HomeMy WebLinkAbout04-29-08 (2)
-.J
REV-1500 EX (06-05)
P A Department of Revenue
Bureau of Individual Taxes
PO BOX 280601
Harrisburg, PA 17128-0601
15056041158
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
County Code Year
21 06
File Number
0423
ENTER DECEDENT INFORMATION BELOW
Social Security Number
Date of Death
Date of Birth
177-12-7571
03052006
05131920
Decedent's Last Name
Suffix
Decedent's First Name
SCHAFFER
RAYMOND
MI
L
(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
[]] 1. Original Return
D 4. Limited Estate
[]] 6. Decedent Died Testate
(Attach Copy of Will)
D 9. Litigation Proceeds Received
0.- 8. Total Number of Safe Deposit Boxes
Spousal Poverty Credit (date of death D 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
o 2.
04a.
[]] 7.
010.
Future Interest Compromise (date of
death after 12-12-82)
Decedent Maintained a Living Trust
(Attach Copy of Trust)
Supplemental Return
o
D
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
LOWELL R. GATES
717-731-9600
Firm Name (If Applicable)
GATES~ HALBRUNER & HATCH~ p.C.
REGISTER OF ~LS USE ONL ~
(--" C_':::>
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--0
._~
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"'-)
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First line of address
1013 MUMMA ROAD~ SUITE 100
Second fine of address
City or Post Office
State
ZIP Code
-,---,
"c~;j ~
-',--1
~~1JLED
LEMOYNE
PA
17043
<::J
Co
L.R.GATES@GATESLAWFIRM.(OM
MECHANICSBURG~ PA 17055
DATE
(/3
A
1013
100 LEMOYNE~ PA 17043
PLEASE USE ORIGINAL FORM ONLY
Side 1
L
15056041158
6M4647 3.000
15056041158
-.J
Estate of
177-12-7571
Executors (Page 1)
Name
Address
Tax 1D
Patricia A. Wenrich
4 Laurel Drive
Mechanicsburg, PA 17055-
194-26-9266
--.J
15056042159
REV-1500 EX
Decedent's Name:S C H A F FER
RECAPITULATION
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) D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) D 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/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)
RAYMOND
Decedent's Social Security Number
177-12-7571
L
. 1. 0.00
. 2. 0.00
. 3. 0.00
. 4. 0.00
. 5. 7566.00
. 6. 0.00
. 7. 72885.00
. 8. 80451.00
. 9. 27619.00
10. 0.00
11. 27619.00
12. 52832.00
13. 21843.00
14. 30989.00
TAX COMPUTATION. SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate. or
transfers u~er See. 9116
(a)(1.2) X .0_ 0 . 00
16. Amount of Line 141axable
at lineal rate X .O~ 0 . 00
17. Amount of Line 14 taxable
at sibling rate X .12 0 . 00
18. Amount of Line 14 taxable
at collateral rate X .15 30989 . 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. 0.00
17. 0.00
18. 4648.35
19. 4648.35
D
15056042159
--.J
REV-1500 EX Page 3
Decedent's Complete Address:
File Number
0423
DECEDENTS NAME
SCHAFFER RAYMOND L
STREET ADDRESS
261 REDWOOD LANE
CUMBERLAND
CITY IISTATE I ZIP
CARLISLE PA 17013-
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
4648.35
0.00
3000.00
150.00
Total Credits (A + B + C) (2)
3150.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
0.00
0.00
0.00
Total Interest/Penalty (D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3. enter the difference. This is the OVERPAYMENT.
Fill in box on Page 2, Line 20 to request a refund. (4)
0.00
5. If Line 1 + Line 3 is greater than Line 2. enter the difference. This is the TAX DUE. (5)
1498.35
0.00
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
1498.35
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
[K]
[K]
D
[K]
D
D
D
No
D
o
[Xl
D
00
[Xl
[Xl
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1. 1994 and before January 1. 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is three (3) percent [72 P.S. 99116 (a) (1.1) (i)].
For dates of death on or after January 1. 1995. the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent
[72 P.S. 139116 (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. g9116(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. g9116(1.2) [72 P.S. g9116(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. g9116(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
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
REV-1502 EX + (6-98)
ESTATE OF
FILE NUMBER
Ravmond L. Schaffer
21 06 0423
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 knlllMedge of the relevant facts.
Real property which Is jolntly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1. None
DESCRIPTION
VALUE AT DATE
OF DEATH
3W4695 1.000
TOTAL (Also enter on line 1, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$
0.00
REV-1503 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
Raymond L. Schaffer
21 06 0423
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1. None
DESCRIPTlON
VALUE AT DATlE
OF DEATH
3W48961.000
TOTAL (Also enter on line 2. Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
0.00
REV-1504 EX + (6-98)
SCHEDULE C
CLOSELY-HELD CORPORATION,
PARTNERSHIP OR SOLE-PROPRIETORSHIP
FILE NUMBER
Ravmond L. Schaffer
21060423
Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a
sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships.
ITEM
NUMBER
DESCRIPTION
VALUE AT
DATE OF DEATH
1.
None
3W4697 1.000
TOTAL (Also enter on line 3, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$
0.00
REV.1507 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Raymond L. Schaffer
SCHEDULE D
MORTGAGES & NOTES
RECEIVABLE
FILE NUMBER
21 06 0423
All property Jolntly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
None
TOTAL (Also enter on line 4, Recapitulation) $
0.00
3W46AC 1.000
(If more space is needed, insert additional sheets of same size)
REV-1508 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Ravmond L. Schaffer
FILE NUMBER
21 06 0423
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
VALUE AT DATE
OF DEATH
1
Hoffman-Roth Funeral Home, Inc. - Refund for overpayment
on funeral expenses
2,254.00
2
Mobile Home (Sold 10/19/2006)
4,234.00
3
Veteran's Administration - Burial Allowance
1,005.00
4
Return of Security Deposit
70.00
5
Miscellaneous
3.00
3W46AD 1.000
TOTAL (Also enter on line 5 Recaoitulationl $
(If more space is needed, insert additional sheets of the same size)
7,566.00
REV-1509 EX + (6-98)
SCHEDULE F
JOINTLY-OWNED PROPERTY
COM\1ONWEA L TH OF PENNSY LV A NIA
It-J-iERrrANCETAX RETURN
RESIDENT DECED8'JT
ESTATE OF
FILE NUMBER
Raymond L. Schaffer 21 06 0423
If an asset was made joint within one year of the decedent's date of death, It must be reported on Schedule G.
SLRVIVING JOINT TENANT(S) NAME
ADDRESS
RB.A TIONSHIP TO DECEDENT
JOINTL Y-OWNED PROPERTY:
LETTER DATE DESCRIPllON OF PROPERTY %OF DA TE OF DEA TH
ITEM FOR JOIN MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DA TE OF [lEA TH DECD'S VALUE OF
NUMBER OR SIMIlAR IDENTIFYING NUMBER. ATTACH DEED FOR
NUMBER TENANT JOINT JOINTLY-HELD REAL ESTATE. VALUE OF ASSET MEREST DECEDENl'S INTEREST
None
TOTAl IAI"o "nt"r nn lin" R R i $ 0.00
(W rrore space is needed, insert addijional sheets of the same size)
3W46AE 1. 000
REV.1510 EX + (6-98)
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Raymond L. Schaffer
FILE NUMBER
21 06 0423
ITEM
NUMBE~
1.
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERlY
If'.Cl...l..OE TI-E NAME OF TI-E TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT .MCl
Tl-E DATE OF TR.AN3FER. ATTJICH A COPY OF TI-E DEED FOR REAL ESTATE.
3W46AF 1.000
National Western Life Insurance
Co. Annuity Certificate
#0101059759 (Payable to the
Schaffer Revocable Living
Trust)
2
Members First Federal Credit
Union Account #40143-11 - (Held
in the Schaffer Revocable
Living Trust)
3
Members First Federal Credit
Union Account #40143-00 (Held
in the Schaffer Revocable
Living Trust)
4
Members First Federal Credit
Union Investment Savings
Account #40143-5 (Held in the
Schaffer Revocable Living
Trust)
DATE OF DEATH
VALUE OF ASSET
% OF DECO'S
INTEREST
55,388.00 100.0000
5,119.00 100.0000
32.00 100.0000
12,346.00 100.0000
(If more space is needed, insert additional sheets of the same size)
TOTAL (Also enter on line 7, Recapitulation) $
EXCLUSION
(IF APPLlCABLEl
0.00
0.00
0.00
0.00
TAXABLE
VALUE
55,388.00
5,119.00
32.00
12,346.00
72.885.00
REV-1511 EX + (12-99)
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Raymond L. Schaffer
ITEM
NUMBER
A.
B.
3W46AG 1.000
Debts of decedent must be reported on Schedule I.
DESCRIPTION
1.
FUNERAL EXPENSES:
Hoffman-Roth Funeral Home, Inc. (Funeral bill)
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) Patricia A. Wenrich
Social Security Number(s) I EIN Number of Personal Representative(s) 194 -2 6- 92 6 6
Street Address 4 Laurel Drive
City Mechanicsburg
Year(s) Commission Paid: Pendinq
State PA
Zip 17055
2.
Attorney Fees
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
Penny G. Davis, Tax Collector for Middlesex Township
2
UGI Gas Service (heating bill)
3
PPL Electtric (electric bill)
Total from continuation schedules
FILE NUMBER
21 06 0423
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$
AMOUNT
7,240.00
4,022.00
11,753.00
154.00
73.00
251.00
139.00
3,987.00
27.619.00
Estate of: Raymond L. Schaffer
177-12-7571
Schedule H Part 7 (Page 2)
4
S&Z Painting and General Construction (mobile home
maintenance)
600.00
5
Country Manor West - April 2006 Rent for 261 Redwood
Lane, Carlisle
2,066.00
6
Miscellaneous Expenses of Administratrix (Stamps,
mailing, trash bags, travel and other misc.
expenses)
776.00
7
PA Department of Revenue
120.00
8
Codie Behrens (lawn care)
70.00
9
The Patriot News (estate publication notice)
280.00
10
Cumberland Law Journal (estate publication notice)
75.00
Total (Carry forward to main schedule)
3,987.00
REV-1512 EX + (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX REnJRN
RESIDENT DECEDENT
ESTATE OF
Raymond L. Schaffer
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
21 06 0423
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1.
None
3W46AH 2.000
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
0.00
REV-1513 EX+ (9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYL VANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Ravmond L. Schaffer
1
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions. and transfers
under Sec. 9116 (a) (1.2)]
George A. Wenrich Estate
4 Laurel Road
Mechanicsburg, PA 17055
(Pro-Rata Specific Bequest)
FILE NUMBER
21 06 0423
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
NUMBER
I
None
7,281.00
2 George A. Wenrich Estate
4 Laurel Drive
Mechanicsburg, PA 17055
(Residuary Trust Estate) None 6,864.00
3 Mary Dorman
110 Flannigan Avenue
Williamsport, PA 17701
(Pro-Rata Specific Bequest) None 7,281.00
4 Ramona Chenoweth
1 W. Penn Street, Apt. 107
Carlisle, PA 17013
(Pro-Rata Specific Bequest) None 7,281.00
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
See Attached
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
$
21. 843.00
3W46AI 1.000
(If more space IS needed, Insert additional sheets of the same size)
Local Registrar. The original certificate will be forwarded to the State Vital Rec-ords Office for permanent filing.
WARNING: It is Illegal to duplicate this copy by photostat ur photograph.
No.
~ ~.~eu-~~~
Local Registrar ....
Fee for this certificate. $6.00
p
12270215
MAR
9 2006
Date
qo
::t
qo
......
"-
qo
Hl05_143 Rev. 01106
TYPEJPRINT IN
PERMANEKT
BLACK INK
1 NameolOecedent(FlJIt,f!'iddIe,Bst)
Ra~nd L.
5. J\QefWI""""'Y)
85
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH STATHILE NUMBER
" Dec~s Usual iOO 01 WI)I); done
Servi~"~ch
Schaffer
13. DetedenI's EducaOOn 0 h"
_10-12) ColIeg'114"5+I
11
14 MariIBI Slalus.: Malried. Never married.
-.""'''"''(Speci(j!
Divorced
Qh".
10. Race: Am.rP:an IndiaftJlad. wt\k.
(Soed/)1
White
15. SuMiilg 5pouH (" wiIe.\PV'lllT8iden Rilme)
V,.
fib, ColInlyolOUlh
Q
Lebanon
......
ll)
00
00
C")
8
261 Redvlood Lane
Carlisle PA 17013
l1a.Slale
PI\.
Cunber1and
OidDecedenI
lNeina
T~~
I7c.>> Yes, Decedetlf Lived in
Middlesex
Twp.
..
11b. County
t7d.O No,Deceder1IliYedwlhin
Acl.ualUrbol
ClyAlom
Hati!y' Schaffer
19. Moth.,., Name IFni:. niOfIe, IYIIidIlft swnatnI
Mabel Arney
zoo. hbnn&nI's Malk!g Addres& ISlrIlllli. dyI\Jwn, stM. ~ cocte)
4 Laurel Dr., Mechanicsburg PA 17055
18. falhefs Nafne (FirsI,rniddle,lasI)
'*
()
208. Inlormanrs Name (Type.'prinll
George Wenrick
Cl
UJ
on
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on
""
::;
""
21C. P1ac.olDisposiion(N8Ir80ICltll1lllery,crIl'llakHyOl'Gttlefplacll)
210. lotlllir,n {C'lyAown. stall, zip code)
March 9, 2006
22b. t..Ena Nwmer
Fairview Cemetery
Allentown, PA
Hoffman-Roth Funeral Home
23b. UclJllY
II Signed (MonIh. diy, year)
24. TmtolDealh
25. Dale PJonouncad Dud (Monlh, day, year)
tft. WasCa$eRe-l&rte:d\OaMed'ul~ec?
