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Home My WebLink About03-31-08 (3) e Estate of: J. WAYNE TISDALE Schedule B (Page 5) Item No. Description 39 2,039 Shares Centerline Holding Co. Dividend accrued on 12/30/2007 40 1,000 Shares Pennsylvania Real Estate Investment Trust SBI REIT 41 Schwab Pennsylvania Money Market Account Total (Carry forward to main schedule) e 432-03-9829 Value at Date of Death 16,082.61 856.38 29,452.50 13,518.00 59,909.49 OV-1508 EX + (8-98) e COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF J. WAYNE TI SDALE Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM JUMBER DESCRIPTION 1 Bethany Village - Entrance Fee Refund 2 The Patriot-News - Refund 3 Stephanie P. Diamond, M.D. - Refund 4 Pennsylvania State Bank - Uncashed interest check on hand 5 The Foundation for Enhancing Communities; 4th quarter beneficiary distribution; Check on hand at date of death but deposited after death. 6 Credit Card - Refund; Check on hand but not deposited at date of death 7 Capital Blue Cross - Premium Refund 8 Avalon Insurance Company - Premium Refund 9 United States Treasury - Refund re 2007 income tax return BANK ACCOUNTS HELD BY DECEDENT: 10 100 Par Pennsylvania State Bank Certificate of Deposit No. 22695 See bank information attached. Interest accrued to 12/30/2007 11 100 Par Sovereign Bank Certificate of Deposit No. 0465103174 See attached bank letter Interest accrued to 12/30/2007 12 100 Par Mid Penn Bank Certificate of Deposit No. 306070675 See attached bank letter Interest accrued to 12/30/2007 13 61,000 Par Wachovia Bank Certificate of Deposit No. 9422 Total from continuation schedules FILE NUMBER 21 08 0015 34,404.00 VALUE AT DATE OF DEATH TOTAL (Also enter on line 5, Recaoitulation) $ (If more space is needed, insert additional sheets of the same size) 3W46AD 1.000 13.50 23.23 67.01 1,663.00 37.15 409.20 28.50 1,474.00 20,000.00 6.69 23,000.00 72.08 5,000.00 28.92 61,000.00 28,532.18 175,759.46 . e --1 15056041158 REV-1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY County Code Year 21 08 File Number 0015 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 432-03-9829 12302007 02171919 Decedent's Last Name Suffix Decedent's First Name MI TISDALE J. WAYNE (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 BOXES BELOW 00 1. Original Return o 4. Limited Estate 00 6. Decedent Died Testate (Attach Copy of Will) o 9. Litigation Proceeds Received 07. 010. Future Interest Compromise (date of death after 12-12-82) Decedent Maintained a Living Trust (Attach Copy of Trust) o o 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 02. 04a. Supplemental Return Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT _ THIS SECTION MUST BE COMPLETED, ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number L 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) RICHARD W. STEVENSON, ESQ. 717-237-5208 Firm Name (If Applicable) REGISTER OF WILLS USE ONLY MCNEES WALLACE & NURICK LLC First line of address 100 PINE STREET Second line of address PO BOX 1166 City or Post Office State ZIP Code DATE FILED HARRISBURG PA 17108-1166 Correspondent's e-mail address: RSTEVENSON@MWN.COM tements, and to the best of my knowledge and belief, on of which preparer has any knowledge. DATE ~~~5 P9' BOX 1166 HARRISBURG, PA PLEASE USE ORIGINAL FORM ONLY 17108-1166 L 15056041158 6M4647 3.000 15056041158 --A Side 1 Estate of J. WAYNE TISDALE Executors (Page 1) Name JENNIFER GREENE Address 4700 Hunt Circle Harrisburg, PA 17112- e e 432-03-9829 Tax 10 Name EDWARD W. TISDALE Address 622 SE 47th Terrace Cape Coral, FL 33904- Tax 10 e ---' 15056042159 REV-1500 EX Decedent's Name:T I S D ALE RECAPITU LATION 1. Real estate (Schedule A) . 2. Stocks and Bonds (Schedule B) . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C). 4. Mortgages & Notes Receivable (Schedule D). . . . . . . . . . . . . 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 0 Separate Billing Requested 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . 9. Funeral Expenses & Administrative Costs (Schedule H) . 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). 11. Total Deductions (total Lines 9 & 10). . . . 12. Net Value of Estate (Line 8 minus Line 11) . 13. Charitable and Governmental Bequests/Sec 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) e Decedent's Social Security Number 432-03-9829 J. WAYNE . 1. 0.00 . 2. 1175067.62 . ;3. 0.00 . 4. 0.00 . 5. 175759.46 . 6. 0.00 . 7. 0.00 . 8. 1350827.08 . 9. 28187.34 10. 2469.39 11. 30656.73 12. 1320170.35 13. 0.00 14. 1320170.35 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 .0EL 0 . 00 16. Amount of Line 14 taxable at lineal rate X .0ILS 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 1310170.36 0.00 10000.00 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056042159 6M4648 2.000 15. 0.00 16. 58957.67 17. 0.00 18. 1500.00 19. 60457.67 0 15056042159 ---' e e File Number 0015 REV-1500 EX Page 3 Decedent's Complete Address: DECEDENTS NAME TISDALE STREET ADDRESS J. WAYNE C MBERLAND CITY MECHANICSBURG STATE Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 60457.67 0.00 0.00 3022.88 Total Credits (A + B + C) (2) 3022.88 3. Interest/Penalty if applicable D. Interest E. Penalty 0.00 0.00 0.00 Total Interest/Penalty (0 + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in box on Page 2, Line 20 to request a refund. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 57434.79 A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line S + SA. This is the BALANCE DUE. (58) 57434.79 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: a. retain the use or income of the property transferred; . . . . . . . . . . . . . . b. retain the right to designate who shall use the property transferred or its income; c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . d. receive the promise for life of either payments, benefits or care? ........ 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? . 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes o o o o o o o No [X] 00 00 [X] 00 [X] [X] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. F or 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. 