HomeMy WebLinkAbout03-29-07
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OFFICIAL USE ONLY
Rr:'V-l5UO EX (6-00)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NU BER
-6L
COUNtY CODE
~L 0957 ___
YEAR NUMBER
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DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
Frederick Kath
DATE OF DEATH (MM-DD- YEAR) DATE OF BIRTH (MM-DD-YEAR)
10/17/2006 9/16/1908
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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SOCIAL SECURITY NUMBER
188-32-4381
THIS RETUIVl MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
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00 1. Original Retum
D 4. Limited Estate
D 6. Decedent Died Testate (Attach copy of 'Mil)
D 9. Litigation Proceeds Received
D 2. Supplemental Retum D 3. Remainder Retum (dale of death prior to 12-13-82)
D 4a. Future Interest Compromise (date of death efter 12-12-82) D 5. Federal Estate Tax Retum Required
D 7. Decedent Maintained a Living Trust (Attach copy of Trust) _ 8. Total Number of Safe Deposit Boxes
D 10. Spousal Poverty Credit (dlte of deeth between 12-31-91 end 1-1-95) D 11. Election to tax under Sec. 9113(A) (Attlch Soh 0)
THIS SECTION MUST $E COMPI.,ETED. ALLCOIi{RESPO....DENCE A....OCONFIDENTIAI. T~JNFORMATIONSHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
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Hubert X. Gilro
FIRM NAME (If Applicable)
10 B High Street
Martson, Deardorff, William, Otto, Gilroy & Faller
TELEPHONE NUMBER
717-243-3341
Carlisle, PA 17013
1. Real Estate (Schedule A) (1) 0
2. Stocks and Bonds (Schedule B) (2) 1,735,413
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 0
4. Mortgages & Notes Receivable (Schedule D) (4) 0
5. Cash, Bank Deposits & Miscellaneous Personal Property 60,009
(Schedule E) (5)
Z 6. Jointly O'M1ed Property (Schedule F) (6) 0
0 o Separate Billing Requested
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:5 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 0
::J (Schedule G or L)
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0: 8. Total Gross Assets (total Lines 1-7) (8)
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0 9,106
w 9. Funeral Expenses & Administrative Costs (Schedule H) (9)
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10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 8,660
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 \\ot1ich an election to tax has not been
made (Schedule J) (13)
14. Net Value Subjectto Tax (Line 12 minus Line 13) (14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax 0 ~(15)
Z rate, or transfers under Sec. 9116 (a)(1.2) x.O
0
i= 16. Amount of Line 14 taxable at lineal rate 1,777,656 x.O ~(16)
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a.. 17. Amou nl of Line 14 taxable at sibling rate x .12 (17)
2
0 0
U 18. Amount of Line 14 taxable at collateral rate x .15 (18)
)(
ol( Tax Due
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OFFICIAL USE ONLY
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1,795,422
17,766
1,777,656
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1,777,656
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79,995
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79,995
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
3W4645 1.000
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. ec en s om pie e ress:
STREET ADDRESS
c/o Tom Frederick
713 Yorkshire Drive
CITY I STAiE \ ZIP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
79,995
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73,000
3,842
Total Credits (A + 8 + C) (2)
76.842
3. Interest/Penalty if applicable
D. Interest
E. Penalty
o
o
TotallnteresUPenalty (0 + E) (3)
o
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
(4)
o
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(5)
3,153
A. Enter the interest on the tax due.
(5A)
o
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Pa able to: REGISTER OF WILLS, AGENT
(58)
3.153
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred;. . . . . . . . . . . . . . .
b. retain the right to designate who shall use the property transferred or its income; .
c. retain a rewrsionary interest; or . . . . . . . . . . . . . . . . . . . . . . . .
d. receive the promise for life of either payments, benefits or care? . . . . . . . . .
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . .. !ZJ
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 design ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. D [j
IF THE ANSWER TO ANY OF THE ABOV ESTIONS IS YES. YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury. I declare that I haw . lld 'ratum, induding panying schedules and statements, and to the best of my knowledge and belief, it is tOle, correct and complete.
Declaration of preparer other than pe rap atiw is based on, formation of which preparerhas any knowledge.
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No
Yes
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ADDRESS
POBox 668
Carlisle, PA 17013
DAiE
Carlisle, PA 17013
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For dates of death on or after July 1, 1994 and before January 1. 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. 99916 (a) (1.1) (i)).
For dates of death on or after January 1. 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 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 disdosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 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 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)J.