2:45 p, II. March 5, 2006
CAUSE Of OE.\ rn (See lnstrutUons .and exampk5)
Ilem '0_ Pan I: Ental lhe ~ - diseases, in;Jries, or ~Iions -rhat dwlKlJy caused the dealh.. 00 NOT 1!f1181lemirelevenls such ascardial: anest,
respi!alofy anast 01 venlri:lMr litrilatiJn wIhoutsho~1ht. etiobgy. 00 MOl BbbI~'" E\"Aef DI'olf anetalM on a n.
...EDlATECAUSE(F..'......'" Colon Cancer with Liver metastasis
coodili:lnresulWloindealh) ~ a.
Otrl to (or IS iI consequence ot):
: ApproDrele inlIYVaJ:
: onsetlodealh
o Yas ~No
PaI1I1: En.. ohr siJniIil:anl condilions conIrbulina 10 dealh,
blinolrasullitg..DIeunderlyilgeausegiv.-.inPatlI.
28. DM:Ilol:laa::O Usa ConIrbb b Oealh?
o Vas 0 Probably
o No 0 Unknowrl
29 lIFemaIe.:
o Notpregnantwithinpasl'flllll'
o Preg\lMallimeol'deaIl
o NoI;pr~nt.bulpregnanlwthin42days
oldealh
o NoI.prs;nanl,lMPfagnanl'3 day$lD1 year
belorldaaJh
o Unknown iI pregnanl wWllhl j)a5I year
32c. ~oI~HorN.r:am\SbHl.F~,OIficI
8uiIof...el<f_
SeQUenlialy is! condiUons. ~ a~ .
leadinQIolhecaUS8 blld 011 l.i'Ie a
- Enter !he UNOERl Y1NG CAUSE
_ (d:Sweoriljurylha1inftiaied!he
~tf\~ Tesuling1'r ~ta\tll uSt
Ove 10 lor as , consequence of):
Due 10 (or as a consequena 01\.
o Yes R~
,
3lIl- W8l'rAulopsyFWMgs
Nai/ebIePriorto~
oICauseolOealh1
DYes 0 No
31. MannelOlOealh
XI Haw'. 0 HonVcide
O~ O~ImI8SligaI>>n
o Suiti:fe 0 Coulcl NoISe Oetenrftd
321. Dale 01 \ajuly {UonIIo.. day, yeaf)
32d. Trmeollnjuly
II.
321. IITransporlalion~{SpedM
o DrN'IfAJpwalQl 0 Pas.&.eng.
o P1ldesIrian 0 Oher-Specify.'
3211, locatiofl(StreeltayJtown.SlaleJ
301. Wu ,n AiAop5y
PeriDnned7
I-
:z
UJ
Cl
UJ
~
Cl
o
w
'"
<<
Z
338. Certlfter(chaC1onttone)
Ce1tItyIng physician (Physician Clltifyi'rqcsuseol dliiC when anolhl!f physician has pronounced c1ee1h and ~ Rem 23)
To ltIt beSt of my knowledge, dead1 occumd ciullo the Clus..:sl and mal1net' as stated ___0
I'tonomcing and cen\1yb'lg phy5kian (Phy5i:ian blIIh IJfOIIOllfICk'I death and car1ilying 10 dluse of death)
To the beSt 01 my knowteave, death occurred at the time, c1ale.and place. and d_to lhe UIISe(S) and lI'IIIU'ItiilS s1a1ed_____....xJ
lledk:al eumtnedcorow
On the basis 0' ~umtnallon andlllr Irwesllg.alion, In my opinion, dUlh occurred at the lime. dalt. ;md plxe. and due- 10 the ~use(s) and maMl!f as s~ted ___._0
33cL 0aI1 Signed (MonIh.c1ay, YNl")
March 5, 2ClO6
Shubha R. Acharya, M.D.
I \ ~ VA Medical Center, Lebanon, PA 17042
1.':.1 I~I lul
(See instructions and examples on reverse)
Estate of Raymond L. Schaffer
Pennsylvania Inheritance Tax Return
Form REV-1500
EXHIBIT B
Copy of the Last Will and Testament of Raymond L. Schaffer
Dated August 20, 2003
LAST WILL AND TEST AMENT
(pour-Over Will)
OF
RAYMOND L. SCHAFFER
IDENTITY
I, RAYMOND L. SCHAFFER, residing in the County of Cumberland, Commonwealth of
Pennsylvania, being of sound mind and memory, and not acting under duress or undue influence of any
person whomsoever, hereby declare this to be my Last Will and Testament, and I do hereby revoke all
other former Wills and Codicils to Wills heretofore made by me. My Social Security Number is 177-12-
7571.
r--.>
I have the following child: Diane Farrel, born C;, ~ :77
~'~ ~~~ (f; ~
DEBTS, TAXES AND ADMINISTRATION EXPENSES >'- -;i: ::--; , .~' ;i1
~~-~ '~1 ~~ -~, . Cb
I have provided for the payment of all my debts, expenses of administration of P[9P~~ wh~r~ver ('~~ ~~
situated passing under this Will or otherwise, and estate, inheritance, transfer, and succes.:~@'iaxes,:(}1her :,,1 =H
than any tax on a generation-skipping transfer that is not a liability of my Estate (inchldiirg intere~t.jll1d ;c:; ~,-;~
penalties, if any) that become due by reason of my death, under TIIE RA YMONIgL'SCHA.f-EER :..J ~2
REVOCABLE LNING TRUST executed on even date herewith (the "Revocable Trust"). l'f'the . ,
Revocable Trust assets should be insufficient for these purposes, my Executor shall pay any unpaid items
from the residue of my Estate passing under this Will, without any apportionment or reimbursement. In
the alternative, my Executor may demand in a writing addressed to the Trustee of the Trust an amount
necessary to pay all or part of these items, plus claims, pecuniary legacies, and family allowances by court
order.
PERSONAL AND HOUSEHOLD EFFECTS
It is my intent that all my personal and household effects were transferred to the Revocable Trust
as a result ofthe Declaration of Intent signed this date. Ifthere are any questions regarding the ownership
or disposition of these assets, it is my desire that such assets pour into the Revocable Trust, signed by me
this date in accordance with the provisions of the section titled "Residue of Estate."
RESIDUE OF EST A TE
I give, devise and bequeath all the rest, residue and remainder of my property of every kind and
description (including lapsed legacies and devices), wherever situated and whether acquired before or
after the execution of this Will, to the Trustee under that certain Trust executed by me on the same date of
the execution of this Will. The Trustee shall add the property bequeathed and devised by this item to the
corpus of the above described Trust and shall hold, administer and distribute said property in accordance
with the provisions of the said Trust, including any amendments thereto made before my death.
If for any reason the said Trust shall not be in existence at the time of death, or if for any reason a
court of competent jurisdiction shall declare the foregoing testamentary disposition to the Trustee under
said Trust as it exists at the time of my death to be invalid, then I give all of my Estate including the
residue and remainder thereof to that person who would have been the Trustee under the Trust, as
POUR-OVER WILL
Page 1
{~fl
Testator
Trustee, and to their substitutes and successors under the Trust, described herein above, to be held,
managed, invested, reinvested and distributed by the Trustee upon the terms and conditions pertaining to
the period beginning with the date of my death as are constituted in the Trust as at present constituted
giving effect to amendments, if any, hereafter made and for that purpose I do hereby incorporate such
Trust by reference into this my WilL
EXECUTOR
I hereby nominate and appoint George A. Weinrich to serve without bond as my Independent
Executor of this my Last Will and Testament.
Whenever the word "Executor" or any modifying or substituted pronoun therefore is used in this
my Will, such words and respective pronouns shall be held and taken to include both the singular and the
plural, the masculine, feminine and neuter gender thereof, and shall apply equally to the Executor named
herein and to any successor to substitute Executor acting hereunder, and such successor or substitute
Executor shall possess all the rights, powers, duties, authority, and responsibility conferred upon the
Executor originally named herein.
EXECUTOR POWERS
By way of lllustration and not of limitation and in addition to any inherent, implied or statutory
powers granted to executors generally, my Executor is specifically authorized and empowered with
respect to any property, real or personal, at any time held under any provision of this my Will: to allot,
allocate between principal and income, assign, borrow, buy, care for, collect, compromise claims, contract
with respect to, continue any business of mine, convert, deal with, dispose of, enter into, exchange, hold,
improve, incorporate any business of mine, invest, lease, manage, mortgage, grant and exercise options
with respect to, take possession of, pledge, receive, release, repair, sell, sue for, make distributions in cash
or in kind of partly in each without regard to the income tax basis of such asset and in general, exercise all
of the powers in the management of my Estate which any individual could exercise in the management of
similar property owned in its own right upon such terms and conditions as to my Executor may seem best,
and execute and deliver any and all instruments and do all acts which my Executor may deem proper or
necessary to carry out the purpose of this my Will, without being limited in any way by the specific grants
or power made, and without the necessity of a court order.
My Executor shall have absolute discretion, but shall not be required, to make adjustments in the
rights of any Beneficiaries, or among the principal and income accounts to compensate for the
consequences of any tax decision or election, or of any investment or administrative decision, that my
executor believes has had the effect, directly or indirectly, of preferring one Beneficiary or group of
Beneficiaries over others. In determining the Federal Estate and Income Tax liabilities of my Estate, my
Executor shall have discretion to select the valuation date and to detennine whether any or all of the
allowable administration expenses in my Estate shall be used as Federal Estate Tax deductions or as
Federal Income Tax deductions.
POUR-OVER WILL
Page 2
Q~_S
Testator
CONTESTS AND SPECIFIC OMISSIONS
If any beneficiary under this will, singly or in conjunction with any other person or persons, directly or
indirectly:
1. contests in any court the validity of this will or, in any manner, attacks or seeks to impair or
invalidate any of its provisions;
2. contests in any court the validity of the Testator'srrestatrix's Will or, in any manner, attacks or
seeks to impair or invalidate any of its provisions;
3. seeks to obtain an adjudication in any proceeding in any court that this trust or any of its
provisions or that Testator'srrestatrix's Will or any of its provisions is void;
4. claims entitlement by way of any written or oral contract to any portion of the
Testator'srrestatrix's estate, whether in probate or under this instrument;
5. unsuccessfully challenges the appointment of any person named as Executor or successor
Executor of the Testator'srrestatrix's Will;
6. objects in any manner to any action taken or proposed to be taken in good faith by the Executor
ofthe Testator's/Testatrix's Will;
7. objects to any construction or interpretation of this Will, or any provision of it, that is adopted or
is proposed in good faith by the Executor;
8. unsuccessfully seeks the removal of any person acting as the Executor of the
Testator'slTestatrix's Will;
9. files any creditor's claim in Testator'srrestatrix's estate (without regard to its validity), whether
the claim arose before or after the date of this instrument, but excepting claims for cash advanced
or paid for expenses of the Testator'srrestatrix's last illness or funeral paid by said claimant;
10. attacks or seeks to invalidate any designation of beneficiaries for any life insurance policy on
Testator'sITestatrix's life;
11. attacks or seeks to invalidate any designation of beneficiaries for any pension or IRA or other
form of qualified or non-qualified asset or deferred compensation account, agreement or
arrangement;
12. attacks or seeks to invalidate any will which TestatorlTestatrix has created or may create during
Testator's/Testatrix's lifetime, or any provision thereof, as well as any gift which
Testator/Testatrix has made or will made during Testator'slTestatrix's lifetime, whether before or
after the date of this instrument;
13. attacks or seeks to invalidate any transaction by which Testator/Testatrix sold any assets (whether
to a relative of Testator's/Testatrix's or otherwise); or
14. refuses a request of Testator's/Testatrix's, Executor or other fiduciary to assist in the defense
against any of the foregoing acts or proceedings,
then that person's right to take any interest given to him or her by this trust shall be determined as it would
have been determined if the person had predeceased the execution of this will instrument without issue
survlYmg.
The provisions of the foregoing paragraph shall not apply to any disclaimer by any person of any benefit
under this will. In the event that any of this provision is held to be invalid, void or illegal, the same shall
be deemed severable from the remainder of this provision and shall in no way affect, impair or invalidate
any other provision in this will; and if such provision shall be deemed invalid due to its scope or breadth,
such provision shall be deemed to exist to the extent of the scope or breadth permitted by law.
POUR-OVER WILL
Page 3
(:JJJ
Testator
S~ULTANEOUSDEATH
If any other Beneficiary should not survive me for sixty (60) days, then it shall be conclusively
presumed for the purpose of this my Will that said Beneficiary predeceased me.
--:>
~~~
Testator
This instnnnent consists of 6 typewritten pages, including the Attestation Clause, se~.ovin Clause,
signature of Witnesses, and...acknowledgment of officer. I have signed my name at the . 0 of each of
the ~;~es. ~s~ent is being signed by me on this day of
POUR-OVER WILL
Page 4
ATTESTATION CLAUSE
The Testator whose name appears above declared to us, the undersigned, that the foregoing
instrument was his/her Last Will and Testament, and he or she requested us to act as witnesses to such
instrument and to his/her signature thereon. The Testator thereupon signed such instrument in our
presence. At the Testator's request, the undersigned then subscribed our names to the instrument in our
own handwriting in the presence of the Testator. The undersigned hereby declare, in the presence of each
of us, that we believe the Testator to be of sound and disposing mind and memory.
Signed by us on the same day and year as this Last Will and Testament was signed by the
Testator.