89116 (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. g9116 (a) (1.1) (ii)]. The statute does not exemot 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. F or 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 use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. 89116(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. 89116(1.2) [72 P.S. 89116(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. 89116(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. 6M4671 1.000 REV-1503 EX + (6-98) e SCHEDULE 8 STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER 21 08 0015 J. WAYNE TISDALE All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 2 1. THE FOLLOWING ASSETS WERE HELD IN THE DECEDENT'S CHARLES SCHWAB ACCOUNT NO. 8846-6299; SEE ATTACHED COpy OF DECEMBER 2007 STATEMENT; THE ASSETS WERE VALUED PER THE STATEMENT OR IF AVAILABLE ON YAHOO FINANCE: ------------------------- 40,000 Par General Mtrs Accep Bond 7.25% Smartnotes Due 8/15/18, callable 1/15/08 Interest accrued to 12/30/2007 30,228.28 128.89 75,000 Par Household Fin Co. 6.3% Internotes due 9/15/23, Callable 9/15/08 Interest accrued to 12/30/2007 75,180.38 210.00 3 10,000 Par Bethlehem PA Area Bond 5% due 10/15/18, callable 10/15/08 Interest accrued to 12/30/2007 10,157.50 105.56 4 25,000 Par Canton PA Area Bond 4.25% Due 5/15/26, callable 5/15/09 Interest accrued to 12/30/2007 24,904.25 135.76 5 20,000 Par Center Area School Bond 4.5%, due 12/1/28, callable 12/1/11 Interest accrued to 12/30/2007 19,945.60 75.00 6 20,000 Par Delaware Cnty Bond 4.875% Due 11/15/26, callable 11/15/08 Interest accrued to 12/30/2007 20,049.40 124.58 7 30,000 Par Doylestown PA Hospital bond 5%, due 7/1/23, callable 2/2/08 Interest accrued to 12/30/2007 30,027.00 750.00 Total from continuation schedules 963,045.42 3W4696 1.000 TOTAL (Also enter on line 2, Recapitulation) $ 1,175,067.62 (If more space is needed, insert additional sheets of the same size) e e Estate of: J. WAYNE TISDALE 432-03-9829 Schedule B (Page 2) Item No. Description Value at Date of Death 8 20,000 Par Erie PA Pkg Auth Pk Bond 5%, due 9/1/26, callable 9/1/13 Interest accrued to 12/30/2007 20,663.40 333.33 9 15,000 Par Erie PA Swr Auth SW Bond 5%, due 12/1/21, callable 6/1/11 Interest accrued to 12/30/2007 15,673.95 62.50 10 15,000 Par Erie PA Swr Auth SW Bond 5%, due 12/1/21, callable 6/1/11 Interest accrued to 12/30/2007 15,673.95 62.50 11 25,000 Par Harrisburg PA Auth Bond 5%, due 7/15/23, callable 7/15/12 Interest accrued to 12/30/2007 26,101.00 576.39 12 15,000 Par Norwin PA Sch District Bond 5%, due 4/1/31, callable 4/1/10 Interest accrued to 12/30/2007 15,607.50 187.50 13 30,000 Par Pennsylvania State Bond 4.75%, due 12/1/27, callable 12/1/08 30,089.70 Interest accrued to 12/30/2007 118.75 14 25,000 Par Pennsylvania St Higher Ed Bond 5%, due 7/15/31, callable 7/15/11 26,760.75 Interest accrued to 12/30/2007 576.39 15 5,000 Par Pennsylvania State Tpk Bond 5%, due 12/1/23, callable 12/1/08 5,140.10 Interest accrued to 12/30/2007 20.83 16 50,000 Par Pennsylvania St Tpk Bond, 5%, due 7/15/26, callable 7/15/11 Interest accrued to 12/30/2007 53,521. 50 1,152.78 17 15,000 Par Pennsylvania State Tpk Bond, 5%, due 12/1/26, callable 12/1/11 Interest accrued to 12/30/2007 15,464.10 62.50 Total (Carry forward to main schedule) 227,849.42 e tit Estate of: J. WAYNE TISDALE 432-03-9829 Schedule B (Page 3) Item No. Description Value at Date of Death 18 25,000 Par Pennsylvania St Tpk Bond, 5%, due 7/15/31, callable 7/15/11 Interest accrued to 12/30/2007 26,760.75 576.39 19 20,000 Par Pennsylvania State Bond, 5.875%, due 11/15/16, callable 2/2/08 Interest accrued to 12/30/2007 20,222.60 150.14 20 20,000 Par Philadelphia PA Bond, 5%, due 3/15/28, callable 3/15/09 Interest accrued to 12/30/2007 20,659.80 294.44 21 30,000 Par Phoenixville PA Bond, 4.6%, due 2/15/24, callable 2/15/08 Interest accrued to 12/30/2007 30,012.00 521. 33 22 50,000 Par Pittsburgh & Allegheny Bond, 5%, due 2/1/24, callable 8/1/09 Interest accrued to 12/30/2007 51,391. 00 1,041.67 23 40,000 Par Plum Boro PA School Bond, 2.9%, due 9/15/12 Interest accrued to 12/30/2007 38,712.40 341. 56 24 10,000 Par Quakertown PA Cmn Bond, 4.2%, due 8/1/20, callable 8/1/11 Interest accrued to 12/30/2007 10,023.50 175.00 25 25,000 Par South Brunswick Bond, 4.25%, due 10/15/22, callable 10/15/14 25,115.75 Interest accrued to 12/30/2007 224.31 26 25,000 Par Southeastern PA TRA Bond, 5%, due 3/1/20, callable 3/1/09 25,687.25 Interest accrued to 12/30/2007 416.67 27 10,000 Par State College PA Bond, 4.1%, due 5/15/18, callable 11/15/11 10,086.60 Interest accrued to 12/30/2007 52.39 Total (Carry forward to main schedule) 262,465.55 e Estate of: J. WAYNE TISDALE Schedule B (Page 4) Item No. Description 28 80,000 Par State Pub Sch Bl Bond, 4.25%, due 3/15/21, callable 3/15/14 Interest accrued to 12/30/2007 29 40,000 Par State Pub Sch Bldg Bond, 5%, due 11/1/26, callable 11/1/14 Interest accrued to 12/30/2007 30 55,000 Par State Pub Sch Bldg Bond 5%, due 6/1/29, callable 6/1/13 Interest accrued to 12/30/2007 31 5,000 Par Washington Cnty Bond, 5.125%, due 9/1/27, callable 9/1/12 Interest accrued to 12/30/2007 32 45,000 Par Washington Cnty Bond, 5.125%, due 9/1/27, callable 9/1/12 Interest accrued to 12/30/2007 33 60,000 Par West Branch PA Area Bond, 5%, due 3/15/24, callable 3/15/09 Interest accrued to 12/30/2007 34 15 Units Penn Insd Muns Series 150 35 15,000 Par Capmark Bank N.A. 4.85% Certificate of Deposit due 10/17/08 Interest accrued to 12/30/2007 36 6,000 Shares Putnam Investment Grade Municipal Trust Dividend accrued on 12/30/2007 37 1,939 Shares Putnam Municipal Bond Fund, Inc. Dividend accrued on 12/30/2007 38 2,136.734 Shares Dryden Global Total Return Fund Class A Total (Carry forward to main schedule) e 432-03-9829 Value at Date of Death 80,168.80 1,001.11 43,820.40 333.33 59,494.05 229.17 5,402.70 85.42 46,903.50 768.75 61,400.40 883.33 3,132.45 14,970.75 151. 48 56,580.00 245.40 22,579.66 97.73 14,572.53 412,820.96 e Estate of: J. WAYNE TISDALE Schedule B (Page 5) Item No. Description 39 2,039 Shares Centerline Holding Co. Dividend accrued on 12/30/2007 40 1,000 Shares Pennsylvania Real Estate Investment Trust SBI REIT 41 Schwab Pennsylvania Money Market Account Total (Carry forward to main schedule) e 432-03-9829 Value at Date of Death 16,082.61 856.38 29,452.50 13,518.00 59,909.49 REV-150B EX + (5-9B) e COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF J. WAYNE TISDALE FILE NUMBER 21 08 0015 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 1 Bethany Village - Entrance Fee Refund 2 The Patriot-News - Refund 3 Stephanie P. Diamond, M.D. - Refund 4 Pennsylvania State Bank - Uncashed interest check on hand 5 The Foundation for Enhancing Communities; 4th quarter beneficiary distribution; Check on hand at date of death but deposited after death. 