The tax rate imposed on the net value of transfers to or forthe use of the decedent's siblings is 12% (72 P.S. 9 9116(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.
3W4646 1 000
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REV-1503 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
Kathryn W. Frederick
21 06 0957
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION
1. Smith Barney brokerage account
(see attached)
VALUE AT DATE
OF DEATH
1,735,413
3W4696 1 000
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
1,735,413
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I~EV-1508 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Kathryn W. Frederick
FILE NUMBER
21 06 0957
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jolntly-owned with the right of survivorship must be disclosed on Schedule F.
VALUE AT DATE
OF DEATH
ITEM
NUMBER DESCRIPTION
1 Coins & silver
550
2 Embarq refund
15
3 Gifts within one year of death in
excess of $3,000 per recipient
28,000
4 Orrstown Bank
Interest accrued to 10/17/2006
31,432
12
3W46AD 1000
TOTAL (Also enter on line 5, Recabitulation\ $
(If more space is needed, insert additional sheets of the same size)
60,009
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REV-1S11 EX + (12-99)
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SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INl'ERlTANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kathryn W. Frederick
ITEM
NUMBER
A.
B.
3W46AG 1.000
Debts of decedent must be reported on Schedule I.
DESCRIPTION
FUNERAL EXPENSES:
1.
George's Flowers
2
Hoffman-Roth Funeral Home
Total from continuation schedules
. . . . . . . . .
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address
City
State
Zip
2.
Year(s) Commission Paid:
Attorney Fees
3. Family Exemption: (If decedent's address is not the same as claimant's, attach elCplanation)
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.
1
Register of wills
FILE NUMBER
21 06 0957
TOTAL (Also enter on line 9, Recapitulation)
(If more space IS needed. insert additional sheets of the same size)
AMOUNT
$
69
3,235
637
3,000
1,150
1,000
15
9,106
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Estate of: Kathryn W. Frederick
188-32-4381
Schedule H Part 1 (Page 2)
Item
No. Description
Amount
3 Sunnyside Restaurant-reception
637
Total (Carry forward to main schedule)
637
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ReV-1512 ex + (12-03)
COMMONWEALTH OF PENNSYLVANIA
INI-ERITANCETAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kath~n w. Frederick
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
~1 06 0957
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
Boyer &: Ritter
250
2
Chase VISA
61
3
PA &: Fed Income Taxes
4,241
4
Pharmerica - drugs
210
5
UCC Homes
3,898
3W46AH 2000
TOTAL (Also enter on line 10. Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
8 660
"
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kathrvn W. Frederick
SCHEDULE J
BENEFICIARIES
. REV-1513 EX+ (9-00)
NUMBER
I
1
NAME AND ADDRESS OF PERSON(S) RECEMNG PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers
under Sec. 9116 (a) (1.2)]
Theodore C. Frederick
5327 N. 31st Place
Phoenix, AZ 85016-3719
FILE NUMBER
21 06 0957
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
50% Residue: 888,828
Son
888,828
2 Thomas E. Frederick
713 Yorkshire Dr
Carlisle, PA 17013
50% Residue: 888,828
Son
888,828
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 II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
$
o
3W46AI 1000
(If more space IS needed, Insert additional sheets of the same size)
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WI LL
I, KATHRYN W. FREDERICK, of 26C1iftofl T~,Carliste, Cumberland County, Pennsylvania,
declare this to be my Will and revoke all prior Wills and Codicils.
EI.BSI:
Tangible Personal Prooertv.
I give all tangible per~onal property owned by me at my death and all insurance
policies on such property as follows:
(a) In as nearly equal shares as is practicable to such of my children as
survive me by thirty (30) days. If my son, THEODORE C. FREDERICK, III, fails to survive me,
then I give, devise and bequeath his share to my daughter-in-law, BARBARA S. FREDERICK,
per stirpes. If my son, THOMAS E. FREDERICK, fails to survive me, I give, devise and
bequeath his share to my daughter-in-law, MONICA C. FREDERICK. If both THOMAS E.
FREDERICK and MONICA C. FREDERICK fail to survive me, then I give, devise and bequeath
my son THOMAS E. FREDERICK's share to my son, THEODORE C. FREDERICK, HI.
