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Home My WebLink About02-06-08 REV-1500 EX + (&.QO) REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ~ Z W C W U W C DURR DONALD DATE OF DEATH (MM-DD-Year) J, DATE OF BIRTH (MM-DD-Year) 04/23/2007 04/30/1932 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) W I- ~:$Ul uO::lo:: w~u J: 0::9 UD..lIl D.. < [X] 1. Original Return D 4. Limited Estate [X] 6. Decedent Died Testate (Attach copy otWill) D 9. Litigation Proceeds Received D 2. Supplemental Return D 4a. Future Interest Compromise (date ot death after 12-12-82) [X] 7. Decedent Maintained a Living Trust (Attach copy ofTrust) D 10. Spousal Poverty Credit (dateotdeath between 12-31-91 and 1-1-95) OFFICIAL USE ONLY FILE NUMBER I,., V' 7 2 1 - 0 7 ~O COi:iNTYCOOE -YEA~ - - NUM'iiER- - SOCIAL SECURITY NUMBER 2 9 3 - 2 6 - 9 7 1 '1 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WillS SOCIAL SECURITY NUMBER D 3. Remainder Return (dateotdeath prior to 12-13-82) D 5. Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Attach Sch 0) I- Z W Q Z o D.. Ul W 0:: 0:: o U THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL T AX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS STEPHEN L. BLOOM ESQUIRE 60 WEST POMFRET STREET FIRM NAME (If Applicable) IRWIN & McKNIGHT TELEPHONE NUMBER 717 249-2353 CARLISLE PA 17013 331,772.51 X _(15) 0.00 208,332.10 X .045 (16) 9,374.94 0.00 X .12 (17) 0.00 0.00 X .15 (18) 0.00 (19) 9,374.94 z o i= :3 ::::J !::: a.. oCt: U W c:: 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10.lJebts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o S ::::J a.. :!: o u ~ ~ 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. D CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > >BESU~E TO ANSWERAll QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 184,189.80 OFFICIAL USE ONLY (. ) '~j ; I I I I I i I I I I ~__~__._..J 366,829.381 c..,.) (.. (8) 551 ,019.18 10,914.57 (11) (12) (13) 10,914.57 540,104.61 (14) 540,104.61 o d , C I t Add ece ents omple e ress: STREET ADDRESS 22 THORNHILL COURT CITY -I STATE 1 ZIP CARLISLE PA 17015 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 9,374.94 8.900.00 0.00 Total Credits (A + 8 + C) (2) 8,900.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( 0 + E) (3) 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) 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. (5A) 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) Make Check to: REGISTER OF AGENT 0.00 0.00 474.94 474.94 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; ........................................................................... 0 !Xl b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 !Xl c. retain a reversionary interest; or ...................................................................................................... 0 !Xl d. receive the promise for life of either payments, benefits or care? ............................................................. 0 00 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................. 0 !Xl 3. Did decedent own an 'in trust for" or payable upon death bank account or security at his or her death? ................. 00 D 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... ll(I 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. 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 and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ,( a '1 'fa. 2iJ{6t( /. / vLt-;/{ ADDRESS 22 THOR HILL CURT CARLISLE SIGNATURE OF PREPARER OTHER THAN REP ES DATE 2-/6 /-'1 I I ADDRESS 60 WEST f50MFRET STREET CARLISLE PA 17015 DATE ,,:2 6 0$1 PA 17013 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. ~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 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 disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.Jf/?'" ",., / ~ For dates of death on or after July 1, 2000: v~ 7 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 pa~ J or a stepparent of the child is 0% [72 P.S. ~9116(a)(1.2)]. .:::..J 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. ~9116(1.2) [72 P.S. ~9116(a)(1 )]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~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-1502 EX + (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER DURR DONALD J. 21 07 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 oropertv which is iointly-owned with rioh! of survivorship must be disclosed on Schedule F. SCHEDULE A REAL ESTATE ITEM NUMBER 1. DESCRIPTION 22 THORNHILL COURT, SOUTH MIDDLETON TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA (CUMBERLAND COUNTY DB 149, PAGE 164) COUNTY ASSESSED VALUE OF $161,570.00 AS OF DATE OF DEATH MULTIPLIED BY THEN-APPLICABLE COMMON LEVEL RATIO OF 1.14 YIELDS DATE OF DEATH VALUE OF $184,189.80 VALUE AT DATE OF DEATH 184,189.80 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 184 189.80 REV-1510 EX + (6-98) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF DURR DONALD J. FILE NUMBER 21 07 This schedule must be completed and filed il the answer to any 01 questions 1 through 4 on the reverse side 01 the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY ITEM INCLUOE 1HE NAME OF 1HE 1RANSFEREE, 1HEIR RELATIONSHIP 10 DECEDEN1 AND DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE NUMBER mE DATE OF TRANSFER. AITACH A COPY OF 1HE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST VALUE (IF APPLICABLE) 1. AMERIPRISE FINANCIAL - RIVERSOURCE FIXED 34,845.51 100. 34,845.51 ANNUITY-VALUE PLUS IRA #0000-0931-0296-3534-5-004 (BENEFICIARY: SPOUSE, MARILYN A. DURR) 2. AMERIPRISE FINANCIAL - REVERSOURCE FIXED 26,618.82 100. 26,618.82 ANNUITY-VALUE PLUS IRA #0000-0930-0249-2551-1-004 (BENEFICIARY: SPOUSE, MARILYN A. DURR) 3. AMERIPRISE FINANCIAL - REVERSOURCE FIXED 16,141.42 100. 16,141.42 ANNUITY IRA #0000-0931-0155-8267-5-004 (BENEFICIARY: SPOUSE, MARILYN A. DURR) 4. AMERIPRISE FINANCIAL 6,009.96 100. 6,009.96 IRA #01012967988-1-002 (BENEFICIARY: SPOUSE, MARILYN A. DURR) 5. AMERIPRISE FINANCIAL 27,322.27 100. 27,322.27 IRA #01233448535-1-002 (BENEFICIARY: SPOUSE, MARIL YN A. DURR) 6. AMERIPRISE FINANCIAL 8,174.88 100. 