 9 & 10). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 11. : 138,151.03 . M~....,.,.,."..V"""'~~_..__.....,.#.y_....^.-N....N"'^'"._........N....N~....-.v~_........'"___,...........-".A........v.___.r~.Y...N_Y."_""^".NNNN4_~N~.......,;.,.",,_..... 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. · 62,173.33 ' 13. Charitable and Governmental Bequests/See 9113 Trusts for which .'=NN_'___m_m_nmmmm..._m"''''''."uu.'w_m'__w'wm__"wN,"__.~,v.~_'^,'.~n.' an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 0.00 : ,~J"""u.u-N....n....NN.._.N'..J_-,.u.r..J"......_."'.V~.N...........J.y.-_......N^"V~_-_.,/'M..N"JU._NON...~.u..._~._N__._~..._.y~IN~"'.....uU4N'..:-. 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 taxable at lineal rate X.O 45 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X. 1 5 62,173.33 ' 15. 62,104.67 16. 2,794.71 17. 68.66 18. 10.30 2,805.01 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT <8> 15056052059 Side 2 15056052059 --.J L . REV-1500 EX Page 3 - Decedent's Complete Address: ~-_..--.....~...............,"""'" _~-_VN.'.'_'.-_' "....w.'.....w~......-..N.._.....A.'oA..J...._w.u...._y".'NN.v.v......."...n.........,.....-.',........-.."..".... DECEDENTS NAME DECEDENT'S SOCIAL SECURITY NUMBER CINDY M WISE 191-40-8938 STREET ADDRESS 609 LAVINA DRIVE CITY I STATE I ZIP MECHANICSBURG PA 17055 File Number r---1 r-:::-l i--~--'-_._._.,--~."'.,.^.^^..,._^-----~_.l I 21 Ii 05 110869 1 ~ L ~ : Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 2,805.01 3,500.00 140.25 Total Credits (A + B + C ) (2) 3,640.25 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( 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) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5A) (5B) 0.00 835.24 0.00 0.00 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 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 [i] d. receive the promise for life of either payments, benefits or care? ...................................................................... D 00 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .......... ......... ........................ ..................... ....................... ..... .......... ........ D 00 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 exemDt 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 P.S. 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. .. REV-1502 EX+ (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF CINDY M. WISE FILE NUMBER 21-05-0869 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH DWELLING HOUSE AND LOT, 609 LAVINA DR., LOWER ALLEN TWP., CUMBo CY, PA (ASSESSMENT AT 100% OF F.M.v.) TOTAL (Also enter on line 1. Recapitulation) (If more space is needed, insert additional sheets of the same size) 136,380.00 136,380.00 .. Page 1 of 1 Detailed Results for Parcel 42-27-1886-125. in the 2004 Tax Assessment Database DistrictN 0 42 Parcel_ID 42-27-1886-125. MapSuffix HouseNo 609 Direction Street LA VINA DRIVE Ownerl WISE, CINDY M Owner2 PropType R PropDesc Liv Area 1876 CurLandVal 20000 Curlm p V al 116380 CurTotVal 136380 CurPretVal Acreage 0.23 CIGrnStat TaxEx 1 SaleAm t 116000 SaleMo 9 SaleDa 28 SaleCe 19 SaleYr 89 DeedBkPage 0034E-00699 YearBIt 1977 HF _File_Date 10/19/2004 HF _Approval_Status A http://taxdb.ccpa.net/details.asp?id=42-27-1886-125.&dbselect=l 9/27/2005 . REV-1503 EX+ (6-98) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF CINDY M. WISE FILE NUMBER 21-05-0869 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION 202 sh. 1MB stock, certificate #525490 plus 3 shares same, book-entry, all @ 80.165 840 sh. Mid Penn Bancorp stock, cu. 59540G 107, @ 25.9 VALUE AT DATE OF DEATH 2. 