(b) With respect to any item passing under subparagraph tal to a minor, my
Executor (i) may hold and deliver it to the minor at majority or earlier, or deliver it to any
person tohold for the minor; or (ii) may sell it, hold and invest the proceeds and, at any time,
pay the proceeds to the min()~, to .the. Custodian appointed in this Will or to the guardian .of the
person or estate of the minor to hold for the minor, or apply the proceeds for the minor' 5
benefit for any reason without considering other funds available to the minor. The receipt of
any person who receives an item or payment hereunder shall be a complete discharge to my
Executor.
(cl My Executor shall pay, as an expense of settling my estate, all costs of
delivering such tangible personal property, including the costs of packaging, delivery and
insurance.
SECOND:
Residue.
I give the residue of my estate as follows:
ta) One-half (Y:zl of the residue to my son, THOMAS E. FREDERICK, if he
survives me by thirty (30) days, or if he fails to survive me, to my daughter-in-law, MONICA
K~ !P. ~
PAGE ONE OF TEN PAGES
,
. ,
C. FREDERICK, if she survives me by thirty (30) days. If neither my son, THOMAS E.
FREDI;RICK, nor my daughter-in-law, MONICA C.,fREDERICKlsurvive me, then I direct that
the one-half (Yz). of the residue of mvestate otherwise bequeathed herein, shall be further
divided into two equal parts and given, as follows:
( 1 ) One equal part of the residue to be divided equally between my
grandsons, THEODORE C. fREDERICK, IV, and MATTHEW FREDERICK, per stirpes.
(2) One equal part of the residue to my Trustee, in trust, for the
benefit of my granddaughters, EVE FREDERICK. and KATHRYN FREDERICK, as provided for
in Paragraph THIRD.
(b) One-half (Yz) of the residue to my son, THEODORE C. FREDERICK, III, if
he survives me bY thirty (30) days, or if he fails to survive me, then' direct that the one-helf
( % ) of the. residue of my estate otherwise bequeathed herein, shall be further divided into
two equal parts and given, as follows:
(1 ) One equal part of the residue to be divided equally between my
grandsons, THEODORE C.fREDERICK, IV,and MATTHEW FREDERICK, per stirpes.
(2) One equal part of the residue to my daughter-in-law, BARBARA
S. FREDERICK, if she survives me by thirty (30) days, or if she fails to survive me, to my
Trustee, in trust, for the benefit of my granddaughters, EVE FREDERICK and KATHRYN
FREDERICK, as provided for in Paragraph THIRD.
THIRD:
Iw&1.
That portion of the residue of my estate given to my Trustee, in trust. for the
benefit of my granddaughters, EVE FREDERICK and KATHRYN FREDERICK, shall be divided
by my Trustee into two equal shares, and:
(a) The share of a then-deceased granddaughter shall be retained in trust for
the then-living granddaughter.
(b) The share of a then-living granddaughter shall be retained in a separate trust
for the then-living granddaughter, and my Trustee shall:
(1 )
Pay the net income therefrom at least quarterly to such
granddaughter.
k.w. '::f-:
PAGE TWO OF TEN PAGES
(2) Pay to or apply for the benefit of such granddaughter so much
of the principal of such granddaughter's separate trust as my Trustee deems advisable for his
or her maintenance, education, health and support. In the exercise of this power for any
person, funds available to my granddaughter from other sources shall be considered by my
Trustee.
(3) Pay the principal thereof to such granddaughter upon her written
request after attaining age twenty-five (25).
(c) On the death of any such granddaughter before the entire principal of her
trust has been distributed, the Trustee shan pay the remaining principal to my then-surviving
granddaughter.
(d) If at any time, either upon my death, or before the entire principal of a trust
has been distributed, there is no one living who is entitled to income or principal under the
foregoing trust provisions, the residue or the principal of the trust, as the case may be, shall
be paid to the then-living descendants of mine, per stirpes.
(e) Except as provided in Paragraph SIXTH(!), all income accrued or
undistributed at the death of an income beneficiary shall be paid to the succeeding income or
principal beneficiaries.
(1) If any trust hereunder has not already terminated by its terms, it shall
terminate one day before the expiration of twenty-one years after the death of the survivor of
such of my descendants as are living at my death, and the principal shall then be distributed
absolutely to the persons then receiving income from such trust in proportion to their
respective interests in the income.
FOURTH:
Spendthrift Provision.
Until distributed, no gift or beneficial interest shall be subject to anticipation or
to voluntary or involuntary alienation.
FIFTH:
Death Taxes.