8,174.88 IRA #04373448535-2-002 (BENEFICIARY: SPOUSE, MARIL YN A. DURR) 7. AMERIPRISE FINANCIAL 15,977.49 100. 15,977.49 IRA #08283448535-9-002 (BENEFICIARY: SPOUSE, MARILYN A. DURR) 8. AMERIPRISE FINANCIAL 12,965.23 100. 12,965.23 IRA #05133448535-9-002 (BENEFICIARY: SPOUSE, MARILYN A. DURR) 9. AMERIPRISE FINANCIAL 7,888.97 100. 7,888.97 IRt\ #09283448535-8-002 (BENEFICIARY: SPOUSE, MARILYN A. DURR) 10. 2,000 SHARES - M&T BANK PRIME MMKT-INST-FD 2,000.00 100. 2,000.00 (HELD BY TRUST OF DECEDENT) 11. 2,588.1 SHARES - M&T BANK PRIME MMKT-INST-FD 2,588.10 100. 2,588.10 (HELD BY TRUST OF DECEDENT) 12. 4,382.19 SHARES - M&T BANK INTERMEDIATE TERM 42,857.82 100. 42,857.82 BD-INST 1-FD #220 (HELD BY TRUST OF DECEDENT) 13. 5,838.661 SHARES - M&T BANK SHORT DURATION GOVT 56,051.15 100. 56,051.15 BD-INST 1-FD #120 (HELD BY TRUST OF DECEDENT) 14. 4,012.671 SHARES - M&T BANK US GOVT BOND FUND 37,077.08 100. 37,077.08 INST 1 #822 (HELD BY TRUST OF DECEDENT) 15. 7,659.115 SHARES - VANGUARD LONG-TERM 70,310.68 100. 70,310.68 CORPORATE FUND #28 (HELD BY TRUST OF DECEDENT TOTAL (Also enter on line 7 Recapitulation) $ 366.829.38 (II more space is needed, insert additional sheets 01 the same size) REV-1511 EX + (12-99) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF DURR FILE NUMBER DONALD J. 21 07 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. HOFFMAN-ROTH FUNERAL HOME AND CREMATORY, INC. 2,084.57 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees IRWIN & McKNIGHT 5,300.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00 Claimant MARILYN A. DURR Street Address 22 THORNHILL COURT City CARLISLE State P A Zip 17015 Relationship of Claimant to Decedent SPOUSE 4. Probate Fees 5. Accountant's Fees 6. Tax Return Prepare~s Fees 7. REGISTER OF WILLS - FILING FEE 30.00 TOTAL (Also enter on line 9, Recapitulation) $ 10914.57 (If more space is needed. insert additional sheets of the sarne size) R<V-"" ex <- Ie. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER DURR n(")t'l.ll'.1 D .1. ?1 07 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 1. TAXABLE DISTRI BUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. MARIL YN A. DURR Spousal 155,944.55 22 THORNHILL COURT BENEFICIARY DESIGNATED CARLISLE, PA 17015 ASSETS 2. MARILYN A. DURR Spousal 175,827.96 22 THORNHILL COURT LIFE INTEREST CARLISLE, PA 17015 RESIDUARY TRUST 3. ERIC D. DURR Lineal 69,444.03 276 WHITE VIEW ROAD 1/3 REMAINDER INTEREST WYNANTSKILL, NY 12198 IN RESIDUARY TRUST 4. KENNETH D. DURR Lineal 69,444.03 18209 DARK STAR WAY 1/3 REMAINDER INTEREST BOYDS, MD 20841 IN RESIDUARY TRUST 5. JONATHAN D. DURR Lineal 69,444.04 7106 FORTUNE DRIVE #13 1/3 REMAINDER INTEREST MIDDLETON, WS 53562 IN RESIDUARY TRUST ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. I I TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) REV-1514 EX + (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN Check Box 4 on Rev.1500 Cover Sheet FILE NUMBER DURR DONALD J. 21 07 This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to 5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death on or after 5-1-89. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. D Will [Xl Intervivos Deed of Trust D Other LIFE ESTATE INTEREST CALCULATION NAME(S)OF LIFE TENANT(S) DATE Ute IjIKJH NEAREST AGE AT TERM OF YEARS ..- DATE OF DEATH LIFE ESTATE IS PAYABLE MARIL YN A. DURR 7/7/1934 73 [:&I Life or DTerm of Years - D Life or D Term of Years - D Life or DTerm of Years - D Life or D Term of Years - 1. Value of fund from which life estate is payable. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $ 395,074.63 2. Actuarial factor per appropriate table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " .44505 Interest table rate - D 31/2% D 6% D 10% [Xl Variable Rate 5.6 % 3. Value of life estate (Line 1 multiplied by Line 2) .......................................... $ 175,827.96 ANNUITY INTEREST CALCULATION NEAREST AGE AT TERM OFYEARS -,-, ~,,,. .. DATE OF DEATH ANNUITY IS PAYABLE D Life or DTerm of Years - D Life or DTerm of Years - DLife or DTerm of Years - DLife or DTerm of Years - 1. Value of fund from which annuity is payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $ 2. Check appropriate block below and enter corresponding (number) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Frequency of payout - D Weekly (52) D Bi-weekly (26) D Monthly (12) D Quarterly (4) D Semi-annually (2) D Annually (1) D Other ( ) 3. Amount of payout per period. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $ 4. Aggregate annual payment, Line 2 multiplied by Line 3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Annuity Factor (see instructions) Interest table rate - D 31/2% D 6% D 10% D Variable Rate % 6. Adjustment Factor (see instructions). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. Value of annuity - If using 3 1/2%, 6%, 10%, or if variable rate and period payout is at end of period, calculation is : Line 4 x Line 5 x Line 6 ............................ $ If uSing variable rate and period payout is at beginning of period, calculation is : (Line 4 x Line 5 x Line 6) + Line. 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13, 15, 16 and 17. (If more space is needed, insert additional sheets of the same size) "".'.'''''''''* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 0 ELECTION UNDER SEC. 9113(A) SPOUSAL DISTRIBUTIONS ESTATE OF FILE NUMBER DURR DONALD J. 21 07 Do not complete this schedule unless the estate is making the election to tax assets under Section 9113(A) of the Inheritance & Estate Tax Act. If the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust. This election applies to the Trust (marital, residual A, B, By-pass, Unified Credit, etc.). If a trust or similar arrangement meets the requirements of Section 9113(A), and: a. The trust or similar arrangement is listed on Schedule 0, and b. The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule 0, then the transferor's personal representative may specifically identify the trust (all or a fractional portion or percentage) to be included in the election to have such trust or similar property treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property is included as a taxable transfer on Schedule 0, the personal representative shall be considered to have made the election only as to a fraction of the trust or similar arrangement. The numerator of this fraction is equal to the amount of the trust or similar arranqement included as a taxable asset on Schedule O. The denominator is equal to the total value of the trust or similar arranqement. PART A: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, which pass to the decedent's survivin souse under a Section 9113 A trust or similar arran ement. DESCRIPTION VALUE The assets that comprise the Residuary Trust under the Revocable Agreement of Trust of Donald J. Durr dated January 5, 1996 395,074.63 Part A Total $ 395074.63 PART B: Enter the descri tion and value of all interests included in Part A for which the Section 9113 A election to tax is bein made. DESCRIPTION VALUE The assets that comprise the Residuary Trust under the Revocable Agreement of Trust of Donald J. Durr dated January 5, 1996 395,074.63 Part B Total (If more space is needed, insert additional sheets of the same size) 395074.63 I W. I I' -. I' F \FILES\DATAFILE'WILLS-S424-H TRU Ceated \2/\1/95 a l 0436 PM Revtsed 01/04/960: 0809 PM REVOCABLE AGREEMENT OF TRUST I: I I I I, DONALD 1. DURR, of 1062 Rebecca Street, Carlisle, North Middleton Township, Cumberland County, Pennsylvania, hereby transfer to myself and MARILYN A. DURR, of 1062 Rebecca Street, Carlisle, North Middleton Township, Cumberland County, Pennsylvania, as Trustees (hereinafter "Trustee"), the property described in the attached Schedule "A" to be held, together with any other property hereafter transferred to my Trustee, in trust, as provided below. FIRST: PROVISIONS DURING MY LIFETIME: During my lifetime my Trustee shall pay the net income to me, or as I may direct in wTiting, and from time to time shall pay to me, or as I may direct in wTiting, as much (even if all) of the principal as I may so direct. Upon my incapacity, my Trustee may apply the income and such portions of the principal as my Trustee deems advisable for my benefit during such incapacity and may pay to or apply for the benefit of my \-vife, MARIL Y"N A. DURR, while we both are living, such of the net income and principal not needed for my benefit as my Trustee deems advisable for her maintenance, health or support, without considering funds available to her from other sources. Income not so applied shall be accumulated and invested_ I I' I I I SECOND: PAYMENT OF CERTAIN EXPENSES AT MY DEATH: After my death, my Trustee may make such payments from the principal of the trust as my Trustee deems desirable to facilitate the settlement of my estate, including but not limited to payment of any or all of my debts, funeral and burial expenses, and any administration expenses of my estate even though they do not relate to property subject to this trust. Neither my executor nor any beneficiary of my estate shall be required to reimburse my Trustee for any such expenditures. The balance of funds not so distributed shall be held and distributed as hereinafter provided. THIRD: DISPOSITION OF BALANCE: As of my death, my Trustee shall divide the principal as follows: A. If my wife, MARILYN A. DURR, survives me (which shall be presmned for purposes of this paragraph if there is insufficient evidence to show which of us survived), my Trustee shall divide the principal into two separate trusts, a MARITAL TRUST under Paragraph FOURTH and a RESIDUARY TRUST under Paragraph FIFTH. B. The MARITAL TRUST shall be composed of the smallest fractional share of the I I I I -1- - - - - - I' I: I' I' I I' I I I I I I I I principal (taking into account assets added by my will or otherwise) which, when added to all assets otherwise passing or having passed to my said wife which are includable in my gross estate and qualify for the marital deduction, will: I, Reduce the federal estate tax payable because of my death to the minimum ifmy said wife survives me by six (6) months or more, or 2, Reduce the federal estate tax payable because of both of our deaths to a minimum if my said wife survives me by less than six (6) months, Such minimum federal estate tax shall be determined by taking into account all other deductions allowed on my federal estate tax return and all credits against the federal estate tax, including the unified credit and the state death tax credit; provided that the state death tax credit shall not be taken into account to the extent that it would increase state death taxes, All property allocated to or held in the MARlT AL TRUST shall be the type of property which qualifies for the marital deduction, In addition, all such property shall, at the direction of my said wife, be converted within a reasonable time to income producing property, C. Subject to the payment of any death taxes as hereinafter provided, the RESIDUARY TRUST shall be composed of the remaining principal or, if my said wife fails to survive me, the entire principal. FOURTH: MARlT AL TRUST: As to the principal passing hereunder: A. During the lifetime of my said wife: 1, My Trustee shall pay to her the net income quarterly for life; and 2, My Trustee may pay to her or apply for her benefit as much (even if all) of the principal as she may from time to time request in ViTiting, In addition, my Trustee may pay to her or apply for her benefit as much of the principal as my Trustee deems advisable for her benefit for any reason, without considering funds available to her from other sources, B, At my said wife's death, subject to the payment of certain death taxes arising as a result of her death (pursuant to the provisions of the paragraph herein entitled "DEATH TAX PROVISIONS"), my Trustee shall pay the then remaining principal to such persons, including her estate, in such manner and shares, for such estates, or upon such trusts as she may appoint in her last -2- ~ ~ ~ ~ ~. I I I I I I I I I I I I I I will by specific reference to this general