Loading...
HomeMy WebLinkAbout05-15-08 ...J 15056041125 REV-1500 EX (06-05) PA Department of Revenue '* ~~~~~~~~~~ual Taxes. . INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW o 2 1 820 0 8 o 6 1 7 192 Decedent's Last Name Suffix Decedent's First Name MI PALERMO J 0 H N E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WillS FILL IN APPROPRIATE OVALS BELOW 00 1. Original Return o 4. Limited Estate 00 o 2. Supplemental Return D D 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust 0 (Attach Copy of Trust) 10. 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"" <:::::) 7 1 7 Sd 3 ji5 3 4:ul=~J, ~"'i :0 ::E i:T~ 'J REGISre~ ~ LS US!'oNL Y~:.: :'~3 ; -~..rn - I'jl";'l ;:;; ~ CJ1 ::.:~:. ':::J C) 0 :;DIo ,~. <.::;.~ OI1:x ,.1 ;::: c ;') lJ 00.'., --~a~ ... I' :::r> .;:- \0 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received D D D o 8. Total Number of Safe Deposit Boxes I v 0 v o T T 0 I I Firm Name (If Applicable) MARTSON LAW OFF I C E S First line of address o E A S T H I G H STREET Second line of address City or Post Office State ZIP Code DATE FILED CARLI SLE P A 1 7 0 3 Correspondent's e-mail address: Under penanies of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. S N J RE OF PERS N ROBLE FOR FILlN RETURN DATE MECHANICSBURG PA 17055 <,\D TE~ CARLISLE PLEASE USE ORIGINAL FORM ONLY PA 17013 Side 1 .~ L 15056041125 15056041125 .....J .....I 15056041125 REV-1500 EX (06-05) PA Department of Revenue '* Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW 021 8 200 8 o 6 1 7 192 Decedent's Last Name Suffix Decedent's First Name MI PALERMO J 0 H N E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return o 4. Limited Estate ~ o 2. Supplemental Return o o 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust 0 (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death 0 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 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received o o o o 8. Total Number of Safe Deposit Boxes I V 0 V o T T 0 I I I 717243334 Firm Name (If Applicable) REGISTER OF WILLS USE ONLY MARTSON LAW OFFICES First line of address o E A S T H I G H STREET Second line of address City or Post Office State ZIP Code DATE FILED CARLI SLE P A 17013 Correspondent's e-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of pre parer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE MECHANICSBURG PA 17055 D TE~ THER THAN REPRESENTATIVE ADDRESS 10 EAST HIGH STREET CARLISLE PLEASE USE ORIGINAL FORM ONLY PA 17013 Side 1 L 15056041125 15056041125 .....I .-J 15056042126 REV-1500 EX Decedent's Name: JOHN E. PALERMO RECAPITULATION 1. Real estate (Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 2. Stocks and Bonds (Schedule B) .................................. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages & Notes Receivable (Schedule D) ........................ 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... 5. 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 0 Separate Billing Requested. . . . . .. 7. 8. Total Gross Assets (total Lines 1-7) ........................... 8. 9. Funeral Expenses & Administrative Costs (Schedule H) . . . . . . . . . . . . . . " 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10) ...........................11. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . 14. 1 8 459 8. 5 8 TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X.O _ 0 . 0 0 15. 16. Amount of Line 14 taxable at lineal rate X .O~ 1 8 4 5 9 8 . 5 8 16. 17. Amount of Line 14 taxable at sibling rate X .12 0 . 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 0 . 0 0 18. 19. Tax Due . .. . . . '" . . .. . . . . .. . . . . . . ...... . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056042126 90500.00 436 5 . 6 4 6342.58 2 2 4 0 6 . 4 4 2 6 2 8 6 4 . 6 6 2 4 0 0 2 . 8 4 5 4 2 6 3 . 2 4 7 8 2 6 6 . 0 8 8 4 5 9 8 . 5 8 o . 0 0 8306.94 o . 0 0 o . 