(a) AU death taxes (and interest and penalties thereon) imposed as a result
of my death upon property passing under my Will and upon proceeds of insurance on my life I
y.0.f--
"
PAGE THREE OF TEN PAGES
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but not otherwise, shall be paid out of the principal of my residuary estate, each share thereof,
whether outright or in trust, to bear a pro rata portion of such taxes.
$1~TH:
Administrative Powers.
My Executor and Trustee shall have the following powers in addition to those
conferred by law until all property is distributed:
(a) To retain any real or personal property (including stock of the corporate
Trustee, if any, or of a company controlling it) in the form in which it is received.
(b) To sell at public or private sale for cash and/or credit, to exchange, and
to lease for any period of time, any real or personal property and to give options for such sates,
exchanges, or leases.
(c) To purchase aU forms of property, including but not limited to stocks,
bonds, notes and other securities (including stock of the corporate Trustee, if any, or of a
company controlling it), common trust funds and real estate, or any variety of real or personal
property, without being confined to so-called legal investments and. without regard for the
principle of diversification.
(d) To purchase securities at a premium or discount and to charge such
premium or credit such discount to principal or income.
(e) To exercise any option arising from the ownership of any investment; to
join in any recapitalization, merger, reorganization, liquidation, dissolution, consolidation or
voting trust plan affecting any investment; to delegate powers with respect thereto; to deposit
securities under agreements and pay assessments; to subscribe for stock and bond privileges;
and generally to exercise all rights of security holders.
(f) To hold property unregistered or in the name of a nominee.
(g) To mortgage, divide, alter, repair and improve real property and generally
to exercise all rights of real estate ownership.
(h) To distribute in cash, in kind, or partly in each, and to cause any share
to be composed of cash, property, or undivided fractional shares in property different in kind
from any other share.
f! I<< t--
PAGE FOUR OF TEN PAGES
-..
(i) To compromise claims by or against my estate or any trust hereunder,
including but not limited to tax issues and disputes, without order of court or consent of any
party in interest and without regard for the effect of such compromise on any interest
hereunder.
(j) To borrow money and. to pledge any real or personal property as security
for the repayment thereof.
(k) To buy real and personal. property from my Executor, and to lend money
to my estate upon such terms and conditions as my Trustee deems advisable, even if an
Executor is . also. a Trustee.
(I) T o apply income for the benefit of any incapacitated individual to whom
income mayor must be distributed for any reason during the period.of incapacity. Income not
so applied shall be accumulated, invested, and if not sooner applied, paid to such individual
upon gaining capacity or to his or her personal representative if he or she dies before gaining
capacity .
(m) With respect to a principal share vesting in a beneficiary who, in the
opinion of my Executor or Trustee, is incapacitated by reason ofage (other than minority) or
illness (mental or physical) when such share vests in him or her: to hold the share during his
or her incapacity and to invest the share and all accumulations thereon; to apply so much of
the income and principal as OlY Executor or Trustee deems advisable for such beneficiary's
benefit for any reason without considering other funds available to him or her; and to deliver
the balance of principal and income to the beneficiary at such time as he or she gains capacity.
In addition, at any time to pay the entire share to the guardian of the estate of the
incapacitated beneficiary to hold for his or her benefit. The receipt of a guardian or such other
person as may be selected by my Executor or Trustee to receive a distribution under this
subparagraph shall be a full and complete discharge to my Executor or Trustee.
(0) To apply expenses of my estate permitted .asincome tax or estate.tax
deductions and to value my estate for estate tax purposes by any method permitted, without
adjusting between income and principal for any effect thereon.
(p) Whenever Trustee determines that the size of any trust does not warrant
the cost of continuing it, or that its administration would be impractical for any other reason,
to pay the principal without further responsibility to the income beneficiary, subject to the
1<' to .7-
,
PAGE FIVE OF TEN PAGES
-
provisions of subparagraph (m) or Paragraph TENTH; provided, however, that no Trustee shall
participate in any decision to terminate any trust of which he or she is a current income
beneficiary hereunder.
(q) To pool the assets of all separate trusts under Paragraph THIRD for
investment purposes, allocating to each such trust an undivided proportionate interest in the
pooled assets.
(r) To merge any trust hereunder with any other trust held by Trustee
whether created by me or by any other person by Will or Deed, if the trusts are for the primary
benefit of the same persons and contain substantially similar terms.