power, and shall pay the then remaining principal not effectively so appointed, to the RESIDUARY TRUST, to be held or distributed under the terms thereof as applied to the circumstances then existing. FIFTH: RESIDUARY TRUST: As to the principal passing hereunder: A. During the lifetime of my said wife: 1. My Trustee shall pay to her the net income at least quarterly; 2. My Trustee may pay to her, or apply for her benefit, as much of the principal as my Trustee deems advisable for her maintenance, health or support, without considering funds available to her from other sources; provided that no payment of principal shall be made hereunder until the MARITAL TRUST is completely exhausted. B. Atthe death of the survivor of myself and my said wife, my Trustee shall pay the then remaining principal into as many equal shares as there are children of mine then living and children of mine then deceased represented by descendants then living, and each such share shall be held or distributed as follows: 1. My Trustee shall pay the share of a then-deceased child to said child's then living descendants, per stirpes. 2. My Trustee may retain the share of a then-living child in a further separate trust, and as to each such trust, during the child's lifetime: a. My Trustee shall pay the net income therefrom to the child at least quarterly; b. My Trustee may pay to or apply for the benefit of the child so much of the principal as my Trustee deems advisable for the child's maintenance, education, health or support, after first considering funds available to the child from other sources; c. At the child's v,Titten request, my Trustee shall pay the principal to the child as follows: At any time after attaining age twenty-five (25), the entire principal. d. Upon the death of a child before the entire principal of said child's trust has been distributed, my Trustee shall pay the remammg -3- , , , ~. ~. I' I' I ( I I I I I I I I I I principal to such of the descendants of said child as are then living, per stirpes. In default of such descendants, my Trustee shall pay the same to my then living descendants, per stirpes; any additional share of a child of mine for whom a trust is then in existence hereunder shall be added to such trust, to be held under the terms thereof as applied to the circumstances then existing. C. All RESIDUARY TRUST income accrued or undistributed at the death of my said wife shall be paid to the succeeding beneficiaries. SIXTH: DISCLAIMERS: A. If any person otherwise entitled to take hereunder (or such person's legal representative) files a written disclaimer, in whole or in part, with respect to any provision of this agreement with my executor or Trustee within the period allowed by Section 2518 of the Internal Revenue Code, as the same may be amended, such person: 1. shall be treated as having predeceased me for purposes of holding or distributing the disclaimed share, and 2. shall not participate in any exercise of discretion regarding distributions of the disclaimed share and any accumulations thereon, but such person shall not be treated as having predeceased me for purposes of holding, distributing, or participating in any such discretion under any provision to "vhich the disclaimer does not extend. B. In the event my said wife files a \\-Titten disclaimer, in whole or in part, with respect to the MARITAL TRUST, such portion so disclaimed shall be held in a separate DISCLAIMER TRUST under terms and conditions identical to the RESIDUARY TRUST as applied to circumstances then existing. SEVENTH: SPENDTHRIFT PROVISIONS: Until distributed, no gift or beneficial interest shall be assignable by, or available to anyone having a claim against, a beneficiary. This provision shall not prevent a beneficiary from disclaiming or releasing an interest hereunder. EIGHTH: MARITAL DEDUCTION PROVISIONS: It is my intention that the MARlT AL TRUST created herein shall be eligible to qualify for the marital deduction available at my death. Accordingly, any provision of this agreement which may appear to conflict with my intention shall -4- - - - - -- I I I I I I I I I I I I I I be construed so as to accomplish that intention, and, notwithstanding any provision in this agreement to the contrary, any power, duty or discretion given to my Trustee hereunder shall be void to the extent that the exercise or discharge thereof would cause the disallowance of all or any part of the marital deduction. NINTH: DEATH TAX PROVISIONS: A. To the extent not paid by my executor, all death taxes (and interest thereon and penalties) imposed as a result of my death upon the property passing under this agreement, my will, but not otherwise, shall be paid out of the principal of the RESIDUARY TRUST (including assets added by my will), each share thereof~ whether outright or in trust, to bear a pro rata portion of such taxes. B. Any increase in death taxes imposed on my said wife's estate at her death because of her interest in the MARITAL TRUST created hereunder shall be paid from the principal of that trust, except to the extent that my wife, by a specific reference to the MARITAL TRUST in her will, relieves it of this obligation. TENTH: INCAPACITATED BENEFICIARIES: A. If any beneficiary is incapacitated my Trustee may: 1. Apply for his or her benefit the income otherwise payable to such beneficiary or accumulate, hold and later pay such income pursuant to subparagraph 2. below. 