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10-29-08 (4)
3 h ~~ -~ 1505604114? REV-1500 EX (06-05) OFFICWL USE ONLY PA Department Of Revenue County code veer Ffle Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO 80x.280601 2 1 0 8 0 0 2 7 6 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 230 24 2032 O1 31 2008 05 07 1910 Decedent's Last Name Suffix Decedent's First Name MI C~CKLIN MARY B (If AppBcable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffer Spouse's First Name Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW X^ 1. Original Return C 4. Limited Estate g Decedent Died Testate (Attach Copy or Will) MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4a. Future Interest Compromise ~ 5. Federal Estate Tax Return Required (date of death afler 72-12-82) ~ Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Trusq 9. Litigation Proceeds Received ~ 1 p, Spousal PoveM credft (date of death 11. Election to tax under Sec. 9113(A) between 12-31- 1 and t-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 JAN M WILEY 717 432 9666? _ . ~~ Finn Name (if Applicable) .- REGISTER OF~IILLS U~NLIf THE WILEY GROUP , PC i '_c7 -, -~ ~, rv _ Flrst line of address - ~ -. . i 1 3 0 W . CHURCH STREET ~ ~ ,~ ,~; ~ _ -~c.- - ~ Second line of address - _ ~ _ _..i ,. ' -~ D fV -.i DATE FILED ~'"'~ City or Post Office State ZIP Code DILLSBURG PA 17019 Correspondent's e-mail address: Under penalties of pery'ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, k is true, correct and complete. DeGaration of preparer other than the personal representative Is based on all information of which preparer has any knowledge. R. Baumgardner Sr. '3 116 Euclid Avenue, Charles Town, WV 25414 SIGN~JJ!?E OF PREPARER OTHER THAN REPRESENTATIVE DATE , ~~ ('~ n n INS e ~ Jan M Wiley t0 ~a3/~ 1~0 W. Church Street, Dillsburg, PA~7019 ~ Side 1 15056041147 15056041147 i r ~ 15056042148 REV-1500 EX Decedent's Social Security Number oeceaenc~s New: Mary B. C o c k l i n 2 3 0 2 4 2 0 3 2 RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 4 2. 7 6 3 1 4 3. Closely Held Corporation, Partnership orSole-Proprietorship (Schedule C).......... 3. 4. 5• 6. 7. 8. Mortgages 8 Notes Receivable (Schedule D) .......................................................... Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ................ Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. Inter-Vivos Transfers & Miscellaneous Non-Probate Properly (Schedule G) ~ Separate Billing Requested ............. Total Gross Assets (total Lines 1-7) ....................................................................... 4. 5. 6. 7, 8. 1 1 2 5 5 7 6 8 3 9 2 5 8 3 9 2 4 5 4 0 4 0 9 4 9. Funeral Expenses 8 Administrative Costs (Schedule H) ......................................... 9. 6 7 4 9 9 4 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 7 8 6 1 4 4 11. Total Deductions (total Lines 9& 10) ...................................................................... 11, 7 5 3 6 0 8 4 12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 7 6 3 8 8 5 1 0 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................................................. 13, 2 7 0 0 0 0 0 0 14. Net Value Subject to Tax (Line 12 minus Line 13) ................................................. 14. 4 9 3 8 8 5 1 0 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 .o0 0 0 0 15. 0 0 0 16. Amount of Line 14 taxable at lineal rate X .045 0 0 0 16• 0 0 0 17. Amount of Line 14 taxable at sibling rate X .12 1 7 6, 1 2 2. 7 9 17. 2 1, 1 3 4. 7 3 18. Amount of Line 14 taxable at collateral rate x .15 3 1 7, 7 6 2. 3 1 18. 4 7, 6 6 4. 3 5 19. Tax Due ..................................................................................................................... 19. 6 8 7 9 9 0 8 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. a Side 2 15056042148 15056042148 J ~~ REW 1500 EX Page 3 Decedent's Complete Address: File Number 21-08-00276 DECEDENT'S NAME Mary B. Cocklin STREET ADDRESS 100 Mt. Allen Drive CITY Mechanicsburg STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 79,800.00 3,439.95 (1) 68,799.08 Total Credits (A + B + C) (2) 83,239.95 3. Interest/Penalty if applicable p. Interest E. Penalty Total Interesf/Penalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) 14,440.87 Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 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 .................................................................................................................. 0 ^ 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? ....................................................................................................................... ^ ^x 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... ~ Ox 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 p2 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. • i~.