(s) To employ accountants, agents, investment counsel, brokers, bank or
trust company to perform services for and at the expense of my estate or any trust or trusts
hereunder for which such services are performed and to carry or register investments in the
name of the nominee of such agent, broker, bank or trust company. The expenses and
charges for such services shall be charged against principal or income or partly against each
as my Executor and Trustee may determine. My Executor and Trustee are expressly relieved
of any liability or responsibility whatsoever for any act or failure to act by, or for following the
advice of, such accountants, agents, investment counsel, brokers, bank or trust company, so
long as my Executor and Trustee exercise due care in their selection. The fact that an
Executor or Trustee may be a member, shareholder or employee of any accounting, investment
or brokerage firm, agent, or bank or trust company so employed shall not be deemed a conflict
of interest. Any compensation paid pursuant to this subparagraph shall not affect in any
manner the amount of or the right of my Executor or Trustee to receive commissions as a
fiduciary.
SEVENTH:
Administrative Provisions.
(a) A beneficiary's incapacity shall be determined solely by my Trustee. The
incapacity of a beneficiary who is also a Trustee shall be determined solely by my other
Trustee. No Trustee who is also a beneficiary hereunder, if incapacitated in the opinion of my
other Trustee, shall participate in any decision to apply income for his or her benefit.
(b) No Trustee hereunder shall participate in any decision to pay income or
principal to or for the benefit of himself or herself or any individual whom he or she is legally
obligated to support.
kW'1-
PAGE SIX OF TEN PAGES
";'''_''!i.;.;,;:7'''!1NT,::7'''''''''''. ':~p(fl"
."-.~tr ~'t
y{
(c) The receipt of any recipient of an item to hold for, or any payee
of a payment for the benefit of, an incapacitated beneficiary shall be 8 complete discharge to
my Executor and Trustee.
EIGHTH:
Power of Aopointment.
I decline to exercise any power of appointment given to me under any Will,
Codicil or Deed of Trust.
NINTH:
Definitions.
(a) The words "Executor," "Trustee," "Guardian" and "Custodian" when
used in this Will shall include all genders and the singular and plural as the context may
require.
(b) The word "descendants" when used in this Will shall include adopted
persons adopted before age twenty"one and their descendants.
(c) The words "incapacitated" and "incapacity" when used in this Will shall
refer to an inability to use funds by reason of age or illness (mental or physical).
(d) When a "per stirpes" distribution of income or principal to a designated
individual's descendants is provided for under this Will, such income or principal shall be
divided into as many equal shares as there are then living children of such individual and then
deceased children represented by descendants then living, and each then living child shall
receive one share, and the share of each deceased child shall be divided among his or her
descendants in the same manner, repeating this pattern with respect to succeeding
generations until all shares are determined.
(e) Paragraph headings in this Will are for reference only and shall not affect
the meaning, construction or effect of this Will.
TENTH:
Custodian.
(a) I appoint such individual or corporation (including a fiduciary serving
hereunder) as is designated in writing by my Executor as Custodian for (i) any beneficiary who
has not attained age twenty-one (21) at the time an interest is distributable outright to him or
kWr-
PAGE SEVEN OF TEN PAGES
.
---<r-fl!'~~
-
her under this Will, and (ii) except to the extent a valid appointment of a Custodian has
otherwise..been made, any person who. has not attained age twenty-one (21) at the time an
interest is distributable outright to him or her as the result of my death from any other source.
Such appointment shall be deemed to be made under the Uniform Gifts to Minors Act or
Uniform Transfers to Minors Act then in effect in:
1 . The jurisdiction in which I am domiciled at death, or
2. The jurisdiction in which the beneficiary is domiciled, or
3. The jurisdiction of an existing Uniform Act custodianship for the
minor.
The selection among the foregoing shall be made by my Executor, in my Executor's absolute
discretion.
(b) If the applicable Uniform Act in the governing jurisdiction permits the
postponement of distribution to an age beyond age twenty-one (21) if so directed in the
governing instrument, I hereby direct that distribution shall be postponed until the maximum
age permissible under the Uniform Act.
(c) If I am Custodian under the Uniform Transfers (or Gifts) to Minors Act for
any Custodianship property, and no successor has been otherwise appointed, I hereby appoint
my Executor (or if my Executor declines to serve, such individual or corporation as may be
designated in writing by my Executor) to serve as Custodian under the Uniform Transfers (or
Gifts) to Minors Act for any Custodianship property of which I am the Custodian. Upon
written acceptance of the successor Custodianship, my Executor (or such designee) shall be
authorized to take custody of any such property.
ELEVENTH:
Executor and Trustee.