WITNESSES:
ADDRESSES:
~~/h&~
() G ~ 0;-7 c JJ r kJe /tJr; c ."'-
(printed Name of Witness)
t{ t&-uPC I IJr
;II) ecl-a/uI;~' c:, t-c rs i p~ /7 oS- S~
City, State, Zip I /
~~
~d~~
nnte ame of WItness)
4fi~~e:r
~;/~/;JP
POUR-OVER WILL
Page 5
au
Testator
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SELF-PROVING CLAUSE
BEFO~ ~-1' t~ undersi~ed aut~, on this ~. so~ ~~ared)RAYMOND L.
SCHAFFER~ ~ A /LA)/~/lI6 and ~ 'l ~# ,
lmown to me to be the Testator and the witnesses, respectivelY: whose names are subscribed to the
foregoing instrument in their respective capacities, and all of them being by me duly sworn, RAYMOND
L. SCHAFFER, Testator, declared to me and to the witnesses, in my presence, that the instrument is
hislher Will and that he or she had willingly made and executed it as hislher free act and deed for the
purposes therein expressed; and the Witnesses, each on his or her oath, stated to me in the presence and
hearing of the Testator, that the Testator had declared to them that the instrument is his Will and that he or
she executed the same as such and wanted each ofthem to sign it as a witness; and upon their oaths, each
witness stated further that he or she did the same as a witness in the presence of the Testator, and at his
request and that he or she was at that time eighteen (18) years of age or over and was of sound mind, and
that each of the witnesses was then at least fourteen (14) years of age.
LJ 'f!fcJ ~~
~L. CHAFFER I
Testator
~;fhJ~
-- .
'- Wl~SS ,
(sc:=v~e- 11-.. tOe/fJrlc(
(t>rinted N me of Witness)
~
~gtf#~
(Printed Name of Witness)
FER, Testator,
and
day of
-....-~-~O'....~-,.~.,"":>
!,~~~~~~~~~;:~~~"j
POUR-OVER WILL
Page 6
IN THE MATTER OF
THE ESTATE OF RAYMOND L. SCHAFFER
Date of Death: March 5, 2006
EXHIBIT B
Copy of the of Raymond L. Schaffer
Revocable Living Trust UIA Dated July 16, 2003
Estate of Raymond L. Schaffer
Pennsylvania Inheritance Tax Return
Form REV-1500
EXHIBIT C
Copy of the Schaffer Revocable Living Trust Agreement
Dated July 16, 2003, with Amendments thereto dated:
1. August 20, 2003
2. August 20, 2003
3. August 20, 2003
4. August 20, 2003
5. Undated (Invalid)
REVOCABLE LIVING TRUST AGREEMENT
Jt ' .4llIS AGREE~NT AND DECLARATION OF TRUST, made effective th/ # day of
L/ (/ , 20 (J. , by RAYMOND L. SCHAFFER, Grantor, Settlor and Trustee, who resides
at 261 Redwood Lane, Carlisle, County of Cumberland, Commonwealth of Pennsylvania, does hereby
establish a Trust upon the conditions and for the purposes hereafter set forth.
WITNESSETH:
WHEREAS, in order to provide the future comfort and security to himself and the other
beneficiaries hereafter mentioned, Grantor desires to create a revocable trust for the purposes hereinafter
set forth;
ARTICLE ONE
Terms of the Trust
Section 1.01 - Trust Estate Defined
NOW, THEREFORE, in consideration of the premises and of the Covenants herein contained this
Revocable Trust is formed to hold title to real and personal property for the benefit of the Settlor of this
Trust and to provide for the orderly use and transfer of these assets upon the death of the Settlor. The
"Trust Estate" is defined as all property transferred or conveyed to and received by the Trustee held
pursuant to the terms of this instrument. The Trustee is required to hold, administer, and distribute this
property as provided in this Trust Agreement.
The name of this Trust Agreement shall be:
THE RAYMOND L. SC:1;HAF. REVOC~LE LIVING TRUST AGREEMENT
DATE V:' )6 200
, , --
Section 1.02 - Definitions of Terms
As used in this Trust Agreement:
1. The term "Settlor" shall mean RAYMOND L. SCHAFFER.
2. The term .'Descendant" shall mean the lawful issue of a deceased parent in the line of
descent, but does not include the issue of any parent who is a descendant of the deceased
person in question and who is living at the time in question.
3. The terms "Child" and "Descendant" include any issue born to decedent, a child legally
~dopted by the decedent, and a posthumous child of a decedent. A posthumous child is to
be considered as living at the time of his or her parent's death.
4. The term "Survives" or "Surviving", unless otherwise indicated herein, shall be construed
to mean surviving the decedent for at least sixty (60) days. If the person referred to dies
REVOCABLE LIVING TRUST AGREEMENT
Page 1
within sixty (vv) days of the death of the decedent, the reterence to him or her will be
construed as if he or she had failed to survive the decedent; provided, however, that any
such person will have, during such period, the right to the use and enjoyment as a life
tenant of all property in which his or her interest will fail by reason of death during such
period.
5. The term "Issue" will include all natural and adopted children, if applicable, and
descendants and those legally adopted into the line of descent.
6. The term "Per Stirpes" means strict per stirpes and does not mean per capita with
representation. Beneficiaries entitled to take under a "per stirpes" clause will include
both natural and adopted children and their descendants.
7. The terms "Trust Assets" and "Trust Estate" include all assets of any trust created
hereunder and income derived from such assets and all proceeds of any description
derived from the sale, exchange, or other disposition of such assets.
8. When required to give reasonable effect to the context in which used, pronouns in the
masculine, feminine, or neuter gender include each other, and nouns and pronouns in the
plural or singular number include each other.
Section 1.03 - Trustee Designation
Settlor is hereby designated as Trustee. The term "Trustee" as used in this Trust Agreement shall refer to
Settlor so long as he or she serves as Trustee, and/or to any successor Trustee who assumes the role of
Trustee. These Trustees shall serve in the order as provided in Section 8.01 of this Trust Agreement.
Section 1.04 - Additions to Trust Properties
1. The Trustee, at any time during the continuance of this Trust in his or her sole discretion after
consideration of the possible tax consequences to all concerned, is authorized to receive into the
Trust additions of cash and other properties from any source whatsoever, whether by gift, will, or
otherwise. However, the Trustee shall accept all assets which any person or persons may give,
devise, or bequeath by Last Will and Testament to this Trust, and shall accept all assets
transferred to this Trust pursuant to the provisions of any other Trust document or documents.
2. In addition, any person or persons may designate this Trust as the Beneficiary, Primary or
Contingent, of any death benefits to include insurance benefits, pension benefits, or other
benefits. Until such benefits mature, the Trustee shall have no responsibility with respect to those
benefits.
Section 1.05 - Apportionment
The Trustee of the Trust is directed to apportion receipts and expenditures of the types described below
between principal and income as follows:
1. Whenever the principal, or any part thereof, of the Trust property is invested in secuntIes
purchased at a premium or at a discount, any premium will be charged against principal and any
discount will be credited to principal;
REVOCABLE LIVING TRUST AGREEMENT
Page 2
2 Any stock dividends aIill rights to purchase additional stock issued on securities held in trust will
be treated as principal. All other dividends, except liquidating distributions, will be treated as
income; and
3. The amount of any applicable depletion allowance for federal income tax purposes will be treated
as mcome.
Section 1.06 - Discretionary Termination
The Trustee may terminate any Trust when, in the opinion of the Trustee, the principal is reduced to such
an extent that it is not in the best interest of the Beneficiary or Beneficiaries to continue the Trust. The
judgment of the Trustee with respect to this decision to terminate will be final and not subject to judicial
review. If the Trustee terminates a Trust according to this Section, the date the Trust terminates will be
deemed the date fixed for termination of the Trust, and the Trustee will distribute the assets of the
terminating Trust to the Beneficiary or Beneficiaries pursuant to this Agreement.
Section 1.07 - Amendment and Revocation
At any time during the life of the Settlor, the Settlor may, by a duly executed instrument filed with the
Trustee:
1. Amend this Trust Agreement in any manner; and/or
2. Revoke this Trust Agreement in part or in whole. Ifthe Trust Agreement is revoked in whole, the
Trustee shall transfer title to all Trust property of every kind and description back into the
individual name of the Settlor. The instrument of amendment or revocation shall be effective
immediately upon its proper execution by the Settlor, but until a copy has been received by a
Trustee, that Trustee shall not incur any liability or responsibility either (i) for failing to act in
accordance with such instrument or (ii) for acting in accordance with the provisions of this Trust
Agreement without regard to such instrument.
3. Withdraw from the Trust Estate all or any part of the principal and accumulated income of the
Trust to satisfy liabilities lawfully incurred in the administration of this Trust.
Section 1.08 - Revocation or Alteration by Settlor Alone
The rights of revocation, withdrawal, alteration, and amendment reserved in this Article may only be
exercised by the Settlor and may not be exercised by any other person, including an agent, a guardian, or
a conservator.
Section 1.09 - Irrevocability
Except as otherwise provided, on the death of Settlor, the designation of Beneficiaries of specific gifts in
this Trust shall become irrevocable and not subject to amendment or modification.
Section 1.10 - Settlor Powers
The Settlor shall be the Trustee unless and until he or she resigns in writing or is determined incompetent
under the terms provided herein. The Settlor shall retain all absolute rights to discharge or replace any
Successor Trustee so long as the Settlor is competent.
REVOCABLE LIVING TRUST AGREEMENT
Page 3
ARTICLE TWO
Trust Administration
Section 2.01 - Trust Income
During the life of the Settlor, the Trustee shall at least annually, unless otherwise directed by Settlor in
writing, pay to or apply for the benefit of Settlor, all of the net income from the Trust Estate.
Section 2.02 - Protection of Settlor in Event of Incapacity
During the life of the Settlor, should Settlor become incapacitated as defined in Section 2.03 below, the
Trustee may, in the Trustee's absolute discretion, pay income and principal for the benefit of the
incapacitated Settlor, and may pay to or apply for the benefit of that Settlor such sums from the net
income and from the principal of the Estate ofthe Trustee, in the Trustee's absolute discretion, believes is
necessary or advisable for the medical care, comfortable maintenance, and welfare ofthe Settlor.
Section 2.03 - Incapacity
In the event that any Trustee or any Beneficiary hereunder comes into possession of any of the following:
1. A jurisdictionally applicable court order holding the party to be legally incapacitated to act on his
or her behalf and appointing a guardian or conservator to act for him or her; or
2. Written certificates which are duly executed, witnessed, and acknowledged of two licensed
physicians, each certifying that the physician has examined the person and has concluded that, by
reason of accident, mental deterioration, or other cause, such person has become incapacitated
and can no longer act rationally and prudently in his or her own financial best interest; or
3. Evidence which such Trustee or Beneficiary deems to be credible and currently applicable that a
person has disappeared, is unaccountably absent, or is being detained under duress, and that he or
she is unable to effectively and prudently look after his or her own best interests, then in that
event and under those circumstances:
a. Such person is deemed to have become incapacitated, as that term is used in this Trust
agreement; and
b. Such incapacity is deemed to continue until such court order, certificates, and I or
circumstances are inapplicable or have been revoked.
A physician's certificate to the effect that the person is no longer incapacitated shall revoke a certificate
declaring the person incapacitated. The certificate which revokes the earlier certificate may be executed
by either the original certifying physician or by two other licensed, board certified physicians. No Trustee
shall be under any duty to institute any inquiry into a person's possible incapacity. The reasonable
expense of any such inquiry shall be paid from the Trust Assets.
Section 2.04 - Principal Invasion
During the life of the Settlor, should the net income of assets contained in this Trust at the time of the
Settlor's death be insufficient to provide for the care, maintenance, or support of the Settlor as herein
defined, the Trustee may, in the Trustee's sole and absolute discretion, pay to or apply for the benefit of
the Settlor or any of their dependents, such amounts from the principal of the Trust Estate as the Trustee
deems necessary or advisable for the care, maintenance, or support of the Settlor.
REVOCABLE LIVING TRUST AGREEMENT
Page 4
Section 2.05 - Residence
If the Settlor's residence property is a part of the Trust, the Settlor shall have possession of and full
management of the residence and shall have the right to occupy it free of rent. Any expenses arising from
the maintenance of the property and from all taxes, liens, assessments, and insurance premiums, are to be
paid from the Trust to the extent that assets are available for payment. It is the intent of the Grantor to
retain all homestead rights available to him or her under the applicable state law.
ARTICLE THREE
AdministrationIDistribution of Trust
Section 3.01 - Death
On the death of the Settlor, the Trustee shall distribute the principal of the Trust and any accrued or
undistributed income from the principal of the Trust in such a manner and to such persons, including the
Estate of the Creditors, as directed in this Trust Agreement.
Section 3.02 - Payment of Death Expenses
On the death of the Settlor, the Trustee shall pay from the Trust Estate constituting the Settlor's last
illness, funeral, burial and any inheritance, estate, or death taxes that may be due by reason of the Settlor's
death, unless the Trustee in his or her absolute discretion determines that other adequate provisions have
been made for the payment of such expenses and taxes.
Section 3.03 - Trust Income and Principal Distribution
1. The Trustee shall apply and distribute the net income and principal of each of the shares of the
resulting Trust Estate, after giving effect to the section of this Trust Agreement entitled "Special
Directives" to the following Beneficiaries in the indicated fractional shares:
Miriam L. Brown
Howard R. Brown
1/2
1/2
2. If any of the above Beneficiaries, or any other Beneficiary, is under the age of 21 years when the
distribution is to be made, the Trustee shall have authority to distribute the same, in whole or in
part, to a custodian for the minor appointed under a Uniform Gifts or Transfers to Minors Act, or
the Trustee may retain any such property and administer and distribute the same for the benefit of
the minor, paying to or for the benefit of such minor so much of the income and principal of the
retained property from time to time as the Trustee deems advisable for the health, education,
support, and maintenance of the minor. When the person for whom the property is held attains
the age of 21 years, the property shall thereupon be distributed to him or her free of trust unless
otherwise stated in this Agreement. If the minor should die before attaining the age of majority,
the property shall then be paid and distributed to the estate of the minor.