~~st ill rxrcd C~estrzmrnt of MARY B. COCRLIN BE IT REMEMBERED, that I, MARY 8. COCRLIN, of Messiah Village, Mechanicsburg, Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making null and void any and all Wills and Testaments and writings in the nature thereof by me at any time heretofore made. ITEM 1: I direct that all my just debts and funeral expenses be paid as soon after my demise as may be convenient. ITEM 2: All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, whether it be real, personal or mixed, including property over which I have a power of appointment, I give, devise and bequeath unto my brother, DONALD R. BAIIMGARDNER, SR., with the understanding that he shall distribute the same in accordance with my last wishes. ITEM 3: I direct my hereinafter named Executrix to pay all inheritance, estate, succession and legacy taxes of whatsoever nature and kind, to which my estate or the transfer of any property passing hereunder or otherwise passing try reason of my demise, may he subject and t~ charge such taxes against my residuary estate, it being my intention that none of the aforesaid taxes, either WITNESS: // ~ ~~~~~- ( SEAL ) lJ/ MARY B. COCKLIN Y -1- ~ \ . federal or state, on any property required to be included in my gross estate, under the provisions of any state or federal law now in force or hereafter enacted, shall be prorated among the persons interested in my estate to whom such property is or may be transferred or to whom any benefit accrues. ITEM 4: I appoint my brother, DONALD R. BAIIM(iARDNER, 8R. , as Executor of this my Last Will and Testament. Should my brother predecease me, fail to qualify, cease to act or renounce probate, I then appoint VERA M. BAIIMQARDNER, as Executrix of this my Last Will and Testament. ITEM 5 s I direct that my Executor employ JAN M. WILEY, EBQIIIRE, as attorney for my estate, if he is available. ITEM 6: I direct that my Executor shall not be required to give bond for the faithful performance of his duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and -~6) seal this~_ day of -~_,~~r(.~~~ ~ 1996. WITN SS: C i I ~~, ~<:rh~.l 1~ !~ :~.4!c-Ut ( SEAL) MAR /B. COCRLIN .` •. ~ i COMMONWBALTH OF PENNSYLVANIA 88 COUNTY OF YORK We, MARY B. COCRLIN, KENNETH J. HAdREEN, EBQUIRE and JANICE E. YOCUM, the Testatrix and the witnesses respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she had signed willingly (or willingly directed another to sign for her), 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 this Last Will and Testament as witness and that to the bPSt of their knowledge the Testatrix was at the time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. ,, j; MARY COCKLIN WITNESS ITNESS Sworn to and subscribed be-f7ore me this /3 ~h day of _ ~-Y---~~JI~J/ L~~-z~-/L/~ , 1996. NOTARY PUBLIC MY COMMISSION EXPIRES: ~;.. 8v ~ Gi• :o~~mppry~~PirrEAo q ~~. 'VlyCormYss' : tvi~ 17',1987 ~ h,euiUdr, nisyl~,~~acu 1cso:i N.~~..,...>~ G ~:.. SECOND AMENDMENT TO THE TRIIST OF G. KENNETH AND MARY B• COCRLIN TRIISTORS BANK N ,A. SIICCESSOR TO THE FIRST BANK ~ COMPANY MECgANICSBIIRG PA TRIISTEE IGINAL DATE OF TRIIST: SEPTEBZ,iBER221 119 E OF FIRST AMENDMENT: JAN M, WII,EY & ASSOCIATES AT[ORI'7EY9 A7 LAµ' ~E i ~ RgAL7IMORE S~ COCKLIN, entered WHEREAS, G. KENNETH COCKLIN and MARY B. Trust Company, into a Revocable Trust with First Bank and 1989, a copy of Mechanicsburg, Pennsylvania, dated November 2~, is attached hereto, and is the referenced trust includec which in the Amendment. 1995, survive WHEREAS, G. KENNETH COCKLIN died on July 13, his wife, MARY B• COCKLIN, the Trustor herein named; by WHEREAS, MARY B- COCKLIN, amended the original Trus Bement; a copy of said original Trust Agreement and Amenclmen Agr is attached hereto; letely delet WHEREAS, MARY B• COCKLIN now wishes to comp f the terms and conditions of the first Amendment to t1 all o original Trust Agreement. ++ t' WHEREAS, MARY B. COCKLIN, is desirous of amending "One through Fiv provisions of the original Trust Item 4(c) ++ • and as follows: To Delete items 4(c) "One through Five ~ a JAN M. WILEY & ASSOCIATES ATTORV EYS AT L1 W ~.ti~E $OU'ffi BALTL'HORE ST. DILL59URG. P.1 17019 substitute the following bequests in lieu thereof: (a) Trustor herein gives the sum of Fifty Thousand ($50,000.00) to MESSIAH COLLEGE, Mechanicsburg, Pennsylvania. (b) Trustor herein gives the sum of Fifty Thousand ($50,000.00) to MESSIAH VILLAGE, Mechanicsburg, Pennsylvania. (c) Trustor herein gives the sum of Fifty Thousand ($50,000.00) to THE BRETHREN IN CHRIST CHURCH; of Messiah Village, Mechanicsburg, Pennsylvania. (d) Trustor herein gives the sum of Five Thousand ($5,000.00) Dollars to THE CHILDRENS HOME OF THE UNITED METHODIST CHURCH, Mechanicsburg, Pennsylvania. (e) Trustor herein gives the sum of Five Thousand ($5,000.00) Dollars to THE ZEMBO LUNCHEON CLUB. (f) Trustor herein gives the sum. of Ten Thousand to FILEYS CEMETERY ASSOCIATION. {g) Trustor herein gives the sum of Ten Thousand ($10,000.00) Dollars to THE TRINITY LUTHERAN CEMETERY, of Tanneytown, Maryland. (h) Trustor herein gives the sum of Twenty Thousand ($20,000.00) Dollars to THE DILLSBURG CEMETERY ASSOCIATION, Dillsburg, Pennsylvania. (i) Trustor herein gives the sum of Fifty Thousand _ __ i ~. -- _. • ($50,000.00) Dollars to THE CALVARY UNITED METHODIST CHURCH. (j) Trustor herein gives the sum of Ten Thousand ($10,000.00) to THE MASONIC HOMES, of Elizabethtown, Pennsylvania. (k) Trustor herein gives the sum of Ten Thousand ($10,000.00) Dollars to THE DILLSBURG FIRE COMPANY, Dillsburg, Pennsylvania. I hereby confirm all other provisions of the trust above referenced, however the name of the Trustee shall now be changed to PNC BANK, N.A., successor to the First Bank and Trust Company. IN WITNESS WHEREOF-~ TRUSTOR AND TRUSTEE have executed this Amendm nt at / /-~ ~ /l~-r~~ Pennsylvania on the =~da of ~/ 1996. y -~ WI ESS: '~ - ~, ~ ( SEAL) ~ MARY B COCKLIN ATTES PNC BANK, N.F. ~ r SEAL) ,~ By Secretary ,,-1 /~~_ JAN M. WILEY & ASSOCIATES ATTORNEYS AT (aW ONE SOUTH gALTIMURE ST. D(LL58URG, PA 1)019 ~_ . ~?= i~-~~. ~. =''~ ~" ~~ /~ `~~ ~. ( y ~_YN H- wILEY _-~SSOCI~,TES +rroR~et nr uw BARLO CIRCLE ~ILISBCRG. P~ 17019 _. t'~,y AMEN~~7~NT TO THE TRUST OF v ~. KENNETH AND MARY B. COCRLIN, TRIISTORS _AND. PNC BANK, N.A., SIICCESSOR BY MERGER AITH THE FI: t ~'~, TRIIST COMPANY, MECHANICSBIIRG, PA, TRIISTEE ORIGINAL, DATE OF TRIIST: NOVEMBER 20. 1989 BANK & / WHEREAS, G. KENNETH COCKLIN and MARY B. COCKLIN, entered into a Revocable Trust with First Bank and Trust CompanY~ Mechanicsburg, Pennsylvania, dated November 20, 1989, a copy of which is attached hereto, and is the referenced trust included in this Amendment; WHEREAS, G. KENNETH COCKLIN died on July 13, 1995, survi~i~'d by his wife, MARY B. COCKLIN, the Trustor herein named; WHEREAS, MARY B. COCKLIN, Trustor is desirous of amending the provisions of the original Trust 4(C) "One through Six", ~>; fo 11ows (A) To delete original items 4(c) "One through Six"- (B) To substitute the following bequests in lieu thereof: 1. Trustor herein gives the sum of One Hundred Thousand ($100,000.00) Dollars to MESSIAH COLLEGE, Grantham, Pennsylvania. 2. Trustor herein gives the sum of One Hundred Thousand ($100,000.00) Dollars to MESSIAH VILLAGE:, Mechanicsburg, Pennsylvania. ^_ _ __ _ JAN M. WILEY & ASSOCIATES ATTORNEY AT L1W BARLO CIRCLE DLLiSBURG, PA 17019 3. Trustor herein gives the sum of Two Hundred Thousanc ($200,000.00) Dollars to THE BRETHREN IN CHRIST CHURCF OF MESSIAH VILLAGE, Mechanicsburg, Pennsylvania. 4. Trustor herein gives the sum of Five Thousand ($5,000.00) Dollars to THE CHILDRENS HOME OF THE UNITED METHODIST CHURCH, Mechanicsburg, Pennsylvania. 5. Trustor herein gives the sum of Five Thousand ($5,000.00) Dollars to THE ZEMBO LUNCHEON CLUB. 6. Trustor herein gives the sum of Five Thousand ($5,000.00) Dollars to FILEYS CEMETERY ASSOCIATION. 7. Trustor herein gives the sum of Five Thousand ($5,000.00) Dollars to THE TRINITY LUTHERAN CEMETERY, Taneytown, Maryland. 8. Trustor herein gives the sum of Ten Thousand ($10,000.00) Dollars to THE DILLSBURG CEMETERY ASSOCIATION, Dillsburg, Pennsylvania. 9. Trustor herein gives the sum of Three Thousand ($3,000.00) Dollars to THE CALVARY UNITED METHODIST CHURCH, Dillsburg, Pennsylvania. 10. I give the sum of Ten Thousand ($10,000.00) Dollars to THE MASONIC HOMES, Elizabethtown, Pennsylvania. 11. I give the sum of Fifty Thousand ($50,000.00) Dollars to JAMES R. COCKLIN, of 680 Fickes School Road, York Springs, Pennsylvania. i 12. All the rest, residue and remainder of my trust, of whatsoever nature and wheresoever situate, whether it be real, personal or mixed, including property over which I have a power of appointment, I give, devise and bequeath as follows: r1. k'ILEY ~ .ASSOCIATES TORVEY AT LAW BARLO CIRCLE LSBI:RG. PA 17019 (a) One-half (1/2) thereof to the surviving nephews and nieces of my husband, G. KENNETH COCKLIN, in equal shares; (b) The remaining one-half (1/2) thereof to my surviving nephews and nieces (the Baumgardner's). C- I hereby confirm all other provisions of the trust above referenced, however the name of the Trustee shall be now changed to PNC BANK, N.A., successor to The First Bank and Trust Company. IN WITNESS WHEREOF, TRUSTOR AND TRUSTEE have executed this Amendment at 789 Messiah Village, Mechanicsburg, Pennsylvania on 5/ the ~~ day of ~- t 1995. WITNESS: //~ !, MARY COCRLIN (SEAL) ATTEST: m. V.- ~~T- I ruST OFFS cer PNC B~, N. A~ BY. - (SEAL) • TRUST \'ILEY & BENN, P. C. ATTOflNEYS AT LAW 20~-206 MUNPEfl LANE P.O. BOX 288 DILLSBUPG. PA 17019 t THIS TRUST AGREEMENT made this ~ day of 1989, by and between G. KENNETH COCRLIN and MARY B. COCRLIN, of 789 Messiah Village, Mechanicsburg, Cumberland County, Pennsylvania, hereinafter referred to as TRUSTORS and FIRST BANK & TRUST COMPANY, of Main and Market Streets, Mechanicsburg, Pennsylvania, hereinafter referred to as TRUSTEE. W I T N E S S E T H WHEREAS, TRUSTORS are now the owners of property and assets as described in Exhibit "A", attached hereto; WHEREAS, TRUSTORS desire to make provisions for the care and management of such property and assets, the collection of the income thereform, and the disposition of both such income and such property and assets in the manner herein provided; NOW THEREFORE, for the reasons set .forth above, and in consideration of the mutual covenants set forth -1- ., • LJ herein, TRIISTORS and TRUSTEE agree as follows: 1. TRIIST ESTATE: TRUSTORS assign, transfer, and convey to TRUSTEE the property and assets described in Exhibit "A", attached and incorporated by reference herein, receipt of which is hereby acknowledged by TRUSTEE (such property and assets hereinafter referred to as principal). The principal shall be held by TRUSTEE in Trust on the terms and conditions hereinafter set forth. 2_ REVOCATION AND AMENDMENT: TRUSTORS reserve the right at anytime, by an instrument in writing deliverd to TRUSTEE, to revoke or amend this Trust in whole or in part. The duties and liabilities of TRUSTEE shall under no circumstances be substantially increased by any amendment hereunder except with its written consent. 3_ ADDITIONS TO TRIIST ESTATE: With the consent of TRUSTEE, any person may, from time to time, by conveyance, assignment, transfer, will or otherwise, add property or assets of any kind to the Trust Estate or any part thereof. Such property or assets shall thereupon be subject to all the terms «'ILEY & BENN, P. C. ATTORNEYS AT LAW 30~-206 ~1UMPER LANE P. O. BOX 288 DILLSBURC. PA 1019 -2- • and provisions of this Agreement. 4_ DISTRIBIITION OF INCOME AND PRINCIPAL: TRUSTEE shall hold, manage, invest and reinvest the property and assets of the Trust, shall collect and receive the income therefrom, and after deducting all necessary expenses, incident to the administration of the Trust in the manner herein provided, shall dispose of the net income and principal of the Trust as follows: (a) TRUSTEE shall pay to TRUSTORS during their lifetime, in monthly installments, the net income --~(i„LV v1 derived the principal of the Trust Estate. The i~\vcu- ~- TRUSTEE shall also have the right to noes the Trust Estate and pay from the principal of the Trust Estate any funds which TRUSTEE deems necessary for the health, care, support, maintenance, education, recreation, ect. to the TRUSTORS. (b) TRUSTEE shall not change the type of investments as set forth in Schedule "A" hereinafter, without the consent of the TRUSTORS. It being the intent of the TRUSTORS to keep the investments in substantially the same form as they are upon the execution of this Agreement. However, the TRUSTORS may at any time request the TRUSTEE to change the ~i'ILEI' & BENN, P. C. ATTORNEYS AT LAW 40~-206 ~SUMPEA LANE P.O. BOX 288 DILLSHUAC, PA 17019 -3- ~ .. c `t~~~1 ~~ \~, li^Y ,7 ~~ ~~ ,` v"' ~ ~ ~'~ ~a ~ ~ -"~ ~ ~~~ ~~ ~~ , ~ E, '~j ' ` , `~ ~\~ ,e`er ~. }~ ~}`~ ,~„ ~_,, ~~ :` ,\ i~~' f j` !~ v .1 y' \ `. «'ILEY & BENN, P. C. ATTOR\EYS AT LAW !Ot-206 MUNPER LANE P.O_ BOX 288 D[LLSHURC, PA !7018 investments and the TRUSTEE may at any time recommend to the TRUSTORS changes in investments all of which will be permitted when the TRUSTORS sign a consent form acknowledging the change for the TRUSTEE_ ' (c) Upon the death of either the TRIISTORS herein, ~ the TRUSTEE may pay the expenses of the TRUSTOR'S last illness and funeral, and also inheritance tax from the Trust Estate unless other adequate provisions shall have been made therefore. Upon the last death of the TRUSTORS herein, and after payments of such expenses as set forth above, the net income and principal of the Trust Estate shall be paid and distributed as follows, to wit: ~). TRUSTORS herein give the sum of Three Thousand ($3,000`.00) Dollars to Filey's Cemetary Association. ~~) TRUSTORS herein give the sum of Three Thousand ($3,000\.00) Dollars to Trinity Lutheran Cemetary, of Taneytown, Maryland. ~) TRUSTORS herein give the sum of Three Thousand ($3,000\.00) Dollars to Dillsburg Cemetary Association. TRUSTORS herein give the sum of Three Thousand ($3,000.00) Dollars to Calvery United Methodist Chruch, -4- of Dillsburg, Pennsylvania. ~~ ~~ ~;~ v~ ) TRUSTORS herein give the sum of Three Thousand e Lod i Y g on ($3,000.00) Dollars to Eureka Home Associat #302, of Mechanicsburg, Pennsylvania. (g) One-half (~) of the balance of the Trust Estate shall be placed in further Trust for the benefit t3iC tt ~z (~ of DONALD R. BAUMGARDNER and CHARLES D_ BAIIMGARDNER, equally and interest only shall be payable to DONALD R. BAUMGARDNER and CHARLES D. BAUMGARDNER, equally for and during their natural lives. Upon the death of DONALD R. BAUMGARDNER, his one-forth (a) share of the Trust Estate shall be distributed in equal shares to DEBRA R. PISCITELLI, and DONALD R_ BAIIMGARDNER, JR_ per stirpes. Upon the death of CHARLES D_ BAUMGARDNER, his one-forth (4) share of the Trust Estate shall be distributed equally between BETTY J_ WEBER and JEAN RYAN_ c ___ (2) The remaining one-half (~) of the Trust Estate shall be paid and distributed in Trust to the FIRST BANK ~ TRIIST COMPANY to the benefit of JAMES i+.r ~~\G'vr~ 5!`J -t ,'~'':~N: ~~_` i~a~1l~"~~~r ~C'k. `7111 Z` 1.L~~y1~ SARA MYERS and JAMES R_ COCRLIN, equally COCRLIN , A_ with interest only paid quarterly to said benef iciaries equally. Upon the death of JAMES A. COCRLIN one-sixth (1/5) of the Trust Estate shall be paid to J. LARRY ~ N[LEY & BENN, P. C. ATTORNEYS AT LAW 20~-206 MUMPER LANE e.o. sox ssa DILLSBURG. PA 17019 -5- f ~ _~ I:` COCRLIN, DONNA C. GROVE and JOHN A. Cocxt.zri in equate shares per stirpes. Upon the death of SARA J. MYERS, one-sixth (1/6) shall be paid unto JANE M. RHONE, LINDA M. GRUBER and WAYNE E_ MYERS in equal shares per stirpes. Upon the death of JAMES R. COCRLIN, the remaining one-sixth (1/6) share of the Trust Estate shall be distributed unto BRIAN R. COCRLIN. S_ TRUSTORS INVASION OF CORPUS: If TRUSTORS deem the net income payable hereunder insufficient to provide for their health, care, support, maintenance, education, recreation, or for any other purpose or reason, whatsoever, TRUSTORS have the power to invade the Trust Estate and receive from the principal of the Trust Estate those funds which TRUSTORS, in their sole and absolute discretion, deems necessary. TRUSTORS have the right to extinguish the entire Trust Estate to provide for such health, care, support, maintenance, education, recreation, etc. 6. POWERS OF TRUSTEE: In the administraiton of the Trust, TRUSTEE, in addition to all other powers granted by law, shall have the following powers, all of which shall be exercised in a fiduciary capacity and primarily in the interest of the TRIISTORS_ y ~VILEY K BENN, P.C. ATTORNEYS AT LAW 40~-206 MUMPER LANE e.o. Box 4ae DIL LSBURC. PA I70 i9 -6- ~~ • (a) To retain any property or undivided interest in property, received from the TRIISTORS or from any other source including residential property, regardless of any lack of diversification, risk or non-productivity; (b) To invest and reinvest the Trust Estate in bonds, notes, stocks, or corporation regardless of class, real estate or any interest in real estate, and interest in trust including common trust, funds, or any other property or undivided interest in property, wherever located, without being limited