I appoint my son, THOMAS E. FREDERICK, Executor. If my said son, THOMAS
E. FREDERICK, fails to qualify or ceases to act for any reason, I appoint my son, THEODORE
C. FREDERICK, III, Executor. I appoint FINANCIAL TRUST SERVICES COMPANY, or the
successor to its trust business, Trustee under Paragraph SECOND. My Executor and Trustee
shall not post security in any jurisdiction. My corporate Executor and Trustee, if any, shall
receive compensation for its services hereunder in accordance with its Schedule of Fees in
effect from time to time during the period over which its services are performed. W::t-
/~ .
.
PAGE EIGHT OF TEN PAGES
~
Executed this .2L day of -:ht ~ ' 1999.
~~.W'YA~JSEALI
'KATHRYN.. . FREDERICK
The preceding instrument, consisting of this and nine (9) other typewritten pages, each
identified. by the signature of the Testatrix was on the day and date thereof signed, published
and declared by the Testatrix therein named as and for her last will, in the presence of us, who
at her request, in her presence and in the presence each other have subscribed our names.
/)
(/~~"-~::)~~
/
COMMONWEALTH OF PENNSYLVANIA
: ss
COUNTY OF CUMBERLAND
We, ",C and Con..., I ~ J: Tt"; -tt. , witnesses
whose names ar signed to the attached or foregoing instrument being duly qualified according
to law, do depose and say that we were present and saw the Testatrix sign and execute the
instrument as her last will; that she signed willingly and executed it as her free and voluntary
act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix
signed the will as witnesses; and that to the best of our knowledge, the Testatrix was at the
time 18 or more years of age, of sound mind and r no constraint or undue influence.
/"1 ...., .
~,;;...-.._,.....~~) '---/~L
/
PAGE NINE OF TEN PAGES
Sworn and subscribed to
,4Z
before me this .8) day
of ~uh , 1999.
NOI'MlALIUL
KM!M.'~__PUaIC
CMI-"8ClRO. c.rUllRl.Neco.. ItA
MY COflrIlIlCII....._ .....
.~~~
.. . . Notary P~bliC
COMMONWEALTH OF PENNSYLVANIA:
: ss
COUNTY OF CUMBERLAND
I, KATHRYN W. FREDERICK, whose name is signed to the attached instrument, having been
duly qualified according to law, do hereby acknowledge that I signed and executed the
instrument as my last will; that I signed it as my free and voluntary act for the purposes
therein expressed.
~~_ UJ.'1~~
-KATHRYN W REDERICK
Sworn and subscribed to and acknowledged before me this 8/ ~ay of ~~
1999.
~.;t ~.__
. .. ... Notary Public - r
NOrARW.tuL
KARIN F.1m!RI, IIOTARY IIU8UC
CMllILE BOlIO. Q........... co.. 'A
MY C'OlI......1ON IXPIRII URCH 11."
PAGE TEN OF TEN PAGES
Estate of Kathryn W. Frederick
Value of Estate at time of Death October 17, 2006
Cash in Bank (Orrstown)
Brokerage account (Smith Barney)
Contents of Safe Deposit Box (Coins & Silver)
Total Value
Gifts of cash: April 2006
Thomas E. Frederick (186-30-7433)
Theodore C. Frederick III (204-26-8387)
Monica C. Frederick (207-34-6790)
Barbara Frederick (215-62-3640)
$ 31,432.15
1,735,412.66
550.00
~y tne
~.
i-I'
$1,767,394.81
$10,000.00
10,000.00
10,000.00
10,000.00
e"l"f'!/
f S:-o a
10 clO
....----.
77S1')
'fr C)Or)
'lIf...~. t."':i:..,~-~) ','j .i.~
j
(., (;-,0.0:' :.,1
33"--
"
,
~o ' ".0 II
\ ( VIA'::' \.,,~ ,
Estate of Kathryn W. Frederick
Accounting as of: December 8, 2006
Cash in Bank 10/17/06
Less: Draft Capital Blue Cross
Plus: Interest
Cash transferred to Estate Acct
Income:
Div/Int Smith Barney
Refund Capital Blue Cross
Frank Loney Purchase of Coins
Div Wilmington Trust Smith Barney
Refund Embarq
Div Smith Barney
Proceeds CD's Smith Barney
Total Income
Expenses:
Pharmerca (Drugs)
DCC Homes
Sunnyside Restaurant
George's Flowers
Broujous & Gilroy P.C. (atty)
Hoffinan-Roth Funeral Home
Chase Visa
DCC Homes
Shirley Gartzke (nurse)
Michell Campbell (nurse)
Rita McAlister (nurse)
First Lutheran Church
Total Expenses:
Cash as of December 8, 2006
Distribution December 8, 2006
Cash as of December 9, 2006
$31,432.15 /
115.60/
12.37 tI
'( $ 1,298.91
115.60.J
/ 550.00-
<( 3,225.60 /
14.91 ,/
'\ 28.81
216.825.84
$ ~ 209.90,A
vi'
3,741.79 f
v 637.41..t-
v 68.90 1
,/ 1,690.001
/ 3,234.70.t-
61.31 --r
156.45 .t
500.00 l
500.00 (
500.00 r
i
1,000.00,J
Ii
,/
57!o-~{73ji
, ,
$31,328.92
$222,059.67
$ 12,300.46
$241.088.13
$141,000.00
$100,088.13
.