3. If all of the Settlor's Beneficiaries and their children should fail to survive the final distribution of
the Trust Estate, all of the Trust Estate not disposed of as hereinabove provided shall be
distributed as provided for in this Trust Agreement.
REVOCABLE LIVING TRUST AGREEMENT
Page 5
Section 3.04 - Principle of Representation
If a Beneficiary of the Settlor should fail to survive to collect his or her share, that share shall pass to the
surviving issue of that deceased Beneficiary per stirpes and with right of representation.
ARTICLE FOUR
Trustee Powers & Provisions
Section 4.01 - Non-Income Producing Property
During the life of the Settlor, the Trustee is authorized to retain in the Trust, for so long as the Trustee
may deem advisable, any property received by the Trustee from the Settlor, whether or not such property
is of the character permitted by law for the investment of Trust funds.
Section 4.02 - Trustee Powers
The Trustee shall have all powers conferred upon a Trustee by law for the orderly administration of the
TIUst Estate. If any property is distributed outright under the provision of this TIUst Agreement to a
person who is a minor, distribution may be made under the Pennsylvania Uniform Transfer to Minors Act
("P AUTMA"). The Trustee is further authorized to sign, deliver, and/or receive any documents necessary
to carry out the powers contained within this Section.
The Trustee of any trust created under this Trust Agreement (including any substitute or successor
Trustee) will have and be subject to all of the powers, duties, and responsibilities granted or imposed by
the Pennsylvania Consolidated Statutes (20 Pa. e.S. Section 101 et seq.) as such Statute may provide at
the time of administration of the Trust, except to the extent that the same are inconsistent with the
provisions of this Agreement.
Section 4.03 - Specific Powers of Trustee
In addition, the Trustee will have the following specific powers:
1. Trust Estate: The Trustee may leave invested any property coming into its hands hereunder in
any form of investment even though the investment may not be of the character of investments
permitted by law to trustees, without liability for loss or depreciation in value. The Trustee may
sell, mortgage, exchange, or otherwise dispose of and reinvest property which may at any time be
a part of the Trust Estate upon such terms and conditions as the Trustee may deem advisable.
The Trustee may invest and reinvest the Trust Assets from time to time in any property, real,
personal, or mixed, including without limitation, securities of domestic and foreign corporations
and investment trusts or companies, bonds, debentures, preferred stocks, common stocks,
mortgages, mortgage participation, and interests in common trust funds, all with complete
discretion to convert realty into personalty or personalty into realty or otherwise change the
character of the Trust Estate, even though such investment (by reason of its character, amount,
proportion to the total Trust Estate, or otherwise) would not be considered appropriate for a
fiduciary apart from this provision and even though such investment caused part or all of the total
Trust Estate to be invested in investments of one type or of one business or company.
2. Holding Property: The Trustee may hold property in the Trustee's name, as trustee, or in the
name of a nominee without disclosing the Trust.
REVOCABLE LIVING TRUST AGREEMENT
Page 6
3.. Release of Power: 11 the Trustee deems it to be in the best interest of the Trust and its
Beneficiaries, the Trustee, by written instrument signed by such Trustee, will have the power and
authority to release, disclaim, or restrict the scope of any power or discretion granted in this Trust
Agreement or implied by law.
4. Agents, Employees: The Trustee may employ one or more agents to perform any act of
administration, whether or not discretionary, including attorneys, auditors, investment managers,
or others, as the Trustee shall deem necessary or advisable. The Trustee may compensate agents
and other employees and may delegate to them any and all discretions and powers.
5. Leases: The Trustee may lease any Trust Assets generally or for oil, gas, and mineral
development, even though the lease term may extend beyond the term of the Trust of which the
property is a part. The Trustee may enter into any covenants and agreements relating to the
property so leased or concerning any improvements which may then or thereafter be erected on
such property.
6. Common Funds: The Trustee may hold any of the Trust Assets in a common fund with property
from other trust estates and may make investments jointly with any other trust, the property of
which is included in the common fund.
7. Securities: With respect to securities held in the Trust Estate, the Trustee may exercise all the
rights, powers, and privileges of an owner, including but not limited to, the power to vote, give
proxies, and to pay assessments and other sums deemed by the Trustee necessary for the
protection of the Trust Estate. In addition, the Trustee may participate in voting trusts,
foreclosures, reorganizations, consolidations, mergers, and liquidations, and in connection
therewith, to deposit securities with and transfer title to any protective or other committee under
such terms as the Trustee may deem advisable. In addition, the Trustee may exercise or sell stock
subscription or conversion rights and may accept and retain as an investment any securities or
other property received through the exercise of any of the foregoing powers, regardless of any
limitations elsewhere in this instrument relative to investments by the Trustee.
8. Purchases from Estate: The Trustee may purchase property of any kind from the Executor or
Administrator of the Estates.
9. Lending: The Trustee may make loans, secured or unsecured, to the Executor or Administrator
of the Estate, to any Beneficiary of the Trust, or to the Trustee. Further, the Trustee may use
Trust Assets to guarantee obligations of any income Beneficiary of the Trust (unless such
Beneficiary is serving as Trustee).
10. Distributions to or for Beneficiaries: The Trustee may make any distribution contemplated by
this Trust Agreement (l) to the Beneficiary; (2) if the Beneficiary is under a legal disability or if
the Trustee determines that the Beneficiary is unable to properly manage his or her affairs, to a
person furnishing support, maintenance, or education for the Beneficiary or with whom the
Beneficiary is residing for expenditures on the Beneficiary's behalf; or (3) if the Beneficiary is a
minor, to a trustee of an existing trust established exclusively for the benefit of such minor,
whether created by this Trust Agreement or otherwise, or to a custodian for the Beneficiary, as
selected by the Trustee, under the Pennsylvania Uniform Transfer to Minors Act. Alternatively,
the Trustee may apply all or a part of the distribution for the Beneficiary's benefit. Any
distribution under this paragraph will be a full discharge of the Trustee with respect thereto. On
any partial or final distribution of the Trust Assets, the Trustee may apportion and allocate the
assets of the Trust Estate in cash or in kind, or partly in cash and partly in kind, or in undivided
interests in the manner deemed advisable at the discretion of the Trustee and to sell any property
REVOCABLE LIVING TRUST AGREEMENT
Page 7
deemed necessary by tht: Trustee to make the distribution. The Trustee may distribute gifts of up
to the maximum allowable per year per donee out of principal and/or interest.
11. Insurance: The Trustee may purchase new life insurance, pay the premiums on existing life
insurance on the life of any Trust Beneficiary, purchase annuities (either commercial or private)
from any corporation, trust, or individual, and may procure and pay the premiums on other
insurance of the kinds, forms, and amounts deemed advisable by the Trustee to protect the
Trustee and the Trust Estate.
12. Borrowing: The Trustee may borrow money from the Trust Estate and others. To secure the
repayment thereof, the Trustee may mortgage, pledge, or otherwise encumber part or all of the
Trust Assets, and in connection with the acquisition of any property, the Trustee may assume a
liability or may acquire property subject to a liability.
13. Repairs: The Trustee may make ordinary and extraordinary repairs and alterations to buildings
or other Trust Assets.
14. Reserves: The Trustee may establish such reserves out of income for taxes, assessments, repair,
and maintenance as the Trustee considers appropriate.
15. Continuation of Business: The Trustee may continue any business or businesses in which the
Trust has an interest at the time of the Settlor's death for so long as the Trustee may, in its sole
discretion, consider necessary or desirable, whether or not the business is conducted by the Settlor
at the time of his/her death individually, as a partnership, or as a corporation wholly owned or
controlled by him, with full authority to sell, settle, and discontinue any of them when and upon
such terms and conditions as the Trustee may, in its sole discretion, consider necessary or
desirable.
16. Retain Property for Personal Use: The Trustee may retain a residence or other property for the
personal use of a Beneficiary and to allow a Beneficiary to use or occupy the retained property
free of rent and maintenance expenses.
17. Dealings with Third Parties: The Trustee may deal with any person or entity regardless of
relationship or identity of any Trustee to or with that person or entity. The Trustee may hold or
invest any part of or all of the Trust Estate in common or undivided interests with that person or
entity.
18. Partitions, Divisions, Distributions: The Trustee will have the power to make all partitions,
divisions, and distributions contemplated by this Trust Agreement. Any partitions, divisions, or
other distributions may be made in cash, in kind, or partly in cash and partly in kind, in any
manner that the Trustee deems appropriate (including composing shares differently). The Trustee
may determine the value of any property, which valuation will be binding on all Beneficiaries.
No adjustments are required to compensate for any partitions, divisions, or distributions having
unequal consequences to the Beneficiaries.
19. Claims, Controversies: The Trustee may maintain and defend any claim or controversy by or
against the Trust without the joinder or consent of any Beneficiary. The Trustee may commence
or defend at the expense of the Trust any litigation with respect to the Trust or any property of the
Trust Estate as the Trustee may deem advisable. The Trustee may employ, for reasonable
compensation, such counsel as the Trustee shall deem advisable for that purpose.
REVOCABLE LIVING TRUST AGREEMENT
Page 8
20. Merger of Trusts: If in any time the Trustee of any trust created hereunder shall also be acting as
trustee of any other trust created by trust instrument or by trust declaration for the benefit of the
same beneficiary or beneficiaries and upon substantially the same terms and conditions, the
Trustee is authorized and empowered, if in the Trustee's discretion such action is in the best
interest of the Beneficiary or Beneficiaries, to transfer and merge all of the assets then held under
such trust created pursuant to this Trust Agreement to and with such other trust and thereupon to
terminate the trust created pursuant to this Trust Agreement. The Trustee is further authorized to
accept the assets of any other trust which may be transferred to any trust created hereunder and to
administer and distribute such assets and properties so transferred in accordance with the
provisions of this Agreement.
21. Termination of Small Trust: Any corporate Trustee which is serving as the sole Trustee of any
Trust or any Share thereof may at any time terminate such Trust or Share if, in the Trustee's sole
judgment, the continued management of such Trust or Share is no longer economical because of
the small size of such Trust or Share and if such action will be deemed to be in the best interests
of the Beneficiary or Beneficiaries. In case of such termination, the Trustee will distribute
forthwith the share of the Trust Estate so terminated to the income Beneficiary, per stirpes. Upon
such distribution, such Trust or Share will terminate and the Trustee will not be liable or
responsible to any person or persons whomsoever for its action. The Trustee will not be liable for
failing or refusing at any time to terminate any Trust or a Share thereof as authorized by this
paragraph.
22. Power to Determine Income and Principal: Dividends payable in stock of the issuing
corporation, stock splits, and capital gains will be treated as principal. Except as herein otherwise
specifically provided, the Trustee will have full power and authority to determine the manner in
which expenses are to be borne and in which receipts are to be credited as between principal and
income. The Trustee has the power to determine what will constitute principal or income and
may withhold from income such reserves for depreciation or depletion as the Trustee may deem
fair and equitable. In determining such matters, the Trustee may give consideration to the
provisions of the Pennsylvania Statutes (or its successor statutes) relating to such matters, but it
will not be bound by such provisions.
23. Generation-Skipping Taxes and Payment: If the Trustee considers any distribution or
termination of an interest or power hereunder as a distribution or termination subject to a
generation-skipping tax, the Trustee is authorized:
a. To augment any taxable distribution by an amount which the Trustee estimates to be
sufficient to pay such tax and charge the same to the particular trust to which the tax
related without adjustment of the relative interests of the Beneficiaries;
b. To pay such tax, in the case of a taxable termination, from the particular trust to which
the tax relates without adjustment of the relative interests of the Beneficiaries. If such tax
is imposed in part by reason of the Trust Assets, the Trustee will pay only the portion of
such tax attributable to the taxable termination hereunder taking into consideration
deductions, exemptions, credits, and other factors which the Trustee deems advisable;
and
c. To postpone final termination of any particular trust and to withhold any portion or all of
the Trust Estate until the Trustee is satisfied that the Trustee no longer has any liability to
pay any generation-skipping tax with reference to such trust or its termination.
REVOCABLE LIVING TRUST AGREEMENT
Page 9
Section 4.04 - Special ProvisiuJ1 for S Corporation Stock
Notwithstanding what is otherwise provided in this Trust Agreement, if at any time the Trust contains any
stock of a corporation which elects or has elected treatment as an "S Corporation" as defined by Section
1361(a)(1) of the Internal Revenue Code (or any corresponding successor statute), such stock will be
segregated from the other assets of such and treated as a separate trust. The Trustee will further divide the
separate trust into shares for each Beneficiary and such shares will be distributed outright or held in trust
as herein provided. In addition, all other provisions of this Trust Agreement will apply to each share held
in trust (and constituting a separate trust) except that the Trustee will distribute all of the income from
each separate trust to its Beneficiary in convenient installments at least annually. It is the Settlor's intent
that each separate trust will be recognized as a "Qualified Subchapter S Trust" ("QSST") under Section
136l(d)(2) of the Internal Revenue Code (or any corresponding successor statute). Notwithstanding any
provisions of this Trust Agreement to the contrary, the Trustee's powers and discretions with respect to
the administration of each separate trust (including methods of accounting, bookkeeping, making
distributions, and characterizing receipts and expenses) will not be exercised or exercisable except in a
manner consistent with allowing each separate trust to be treated as a QSST as above described.
