HomeMy WebLinkAbout10-12-07
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15056041192
REV -1500 EX (06-05)
OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes
PO BOX 280801
Harrisburg, PA 17128-0601
County Code Year
File Number
INHERITANCE TAX RETURN
RESIDENT DECEDENT
21 07
0784
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
Date of Birth
186 38 0954
08 02 2007
Decedent's Last Name
Suffix
Decedent's First Name
MI
Stapf
Mary
S
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name
Suffix
Spouse's First Name
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
_ 1. Original Return
c:J 2. Supplemental Return
c:J 3. Remainder Return (date of death
prior to 12-13-82)
c:J 5. Federal Estate Tax Return Required
c:J 4. Limited Estate
c:J 4a. Future Interest Compromise (date of
death after 12-12-82)
_ 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
c:J 10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
o 8. Total Number of Safe Deposit Boxes
_ 6. Decedent Died Testate
(Attach Copy of Will)
c:J 9. Litigation Proceeds Received
c:J 11. Election to tax under Sec. 9113(A)
(Attach Sch. 0)
CORRESPONDENT - This section must be completed. All Correspondence and Confidential Tax Information Should be Directed to:
Name Daytime Telephone Number
Robert R. Church, Esq.
717 255 8D59
.._..1
Firm Name (If Applicable)
REGISTEROF WILLSW;E ONl:.Y'j
Keefer Wood Allen & Rahal,
LLP
r',
First line of address
p.o. Box 11963
Second line of address
en
City or Post Office
Harrisburg
State
ZIP Code
DATE FILED
PA
17108-1963
Correspondent's e-mail address:rchurch@keeferwood.com
Under penalties of perjury, I declare that I have examined this return, including accompanying sc hedules and statements, and to the best of my knowledge and belief.
it is true, correct and complete. Declaration of the pre parer other than personal representative is based on all information of whic h preparer has any knowledge.
DATE
10-9-07
Road, Harrisburg, PA 17112
DATE
0-2- -O~
ADDRESS
PO Box 11963, Harrisburg, PA
Rahal, LLP
Side 1
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15056041192
15056041192
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15056042193
Rev-1500 EX
Decedent's Social Security Number
186 38 0954
Decedent's Name: Mary S. Stapf
RECAPITULATION
1. Real estate (Schedule A)
1.
0.00
2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2.
0.00
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . . .. 3.
0.00
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . . .. 5.
0.00
1,654.54
4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . .. 4.
6. Jointly Owned Property (Schedule F) c:::J Separate Billing Requested . . . . .. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) c:::J Separate Billing Requested . . . . . . 7.
0.00
8. Total Gross Assets (total Lines 1-7)
8.
242,032.58
243,687.12
23,157.69
9. Funeral Expenses & Administrative Costs (Schedule H) . . . . . . . . . . . . . . . . . . .. 9.
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . . .. 10.
9,441.12
11. Total Deductions (total Lines 9 & 10) ... . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 11.
32,598.81
12. Net Value of Estate (Line 8 minus Line 11). . . . . . . . . . . . . . . . . . . . . . . . . . . .. 12.
13. Charitable and Governmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . .. 13.
211,088.31
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 .00 0.00
16. Amount of Line 14 taxable
at lineal rate X .045 211 ,088 . 31
17. Amount of Line 14 taxable
at sibling rate X .12 0 . 0 0
18. Amount of Line 14 taxable
at collateral rate X .15 0 . 0 0
0.00
211,088.31
15.
0.00
16.
9,498.97
17.
0.00
18.
0.00
19. TAX DUE .................................................... 19.
9,498.97
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
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Side2
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15056042193
15056042193
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Rev-1500 EX Page 3
File Number
21
07
0784
DECEDENTS SOCIAL SECURITY NUMBER
186-38-0954
CITY
Mechanicsburg
STATE
PA
ZIP
17055
Tax Payments and Credits:
1.
2.
Tax Due (Page 2 Line 19)
Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
9,498.97
0.00
0.00
474.95
Total Credits (A + B + C)
(2)
474.95
3.
Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E)
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Une 20 to request a refund.
0.00
0.00
(3)
(4)
(5)
(5A)
(5B)
0.00
4.
5.