2. Hold as a separate trust any gift hereunder which has vested in and is otherwise payable to such beneficiary (and any accumulations on such gift) until such beneficiary has capacity, or has sooner died, whereupon my Trustee shall distribute the balance of such gift remaining hereunder to such beneficiary if he or she is then living, and, if not, to the executor or administrator of such beneficiary's estate. Until such beneficiary has capacity, or has sooner died, my Trustee may, in my Trustee's sole and absolute discretion, apply any part or all of such gift for his or her benefit or distribute the same, in cash or kind, to the beneficiary or to the guardian of the person or estate of the beneficiary. B. If any gift is held under or pursuant to subparagraph A.2 above, my Trustee shall -5- - - - - - - - I I I I I I I I I I I - have, with respect to such gift, all the management powers otherwise provided herein. I designate any successor Trustee to act as Trustee of any trust hereunder if the initial Trustee fails to qualify or ceases to act. C. Notwithstanding any provision herein to the contrary, no income, gift, or any accumulations thereon to which my said wife is otherwise entitled hereunder shall be withheld over her objection or that of a duly appointed guardian of her estate. ELEVENTH: MANAGEMENT POWERS: My Trustee shall have the following po\vers in addition to those conferred by law as to all property subject to the Trustee's administration until all such property is distributed: A. To retain any real or personal property (including stock of a corporate Trustee 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 sales, exchanges, or leases; c. To purchase all forms of property, including but not limited to stocks, bonds, notes and other securities (including stock of a corporate Trustee 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 in an equitable manner if my Trustee, in my Trustee's sole discretion, determines that the law otherwise applicable would be inequitable under the circumstances; 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 umegistered 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; -6- - - - - - - - - I I I I l - a - t - - 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; 1. To compromise claims by or against my estate or any trust hereunder, including but not limited to ta.'C 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; 1. To borrow money and to pledge any real or personal property as security for the repayment thereof. K. \Vhenever my 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 provisions of the paragraph herein entitled "INCAPACITATED BENEFICIARIES"; 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; L. If there is no corporate trustee, to employ one or more agents including but not limited to accountants, investment counsel, brokers, bank or trust company, to perform services for and at the expense of my estate and to carry or register investments in the name of the nominee of such agent. The expenses and charges for such services shall be charged against principal or income or partly against each as my Trustee may determine. My Trustee is expressly relieved of any liability or responsibility \vhatsoever for any act or failure to act by, or for following the advice of, such agents, so long as my Trustee exercises due care in their selection. The fact that a Trustee may be a member, shareholder or employee of any agent 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 Trustee to receive commissions as a trustee. TWELFTH: MISCELLANEOUS: A. The incapacity of a beneficiary who is also a Trustee shall be determined solely by the other Trustee. B. No Trustee who is a beneficiary hereunder shall participate in any exercise of discretion regarding distributions to or for the benefit of said Trustee or any individual whom said Trustee is legally obligated to support. -7- - - - - - , I I I I I I - i i i t t j C. My Trustee shall not be responsible for assuring that any party chosen by my Trustee to receive any distribution on behalf of a beneficiary hereunder actually pays the same to or for said beneficiary. THIRTEENTH: DEFINITIONS: A. The word "Trustee" when used herein shall include all genders and the singular and plural as the context may require. B. The words "incapacity" and "incapacitated" when used herein shall refer to an inability, as determined by my Trustee in my Trustee's sole and absolute discretion, to use funds by reason of age or illness (mental or physical); provided that my own incapacity to act as a Trustee shall be determined by a "'Titten certification, lodged with my said wife and FINANCIAL TRUST SERVICES COMPANY of Carlisle, Pennsylvania, from my personal physician or other competent medical authority that I am so disabled by age or illness (physical or mental) that I am unable to administer the trust hereunder. FOURTEENTH: Trustee: At the earliest to occur of my death, incapacity or my wTitten direction during my lifetime, FINANCIAL TRUST SERVICES COMPANY shall become a co- Trustee and shall take possession of the assets held hereunder. My Trustee shall not post security in any jurisdiction. My corporate Trustee shall receive compensation for its services hereunder in accordance with its Schedule of Fees in effect from time to time during the period in which its services are performed. FIFTEENTH: RESERVATION OF RIGHTS: I reserve the right at any time or times, by written instrument (other than a will) lodged with my Trustee, to amend or revoke this agreement of trust in whole or in part, provided that the duties, powers and liabilities of my Trustee shall not be substantially increased without its written consent. I may add other property to this trust and any other person may do the same, provided that my Trustee gives its \vritten consent to each such addition. SIXTEEN: GOVERNING LAW: This trust has been accepted by my Trustee in the Commonwealth of Pennsylvania and all questions pertaining to its validity, construction and -8- ~ - - - - l l l l , , I I I I I I I I administration shall be determined in accordance with the laws of that Commonwealth without regard to its law on the choice of law. Executed in duplicate ~ 6 In the presence of: Witness: ,..,..../-/ ,J P .,/ .( ,.- _----,--,/1.;" :...:-:-;;..... "'j~' ", 'X ...- ------- , , _c,,_......~~~_.~~ Received and Accepted: ,.",,"""- /--'t ,,-/' ~--> - .~_.->...-' -,' .,,/ -.~~ :__.....~_._~:: ~:.':'----- /' J' -" ~.~~~j.:'..'~ -' .".~ / I ,_:~-~----- ..~,~~..-...,., -~"" -~--. ...... ,199& Donald J. Durr, T stee " ,," '. ," ,,/"', '-{' 'k' / f.,/ I / I '/ / ,/1 ",(..,,-,"/ /'" I Mari1yn A. ciuir, Trustee / /.