ARTICLE FIVE
Trustee Powers with a Probate Estate
Section 5.01 - Coordination with Settlor's Probate Estate
1. At any time during the continuance of this Trust, including subsequent to the death of Settlor, the
Trustees may, in their sole and uncontrolled discretion, distribute to the deceased Settlor's
Probate Estate cash and/or other property as a Beneficiary of the Trust.
2. All other provisions to the contrary notwithstanding, under no circumstances shall any restricted
proceeds, as hereinafter defined, be either directly or indirectly: (i) distributed to or for the benefit
of the Settlor's Executors or the Settlor's Probate Estate; or (ii) used to pay any other obligations
of the Settlor's Estate. The term "Restricted Proceeds" means:
a. All qualified plans, individual retirement accounts, or similar benefits which are received
or receivable by any Trustee hereunder, and which are paid solely to a Beneficiary other
than the Executor of the Settlor's Gross Estate for Federal Estate Tax purposes; and
b. All proceeds of insurance on the Settlor's life which, if paid to a Beneficiary other than
the Settlor's Estate, would be exempt from inheritance or similar death taxes under
applicable state death laws.
Section 5.02 - Direction to Minimize Taxes
In the administration of the Trust hereunder, its Fiduciaries shall exercise all available tax related
elections, options, and choices in such a manner as they, in their sole but reasonable judgment (where
appropriate, receiving advice of tax counsel), believe will achieve the overall minimum in total combined
present and reasonably anticipated future administrative expenses and taxes of all kinds. This applies not
only to said Trust, but also to its Beneficiaries, to the other Trusts hereunder and their Beneficiaries, and
to the Settlor's Probate Estate.
Without limitation on the generality of the foregoing direction (which shall to that extent supercede the
usual fiduciary duty of impartiality), such Fiduciaries shall not be accountable to any person interested in
this Trust or to Settlor's Estate for the manner in which they shall carry out this direction to minimize
REVOCABLE LIVING TRUST AGREEMENT
Page 10
overall taxes and expenses (imauding any decision they may make not to incur the expense of a detailed
analysis of alternative choices). Even though their decisions in this regard may result in increased taxes
or decreased distributions to the Trust, to the Estate, or to one or more Beneficiaries, the Fiduciaries shall
not be obligated for compensation readjustments or reimbursements which arise by reason of the manner
in which the Fiduciaries carry out this direction.
Section 5.03 - Judgment and Discretion of Trustee
In the absence of proof of bad faith, all questions of construction or interpretation of any trusts created by
this Trust Agreement will be finally and conclusively determined solely by the Trustee, according to the
Trustee's best judgment and without recourse to any court. Each determination by the Trustee is binding
on the Beneficiaries and prospective Beneficiaries hereunder, both in being and unborn, as well as all
other persons, firms, or corporations. The Trustee, when exercising any discretionary power relating to
the distribution or accumulation of principal or income or to the termination of any trust, will be
responsible only for lack of good faith in the exercise of such power. Each determination may be relied
upon to the same extent as if it were a final and binding judicial determination. In the event of a conflict
between the provisions of this Trust Agreement and those of the Pennsylvania Statutes, the provisions of
this Agreement will control.
ARTICLE SIX
Resolution of Conflict
Section 6.01 - Resolution of Conflict
Any controversy between the Trustee or Trustees and any other Trustee or Trustees, or between any other
parties to this Trust, including Beneficiaries, involving the construction or application of any of the terms,
provisions, or conditions of this Trust shall, on the written request of either or any disagreeing party
served on the other or others, shall be submitted to arbitration. The parties to such arbitration shall each
appoint one person to hear and determine the dispute and, if they are unable to agree, then the two persons
so chosen shall select a third impartial arbitrator whose decision shall be final and conclusive upon both
parties. The cost of arbitration shall be borne by the losing party or in such proportion as the arbitrator(s)
shall decide. Such arbitration shall comply with the commercial arbitration rules of the American
Arbitration Association, 140 West 51st Street, New York, NY 10200.
Section 6.02 - Incontestability
The beneficial provisions of this Trust Agreement are intended to be in lieu of any other rights, claims, or
interests of whatsoever nature, whether statutory or otherwise, except bona fide pre-death debts, which
any Beneficiary hereunder may have in Settlor's Estate or in the properties in trust hereunder.
Accordingly, if any Beneficiary hereunder asserts any claim (except a legally enforceable debt), statutory
election, or other right or interest against or in Settlor's Estate, or any properties of this Trust, other than
pursuant to the express terms hereof, or directly or indirectly contests, disputes, or calls into question,
before any court, the validity of this Trust Agreement, then:
1.. Such Beneficiary shall thereby absolutely forfeit any and all beneficial interests of whatsoever
kind and nature which such Beneficiary or his or her heirs might otherwise have under this Trust
Agreement and the interests of the other Beneficiaries hereunder shall thereupon be appropriately
and proportionately increased; and
REVOCABLE LIVING TRUST AGREEMENT
Page 11
2. All of the provisions 01 this Trust Agreement, to the extent that they confer any benefits, powers,
or rights whatsoever upon such claiming, electing, or contesting Beneficiary, shall thereupon
become absolutely void; and
3. Such claiming, electing, or contesting Beneficiary, if then acting as a trustee hereunder, shan
automatically cease to be a Trustee and shall thereafter be ineligible either to select, remove, or
become a Trustee hereunder.
Section 6.03 - Trust Contests and Specific Omissions
If any beneficiary under this trust, singly or in conjunction with any other person or persons, directly or
indirectly:
1. contests in any court the validity of this trust or, in any manner, attacks or seeks to impair or
invalidate any of its provisions;
2. contests in any court the validity of the Settlor's Trust or, in any manner, attacks or seeks to
impair or invalidate any of its provisions;
3. seeks to obtain an adjudication in any proceeding in any court that this trust or any of its
provisions or that Settlor's Trust or any of its provisions is void;
4. claims entitlement by way of any written or oral contract to any portion of the Settlor's estate,
whether in probate or under this instrument;
5. unsuccessfully challenges the appointment of any person named as Trustee or successor Trustee
of this Trust,
6. objects in any manner to any action taken or proposed to be taken in good faith by the Trustee
Settlor's Trust;
7. objects to any construction or interpretation of this Trust, or any provision of it, that is adopted or
is proposed in good faith by the Trustee;
8. unsuccessfully seeks the removal of any person acting as Trustee of any Trust created under this
instrument;
9. files any creditor's claim in Settlor's estate (without regard to its validity), whether the claim arose
before or after the date of this instrument, but excepting claims for cash advanced or paid for
expenses of the Settlor's last illness or funeral paid by said claimant;
10. attacks or seeks to invalidate any designation of beneficiaries for any life insurance policy on
Settlor's life;
11. attacks or seeks to invalidate any designation of beneficiaries for any pension or IRA or other
form of quahfied or non-qualified asset or deferred compensation account, agreement or
arrangement;
12. attacks or seeks to invalidate any trust which Settlor has created or may create during Settlor's
lifetime, or any provision thereof, as well as any gift which Settlor has made or will made during
Settlor's lifetime, whether before or after the date of this instrument;
13. attacks or seeks to invalidate any transaction by which Settlor sold any assets (whether to a
relative of Settlor's or otherwise); or
14. refuses a request of Settlor's Trustee, Executor or other fiduciary to assist in the defense against
any of the foregoing acts or proceedings,
then that person's right to take any interest given to him or her by this trust shall be determined as it would
have been determined if the person had predeceased the execution of this trust instrument without issue
survlVmg.
REVOCABLE LIVING TRUST AGREEMENT
Page 12
111e provisions of the foregoing paragraph shall not apply to any disclaimer oy any person of any benefit
under this trust or under the Settlor's Trust. In the event that any provision of this Article is held to be
invalid, void or illegal, the same shall be deemed severable from the remainder of the provisions of this
Article and shall in no way affect, impair or invalidate any other provision in this Article; and if such
provision shall be deemed invalid due to its scope or breadth, such provision shall be deemed to exist to
the extent of the scope or breadth permitted by law.
Section 6.04 - Benefits Confidential
The Settlor further declare that it is hislher desire and intent that the provisions of this Trust Agreement
are to remain confidential as to all parties. The Settlor directs that only the information concerning the
benefits paid to any particular Beneficiary shall be revealed to such individual and that no individual shall
have a right to information concerning the benefits being paid to any other Beneficiary.
ARTICLE SEVEN
General Provisions
Section 7.01 - Distribution in Kind or in Cash
On any division of the assets of the Trust Estate in to shares or partial shares, and on any final or partial
distribution of the assets of the Trust Estate, the Trustee, at his or her absolute discretion, may divide and
distribute undivided interests of such assets on a pro rata or non-pro rata basis, or may sell any part of or
all of such assets and may make divisions or distributions in cash or partly in cash and partly in kind. The
decision of the Trustee, either prior to or on any division or distribution of such assets, as to what
constitutes a proper division of such assets of the Trust Estate, shall be binding on all persons interested in
any trust provided for in this Trust Agreement.
Section 7.02 - Spendthrift Provision
Neither the principal nor the income of the trust shall be liable for the debts of a Beneficiary. Except as
otherwise expressly provided in this Agreement, no Beneficiary of any trust shall have any right, power,
or authority to alienate, encumber, or hypothecate his or her interest in the principal or income of this
Trust in any manner, nor shall the interests of any Beneficiary be subject to the claims of his or her
creditors or liable to attachment, execution, or other process of law. The limitations herein shall not
restrict the exercise of any power of appointment or the right to disclaim.
Section 7.03 - Definition of Children
The terms "Child" and "Children" as used in this Agreement mean the lawful issue of a Settlor. This
definition also includes children legally adopted by a Settlor.
Section 7.04 - Handicapped Beneficiaries
Any Beneficiary who is determined by a court of competent jurisdiction to be incompetent shall not have
any discretionary rights of a Beneficiary with respect to this Trust, or to their share or portion thereof.
The Trustee shall hold and maintain such incompetent Beneficiary's share ofthe Trust estate and shall, in
the Trustee's sole discretion, provide for such Beneficiary as that Trustee would provide for a minor.
Notwithstanding the foregoing, any Beneficiary who is diagnosed for the purposes of governmental
benefits (as hereinafter delineated) as being not competent or as being disabled, and who shall be entitled
to governmental support and benefits by reason of such incompetency or disability, shall cease to be a
Beneficiary of this Trust. Likewise, they shall cease to be a Beneficiary if any share or portion of the
REVOCABLE LIVING TRUST AGREEMENT
Page 13
principal or income of the TruSI shall become subject to the claims of any governmental agency for costs
or benefits, fees, or charges.
The portion of the Trust Estate which, absent the provisions of this section, would have been the share of
such incompetent or handicapped person shall be retained in trust for as long as that individual lives. The
Trustee, at his or her sole discretion, shall utilize such funds for the maintenance of that individual. If
such individual recovers from his or her incompetency or disability and is no longer eligible for aid from
any governmental agency, including costs or benefits, fees, or charges, such individual shall be reinstated
as a Beneficiary after 60 days from such recovery and the allocation and distribution provisions as stated
herein shall apply to that portion of the Trust Estate which is held by the Trustee subject to the foregoing
provisions of this section. If said handicapped Beneficiary is no longer living and shall leave children
then living, the deceased child's share shall pass to those children per stirpes. If there are no children, the
share shall be allocated proportionately among the remaining Beneficiaries.
ARTICLE EIGHT
Successor Trustee Appointments
Section 8.01 - Trustees
All Trustees are to serve without bond. The following will act as Trustees of any Trusts created by this
Trust Agreement, in the following order of succession:
First:
The undersigned, Raymond L. Schaffer
Second:
At the death or incapacity of Raymond L. Schaffer, Miriam L. Brown shall
serve as First Successor Trustee.
Third:
Howard R. Brown shall serve as Second Successor Trustee.
Last:
A Trustee chosen by the majority of Beneficiaries, with a parent or legal guardian
voting for minor Beneficiaries; provided, however, that the children of any
deceased Beneficiary shall collectively have only one vote.
Section 8.02 - Allocation and Distribution of The Trust Assets
The Trustees shall allocate, hold, administer, and distribute the Trust Assets as hereinafter provided:
1. Upon the death of the Settlor, the Trustee shall make any separate distributions the Trust Assets
in the manner hereinafter prescribed.
Section 8.03 - Personal Property Distribution
Notwithstanding any provision of this Trust Agreement to the contrary, the Trustee must abide by any
memorandum by the Settlor, particularly that contained in the section entitled "Special Directives"
incorporated into this Trust Instrument, directing the disposition of Trust Assets of every kind including,
but not limited to, furniture, appliances, furnishings, pictures, china, silverware, glass, books, jewelry,
wearing apparel, and all policies of fire, burglary, property damage, and other insurance on or in
connection with the use of property. Otherwise, any personal and household effects of the Settlor shall be
distributed with the remaining assets ofthe Trust Estate.
REVOCABLE LIVING TRUST AGREEMENT
Page 14
Section 8.04 - Liability of Trustee
The Trustee will not be responsible or liable for any loss which may occur by reason of depreciation in
value of the properties at any time belonging to the Trust Estate nor for any other loss which may occur,
except that the Trustee will be liable for each Trustee's own negligence, neglect, default, or willful wrong.
The Trustee will not be liable or responsible for the acts, omissions, or defaults of any agent or other
person to whom duties may be properly delegated hereunder (except officers or regular employees of the
Trustee) if such agent or person was appointed with due care. The Trustee may receive reimbursement
from the Trust Estate for any liability, whether in contract or in tort, incurred in the administration of the
Trust Estate in accordance with the provisions hereof, and the Trustee may contract in such form that such
Trustee will be exempt from such personal liability and that such liability will be limited to the Trust
Assets.