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
9,024.02
0.00
9,024.02
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE 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; . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. IZl D
b. retain the right to designate who shall use the property transferred or its income; ............. 0 IZJ
c. retain a reversionary interest; or ................................................ 0 IZJ
d. receive the promise for life of either payments, benefits or care? ........................ 0 IZJ
2. If death occurred after December 12, 1982, did decedent transfer property within one year
of death without receiving adequate consideration? .................................... 0 IZJ
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 0 IZJ
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property
which contains a beneficiary designation? .......................................... 0 IZI
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. Sect. 9116(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. Sect. 9116(a)(1.1 )(ii)). The statue 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. Sect. 9116(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. Sect. 9116(1.2) [72 P.S. Sect. 9116(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. Sect. 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.
REV -1508 EX+ (8-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECED ENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONALPROPERTV
ESTATE OF
Mary S. Stapf
FILE NUMBER
21 07 0784
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 Scheduel F.
ITEM
NUMBER DESCRIPTION
Social Security Benefit Payment for July
VALUE AT DATE
OF DEATH
1,521.10
2 Capital Blue Cross premium refund
133.44
TOTAL (Also enter on line 5, Recapitulation)
1,654.54
(If more space is needed, insert additional sheets of the same size)
REV-1510 EX+(6-98)
COMMONWEAL TH OF PENNSYLVANIA
INH ERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
Mary S. Stapf
FILE NUMBER
21 070784
Th is schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVE R SH E ET is yes.
DESCRIPTION OF PROPERTY
ITEM INCLUDE NAME OF TRANSFEREE, RELATIONSHIPTO DECEDENT & DATE OF DEATH %OFDEC'S EXCLUSION TAXABLE
NUM DATEOFTRANSFER. ATTACH COPYOF DEED FOR REAL ESTATE VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1 Mary S. Stapf Revocable Trust under Trust 0.00 0.00
Agreement dated June 18, 1996, Hershey Trust
Company, Trustee. Per the Trust Agreement the
Settlor's Probate Estate is the sole beneficiary
upon Settlor's death.
Assets held in trust at DaD Value:
2 22 units Equity REIT CTF 5,495.79 100 0.00 5,495.79
3 Accrued Income to DaD on Equity REIT CTF 7.40 100 0.00 7.40
4 138 units Value Equity Fund CTF 61,607.14 100 0.00 61,607.14
5 Accrued Income to DaD on Value Equity CTF 75.76 100 0.00 75.76
6 127 units Fixed Income CTF 125,345.77 100 0.00 125,345.77
7 Accrued Income to DaD on Fixed Income CTF 513.63 100 0.00 513.63
8 $25,000 JP Morgan & Co. 6% Bond due 1/15/09 25,166.93 100 0.00 25,166.93
9 Accrued Income to DaD on JP Morgan 6% 70.83 100 0.00 70.83
Bond
10 $10,000 FHLM 4.5% Bond due 11/15/11 9,773.14 100 0.00 9,773.14
11 Accrued Income to DaD on FHLM 4.5% Bond 96.25 100 0.00 96.25
12 Money Market Cash 13,879.94 100 0.00 13,879.94
TOTAL (Also enter on line 7, Recapitulation) 242,032.58
(If more space is needed, insert additional sheets of the same size)
. .
REV-1511 EX+(10-06)
COMMONWEAL TH OF PENNSYL VANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Mary S. Stapf
FILE NUMBER
21 07 0784
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
FUNERAL EXPENSES:
Neill Funeral Home
11,349.06
A.
2
Harrisburg Country Club
funeral luncheon
963.01
3
Brachendorf Memorials
stone inscription
250.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City
State
Zip
Year(s) Commission Paid:
2.
Attorney Fees
10,000.00
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
369.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7
Patriot News
Trust Advertising Fee
226.62
TOTAL (Also enter on line 9, Recapitulation)
23,157.69
(If more space is needed, insert additional sheets of the same size)
. .