by any statute or rule of law concerning investments by TRUSTEE; (c) To sell any Trust property, for cash or on credit, at public or private sales; to exchange any Trust property for other properties; to grant options to purchase or acquire any Trust property; and to determine the prices and terms of sales, exchanges, and options; (d) To operate, maintain, repair, rehabilitate, 'ILEY dr BENN, P. C. ATTORNEYS Ai LAW 20~-Y06 MUMPEp LANE P. O. BOX Y88 DILLSBURC, PA 17019 - 7 - • alter, improve or remove any improvements on real estate; to make leases and subleases for terms of any length, even though the terms may extend beyond the termination of the Trust; to subdivide real estate; to grant easements, give consents, and make contracts related to real estate or its use; to release or dedicate any interest in real estate; (e) To borrow money for any purpose and to mortgage or pledge any Trust properties: (f) To employ attorneys, auditors, depositories, proxies and agents with or without discretionary powers; and to keep property in the name of a trustee or nominee, with or without disclosure of any fiduciary relationships or in bearer forms: (g) To determine the manner or ascertainment of income and principal, in the allocation or apportionment between income and principal of all receipts and disbursements; (h) To take any action with respect to conserving or realizing upon the value of any Trust property, and in respect to foreclosures, LEY bt BENN, P. C. tT TORNEYS A7 LAW t-S06 MUMPER LANE P.O. ROX 2E8 IL LSBURC, PA 17019 .8. reorganizatins or other charges affecting the Trust property; to collect, pay, contest, compromise or abandon demands of or for against the Trust Estate wherever sitauted; and to execute contracts, notes conveyances and other instruments, including instruments containing covenants and warranties binding upon and creating a charge against the Trust Estate, and containing provisions excluding personal liabilities; (i) To receive additional property from any source and add it to and commingle it with the Trust Estate; (j) To make any distribution or division of the Trust property in cash or in kind or both, and to continue to exercise any powers and discretion hereunder for a reasonable period after the termination of the Trust, but only for so long as no rule of law relating to perpetuities would be violated. (k) To invest principal and income without restriction to so-called "legal investments" for fiducaries. TRUSTEE may make short and/or long-tem investments with trust WILEY & BENN, P. C. A2TOANEYS AT LAW 20~-208 MUMPEA LANE P.O. BOX 288 DILLSBUAC. PA 17019 -Q_ ~ ~ principal and income in a money market fund for which TRIISTEE- receives fees for record-keeping and/or other services it performs for such fund, or in a deposit account at a bank affiliated with TRUSTEE, or TRUSTEE itself_ 7. DURATION OF TRUSTEE'S POWERS: All of the rights, powers, authorities, privileges and immunities given to TRIISTEE by this Agreement shall continue after termination of the Trust created hereby until TRUSTEE shall have made actual distribution of all property held by it hereunder. 8. FEES: As compensation for its services hereunder, TRUSTEE may retain from time to time from trust principal, income or partly from each those fees which are specified in its published or otherwise generally applicable fee schedule in effect at the time its services are being rendered. Grantor reconizes that this schedule might be changed from time to time. 9. TERMINATION OF TRUST: This Trust shall terminate upon the last death of the TRUSTORS or in the event that the assets of ILEY 8c BENN, P. C. ATTORNEYS .~T LAW YOt-406 NUMPER LANE P.O. BOX 486 DILLSRURG. PA I701o -10- • the Trust Estate are completely extinguished, which ever shall come first. 10. GOVERNING LAW: This Agreement and the dispositions hereunder shall be construed and regulated, and their validity and effect shall be determined, by laws of~ the State of Pennsylvania. IN WITNESS WHEREOF, TRUSTORS and TRUSTEE have executed this Agreement at the Law Offices of WILEY & BENN, P.C., 204 Mumper Lane, Dillsburg, Pennsylvania, on the day and date above first written. ~4'ILEY &BENN, P.C. ATTOA~EYS AT LAW ~ 40~-206 MUMPEP LANE ''~ P.O. 80X 288 ' DILLSAUAC. PA 17019 WITNESS: ~- ~ / ~ ;,• / ,, _ ` . ~. V ~T~~ CO RLIN / / 1/i/fc.,l _7_") - ~,J--c°~..~ ~ (SEAL ) MANY B. COCRLIN ATTEST: ~~~/>' - = Secretary . ~ ~i~ -11- TRUST COMPANY (SEAL) ~l ~ ~ ,., ~CL'1 ~ ~ EXHIBIT "A" 1S'ILEY & BENN, P.C. ATTORNEYS AT LAW 401-206 MUMPER LANE P.O. BOX Y88 DILLSBURC, PA 17019 i • SCHEDULE A (STOCKS) 112 shs Chrysler Corp. 49 Ford Motor Co. 50 Pennsylvania Power & Light 8.40 Pfd 50 Pennsylvania Power & Light 9.24 Pfd 300 DQE, Inc. (formerly Duquesne Light) 100 Centerior Energy 142 Dauphin Deposit Corp. 684 PNC Financial Corp. 813 American Telephone & Telegraph 243 Southwestern Bell 242 American Information Technologies 162 NYNEX 162 Bell Atlantic 364 BellSouth 324 Pacific Telesis Group 162 US West, Inc. 4576 Mellon Bank Corp Pfd B CV 6.75% 100 United Telecommunications, Inc. 30 Metrflliolitan Edison Co Pfd H 8.32% SCIIEDULE A (BONDS) $25,000 Luzerne County Industrial Development Authority Exempt Facilities Revenue Bond, 1987 Serie:> B rate 8% due December 1, 2017 $10,000 State Public School Building authority School Lease Revenue Bond, Series BC rate 8.75% due November 1, 1990 $15,000 York Couhty Hospital Authority Hospital Revenue Bond, Series of 1985 rate 7.20% due December 1, 1991 $20,000 Pennsylvania Higher Educational Facilities