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HomeMy WebLinkAbout02-1098~i PETITION FOR ERS ROBATE and GRANT OF LETT E ~ ~' 1 ~ 'state of Janet G. Brode rick No. ~~ ~ zlso known as To: Register of Wills for the Deceased. County of Cumberland in the Social Security No. 360-10-25 7 Commonwealth of Pennsylvania The petition of .the undersigned espectfully represents that: Your petitioner(s), who is/u»18 years of age or older an the execut or named above decede f th ill l dated December 3 , 19 9 9 , 19 e ast w o in the , dicil(s) dated N A d co an (state relevant c rcumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at deat in Cumberland County, Pennsylvania, with rincipal h er l or t famil esidence at 113 Parkview Road, New Cumberland, Borot p y as New Cumberland (list street, number and muncipality) Decendent, then 81 yea s of age, died November 9 ~ ~~ 2002 at H i H i al• H rr' bur PA Except as follows, decedent did o± marry, was not divorced and did not have a child born or adopted after execution of the will offered f r probate; was not the victim of a killing and was never adjudicated incompetent: N/A ~ Decendent at death owned proper~ y with estimated values as follows: (If domiciled in Pa.) Ally 300 , 000.00 personal property $ (If not domiciled in Pa.) Pe sonal property in Pennsylvania $ (If not domiciled in Pa.) Pe sonal property in County $ 140,000.00 $ Value of real estate in Pennsylvan d as follows: 113 Park t it a iew Road, New Cumberland, Borou h of New ua e s Cumberland Cumberland Co nt Penns lvania WHEREFORE, petitioner(s) r spectfully request(s) -the probate of the last will and codicil(s) resented herewith and the grant f letters teGtamentar~ p % n.c.t.a.) (testamentary; administration c.t.a.; administration d.t theron. I U ~ Q ', ' Michael J. Broder ck ~'~ New Cumber and P 17070 ~a w . ~ o a eo in OATH O PERSONAL REPRESENTATIVE COMMONWEALTH OF ENNSYLVANIA ss ~ COUNTY OF The petitioner(~g) above-named wear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of th knowledge and belief of petitioner(x) and that as personal represen tative(x) of the above decedent p~ ttioner($) will well and truly administer the estate according to law ~~ Sworn to or affirmed and subscribed ~ ~" before me this f h dayy of a November ~: Z002 ~ ~. ~.. . i vrlf~nw c~t~ ~ ~ ugh of Register ~- 21-2002-1098 EStatC Of J net G. Eroderick DECREE OF Deceased BATE AND GRANT OF LETTERS AND NOW December 5 the reverse side hereof, satisfacto IT IS DECREED that the instru described therein be admitted to p Janet G. P 11' }a~2002 , in consideration of the petition on proof having been presented before me, ent(~ dated December 3, 1999 abate and filed of record as the last will of oderick and Letters Testament are hereby granted to Mic FEES Probate, Letters, Etc......... . Short Certificates(3) ......... . ~tk •x-Pac~s~~ ~~. . JCP el J. Broderick /~ Register of Wills Donna M. Otto, 1st Deputy 340.00 ,. Hock, Esquire (~~19211) 9.00 ATTORNEY (Sup. Ct. LD. No.) 39.00 3211 N. Front St.; PO Box 5300 10:00 Harrisburg, PA 17110-0300 ADDRESS TOTAL 39$ . 00 Filed (717) 238-8187 •L~eembEr• •5th; 2.002... ........ . PHONE MAILED LETTERS TO A`I'I'ORI~TEY ON ~DECEMIF3ER '5th, 2002 ~ i. ~ '(fir t . . ~ •.t:7t ~ Ir -~, if ~( ,~- t r ?j c<.,rCCCd\- CO~JLtrl~ }I'ORl ~fPl Or1U!n~d C r- ~.7a Cot Sratc '(tad hceorcls fl}ti,ti rl,(~ :, _ ` , t ~! , ~'~ ° ~~+~dG: i is iid c~~d to d~piicato this oo ~ ` pY y photostat or pho~t~(;Ir,~ph. . ~, I;;,,, ", ,• p,~1N DF p""~, ~ y~ ,~ r~~ f--., -- _ - __.--- ~~ `'~' ~~ . ' ~ . rl P 8644017 w © ~. s =~ ;. \ ~~pl\_ ~~~/,i r3 ReY. v0T COMMONWEALTH U PENNSYLVANIA • DEPARTMENT OF HEALTH • V ITAL RECORDS CERTIFICATE OF DEATH NAME OF DECEDENT (F,rsl. Middle. ;eel ---'--- --- ,.Janet C, ~ B AGE (Lau Butndayl UNDEq t VEM UNDER I DAY G __ STATE FILE NUMBER SE% SGCIAL SE(,URITV NUMBER oderick ,female 360 -„j 0 DA DEATH ,MCnN Udy. rn~djt- 3. - 2 54 7 _ ATE OF BIRTH MpMhs . Days Howa Mirwtes ,MOnm Oay een __ ) / ~~C~ BIRTHPLACE ;Coy and PLACE OF DEATH t•~:, ,; . / l . 81 : , Slate ar F y one -..,an ,nwrur:l,uny on ulne~ ,pool cregn t:ounayl HO Yr=. 