16,433.83 21,756.00 TOTAL (Also enter on line 2, Recapitulation) $.. (If more space is needed, insert additional sheets of the same size) 38,189.83 IBM: Historical Prices for INTL BUSINESS MACH - Yahoo! Finance Page 1 of3 Yahoo! Mv Yahoo! Mail "'YAHOOt, FINANCE Sign In New Use r? fu9..nJl.Q. Search I ; the Web _~-u_mmmm~''''''___''_'''' Finance Home - HelD Wednesday, Apri112, 2006, 11:16AM ET - U.S. Markets close in 4 hours and 44 minutes. Dow +0.430/0 Nasdaq +0.:1 Home Investing News & Commentary Retirement & Planning Banking & Credit Loans Taxes My Port Market Overview Market Stats Stocks Mutual Funds ETFs Bonds Options Industries Currency Education Get Quotes lom"..'.._~........_..._..........o....._..>>..w_J Symbol Lookup I Finance Search International Business Machines Corp. (IBM) .. 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First I Prev I Next I Last ~ Download To Spreadsheet ADVERTISEMENT http://finance . yahoo. com! q/hp ?s= MBP &a=08&b= 16&c=2005 &d=O 8&e= 16&f=200 5& g=d 4/12/2006 REV-150B EX+ (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF CINDY M. WISE FILE NUMBER 21-05-0869 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. DESCRIPTION Americhoice FCU savings #1983-01, principal 5,698.78 plus 7.10 accrued interest VALUE AT DATE OF DEATH TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 4,768.85 3,500.00 5,760.00 1,400.00 4,451.60 Americhoice FCU checking #1983-13 Household furniture and furnishings 1998 Honda Civic, 75,000 mi. 1997 Plymouth Breeze, sale proceeds IBM wages and unused vacation credit pay 25,586.33 REV-1509 EX+ (6-98) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF CINDY M. WISE FILE NUMBER 21-05-0869 SURVIVING JOINT TENANT(S) NAME If an asset was made joint within one year of the decedent's date of death) it must be reported on Schedule G. A,. Marie (Wise) Casner B'Sandra L. Brown C. JOINTLY-OWNED PROPERTY: ADDRESS 308 North Road Elizabethville, PA 17023 126 W. Portland Street, #2 Mechanicsburg, PA 17055 RELATIONSHIP TO DECEDENT mother friend DATE OF DEATH VALUE OF DECEDENT'S INTEREST LmER DATE DESCRIPTION OF PROPERTY ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. 1. A. 02/15/61 $25 Series E, US Savings Bond issued Feb. 1961 2. B. 10/15/80 $50 Series EE, US Savings Bond issued Oct. 1980 TOTAL (Also enter on line 6, Recapitulation) (If m?re space is needed, insert additional sheets of the same size) AmeriChoice Federal Credit Union 2175 Bumble Bee Hollow Road Mechanicsburg, P A 17055 To: SAIDIS, SHUFF, FLOWER & LINDSAY Re: Estate of Cindy M. Wise, Deceased Date of Death: September 16, 2005 Social Security No.: 191-40-8938 The following is a complete record of the above-referenced decedent's accounts as of September 16, 2005 (date of death of decedent). Account No. Type of . Principal Balance Accrued Names on Date Account on 9/16/2005 Interest as of Account (All Opened 9/16/2005 Owners) \Q02>-O\ 5 {oq<Q.10 1. \0 1\ IlL \q03-l?> 4'/lD0,ceS- n ltL \ q~?J - CC~ d 1 ~~5l i 0 10\ \ C\cM-~; d 1551.(p4 \O~-LD3 q03- ~.. ?:>13~J~ g ( \Q0o-Q1 J rlS- Cl..-. Safe Deposit Box , - $~f~ Title: J1Iernher S~rvl[e 1?ep~~ Y'€- Date: IOlio I D~ Kelley Blue Book Used Car Pricing - Yahoo! Autos Yahoo! Mv Yahoo! Mail ~tAUTOS Sign In New User? ~ Page 1 of3 Se.arch I 'the Web AL MOVINGYOUREMAIL:Mt;5SAGES,CONT,ACTS AND. FAVORITESTOVER1Z0NVAliDOI ,.POR DSL. ;';'.'<:;::~'::,;'.';'~>,':<":':'_,~;~<i~~::::::':::':;;~:~<~~~~~).:o:-.:c<~*::;;;::':':':';:"',:::::::::,~:~,::::<~::;:<::::~:;;:;:--l_::',:::~:;,::;,::::;)_;,;:,;:/,:;:<:::::::,.:~:::~":,,,;:::::::::::~;AA.::::-~~~::'~::;";;:;<:;;'_~::::~~:;~::;<::;:<:::0;';::~'.:~::';:':;;:;:':;";;;<:;;'~:'-::::;;:~::':::':'::;~:x;::':;'hX<:.:w~:v.::::::::;;:~"':':':::::':::;'::::::;'::,:::;,;;:.:-:-;., Search this site BETA 1m....." Home New Cars Used Cars Research Finance Car Insurance Find a Car I Sell Your Car I Blue Book Pricina I Certified Pre-Owned I Reviews I Vehicle Historv ~~P-'QI.t_~ I Il~ & , Blue Book Pricing 1. Make Model & Year 2. Trim 3. Condition 4. Pricing Report Provided by Step 4: Kelley Blue Book Pricing Report ~ 1M this reoort . rs2I e-mail reoort ~ print reoort Buver's Reoort Seller's Report 1998 Honda Civic DX Sedan 4D in or near 17055 April 12, 2006 Private Party Value .1. $5,760 Trade-in Value ~ $4,385 Mileage: 75,000 Condition: Good ~ Engine: 4-Cyl. 1.6 Liter Transmission: Automatic Drive: FWD Equipment: Air Conditioning, Power Steering, AM/FM Stereo, Tilt Wheel, Dual Front Air Bags Next Steps Sell your car using Yahoo! Autos and reach an audience of millions. r-;'~-MI Other Things To Do Get a quote on a new car Find a used car on Yahoo! 