6 Credit Card - Refund; Check on hand but not deposited at date of death 7 Capital Blue Cross - Premium Refund 8 Avalon Insurance Company - Premium Refund 9 United States Treasury - Refund re 2007 income tax return BANK ACCOUNTS HELD BY DECEDENT: 10 100 Par Pennsylvania State Bank Certificate of Deposit No. 22695 See bank information attached. Interest accrued to 12/30/2007 11 100 Par Sovereign Bank Certificate of Deposit No. 0465103174 See attached bank letter Interest accrued to 12/30/2007 12 100 Par Mid Penn Bank Certificate of Deposit No. 306070675 See attached bank letter Interest accrued to 12/30/2007 13 61,000 Par Wachovia Bank Certificate of Deposit No. 9422 Total from continuation schedules 3W46AD 1.000 TOTAL (Also enter on line 5, Recaoitulation) $ (If more space is needed, Insert additional sheets of the same size) VALUE AT DATE OF DEATH 34,404.00 13.50 23.23 67.01 1,663.00 37.15 409.20 28.50 1,474.00 20,000.00 6.69 23,000.00 72.08 5,000.00 28.92 61,000.00 28,532.18 175,759.46 e e Estate of: J. WAYNE TISDALE 432-03-9829 Schedule E (Page 2) Item No. Description Value at Date of Death The account was held jointly between decedent and his daughter, Jennifer Greene. The account was joint for convenience purposes only therefore we are reporting 100% of the account in the decedent's estate. Interest accrued to 12/30/2007 6.95 14 100 Par Wachovia Bank Certificate of Deposit No. 6480 The account was held jointly between decedent and his daughter, Jennifer Greene. The account was joint for convenience purposes only therefore we are reporting 100% of the account in the decedent's estate. Interest accrued to 12/30/2007 21,000.00 61.44 15 Wachovia Bank Checking Account Interest accrued to 12/30/2007 7,463.63 0.16 FOR INFORMATION PURPOSES ONLY 16 J. Wayne Tisdale Charitable Remainder Unitrust The decedent created an irrevocable charitable trust during his lifetime. Per the terms of the trust, at his death, the trust is to be distributed to the Greater Harrisbug Foundation to fund the J. Wayne Tisdale Educational Scholoarship Fund. 0.00 17 Virginia Tisdale Trust B - The decedent was the lifetime beneficiary of this Trust that was created in the Will of his spouse, Virginia. Mrs. Tisdale died on March 31, 1996 (PA File No.22-96-0342) wherein tax on the Trust was deferred until the death of the decedent. Please note that in October 2006, all of the trust assets were distributed from the trust account to the decedent's Charles Schwab personal account. 0.00 Total (Carry forward to main schedule) 28,532.18 REV-1511 EX+ (10-06) e SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS e COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF J. WAYNE TISDALE FILE NUMBER 21 08 0015 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION FUNERAL EXPENSES: Jesse Geigle Funeral Home 1. Total from continuation schedules B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) EXECUTORS WAIVED FEE Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees McNees Wallace & Nurick LLC (Estimated) 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Cumberland Law Journal Legal Advertising 2 Central Penn Business Journal Legal Advertising Total from continuation schedules 7W46AG 1.000 TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) AMOUNT 6,865.92 1,105.00 17,500.00 910.00 1,250.00 75.00 103.00 378.42 $ 28 187.34 e Estate of: J. WAYNE TISDALE Item No. 2 Schedule H Part 1 (Page 2) Description Woodlawn Memorial Gardens Interment Charges Total (Carry forward to main schedule) e 432-03-9829 Amount 1,105.00 1,105.00 e Estate of: J. WAYNE TISDALE Schedule H Part 7 (Page 2) 3 McNees Wallace & Nurick LLC Costs Advanced as follows: Duplicating Postage Local Courier $56.60 33.82 8.00 4 McNees Wallace & Nurick LLC Reserve for closing costs re duplicating, postage, etc. 5 Cumberland County Register of Wills Filing fee re inheritance tax return and inventory Total (Carry forward to main schedule) e 432-03-9829 98.42 250.00 30.00 378.42 REV-1512 EX+ (12-03) e COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF J. WAYNE TISDALE SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21 08 0015 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH Bethany Village Nursing Home Charges 795.12 2 ~llennium Pharmacy Drug Charges 116.91 3 Wachovia Bank Checks outstanding at date of death 307.36 4 united States Treasury Quarterly Estimated Payment re decedent's 2007 Income Tax Return 1,000.00 5 PA Department of Revenue 2007 Income Tax Return -Tax Due upon filing of $40.00, and quarterly estimated payment of $210 paid after decedent's death 250.00 3W46AH 2000 TOTAL (Also enter on line 10. Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 2 469.39 REV-1513 EX+ (9-00) e SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF J WAYNE TISDALE NUMBER I 1 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Marjorie McClain 593-13 Geneva Drive Mechanicsburg, PA 17050 General Bequests: 10,000.00 2 Edward W. Tisdale 3420 S.W. First Place Cape Coral, FL 33904 One Half of Residue: 655,085.18 3 Jennifer Greene 4700 Hunt Circle Harrisburg, PA 17112 One Half of Residue: 655,085.18 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) FILE NUMBER 21 08 0015 AMOUNT OR SHARE OF ESTATE Friend Son Daughter 10,000.00 655,085.18 655,085.18 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 3W46AI 1.000 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 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) $ 0.00 - EXHIBIT A - . . . ESTATE OF J. WAYNE TISDALE PENNSYLV ANIA INHERITANCE TAX RETURN TABLE OF CONTENTS - EXHIBITS A. MISCELLANEOUS DOCUMENTS 1. Table of Contents 2. Copy of Letters Testamentary issued to Edward W. Tisdale and Jermifer Greene and copy of decedent's Will dated August 25,2005 3. Copy - Safe Deposit Box Inventory 4. Copy - Charitable Trust B. SCHEDULE B- STOCKS