Section 8.05 - Successor Trustees
Any Successor Trustee shall have all the power, rights, discretion, and obligations conferred on a Trustee
by this Trust Agreement. All rights, titles, and interest in the property of the Trust shall immediately vest
in the successor Trustee at the time of appointment. The prior Trustee shall, without warranty, transfer to
the Successor Trustee the existing Trust property. No Successor Trustee shall be under any duty to
examine, verify, question, or audit the books, records, accounts, or transaction of any preceding Trustee;
and no Successor Trustee shall be liable for any loss or expense from or occasioned by anything done or
neglected to be done by any predecessor Trustee. A Successor Trustee shall be liable only for his or her
own acts and defaults.
ARTICLE NINE
Rule Against Perpetuities
Section 9.01 - Perpetuities Savings Clause
Notwithstanding any other provision of this instrument, the Trusts created hereunder shall terminate not
later than twenty-one (21) years after the death of the last survivor of the Settlor and any other
Beneficiary or Beneficiaries named or defined in this Trust living on the date of the death of the Settlor.
The Trustee shall distribute remaining Trust principal and all accrued or undistributed net income
hereunder to the Beneficiary or Beneficiaries. If there is more than one Beneficiary, the distribution shall
be in the proportion in which they are Beneficiaries; if no proportion is designated, then the distribution
shall be in equal shares to such Beneficiaries.
ARTICLE TEN
General Provisions
Section 10.01 - Governing Law
It is not intended that the laws of only one particular state shall necessarily govern all questions pertaining
to all of the Trust hereunder.
1. The validity of the Trust hereunder, as well as the validity of the particular provisions of that
Trust, shall be governed by the laws of the state which has sufficient connection with the Trust to
support such validity.
REVOCABLE LDnNG TRUST AGREEMENT
Page 15
2. The meaning and effect of the terms of this Trust Agreement shall be governed by the laws of the
Commonwealth of Pennsylvania.
3. The administration of this Trust shall be governed by the laws of the state in which the principle
office of the Trustee then having custody of the Trust's principal assets and records is located.
The foregoing shall apply even though the situs of some Trust Assets or the home of the Settlor, a
Trustee, or a Beneficiary may at some time or times be elsewhere.
Section 10.02 - Invalidity of Any Provision
If a court finds that any provision of this Trust Agreement is void, invalid, or unenforceable, the
remaining provisions of this Agreement will continue to be fully effective.
Section 10.03 - Headings
The use of headings in connection with the various articles and sections of this Trust Agreement is solely
for convenience and the headings are to be given no meaning or significance whatsoever in construing the
terms and provisions of this Agreement.
Section 10.04 - Internal Revenue Code Terminology
As used herein, the words "Gross Estate," "Adjusted Gross Estate," "Taxable Estate," "Unified Credit,"
"State Death Tax Credit," "Maximum Marital Deduction," "Marital Deduction," and any other word or
words which from the context in which it or they are used refer to the Internal Revenue Code shall be
assigned the same meaning as such words have for the purposes of applying the Internal Revenue Code to
a deceased Settlor's Estate. Reference to sections of the Internal Revenue Code and to the Internal
Revenue Code shall refer to the Internal Revenue Code amended to the date of such Settlor's death.
REVOCABLE LIVING TRUST AGREEMENT
Page 16
SPECIAL DIRECTIVES
OF
RAYMOND L. SCHAFFER
I, RAYMOND L. SCHAFFER, a resident of the County of CUMBERLAND, Commonwealth of
Pennsylvania, being of lawful age, and of sound and disposing mind and memory, and not acting under
duress, fraud, or undue influence, hereby make, publish and declare this to be my Special Directive, and I
incorporate THE RAYMOND L. SCHAFFER REVOCABLE LNING TRUST AGREEMENT.
FIRST
The natural objects of my affection are:
My Child -
Diane Farrel
My Sister -
Miriam L. Brown
SECOND
I direct that all estate and inheritance taxes payable as a result of my death, not limited to taxes
assessed on property, shall be paid out of the residue of my Estate, and shall not be deducted or collected
from any League, Devisee, or Beneficiary hereunder.
THIRD
In the event either of my named Beneficiaries should predecease me, all of the Trust Estate shall
be distributed to the remaining primary Beneficiary.
FOURTH
In the event all of my named Beneficiaries predecease me, all of the Trust Estate shall be
distributed to my heirs at law.
FIFTH
I direct that all outstanding debts and/or loans owed by any Beneficiary shall be forgiven and
deemed as having not existed.
SIXTH
I direct that the UNITED METHODIST CHURCH (New Kingston, Pennsylvania) shall receive
the sum of $5,000.00.
REVOCABLE LIVING TRUST AGREEMENT
Page I 7
SEVENTH
I direct that ST. STEPHEN LUTHERAN CHURCH (New Kingston, Pennsylvania) shall receive
the sum of $5,000.00.
EIGHTH
I direct that the SALVATION ARMY (Carlisle, Pennsylvania) shall receIve the sum of
$5,000.00.
NINTH
I direct that MARY DORMAN, GEORGE A. WENRICK and WENDA L. RITTER shall each
receive the sum of$5,000.00.
TENTH
I direct that DIANE FARREL shall be specifically excluded from receiving any portion of this
Trust Estate.
ELEVENTH
I direct that, before any distribution of the assets of the Trust Estate to the named Beneficiaries,
certain specific distributions, if any, shall be made from the assets as set forth on the list attached hereto
and marked "Exhibit A."
REVOCABLE LIVING TRUST AGREEMENT
Page 18
DATED to be effective this
./
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SETTLOR:
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RA YM .' L. SCHAFFER t 1/
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
This instrument was acknowledged before me on the date herein set forth by RAYMOND L.
SCHAFFER as Settlor and Trustee to certifY which witness my hand and seal of office.
NOTARIAL SEAL
TODD B. GARRY, Notary Public
lower Southampton Twp., Bucks County
My Commission Expires May 3, 2004
REVOCABLE LIVING TRUST AGREEMENT
Page 1 9
GENERAL AMENDMENT TO REVOCABLE LIVING TRUST AGREEMENT
TO: RAYMOND L. SCHAFFER, AS TRUSTEE UNDER
THE RAYMOND L. SCHAFFER REVOCABLE LIVING TRUST AGREEMENT
DATED: JULY 16,2003
Pursuant to the right reserved to me, as Settlor under Article One of the above Trust Agreement, I
amend THE RAYMOND L. SCHAFFER REVOCABLE LIVING TRUST AGREEMENT as
follows:
I amend Article VIll Section 8.01 of the Trust Agreement and substitute therefore the following:
Section 8.01 - Trustees
All Trustees are to serve without bond. The following will act as Trustees of any Trusts created by this
Trust Agreement, in the following order of succession:
First:
The undersigned, Raymond L. Schaffer
Second:
At the death or incapacity of Raymond L. Schaffer, George A. Weinrich shall
serve as First Successor Trustee.
Last:
A Trustee chosen by the majority of Beneficiaries, with a parent or legal guardian
voting for minor Beneficiaries; provided, however, that the children of any
deceased Beneficiary shall collectively have only one vote.
'1/1
DATED this ~
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(Prin-re'd Name of Witness)
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day or1J0~
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T STEE /
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C; e dr i c fl ;iJ.e-Kl r, ~ I...
(Printed N e of WItness)
I
:J fI day of
).. ~~J
J j/~ER MY Hp-~ seal of office on this the
.
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Notarid S0.~\.. " C"'. ;hiir- i\
Cyfi.h:-" L 1110r,"j'". t W.!d Y ,u,.. ~. .
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nov"poEln ., . ", " C"j04
My Commissior. E>'P,.BS :.-;:::::~__...,._
mber, Pennsylvania f;sc.vc;istion o~ Nolane"
GENERAL AMENDMENT TO REVOCABLE LIVING TRUST AGREEMENT
TO: RAYMOND L. SCHAFFER, AS TRUSTEE UNDER
THE RAYMOND L. SCHAFFER REVOCABLE LIVING TRUST AGREEMENT
DATED: mLY 16, 2003
Pursuant to the right reserved to me, as Settlor under Article One of the above Trust Agreement, I
amend THE RAYMOND L. SCHAFFER REVOCABLE LIVING TRUST AGREEMENT as
follows:
I amend Article III Section 3.03 Paragraph 1 of the Trust Agreement and substitute therefore
the following:
Section 3.03 - Trust Income and Principal Distribution
1. The Trustee shall apply and distribute the net income and principal of each of the shares of the
resulting Trust Estate, after giving effect to the section of this Trust Agreement entitled "Special
Directives" to the following Beneficiaries in the indicated percentile shares:
George A. Weinrich
100%
'btJ
DATED this d!:-
<'~~f~
SETOR.. ,. ~
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VW1TNESS .
~
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(Printed Na e of WItness)
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(Pri Name 0 itness)
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GIVEN UNDER MY HAND and seal of office on this the
f'-\\"f;,.\)S T , .1Do3.
" ~
cJ..O day of
\
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, ~...U"I\_.L; ('~
Pu lie, Commonwealth of Pennsylvania
Notarial Seal
Cynthia L Thomas, Notary Public
Hampden Twp., Cumberiand County
My Commission Expires Nov. 1, 2004
Member, Pennsylvania AsscciatiQo of Noteries
GENERAL AMENDMENT TO REVOCABLE LIVING TRUST AGREEMENT
TO: RAYMOND L. SCHAFFER, AS TRUSTEE UNDER
THE RAYMOND L. SCHAFFER REVOCABLE LIVING TRUST AGREEMENT
DATED: JULY 16,2003
Pursuant to the right reserved to me, as Settlor under Article One of the above Trust Agreement, I amend
THE RAYMOND L. SCHAFFER REVOCABLE LIVING TRUST AGREEMENT as follows:
I amend the SPECIAL DIRECTIVES Section of the Trust Agreement to include therefore the
following:
TWELFTH
I direct that the SIXTH, SEVENTH, EIGHTH AND NINTH SPECIAL DIRECTIVES shall be deleted.
THIRTEENTH
UNITED METHODIST CHURCH (New Kingston, Pennsylvania) shall receive the sum of$10,000.00.
FOURTEENTH
I direct that ST. STEPHEN LUTHERAN CHURCH (New Kingston, Pennsylvania) shall receive the smn
of$10,000.00.
FIFTEENTH
I direct that the SALVATION ARMY (Carlisle, Pennsylvania) shall receive the sum of$IO,OOO.OO. (/
. SIXTEEN~/Y
I dimt !hot MARY DORMAN, GEORGE A. WE~ :m.:oA, L. RIT,T, ER shall each receive, the "r-
smn of$lO,OOO.OO. d'.r;; rl/. .;1.. - CJ/ JI--/x.-...- .1;-
,,1' ,#.r,~~'..r;;~ .v~,A//v C/icll#{.Aj.?/'I:.r;V};II/I.../~pCg)J(f.- "1,1/[, I" ,
,! i/IFVI.~--1 /l /7A ( ~.. Wf/I ~/tl .,f~'_
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W: WITNES~-
~ ~ /? -../ v HOT SEAL .
~gH~ C~r ~ T:~~ty
( rinted Name of Witness) (Printed Name ofW me Comm\IslMExpiresMay3.2004
J~~ER ~d seal of office on this lhL day of
.~
No!ari<l\ Se.ai Nota.
Cynth!a L Tho~as. No~ary, f:.ubHc
Hempden Twp., Gumb6!',aoo Goun!y I
My Commfssioii E;,pi:<3S Nov. '.:~::~.-.J
Member, Pennsylv.:nie Association cf Notanl1:3
)
/
GENERAL AMENDMENT TO REVOCABLE LIVING TRU~T AGREEMENT
TO: RAYMOND L. SCHAFFER, AS TRUSTEE UNDER
THE RAYMOND L. SCHAFFER REVOCABLE LIVING TRUST AGREEMENT
DATED: JULY 16, 2003
Pursuant to the right reserved to me, as Settlor under Article One of the above Trust Agreement, I
amend THE RAYMOND L. SCHAFFER REVOCABLE LIVING TRUST AGREEMENT as
follows:
I amend the SPECIAL DIRECTIVES Section of the Trust Agreement to include therefore the
following:
SEVENTEENTH
I direct that wherever the name MIRIAM L. BROWN appears in this Trust Agreement, it shall be
read as MIRIAM M. BROWN.
dayof4P7~ J
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(pri~d Name of Witness)
DATED this /
WITNES
.
G?d r-li/~ )4 Jt!a ~ lIe "-
(Printed ame of WItness)
GIVEN UNDER MY HAND and seal of office on this the ~ day of
~\)(; uST , c20Q3.
\rD(\ .'''- '\~,<::::
Ii 0) ~
Pu lie, Commonwealth of Pennsylvania
1
Nolana' Seal I
Cynthia L. Thomas, Notary Public
Hampden Twp., Cumberiar.d Co~mt'l .
My Commission Expires Nov. 1. 200(~.-1
Member, Pennsylvania l'.ssociation 01 Notmies
GENERAL AMENDMENT TO REVOCABLE LIVING TRUST AGREEMENT
TO: RAYMOND L. SCHAFFER, AS TRUSTEE UNDER
THE RAYMOND L. SCHAFFER REVOCABLE LIVING TRUST AGREEMENT
DATED: IDLY 16,2003
Pursuant to the right reserved to me, as Settlor under Article One of the above Trust Agreement, I
amend THE RAYMOND L. SCHAFFER REVOCABLE LIVING TRUST AGREEMENT as
follows:
I amend the SPECIAL DIRECTIVES Section of the Trust Agreement to include therefore the
following:
EIGHTEENTH
I direct that the FIFTEENTH SPECIAL DIRECTIVE shall be deleted.
NINETEENTH
I direct that the SALVATION ARMY (Carlisle, Pennsylvania) shall receIve the sum of
$4,000.00.
TWENTIETH
I direct that my sister, MIRIAM M. BROWN, shall receive the sum of$15,000.00.
DATED this
day of
'<-
WITNESS
x
- WITNESS
(Printed Name of Witness)
(Printed Name of Witness)
GIVEN UNDER MY HAND and seal of office on this the
day of
Notary Public, Commonwealth of Pennsylvania
Page 1 of 1.
7
~- j,--- -
CERTIFICATE OF TRUST
THE
RAYMOND L. SCHAFFER
REVOCABLE LIVING TRUST AGREEMENT
DATED: JULY 16,2003
The undersigned hereby certifies that I created a Revocable Living Trust. This Trust is known as
THE RAYMOND L. SCHAFFER REVOCABLE LIVING TRUST AGREEMENT, dated the 16TH day
of July, 2003. RAYMOND L. SCHAFFER, Grantor, Settlor and Trustee, resides at 261 Redwood Lane,
Carlisle, County of Cumberland, Commonwealth of Pennsylvania.
IT IS AGREED BETWEEN THE PARTIES HERETO AS FOLLOWS:
Description of Trust
The party hereto desires to confirm the establishment of a Revocable Trust on this date for the benefit of
the Settlor and containing herein the following provisions:
TERMS OF THE TRUST
1. The Settlor is designated as the Trustee to serve until his death, resignation, or incompetence.
2. Upon the end of the terms of the original Trustee, George A. Weinrich is designated as First
Successor Trustee.
TRUSTEE POWERS
3. Any Trustee/Settlor has the power and authority to manage and control, buy, sell, mortgage, and
transfer the Trust property in such manner as the Trustee may deem advisable, and shall have,
enjoy and exercise all powers and rights over the concerning said property and the proceeds
thereof as fully and amply as though said Trustee were the absolute and qualified owner of same,
including the power to grant, bargain, sell and convey, encumber and hypothecate, real and
personal property, and the power to invest in corporate obligations of every kind, stocks,
preferred or common, and to buy stocks, bonds and similar investments on margin or other
leveraged accounts, except to the extent that such management would cause ineludability of an
irrevocable trust in the Estate of a Trustee.
TRUST ADMINISTRATION
4. Following the death of Trustee, the Trust will continue or be distributed in whole or in part for the
benefit of other named Beneficiaries according to the terms of the Trust.
5. While Settlor is living and competent, except when there shall be a Corporate Trustee, Trustee
may add money to or withdraw money from any bank or savings and loan or checking account
owned by the Trust.
6. Unless otherwise indicated to a prospective transferee, the Trustee has full power to transfer
assets held in the name of the Trust. Subsequent transferees are entitled to rely upon such
transfers provided that the chain of title is not otherwise deficient.
CERTIFICATE OF TRUST
Page 1
7. The Trust Agreement also states that any bank, corporation, brokerage firm, or other entity or
individual, may conclusively presume that the Trustee has full power and authority over the Trust
Assets and such person or institution shall be held harmless and shall incur no liability by reason
of so presuming.
8. The situs of the Trust is the COMMONWEALTH OF PENNSYLVANIA.
9. Any conflict between this abstract and the Trust shall be decided in Favor of the Trust.
IN WITNESS WHEREOF, the party has hereto executed this Summary of Trust this date.
SETTLORJTRUSTEE
/)
G(~'f'/:- J'~~
RA OND L. SCHAFFER
COMMONWEALTH OF PENNSYLVANIA}
COUNTY OF CUMBERLAND} ss.
;) 'Vr,
On this, the CY..~ day of AOC--; \)ST , d.D~ before me, a Notary Public, personally
appeared RAYMOND L. SCHAFFER, personally known to me to be the person whose name is
subscribed on this instrument, and acknowledged that he/she executed it for the purposes herein
expressed.
Notarial Seal
Cynthia l.Thomas, Not~.rj Public
Hampden Twp., Cumb6rif.r;u Co~nt'l
E-. \' "'C,fH
My Commission xplfeS '.G\'. I, ,,:.:..':'
ef. Pennsylvania [\ssvciaf.on o! NomrieS
Nota
CERTIFICATE OF TRUST
Page 2
Raymond L. Schaffer
261 Redwood Lane
Carlisle, Pennsylvania 17013
George A. Weinrich
Dear George A. Weinrich:
I have executed a Revocable Living Trust Agreement and have named you to succeed me in the
capacity of Successor Trustee. Your duties as such will be to distribute the Trust property to my
Beneficiaries as designated in the Trust Agreement.
Please indicate your acceptance of this appointment by signing where indicated at the bottom of
this letter and returning the letter to me.
Sincerely,
/"-;Z
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0. ." <.t;:~
~AFFER ·
TrustorlTrustee
I accept appointment as Successor Trustee of THE RAYMOND L. SCHAFFER REVOCABLE
LIVING TRUST. ... . . .7/f..:) _ _ /J
._~;f'w~
GEORG A. WEINRICH
,J
~/7-o/D3
Date
Trustee, please retum this acceptance letter to the Trustor at the letterhead address. This signed letter will
be k/;pt by Mr. Schaffer with his trust documents
STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SHORT CERTIFICATE
I,
GLENDA FARNER STRASBAUGH
Register for the Probate of wills and Granting
Letters of Administration in and for
CUMBERLAND County, do hereby certify that on
the 20th day of August, Two Thousand and Seven,
Letters of ADMINISTRATION D.B.N. C. T.A.
in common form were granted by the Register of
said County, on the
es ta te of RA YMOND L SCHAFFER
, late of MIDDLESEX TOWNSHIP
IFilst. Middle. Last!
in said county, deceased, to PA TRICIA A WEINRICH
IFirst. Middle. Last)
and that same has not since been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the
seal of said office at CARLISLE, PENNSYLVANIA, this 20th day of August
Two Thousand and Seven.
File No. 2006-00423
PA File No. 21- 06- 0423
Date of Death 3/05/2006
S.S. # 177-12-7571
,Jftwrk ~~,~~~
ll~ ~. D.wJ
r' Deputy
NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL
Estate of
Pennsylvania Inheritance Tax Return
Form REV-1500
EXHIBIT E
PA Inheritance Tax & Estate Tax Official Receipt
Dated May 17, 2006
lJ~PAH rMrivr at: ~EvCNlJ[
rJl:;:::F~l) :JF IN(lIVIUUA'.. T AI<f:S
~)EP'1 2.:JI)f;Ii) I
. '^Hr-I.:;BUnG. ~.^ 171 2B-0501
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 006706
DUPLICA TE
WENRICH GEORGE A
4 LAUREL DRIVE
MECHAN!CSBURG, PA 17055
,---. \>\\t1
ESTATE INFORMATION; SSN; 000..00-0000
FILE NUMBER: 2106..0423
DECEDENT NAME: SCHAFFER RAYMOND L
DATE OF PAYMENT: 05/17/2006
POSTMARK DATE: 05/17/2006
COUNTY: CUMBERLAND
DA TE OF DEATH: 03/05/2006
.
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
~
101 I $3,000.00
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TOTAL AMOUNT PAID:
REMARKS: GEORGE A WENRICH
CHECK# 509
SE;^I
INITIALS: eM
RECEIVED BY:
REGISTER OF WILes
$3,000.00
GLENDA FARNE~STRASBAUGH
REGISTER OF WILLS
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Estate of Raymond L. Schaffer
Pennsylvania Inheritance Tax Return
Form REV-1500
EXHIBIT F
Documentation of Assets
1~
MEMBERS 1st
FEDERAL CREDIT UNION
ACCOUNT TITLE:
Schaffer Revocable Living Trust
REGULAR SAVINGS ACCOUNT:
Account Number/Suffix 40143-00
Date Account Established 06/04/1984* t/
Principal Balance at Date of Death $31.78
Accrued Interest to Date of Death $.00
Total Principal and Accrued Interest to Date of Death $31.78
Interest Earned 01/01/2006 - 02/28/2006 $.00
Name of Trustee Raymond Schaffer
'V:::'
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*Converted to Trust Accour.t on 07/17/2003
CHECKING ACCOUNT:
Account Number/Suffix 40143-11
Date Account Established 06/04/1984
Principal Balance at Date of Death $5.118.16
Accrued Interest to Date of Death $.00
v
Total Principal and Accrued Interest to Date of Death $5.118.16['") "1;:=-.,,,-,
Interest Earned 01/01/2006 - 02/28/2006 $.68 'C- <,
Name of Trustee Raymond Schaffe;~-:/ /
INVESTMENT SAVINGS ACCOUNT:
Account Number/Suffix 40143-05
Date Account Established 09/26/1985
Principal Balance at Date of Death $12.308.99
Accrued Interest to Date of Death $2.35
Total Principal and Accrued Interest to Date of Death $$12.311.34') V":--
Interest Earned 01/01/2006 - 02/28/2006 34.55 '-?-' '.;~
Name of Trustee Raymond Schaffer'i",_.
(~f
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~~~R.Cill~
Danielle A. Kline
Insurance Services Specialist
October 11. 2007
~
Estate of: Raymond Schaffer
Date of Death: March 5, 2006
Social Security Number: 177-12-7571
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snoo Louise Drive . Po. Bm: 41) . Mt'chal1lcsbmg, Pennsylval1la 17055 . (8nO) 283-2328 . wvv\v.nl.embt'rs I s[org
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~-@NATIONAL
WESTERN
LIFE INSURANCE COMPANY
November 16, 2006
Mr. George Weinrich
Trustee for Raymond Schaffer Trust
4 Laurel Dr.
Mechanicsburg, P A 17055
Subject: Annuity Certificate No. 0101059759
Raymond Schaffer, deceased
Dear Mr. Weinrich,
We have no received an election for settlement of the death claim under this annuity
which is payable to the Raymond Schaffer Trust dated July 16, 2003. The Trust has the
following options:
1. Lump sum payment of the Cash Value of$55388.01.
2. Installment payout of the Accumulation Account Value off$75450.68 over a 5
year fixed period.
Additional forms are enclosed for these options. Please complete and return the
applicable formes) for the option elected together with a certified death certificate for Mr
Schaffer. Please contact us with any questions or if further information is needed to
make an election for settlement.
National Western Life
Policy Benefit Department
DK
850 lAST _'\;\DfR~l):'\. L~"'L . \\ \1\', ~\', - _- )!,O~ ,. :;l~-~_~h-lnjll
\UTOr-.1ATED\'OJlE RE~,r~()'<\r !i:!il Fit -"-:- f-,"~ ~(l(ji .. \\\r-"~OO"-_;I ~-!1:
CLIENT SERVICE~ DIRt' I \\_\;"1 t j',_t ~IJU 'J~_ < (:.-\l\!> :--Oll-:=:_~1-;11~'
Estate of Phyllis R. Beaver
Pennsylvania Inheritance Tax Return
Form REV-1500
EXHIBIT G
Documentation of Expenses
ST.:
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f-'\:ill<i{.:\"~":l"",PH \;N1Q,
Market plaza
4 Market Plaza Way
. PA 17055
Mechankcsburg 717-697-1884
Inquiries Call:
Acct XXXXXXX403
Eft: 03/29/06
Tlr: 0169
'Nithdrw1 from
Prev Ba1:
Amount:
New Bal:
Seq:
cash Disbursed
Twenties Disbursed
Tens Disbursed
SCHAFFER REVOCAB
Date: 03/29/06
Time: 11:19am
CHECKING 11
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THE HOME DEPOT 4120
6000 CARLISLE PIKE, MEeH PA 17055
STORE MANAGER MARK ULRICH C7J7i 795-9602
4120 00008 875E2 03/19/0(
SALE 11 AR658H 11 : 02 At
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073257132428 42 TRASH BAG
012587701010 33 GAL GLAD
008236487701 KEY RINGS
736511500660 66KWIKSETKEY
2 @ 1. 35
736511500677 67WEISERKEY
2 !41 1. 35
13.72
11.84
0.97
2.70
2.70
31. 93
1.92
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SUBTOTAL
SALES TAX
TOTAL
XXXXXXXXXXXX8568 HOME DEPOT
AUTH CODE 019302/3031558
1111111111111111111~llllllllllllllllllr
4120 08 87562 03/1912006 4475
NOW HIRING Srrm,IG SEASmJ AS;,OCIA f[:,
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Meehan i esburg Ma i n Pas t Off i ce
MECHANICSBURG, Pennsylvanla
170553459
4134870055-0098
04/15/2006 (800)275-8777 09:44:01 A
__U____ Sales Reee i pt----------
Pr-oduet Sale Uni t Final
Description Qty Price Price
- --------. --_._--_._,..._~_. -- - ------~
HARRISBURG PA 17120 $0.63
First-Class
2.00 02.
---.-----
--------
Issue PVI: $0.63
-----
Total: $0.63
Paid by:
Cash I $1. 00
Change Due: j/ -$0 37
8i 11#: 1000202296918
CI erk : 16
- All sales final on stamps and postage.
Refunds for guar'anteed serv 1 ces only.
Thank you for- y'our- buo:> i ness.