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(Please print and/or save this page before submitting your survey) Service Excellent Good Fair Poor Savings Bond Calculator c c' C' Co http://wwws . publicdebt. treas .gov /BC/SBCPrice 11/9/2005 REV-1510 EX+ (6-98) * COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF CINDY M. WISE FILE NUMBER 21-05-0869 ITEM NUMBER 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. DESCRIPTION OF PROPERTY INCLUOE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COpy OF THE DEED FOR REAL ESTATE. EXCLUSION TAXABLE VALUE 1. DECEDENT (56) HAD ROTH IRAs and 401(K) NOT SUBJECT TO TAX TOTAL (Also enter on line 7 Recapitulation) (If more space is needed, insert additional sheets of the same size) 0.00 .. REV-1511 EX+(12-99) '* SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF CINDY M. WISE FILE NUMBER 21-05-0869 ITEM NUMBER A. B. 1. DESCRIPTION Debts of decedent must be reported on Schedule L AMOUNT 1. FUNERAL EXPENSES: MALPEZZI FUNERAL HOME, PROFESSIONAL SERVICES OAK RENTAL CASKET BURIAL VAULT & URN ELlZABETHVILLE MONUMENT, HEADSTONE & ENGRAVING FUNERAL REGISTER PROGRAMS, ETC GRAVE OPENING DEATH CERTS., OBITS., FLOWERS, CLERGY HONORARIA ADMINISTRATIVE COSTS: 2 4 5 6 7 Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City 2. Attorney Fees Year(s) Commission Paid: 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant KATHRYN WISE Street Address 609 LAVINA DR. City.. MECHANICSBURG Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. PPL ELECTRIC, 6 MONTHS ELECTRIC HEAT & LIGHT BILLS 8. UNITED WATER PA, 6 MONTHS WATER BILLS 9. PNC BANK CHECK PRINTING FEES 10. WASTE MANAGEMENT, TRASH COLLECTION 11. COUNTY AND LOCAL REAL ESTATE TAXES 12. UPPER ALLEN TWP. SEWER BILLS, 6 MONTHS TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) REV-1512 EX+(12-03) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF CINDY M. WISE FILE NUMBER 21-05-0869 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH WASHINGTON MUTUAL, MORTGAGE LOAN BALANCE 2. UNITED WATER PA 1. 104,744.19 3. PPL ELECTRIC 4. WASTE MANAGEMENT 5. SAlOIS, FLOWER & L1NDSA Y, LIFETIME LEGAL SERVICES 300.00 6. MBNA CREDIT CARD DEBT 7. AMERICHOICE VISA CREDIT CARD DEBT 8. LOWER ALLEN TWP. SEWER BILL 10. 2005 FEDERAL INCOME TAX 11. LOCAL INCOME TAX 417.99 14. VERIZON WIRELESS 12. HOLY SPIRIT HOSPITAL 13. CARDIOVASCULAR SURGICAL INST. 15. COMCAST 112.45 17. VERIZON, HOME LAND-LINE PHONE WEST SHORE ANESTHESIA 129.60 16. 312.40 18. PINNACLE HEALTH HOSPITALS 505.12 19. EAST SHORE ONCOLOGY TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 113,471.63 "- REV-1513 EX+ (!l-OO) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF CINDY M. WISE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [include outright spousal distributions. and transfers under ~ec.9116{a) (1~?)L, KATHRYN E. WISE, 609 Lavina Dr. Mechanicsburg, PA 17055 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) 2 MARIE CASNER, 308 North Road, Elizabethville, PA 17023 3 SANDRA BROWN, 126 W. Portland Street, #2, Mechanicsburg, PA FILE NUMBER 21-05-0869 AMOUNT OR SHARE OF ESTATE 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS (If more space is needed, insert additional sheets of the same size) TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Ln o o N r- U) ::> CJ :) <( r- z w ~ w r- <( ~ tf) Z <( o ---I W 2 o I fIl. Washington Mutual HOME LOANS Customer Service: Toll free 1.866.926.8937 Se habla espanol TDD: Dial 7-1-1 for relay assistance For a refinance or purct1ase loan, call 1.866.888.5935 www.wamu.com #BWNCLNN #3906329228968097# 2018982 01 AT 0.292 "'AUTO T8 0 913217055-4943 MA1 111.111'1111111111.1..1.11111111.111111111111.1111.1.1111111.1 CINDY M WISE 609 LAVINA DR MECHANICSBURG PA 17055-4943 I Your Next Payment Next Payment Due: Principal and Interest: Escrow: Current Payment: Total Amount Due:* October 01. 