~ ," r(: -9- ~ ~ ~ - - - - - , ~ , I I I I I I I I COMMONWEAL TH OF PENNSYLVANIA ) : 55. COUNTY OF CUMBERLAND ) On this, the <51+0 day of cJ~ ' 199b, before me, ~Q.I CIA- l" .1A-n1 E:S , a notary public, personally appeared Donald 1. DUff (Trustor), and in due form of law acknowledged the above instrument to be his act and deed and desired the same might be recorded as such. IN WITNESS WHEREOF, I hereunto set my hand and official seal. r'.J~i~::;'i::.! ;~'_~;'! ~ t ~ CprnJ.4J (SEAL) T(:,:,:;, '~~'-:'=~11,:2~'~':,;;~.:~~'~:~,;:' :=.. :"_:;(~ c:");";:,;,' ~'.:>..'.. ;:::'7 COMMON\VEAL TH OF PENNSYL VANIA ) : 55. COUNTY OF CUMBERLAND On this, the 6th 1e.\CJr-t l. 3t\h'1ES ) day of ~ ' 199/", before me, , a notary public, personally appeared Donald 1. Durr and Marilyn A. DUff (Trustees), and in due form of law acknowledged the above instrument to be their act and deed and desired the same might be recorded as such. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ';. ,.;:.1 ~ ~fu:,,;( (f-/k..W(SEAL) '::';:." ;:~'U:(~:";.~~:; '.0'- ~'T"",_~_~,,,,,,",'-_--'___'" _.&.~",_.~," ,,,.,,,.-.-, -10- /!fU 7.JJ 3c2'9; t ( '7Y~7/ Cumberland County Tax Parcel 40-24-0748-103 (Lot No. 79, Phase 4) ~:' ~~ :- ~~ ~',i- ; \. / I ~ C [ C:~ ~: ~- C () .;-:. C' ~~~; c r: ~~: ~~ f_ J S :_' \~ G ~ ~, ~ ~.\ ,l J~) C 0 U ~ ~ f Y ". f i f>\ '96 NO\/lb Rrl 1 ,~7 DEED THIS DEED is made the /-' ~ 0.,1::> / day of -!i:tJ--{,-",('ii)J-C '-----' , 1996, BET WEE N GREENFIELD COURT LIMITED PARTNERSHIP, a Pennsylvania limited partnership, record owner, and MAX D. MARBAIN, an adult individual, equitable owner, (together "Grantor"), AND DONALD J. DURR and MARILYN A. DURR, Trustees of the Revocable Agreement of Trust of Donald J. Durr dated January 5, 1996 ("Grantee") : WIT N E SSE T H That the Grantor in consideration of One Hundred Forty-Seven Thousand Nine Hundred Dollars ($147,900.00) paid by the Grantee to the Grantor, the receipt whereof is hereby acknowledged, does hereby grant and convey unto the Grantee: ALL THAT CERTAIN lot or parcel of land situate in South Middleton Township, Cumberland County, Pennsylvania, being designated Lot No. 79 (Phase 4) on a certain Final Subdivision Plan for Greenfield [Court] Limited Partnership recorded in Cumberland County Plan Book 68, Page 34 (the "Plan"), as more particularly described as follows, to wit: BEGINNING at a point on the northern right-of-way line of Thornhill Court (50.00 feet wide), said point being on the dividing line between Lot No. 78 and Lot No. 79 as shown on the Plan; thence continuing along the said dividing line North 02 degrees 26 minutes 12 seconds West a distance of 120.38 feet to a point at the intersection of Lot Nos. 84, 83, 79 and 78; thence continuing along Lot No. 83 South 84 degrees 50 minutes 56 seconds East a distance of 36.32 feet to a point on the dividing line between Lot No. 79 and Lot No. 80; .).,. i .~.'. _ - J, ~.'.t._):~ lb'.; thence continuing along the said dividing line South 02 degrees 26 minutes 12 seconds East a distance of 117.64 feet to a point on the northern right-of-way line of Thornhill Court aforementionedj thence continuing along Thornhill Court North 89 degrees 09 minutes 57 seconds West a distance of 36.06 feet to a point on the dividing line between Lot No. 78 and Lot No. 79, said point being the point and place of BEGINNING. BEING Lot No. 79 as shown on the Plan and CONTAINING 4,284.37 square feet. TOGETHER WITH AND SUBJECT TO the rights and obligations created by a Declaration of Easement dated December 14, 1995 and recorded in Cumberland County Miscellaneous Book 510, Page 738. UNDER AND SUBJECT to a stormwater and utility easement along the northern side of the lot as more particularly shown on the Plan. BEING part of the same premises which Max D. Marbain, Agent, by deed dated May 11, 1990, and recorded in Cumberland County Deed Book 0, Volume 34, Page 239, granted and conveyed unto Greenfield Court Limited Partnership. AND the said Greenfield Court Limited Partnership entered into an Agreement of Sale and Purchase dated November 1,1990, with Marbain, Inc. (the "Agreement"), a Memorandum of which is recorded in Cumberland County Miscellaneous Book 415, Page 1028. AND the said Marbain, Inc.'s interest in the Agreement was assigned to Max D. Marbain, an adult individual, by Assignment of Purchaser's Interest in Agreement dated May 27, 1993, and recorded in Cumberland County Miscellaneous Book 445, Page 299. UNDER AND SUBJECT to a Master Declaration of Covenants, Conditions and Restrictions Applicable to Building Lots in Greenfield Residential Development dated March 4, 1993, and recorded in Cumberland County Miscellaneous Book 439, Page 185. FURTHER UNDER AND SUBJECT to all easements, restrictions, encumbrances and other matters of record - 2 - 'f . ~" ...., r''"'' r- ,;,JU, J..4~ PACt ..LbJ or which a physical inspection of the premises would reveal. Grantor hereby covenants and agrees that Grantor will warrant SPECIALLY the property hereby conveyed. IN WITNESS WHEREOF, the Grantor has caused this Deed to be duly executed as of the day and year first written above. GRANTOR: GREENFIELD COURT LIMITED ,P~- B ~ Max D. Marbain ~ A Max D. Marbain WITNESS: // ~ c' /~ ~~-;~/ /)- ~ '';( '/ ;' '. [' .,f'.;/fi:J' .' :1:1 . ,-. L; ;- i l /~~-~~-U \ ~:~:;~\; i ~:; ~ ~ .(' . J r"rt r'r, r:.n ;: ~ ~ ~~~ - 3 - "',y"-,'._*,,, ~U{;~, 149 PAC,t It;G ....-- r..,) '1:1ct' j:1 ....1~; ~~~: ~~~ ::'~~ ; .~ ~:i: :-J"~ ~ ~_ti ;~t1 ~:;. ~it L.rt (~" ~:> (..1' (..11 :::Cl 1-'-1 1'1) :::1 li9 1,,'. I:U ,--J-- C--;I --0; --'I ,-' ::l.,.7'" ::r.", iia1! In t:::r'" ....... I'[t -..1::' -'I '..~::l 1-,,1 '=' :::r. d", 1:1,1 C :1::)- \ ::''':i 9.: ;::c c::-;. :::;-t L::I.. ._~ Co.../ :::0-:1 i~~;. t..I""J r...) ". 1:-') (:::1 CCJ 1-" I''':'' ;~~ ::2:: --.] ITI -. ....... f-" ,_. ~,,' rt"1 '1"1 ;m! ~~. --I .":t'" '-(1 '..:: :1,:t:; ~ ::1:"..- I--~ .-1- ;:t:, f"- ...... rtJ ....... ,...4. ." ('-1 ....~ <:> t-,I. Cl (,)1 ..c:~ ....... ..... ....-. r.,..l ..... '':'" J....t. ,;...J ..> I'D '..::'"1 1:1-" "-" .... '..!::t C.;"" 0 ....., '::::.; 11:- (., .; rn ...1> ,,-n .....;1 COMMONWEALTH OF PENNSYLVANIA /) / ,1 f COUNTY OF L).c}.'L~ )JLLJvl/D SS: On this, the !.3__ti'-..