AND BONDS; Charles Schwab December 2007 account statement C. SCHEDULE E - Cash, Bank Deposits, & Misc. Personal Property 1. Pennsylvania State Bank - Account Information 2. Sovereign Bank - Account Information 3. Mid-Penn Bank - Account Information 4. Wachovia Bank - Account Information . - REGISTER OF WILLS CUMBERLAND COUNTY PENNSYLVANIA CERTIFICATE OF GRANT OF LETTERS No. 2008-00015 PA No. 21-08-0015 Esta te Of: J WA YNE TISDALE IFi,st Middle, Last) Late Of: LOWER ALLEN TOWNSHIP CUMBERLAND COUNTY Deceased Social Securi ty No: 432-03-9829 WHEREAS, on the 4th day of January 2008 an instrument dated August 25th 2005 was admitted to probate as the last will of J WA YNE TISDALE (First, Middle, Last) la te of LOWER ALLEN TOWNSHIP, CUMBERLAND County, who died on the 30th day of December 2007 and WHEREAS, a true copy of the will as probated ~s annexed hereto. THEREFORE, I, GLENDA FARNER STRASBAUGH Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: ED WARD W TISDALE and JENNIFER GREENE who have duly qualified as EXECUTOR(RIX) and have 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 4th day of January 2008. "- P~1 **NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) . . t(Q)\?~ LAST WILL AND TESTAMENT OF J. WAYNE TISDALE I, J. WAYNE TISDALE, of Cumberland County, Pennsylvania, make this Will, hereby revoking all my former Wills and Codicils. ARTICLE ONE PECUNIARY BEQUESTS 9 1.1 I bequeath the sum of Ten Thousand Dollars ($10,000) to my friend, MARJORIE McCLAIN, presently of 593-13 Geneva Drive, Mechanicsburg, Pennsylvania, if she survives me. ARTICLE TWO RESIDUE 92.1 I devise and bequeath all the residue of my estate to my issue living at my death, per stirpes. ARTICLE THREE APPOINTMENT OF FIDUCIARIES 93.1 I appoint my son, EDWARD W. TISDALE ("My Son") and my daughter, JENNIFER GREENE ("My Daughter") as Co-Executors of this Will. If either My Son or My Daughter is unable or unwilling to act or continue to act, for any reason whatsoever, my remaining child shall thereafter serve as sole Executor. If neither of my children is able and willing to act or continue to act, KATHRENE GREENE WEBB shall serve as successor Executor. All references herein to the "Executor" shall mean my originally appointed Executors or my successor Executor, as the case may be. . . ARTICLE FOUR POWERS OF FIDUCIARIES ~ 4.1 No fiduciary under this Will shall be required to give bond or other security for the faithful performance of the fiduciary's duties. ~ 4.2 Any such fiduciary shall have the powers set forth in the Pennsylvania Probate, Estate and Fiduciaries Code. ARTICLE FIVE PROVISION FOR TAXES ~ 5.1 All estate taxes, inheritance taxes, transfer taxes and other taxes of a similar nature payable by reason of my death to any government or subdivision thereof upon or with respect to any property subject to any such tax, and any penalties thereon, shall be paid by the Executor out of the principal of that portion of my estate disposed of by ArticlaTwo of this Will. ARTICLE SIX PROVISION FOR DEBTS AND EXPENSES ~ 6.1 I direct that any of my legally enforceable debts, any expenses of my last illness, funeral and burial, and any of the administrative expenses of my estate shall be paid from the principal of that portion of my estate disposed of by Article Two of this Will. ARTICLE SEVEN MISCELLANEOUS PROVISIONS ~ 7.1 If any person and I die under such circumstances that it is impossible to determine which of us survived, it shall be conclusively presumed and this Will shall be construed as if such person had predeceased me. -2- . . ~ 7.2 Whenever a fiduciary is directed to distribute property to or for the benefit of any beneficiary who is under (a) twenty-one (21) years of age, or (b) a legal disability or otherwise suffers from an illness or mental or physical disability that would make distribution directly to such beneficiary inappropriate (as determined in such fiduciary's sole discretion exercised in good faith), the fiduciary may distribute such property to the person who has custody of such beneficiary, may apply such property for the benefit of such beneficiary, may distribute such property to a custodian for such beneficiary, whether then serving or selected and appointed by the fiduciary (including the fiduciary), under any applicable Uniform Transfers to Minors Act or Uniform Gifts to Minors Act, may distribute such property to the guardian of such beneficiary's estate, may distribute such property directly to such beneficiary's estate, or may distribute such property directly to such beneficiary (except if any of the conditions hereinbefore described in (b) apply), without liability on the part of the fiduciary to see to the application of such property. This provision shall not in any way operate to suspend such beneficiary's absolute ownership of such property or to prevent the absolute vesting thereof in such beneficiary. ~ 7.3 Except as otherwise may be provided in this Will, during the continuance of any of the trusts created under the provisions of this Will, and thereafter until the property is distributed to and received by any beneficiary hereunder, the principal sums thus held in trust for any beneficiary, respectively, and the income thereof shall not be subject to or liable for any contracts, debts, engagements, liabilities or torts of such beneficiary now or hereafter made, contracted, incurred or committed, but shall be absolutely free from the same, and such beneficiary shall have no power to sell, assign or encumber all or any part of the principal sums or such beneficiary's interest therein, respectively, or the income thereof, or to anticipate the income. -3- . . S 7.4 An individual fiduciary shall be entitled to receive reasonable compensation for such fiduciary's services hereunder. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 25th day of August, 2005. 