10-7-1 921 :. ' a ' SPITAL. pp bite O, w IL g Inpatwn[pp EFUO i THER: N . COUNTY OF DEATH CITY, BORO, TWP OF DEATH FAC utpaheM J ppA ^ T N. LlTY NAME pl nq ~n [~l urmrq Omar Noma ^ Rea~OSnw ^ rSpeoryl ^ _ Dauphin Harrisbur ea. k g H s uaun . g,ve streal and numpen WAS DECEDEM OF HISPANIC ORIGIN? RACE ~ American Indian, &eck, WhM. etc. ~ rrisburg Hospital "~ Yea LJ It Y.. (SPecdy) IIPeun C b DECEDENT'S USUAL OCCUPQION KINDOF BUSINESS/INDUSTRY ~ (Give Find of k . u an. _ MBA1Ci^• Fuono Ra;an, etc. whit e EI WAS D ww done duruKJ mpe of wwkr lifr, de clot use reared.) Homemaker ECEDENT EVER IN DECEDENT'S EDUCATION t0. U. S. ARMED fORCES7 SOec,N onl n, Heal, r MARITAL STATUS ~ Married ~ a~ dec«., Domestic ' lta, ^ lau Never Married, Widowed, SURVIVING SPOUSE y° a ^ No GTl Etyma tarylSecundary Co11°ya Dlv lu ,v,le. eve ma,dun na r 14~ S DECEDENT'S MAILING ADDRESS (Sveet. Ciryrtown, Sla e. Lip Cw1e1 DECEDENT'S p cn ( me) penfyl t2 (O t z) p n °r 5 `~2 and r r 1 e ~ Mi c ha e 1 J , ,.. 13' Broderick ACTUAL 113 Parkview Rd. RESIDENCE te. ,°.5,,,, Pennsylvania Did nc.^ y°°.,,°~,„,;,,°d,n IS o,ns[ructwns ,.New Cumberland, PA 17070 on 'Her a,de, decedent ~. liwm. FATMER'$NAME IFusl. Middle, Lasl) 1 .Goan Cumberland lownarnp7 No. decWeM trved na ~' en 1eFrank . mac[uallunna°I_~lew (:D~erl and MOTHER'S NAME F Groth INFORMANT'S NAME (fyperPrinp ~ ,isl M,ddle. Maiden Surnamel -ciryrDOro Emma a ichael J 1e Thome INFOR ' . : Bro METHOD OF DISPOSITION MANT S MAILINGADORESS(SUeeLG /TOwn,$WIe2 Coda crick N w ) 2.113 Parkview Road, New Cumbe l Burial Cremation ^ Removal hom Slau ^ D ^ DATE OF DIS (Monet, Day r OSITION and, PA 17070 l PLACE OF DISPOSITION ~ Noma of Cemete C one[wn a![er ISpecML ^ '21 , ry, or Other Place rematory LOCATION ~ Gry/Town. State, Zp Coda ' ' SIGNATURE OF FU l RPERSONACTING vem er 12, 2002 ~pmberland Valle Memo i l ASSUCH n'~ r a Y ~1e5t Pennsboro LICENSE NUMBER NAME AND 21 TW p 9...5-- Complet°"ems 23ac °nly a iMJ To tM Den olm knew, PhYsicwn u Y ed d ADDRESS OF FACILI FS 012-849-L TMPar he or pg z2°~ 22303 Bridge St. ~ew'~um~ rI n ~S l n - ge, eath occurre nq evadable aUi death Ip (Sprwture and Tdle) cand ease f , e a d PA al Iha nma, dale and place staled 1 5070 y o death LICENSE NUMBER ' Ilema 21-28 mull W completed by 21i~ ti p°MO^ who pronounces death. TIME OF DEATH DA7 DATE SIGNED IMonm. DaY. '!earl P UNCED DEA91MOrah. Day, 1 dr 23b' WAS CASE REFERRED TO 27. PART I: Eller the diseases S i i MEDICAL E%AMINER/CORONER7 /// ~ ~~~ ~~~ / ~ / ^ , njur es or compli[alans which caused the death. po not enter the Lut oMy one cause on 6erJl FM 26. No ^ " ~ ° a tlylrp auto as Cdrdid . IYYEDIATE CAUSE (F~nal disease a condmon ~ , t 0l leapndlOry dlltlsl, srgck Or ntlan ldllure. IA npproaimate PART 11: Other srgniacent rnrwations contriputirg to death, put ' i Larval Uetwean not nwaing m ttw urWe g j orwel arW deaN n1^^9 Douse Ivan m PART ~ 'resWlingnaeam)-y a • " V/ ' / S v ` f' `.~ /v) ~ I. 1 I D)~TD (OR CONSEOUEN OF): __ t SeGUeMiaay list corldiltona p, ~ _ l arty, Ieading w enmediats ~cauae. Enter UNDERLYING DUE TO I AS A CONSEQUENCE OFl: ~ _ _ CAUSE IDiseas°or.nryry _~ mat nutialed aveMS ~ c 1 ` esuplnp m deaml LAST DUE TO (OR AS A COCONSEQUENCE tel: I - d. WAS AN AUTOPSY WERE AUTOPSY FINDINGS MANNER OF DEATH ; PERFORMEDi AVAILABLE PRIOR TO I ' __ ~ COMPLETION OF CAUSE ~ OF DEAM7 DATE OF INJURY TIME OF INJURY lMprim. Day, Yearl INJURY AT WORKT DESCRIBE HOW INJURY OCCURRED Natural Hom~cMe q . ^ ~ AccideM ^ f'~ PBrWing lnv Yes ^ No Vea ^ No Ly SuicWe ^ ^ aligalan Yes ^ Nq ^ 30a /'-" Could rat De 34. _- 2aD. 29 CERTIFIER ICnaca oniy oriel . _ __ _ _ etennmed J04_ M. ~, PLACE OF INJURY -AI home, farm, streal, IactorY. ulfica budding, etc. ISpecdvl Spa. rf LOCATION (Scree[ C,NyTOwn, Statel 'CERTIFYING PHYSICIAN /Phys,cwn cenrt m To the Deat of my knowledge darn o u ~~~°o NATURE A earn n 301. , cc rred due [o the cauaels) and manner as stated ~~ a d comWeled !lam 231 TITL O CERTIFIER ~~~~~~~~~~~~~ 'a 'PRONOUNCING AND CERTIFYING PHVSICIANIPn ve:~dn d n ~~~~~~~~~~~~~~~~~~~~~~~~~~-~~ _ 310. , o ;,e-,nuu~,:~nr _i To tM beet ul my kn°wled P ] Uealn and ceitdymg lu': 9e, death occurred al me Iln», dale, antl lace, and due to tM cause a use of deaml LICENSE NU 8/E,R V rM manner as elated ................... ~ ~.) 2 tc. ~ // / ? / ...... y DATE SIGNED IMmm Da .Year 'MEDICAL EXAMINER/CORONER On the hasia of examination and/or inveatlgalion, in m o manner as stated......... Y Plmon, death occurred al the ti ................ .. Sta _ __.._-__ 31d. NAME AND ADDRESS OFP R50y wH0 COMP ETED CAU OF qT Ills 2 ~) TYPe a P°nt ~ . ,/, , /, D ~ ~C,~~~ /~~~ e, date, and lace p and due to th ~('(~,((( L( /l f . ............... RE Aq'S SIGNA7 O , e cause(s) and ............ ^ a rw, Sf ~ ~~ ~ 32. `r"~/~t7~ ••- ]3 ~ ~ ~ DATE F IL E D IMw,Ih. OaY. Yearl L ~=,~~ y ~ / / G1/~__L L_/ I( ~ N. / ~' / ADD -Z JANET G. BRODERICK I, JANET G. BRQDERICK, of Cumberland County, Pennsylvania, do hereby make this my Last Will and Testament, revoking any and all former Wills and Codicils made by me. FIRST: I am married Lo Michael J. Broderick, and ali references to my husband in this will are to him. I have three children: Susan J. Brooks (born June 7, 1952), Ellen L. Myers (born March 29, 1954), and Joan M. Broderick (born August 14, 1957). These and any other children born to or adopted by my Husband and me are described In th1S W111 as "my children," or as "a child of mine." Any person born to or adopted by a child pf mine is described in this will as "my issue." Provided, however, no adopted person shall benefit hereunder unless the order or decree of adoption is entered before such adopted person attains the age of twenty-one (21) years. SECOND: I give my tangible personal property and all casualty insurance that I am carrying on said tangible personal property to my husband, Michael J. Broderick, or, if he does not survive me, I give said property to my children to be divided -1- equitably among or between them as they may determine, or, if they are unable to agree, as my Executor shall determine. I have complete confidence that my husband and/or my Executor will honor any written instructions that I may leave with regard to said tangible personal property. Any such property not so distributed shall be sold, and the proceeds added to my residuary estate to pass as hereafter described. THIRD: If my husband, Michael J. Broderick, shall survive me, I bequeath to my Trustee, hereinafter named, IN TRUST NEVERTHELESS, cash, securities or other property in the amount specified below, to be known as the "Bypass Trust." (1) The bequest shall be $650,000, subject however, to Paragraphs (2) and (3) below. (2) The bequest shall increase or decrease, based upon the availability of my federal unified credit for estate and gift taxes and the maximum allowable federal estate tax credit for state death taxes (but only to the extent that the use of such state death tax credit does not increase the death tax payable to any state), whether due to statutory changes, lifetime gifts in excess of the federal unified estate and gift tax exemption-equivalent amounts, or any other transfer which affects the availability of my federal credits aforesaid. (3) The bequest shall decrease, even to zero, if necessary to reduce federal estate tax payable as a result of my death to zero, considering that my intention is to fund the Bypass Trust by using my available federal unified credit for estate and gift taxes and my federal estate tax credit for state death taxes and to eliminate federal estate tax on the balance of my federal taxable estate by using the federal estate tax unlimited marital deduction. FOURTH: I give, devise, and bequeath the rest, residue and remainder of my estate, real and personal, to my husband. Should he not survive me, I give, devise, and bequeath such rest, residue and remainder to my Trustee, hereinafter named, IN TRUST NEVERTHELESS, to be held, administered and distributed for all purposes as part of the Bypass Trust. FIFTH: The Bypass Trust shall be held, administered and distributed as follcws: (1) My Trustee shall pay to or apply for the benefit of my said husband all of the net income from the Bypass Trust in convenient installments in such shares and proportions as my Trustee in its sole discretion shall determine primarily for the ~~,a~~~ ~~~ ~~,p -3- medical care, education, support and maintenance in reasonable comfort of my said husband, taking into consideration to the extent my Trustee deems advisable, any other income or resources of my said husband known to my Trustee, considering that my husband is the primary object of my bounty. (2) My Trustee may pay to or apply for the benefit of my said husband such sums from the principal of the Bypass Trust in such shares and proportions as in its sole discretion shall be necessary or advisable from time to time for the medical care, education, support and maintenance in reasonable comfort of my said husband, taking into consideration to the extent my Trustee deems advisable, any other income or resources of my said husband known to my Trustee, considering that my husband is the primary object of my bounty. (3) In addition to the income and discretionary payments of principal from this Trust, there shall be paid to my said husband during his lifetime from, the principal of this Trust upon his written request during the last month of each fiscal year of the Trust an amount not to exceed during such fiscal year the amount of Five Thousand Dollars ($5,000) or five percent (50) of the aggregate value of the principal of the -4- Bypass Trust on the last day of such fiscal year without reduction for the principal payment for such fiscal year, whichever is greater. This right of withdrawal is noncumula- tive, so that if my said husband does not withdraw, during such fiscal year, the full amount to which he is entitled under this Paragraph, his right to withdraw the amount not withdrawn shall lapse at the end of that fiscal year. (4) My husband shall have a special power to appoint all or any portion of the Bypass Trust during his lifetime by written document, delivered to my Trustee, referring expressly to this Article, or by Will, validly executed and attested referring expressly to this Article, among such other person or persons hereinafter named or described absolutely or in trust, as he may indicate. My aforesaid husband shall have no power to appoint the principal of this fund or income accumulated thereon to himself, his estate, to his creditors, or to the creditors of his estate. My Trustee may rely upon an attested Will probated in any state that otherwise meets the requirements of this Paragraph. (5) In default of the exercise of such power of appointment by my said husband, or insofar as any part of the ~ ~ ~~ -5- Bypass Trust shall not be effectively appointed, then upon the death of my said husband, the entire remaining principal of the Bypass Trust, or the part of such trust not effectively appointed shall be distributed to my children, per stirpes. SIXTH: If any share hereunder becomes distributable to a beneficiary who has not attained the age of twenty-five (25) years, then such share shall immediately vest in such benefici- ary, but notwithstanding the provisions herein, my Trustee shall retain possession of such share in trust for such beneficiary until such beneficiary attains the age of twenty-five (25) years, using so much of the net income and principal of such share as my Trustee deems necessary to provide for the proper medical care, education, support and maintenance in reasonable comfort of such beneficiary, taking into consideration to the extent my Trustee deems advisable any other income or resources of such beneficiary or his or her parents known to my Trustee. Any inccme riot so paid or applied shall be accumulated and added to principal. Such beneficiary's share shall be paid over and distributed to such beneficiary upon attaining the age of twenty-five (25) years, or if he or she shall sooner die, to his or her executors or administrators. I recommend that my Trustee -6- consider distributing all income from such share to such beneficiary when such beneficiary attains the age of twenty-one (21) years. My Trustee shall have with respect to each share so retained all the powers and discretions had with respect to the trusts created herein generally. SEVENTH: If any beneficiary and I should die under such circumstances as would render it doubtful whether the benefi- ciary or I died first, then it shall be conclusively presumed for the purposes of this my Will that said beneficiary prede- ceased me. EIGHTH: (1) I name Michael J. Broderick as my Executor. If he is unable or unwilling to serve, I name Susan J. Brooks, of Spartanburg, South Carolina, Ellen L. Myers of Boiling Springs, Pennsylvania, and Joan M. Broderick of Palmyra, New Jersey as my Co-Executrices. I direct that my Executor or Co- Executrices, herein referred to as my Executor regardless of number or gender, serve without bond in any jurisdiction in which called upon to act. (2) I name Ellen L. Myers of Boiling Springs, Pennsylvania as my Trustee. If she is unable or unwilling to serve, I name Joan M. Broderick of Palmyra, New Jersey as my ,~` -7- substituted Trustee. If she is unable or unwilling to serve, I name Susan J. Brooks of Spartanburg, South Carolina as my substituted Trustee. I direct that my Trustee, herein referred to as my Trustee regardless of number or gender, serve without bond in any jurisdiction in which called upon to act. (3) Except as otherwise provided herein, if my Executor or Trustee or any successor as herein defined should fail to qualify as Executor or Trustee hereunder, or for any reason should cease to act in such capacity, the successor or substitute Executor or Trustee shall be some bank or trust company with trust powers, which successor or substitute Executor or Trustee shall be designated in a written instrument filed with the court having jurisdiction over the probate of my estate and signed by my husband or if he fails to act, signed by the court having jurisdiction over the Trust. The situs of the Trust may be transferred to the situs of such successor or substitute Trustee by designation in the written instrument aforesaid. (4) For services as Executor and Trustee, my Executor and Trustee shall receive reasonable compensation. ,,~.~~' NINTH: (1) I give to any Executor and to any Trustee named in this Will or any Codicil hereto or to any successor or substitute Executor or Trustee all of the powers enumerated in this Will and all of the powers applicable by law to fiduciaries in the Commonwealth of Pennsylvania and in particular through the Pennsylvania Probate, Estates and Fiduciaries Code, as effective and as in effect on the date hereof, during the administration and until the completion of the distribution of my estate, and until the termination of all trusts created in this Will or any Codicil hereto and until the completion of the distribution of the assets of such trusts. I direct that all such powers shall be construed in the broadest possible manner and shall be exercisable without court authorization. (2) In determining the federal estate and income tax liabilities of my estate, my Executor shall have discretion to select the valuation date and to determine whether any or all of the allowable administration expenses in my estate shall be used as federal estate tax deductions or as federal income tax deductions and shall have the discretion to file a joint income tax return with my husband. My Executor shall have the authority to make a QTIP election or a reverse QTIP election i p C -9- with respect to any trust created under this Will and shall have the discretion to allocate the $1,000,000 Generation Skipping Tax exemption as he deems appropriate. (3) If at any time any trust created hereunder (or any share thereof if the trust shall have been divided into shares) shall be of such value that, in the opinion of my Trustee, the administration expense of holding the assets contained therein in trust is not justified, my Trustee, in its absolute discretion, may terminate such trust and distribute the trust property to the person or persons then entitled to receive or have the benefit of the income therefrom or the legal representative of such person. If there is more than one income beneficiary, my Trustee shall make such distribution to such income beneficiaries in the proportion in which they are beneficiaries or if no proportion is designated in equal shares to such beneficiaries. (4) My Executor and Trustee are authorized and em- powered to acquire and to retain, either permanently or for such period of time as my Executor or Trustee may determine, any assets, including the capital stock of any closely held corpora- tion, whether such assets are or are not of the character / r C /~ -10- approved or authorized by law for investment by fiduciaries and whether such assets do or do not represent an overconcentration in one investment. (5) My Executor and my Trustee are authorized and empowered to disclaim any interest, in whole or in part, of which I, my Executor, or my Trustee, may be the beneficiary, devisee, or legatee, by executing an appropriate instrument (in accordance with section 2518 of the Internal Revenue Code of 1986, as amended and supplemented, or such similar section as may then be in effect). (6) My Executor and Trustee are authorized and em- powered to sell at public or private sale, or exchange, and to encumber or lease, for any period of time, any real or personal property and to give options to buy or lease any such property. Additionally, my Executor and Trustee are authorized and em- powered to compromise claims, to borrow from anyone (including a fiduciary hereunder) and to pledge property as security therefor, to make loans to and to buy property from anyone (including a fiduciary or beneficiary hereunder); provided that any such loans shall be adequately secured and at a fair interest rate. -11- (7) My Executor and Trustee are authorized and em- powered to allocate property, charges on property, receipts and income among and between principal or income, or partly to each, without regard to any law defining principal and income. TENTH: No person who at any time is acting as a trustee or co-trustee (if any) hereunder shall have any power or obligation to participate in or to exercise any discretionary authority that I have given to my Trustee to pay principal or income to such person, or for his or her benefit or in relief of his or her legal obligations. Such discretionary authority shall be exercised solely by a disinterested co-trustee. ELEVENTH: No interest of any beneficiary under this Will, any Codicil hereto, or any trust created herein, shall be subject to anticipation or to voluntary or involuntary alien- ation. TWELFTH: All estate, inheritance, succession and other death taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property comprising my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid out of the residue of my estate, as if such taxes were expenses of -12- administration, without apportionment or right of reimbursement. I authorize my Executor and Trustee to pay all such taxes at such time or times as deemed advisable. IN WITNESS WHEREOF, I have set my hand and seal on this my Last Will and Testament this 3rd day of December 1999. ,,~ / ~~ ~ ( SEAL ) JANET G. BRODERICK SIGNED, SEALED, PUBLISHED, and DECLARED by JANET G. BRODERICK as and for her Last Will and Testament, on the day and year last above written, in the presence of us, who, at her request, in her presence, and in the presence of each other, all being present at the same time, have hereunto subscribed ~~~~~ our names as witnesses: ~L -13- SELF-PROVING AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF CUMBERLAND WE, Janet G. Broderick, and Wayne M. Pecht , Stefanie A. Morrison and Patricia D. Olyarnik , the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly s~J~crn, do hereby declare to the undersigned authority tlai: the Testatrix signed and executed the instrument as her Last Will 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 Will as witness and 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. k% L, ~`J 'Janet G. Broderick„ Testatrix Witne Witness/ ~\ witness Subscribed, sworn to, and acknowledged before me by Janet G. Broderick, the Testatrix, and subscribed and sworn to before me by Wayne M. Pecht Stefanie A. Morrison and Patricia D. Olyarnik witnesses, this 3rd day of December 1999. ~_ ,....,n....-~ _~.~.. ` Notarial Seal ~ Cynthia ,J Rule, Nota p & Camp HiA Borp, Cumberland County My Commission Expires Jan. 24, 2nnn -14- Not ry Public CERTIFICATION OF NOTICE UNDER RULE 5.6 a Name of Decedent Janet G. Broderick Date of Death November 9 2002 Will No.: 2002-01098 Admin. No.: To the Register: I hereby certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on November 13 2002 Name 489 W. Address ~partanbur~, SC 293 13 Parkview Road• New Cumberland PA 170 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None Date: December ~ 2002 Signa i~ Name Jered L. Hock EsQUire Address 3211 North Front Street P.O. Box 5300 Harrisbure PA 17110-0300 Telephone (717) 238-8187 Capacity: Personal Representative X Counsel for Personal Representative Document #: 247483.1 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: REV-1162 EX(11 96) PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 002142 HOCK JERED L ESQ P O BOX 5300 321 1 NORTH FRONT STREET HARRISBURG, PA 17110 fold ACN ASSESSMENT AMOUNT CONTROL NUMBER TOTAL AMOUNT PAID: REMARKS: MICHAEL J BRODERICK C/O JARED L HOCK ESQUIRE CHECK# 1014 INITIALS: AC SEAL RECEIVED BY: DONNA M. OTTO REGISTER OF WILLS 523,500.00 DEPUTY REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-961 NO. CD 002873 HOCK JERED L ESQ P O BOX 5300 321 1 NORTH FRONT STREET HARRISBURG, PA 17110 fold ACN ASSESSMENT AMOUNT CONTROL NUMBER TOTAL AMOUNT PAID: REMARKS: M J BRODERICK C/O JEROD L HOCK ESQUIRE CHECK#160 INITIALS: JA SEAL RECEIVED BY: DONNA M. OTTO REGISTER OF WILLS 5533.00 DEPUTY REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 003233 HOCK JERED L ESQ P O BOX 5300 321 1 NORTH FRONT STREET HARRISBURG, PA 17110 fold ACN ASSESSMENT AMOUNT CONTROL NUMBER TOTAL AMOUNT PAID: REMARKS: MICHAEL J BRODERICK C/O JERED HOCK ESQUIRE CHECK# 235 INITIALS: SK SEAL RECEIVED BY: DONNA M. OTTO REGISTER OF WILLS $40.45 DEPUTY REGISTER OF WILLS Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of Ian t Brod ri k No. 00 -010AR also known as Date of Death Nny mb r 9 20=-x_ Deceased Social Security No. _ 360-10- 5a~ Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unswom falsification to authorities. Attorney: JerPd L Hock FcO~irP LD. No.: _ 19211 Address: 3211 North Front StrPPt PO Box X00 ~-lardsbura PA 17110 0'00 Telephone: _(7171 8-8187 Michael J. Broderick 113 ParkviPw Rnad• t~e~~ (`umhP~ ~A 17070 Dated _~~' /G „~ p0.3 , Description House and 1/3 lot located at 113 Parkview Road, New Cumberland Borough, Cumberland County, Pennsylvania Ameritrade -Account No. 774455668, cash holdings 19 Shares of MetLife 40 Shares of MetLife -received from New Jersey Unclaimed Property on Aug. 20, 2003, previously unknown to Executor and not included in Item 6.4. of the original Inheritance Tax Return MetLife -prior year dividend, received from New Jersey Unclaimed Property on Aug. 19, 2003 TIAA CREF -longterm care annual premium refund (Attach Additional Sheets if necessary) Value 140,000.00 5,000.00 515.00 1,084.00 25.00 2,547.00 Total: $ 149,171.00 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. Form RW-7 (Dauphin Courrty) -Rev. 9/92 ~~'~ /a.~-oS--' BUREAU OF INDIVIDUAL Taxes COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX DIVISION DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 IX AFP (01-03) DATE 09-22-2003 ESTATE OF BRODERICK JANET G DATE OF DEATH 11-09-2002 FILE NUMBER 21 02-1098 JERED L HOCK ESQ •COUNTY CUMBERLAND METZGER WICKERSHAM ACN 101 PO BOX 5300 Amount Remitted HBG PA 17110•. MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETA_IN LOWER PORTION FOR YOUR RECORDS ~ ------------------- REV-1547 EX AFP CO1-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR ---------------------------------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BRODERICK JANET G FILE N0. 21 02-1098 ACN 101 DATE 09-22-2003 TAX RETURN WAS: C X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) C1) 140,000 00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) 370 , 941 00 credit to 3. Closely Held Stock/Partnership Interest (Schedule C) Your account, (3) .0 0 submit the upper portion 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 111,704.00 taxtpaymentm with your 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) c7) .00 8. Total Assets (B) 622, 644.00 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (q) 33,920.00 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions (l0) 5.450 00 12. