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Home My WebLink About07-03-08 15056051058 REV-1500 EX ( -05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes Coun Year File Number ~ INHERITANCE TAX RETURN - ~- - -- - - - PO BOX 280601 ~ I Harrisburg, PA 17126-0601 21 I i 07 0963 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 205-09-9398 10-2 0-2007 10-14-1915 Decedent's Last Name _ - __ - - Suffix Decedent's First Name - - - . _ - _ MI Keller _ _ Mrs. j ~ Corinne I l K. - - - (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name _ - - MI none I i ~ - - -_ _ - --_ Spouse's Social Security Number -- ___ _- _ - - _ - ----~ I - THlS RETURN MUST BE FILED IN DUPLICATE WITH THE "A i - -- __-. REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 11 1. Original Return c~ 2. Supplemental Return c_~ 3. Remainder Return (date of death prior to 12-13-82) c~ 4. Limited Estate o 4a. Future Interest Compromise (date c _~ 5. Federal Estate Tax Return Required of death after ~ 2-12-82) 11 6. Decedent Died Testate c~ (Attach Copy of Will) 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Trust) c~ 9. Litigation Proceeds Received o 10. Spousal Poverty Credit (date of death cJ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name _ Daytime Telephone Number S. Berne Smith, Es - i 717-737-6789 ~ - ( PP ) _ Firm Name If A licable ~ c~ ~ l._. , rt "; ,~ S. Berne Smith Attorne -at-Law Y - ~ r ~ 3 ~I ~ REGISTE14~ S U~ONLY~ s - t f d y 107 Nn24 St reet ~ O `~, '"j _ Second line of address -- i - - - - - ~.' - _ - _- _ -_ _ - _ _ __ r,. - __ I ~ ~~ .. -- . . .; .,~ -~ DATE FILED vD City or Post Office _ _ - _ _ State ZIP Code _ _ _ .. - _ - Camp Hill PA i 17011-3602 Correspondent's a-mail address: s.berne@yahoo.com Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has anv knowledge. 51~rvr~ I uttt Ur F'EFiSON RESPONSIBLE OR FILING RET N Edna R. Brehm, Executrix ~,~ 1~o~ah<~ ADDRESS 86 Old Stone House Road, Carlisle, PA 17015 SIGNATURE OF PREPARER OTHE THA,~REPRESENTATIVE ~ S. Berne Smith ~ j/5~,,~~ ~~~,..a,~ ADDRESS :~ 107 N. 24'" Street, Camp Hill, PA 17011-3602 PLEASE USE ORIGINAL FORM ONLY 15056051058 Side 1 DATE %/~ 8 __ DAT 7~/ ~ 15056051058 `'n f ` 15056052059 REV-1500 EX Decedent's Social Security Number Decedent s Name Corinne Keller 205-09-9398 RECA PITULATION 1 Real estate (Schedule A) 1 50.00 2 Stocks and Bonds (Schedule B) 2 510 492.68 3 Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) 3. SO 00 4 Mortgages & Notes Receivable (Schedule D) 4. S0.00 5 Cash.. Bank Deposits 8 Miscellaneous Personal Property (Schedule E) 5 521.769 43 6 Somtly Owned Property (Schedule F) ~--~ Separate Billing Requested 6. 50.00 7 Inter-Vivos Transfers & Miscellaneous Non-Probate Property 7 5202 003 88 (Schedule G) ~~ Separate Billing Requested 8 Total Gross Assets (total Lines 1-7) 8. 5234.265 99 9 Funeral Expenses & Administrative Costs (Schedule H) 9 $7,992.11 10 Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 10 5261.51 11 Total Deductions (total Lines 9 & 10) 11 $8.253.62 12 Net Value of Estate (Line 8 minus Line 11) 12 $226,012.37 Charitable and Governmental BequestslSec 9113 Trusts for which 13 $0.00 13 an election to tax has not been made (Schedule J) 14 Net Value Subject to Tax (Line 12 minus Line 13) 14. $226,012.37 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15 Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 $0.00 (a)(1.2) X 0. 15. 16 Amount of Line 14 taxable $217 777.36 $9,79998 , at lineal rate X .045 16. 17 Amount of Line 14 taxable $0.00 at sibling rate X 12 17. 18 Amount of Line 14 taxable $8 235.01 $1,235.25 , at collateral rate X .15 18 19 TAX DUE 19 $11,035.23 20 FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAY MENT ~ - Side 2 15056052059 15056052059 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 ~ 07 0963 DECEDENT'S NAME Corinne Keller DECEDENT'S SOCIAL SECURITY NUMBER 205-09-9398 STREET ADDRESS 5225 Wilson Lane CITY Mechanicsburg STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) $11,035.23 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments _ _ _ _ _ $9,000.00 C. Discount $473.68 - -- - - - Total Credits (A + B + C) (2) $9,473.68 3. InterestJPenalty if applicable D. Interest E. Penalty _ Total InterestlPenalty (D + E) (3) $0.00 4. 1f Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval 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) $1,561.55 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) $1,561.55 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; ^ 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? ® ^ 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. §9116 (a) (1.1) (I)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. 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. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1503EX ~ (6-98) -, SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BON DS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Corinne Keller FILE NUMBER 0963 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Ameriprise Mutual Funds Account # 01013088621 0 002, being 822.194 shares at $10.72 per share. (See printout from Ameriprise dated October 31, 2007, issued to John A. Benkovich, Jr., with respect to date of death values of this and the next mutual fund, Attachment A hereto $8,813.92 2. Ameriprise Mutual Funds Account # 01132802207 1 002, being 1678.76 shares at $1.00 per share for a date of death value of $1678.76. See Attachment A hereto. $1,678.76 TOTAL (Also enter on line 2, Recapitulation) ~ $10,492.68 (If more space is needed, insert additional sheets of the same size) RAE V-1508 EX +~6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Corinne Keller FILE NUMBER 0963 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Solitaire Marquise Cut Diamond Ring -See appraisal from James Line Jewelers dated November 8, 2007, attached hereto as Attachment B. $3,712.00 2. A 14 karat gold diamond insert with eight small diamonds with total weight of .25 carats. See Attachment B hereto. $322.50 3. A 14 karat yellow gold band inset with various small diamonds ranging in size from .15 karats to .30 karats. See Attachment B hereto. $2,520.00 4 Two 10 karat yellow gold anniversary style rings, each having five round cut cubic zirconia, valued at $59.00 each. See Attachment B hereto. $118.00 5. One costume jewelry ring with a blue stone. No value, see Attachment B hereto. $0.00 6. Victorian Rocking Chair. See Attachment C hereto, being Appraisal dated January 5, 2008, prepared by Mary A. Roell, C.A.P.P. $350.00 7. PNC Bank checking account # 5003218657 (See Attachment D hereto). $11,989.39 8. Payment from Long Term Care Insurance - RiverSource Life Ins. Co., 12 days at $70.00 per day. Policy # 91003381929. $840.00 9. Repayment of overpayment to Bethany Village Nursing Home from Asbury Communities, Inc. (See Attachment E hereto). $1,701.31 10. PA State Employee Retirement System -final retirement payment for part of the month of October $216.23 TOTAL (Also enter on line 5, Recapitulation) I $21,769.43 (If more space is needed, insert additional sheets of the same size) RSV-1510 EX + U-98) SCHEDULE G ~± INTER-VIVOS TRANSFERS & COMMONWEALTH OE PENNSYLVANIA MISC. NON-PROBATE PROPERTY INHERITANCE TAX RETURN ESTATE OF Corinne Keller FILE NUMBER 0963 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. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1. Annuity issued by Ameriprise Financial Services at #93006202109 0 004 $796.85 100.0% $0.00 $796.85 (See printout from Ameriprise dated October 31, 2007, issued to John A. Benkovich, Jr. with respect to date of death values of this and Annuities numbers 2 through 8 below, Attachment A hereto). 2. Annuity # 93006660806 6 004 - Attachment A $49,165.03 100.0% $0.00 $49,165.03 3. Annuity # 93006661207 6 004 - Attachment A $51,057.76 100.0% $0.00 $51,057.76 4. Annuity # 93006661378 5 004 - Attachment A $8,044.85 100.0°l0 $0.00 $8,044.85 5. Annuity # 93007058042 6 004 - Attachment A $43,660.59 100.0°!° $0.00 $43,660.59 6. Annuity # 93007241564 7 004 - Attachment A $24,624.51 100.0% $0.00 $24,624.51 7. Annuity # 93007241568 8 004 - Attachment A $9,826.14 100.0% $0.00 $9,826.14 8. Annuity # 93007745419 5 004 - Attachment A $6,943.14 100.0% $0.00 $6,943.14 9. Met Life Investors USA Annuity Contract # A2071934 $7,885.01 100.0% $0.00 $7,885.01 (See Attachment F hereto, being a copy of the statement of PNC Investments statement as of December 31, 2007. The actual date of death value as of October 20, 2007, does not show on the statement, but the amount was $7,885.01, according to the bank) TOTAL (Also enter on line 7, Recapitulation) $202,003.88 (If more space is needed, insert additional sheets of the same size) REV-511 EX+C10-06) ... Y! COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES 8 ADMINISTRATIVE COSTS ESTATE OF Corinne Keller FILE NUMBER 0963 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Auer Memorial Home & Cremation for funeral $917.49 2. Calvary United Methodist Church Cemetery $325.00 3. E. F. Readding Sons for engraving the stone $90.00 4. Pastor Dozier for conducting the funeral service $70.00 5. Funeral luncheon $62.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Edna R. Brehm $1,500.00 Street Address 86 Old Stone House Road City Carlisle State PA Zip 17015 Year(s) Commission Paid: 2. Attorney Fees - S. Berne Smith, Esq. $3,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Cumberland County Register of Wills $149.00 5. Accountant's Fees 6. Tax Return Preparer's Fees Fred Thomas, accountant $60.00 7_ Postage $15.86 8. Publication of Estate Notices in the Sentine{ and The Cumberland Law Journal $217.66 9. Filing Fees - $40.00 10. Executrix expenses 11. Line Jewelers appraisal expense $143.10 12. Bedford Street Antiques appraisal expense $50.00 13. UPS Store -cost of sending rocker chair to Florida $386.96 14. Executor's Out of Pocket Expenses incurred for mileage and advances to Nancy Kuhn $465.04 TOTAL (Also enter on line 9, Recapitulation) $7,992.11 (If more space is needed, insert additional sheets of the same size) P.EV-1512 EX +Y12-03j .. V' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Corinne Keller SCHEDULE{ DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 0963 Record debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses ITEM NUMBER DESCRIPTION AMOUNT 1. Joseph Simpson Library for lost library book $12.00 2. Millennium Pharmacy $149.51 3. Benevolent Care Fund of Bethany Village -charitable gift $100.00 TOTAL (Also enter on line 10, Recapitulation) ~ $261.51 (If more space is needed, insert additional sheets of the same size) FtEV-1513 Ex + (,9-00)) z ~: ~` SCHEDULE J COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF Corinne Keller FILE NUMBER 0963 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS [include outright spousal distributions, and I transfers under Sec. 9116 (a) (1.2)] Nancy Corinne Kuhn, 1533 Catherine Street, Harrisburg, PA 17104 Daughter 100 % of the Residue 2. Judy Woodling, 1623 Carrera Drive, The Village, FL 32159 Niece specific bequest with appraised value of $350.00 3. Edna R. Brehm, 86 Old Stone House Road, Carlisle, PA 17013 Friend Beneficiary of Annuity with date of death value of $7885.01 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $0.00 (If more space is needed, insert additional sheets of the same size) FIRST CODICIL TO WILL OF CORINNE K. KELLER I, CORINNE K. KELLER, of Bethany Village, Mechanicsburg, Cumberland County, Pennsylvania, declare this to be the First Codicil to my Will executed on December 29, 2003. 1. I hereby amend my Will to make the following specific bequests of some of my personal assets: A. My antique gold plated broach set with various colored stones and pearls, which had belonged to my Great Grandmother Weist goes to my very special friend, Catherine Yellin, of Palm Harbor, FL. B. My antique Rocking Chair with the needlepoint back and seat goes to my niece, Judy Woodling, of The Villages, FL.. C. My needlepoint clock and the four (4) counter cross stitch pictures go to my niece, Judy Woodling, of The Villages, I~L. These items were made by and given to my by Judy's mother, who was my sister. 2. In all other respects, my Will shall remain unchanged. IN WITNESS whereof, I, CORINNE K. KELLER, herewith set my hand to this, a Codicil to my last Will, typewritten on two (2) sheets of paper including the self-proving attestation clause and signatures of witnesses, this ~~ day of ~,I%6v- , 2007. ~, -~ ~~ ~ (SEAL) CORINNE K. L ER Witnessed: ~u,~~ _ 'liU residing at `~ ~~ ~ w,) Sy~~ Lo. Y/lee ~U~~ c Shy,' c.~~' _~, ; ~ ~'~ :; -_ ~;~ ~~_ residing at ~i'~r,;~ ~_. Il_ >~ ~,,. -., ,; ~ ~lvvv.~,r residing at ~~' ?'~ 'v`~;~\S`~.~Z. ~~t ~`~l`.tL~nv.r~i..,b~;~~~. ~~1~ i ~} COMMONWEALTH OF PENNSYLVANIA COiJNTY OF CUMBERLAND SS: CORINNE K. KELLER, (the testatrix), n-~ ~-^~ ~~' - ~ ~l,t~c, z ~~~ 1' and 1 ~ '~ ~/ t~c~ (the witnesses), whose nxfnes are signed to the foregoing instrument, being first duly sworn, each hereby declares to the undersigned authority that the testatrix signed and executed the instrument as a codicil to her last will in the presence of the witnesses and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the codicil as witness and that to the best of his or her knowledge the testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. WITNESS: TESTATRIX: i J CORINNE K. KELLER WITNESS: WITNESS: ~~ '-~ ~. _, `. Subscribed, sworn to and acknowledged before me by CORINNE K. KELLER, the Testatrix, and subscribed and sworn to before me by ~~~n~~ ~.~ .~J/f~- > ~: ~,~ ~ k~ro ~~" and ~ .-~ ~lyv ,the witnesses, this 3~/' day of ~~ch ,~~-r- , ?007. ~-'- - ~ ~ - ~~zti' Notary Public My Commission Expires: (SEAL) Not~RU-L sEAI JOHN R E BOWEN Nofory PU411C LOWER ALLEN TWP. CUMBERLAND COUNTY MV C~T11iilOfl EXpirN MCr 23, 2010 LAST WILL AND TESTAMENT OF CORINNE K. KELLER I, CORINNE K. KELLER, of Bethany Village, Mechanicsburg, Cumberland ~ oucity. Pennsylvania, being of sound mind and disposing memory, though I realize the uncertainty uC this life, 1 have full confidence and trust in my Lord and Savior, Jesus Christ, in His death on the cross for my sins and in His shed blood as an atonement for my soul; and I know by faith that because of His sacrifice on the cross for me I have eternal life, do hereby make this Will, hereby revoking all my former Wills and Codicils: Article One: ~'angible Personal Property: i .1 1 bequeath all my tangible persona! property to my daughter, Nancy Corinne Kuhn, of Har--isburg, PA. 1.2 1 direct that the expenses of storing, packing, shipping, insuring and delivering :,n~ such property to the beneficiary entitled thereto shall be paid by the Executor as an admin,sn-ative expense of my estate. Article Two: Residue: §2.1 I devise and bequeath all the residue of my estate of whatever nature and wherever situated to my daughter, Nancy Corinne Kuhn, if she survives me. With respect to this heyuest, 1 direct my Executor to purchase an annuity, or annuities, for my daughter from one or mart responsible and sound companies which sell annuities so that my daughter will receive an ,ncome, payable at least quarter annually. The contingent beneticiaries on such annuities shall be the four charities named in X2.2 hereinafter. The primary objective of the annuity should be to provide a sufficient income to help support my daughter during her lifetime with any remainder ~~in~ to the charities. §2.2 If I am not survived by my daughter, I devise and bequeath all the rest of my estate, of whatever nature and wherever situated, ire equal shares as charitable bequests to the charities named in Sections 2.2.1, 2.2.2, 2.2.3 and 2.2.4 in which I have had a deep and abiding interest during my lifetime. If any of these charities should not be in existence at the time of my death that bequest shall lapse, and the gift shall be allocated prorata among those named charities which are then in existence. §2.2.1 The United Methodist Children's Home, Mechanicsburg, 1'A; §2.2.2 Derry Street United Methodist Church, Harrisburg, PA; §2.2.3 Covenant House, New York, NY; and §2.2.4 The Care Assurance Endowment Fund, Bethany Village, Mechanicsburg, PA. Article Three: Provision for Debts and Expenses: §3.1 I direct that any of my legally enforceable debts, any expenses of my last illness, funeral and burial, and any of the administrative expenses of my estate shall 6e paid from the principal of that portion of my estate disposed of by Article Two of this Will. Article Four: Appointment of Fiduciaries: §4.1 l appoint my friend, Edna R. Brehm, of Carlisle, PA as Executrix of this V~'ill. If Edna R. Brehm is unable or unwilling to serve or continue to serve, for any reason whatsoever, I appoint my daughter, Nancy Corinne Kuhn, as first, contingent Executrix. All references herein to the "Executor" shall mean my originally appointed Executrix or my successor hxecutrix, as the case may be. I specifically request my Executor to work tlu-ough the Camp HiI1, 1'A office of John A. Benkovich, Jr., my long time American Express financial advisor or his successor. Article Five: Powers of Fiduciaries: §5.1 No fiduciary under this Will shall be required to give bond or other security for the faithful performance of the fiduciary's duties. §5.2 Any such fiduciary shall have the following powers, in addition to those given by law §5.2.1 To invest in, accept and retain any real or personal property, including stock of a corporate fiduciary or its holding company, without restriction to legal investments; 2 §5.2.2 To sell, exchange, partition or lease for any period of time any real or personal property and to give options therefor for- cash or credit, with or without security; §5.2.3 To borrow money from any person including any fiduciary acting hereunder, and to mortgage or pledge any real or personal property; §5.2.4 To hold shares of stock or other securities in nominee registration form, including that of a clearing corporation or depository, or in book entry form or unregistered or in such other form as will pass by delivery; §S.2.S "fo engage in litigation and compromise, arbitrate or abandon claims; §5.2.6 To make distributions in cash, or in kind at current values, or partly in each, allocating specific assets to particular distributes on a non-pro rata basis, and for such purposes to make reasonable determinations of curre:nt values; §5.2.7 To make elections, decisions, concessions and settlements in connection with all income, estate, inheritance, gift or other tax returns and the payment of such taxes, without obligation to adjust the distributive share of income or principal of any person affected thereby; §5.2.8 To disclaim any interest I may have in any estate if- the Executo-- deems such disclaimer to be in the best interests of my estate and the beneficiaries thereof; Article Six: Provision for Taxes: §6.1 All estate taxes, inheritance taxes, transfer taxes and other taxes of a similar nature payable by reason of my death to any government or subdivision thereof upon or- with respect to any property subject to any such tax ("Death Taxes"), and any penalties thereon, shall be paid by the Executor out of the principal of that portion of my estate disposed of by Article Two of this `~ i l l Article Seven: Miscellaneous Provisions: §7.1 As used in this Will, the term "Internal Revenue Code" shall mean the Internal Keventte Code of 1986, as amended from time io time, or the corresponding provision of subsequent law. §72 if any beneficiary hereunder should die within thirty (30) days after me o~- within thirty (30) days after any other person the survival of whom determines his rights hereunder, then 3 such heneficiary shall be deemed to have predeceased me or such other person for all purposes hereunder [N WITNESS WHEREOF, I, CORINNE K. KELLER, have hereunto set my hand and seal to this, my last Will, typewritten on five (5) sheets of paper, including the self-proving *~ attestation clause and signatures of witnesses, this Zy day of December, 2003. ,~- - ' J ~/1 r ~ t7~- v " (SEAL) CORINNE K. KELLER Signed, sealed, published and declared by the above named CORINNE K. KELLER as and f-or I~er last Will, in the presence of us and each of us, who, at her request and in her presence atld in tl~e presence of each other, have hereunto subscribed our names as witnesses thereto the day and vcar last above written. ' / V .~) f~Cv~ Residing at ,3~~ (,CiO ~ ? ~T~~ ~, ~~~ ~ ~ ,Residing at ~~ L~, ~ ~~2C.G~, /f~ /~ C ~~ vJ..c~~---_.. % ~ Residing at 10 ~ ~. 2 ~+ l' S'r. COMMONWEALTH OF PENNSYLVANIA: SS. ~'OUNTY OF CUMBERLAND We, CORINNE K. KELLER, the testatrix, and // / ~tc~.^r<. , ~u,/1c>-- L- ~,~14 ~ ~ P--- - and S ~ c ~ N ~ S r~ , T H ,the witnesses, whose names are signed to the attached ur foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that 4 the testatrix signed and executed the instrument as her last Witt; that the testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testatrix signed the Will as a witness and that to the best of his or her knowledge the testatrix was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. l • ~'' 1 ~ 1 A _ // CORINNE K. LLER Wi Hess ~ ~ fitness Witness Subscribed, sworn to and acknowledged before me by CORINNE K. KELLER, tl~e testatrix, and subscribed and sworn to before me by __/rLz~..,^Pc•%i ~y`-'~~i"' ~ /-ICi/!., 71°S~e'~- atld 77 /3 ~ ,a N.:" .5,'-~ ~ r ~-~ ,the witnesses, this 2- `~ day of December, 2UU3 Notary Public My Commission expires: NoTARI,a~SE~ SEAL JOHN R.E. BONIEN, NOTARY PUBUC LOWER ALAN TWP., COUNTY OF CUMBERLAND MY COMMISSION EXPIRES MARCH 25, 2006 To John A Benkovich/Field/AMPF@AMPF cc bcc Subject 12269908 5 001 CORINNE K KELLER - DEATH SETTLEMENT REQUIRF_MENTS -PLEASE DO NOT DELETE RiverSource Life Insurance Company RiverSource Funds Ameriprise Certificate Company Ameriprise Brokerage 70100 Ameriprise Financial Center Minneapolis, MN 55474 October 31, 2007 JOHN A BENICOVICH JR AMERIPRISE FINANCIAL SERVICES 4661 TRINDLE RD CAMP HILL, PA 1701 l -5603 Dear JOHN A BENICOVICH JR: W e have received notification of CORINNE K KELLER's death. The deceased's name appears on the following accounts. Account values as of 10/20/2007 are listed below. At the end of this letter, you will find a Iist of beneficiaries shown in our initial review of the accounts Account Information Mutual Funds Account Number Ownership 0101308862] 0 002 lndividual O 1132802207 l 002 Individual Annuities -Post 1985 Account Number Ownership 93003375908 3 004 P/0 Individual 93006202109 0 004 P/O Individual 93006660806 6 004 Individual 93006661207 6 004 lndividual 93006661378 5 004 Individual 93007058042 6 004 lndividual 93007241564 7 004 P/O Individual 93007241568 8 004 P!O Individual 93007745419 5 004 lndividual Mutual Funds /~ %T~ c N r'l ~ tit'T ~~ Account Number Total Value 01013088621 0 002 $8,813.92 011328022071002 $1,684.24 Annuities -Post 1985 Account Number Total Value 93003375908 3 004 P/O $0.00 93006202109 0 004 P/0 $796.85 93006660806 6 004 $49,165.03 93006661207 6 004 $51,057.76 93006661378 5 004 $8,044.85 93007058042 6 004 $43,660.59 93007241564 7 004 P!O $24,624.51 93007241568 8 004 P/O $9,526.14 93007745419 5 004 $6,943.05 # of shares Asset Value Per Share 822.194 10.72 1678.76 1.00 The date of death values provided are for estate tax purposes and are not a value to be paid. Accounts may be subject to market fluctuation as governed by each product. Please note that the values indicated for any Life Insurance product(s) reflect the gross death benefit at date of death, not the cash value. Values for any proprietary mutual funds include accrued dividends as applicable. Values provided for brokerage products are manually calculated, and should be used as estimates only. The prices used to provide values are estimates obtained from outside sources believed to be reliable. Ameriprise Financial provides these values as a service to its clients. Actual values used in preparation of tax returns or for planning purposes should be verified by your legal and accounting advisors. Payout Annuity -Mode E, Life Income or Joint Life both Annuitants Deceased -continuation of payments Account number 93006202109 0 004 is an annuit)~ in payout. The first payment was issued on 06/20/1998 and payments will continue according to the terms of the contract until 03/20/2008. Therefore, all payments between the date of death and the last payment date are now due to the named beneficiary. The only option available to the beneficiar`~ is to continue to receive the payments (if greater than $20.00 per installment) until the last payment date. To continue payments, submit the requirements described in the Required Documents section of this letter. Payout Annuity -Mode E, Life Income or• Joint Life both Annuitants Deceased -continuation of payments Account number 93007241564 7 004is an annuit)~ in payout. The first payment was issued on 11/20/2003 and payments will continue according to the terms of the contract until 10/20/2023. Therefore, all payments between the date of death and the last payment date are now due to the named beneficiary. 'Che only option available to the beneficiary is to continue to receive the payments (if greater than $20.00 per installment) until the last payment date. To continue payments, submit the requirements described in the Required Documents section of this letter. Payout Annuity -Mode E, Life Income or Joint Life both Annuitants Deceased -continuation of payments Account number 93007241568 8 004 is an annuity in payout. The first payment was issued on 11/20/2003 and payments will continue according to the terms of the contract until 10/20/2023. Therefore, all payments between the date of death and the last payment date are now due to the named beneficiary. '['he only option available to the beneficiary is to continue to receive the payments (if greater than $20.00 per installment) until the last payment date. To continue payments, submit the requirements described in the Required Documents section of this letter. Payout Annuity -Non-Refund According to the contract provisions for account number 93003375908 3 004, no further payments are due and any payments issued after the date of death must be returned to Ameriprise Financial. Refer to the Required Documents section of this letter to determine if there are any payments that must be returned. .Tames Line Jewelers Quality you can trust, at a price you can a, jj"ord. 200 S. Spring Garden St. Carlisle, PA 17013 717-249-4888 Appraisal November 08, 2007 To whom it may concern: This is to certify the following articles of jewelry submitted by Edna Brehm to James Line Jewelers for appraisal for the Estate of Corinne Keller have current values as itemized below. A solitaire Marquise Cut diamond weighing .62 carats of G.I.A. color grade F, and clarity grade VS-1, set in a 14 karat yellow gold mounting valued at $3,712.00 A 14 karat gold diamond insert having eight round Brilliant cut diamonds, and an approximate total weight of .25 carats, valued at $322.50 A 14 karat yellow gold band, the top measuring 11.5 millimeters tapering to 10 millimeters at the sides, having three flush set diamonds, one being an Old Mine Cut weighing approximately .25 carats, the center diamond being a round Brilliant cut with a chipped girdle, weighing approximately .30 carats, and a round Brilliant cut diamond weighing approximately .18 carats; with five single cut diamonds on each side having an approximate total cazat weight of .15 carats, valued at $2,520.00 Two 10 karat yellow gold anniversary style rings, each having five round cut cubic zirconia, valued at $59.00 each A ring having a blue stone surrounded by white stones of costume quality, no value. ~' dames Line jewelers APPRAISAL REPORT OF PERSONAL PROPERTY OF ESTATE OF CORINNE K. KELLER FOR EDNA R. BREHM 86 Old Stone House Road So. Carlisle, Pa 17015 AS OF: January 5, 2008 BY: Mary A. Roell C.A.P.P. 44 North Bedford Street Carlisle, Pa 17013 717-241-5309 ~/ T DEFINITIONS AS USED IN THIS REPORT APPRAISAL An opinion or estimate of value based upon relevant and factual data, as of a given date, and usually is written. VALUE Present worth of future benefits. FAIR MARKET VALUE A dollar figure (determined by historical data and current market conditions) at which the property would change hands between a willing buyer and a willing seller, neither being under compulsion to buy nor the compulsion to sell and both having reasonable knowledge of relevant facts of the property. VALUATION DATE January 5, 2008 INSPECTION DATE January 5, 2008 MARKET CONDITIONS Market prices of modern household goods and glassware have leveled Off within the past five years due to an economic upswing of the country. Regionally, market prices also reflect a leveling off. Locally, market prices are showing moderate increases due to a slow seasonal start and steady demand of the past year. APPRAISAL CERTIFICATE I hereby certify that upon request for valuation of the personal property of the Estate of Corinne K Keller, deceased. By Edna R. Brehm, 86 Old Stone House Road So., Carlisle, Pa. 17015. I have personally and physically inspected the following listed personal property for the purposes of appraising and reporting the FAIR MARKET VALUE, AS OF this 5th day of January, 2008. The information and values contained in this report are based upon my experience as an antique dealer and appraiser, and other reliable sources. The personal property was found to be in very GOOD condition, unless otherwise noted. Values are reported piece by piece, and as a whole. All values reported have been determined with consideration to condition of item, market conditions, and sale ability factors. APPRAISAL SUMMARY It is in my opinion that, as of this 5th. Day of January 2008, the FAIR MARKET VALUE of the listed personal property of Corinne K. Keller, is. (Three Hundred Fifty Dollars) ($ 350.00) Signed, Mary A. Roell C.A.P.P. SOURCES OF VERIFICATION: Art Roell Antique Dealer 30 years Experience Carlisle, Pa BOOKS AND INTERNET Frank Loney Antique Dealer & Appraiser 20 years Experience Carlisle, Pa Internet Pricing and information PERSONAL PROPERTY ~ CORINNE K. KELLER Victorian Rocking Chair 1890's Walnut frame ~ Covered with Navy floral needle point (not original to rocker). Bottom shows that original seat and back were cane. Condition .... Very Good .................... $300.00 to $350.00 TOTAL $350.00 ASSUMPTIONS AND LIMITING CONDITIONS FAIR MARKET VALUE The term "Fair Market Value" as used in this report is defined as follows: The highest price estimated in terms of money which the property will bring in a competitive and open market under all conditions requisite to a fair sale, with the buyer and seller each acting prudently and knowledgeably, and assuming the price is not affected by undue stimulus. This appraisal is based upon the following assumptions, limitations and conditions: 1. The information contained in this report is gathered from sources considered reliable and from personal examination and research of authenticity and that comparable sale and/or auction prices were available and dependable. 2. No responsibility is assumed for matters legal in nature, including but not limited to: representation of others of value, authenticity, condition, origin, or provenance of an item appraised. 3. The appraiser assumes that a normal and careful examination of the property was sufficient to determine its quality and condition and that no extraordinary examination procedures would be utilized unless specifically requested and the expenditure of funds therefore authorized. 4. Court Attendance -The appraiser's court attendance and giving or expert testimony are not included as part of this report. THE UNDERSIGNED HEREBY CERTIFIES: 1. Appraiser has no interest now, heretofore, or contemplated in the future in property covered by this appraisal. 2. That, to the best of my knowledge and belief all statements and information included in this appraisal are true and based upon objective findings and that no pertinent information has been knowingly withheld or deleted in this report. 3. That neither the employment to make this appraisal nor compensation for doing so is contingent upon the value of the property. Even though it is the firm belief of the appraiser that the information furnished in this appraisal report and the conclusions drawn from this information are true and correct, they are not guaranteed. RESPECTFULLY SUBMITTED Mary A. Roell C.A.P.P. STATEMENTS OF QUALIFICATIONS MARY A. ROELL, ANTIQUE DEALER & APPRAISER • PROFESSIONAL ACCOMPLISHMENTS In the antique business for over 25 years. Furniture and Art restoration business for 15 years General Manager of Albion Point Antiques & Collectibles, a successful antique co-op in Carlisle, Pa with 120 dealers. Member of the design and implementation team for start up of Albion Point. In business from September 1998 to March 2003. • PRESENTLY Owner of Bedford Street Antiques, LLC, a successful award winning co-op in Carlisle, Pa with over 90 dealers. Opened for business in December of 2003. • PROFESSIONAL DESIGNATIONS C.A.P.P., designation earned with successfiil completion of Certified Appraiser's of Personal Property, 30-hour program with intense study of appraisal fundamentals, February 2000. C.R.A.D.A., Capital Region Antique Dealers Association, Member for 7 years, Director for 2 years. Vice President and Social Director for 2 years. P.A.D.A., Pennsylvania Antique Dealers Association, Member for 9 years, Director for 3 year. Secretary ~ Downtown Neighborhood Connection, (Elm Street Project) and on Committee for Facade Improvement Program. Signed, Mary A. Roell C.A.P.P. MARY A. ROELL C.A.P.P. 44 North Bedford Street Carlisle, Pa 17013 717-241-5309 STATEMENT January 5, 2008 Edna R Brehm 86 Old Stone House Road So. Carlisle, Pa. 17015 717-697-8299 APPRAISAL FEE: $ 50.00 PERSONAL PROPERTY: Estate of ~ Corinne K. Keller, to include personal property inspection, research and consultations as of January 5, 2008. Thank you! Signed, Mary A. Roell C.A.P.P. Ser~or Checking Plan Account Statement ~ PNCBANK I'NC Bank For the period 1 O/10/Z007 to 11/07/2007 Primary account number: 50-0321-8657 Page 1 of 2 Number of enclosures: 0 EST OF CORINNE K KELLER DECD ~ For 24-Hour banking, and transaction or EDNA R BREHM EXTRX interest rate information, sign on to 'a' PNC Bank Online Banking at pnc.com. Sb OLD STONEHOUSE RD S For customer service call 1-888-PNC-BANK CARLISLE PA 17015-9798 between the hours of 6 AM and Midnight ET Para servicio en esparTol, 1-866-HOLA-PNC MovingT Please contact t1s at 1-888-PNC-BANK ® Write to: Customer Service PO Box 609 Pittsburgh PA 15230-9738 Visit us at pnacom .- TDD terminal: 1-800-531-1648 For hearu,p unpaired rlicurs oily Give the gift of PNC Bank Visa(1~ Gift Cards this holiday season. Perfect for everyone and available in whole dollar amounts up to $500. Stop by a participating PNC Bank branch for more details. Senior Checking Plan Est Of Corinne K Keller Decd Edna R Brehm Extrx Regular Checking Account Summary Account number: 50-0321-8657 Balance Summary Please see the Activity Detail section for Beginning Deposits and Checks and other additional information. Ending balance other additions deductions balance / ~ Y,8ti1.48 11,622.98 3,Z99.~3 11,180.03 UI Average monthly Charges balance and fees 9,98(;.14 .oo Transaction Summary Checks paid/ Check Card POS Check Card/Bankcard withdrawals signed transactions POS PIN transactions 8 1 0 Total ATM PNC Bank Other Bank transactions ATM transactions ATM transactions 0 0 0 Activity Detail __.._. Deposits and other Additions Date Amount Description 10/12 2,030.00/Direct Deposit - Claim Pymt IDS Non-1VY A048025 ]0/ 15 1,63 3.fi3/Direct Deposit -AMP Payout Ameriprise Finc XXXXXXX2207 10/ 1(i 6, ,00.00 Direct Deposit -AMP Payout Ameriprise Finc XXXXXXX862] 10/31 324.3~,~ Direct Deposit. -Annuitant PA Treasury Dept. XXXXXXXXXXX0698 11/02 1,135.00 /Direct Deposit. - Soc Sec. US Treasury 303 XXXXX9398A f3 C it f't ~' N 7 There were 5 Deposits and Other Additions totaling $11,622.88. FORM953R-1005 .Senior Checking Plan Account Statement For the period 10/10/2007 to 11!07/2007 ~~ For 24-hour information, sign on to PNC Bank Online Banking EST OF CORINNE K KELLER DECD on pnc.corn. Primary account number. 50-0321-8657 Account number: 5(1-ll'3Y1-$657 - con(inued Page 2 of 2 Checka and Substitute Checks Check Date Reference Check Date Reference number Amount paid number number Amount paid number ~~ 100.00 10/22 oa7teoo.5s 833 400.OU ~ 10/ 141 o2asoztst `t30 * xi00.00 ~ 10/Iti osyo55o83 834 134.E{8~ lt)/;?~1 osg>rs~giH 8. 112.14/ 1O/lg o2a3oG115 ~ 43(i * 6!'i7.00~ lf)/2~I o2r~+~~3~~3 8823` 1Oj23 Os8157271 837 149.00 lO'2xi osss~tls+~x " Gap in check sequence Banking/Check Card Withdrawals and Purchases Date Amount Description 10/10 23.58 /5511 Check C:ud Purchase USPS 4134870007 Online and Electronic Banking Deductions Date Amount Description 11,~0`.t. 1,135.00 / Di: ect °~; nu°nt - Rene: sal US Treasut}~ 303 XXXXX9398A Daily Balance Detail Date Balance 10/ 10 2,837.90 IO/1'Z 4,SG7.90 10/ I5 G,501.53 Date Balance 10/16 12,501.xi3 10/19 X89.39 !0/22 '11,889.3. There were 8 checks listed totaling $2,140.85. There was 1 other Banking Machine/Check Card deductions totaling $23.58. There was 1 Online or Electronic Banking Deduction totaling $1,135.00, Date Balance Date Balance 10/23 11,801.1G ]0/_~ I 11,18x+.03 ] 0/ 24 11,009.G8 11/02 11,185.03 10/2xi 10,8ti0.G8 Make your holiday shopping easy and rewarditlg this year when you use your 1'NC Bank VisaG' Check Cat~3 or PNC Bank Vis2tw Plalimun Crrdit Card. 1lccented at more than 20 million locations worldwide and online. i lave a foal? Get a plan. Come iu for your cuittplinteutary Gttattciai assessment. You have a better chance of realizing your goals when you write them down. That includes financial goals. A PNC Financial Consultant can help you create a plan for education expenses, a new hove, retirement and any dream you have. Call 1-8(10-YNC-Glll, visit us at pnc.com or stop by the nearest PNC Bank Branch. No( FDIC Inaurerl. blay Lose Vatue. do (tank Guarantee. Important lnvestnr Infnrmatlnn: Securities and brokerage szrvices ate provide) I+y PNC Investments LLC. member FIN1tA and SIFC. Atuurities and other insurance pitxiucts are o0ered ny PNC lnsmance 5er,ices, LI,C a licensed irtsutance agency. Asbury Communities, Inc. To: Estate of Corinne Keller 29152 Invoice Number Date JAN022008 01/02/2008 Description Refund Overpayment Amount $1,701.31 Check Number: Check Date Discount $.00 0000139904 01 /03/2008 Paid Amount $1,701.31 $1,701,31 $.00 $1,701.31 C ~~ z 0 a- ~. a ~' w A A ~~ i oQ- W j 0 a- ,!L ~ F Y ~ m ry ^n 23 a P ~ a °i o co N ~ Z 3 ~~ O a ~ o z Z p mF JC , ~ V m r r m ~> ~'~ ~~m- ~~ n~ mmv om D Z ~ n ~ ~ t ~ ~ ~{ - ~ - ~r ~ ~ ` C ~ 3 o o ~ o~ 3 O v /1 C o ,~ m $ C O .~i c =. Q O ~ Q ~ . ~ N . g z ~ o ~ j ~ = ~ n 7I 'G ~ w°N N . ~ ~ O ' d~ 30 3~A Z1 3 0' ~ ~Q ~ ~ ~ w ~ s z ~, Q n ' ~ QM Z CD ,~ m N- Al y~ 7 ~ z~ _ ~ _ ° ° O ~ ~ ~ ~-. O _ n n _ ~ ~ . f/) Z °'< n o n v -* " ~ N~ N ~ O ~ O O N ~ 3 n ? ~ V ~_ . S ~ . 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