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REV-1512 EX+(12-03)
COMMONWEALTH OF PENNSYLVANIA
INH ERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
Mary S. Stapf 21 07 0784
Report debts incurred by decedent prior to death which remained unpaid as of date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Messiah Village 264.75
final nursing home bill
2 Hershey Trust Co 216.67
Trustee's Fee
3 Alert Pharmacy 513.63
prescription drugs for decedent
4 Messiah Village 8,046.07
nursing expenses
5 Reserve for preparation of 2007 1040/PA-40 Returns 400.00
TOTAL (Also enter on line 10, Recapitulation)
9,441.12
(If more space is needed, insert additional sheets of the same size)
, .
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REV-1513 EX+(9-00)
COMMONWEAL TH OF PENNSYL VANIA
INH ERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Mary S. Stapf
FILE NUMBER
21 070784
RELATIONSHIP TO DE~~ENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(SI RECEIVING PROPERTY Do Not List Truste s OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 9116(a)(1.2)]
John S. Stapf, Jr. Son 70,362.77
771 Fishing Creek Valley Road
Harrisburg, PA 17112
Mary Barbara Stapf Cleveland Daughter 70,362.77
409 Central Drive
Briarcliff Manor, NY 10510
Thomas G. Stapf, Jr. Grandson 35,181.38
514 Ridge Road
Elizabethtown, PA
John N. Stapf Grandson 35,181.39
89 Ashley Drive
Marietta, PA 17547
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SH EET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEe. 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)
REGISTER OF WILLS
CUMBERLAND County, Pennsylvania
CERTIFICATE OF GRANT OF LETTERS
No. 2007-00784
Estate Of: MARY S STAPF
PA No. 21-07-0784
(First, Middle, Last)
Late Of:
LOWER ALLEN TOWNSHIP
CUMBERLAND COUNTY
Deceased
Social Securi ty No: 186-38-0954
WHEREAS, on the 21st day of August 2007 an instrument dated
March 20th 1996 was admitted to probate as the last will of
MARY S STAPF
(First, Middle, Last)
late of LOWER ALLEN TOWNSHIP, CUMBERLAND County,
who died on the 2nd day of August 2007 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, GLENDA FARNER STRASBAUGH Register of wills in and
for CUMBERLAND CountYr in the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters TESTAMENTARY to:
JOHN S STAPF JR
who has duly qualified as EXECUTOR(RIX)
and has agreed to administer the estate according to law, all of which
fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYL VANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 21st day of August 2007.
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**NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
LAST WILL AND TESTAMENT OF
MARY S. STAPF
I, MARY S. STAPF, of Cumberland County, pennsylvania, do
hereby make this my Last will and Testament, revoking any former
wills and Codicils made by me.
FIRST: I direct that all my legally enforceable debts,
secured and unsecured, be paid as soon as practicable after my
death.
SECOND: I give my tangible personal property and all
casualty insurance that I am carrying on said tangible personal
property to my children who survive me, to be divided equitably
among or between them as they may determine, or, if they are
unable to agree, as my Executor shall determine, after consider-
ing the wishes of such children. I have complete confidence that
my children or my Executor will honor any written instructions
that I may leave with regard to said tangible personal property.
Any such property not so distributed shall be sold, and the
proceeds added to my residuary estate to pass as hereafter
described.
THIRD: I give, devise and bequeath the rest, residue and
remainder of my estate, real and personal, to my children, John
S. Stapf, Jr., Thomas G. Stapf and Barbara S. Cleveland, per
stirpes.
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FOURTH: If any person under the age of twenty-one (21)
years shall become entitled to any share hereunder, then such
share shall immediately vest in such beneficiary, but notwith-
standing the provisions herein, my Executor may distribute such
beneficiary's share to any adult person standing in loco paren-
tis, or to a legal guardian of such beneficiary, or to a custodi-
an (to be selected by my Executor) under the applicable Uniform
Transfers to Minors Act, without requiring bond of such adult
person, guardian or custodian. The receipt of such adult person,
guardian or custodian shall constitute a full release of my
Executor for any property so distributed.
FIFTH: No person shall benefit hereunder unless such
beneficiary shall survive me by thirty (30) days.
SIXTH:
(1) I name my children, John S. Stapf, Jr., Thomas
G. Stapf" and Barbara Cleveland, as my Co-Executors. Should any
child be unable or unwilling to serve, the others or other shall
serve alone. I direct that my Co-Executors, herein referred to
as my Executor regardless of number or gender, serve without bond
in any jurisdiction in which called upon to act.