2005 565.19 232.97 798.16 7~ $ $ $ cC I Important Messages * To avoid a late charge of $28.26, we must receive your payment of principal, interest, and any escrow deposits and/or past-due payments by 10/16/05 during our business hours. If this date falls on a weekend or holiday, your payment must be received by the next business day. Please see the reverse side for Recent Account Activity. 20189820019634 Page 1 of 2 Home Loan Statement August 2005 Statement Date: Activity Since: Your Loan Number: August 29, 2005 July 28, 2005 0632228680 Your Property and Loan Information Property Address: 609 LAVINA DR MECHANICSBURG PA 17055 $ 104,744.19 4.87500% 399.42 Principal Balance: Interest Rate: Escrow Balance: $ Did You Know? Now is the time to complete your summer home improvement projects! A Washington Mutual Home Equity line of Credit is a great way to finance those projects and ,any other big plans you have for-the summer. Call 1-866-467-8562 today to apply! Year to Date Account Activity Principal Paid: Interest Paid: Property Taxes Paid: Insurance Paid: $ $ $ $ 1,125.34 3,424.77 2,048.50 0.00 Washington Muiual Bank F--N-~ (2-r ._~~ ~= 908- a 11) o o N fr:: W CO o I- U o I- Z w ~ w l- e::{ ~ U) z <l o ---' w ~ o I QUP Washington Mutual HOME LOANS Customer Service: Toll free 1.866.926.8937 Se habla espanol TDD: Dial 7-1-1 for relay assistance For a refinance or purcnase loan, call 1.866.888.5935 www.wamu.com #BWN CLN N #3906329228968097# 2013892 01 AT 0.292 "'AUTO T4 2916317055-4943 MA1 111.111'11111'11.1.1..1.1..11111.111.11111111.1111.1.1111111.1 EST CINDY M WISE ROBIN NESTOR-ADMIN 609 LAVINA DR MECHANICSBURG PA 17055-4943 I Your Next Payment Next Payment Due: Principal and Interest: Escrow: Current Payment: Plus Unpaid Late Charges: Total Amount Due:* November 01, 2005 $ 565.19 $ 232.97 $ 798.16 $ C 28.26 82~ Important Messages * To avoid a late charge of $28.26, we must receive your payment of principal, interest, and any escrow deposits and/or past-due payments by 11/16/05 during our business hours. If this date falls on a weekend or holiday, your payment must be received by the next business day. Please see the reverse side for Recent Account Activity. 2013892 0015827 Page 1 of 2 Home Loan Statement October 2005 Statement Date: Activity Since: Your Loan Number: October 26, 2005 October 19, 2005 0632228680 Your Property and Loan Information Property Address: 609 LAVINA DR MECHANICSBURG PA 17055 $ 104,604.52 4.87500% $ 163.39 Principal Balance: Interest Rate: Escrow Balance: Did You Know? Thank you for trusting Washington Mutual with your home loan! We appreciate your business and we'd like to remind you that Washington Mutual offers a full range of mortgage products to meet your needs. Maybe your family's ready to move to a bigger home oryoll've found your perfect weekend retreat and need a new loan. Or maybe you'd like to save some money and refinance your current mortgage. Whatever your needs may be, we have a loan you'll desire. All you have to do is ask. We're here for you. Call us today toll-free 1-866-608-4624. Year to Date Account Activity Principal Paid: Interest Paid: Property Taxes Paid: Insurance Paid: $ $ $ $ 1,265.01 3,850.29 2,048.50 469.00 Washington Mutual Bank 908-8 FDi"E ~ .......- -~_........'