0 0 8306.94 o 15056042126 --.J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 08 00226 DECEDENT'S NAME JOHN E. PALERMO STREET ADDRESS 21 GLENDALE DRIVE CITY I STATE I ZIP MECHANICSBURG PA 17055 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 8,306.94 415.35 Total Credits (A + 8 + C) (2) 3. InteresVPenalty if applicable D. Interest E. Penalty 415.35 TotallnteresVPenalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in avalon Page 2, Line 20 to request a refund. (4) 0.00 0.00 7,891.59 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (58) 7,891.59 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ...................................................................... 0 00 b. retain the right to designate who shall use the property transferred or its income; ............................... 0 00 c. retain a reversionary interest; or ................................................................................................ 0 00 d. receive the promise for life of either payments, benefits or care? ....................................................... 0 00 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... 0 00 3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ......... 0 00 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .................................................................................................. 00 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 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. S9116 (a) (1.1) (i)l. 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. 99116 (a) (1.1) (ii)l. 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 retum are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. s9116(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. S9116(1.2) [72 P.S. s9116(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. s9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent. whether by blood or adoption. REV-1502 EX + (6-98) '* SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER JOHN E. PALERMO 21 08 00226 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real Drooertv which is iointlv-owned with rlaht of survivorshiD must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION Single dwelling situate at 21 Glendale Drive, Mechanicsburg, Upper Allen Township, being Parcel No. 42-27-1886-088, and being described in Deed dated 02/19/1971, recorded in Cumberland Co. PA, Deed Book "Z", Volume 23, Page 570. (Assessed value of 156,120 x common level ratio) VALUE AT DATE OF DEATH 190,500.00 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 190.500.00 REV-1503 EX + (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF JOHN E. PALERMO FILE NUMBER 21 08 00226 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION 53 shares Prudential Financial (CDSIP 744320102) VALUE AT DATE OF DEATH 3,764.46 2. 6 shares Citizens Communications Co. (CDSIP 177342201) (Ameriprise Acct. 551459167021) 69.34 3. 7000 shares Rite Aid Corp (CDSIP 767754104) (Ameriprise Acct 551459167021) 18,095.00 4. 584 shares Manulife Financial Corp (CDSIP 56501R106) 21,686.84 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 43615.64 REV-1508 EX + (6-98) '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JOHN E. PALERMO FILE NUMBER 21 08 00226 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION Ameriprise Brokerage Account 551459167021, cash balance VALUE AT DATE OF DEATH -10.00 2. M&T Checking Account 67173764 1,100.68 3. Ameriprise IRA Account #5514 5924 1 021, uncashed 2/13/08 distribution check 1,751.90 4. Holy Spirit Hospital, Refund 50.00 5. 2007 Income Tax Refund 1,800.00 6. 2007 P A property tax rebate 250.00 7. Proceeds from sale of personal property 50.00 8. Household goods 1,250.00 9. 1990 Cadillac Deville (poor condition) 100.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 6 342.58 REV-1510 EX + (6-98) '* SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JOHN E. PALERMO FILE NUMBER 21 08 00226 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 PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER. ATTACH A copy OF THE DEED FOR REAl ESl AlE. VALUE OF ASSET INTEREST (IF APPUCABLE) VALUE 1. Ameriprise IRA Account #551459241021; beneficiary: Mary J. 20,349.53 100. 