(2) My Executor shall receive reasonable compensation
for services rendered.
SEVENTH:
(1)
I give to any Executor named in this will or
any Codicil hereto or to any successor or substitute Executor all
of the powers enumerated in this Will and all of the powers
applicable by law to fiduciaries in the Commonwealth of Pennsyl-
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vania and in particular through the Pennsylvania Probate, Estates
and Fiduciaries Code, as effective and as in effect on the date
of my death, during the administration and until the completion
of the distribution of my estate. I direct that all such powers
shall be construed in the broadest possible manner and shall be
exercisable without court authorization.
(2) My Executor is authorized and empowered to acquire
and to retain, either permanently or for such period of time as
my Executor may determine, any assets, including the capital
stock of any closely held corporation, whether such assets are or
are not of the character approved or authorized by law for
investment by fiduciaries and whether such assets do or do not
represent an overconcentration in one investment.
(3) My Executor is authorized and empowered to dis-
claim any interest, in whole or in part, of which I, or my
Executor, may be the beneficiary, devisee, or legatee, by execut-
ing an appropriate instrument (in accordance with section 2518 of
the Internal Revenue Code of 1986, as amended, or such similar
section as may then be in effect) .
(4) My Executor is authorized and empowered to sell at
public or private sale, or exchange, and to encumber or lease,
for any period of time, any real or personal property and to give
options to buy or lease any such property. Additionally, my
Executor is authorized and empowered to compromise claims, to
borrow from anyone (including a fiduciary hereunder) and to
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pledge property as security therefor, to make loans to and to buy
property from anyone (including a fiduciary or beneficiary
hereunder); provided that any such loans shall be adequately
secured and at a fair interest rate.
(5) My Executor is authorized and empowered to allo-
cate property, charges on property, receipts and income among and
between principal or income, or partly to each, without regard to
any law defining principal and income.
EIGHTH: All estate, inheritance, succession and other death
taxes imposed or payable by reason of my death and interest and
penalties thereon with respect to all property comprising my
gross estate for death tax purposes, whether or not such property
passes under this Will, shall be paid out of the residue of my
estate, as if such taxes were expenses of administration, without
apportionment or right of reimbursement. I authorize my Executor
to pay all such taxes at such time or times as deemed advisable.
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IN WITNESS WHEREOF, I have set my hand and seal on this my
, 1996.
Last will and Testament this oZ)~ day of j1J! II/UN
SIGNED, SEALED, PUBLISHED, and
DECLARED by MARY S. STAPF,
as and for her Last Will and
Testament, on the day and year
last above written, in the
presence of us, who, at her
request, in her presence, and
in the presence of each other,
all being present at the same
time, have hereunto subscribed
our names as witnesses:
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MARY s. ISTAPF I j
( SEAL)
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WE, MARY g,.STAPF and~hj JlIJLO /tL/
:Jenntb M. -I-kIne , and --::;'"Ili/ J: lIyk.-' , the
Testatrix and the witnesses, respective1Y~ whose names are signed
to the attached or foregoing 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 that she
had signed willingly (willingly directed another to sign for
her), and that she executed it as her free and voluntary act for
the purposes therein expressed, and that each of the ~Jitnesses,
in the presence and hearing of the Testatrix, signed the Will as
witness and to the best of his or her knowledge the Testatrix was
at that time eighteen (18) years of age or older, of sound mind,
and under no constraint or undue influence.
'''kcU/<4 xl)' --!;{;;}, ,/
MARY s.I STAPF, TesEq:,trix
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wltnessr-
Subscribed, sworn to, and
STAPF, the Testatrix, and
-::JO h h l\e N I ( II I c...-
-n M 07)../-1// ,:::J: -/-tv u J e-
I T-
of MMC i-I ' 1996.
acknowledged before me by MARY S.