Authority Messiah College Revenue Bond, First Series of 1984 rate 9.625% due October 1, 1999 $20,000 Pennsylvania H;lgher Educational Facilities Authority Messiah College Revcmie Refunding Bond, First Series of 1985 rate 9% due September 1, 1999 $20,000 Multi-Purpose Stadium Authority of Lackawanna County Guaranteed Stadium Revenue Bond-Series 1986 rate 8% due August 15, 1996 $30,000 Hempfield Area School District General Obligation Bond, Series•of 1988A rate 7.4% due Ptarch 15, 2001 $10,000 Township of Upper Allen General Obligation Bond, Series of 1985 rate 7% due April 1, 2008 $15,000 Lake Heritage Municipal Authority Adams County, Sewer Revenue Bond-Series of 1989 rate 7.2% due September 1, 1y95 $2,000 Springettsbury Township Sewer ;-,uthority Sewer Revenue Bond Series of 1966 rate 4.20% due April 15, 2005 Bearer--SCA 6/15/90 $15,000 Reading School Authority Berks County ~~, School Revenue Bond Series of '_978 rate 6% due December 1, 1992 Bearer--SCA~~6/1/90 $1,000 Dillsburg Borough Au_hority Waver Revenue Bond, Series of 1960 rate 4 5/8% due Apr'_1 1, 2000 Bearer--SCA 4/1/90 , Rw•160313X+ (8-98) SCHEDULE B STOCKS 8t BONDS cawaNwEA~TN of aENNSnvANw I I INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Cocklin, Mary B. 21-08-00276 All property Jolrrflyownsd vAth rlgM of survlvorsllip must be disclosed on Schedule F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 34 shares of Alcatel-Lucent Stock: 6.33 215.22 2 769 shares of AT&T Stock: 38.49 29,598.81 3 99 shares of Comcast stock: 18.16 1,797.84 4 9 shares of Idearc stock: 16.24 146.16 5 182 shares of Verizon stock: 38.83 7.067.06 6 113 shares of Vodafone stock: 34.85 3,938.05 TOTAL (Also enter on Line 2, Recapitulation) 42.763.14 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) ~11 North 3rd Street '' 2nd Floor Strawberry Square • • Harrisburg, PA 17701 Tel 777 780 1700 Fax 717 233 ?_090 Toll Free 800 237 7700 smith barney October 15, 2008 The Wiley Group Attn: Dawn Gladfelter 130 W. Church Street, Ste 101 Dillsburg, Pa 17019 Re: Mary B Cocklin Estate "llc~{ sh, 3'-}5h ~ ~ ash G'~ sh 4~- 1. Ash Dear Cawn, I received your request for date-of-death balances the Cocklin Estate. I am unable to prepare a report detailing the value of her securities because Smith Barney was not holding the assets at the time of her death. I have composed the values as of 01/31/2008 for stocks that Ms. Cocklin held in direct registration with the transfer agents. They are as follows: Stock Hi h Low Closin AT&T (T) 38.49 36.57 38.49 Alcatel-Lucent ALU} 6.38 6.11 6.33 Vodafone VOD 35.19 33.92 34.85 Comcast (CMCSA) 18.20 17.38 18.16 Idearc IAR 16.47 15.93 16.24 Verizon (VZ) 39.17 37.51 38.83 I hope this information is helpful to you. Please do not hesitate to contact me at 717- 780-1726 with any questions or concerns. ingest P.eg~rd~„ ~i Je nifer onway R gistered Client S ice., , ssociate for ' Ronald Wetzel Senior Vice President -Wealth Management Financial Advisor THE iN!=0R ;~. ~:, ~ ;~_ . O$TAiP~1c i FG::;rt TQ &. ~Ct:it.~3~;:, 5:~ r;;~ . `+..J t l.'.:: ~.i~f-,~~~ tom, !7S A(:C?iit~CY. On CLMri.t7F.r:~ .}, .~ a rl5•~ ~ ~ ~.9~-e5 s + y4 . ~ C~ Citigroup Global Markets Inc. The information set forth was obtained from sources which we believe reliable but we do not guarantee its accuracy or completeness. Neither the information nor any opinion expressed constitutes a solicitation by us of the purchase or sale of any securities. Rev-1609 EX+ (g.96) SCHEDULE F ' coM.aNwEnLrNOFrENNSVLVrww JOINTLY-OWNED PROPERTY INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Cocklin, Mary B. 21-08-00276 B. C. Han asset wu made johd whhin one year of the decedent's date of desth, k must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Donald R. Baumstardner Sr. 116 Euclid Avenue Brother ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH GEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH ALUE OF ASSET % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST 1 A 4/16/2007 PNC Bank CD#31000309253 (This CD 103,864.21 0.500% 51.932.11 was a rollover from an account G~ PNC originally opened on 11/9187) 2 A 4/5/1988 PNC Bank Checking Account 18.875.26 0.500% 9,437.63 #5070101942: 3 A 1119/1987 PNC Bank Savings Account 102,375.31 0.500°/9 51,187.66 #5030073561: Charles Town, WV 25414 JOINTLY OWNED PROPERTY: TOTAL (Also enter on Line 6, Recapitulation) I 112,557.40 (fl more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) ..!.'ay. ~. 2G?$ 2:37Fi~ PNi, BANK 4 i 2-7i~5-2747 Nc. ~9~'. P. 1/2 ~'. ~ PNCBAI~K Tht Thinking Behind Tht Mpnry May 5, 2008 The Wiley Group Attorneys at Law S Dawn Gfadfelter 130 W Church St Suite 101 Dillsburg, PA 17019 RE: Mary B Cocklin (Deceased) SSIV: 230-24-2032 DOD: 01-31-2008 Dear Ms. Gladfelter: to response to your request for Date of Death balances for the customer noted above, our records show the following: Certificate of Deposit Account# 31000309253 Established 04-1b-2007 ~~;,~ ac ~ 5o3ee13~(.e( MARYB COCKLIN DONALD R BAUMGARDNER J(,1 ~~ ~ ''- ~~ ~ ~ DOD balance: $103,657.70 + 206.51 accrued interest , Checking Account Account # 5070101942 Established 0405-1988 MARY B COCKLIN ~ I a ``~ -i j 1 La DONALD R BAUMGARDNER . DOD balance: $18,872.00 + 3.26 accrued interest Savings Account ~~11 ~ . ~ ~Vi!', J /~ ~ ~ Account# 5030073561 Established 11.09-1987 MARY B COCKLIN DONALD R BAU"MGARDNER DOD balance: $102,335.10 + 40.21 accrued interest Page 1 of 2 ,. 2+:~~8 2:38PM PNC BANK 412-70~-2?47 X10. 