- L.I::':DEP. "UIIIII~ln; LAST WILL AND TESTAMENT OF CINDY Mo WISE I, CINDY M. WISE, of Mechanicsburg, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. FIRST I direct the payment of my just debts and the expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. Further, I direct that my body be cremated and that my remains be disposed of as my personal representative shall deem appropriate. I authorize my personal representative to expend funds from my estate, in such amount as my personal representative shall consider necessary and desirable for the purchase, erection and inscription of a suitable marker for my grave. SECOND I bequeath my jewelry, automobiles, household furnishings, personal effects and other tangible personal property of like nature to my daughter, KA THR)~ E. \VISE, with the SAIDIS exception of such items of household furniture and furnishings, if any, as my executrix may SHUFF, FLOWER & LINDSAY deem it convenient and appropriate to give in trust to my Co-Trustees for the benefit of ATIORNEYSoAToLA W 2109 Market Street Camp Hill, PA Dorothy "Sue" Washington for so long as she may reside in my house, as set forth at itenl THIRD, below. Any items of tangible personal property not disposed of by the foregoing directions shall be sold by my executrix and added to the residue of my estate. I wish my (f~ ,. SAIDIS SHUFF, FLOWER & LINDSAY ATTORNEYS-AT-LA W 2109 Market Street Camp Hill, PA executrix to be aware that certain items among the furnishings now in my home belong to Dorothy "Sue" Washington, and are not part of my estate. . THIRD I give and devise my personal residence at 609 Lavina Drive, Mechanicsburg, P A, along with a bequest of cash in amount determined by my executrix to be sufficient to defray the annual cost of real estate taxes, insurance and routine maintenance, to my Trustees hereinafter named, IN TRUST, NEVERTHELESS, to be held by them and managed under the following tenns and conditions: 1. My friend, DOROTHY "SUE" WASHINGTON, shall be permitted to reside in my personal residence for a period of six (6) months following my death, without obligation to pay real estate taxes, insurance or costs of maintenance; 2. After the expiration of six (6) months following my death, and subj ect to my directions at item FOURTH hereunder, my trustees shall be authorized, in their discretion, to sell my residence and add the proceeds thereof to the Trust created at item FIFTH hereunder; Otherwise- 3. After the expiration of six (6) months following the date of my death, my friend, DOROTHY "SUE" WASHINGTON, shall be permitted to continue to reside in my residence for the remainder of her lifetime, but only for so long as she does in fact reside therein, provided that she shall pay to my trustees from time to time, and without unreasonable delay, the full amount of all costs of real estate taxes, homeowner's insurance and ordinary repairs and maintenance, which costs it is my desire that my trustees shall have paid in the first instance. In the event that DOROTHY "SUE" WASHINGTON, for any reason, should be absent from the said premises for more than forty-five (45) days during any 2 C'~ . SAIDIS SHUFF, FLOWER & LINDSAY ATTORNEYS-AT-LAW 2109 Market Street Camp Hill, PA two-month period, my trustees shall sell the residence and distribute the proceeds thereof according to my directions for the residue of my estate. 4. My daughter, KATHRYN, also shall have the right to reside in my residence at any time during the occupancy of Dorothy "Sue" Washington. 5. Upon the death of Dorothy "Sue" Washington, my trustees shall convey the residential property to my daughter, KATHRYN, or, at her election, sell it and distribute the proceeds thereof according to my directions for the residue of my estate. FOURTH I authorize my personal representative or my Trustees, in their discretion, to use any life insurance proceeds received by them in consequence of my death to retire any mortgage- secured indebtedness which may encumber my personal residence at the time of my death. It is my wish that they do so, but I do not require it of them, because of the possibility that my estate, including such non-probate property as may pass directly into the hands of my executrix and/or my trustees, may not be sufficient to preserve my residence in trust, and also to