20,349.53 Danella, daughter (principal and accrued interest) 2. RiverSource Life Insurance Company Defered Annuity, Ameriprise 0.00 O. 0.00 Account No. 93001063642 9 004, no further payments are due (see attached letter from Ameriprise) 3. Sovereign Bank Money Market Trustee Account 2331048231, 2,056.91 100. 2,056.91 beneficiary: Mary J. Danella TOTAL (Also enter on line 7 Recapitulation) $ 22,406.44 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+(12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JOHN E. PALERMO SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21 08 00226 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: I. Malpezzi Funeral Home 11,673.01 2. Saint Elizabeth Parish, funeral reception 50.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees Martson Law Offices (estimated) 11,000.00 3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills of Cumberland County 330.00 5. Accountanfs Fees 6. Tax Return Preparer's Fees 7. Stock valuation reports 7.75 8. Certified mail, Dept. of Public Welfare 5.21 9. Short certificates 8.00 10. Checkbook charge 9.37 II. State Farm Insurance, homeowner's pending disposition of real estate 349.00 12. United Water, service pending disposition of real estate 27.00 13. PPL, service pending disposition of real estate 435.00 14. York Waste Disposal, estimate of trash removal expense 43.50 15. Additional probate fee 50.00 16. Filing fee, inheritance tax return 15.00 TOTAL (Also enter on line 9, Recapitulation) $ 24.002.84 (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (12-03) '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JOHN E. PALERMO FILE NUMBER 21 08 00226 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. DESCRIPTION VALUE AT DATE OF DEATH 47,097.88 M&T Bank, Home Equity Line of Credit (principal and accrued interest) Chase MasterCard #5184 4500 4241 6218 5,753.57 Capital One MasterCard #5291-4923-2943-3037 90.19 AT&T, account payable 16.60 United Water, account payable 19.12 PPL, account payable 300.68 York Waste Disposal, account payable 43.50 Harrisburg Pharmacy, copay 9.02 Holy Spirit Hospital, copay 31.00 Andrews & Patel Asso., copay 5.80 M&T Bank, outstanding checks 297.31 Marlin A. Y 000, Treasurer, county/township tax effective 1/1/08 593.57 Marlin A. Y 000, Treasurer, personal tax effective 1/1/08 5.00 TOTAL (Also enter on line 10, Recapitulation) $ 54.263.24 (If more space is needed, insert additional sheets of the same size) RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outri8ht spousal distributions, and transfers under Sec. 9116 (a (1.2)] 1. Mary J. Danella Lineal 22,406.44 907 Bonny Lane Schedule G Mechanicsburg, P A 17055 2. Mary 1. Danella Lineal 162,192.14 Same Residue 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 TAXIS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 'N~""~'''* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JOHN E. PALERMO SCHEDULE J BENEFICIARIES FILE NUMBER 21 08 00226 (If more space is needed, insert additional sheets of the same size) m1 M&fBank 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Phone (888) 502-4349 Fax (302) 934-2955 April I, 2008 Martson Law Offices Attorneys At Law 10 East High Street Carlisle, Pennsylvania 17013 Re: Estate of John E Palermo Social Security: 071-14-7748 Date of Death: Februarv 18, 2008 Dear Sir or Madam: Per your inquiry dated March 27, 2008, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account A ccount Number 67173764 Ownership (Names oj) Elizabeth A Palermo * John E Palermo * Opening Date 04/28/7 1 Closed 03/] 4/08 Balance on Date of Death $1,397.99 Accrued Interest $ 0.00 Total $1,397.99 2. Type of Account Installment Loan Account Number ] 204445200383 4998 Ownership (Names oj) John E Palermo * Opening Date 05/04/93 Balance on Date of Death $47,089.62 ** This amount is not to be used for payoff