-'day of--l~I...L1Lk(A_J , 1996, before me, a Notary Public in and for the above-named Commonwealth and County, the undersigned officer, personally appeared MAX D. MARBAIN, individually and as Attorney-in-Fact for GREENFIELD COURT LIMITED PARTNERSHIP pursuant to Power of Attorney dated April 6, 1992, and recorded in Cumberland County Miscellaneous Book 415, Page 1034, as restated in Miscellaneous Book 434, Page 883, known to me (or satisfactorily proven), to be the individual who executed the foregoing instrument, and duly acknowledged to me that he executed the same on his own behalf and as Attorney-in-Fact for Greenfield Court Limited Partnership for the purpose contained therein. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ( SEAL) !~~~..II'...... .,'~Hlll j i I j"~ir .\\\\'1":,,,~, ,,"'! ! j'" '1\ ,\\\ -. ,'(. .~/\ V _.'~ ....," ; : (I '.j'-'" , ~.,~,.''''{...,..... ',., / ~{~~:~<~;~~",':::"':. . :::' ~"",,; ,J-... ,~~ ' , ''\,' '-""'- . ::,:'".,1'~~~;',''' '.'- I ,~\< ~~:_~\,~ " "r:'.:\'i .. n :. ~.'j.,:...... '~~~~~t1~;2j?1~} . .~'~.!\J\" Notarial Seal Anna Marie Mader, Notary Public Camp Hill Bora, Cumberland County My Commission Expires Aug. 7, 2000 Member, Pennsylvania ASSOciation of Notaries Ii . h . , U,-1A.A ') Aj,LLrrl!tdL{.J Notary Public . .l.... A c.. FA r ~ -'1. ('7 :.h}lJ~, """'" ~'- u. CERTIFICATION OF ADDRESS I hereby certify that the precise residence of the Grantee herein is: ,"J .....~.:i .-':,...... I r" ."-\ f.... (__,,;,_,,~>,--~, ,"'-i . ,.1 -, ;,-7 c. '; _....~) ~;<:/ --(>< ~j;t:..-~ ...._____,_."..-""7.-r..-?:-=~)----- Attorney or Agent for Grantee COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND RECORDED in the Office of the Recorder of Deeds in and for said County in Deed Book )~~! I I Vol.,-, Page I I,' - i ! I: 'j , ) WITNESS my hand and official seal this r\C.l \/ , 1996. I r:-: day of 'to."~ ""..." ", '.... ~ . .."..... ---':~-,:._"~;'~~~'~ '\. ., -iil:~~~'~-,.il'~1':l; -. ,,~, "...:.. .....''r ~~~~~~ i~':' ~!>~'~~t 'tP" " - ~. " ' ....- :i. \\' tl(... ,t~.1 " .,il' _ ,r,- r ' '11:..';,b.!."I..i'll,1. ,j,.,', ~....".,.~..;, .,..Vol -'/I ....,.. "~~"~J1:' :~'. " .i~'-~}'~1'\"~~ ,~i"~}~~~' '~-" . ,,>-, ," "4~~( ~ 'i'fJ'!' {Oh~fj'I '-, ~\~. ',', . -- 'c;,.:~ ,'~-,~_,t'r',~"", _-, -'~. t~?j.;-_, ,,"; "" .'" /', ,t _ ,.' 1~'.,' ,'-. - . .- _ ", ~k__~ , ,$,,' " ~',':#'--"\\'["~_'iil, :---i4. t.""_ ,~~.i-~- r:: :,1:< \~"" ;. '~\~~,~~f\~~%:., f ~;~J . \., -'"I~"~'J,;,- ~; :,~' l$:~i' it~~,,}/ir '~t:' : -\--- ~.~! ,.', .,~-'''' --"'-,4--, " -,o',- :~'~~i;~~~~~~>>'i ~~~ Recorder of Deeds jdU~. 1.48 fAH: lC8 ..~ Ameriprise' ~. Financial May 1, 2007 MARILYN A DURR 22 THORNHILL CT CARLISLE, PA 17015-7669 Dear MARILYN A DURR: RiverSource Life Insurance Company RiverSource Funds Ameriprise Certificate Company Ameriprise Brokerage 70100 Ameriprise Financial Center Minneapolis, MN 55474 We havc received notificatior. of DONALD J DURR's death. Pieas(' accept our condolences on your loss. The deceased's name is associated with the following accounts. At the end of this letter, you will find a list of beneficiaries shown in our initial review of the deceased's accounts. Account Information Mutual Funds Account Number 010129679881002 01233448535 1 002 04373448535 2 002 05133448535 9002 08283448535 9 002 09283448535 8 002 Annuities - Post 1985 Account Number 93002492551 1 004 931015582675004 931029635345 004 Account Disposition Ownership IRA - beneficiary designated IRA - beneficiary designated IRA - beneficiary designated Joint Tenancy With Right Of Survivorship IRA - beneficiary designated Joint Tenancy With Right Of Survivorship O~l1ership Individual IRA - beneficiary designated IRA - beneficiary designated Account disposition is based on how an account is owned (the ownership type). The following information will help you understand the process that will be used to settle the accounts. Accounts may be subject to market fluctuation as governed by each product. Disposition for IRA - beneficiary designated ownership Upon the death of the owner, all IRA accounts pass to the named beneficiaries. To determine the distribution options available, please consult a tax advisoL If all IRA accounts will not be fully distributed to the benefic iaries within the year of the owner's death, we recommend the accounts be transferred into beneficial ownership by year end. This ensures we are able to meet IRS Form 5498 reporting requirements. Transferring to beneficial ownership is not a taxable distribution to the beneficiary. Insurance and annuities are issued by RiverSoun Life Insurance Company, an Ameriprise Financial company. Ameriprise Brokerage is provided by Ameriprise Financial Services, Inc. Ameriprisc Ameriprise ~ Financial Beneficiary Information We have the following beneficiaries on record for the deceased's accounts. Account Number: 01012967988 1 002 Designation: PRIMARY BENEFICIARY MARILYN A SPOUSE 100.00% SECONDARY BENEFICIARY LIVING, LAWFUL CHILDREN IN EQUAL SHARES Account Number: 0 I 233448535 1 002 Designation: PRIMARY BENEFICIARY MARILYN A SPOUSE 100.00% SECONDARY BENEFICIARY LIVING, LAWFUL CHILDREN IN EQUAL SHARES Account Number: 04373448535 2002 Designation: PRIMARY BENEFICIARY MARILYN A SPOUSE 100.00% SECONDARY BENEFICIARY LIVING, LAWFUL CHILDREN IN EQUAL SHARES Account Number: 05133448535 9 002 Designation: Not applicable for this ownership type. Account Number: 08283448535 9002 Designation: PRIMARY BENEFICIARY MARILYN A SPOUSE 100.00% SECONDARY BENEFICIARY LIVING, LAWFUL CHILDREN I1\; EQUAL SHARES Account Number: 09283448535 8 002 Designation: Not applicable for this ownership type. Account Number: 93002492551 1 004 Designation: PRIMARY BENEFICIARY MARILYN A DURR SPOUSE 100.00% SECONDARY BENEFICIARY LIVING, LAWFUL CHILDREN IN EQUAL SHARES 100.00% 100.00% 100.00% 100.00% 100.00% Insurance and annuities are issued by RiverSourc Life Insurance Company. an Ameriprise Financial company. Ameriprise Brokerage is provided by Ameriprise Financial Services, Inc. Ameriprise ~ Ameriprise <- ~~. Financial Account Number: 931015582675004 Designation: PRIMARY BENEFICIARY MARILYN A DURR WIFE 100.00% Account Number: 931029635345004 Designation: PRIMARY BENEFICIARY MARIL YN A DURR SPOUSE 100.00% SECONDARY BENEFICIARY LIVING, LAWFUL CHILDREN IN EQUAL SHARES 100.00% Insurance and annuities are issued by RiverSoun Life Insurance Company an Ameriprise Financial company. Ameriprise Brokerage is provided b~ Ameriprise Financial Services, Inc. Ameripris, '~ Ameriprise ...11 Financial Disposition for Joint Tenancy With Right Of Survivorship ownership When one owner dies, all accounts registered as joint tenancy with right of survivorship pass to the surviving owner, Although assets do not become part of the estate for distribution, we understand they should be included for inheritance and/or estate tax purposes. Disposition for Individual ownership The deceased was the annuitant on at least one annuity account previously listed, Upon the death of the annuitant, account proceeds typically pass to the beneficiaries named at the time of death, If no beneficiary was designated the proceeds become part of the estate for distribution. DEFERRED ANNUITY NOTICE: The beneficiary(s) has the option of taking the annuity death benefit either as a full distribution or under an "nnuity payment plan, If the beneficiary(s) wishes to elect an annuity payment plan, we must receive written notice of this election within 60 days of our receipt of due proof of death. Due proof of death is considered to mean our receipt of a certified copy of the death certificate, a completed death claim statement, and any other required claim documents, If there are multiple beneficiaries, the 60 day window for electing an annuity payment plan begins for ALL beneficiaries on the date we receive complete requirements from the first claimant. Required Documents In order to take appropriate steps to settle the accounts we will need these documents: / Certified Death Certificate (For accounts: 01012967988 1 002,01233448535 1 002,043734485352002,051334485359 002,082834485359002,092834485358002,930024925511 004,931015582675004. 93102963534 5 004) The death certificate must be an original document that bears certification from the health department or local registrar and includes the cause of death. 'J Estate Settlement Form (3248) , I , (For accounts: '09283448535 8002,'082834485359002, '04373448535 2 002, 05133448535 9 002:'01233448535 1 002;'Gi012967988 1 002) To process a settlement on a Mutual Fund, Certificate or Brokerage account, each claimant must complete an Estate Settlement Form (version 3248-M or later). This form includes separate sections for qualified and non-qualified accounts as well as a section at the end of the form that must be signed and dated by all new account holders for all qualified and non-qualified accounts. Instructions for completion of the Estate Form are available as Form 3248-INST. If the form is submitted for processing without complete information, delays in completion of the claim may result. Insurance and annuities are issued by RiverSourc Life Insurance Company, an Ameriprise Financial company. Ameriprise Brokerage is provided by Ameriprise Financial Services, Inc. Ameriprise Ameriprise ~ Financial I Death Claim Statement Form (33047V) (For accounts: '93101558267 5 004:93002492551 I 004,k)3102963534 5 004) To process a death claim on an annuity or life insurance account, we must receive a completed Insurance and Annuity Death Claim Statement form (33047V) from each claimant. A completed death claim statement must contain the deceased's client information and account number, a completed claimant information section, and an acceptable mode of settlement The form must also contain a Taxpayer Identification Number and withholding election. Failure to select a withholding election on an annuity requires mandatory 10% withholding which is forwarded to the IRS that we cannot refund. In addition, the claimant(s) must sign the form and their signature(s) must be witnessed by an Ameriprise Financial Services advisor or a notary. If any of this information is incomplete, the form will be returned. Please contact our Ameriprise financial advisor, WILLIAM BEL YUSAR at (330) 729-1096 for forms and assistance. More information regarding the Estate Settlement process is available on the Ameriprise.com website. To view the "Estate Settlement Frequently Asked Questions" page on the website, type "Estate Settlement F AQs" in the search field on the website homepage, press the "Enter" key and select the first item on the "GLOBAL" list. Please contact us if you have any questions as you work through these difficult times, and once again, you have our sincerest sympathy. Thank you. Sincerely, Bert McDonough Death Settlements Processing Team 70 I 00 Ameriprise Financial Center Minneapolis, MN 55474 1-800-862-7919, OptiOll 5, 1 Attachment: Beneficiary Information Insurance and annuities are issued by RiverSourc Life Insurance Company. an Ameriprise Financial company. Ameriprise Brokerage is provided by Ameriprise Financial Services. Inc. Ameriprise t~ Arneriprise ~~, Financial When submitting the required documents please attach this cover sheet to the documents. Please include all documents related to the claim or estate settlement including new account applications, claim forms, etc. Please do not include any documents not related to the death claim or estate settlement. This will allow for quicker processing of your claim or estate settlement. 11671663 DONALD J DURR TO: Bert McDonough S07 /1654 Death Settlements Processing Team 70100 Ameriprise Final1cial Center Minneapolis, MN 55474 ATTN: MAILROOM DO NOT SEPARATE ANY OF THIS MAIL. PLEASE DELIVER TO THE PERSON IDENTIFIED IN THE NOTE ABOVE Insurance and annuities are issued by RiverSoun Life Insurance Company. an Ameriprise Financial company. Ameriprise Brokerage is provided by Ameriprise Financial Services. Inc. Ameriprisc Ameriprise ~ Financial Insurance and annuities are issued by RiverSoun Life Insurance Company, an Ameriprise Financial company. Ameriprise Brokerage is provided b) Ameriprise Financial Services, Inc. Ameripris' 'I 'J n 7 iF P. T [1' 'I: /,'! 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