adequately fund the trust set forth below at item FIFTH, for the benefit of my daughter, KATHRYN, whose welfare is my primary object. In the event that my personal representative or trustees shan determine, in their absolute discretion, based upon the circumstances then prevailing, that my desire that such encumbrance be retired and my residence preserved in trust for the benefit of Dorothy "Sue" Washington has become impossible of fulfillment without unreasonably impairing my primary desire to provide an adequate trust for my daughter, then my personal representative and/or my trustees shall sell the residence, no sooner than six (6) months following the date of my death, and add the 3 r V\/\;f,~ . SAIDIS SHUFF, FLOWER & LINDSAY ATIORNEYS-AToLAW 2 I 09 Market Street Camp Hill, PA proceeds thereof to the residue of my estate or to that trust set forth at item FIFTH herein. FIFTH I give, devise and bequeath all the rest, residue and remainder of my estate, together with any other property which may be added, unto my Trustee hereinafter named, IN TRUST, NEVERTHELESS, upon the following terms and conditions: (A) To hold, manage, invest and reinvest the principal so received, and accumulation of income thereon, and to use, pay and apply the income and principal or so much thereof as in Trustee's sole discretion may be necessary for the maintenance, support, medical expenses and education of my daughter KATHRYN E. WISE. (B) The payments authorized by this trust may be made by my trustee directly to my daughter, or may be made directly to any institution entitled to such payment by reason of services rendered or to be rendered to her. (C) The amount to be paid for the benefit of my daughter shall be determined from time to time by her needs, and the times of said payments shall be determined by such need, provided that payments be made at least monthly. (D) All payments of principal and income hereby given shall be free from anticipation, assignment, pledge or obligations of the beneficiary, and shall not be subject to any execution or attachment. (E) All principal and accumulated Income, not so applied, shall be distributed to my daughter, per stirpes, as follows: 4 ~ . SAIDIS SHUFF, FLOWER & LINDSAY A DORNErs- A r- LA W 2109 Market Street Camp Hill, PA (i) When my daughter has graduated from college, she shall receive one-third (1/3) of the principal and accumulated income of the trust; (ii) Five years after her graduation, she shall receive one-half (1/2) of the remaining principal and accumulated income; (iii) Ten years after her graduation, she shall receive the remaining balance of the trust. (iv) In any event, the balance of principal and accumulated income of this trust shall be paid to my daughter no later than her thirty-fifth birthday. SIXTH In addition to the powers conferred by law, I authorize any personal representative, trustee or guardian acting under this instrument, in her absolute discretion: (a) To retain in the form received, or to sell either at public or private sale any real or personal property; (b) To exercise any options to subscribe for stocks, bonds, or other investments. (c) To join in any plan of lease, mortgage, consolidation, exchange, reorganization or foreclosure of any corporation in which my estate or any trust may hold stocks, bonds or other securities; (d) To sell, transfer, convey, mortgage, pledge, lease or exchange any property, real or personal, which at any time may form part of my estate, for the payment of debts or taxes, or for any purpose of administration or distribution, for 5 ( rVvJ . SAIDIS SHUFF, FLOWER & LINDSAY ATTORNEYS-AT-LA W 2109 Market Street Camp Hill. PA such prices and upon such terms as they, in their sole discretion, may deem wise, and to execute and deliver deeds of conveyance or transfer thereof; (e) To make settlements and compromises on such terms as they, in their sole discretion may deem wise without the necessity