Cuslomer- COpy
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Harket Plaza
4 Market Plaza Way
Mechanicsburg FA 17055
Inquiries Call:
717-697-1884
Acct XXXXXXX403
Eff: 07/08/06
Tlr: 1600
SCHAFFER REVOCAB
Date: 07/08/06
Time: 1:30pm
Withdrwl from CHECKING 11
Prev Bal:
Amount:
New Bal:
Seq:
2,311.33
150.00
2,161.33
11293615
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SCHAFFER REVOCABLE LIVING
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"Professional Painting Pays"
S & Z PAINTING AND GENERAL CONSTRUCTION
Interior. Exterior. Paperhanging
Residential · Commercial
FREE ESTIMATES
426 Mumper Ln.
Dillsburg. PA 17019
INVOICE
717-432-2883
DATE
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DESCRIPTION
UNIT PRICE AMOUNT
3 t'.o Ul) 300 ro
- \ ~er
c...\
:Joe co Olo,) ro
1 trD CO
TOTAL
SUBTOTAL ~
PLEASE MAKE CHECKS
PAYABLE TO VALERIE FISH
TAX
DUE UPON RECEIPT
PAYABLE
TO
Control No: 021 - 001022
2006 Statement of Real Estate Taxes
Bill Date'
3/01/2(
PENNY G. DAVIS
152 FIELDSTONE DRIVE
CARLISLE PA 17013
DESC ASSESS.NO - 21001022
MAP NO: 21-06-0015-002 TR07047
261 REDWOOD LANE
COUNTRY MANOR MOBILE HOME PARK
LOT 261
Mobile Home - No Land
MOBILE HOME - LEASED LAND
Assessed Land Improvement ;.neral Total
Values 0 4,220 0 4 220
COUNTY OF CUMBERLAND Discount Face Pena/1
Rates .00219700 2 % 1.
COUNTY R/E 9.27 9.08 9.27 10.
Rates .00018000 2 % 11
COUNTY LIB .76 .74 .76
TOWNSHIP OF MIDDLESEX
Rates I .00087000 2 % l(
MONIC. R/E 3.67 3.60 3.67 4.
TAX AMOUNT DUE-> (:!~~~ $13.70 $15.(
r~ Paid CD or ~ter 3/01~2006 5/01/2006 7/01/20
r~ Paid CD or Before 4/30/2006 6/30/2006
TAX
PAYER
OFFICE
HOURS:
SCHAFFER, RAYMOND L
261 REDWOOD LANE
CARLISLE PA 17013
IF NOT PAID BY 12/1412008 THIS BILL WILL BE RETURNED TO TAX
CLAIM BUREAU FOR COLLECTION AND RUNG OF A UEN AGAINST
YOUR PROPERlY.
12/1412OC
- SEE REVERSE SIDE OF BILL FOR A BREAKDOWN OF YOUR COUNTY TAX DOLLARS
MAR-OCTTUES 10-2 THUR 4-7
SPECIAL HRS APRIL 22&29 10-1 OR
BY APPOINTMENT; CLOSED MAR 21,23
& HOLIDAYS *(717)697-5740*
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}3~~ J?i.llwith Payment. For a R~:;;~ipt . Enclose Self Addressed Stamoed Envf;!Lop~n__ _ __
3211 ** TAXPAYER COpy **
BILL DATE 3/01/2006
12006 PERSONAL TAX NOTICE
COUNTY OF CUMBERLAND
TOWNSHIP OF MIDDLESEX
CASH ONLY AFTER 12/14/06
UNPAID TAXES SUBMITTED TO
i PAYABLE
I TO
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BILL NO 3211
PENNY G. DAVIS
152 FIELDSTONE DRIVE
CARLISLE. PA 17013
DELINQUENT COlL 12/14/06
10.00
FACE
5/01/2006
TO
6/30/2006
. , .
CTL
21
20
5.00
5.00
4.90
4.90
5.00000
5.00000
---;--
SCHAFFER6 RAYMOND
261 REDW 00 LANE
CARLISLE PA 17013
\. 9.80
DISCOUNT
3/01/2006
TO
4/30/2006
CNTY pic
MUN pic
2.0% 10.0%
2.0% 10.0%
MAR-OCT TUES 10-2 THUR 4-7
SPECIAL HRS APRIL 22&29 10-1 OR
BY APPOINTMENT; CLOSED MAR 21,23
& HOLIDAYS *(717)697-5740*
-,,"KLOSE SELF ADDFiESSED STAMPED ENVELOPE IF RECEiPT IS DESIRED
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2006/2007
TAX-YEAR
CV SCH DST/ MIDDLESEX
PERSONAL TAX NOTICE
JULY 1, 2006
DATE
JULY 1 - OCT 31 TUES 10-2, THUR 4
-7 SPEC HRS: AUG 26 & 28 9-12 OR
BY APPT. NOV. 1 - FEB 28 CALL
FOR HRS. CLOSED JULY 25 & 27
5.
5
11.0
PENALTY
AFTER
6/30/20
BILL NUMBER 324 (
MAKE CHECKS PENNY G. DAVIS
PAYABLE TO: 152 FIELDSTONE DRIVE
CARLISLE, PA 17015
PHONE (717) 697-5740
\ PE:C::'TA \ RE:'O::CE
TAXES ARE DUE AND PAYABLE -- PLEASE PAY PROMPTLY
021000020
DURING THIS PERIOD
JUL 1-AUG 31 2006
SEP I-OCT 31 2006
NOV 1-DEC 13 2006
SCHAFFER, RAYMOND
261 REDWOOD LANE
CARLISLE, PA 17013
UNPAID TAXES WILL BE TURNED OVER FOR DELINQUENT COLLECTION AFTER DECEMBER 13, 2006
IF YOU DESIRE.A RECEIPT, ENCLOSE A STAMPED ADDRESSED ENVELOPE WITH ALL COPIES
';
PAY THIS AMOUNl
$
$
$
P-{If~
1" 5"lt
C-~J
......v.I..uuall-U.Utll .I' ulleral nome, Inc.
219 North Hanover Street
Carlisle, P A 17013
(717)243-4511
March 15,2006
Weinstein Law Offices, PC
Foster Plaza, Suite 300
651 Holiday Drive
Pittsburgh, P A 15220-
The Funeral Service for Raymond L. Schaffer
14716-45
We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please
feel free to contact us if you have any questions in regard to this statement.
THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT,
AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS.
FACILITY, STAFF, EQUIPMENT
Graveside Services . . . . . . . . . . .
FUNERAL HOME SERVICE CHARGES
SELECTED MERCHANDISE:
Richmond Casket. . . . . . . . . . . . . . . . . . . . . .
THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE
THATYOUHAVESELECTED . . . . . . . . . . . . .
Cash Advances
Opening Grave. . . . . . . .
Certified Copies of Death Certificate .
Additional mileage . . . . . .
TOTAL CASH ADVANCES AND SPECIAL CHARGES .
Total
Total Cost
.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..
History
03/15/2006 Estate Check # 27841 .
03/15/2006 Homesteaders Life Compan Y.
TOTAL AMOUNT DUE. .
This statement is net and payable in full within 30 days of receipt.
$3025.00
$3025.00
$2440.00
$5465.00
$1585.00
$60.00
$130.00
$1775.00
$7240.00
$2254.00
$-9494.00
() '_I c) 1.f
t
$0.00
-----
;1-40
Please return this portion with your Remittance
--.---------------------------------------------------------------
$
Amount Enclosed
Service 10 # 14716-45
Raymond L. Schaffer
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'l'he Patriot-News Co
812 Market St.
Harrisburg, PA 17101
Inquiries - 717 -255-8237
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~be patriot ..News
Now you know
GATES, HALBRUNER & HATCH, P.C.
ATTN: ACCTS PAYABLE
1013 MUMMA ROAD
SUITE 100
LEMOYNE PA
17043
THE PATRIOT NEWS
THE SUNDAY PATRIOT NEWS
Proof of Publication
Under Act No. 587, Approved May 16,1929
Commonwealth of Pennsylvania, County of Dauphin} ss
Joseph A. Dennison, being duly sworn according to law, deposes and says:
That he is the Assistant Controller of The Patriot News Co., a corporation organized and existing under the laws of the
Commonwealth of Pennsylvania, with its principal office and place of business at 812 to 818 Market Street, in the City of
Harrisburg, County of Dauphin, State of Pennsylvania, owner and publisher of The Patriot-News and The Sunday Patriot-News
newspapers of general circulation, printed and published at 812 to 818 Market Street, in the City, County and State aforesaid; that
The Patriot-News and The Sunday Patriot-News were established March 4th, 1854, and September 18th, 1949, respectively, and
all have been continuously published ever since;
That the printed notice or publication which is securely attached hereto is exactly as printed and published in their regular
daily and/or Sundayl Metro editions which appeared on the date(s) indicated below. That neither he nor said Company is
interested in the subject matter of said printed notice or advertising, and that all of the allegations of this statement as to the time,
place and character of publication are true; and
That he has personal knowledge of the facts aforesaid and is duly authorized and empowered to verify this statement on
behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolution unanimously passed and adopted severally by the
stockholders and board of directors of the said Company and subsequently duly recorded in the office for the Recording of Deeds
in and for said County of Dauphin in Miscellaneous Book "M", Volume 14, Page 317.
PUBLICATION COpy
.~
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This ad # 0001764232 ran on the dates shown below:
October 17, 2007
October 24, 2007
October 31,2007
LR, GA!E.S'~~,
i1lbrunir-'&.HUtcfiiF' .c.
ilminCJCRilad. 'Sillfe100
'Lemovne. PA 17043
wom to and ~i(d before me this 02 day of November, 2007 A.D.
I Notary Public
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
James L a~, Notary Public
CIty Of Haf'l1sbur\}. Dauphin County
My Commission Expires June 2, 2008
Member, Penn.ylvanl. A.toolalion of Notaries
L-/
CUMBERLAND LAW JOURNAL
32 SOUTH BEDFORD STREET
CARLISLE, P A 17013
November 9, 2007
Cumberland Law Journal is published every Friday by the Cumberland County Bar
Association and is designated by the Court of Common Pleas as the official legal publication for
Cumberland County and the legal newspaper for publication of legal notices.
TO:
Lowell R. Gates, Esquire
Raymond L. Schaffer Estate
RE:
Legal advertisements must be received by Friday Noon. All legal advertising must be
paid in advance. Make all checks payable to: Cumberland Law Journal.
Advertisement inserted on following dates:
October 26, November 2, and November 9, 2007
Advertising Cost
75.00
Proof of Publication
$ 0.00
Second Proof Request
$ 0.00
Payment received
$ 75.00
Total Amount Due
$
0.00
-----
-------
Becky H. Morgenthal, Executive Director
PROOF OF PUBLICATION OF NOTICE
IN CUMBERLAND LAW JOURNAL
(Under Act No. 587, approved May 16,1929), P. L.1784
COMMONWEALTH OF PENNSYLVANIA
ss.
COUNTY OF CUMBERLAND
Lisa Marie Coyne, Esquire, Editor of the Cumberland Law Journal, of the County and
State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law
Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid,
was established January 2, 1952, and designated by the local courts as the official legal
periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly
issued weekly in the said County, and that the printed notice or publication attached hereto is
exactly the same as was printed in the regular editions and issues of the said Cumberland Law
Journal on the following dates,
VIZ:
October 26, November 2, and November 9, 2007
Affiant further deposes that he is authorized to verify this statement by the Cumberland
Law Journal, a legal periodical of general circulation, and that he is not interested in the subject
matter of the aforesaid notice or advertisement, and that all allegations in the foregoing
statements as to time, place and character of publication are true.
Schaffer, Raymond L., dec'd.
Late of the Township of Middle-
sex.
Administratrix D.B.N. C.T.A.:
Patricia A. Wenrich, 4 Laurel
Drive, Mechanicsburg, PA 17055.
Attorneys: Lowell R. Gates, Es-
quire, Gates, Halbruner & Hatch,
P.C., 1013 Mumma Road, Suite
100, Lemoyne, PA 17043.
( Lisa arie Coyne, . tor
SWO~TO AND SUBSCRIBED before me this
~day of November, 2007
O/~;t~
Notary
NOTARIAL SEAl
DEBORAH A COLLINS
NOlolY Public
CARLISLE BORO. CUMBERlAND COUNTY
My Commission Expires Apr 28.2010
tf-
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RECEIPT FOR PAYMENT
-------------------
-------------------
GLENDA FARNER STRASBAUGH
Cumberland County - Register Of wills
One Courthouse Square
Carlisle, PA 17G13
Receipt Date:
Receipt Time:
Receipt No. :
9/28/2006
14:29:26
1045829
SCHAFFER RAYMOND L
Estate File No. :
Paid By Remarks:
2006-00423
GEORGE A WENRICH
JA
------------------------ Receipt Distribution ------------------------
Fee/Tax Description PaYment Amount Payee Name
PETITION LTRS TEST
WILL
AUTOMATION FEE
SHORT CERTIFICATE
JCP FEE
Check# 528
Total Received.........
30.00
15.00
5.00
12.00
10.00
----------------
$72.00
$72.00
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND COUNTY GENERAL FUN
BUREAU OF RECEIPTS & CNTR M.D
.I
/y
?
/'
RECEIPT FOR PAYMENT
-------------------
-------------------
GLENDA FARNER STRASBAUGH
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Receipt Date:
Receipt Time:
Receipt No.:
6/26/2007
15:38:25
1048949
SCHAFFER RAYMOND L
Estate File No. :
Paid By Remarks:
2006-00423
GATES HALBRUNER & HATCH PC
MW
------------------------ Receipt Distribution ------------------------
Fee/Tax Description PaYment Amount Payee Name
PET LTRS ADM OTHER
RENUNCIATION
SHORT CERTIFICATE
Cash
Total Received.........
20.00
30.00
32.00
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND COUNTY GENERAL FUN
$82.00
$82.00
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