purposes. For a payoff balance, please call J -800-724-2440. Current Balance $46,700.35 ** This amount is not a payoff balance. Please be advised, there was no safe deposit box found for the above decedent. * If upon reviewing the information above, you believe there are additional accounts not referenced, please provide us with an account number and/or name of any possible joint account holder. For any additional information on the above accounts, including ownership and any changes, closures and/or reimbursement of funds, please call the West Shore Plaza Office # 717- 255-2271. Sincerely, /'") -.-"'t ,", - ~_/{- ,/~, ",_' ,of''-' /~), - Nancy Clagett Records Management Schedule HE ", Item 2 The Personal Advisors of ~ Ameriprise ..~ Financial Re: Estate of John E. Palermo Your letter dated March 27, 2008 A financial advisory practice of Ameriprise Financial Services, Inc. Westwood Center 4661 Tflndle Road Camp Hill. PA 17011 Tel: 717.761.4208 Fax: 717.761.6282 Toll Free: 800.962.8694 An Amerlprlse Platinum Financial Services'" practice Tom Benkovlch, CFP"', ChFC", CFS Senior Financial ,L\dvisor thomas. f. ben kovic h@arnpf.com Jack Benkovlch, CFP", CFS Senior Financial A,jvlsor Joh n. a. benkovich@arnpf.com April I, 2008 Mrs. Corrine L. Myers Martson Law Offices 10 East High Street Carlisle, P A 17013 Kevin Pressmann, ChFC" Associilte Financial Advisor william. k. pressrnan@arnpf.com Dear Mrs. Myers: Christine Slusark Paraplanner christ! ne. m. s I usark@ampf.com You requested information on the annuity listed below. Account Information Account Number 930010636429004 Payout Ownership Individual Account Number 9300 1063642 9 004 Payout Total Value Not Applicable Payout Annuity - Non-Refund According to the contract provisions for account number 9300 I 063642 9 004, no further payments are due. Beneficiary Information Designation: NON REFUND If you need additioanl information, please do nothesitate to call. Sincerely, 1;, /. / " " Jt{!-,( L '/ j Laure t. Kane Office Manager /( ,:' ./\{c )e (j ;\r: !\t11E'r'prl-;e Fll1d(C;ai fr:,'"1i,cr.:se. ;Vr:eriprise F:nan.:ial servic$fl(~.(ifl~r~cr;;~~J{f:?mvJ.()I'Y serv:ces. ;~';\'P';~rrit-~nts, ir"SL.nHr\~(-' F?i'it'rSciALP products offered by \-T:fil:ates of A(i"~ripr\se F;nal':Cial Services, Inc.. Menlt;er ~jf\SD Jf~d SIPC. < 11' r~:j I ry t Sovereign Bank STATEMENT OF ACCOUNTS 1-877 -SOV-BANK (1-877-768-2265) www.50vereignbank.com Statement Period 02J11f08 TO 03/09/08 MONEY MARKET MONEY MARKET ~tcj>~-'Y,': D ",r' , ; !'is fl )/n : r i; JOHN E PALERMO TTEE MARY JO DANELLA BENEF KA THY A LEFRO/S BENEF {d eCk'~f>ecf. ) Account # 2331048231 Your account is currently at a zero balance. If your account remains at a zero balance for two entire statement cycles with no activity, it will be closed. Please deposit funds into this account quickly to prevent it from closing. If this account is not meeting your needs, it would be our pleasure to discuss other options with you. $0.00 $1,39< " ," ' Paid Last Year $12.21 - - ~ , , . iiiiiiiiiiiiiii -- " - , Balances BegJrlning sai~rice Deposits/Credits Withdrawa~ebit$> $2;056.91 ' " + $0.00 ~ $2,056;91- .,' , . Curr.nt Balance Average Daily Balance U$O:OP $2,056.28 Interest Paid this PeriOd. , Earned this Period Paid Year-Ti:l:-Oate'; ..;,>,;",..; >-':~: " , ~ :.;';,-] . -,. J 'The interest earned and the interest paid may differ depending on when interest is credited to your account Account Activity Date Description Additions Subtractions Balance 02-11 02.;29 03-09 Beginning Balance CL.9SIN$'TRANSACTION Ending Balance $2,056.91 $2.056.91 $0.00 $0.00 Schedule "G n, Item 3 page 3 of 3 233/04823/ LAST WILL AND TESTAMENT OF JOHN E. PALERMO I, John E. Palermo, rcsidng at upper All Township in the Borough of Mechanicsburg, County of Cumberland, and Commonwealth of Pennsylvania, being of sound mind, memory and understanding, do hereby make, publish, and declare this as and for my Last Will and Testament, and I do hereby revoke all vVills and Codicils heretofore