of obtaining any court approval thereof; (f) To make distribution hereunder either in cash or kind, as they, in their discretion may deem wise; (g) To terminate any trust created hereunder when my Trustee shall determine, in her sole discretion, that the principal balance thereof shall have been so reduced as to render continued administration impractical, or that, in her judgment, other good and sufficient reasons exist that the trust should be terminated. SEVENTH I direct that any and all inheritance, estate, and _transfer taxes imposed upon my estate passing under this Will or otherwise shall be paid out of the principal of my residuary estate. EIGHTH I hereby nominate, constitute and appoint my sisters, VIRGINIA M. ENDERS, of Elizabethville, P A, and JULIE WARFEL, of Duncannon, P A, to act as Co-Trustees of any trust created hereunder. In the event either of my said co-trustees should decline or, once having been appointed, cease to serve in that capacity, I appoint ROBIN NESTOR, of Lykens, P A to serve as her successor. All references in this Will to my "Trustee" shall be understood to refer to my Co-Trustees and also to my successor Trustee. 6 (~ SAIDIS SHUFF, FLOWER & LINDSAY ATIORNEYS-AT-LAW 2109 Market Street Camp Hill, PA NINTH I do hereby nominate, constitute and appoint my sister, ROBIN NESTOR, of Lykens, P A, to act as Executrix of this my Last Will and Testament. Provided, however, that if she is unwilling or unable to act as Executrix, I direct the duties of Alternate Executrix be performed by my sister, JULIE WARFEL, of Duncannon, P A. TENTH I direct that no personal representative, guardian, trustee or other fiduciary appointed under this instrument shall be required to give bond for the faithful performance of her duties in any jurisdiction. IN WITNESS VVHEREOF, I, CINDY M. WISE, have hereunto set my hand and seal to this my Last Will and Testament, consisting of seven (7) typewritten pages, the first six (6) r.t of which bear my initials in the lower right corner for identification, this /3 - day of September, 2005. \: ~ ''{Il\~ \tJ..r~ CINDY M. v1:rsE, Testatrix Signed, sealed, published and declared by the above-named Testatrix, CINDY M. WISE, as and for her Last Will and Testament in the presence of us, who have hereunto subscribed our names at her request as witnesses thereto, in the presence of said Testatrix and of each other. ~tL ~%r ADDRESS 'IC>6'! !( tJe ~ ~ er IE /J~6.e~(jJMlle ~ ~4 ,. 2.tt>f )-1~~ ~ ~~~ ADDRESS 7 ,. SAIDIS SHUFF, FLOWER & LINDSAY ATfORNEYS-AToLA W 2109 Market Street Camp Hill, PA COMMONWEAL TH OF PENNSYLVANIA COUNTY OF CUMBERLAND WE, CINDY M. WISE, De/rnt1.rh.eGv/elS and -n;CJ~t/FltJ-~1ljer- , the Testatrix and witnesses, respectively whose names are signed to the foregoing or attached instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she signed willingly and that she executed as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix signed the Will as witness and that to the best of their knowledge the Testatrix was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. ~4~~.~~j,~ CINDY WISE, Testatrix ~~~~ ~~ Witness COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF CUMBERLAND : On this, the ;;.ffi-- day of .!~""-, 2005, before me, the undersigned officer personally appeared Thomas E. Fl~own to me (or satisfactorily proven) to be a member of the bar of the highest court of said state, Supreme Court attorney license no. 83993, and a subscribing witness to the within instrument, and certified that he was personally present when CINDY M. WISE, 'whose name is subscribed to the within instrument, executed the same, and that the said person has acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and ,official seal. i~~v(SEAL) ~tary (f 8 COMMONWEALTH OF PENNSYLVANIA Notarial Seal SaraJ. Ensinger, Notal)' Public Camp Hill Bora, Cumberland County My Commission Expires Oct. 17, 2005 Member, Pennsylvania Association of Notarial::