subscribed and sworn to before me by
J-i! nn " lfit. fv1. /fde ~ , and
, witnesses, this .;:101/.4- day
/1 J7
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Notary Public
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Nat?ricJ Seal ,
Arden p~ O'Neal, Notary Public
Lower Aiien Twp" cunioerland County
My eo[l1l'l1ission Expires July 7, 1997
r, PennsytvaniaASSoc;ia1ionofNotaries
TRUST AGREEMENT
~
THIS TRUST AGREEMENT, made the If day of June, 1996 between
MARY S. STAPF of Derry Township, Dauphin County, Pennsylvania 17033, (herein called
Settlor), and HERSHEY TRUST COMPANY, of Hershey, Pennsylvania, and its successors,
(herein called Trustee), WITNESSETH THAT:
1. Trust Property. The Settlor does hereby transfer and deliver to the Trustee
the property listed on the schedule annexed hereto, to have and to hold the same, and any
cash, securities or other property which the Trustee may, pursuant to any of the provisions
hereof, at any time hereafter hold or acquire, all of such property being herein referred to
as the trust estate, in trust, for the uses and purposes and upon the terms and conditions
following:
2. Dispositive Provisions. The Trustee shall hold, manage, invest and reinvest
the trust estate, and shall collect the income thereof and dispose of the net income and
principal as follows:
(a) During the lifetime of the Settlor, the
Trustee shall pay to or for the use of the Settlor,
in quarter annual or more frequent instalhnents,
the net income of the trust estate. Any income not
1
so distributed may be accumulated and invested in the
same manner as the corpus of the trust estate. In
addition to the income, there shall be paid to the
Settlor or applied for her use out of the corpus,
at any time and from time to time, such amounts, if
any, as the Trustee in its discretion shall determine
to be necessary for her maintenance, medical, dental,
surgical, nursing, hospital, institutional and
psychiatric care, comfort and welfare. In addition
to such discretionary invasions of principal, the
Trustee shall pay to Settlor at any time and from
time to time such portion or all of the principal
as she may request for any purpose including gifts
to others.
(b) Upon the death of Settlor, to distribute the
trust estate to Settlor's personal representative to
be disposed of in accordance with Settlor's will or
applicable law.
(c) The primary purpose and intent in creating
this trust is to provide for the income beneficiary.
The rights and interests of remaindermen and/or the
2
Settlor's Estate are subordinate and incidental to
that purpose. The provisions of this Agreement shall
be construed liberally by the Trustee in the interest
and for the benefit of the income beneficiary.
3. Additional Property. The Settlor may at any time or from time to tim(~
transfer and deliver to the Trustee cash, securities and any other property to be added to the
trust estate. All such property hereafter delivered and transferred to the Trustee by Settlor
shall be held, administered and disposed of by the Trustee in accordance with the provisions
of this Agreement without the execution of any further instrument or declaration.
4. Accounting by Trustee. The Trustee may at any time render an account
to the income beneficiary, whose written approval shall be final, binding and conclusive
upon all persons then or thereafter interested in the trust estate. The Trustee may also at
any time render a judicial account of its administration.
5. Security. No bond or other security shall be required of the Trustee in this
or any other jurisdiction.
6. Successor Trustees. No change in name of the Trustee hereunder nor any
merger of its corporate powers with another corporation shall affect its appointment or
3
powers hereunder. The Trustee or any of its substitutes or successors may at any time resign
the trust. Whenever in this Agreement reference is made to Trustee, such reference shall
be deemed to include not only the Trustee expressly named herein, but also any and all
substitutes and successors at any time qualified and acting hereunder, and all rights and
powers given in this Agreement to the Trustee shall be vested in substitute and successor
trustees.
7. Payments to Persons Under Disability. Whenever income or principal
hereunder is to be paid to a person under legal disability, or to a person not adjudicated
incompetent but who by reason of illness or mental or physical disability is unable in the
opinion of the Trustee properly to administer such payments, then payment may be made
(a) directly to such beneficiary; (b) to the legally appointed guardian or representative of
the beneficiary; (c) to some near relative of the beneficiary to be applied for the benefit of
the beneficiary; or (d) by expenditure by the Trustee directly to those furnishing property
or services to the beneficiary. The receipt of any of the foregoing shall be a complete
discharge to the Trustee which shall not be bound to see to the application of any such
payment.
8. Situs.... This Agreement and trust estate shall be governed and construed in
all respects according to the laws of the Commonwealth of Pennsylvania.