39~ i P. 2!2 Please note that this office only provides date of death balances for deposit accounts (IltAs, CDs, Checking and Savings accounts). We do not process any financial transactions or provide statements. If you need assistance with any of these items, please cal] 1-888-PNC-BANK (i-888-762-2265) or stop by your local PNC Bank bramch office. Sincer , Colleen Crowder 1-800-7b2-1775 P7-PFSC-04-F 500 First Ave Pittsburgh, PA 15219 Member FDIC Page 2 of 2 Rsv-1610 EX+ (8-88) COMdONWEALTH OF PENN8VLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Cocklin, Mary B. 21-08-00276 TNs schedule must be completed and flled'R the answer to arty or questions 1 through 4 on the reverse side of the REV-7500 COVER SHEET is yea. ITEM NUMBER INCLUDE NAME OF 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 The G. Kenneth Cocklin and Mary B. Cocklin 683,925.40 683,925.40 Trust Account 1492008 Securities and Money Market: TOTAL (Also enter on Line 7, Recapitulation) I 683.925.40 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) Certificate of Deposit Page 1 or 2 ~ PNCBANk account Verification PNC Bank National Association MARY. B COCKLIN DONALD R BAUMGARDNER 116 EUCLID AVE CHARLES TOWN WV 25414 Base Interest Rate 4.6980 Package Points 0.0500 Certificate Number Reference Number 31000309253 3000125721 Purchase Date Purchase Amount 04/16/2007 $100,000.00 Maturity Date 12/16/2007 Term 8 MONTHS Annual Percentage Yield 4.8500 Renewal Type AUTOMATIC Product Description FIXED RATE CD For Information, Call 1-877-BANK-PNC Account used to purchase this certificate: PNC Bank 5030073561 Interest Rate Effective Until 4.748 12/16/2007 040 Membe Please review the Account Agreement on reverse side for important information about this account. ~D" .PNC WEALTH MANAGEMENT April 29, 2008 Jan M Wiley, Esquire The Wiley Group 130 W Church St Suite 101 Dillsburg PA 17019 Re Estate of Mary B Cocklin Dear Mr Wiley: Per your letter dated April 24, 2008, enclosed please find an Estate Valuation report for all holdings held in the trust as of January 31, 2008. I also enclose the money market balance as of that date. Please review the report and if you have any questions please contact Debra Smith at (717) 730-2275. Sincerely, ~` r _ C Denise C Kyan `,. Trust Administrative Advisor Enclosure Member of The PNC Financial Services Group 4242 Carlisle Pike Camp Hilt Pennsylvania 17011 ESTATE TAX SECURITIES VALUATION PAGE NO. 1 ssues sorted by security. Name of E state: MARY B COCKLIN CCOUNT: 1492008 DATE OF DEATH: Thursday, January 31 2008 SHARES/ DESCRIPTION PAICE HIGH/ASK LOW/BID MEAN SECURITY VALUE ACCRUED D1V/INT COMMENTS TEM CUSIP NO. DATE PRICE PRICE PRICE PAR VALUE _________ __________ _ _________ _ ____________ _ ___ __ _ __ ____________________________ _____ _ 01/31 38.4900 36.5700 37.53000 114,504.03 1) 002068102 3,051 ATST INC COM DN $0.4000 EX 01/08/2008 REC 01/10/2008 PAY 02/01/2008 1,220.40 ALLIED 2RISH BKS P L C 01/31 44.8100 43.5601 44.18505 35,34B.Od NYSE 2) 019226402 800 SPON ADR ORD 6B0 1750 293 39 BLACKROCK MULTI ST MUN SEA TR. 11.0400 01/31 11.04000 433,796.65 MUT FUND 3) 09253A . , PA MUN BD INST 01/31 16.4700 15.9300 16.20000 466.00 NYSE 4) 451663108 30 IDEAAC INC COM VERIZON COlAfUNICATIONS 01/31 39.1700 37.5100 38.34000 23,004.00 NYSE 5) 92343V104 600 COM DIV $0.4300 EX 01/08/2008 REC 01/10/2006 PAY 02/01/2008 256.00 --- ------------- 607,138.72 ------------ 1,476.40 ;rand Totals 608,617.12 Cotal Principal plus Accrued interest and dividends This report was prepared using APPRAISE Ver. 7.4.1 software, an EVALUATION SERVICES, INC. product. Phone 201 784 8500. Visit our web sites at WWW.APPRAISENJ.COM and WWW.COSTBA.SIS.INFO. Page: 1 Document Name: Carol Koscienski ?.~~~ :", ~ 4~20Q8 r-= 013010 :- 2 t ? `?' ~~ 001 0?0108 _ ~'~004 T Oku1 t38 ~~,~` -'__ TRAN CODE TC, ENTER X DETAIL, A/R REVERSAL, C CHANGE, M MEMO p .? a~ =: x: *x* C;~ISFf Fi~'~~?d0~ flt~ 01;`~~'0~ ~~,~OR.r3 ~0 t~ €.; ~ .€. ,.~ ~ . J~` ~,v;~za~ "IEIti;I) '~ 'r I?~ ~._ t:`;~.' ~., . '= < s s;~E . ~;a3 G't:s 1 t. ti -z °r~. 3`xx€ )~`7 _~. tr -,i€~a L.i S ~'~) ! .f i E.~ t1 i'dta :`°t v' ~-"'~t~~r i1(.i r, ~ i art a..>:?c~~ i _, ._ e~wS,s~~~i, f-';'~:~~~.1 'f t ~~ ~ ~ µ M:,7 „~.:~~`i; i`" . ~:~~ ~`~ x r, x. is Liza i 1. 1`>„~:;=~ l ~ h~i~~.. I ~~~': cS= ~~ r, ~~ 4-© A Sess-1 10.128.196.100 PX1EF168 #§1/65 Name: PA00009 - Date: 04/29/2008 Time: 12:54:42 PM r REV•1161 EXt (12.99) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES ~ IN R SIDENTEDECEDENTR" ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Cocklin, Mary B. 21-08-00276 Debts of decedent must be reported on Schedule 1. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 18,520.82 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Donald R. Baumgardner Social Security Number(s) / EIN Number of Personal Representative(s): street address 116 Euclid Avenue c;ty Charles Town State VIN zip 25414 Year(s) Commission paid 24,000.00 2, attorney's Fees The Wiley Group, PC 24,000.00 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 a. Probate Fees Register of Wills: 99.00 5. Accountant's Fees 600.00 6. Tax Return Preparer's Fees 7. Other Administrative Costs 279.58 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 67,499.40 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rw•1602 EX~ (&98) COMt~gNWEALTH OF PENNSYWANIA MIHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H-A FUNERAL EXPENSES continued ESTATE OF FILE NUMBER Cocklin, Mary B. 21-08-00276 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) ~ Rw-1602 Exr (~) a • COMACNVYEALTN OF PENNSYLVANIA INHERRANCE TAX RETURN eec,neur ncrcncur SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Cocklin, Mary B. 21-08-00276 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) • Rsv-7612 EX+ (S.9g) CDM~IONWEALTH OF PENNSYLVANIA INHERRANCE TAx RETURN RESIDENT DECEDENr ESTATE OF Cocklin, Mary B. SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS LE NUMBER 21-08-0o27s Include unrolmburosd medical expenses. ITEM NUMBER DESCRIPTION 1 Alert Pharmacy: 2 Messiah Village: VALUE AT DATE OF DEATH 273.95 7,587.49 TOTAL (Also enter on Line 10, Recapitulation) I 7 861 44 (If more space Is needed, addlUonal pages of the same size) ' Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV-1613 EX+ (9-00) ~ + SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT Cocklin, Mary B. FILE NUMBER 21-08-00276 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE I. TAXABLE DISTRIBUTIONS [include outri ht s o l 0o Na uu T , (Words) ($$$) g p usa distributions and transfers under Sec. ~116(a)(1.2)] 1 Donald R B . aumgardner Jr. c/o Donald R. Baumgardner Sr. Nephew 31,919.44 , 116 Euclid Ave. Charles Town, VVV 25414 2 Donald'B~ Baumgardner,Sr . Brother 116 Euclid Avenue 155,320.54 Charles Town, WV 25414 3 J. Larry Cocklin Nephew 203 Greenbrier Lane 18,809.14 Dillsburg, PA 17019 4 John A. Cocklin Nephew 30 Kimberly Court 18,809.14 Englishtown, NJ 07726 5 Donna C. Grove Niece 401 N. 5th Street 18,809.14 Lemoyne, PA 17043 See continuation schedule attached Continuation 250,217.70 Enter dollar amounts for distributions shown above on lines 5 through 18, as appropna 493,885.10 t Ton Rev 1500 cov h NON TA I er s eet - XABLE DISTRIBUTIONS: II A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS See continuation schedule(s) attached TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHFFr 270,000.00 -~rr~a~~• w, ~~~~ cairn svmvare onry i ne Lackner Group, Inc. ' Form PA-1500 Schedule J (Rev. 6-98) . ,. SCHEDULE J BENEFICIARIES (Part I, Taxable Distributions) 'ESTATE OF: Mary B. Cocklin 01/31/2008 230-24-2032 Item Name and Address of Person(s) Number Receiving Property Relationship 6 Debra K. Piscitelli Niece c/o Donald R. Baumbardner, Sr. 116 Euclid Avenue Charles Town, WV 25414 7 PNC Wealth Mgt., Trustee for Brother Donald R. Baumgardner, Sr. 4242 Carlisle Pike Camp Hill, PA 17011 8 PNC Wealth Mgt. Trustee for James Nephew R. Cocklin 4242 Carlisle Pike Camp Hill, PA 17011 9 PNC Wealth Mgt. Trustee for Sara Sister-in-Law Myers 4242 Carlisle Pike Camp Hill, PA 17011 10 Jean Ryan Niece 584 Crest Haven Court Front Royai, VA 22630 11 Betty K. Weber Niece 5469 Craine Feather Drive Port Orange, FL 32128 Share of Estate (Words) Amount of Estate (ass) 31.919.45 20,802.25 56,427.43 56,427.43 42,320.57 42,320.57 Total 250 217 70 1 ,, . Rw-~aos ex+ Is-es- ~. aaw,~oNwEr~n+oF PENNSV~vnNw INHERITANCE TA%RETURN RE&DENT DECEDENT ESTATE OF Cocklin, Mary B. SCHEDULE J-11B CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS continued FILE NUMBER 21-08-00276 ITEM NUMBER DESCRIPTION 1 Brethren In Christ Church: 2 Calvary United Methodist Church: 3 • Childress Home of the United Methodist Church: 4 Dillsburg Cemetery Association: 5 Dlllsburg Fire Company: 6 Fileys Cemetery Association: 7 Messiah College: 8 Messiah Village: 9 The Masonic Homes (Elizabethtown): 10 Trinity Lutheran Cemetery: 11 Zembo Luncheon Club: Copyright (c) 2002 form software only The Lackner Group, Inc. AMOUNT 50,000.00 50,000.00 5,000.00 20.000.00 10.000.00 10,000.00 50.000.00 50,000.00 10,000.00 10,000.00 5,000.00 Subtotal I 270,000.00 Form PA-1500 Schedule J-IIB (Rev. 6-98) '• + REV-1614 EX+ (g-0o) ~. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN (Check Box 4 on Rev-1500 Cover Sheet) ESTATE OF FILE NUMBER Cocklin, Mary B. 21-08-00276 This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death pnor tc actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death on or after 5-1-89. Indicate the type of instrument which created the future interest below and attach a copy to the tax return K ^ Will ®Intervivos Deed of Trust ^ Other ~„ can be a~riL~ ~ `. Yom- c s NAME($) OF LIFE TENANT(S) DATE OF BIRTH _ .~. ~ ~ r,„ Z.,' NEAREST AGE AT TERM OF YEARS LIFE ESTATE IS DATE OF DEATH PAYABLE Donald Baumgardner, Sr. 06/16/1925 8g ®Life or ^ Term of Years ^ Life or ^ Term of Years ^ Life or ^ Term of Years ^ Life or ^ Term of Years 1. Value of fund from which life estate is payable 2. Actuarial factor per appropriate table Interest table rate - ^ 3'12% ^ 6% ^ 10% ®Vafial71e1?atie 3. Value of life estate (Line 1 multiplied by Line 2) ,. $ 84,641.14 0.24577 $ 20,802.25 rvr~mtta) yr ANNUITANTS DATE OF BIRTH NEARESTAGE AT DATE OF DEATH ~ r:r~m yr r crrrca r+rvrvul I r 15 PAYABLE ^ Life or ^ Term of Years ^ Life or ^ Term of Years ^ Life or ^ Term of Years ^ Life or ^ Term of Years 1. Value of fund from which annuity is payable 2. Check appropriate block below and enter corresponding (number) Frequency of payout-^ vu~dy(~ ^ gl.>y(~ ^ ~'~Y(121 ^ (aualiedy(4) 3. Amount of payout per period $ 4. Aggregate annual payment. Line 2 multiplied by Line 3 5. Annuity Factor (see instructions) Interest table rate - ^ 312% ^ 6% ^ 10% ^ Variablel?d~e 6. Adjustment Factor (see instructions) 0.00 7. Value of annuity - If using 3 112%, 6%, 10% or if variable rate and period payout is at end of period, calculation is: Line 4 x Line 5 x Line 6 $ If using variable rate and period payout is at beginning of period, calculation is: (Line 4 x Line 5 x Line 6) + Line 3 NpTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13, 15, 16, 17 and 18. Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule K (Rev. 6-98)