'I{~ ~t j. WAYNE TISDALE (SEAL) Signed, sealed, published and declared by the above named J. WAYNE TISDALE as and for his Last Will, in the presence of us and each of us, who, at his request and in his presence and in the presence of each other, have hereunto subscribed our names as witnesses th eto the day and year last above written. Residing at &~ R Residing at L \ i D ~J,.J)rk~1) I fYI -4- . . COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF DAUPHIN We, J. WAYNE TISDALE, the testator, and ~ :511 D. c:: re. e I"l e... and ~:c...b~ \.U. Stc \ler\.Sot\ , the witnesses, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as his Last Will; that the testator signed willingly and executed it as his free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testator signed the Will as a witness and that to the best of his or her knowledge the testator was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. WITNESS: TESTATOR d\~ 1> ~ II"'" - ();tJ ~~ fWA~SDALE Subscribed, sworn to and acknowledged before me bid' WAYNE TISDALE, the stator and subscribed and sworn to before me by I ; .514 . Cree. I\L and , witnesses, this 25 h day of August, 2005. NOTARiAl SEAL KAREN D. RAFFERTY, Notary Public city of Harri8txJrg, PA Daupf1in County My Commission ExpIres Feb. 13, 2006 -5- -.J . . REV-485 EX (1-07) ~ SAFE DEPOSIT ~ BOX INVENTORY PA Department of Revenue Social Security or Death Certificate Number [""1 ' 4 .3 2 , ,,,,_,t., Decedent's Last Name 48500041046 ifJ ADDREss OF [)ECEDENT STREET: i i I Date of Death ~1LI Suffix ITD PLEASE USE ORIGINAL FORM ONLY County Code Year File Number [il]] ~ fJTI}[] First Name MI ill 0 CITY: M:chanics1:m NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX N~clmu W. Steveram STREET ADDRESS: ~~g 100 Pi.re St., P.O. Box 1166 , NAME, ADDRESS AND RELATIONSHIP (IF ANY) TO DECEDENT, OF PERSON(S) PRESENT AT THE BOX OPENING a. N~2haro W. Stevenson Attorrey for~~SHIP: STATE: ZIP CODE: PA 17055 plATE: 171ar--fP~: STREET ADDRESS: 100 Pine St., P.O. Box 1166 b. NAME: Jennifer Greene STREET ADDRESS: 47m Hlmt Cirde c, NAME: Harrisburg ~ CITY: plATE: 17~Pfffi RELATIONSHIP: laughter and Co-Executor CITY: Harrisburg RELATIONSHIP: STATE: PA ZIP CODE: 17112 STREET ADDRESS: CITY: STATE: ZIP CODE: NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED NA'if~ovia Pank STREET ADDRESS: 5201 Simpson Ferry Road . NAME OF PERSON MAKING LAST ENTRY No en sirr:e box 0 DA~~t=-~~T ZM,ENT BOX . NUMBE~i BOX NAME AND ADDRESS OF PERSON(S) HAVING ACCESS TO BOX a, NAME: CITY: !1:rl1anicsburg p~TATE: 171)rffDE: DATE AND TIME OF LAST ENTRY N/A I TITLE ~~~wcr~~ REGISTERED b. NAME: -----_._-------_._---~~---- STREET ADDRESS: STREET ADDRESS: CITY: STATE: ZIP CODE: CITY: STATE: ZIP CODE: NAME AND TITLE OF EMPLOYEE TAKING THE INVENTORY Richard W. Stevenson, E'a:t. lEI WAS A WILL IN THE BOX? 0 YES ~ NO If yes, a, Date of will: I i b. Name and address of personal representative, if named In the will i NAME: STREET ADDRESS: CITY: STATE: ZIP CODE: c, Name and address of attorney, if any NAME: STREET ADDRESS: CITY: STATE: ZIP CODE: L 48500041046 48500041046 ---1 REV-485 EX . . SAFE DEPOSIT BOX INVENTORY Page of INSTRUCTIONS (1) Cash: Report total only. (2) Stocks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are to be designated by name of company, certificate number, date of certificate, name in which stock is registered, and number of shares and class of stock. (3) Obligations of U.S. Government: Number of items, date of issue, face value, names in which registered and type of ownership, Le., jointly held, payable on death, etc. (4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds) (5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book, name of bank and branch, and balance. (6) Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible. (7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as fully as possible. (8) All other contents. (9) Return completed form to: DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG, PA 17128-0601 ITEM ITEM DESCRIPTION NO. -- f----- ---.---.-. 1HE :EDX WAS EMP1Y - - ----- - -- -- -~- -- --~_.- - n__ --------- - ----- f---- ._---~~~~--_.- --------- -- ~~-~---------- - .- --------. ----. -~------ -------- ~--~----~ -_._---~------------------------------~--- _.__._-------------~-- ~-- -~--_._- ----..---- --.- .-.---- -.-------- - --------- -----~--------- "--- -- ---------------_.----- ~= ~Y UNDER PENALTY OF PERJURY THAT THE ABOVE RECORD IS PERSON RECEIVING COPY OF CT AND COMPLETE TO Tflt; BEST OF MY KNOWLEDGE AND BELIEF. SAFE DEPOSIT BOX INVENTORY: SIG\~_~ WA ktxp-~~__~_____________ SIGNATURE ---~-----_.~ --. --..--.-- ---'-.-- ____.u._ PRINT NAME .- PRINT NAME AND CHECK APPROPRIATE BOX BELOW: __ RirhFlrrl w. Stevet1SOlL _ . - ----..-- __u._ ---.----- ---.. ..-- -- ._~---- --- n ____ _ ________ PRINT TITLE DATE CHECK APPROPRIATE BOX: Attorney for Estate ~1101 D Executor{trix) D Administrator(lrix) D Estate Representative D Joint owner of safe deposit box NOTE: Attach additional aW' x 11" sheet(s) if necessary or use duplicates of this page of form. The Department is authorized by law, 42 U.S.C. 3405 (c)(2)(C)(i), to require disclosure of Social Security numbers in connection with administering state tax laws. The Department uses the Social Security number to identify the decedent and personal representatives of the estate. The Commonwealth may also use the information in exchange of tax information agreements with Federal and local taxing authorities. The state law prohibits the Commonwealth's personnel from disclosing confidential tax information except for official purposes. . . CHARITABLE REMAINDER UNITRUST INSTRUMENT tcg~y On thisl8~y Of~:;998, I, J WAYNE TISDALE, (hereinafter referred to as "the Donor") desiring to establish a charitable remainder unitrust within the meaning of Section 6 of Revenue Procedure 89 - 20 and Section 664(d)(2) and (3) of the Internal Revenue Code (hereinafter referred to as "the Code") hereby create the j. Wayne Tisdale Charitable Remainder Unitrust and designate GHF, Inc., a Pennsylvania non-profit corporation with trust powers, as the Trustee. 1. Funding of the Trust. The Donor transfers to the Trustee the property described on Schedule A, and the Trustee accepts such property, and agrees to hold, manage and distribute such property of the Trust under the terms set forth in this Trust instrument. 2. Payment of the Unitrust Amount. The Trustee shall pay to J. Wayne Tisdale, hereinafter referred to as "the Recipient") in each taxable year of the Trust during the Recipient's life a unitrust amount equal to ten percent (10%) of the net fair market value of the assets of the Trust valued as of the first day of each taxable year of the die, Trust (the "valuation date"). The unitrust amount shall be paid in equal quarterly amounts from income and, to the extent that income is not sufficient, from principal. Any income of the Trust for a taxable year in excess of the unitrust amount shall be added to principal. If the net fair market value of the Trust assets is incorrectly determined, then within a reasonable period after the value is finally determined for Federal tax purposes, the Trustee shall pay to the Recipient (in the case of an undervaluation) or receive from the Recipient (in the -1- . . case of an overvaluation) an amount equal to the difference between the unitrust amount properly payable and the unitrust amount actually paid. 3. Proration of Unitrust Amount. In determining the unitrust amount, the Trustee shall prorate the same on a daily basis for a short taxable year and for the taxable year ending with the Recipient's death. 4. Distribution to Charity. Upon the death of the Recipient, the Trustee shall distribute all of the then principal and income of the Trust, (other than any amount due the Recipient or Recipient's estate, under paragraphs 2 and 3 above) to The Greater Harrisburg Foundation (hereinafter referred to as "the Charitable Organization"). If the Charitable Organization is not an organization described in sections 170b)(1)(A), 170(c), 2055(a) and 2522(a) of the Code at the time when any principal or income of the Trust is to be distributed to it, then the Trustee shall distribute such principal or income to one or more organizations described in sections 170b)(1 )(A), 170(c), 2055(a) and 2522(a) of the Code, as the Trustee shall select in its sole discretion. 5. Additional Contributions. If any additional contributions are made to the Trust after the initial contribution, the unitrust amount for the year in which the additional contribution is made shall be equal to ten percent (10%) of the sum of (a) the net fair market value of Trust assets as of the first day of the taxable year (excluding the assets so added and any income from, or appreciation on, such assets) and (b) that proportion of the fair market value of the assets so added that was excluded under (a) that the number of days an the period that begins with the date of contribution and ends with the earlier of the last day of the taxable year or the Recipient's death bears to the number of -2- . . days in the period that begins on the first day of such taxable year and ends with the earlier of the last day in such taxable year or the Recipient's death. In the case where there is no valuation date after the time of contribution, the assets so added shall be valued as of the time of contribution. 6. Prohibited Transactions. The income of the Trust for each taxable year shall be distributed at such time and in such manner as not to subject the Trust to tax under section 4942 of the Code. Except for the payment of the unitrust amount to the Recipient, the Trustee shall not engage in any act of self-dealing, as defined in section 4941 (d), and shall-not make any taxable expenditures, as defined in section 4945(d). The Trustee shall not make any investments that jeopardize the charitable purpose of the Trust, within the meaning of section 4944 and the regulations thereunder, or retain any excess business holdings, within the meaning of section 4943. 7. Taxable Year. The taxable year of the Trust shall be the calendar year. 8. Governing Law. The operation of the Trust shall be governed by the laws of the Commonwealth of Pennsylvania. However, the Trustee is prohibited from exercising any power or discretion granted under said laws that would be inconsistent with the qualification of the Trust under section 664(d)(2) of the Code and the corresponding regulations. 9. Limited Power of Amendment. The Trust is irrevocable. However, the Trustee shall have the power, acting alone, to amend the Trust in any manner required for the sole purpose of ensuring that the Trust qualifies and continues to qualify as a charitable remainder unitrust within the meaning of section 664(d)(2) and (3) of the Code. -3- . . 10. Investment of Trust Assets. Nothing in this Trust instrument shall be construed to restrict the Trustee from investing the Trust assets in a manner that could result in the annual realization of a reasonable amount of income or gain from the sale or disposition of Trust assets. 11. Component Status. The principal and income of the Trust distributed, in accordance with Section 4, shall become the assets or be added to the assets of a component of the Charitable Organization within the meaning of that term in regulations relating to community foundations under section 170 of the Code. The component shall be held by GHF, Inc. IN TRUST NEVERTHELESS, for charitable, educational, scientific or civic uses according to the plan known as The Greater Harrisburg Foundation. The component shall be identified as the J. WAYNE TISDALE FUND pursuant to a Letter Agreement, dated , 1998, which is attached hereto and made a part hereof by reference... 12. Other Duties and Powers of the Trustee. In addition to the powers granted the Trustee by law, except as otherwise specifically provided herein, the Trustee shall hold and manage the Trust assets (hereinafter referred to as the Trust Estate) when so collected, together with such other property as may be acquired, during the existence of the Trust, upon the following terms and conditions and with the following powers and authorities, provided, however, that no discretionary power granted hereunder shall be exercisable if the exercise of such power or discretion would be inconsistent with the qualification of this Trust as a charitable remainder unitrust under section 664(d)(2) and (3) of the Code: -4- . . A. To take, hold or retain all or any part of the Trust hereby created in the form in which it may be acquired as long as it deems advisable and to receive all the income, increments, rents and profits therefrom. B. To sell, exchange, partition, lease or otherwise dispose of any property or part thereof, real or personal, which may at any time form part of this Trust Estate at public or private sale for such purposes and upon such terms, including sales on credit with or without security, in