4
. .
9. Powers. \Vithout regard to any legal restrictions otherwise applicable to
Trustees, the Trustee and its substitutes and successors are authorized and empowered in
their sole and absolute discretion to exercise the following discretionary powers as well as any
other powers conferred by law:
(a) To retain, whether originally a part of the
trust estate or subsequently acquired, and to purchase
or otherwise acquire and to retain, any property,
whether or not such property is authorized for invest-
ment under the Pennsylvania Fiduciaries Investment
Act of 1949 or by other law, all without diversifi-
cation as to kind and amount.
(b) To transfer, sell, exchange, partition, lease, mortgage,
pledge, give options upon or otherwise dispose of any property at
any time held by them, at public or private sale or otherwise, for
cash or other consideration or on credit, and upon such terms and
conditions, with or without security, and for such price as they
may determine.
(c) To hold any part of the trust estate in cash
or uninvested for any period deemed advisable.
(d) To borrow money for any trust purpose, create
a security interest in, or pledge all or part of the
5
trust estate to secure such borrowing without incurring
any personal liability therefor.
(e) To pay, extend, renew, modify or compromise,
upon such terms as they may determine, and upon such evidence
as they may deem sufficient, any obligations or claim, including
taxes, either in favor of or against the trust estate.
(1) To register any securities at any time in their names as
Trustee, or in the names of nominees, with or without indicating
the trust character of the securities so registered.
(g) With respect to any securities held hereunder, to vote
upon any proposition or election at any meeting of the person or
entity issuing such securities, and to grant proxies, discretionary or
otherwise, to vote at any such meeting, to exercise conversion,
subscription or other rights, and to receive or hold any new
securities issued as a result of any reorganization, readjustment,
merger, voting trust, consolidation, exchange or exercise of
conversion, subscription or other rights and generally to take
all action with respect to any such securities as could be taken
by the absolute owner thereof.
(h) To make allotments or distributions in
kind.
6
10. Amendment and Revocation. Settlor may any time and from time to time
amend, modify or revoke this trust in whole or in part.
11. Attorney to Acknowledge. Hershey Trust Company hereby appoints
RA YMOND T. CAMERON as its attorney to aclrnowledge this Agreement before any officer
authorized to take such acknowledgement.
12. Compensation of Trustee. Trustee shall receive compensation for its services
under this Agreement at the same rate as is charged from time to time by Trustee in
accordance with its published fee schedule for performing as trustee of revocable agreements
of trust of approximately the same size and complexity as the within Trust.
IN WITNESS WHEREOF, this Agreement has been executed by the Settlor
and Trustee on the date first above mentioned.
WITNESS:
L.&e~~ k-r/
~/(fW
MARY S.- STAPF
SETTLOR
(SEAL)
ATTEST:
HERSHEY TRUST COMPANY
~r~~ 2/=-
By:
7
COMMONWEALTH OF PENNSYLVANIA)
)ss:
COUNTY OF DAUPHIN )
-tt
On this / g. day of June, 1996, before me, the undersigned officer, personally
appeared Raymond T. Cameron, attorney-in-fact for Hershey Trust Company, the Trustee
within-named, who, on behalf of his constituent, in due form of law, acknowledge the
foregoing Trust Agreement to be its act and deed for the purposes therein contained.
~/ <f. ~-' dL~
~otary Public
(SEAL)
iI Notarial Seal
" Mary E. Lehman, Notary Public
Derry Twp., Dauphin County
My Commission Expires Nov. 23, 1999
8
.
j?{2 G
/ f) --2 - 67
Mary S. Stapf Revocable Trust Dated 6/18/1996
Hershey Trust Company, Trustee
Date of Death Value
Units Security
22 Equity REIT CTF
138 Value Equity CTF
127 Fixed Income CTF
25,000 JP Morgan & Co 6% 1/15/09
10,000 FHLM 4.5% Bond due 11/15/11
Money Market Cash
000 Value Aced Inc
$ 5,495.79 $ 7.40
$ 61,607.14 $ 75.76
$ 125,345.77 $ 513.63
$ 25,166.93 $ 70.83
$ 9,773.14 $ 96.25
$ 13,879.94 $
$ 241,268.71....... $ 763.87....... $ 242,032.58........