..
,
STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SHORT CERTIFICATE
I,
GLENDA FARNER STRASBAUGH
Register for the Probate of wills and Granting
Letters of Administration in and for
CUMBERLAND County, do hereby certify that on
the 30th day of October, Two Thousand and Six,
Letters TESTAMENTARY
in common form were granted by the Register of
said County, on the
estate of KATHRYN W FREDERICK , late of CARLISLE BOROUGH
(First, Middle, Last)
in said county, deceased, to THOMAS E FREDERICK
(First, Middle, Last)
and that same has not since been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the
seal of said office at CARLISLE, PENNSYLVANIA, this 30th day of October
Two Thousand and Six.
File No. 2006-00957
PA File No. 21-06-0957
Date of Death 10/17/2006
S. S. # 188-32-4381
~ /. tL piv11{0f 1rt~Jl:>1LVC tj(
~ Register Of Wills / -
U--fle.e ffi~ fIlJu J'
Deputv
NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL
..
H IQ~05 REV 1105
, This IS to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Lo~al Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
2},'_~~~~
Local Registrar
Fee for this certificate, $6.00
p
12728056
OCT 2 6 2006
Date
./
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
.COIJ'lyolDulll
Sept. 16, 1908 Mechanicsburg,PA
Bd. FdIy N...(Ifnol_1lon, gloe_ and.-j
STAlE FILE NUMBER
.. 0.010.... (ManIJ. diy, ,..,
October 17, 2006
5...
7.
and .... or
~
!
S.Middleton Twp.
01__ _01 "001101__
l<lndol_l-,
Aan. Secreta Public School
18. -.-.g ( clly/-'-,Ilp-l
Thornwald Home
442 Walnut Bottom Rd. Carisle, PA17
18. F_._(F"nt._,...._1
George Wertz
200.""""""'_(Typo/fllnl)
Thomas E. Frederick
21._oIOioIIo!!lon
0- DRomcMlflom_
OOhor.Spoc#;:
220 s.-oI
~..
~_23o<onIy_..oIylng
~ionol_..lIrool_..
Cld't_oI_.
_24-111_bo~"'_
"""-_.
PII
DId_
u.o... 17.0 y-._lMId..
T"""'1 ....
CUmberland 1701.... ~O':-oIlMId-
19. --(FhI.-,-.......)
Clara Bates
3lb. -.-.g-_cllyl-,_Ilp_l
713 Yorkshire Dr., Carlisle, PA 17013
Twp.
l?b.County
Carlisle
Cl\yl-
21b. o.oI~(IIomh,doy,,.., 21.. ~oIOiopoIIticn~oI_........,or_plo:o)
2101. UlaIIcn(Cllr/__..._1
2006 Yorktowne Cremation Service York, PA 17401-3374
220. _and-..oIFodIy Hoffman-Roth Funeral Home
Hanover St., Carlisle, Pa 17013
23b. Uc:on._
,hL)
h ^ 01...J ......oV\,. ~ Cl
Due to (OI' .. . dlntlJQUlll\Cl8 01):
~inlerval: Partll:Enlerohf.ltr.anI~lDIIrb6Dkldl:altl 28. OIdTot.;mUaeConWauNlaaOeelh?
On.....Ooalh bulnollOOlllngil"oodoflyilgCIUIIgMililPiotI. 0 YIS DFnlboIIIy
Du,,-,
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i
321."T~"-'YrSpoctj/
DOoWe<IOpem:w DP-
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330 CorlIIlerI_onIycne) 33b. sq,....andTileol
. =:''''::-~~'''::.==:''~Ih~'=:'~.~~'_~~~~~_'::~l___m____________ ' ..