such manner and at such prices as it may determine, but in the event for less than or adequate or full consideration in money or money's worth, including the right to lease real estate for periods in excess of five (5) years and for a term expiring after the termination of the Trust. In the event of a sale, exchange, partition or lease of any of the property of the Trust Estate, there shall be no liability on the part of the purchaser or purchasers to see to the application of the purchase money, but the same shall be held and disposed of by such purchaser or purchasers free and clear of any of the provisions of the Trust. C. To continue any investment which may form a part of the Trust Estate or to invest or reinvest the same in any property, real or personal, of any kind or nature, including stocks, bonds, mortgages, other securities and common trust funds of Trustee or a Custodian selected by the Trustee and mutual and money market accounts operated by the Trustee or a Custodian selected by the Trustee or any affiliate of them without being restricted or limited to investments as now or may hereafter be prescribed for trustees by the laws of the Commonwealth of Pennsylvania or any other state, including the right to acquire, sell or retain stock in the Trustee or the holding company of the Trustee. -5- . . D. To cause securities which may from time to time comprise any part of the Trust Estate to be registered in the name of the Trustee, as Trustee, or in the name of any nominee or to take and keep the same unregistered and retain them or any part thereof in such condition that it will pass by delivery without disclosing the fact that the property is held in a fiduciary capacity. E. To make any loans either secured or unsecured in such amounts, upon such terms, at such rates of interest and to such persons, firms or corporations as it deems advisable. F. To borrow money for any purpose in connection with the administration of the Trust Estate; execute promissory notes or other obligations for the amounts so borrowed by mortgage or pledge of any real or personal property which may at any time form a part of the Trust Estate. G. To vote, in respect to any securities which may at any time form a part of the Trust Estate, upon any proposition or election at any meeting and to grant proxies discretionary or otherwise; vote at any such meeting; join in or become a part of any reorganization, readjustment, merger, voting trust, consolidation or exchange and to deposit any such securities with any committee, depository, trustee or otherwise and to pay out of the Trust Estate any fees, expenses and assessments incurred in connection therewith and to charge the same to principal or income as it may see fit to exercise -6- . . conversion, subscription or other rights, or to sell or abandon such rights and to receive and hold any new securities issued as a result of such reorganization, adjustment, merger, voting trust, consolidation or other rights; and generally take all action in respect to any such securities as it might or could do as absolute owner thereof, to vote any stock in a Trustee or a holding company of a Trustee, except that in the election of directors of a Trustee or the holding company of the Trustee, said stock shall be voted as directed by the Distribution Committee of The Greater Harrisburg Foundation. H. In its discretion to allocate to either principal or income or between them or receipts or expenses which it may be required to pay on behalf of the Trust Estate, except that the Trustee shall pay the quarterly installments and any adjustments of the unitrust amount from income and, to the extent that income is not sufficient, from principal and shall allocate excess income received to principal in accordance with Section 2. I. To divide or distribute, whenever it is required or permitted, the Trust Estate and to make such division or distribution in kind or in money or partly in kind and partly in money. J. To hold and administer the Trust Estate in one or more consolidated funds in whole or in part in which the separate funds shall have undivided interest. K. To determine, in connection with making investments, whether to amortize premiums in whole or in part. L. To compromise claims, on such terms and conditions as Trustee, in her discretion, deems appropriate. -7- . . M. To engage attorneys, investment counsel, accountants, agents, including Custodians which shall be incorporated banks organized under the laws of either the Commonwealth of Pennsylvania or the United States of America, and such other persons as they deem reasonable and to charge the expenses thereof to income or principal as it may determine and to delegate to such persons any discretion which it may deem proper. The Trustee shall not be liable for any negligence, omission or wrongdoing of such counselor agents, provided reasonable care was exercised in their selection. N. No title in the Trust Estate, or in the income accruing therefrom or in its accumulation shall vest in the Donor, the Recipient or the Charitable Organization. Neither the Donor, the Recipient nor the Charitable Organization shall have the right or power to transfer, assign, anticipate or encumber his, her or its interest in the income or principal of said Trust Estate prior to the actual distribution thereof by the Trustee to him, her or it or its trustee. Further, neither the income nor the principal of the Trust Estate shall be liable in any manner, in the possession of the Trustee, for the debts, contracts or engagements of the Donor, the Recipient or the Charitable Organization. 13. Bond. No Trustee shall be required to give any bond or other security. 14. Trustee's Compensation. The Trustee shall be entitled to receive annual compensation for its services hereunder in accordance with the schedule of compensation of the Trustee currently in effect when the services are performed. -8- . . 