[
5495-79+
61607-14+
125345-77+
25166-93+
9773-14+
3879 - 94=
241268-7
pr~ l'L:M
241268-71+
763-87=
C" _b;"~O 32 - 5~
'T01f\lr
7 - 4+
75-76+
513-63+
70-83+
96 - 23=
....-----..-...
{)('c-~~ ~
!
.
Estate Valuation
Date of Death:
Valuation Date:
Processing Date:
08/02/2007
08/02/2007
08/03/2007
Estate of: Mary S. Stapf
Account: Mary S. Stapf TUA
Report Type: Date of Death
Number of Securities: 2
File ID: Stapf, Mary TUA 2322
Shares
or Par
Security
Description High/ASk Low/Bid
Mean &/or Div & Int Security
Adj'ments Accruals Value
1)
25000
MORGAN J P & CO
Financial Times
DTD: 01/25/1999
08/02/2007
INC MTN BE (61688AAX6)
Interactive Data
Mat: 01/15/2009 6%
100.66770 Mkt
100.667700
2~),166.93
Int: 07/15/2007 to 08/02/2007
70.83
2)
10000
FEDERAL HOME LN
Financial Times
DTD: 11/15/2004
08/02/2007
MTG CORP MTN (3128X3K69)
Interactive Data
Mat: 11/15/2011 4.5%
97.73140 Mkt
97.731400
91773.14
Int: 05/15/2007 to 08/02/2007
96.25
Total Value:
Total Accrual:
Total: $35,107.15
$341940.07
$167.08
Page 1
This report was produced with EstateVal, a product of Estate Valuations &
Pricing Systems, Inc. If you have questions I please contact EVP Systems at
(818) 313-6300 or www.evpsys.com. (Revision 7.0.4)
.
HERSHEY TRUST COMPANY
September 12, 2007
Sharon M. Garcia
Keefer Wood Allen & Rahal, LLP
210 Walnut Street
P.O. Box 11963
Harrisburg, P A 17108
Re: Mary S. Stapf Estate
Dear Sharon:
In response to your email, I am providing the following information.
1. The cash balance in the trust at date of death was $ 13,879.94 as per the attached.
2. Accrued income on our common trust funds to date of death is $ 596.79.
I have set you up to receive a monthly statement for the trust.
Enclosed you will find statements for the months of July and August, 2007 and a copy of the
trust agreement.
If you should need any additional information, please do not hesitate to contact me.
Sincerely,
~thOllY
Trust Administrator
fnls
encl.
100 MANSION ROAD EAST. P. O. Box 445 . HERSHEY, PENNSYLVANIA 17033-0445. (717) 534-3225 · FAX (717) 520-1111 · www.hersheyrrust.com
'1oO' .
HERSHEY TRUST COMPANY
September 11, 2007
Sharon M. Garcia
Legal Assistant
Keefer Wood Allen & Rahal, LLP
210 Walnut Street
P.O. Box 11963
Harrisburg, P A 17108-1963
Re: Estate of Mary S. Stapf, deceased
Dear Sharon:
Per your letter dated September 10, 2007, I am providing the date of death values for the
assets held in the trust.
~~~~
The Estate Valuation is attached for the bonds held at date of death. J:J. 0l'1l fJ.'1 '-l _____
Our Commoo Trust Funds held at date of death are as follow.1LI--- + .- I ~ I ~ ~ -qJ1
fJ//J' ~\tA'6'::J .
1. 22 units Common Trust Fund-Equity Reit $ 5,495.79
2. 138 units Common Trust Fund-Value Equity $ 61,607.14
3. 127 units Common Trust Fund-Fixed Income $ 125,345.77
t- 35") /69-.IS
The approximate charge for the preparation of the finall040/PA-40 is $ 400.00. /
If you should need any additional information, please do not hesitate to contact me.
Sincerely,
.~
Nancy L. Sholly
Trust Administrator
Inls
cc:
~b}~ ~~
~~,J aW-@. WD 2;
~ ()~ ......e: .m ~T !-S' -;::
John S. Stapf, Jr., Executor --l"""~ . .." 0
~ JI~+~~~
VJ~
100 MANSION ROAD EAST. P. O. Box 445 . HERSHEY, PENNSYLVANIA 17033-0445. (717) 534-3225 . FAX (717) 520-1111 · www.hersheytrust.com
.