made by me. FIRST I direct that all my just debts and funeral expenses be paid as soon as conveniently practicable after my death, escept that any debt secured by a mOltgage, pledge, or similar encumbrance on property owned 'by me at my death shall be paid by estate at the sole discretion of my executrix. SECOND All the rest, residue, and remaind(:r of my estate, real, personal, and mixed of whatsoever the same may consist and \vheresoever the same may be situate, including the lapsed legacies and any property over 'shieh I may now or hereafter have the power of :.lppointmcnt or other disposition, I g;ve, devise and nequcath to my daughter, \L1ry To D~11l'':!:,1ICshc SUrVl\TS me t~Jr a p,-'riccl ','ftl1irty (30) Jays. lfshc shal! I'rcdt:Cl':lSC l11e then t,) \11\" ::o'r:wdchildrl'n, D:lIill D;llh:;L1l'~(~ Lindsay DanclLl in l:qual 511:1rcs. THIRD .\nythin~ in this. my last \Vill and Tcstaml..'nt, tL, the contrary notwithstanding. in th..: ,-"\L'nt a Icsatcc or dc\. ;scc I1l'I",:i:1 named or design~lkd is a minor at the time distribution is directed to be made, tbC;1 2.nd in that event the share to which such minor is entitled hereunder shall be held in tmst for his benefit during his minority, and my trustees shall payor apply for the benefit of such minor so much of the income and principal of his trust as may be deemed necessary and proper by my trustees, in their-') k discretion, for such minor's support, maintenance, education, and health, and shall distribute, absolutely and outright, the fiJll balance of principal and undistributed income of the tmst to such minor upon his attaining the age of twenty-one (21). In the event minor shall die prior to attaining the age of twenty-one (21), the balance of the trust created for such minor shall be distributed, absolutely and outright, to his then liying lawful issue, if any, per stirpes, and if there be none, then to his brothers and sisters equally, if any and if there be none, to his heirs at law and next of kin as provided by the intestacy laws of the state of my residence in force at the date of my death. FOURTH In the event of the minority or incompetency of any of the beneficiaries herein named, my executors and tmstees, in their discretion, are ~ereby authorized and empowered to make whatever incor::.::, principol, or other distribution of property of whatever character, to which such beneficiary may be entitled, directly to such beneficiary, or to the person or persons having the care or custody of such beneficiary, or to such beneficiary's lawful or natural gaardian, or may apply said distrihutions in behalf of such beneficiary and in such cases my executors and trustees shall not be required to see to the application of any distribution made by viliue of the authority herein contained and the evidences of such payments or a receipt for such pay1nent or distribution, signed by the legal guardian, or either parent 0: the minor, or a person standin~ in loco parentis to the minor, shall he full and sufficient release and acquittance to my executors and trustees of all propc11y and !none)' or o:l~cr 'JCrS0n to \\'hom such dislributill1 is mad..: he rl'quirl,'d to fumishbond or other SCCT',ty. FIFTIf I dir..:ct that all transfer, inhcri:~'-nce, k;acy. succession and other ta.\es. including State and L'dera!. which may be ass.:sscd or imi1os,~d u;)on the transft:r or ,!!1V pl'l--'perty under this Will, or upon property w};ich may be part of my residuary estate;. and no devisee, legatee, donee, transferee, or insurance beneficiary, shall be required to payor contribute to the payment of the same. SIXTH In the administration and. distribution of my estate, my executors or trustees, shall have all the PO\\"CfS and authority grante:i to thcT11 by common law or statute. SEVENTH \Vherever the words "executrix", "executor", "executors", "trustee", or "trustees" are used herein, they shall be construed to mean executors, executor, executrix, tn/stee, trustees, and the survivor or survivors of them, and their successor or ...."ccessors in office. EIGHTH As used herein, each of the masculine, feminine or neuter genders shall include the other genders, the singular shall include the plural, and the plural shall include the singular, wherever appropriate to the context. NINTH I hereby nominate, constitute and appoint my daughter Mary Jo Danella as executrix and trustee of this my Last \Vill and Testament. In the event that my daughter predeceases me or shall not survive ITC for a period of 30 days r then appoint Stephen Palcrr:lo,1r. Cpon death, resignatio:1, incapacity, or failure to qualify of either of my children, hereby nomj;~atc, constitute, and apf-:cint the other child, executrix and trustee in he; place and steaJ, with the same pO\\CS :,S executrix and trustee, as arc ncrcin confcr'-,:d upon 111\ original executors and trust:.'..:. r di:\;ct that none ofrny l'\CCL1;';\'':s ('1" my trustecs :lpPOiiltcd !!:lder rhis \\"ill, nor any SlIcccssor, C\l:ClItor, or my trustees :lOW50C\.cr appointed, shall be required to fumish an:,. :x1:d or security in any jt:risdiction ;;1 \\ hich hem sl1e. or they may be called upon to ~\C t. IN WITNESS WHEREOF, I have hereunto set my hand and seal this />//: ----.-----f rr--- day of \~I;)-/n~Jft j ,2003, in the year 1\,,,0 Thousand and Three, I ,./?</ /(~ / / /'.', ,f /~~~/,. / ".. / > /(/ ;(/,//~.::. 7' /-'" ./" ...~. '.:. ....'" ."r/'.r I ,/,~,(""/" ,,' ,/ ' ,r/ ,r,;' .~ . >/ /' // ('Vitnieis) i..' 'I .' .../ ('Vitness) 1: /...~ //) 'L-F' G ,< / / __- '", ,./ /- /Y, .1. s;:' ",. __"-","" .. ...'~ .... t .'- .. ~ .". ~~, .... " ...- ,To . '.~oT" J~hn E. Palem1'o, Testator / / d:;~';;~!" y/ ~~~~~_.~ ~ . /,:k:r;.", "-/'~ ,A / >;~/ G~ gory S. ~zl~;~Esquire " / Attorney for Testator 20 South Market Street Mechanicsburg, PA. 17055 ',' .,r": _l/ . . ( . ,,> / -;'1" . i 4 _ , _ ~ J , ./ f ' I - - I~~ '\_'" , . . . j / .'-,.:',,/ ",.r, i"!L~" "':'/ 1/(' ..".... ./ -. i .~ 1 ..' . .;' ,". '. :' I,') J (Address) (Addn.'s.~) co:\r\tO:\'WEAL TH OF PE:\':\SYL VA~IA, COL":\fTY OF CUMBERLAND 5S.: ACKNOWLEDGMENT & AFFIDAVIT I, JOHN E. PALERlvIO, the testator in and the undersigned witnesses to the will, the attached or foregoing instmment, who have signed the instmment, having been qualified according to law do depose and say: (a) that I, the testator, do hereby acknowledge that I signed the instmment as my will, that r signed it willingly and as my free and voluntary act for the purposes therein expressed; and (b) that we, the witnesses, were present and saw the testator sign and execute the instrument as his will, that he signed it \villingly and executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testator signed the will as a witness and that to the best of our knowledge the testator was at that time I S or more years of age, of sound mind and under no constraint or undue influence, /}. , ./1 ~j, / ~ ,/ / s-.- ___,."I?"1-d - ,../ ,/; C -::,' ~ , ' ! ':' ,- .: Jolin E. Palermo, TESTATOR /1./ ~ ~.~~,~:I;<~#;L ..' .. " / ,-" f . ;. I / \..-: /' ;. '/ ,., " // '<vV:'(llcSS 'J '\" ~ / ',... \1 I 1 :i ), ~'" I ,,'I, \\,d.,'! f/".', ii, ,J,') I. i \J' \..I._! . '_J I Witness) ! , ") I JI '/'1"'"/' ,.7.';(' \; /'I / 1.""1- "'f. . ..f\ ' ,.> ./, I'M, .... - (.. ~ ,,-- I (" II .'.~' i r J .~,~ I ,v/ /"ii~~. -,'1~~-;7) '......- Address] , n".:,:) 1_/: "-'ll I i i t; i '~-' .. ,J>' I. _ r. " -'1'1\ \';\( ,{ " l }.' I~\ /I.t p)) '-~I .. --:'1, .., ''''":-' - I 1 . '._ r ~ , I Address IJ , /) >.~; 1_-1 J --~:".:;.<~ I .. "':'.'-_J Sworn to and subscribed 'Jcfore me this , l 1"," i\ ! ') I . , day of .Io<l i," " r . I ), tl' !.~~;;..'1_" .. ,;;. "I} I' " . J f ... ill I (_ J' i. ,. 2 (j ,,~ ~ ..... (.. /I-~' }'r.( '.J... r-;otary Public. My commission expires: .: . f " .: ;" ( : >), {" I i {.! J I . I ',. , . ;. i ~Jo1aii<J Se~ "fenther Rothermel. Notary:: I':,c H.1litax Twp" [1alJphm G')v~~. My C.QIrmission Exp,r,'S Jar.. ,=. ::.:. \; ~,.~C'n;,:er. ?~llns"t\J;Y;3 . S:;,Y;,'f<'"" ,:.-...,:.' .