. P_.nd.._.....Ic""(~"'~""'__and_..cauMoI_1
TolhtbelltAmyknowledge.dtlthoccurndllthttimt.....nlpIec.,and due lotheCluH(.! and nwlf*.......... ..D 33c_ UollInIlt. ""-. 33d. o.~/~/,dttI,'.1
. -.'.._"'C...... -.0<._________________ 0 Q { . 9- I ~ - L Ie 10,00
On tht basil at ..amIn11kNl Md I or InvMtIgItIon,ln my opinion, dIIIh occu~ II the time, dIle, and pile', and M 10 the C8UM(.'.nd manntr II SCIIfCL _..D 34. NIme nI Addrns atPersan Who Compfeted Cause d 0taIh ,.... 27} Type I Print
. and~"'f""< b...l J6, 0.. FlIod(_day,"" Darryl Guistwite I DO
H. ~~t.1f\: 1 \,\1 I I..:J. I I I 0 I 522 South Pitt St., Carlisle, Pa 17013
o Y.. 0 No
29.'_
o Nol__post,..
0_",..,.01-
o NoI_but__42dois
ol-
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OlIao9Uldlng,'""(Spod/t1
emlltoondlfionl.jf~r,
b GaUSe IRId on Ine II
En'" UNOEJtL YIHG CAUSE
l_or!jurrIhol_1ho
IMnts""uIIIf1glldlllllh)LAST.
Due to (or .. a OQftIJl!Iquence 01):
Due CD (or _ . oonsaquence oft.
301. W.. anAutlply
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o V.. ~
301>. __RndIngO 31. ~Doo~
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p.o
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.
t>-'
Broujos & Gilroy, p.e
4 North Hanover Street
Carlisle, P A 17013
Ph: 717-243-4574
717-766-1690
Estate of Kathryn W. Frederick
c/o Thomas E. Frederick
713 Yorkshire Drive
Carlisle, P A 17013
AIT:
Fax:717-243-8227
Nov 08, 2006
File #: 06hxg153
Inv #: 11571
q-R:E:Estate
DATE EXPLANATION
Oct-25-06 Conference with Client
Oct-30-06 Preparation of Petition and file work
CONF WITH CLIENT, TRIP TO REGISTER TO FILE PETITION,
PREP OF NOTICE TO BENEFICIARIES, LEITER TO CLIENT,
LEITER TO REGISTER OF WILLS
FEE SUMMARY
LAWYER HOURS EFFECTIVE RATE AMOUNT
HXG
DISBURSEMENTS
2.70
$200.00
$540.00
Disbursements
Receipts
Oct-30-06
filing fee
oJIV}Y
1,150.00
Totals
$1,150.00
$0.00
TomIF~s,Dubunemen~
Previous Balance
Previous Payments
$1,690.00
$0.00
$0.00
Balance Due Now
$1,690.00
.
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IMPORT ANT NOTICE
t \, }J i.
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NOTICE OF ESTATE ADMINISTRATION
THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY
MONEY OR PROPERTY FROM THIS EST ATE OR OTHERWISE.
Whether you will receive any money or property will be determined wholly or partly by the
Decedent's Will. If the Decedent died without a Will, whether you will receive any money or
property will be determined by the intestacy laws of Pennsylvania.
BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYLVANIA
In re: Estate of Kathryn W. Frederick, deceased, October 17, 2006
No. 2006-00957
TO: Thomas E. Frederick
713 Yorkshire Drive
Carlisle, PA 17013
Theodore C. Frederick
5327 N. 31st Place
Phoenix, AZ 85016-3719
Please take notice of the death of Decedent, Kathryn W. Frederick, and the grant of Letters to
the personal representative named below.
The Decedent, Kathryn W. Frederick, died on the October 17,2006 at Cumberland County,
Pennsylvania.
The Decedent died testate, and a copy of her Will is attached hereto.
The personal representative of the Decedent is;
Thomas E.Frederick
713 Yorkshire Drive, Carlisle, PA 17013
(717) 249-2968
Tbe Will b~S been filed with the Omceofthe Register of Wills of Cumberland County,
PennsylvaDla, whose address and telephone number is as follows:
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
(717) 240-6345
Date: November .3
, 2006
ubert X. ... roy, Esquire
Attorney 1< r Personal Representative
Broujos & Gilrov,P.c.
4 N. Hano1\:er Street
Carlisle, PA 17013
(717) 243-4574