NEILL
Funeral Home Inc.
August 9, 2007
Barbara Cleveland
409 Central Drive
Briar Cliff, NY 10510
RE: Mary Stapf 741200200104
Basic Professional Services of Funeral Director & Staff
Embalming
Dressing, Casketing, Cosmetology
Funeral Service
Transferring Remains to Funeral Home
Funeral Vehicle/Hearse
Funeral Vehicle/Service
Memorial Book
Prayer Cards
Flowers
Batesville Huntingdon Green Casket
Eagle Burial Vault
Cemetery
Patriot News Obituary
Certified Death Certificates ( 10 @ $6.00 each)
Clergy
Organist
Hairdresser
$2330.00
795.00
395.00
595.00
495.00
395.00
395.00
25.00
60.00
445.20
2795.00
1295.00
850.00
148.86
60.00
200.00
100.00
45.00
Total Amount of Services Rendered
$11349.06
Please submit payment to:
Neill Funeral Home
3501 Derry Street
Harrisburg, P A 17111
Thank You!
3501 Derry Street
Harrisburg, PA -17111-1817
tel 717 564-2633
fax 717 561-9918
Stephen J. Wilsbach, Supervisor
3401 Market Street
Camp Hill, PA - 17011-4428
tel 717 737-8726
fax 717 737-1859
Rebecca J. Donahue, Supervisor
_ .l ~ ..
Page 1 of 1
.03~DDDD'lO.
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Amount
2007 Aug 20
41179251
6100739562
12665
$963.01
Posting Date
Posting Seq No
Account Number
Check Number
... ," .. ..
~.t~~~j.ah
Form PB-01
100 MOUNT ALLEN DRIVE, MECHANICSBURG, PA 17055
HERSHEY TRUST CO
ATTN: NANCY SHOLLY
PO BOX 445
HERSHEY, PA 17033-0445
QUESTIONS? CALL:
RESIDENT # UNIT
100511 276 D
RESIDENT S
Mrs. MARY STAPF
697-4666
STMT. DATE
07/31/2007
TOTAL AMOUNT DUE
DATE DUE
$8,046.07
08/31/2007
$
.....-----~.----------_._-----_._- -
DATE DESCRIPTION RATE Daysl CHARGES CREDITS BALANCE
Units
Balance Forward I, 7,521.90
07/19/07 PAYMENT RECEIVED - THANK YOU!!! 441.90 7,080.00
07/19/07 PAYMENT RECEIVED - THANK YOU!!! 7,080.00 0.00
*** Nursin~ Care ***
07/01/07 MOTION MONITOR 07/01-07/31 0.16 2.00 0.32 0.32
07106/07 BARBERlBEAUTY SHOP 17.00 1.00 17.00 17.32
SHAMPOO/HAIRCUT/BD
07/13/07 BARBERlBEAUTY SHOP 13.00 1.00 13.00 30.32
SHAMPOO/SET
07/20/07 BARBERlBEAUTY SHOP 13.00 1.00 13.00 43.32
SHAMPOO/SET
07/27/07 BARBERlBEAUTY SHOP 13.00 1.00 13.00 56.32
SHAMPOO/SET
07/31/07 RM/ BRD - NURSING - SEMI-PVT 247.00 31.00 7,657.00 7,713.32
07/01-07/31
07/31/07 AIR MATTRESS 07/01-07/31 4.00 31.00 124.00 7,837.32
07/31/07 PREV AIL BRIEF XL 1.25 67.00 208.75 8,046.07
RESIDENT # CURRENT OVER 30 OVER 60 OVER 90 OVER 120 TOTAL AMOUNT DUE
100511 8,046.07 0.00 0.00 0.00 0.00 $8,046.07
RESIDENT NAME Mrs. MARY STAPF
A 1 % finance charge may be assessed on accounts for which payment has not been received by the due date. Thank you!
Form PB-01
N/A
If you have any questions or concerns about your bill, please address them directly to Fiscal Services at 790-8220. Thank YOU!