15. Acceptance of Trust. The Trustee, shall acknowledge that it has received from the Donor all property described in the Schedule attached hereto by initialing each item. IN WITNESS WHEREOF, J. Wayne Tisdale, the Donor, has hereunto set her hand and seal and GHF, Inc., Trustee, has caused these presents to be signed in its corporate name by its Executive Director and its corporate seal hereto affixed, attested by its Secretary, the day and year first above written. Signed, sealed and delivered in the presence of: "The Donor" ~tJH 1:A'<ir:t ~~(SEAL) /J. Wa ne Tisdale ''The Trustee" ATTEST: GHF, Inc. ~ Secretary Cl" wi' 1~1"l~ -9- . . COMMONWEALTH OF PENNSYLVANIA COUNTY OF ""JJAUPH-JlV On the )~ day of /J'iUS!-, 1998, before me, this subscriber, a Notary Public in and for said Commonwealth and County, came the above-named, J. Wayne Tisdale, SS. satisfactorily proven to me to be the person whose name is subscribed to t within instrument, and acknowledged the above agreement to be his act and deed and desired the same might be recorded as such. WITNESS my hand and Notarial Seal. Notary PUbliC~ NOTARIAL SEAL JEANNETTE CHELGREN. ~otary Public City of Harrisburg, DauphIn County 1 M Commission ires Feb. 15. 200 COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN SS. I hereby certify that on the / ? day of Il-u;Jts f, 1998 , before me, the subscriber, a Notary Public in and for said Commonwealth and County, personally appeared Janice . R. Black, Executive Director of GHF, Inc., and by virtue and in pursuance of the authority conferred upon her, acknowledged the said Charitable Remainder Unitrust Agreement to be the act of GHF, Inc. WITNESS my hand and Notarial Seal the day and year first above written. NOTARIAL SEAL JEANNETTE CHELGREN. Notary Public City of Harrisburg, Dauphin CounIW' Comml88lon Feb. 15, 2001 -10- . . SCHEDULE OF TRUST PROPERTY Trust Agreement dated: ~jlt Ie; g- I . .1998 \ · t!AuU<.. ""-- '-nu. ~ct J,3 t 2. 7, 600 / A\K'.. ~ 2. 0u.M 4<- ~ ~ ~ 1>10,000 I ~~ -11- ~~~!. ~~f~ The ~ f!!':. A Ccmnwm~ Trust Greater Harrisburg Foundation . . (C~~lf a tt.l L<.:- Fr l CZtf'! Ij , 1999 Janice R. Black President THE GREATER HARRISBURG FOUNDATION 200 N. Third Street, P. O. Box 678 Harrisburg, PA 17108-0678 Dear Ms. Black: With this letter I hereby create an endowment fund to be known as the J. Wayne Tisdale Educational Scholarship Fund with GHF, Inc., as Trustee, IN TRUST NEVERTHELESS for charitable, educational, scientific or civic uses according to the purposes under the plan known as The Greater Harrisburg Foundation. This fund will be established with the proceeds of the J. Wayne Tisdale Charitable Remainder Unitrust, when the trust terminates. The Fund will provide scholarships to students whose parent(s) is employed by an independent hardware store, lumber yard or home center at the time of first application and who reside in Pennsylvania. Determination of the scholarship recipient will be based on financial need, and other factors such as grade point average, extracurricular activities and employment history. Scholarships are renewable for up to four years for students who demonstrate leadership through participation in extra- curricular activities at college and maintain a 2.0 (lie) average or better in college. Participation in athletic events is not considered extracurricular activity for this purpose. The fund shall come into being upon the termination of the J. Wayne Tisdale Charitable Remainder Unitrust. The donor reserves the right to have an advisory committee advise the Distribution Committee of the Foundation of its wishes concerning distribution of income. It is understood that the Distribution Committee will evaluate whether the advice is consistent with the specific needs of the proposed recipient and deserving of support according to the criteria of The Greater Harrisburg Foundation. The Distribution Committee shall not be bound by this advice. The advisory committee will consist of two representatives of The Greater Harrisburg Foundation and Edward W. Tisdale, my son, as long is he is able to serve. I also understand that grants from the Fund may not be used to satisfy charitable pledges of mine. For its services in administering the funds, The Greater Harrisburg Foundation shall charge, annually, its normal administrative fee. It is understood that the Distribution Committee of the Foundation has the power to modify any restriction on the Fund. This variance power is explained in more detail in the Foundation Trust Agreement. . . Additions may be made to the J. Wayne Tisdale Educational Scholarship Fund at any time. Sincerely yours, I _ ,~~~~t::~ ~~k~' ____ .Y Accepted for THE GREATER HARRISBURG FOUNDATION: BY~~~ Janice R. Black' President Date ~ 9, ItJ99 I. I. ,- . . Scholarship Procedures J. Wayne Tisdale Educational Scholarship Fund The purpose of the J. Wayne Tisdale Scholarship will be to provide scholarship assistance for the children of employees of independent hardware stores, lumber yards or home centers in Pennsylvania. Eligibility: Students from Pennsylvania who are high school seniors in good standing at the time of application and whose parent(s) are employed by an independent hardware store, lumber yard or home center (not owners) will be eligible to apply for the scholarship. The following criteria will be used in the selection of the recipients: Financial need Evidence of leadership in school or community Extra curricular activities in school or past service to community or church. Applicants must demonstrate a 2.0 ("e") grade point average or better. Applicants must be planning to attend a two or four-year Pennsylvania college or university. Applicants should hold or have held a full or part time job while a senior in high school. Applicants must be under age 28 at the time the grant is awarded. The Greater Harrisburg Foundation will contact independent hardware stores, lumber yards and home centers in Pennsylvania and distribute information and application forms. The application will include a short essay describing student's interests, educational goals and activities. Other pertinent information may be requested on the application form including the verification of financial need, character references, and confIrmation of good citizenship. The maximum grant to any student per year is $2,500, and is renewable up to four years. The committee to determine the award recipients will be comprised of two staff members of The Greater Harrisburg Foundation and Edward W. Tisdale, son of J. Wayne Tisdale. EXHIBIT B ..... 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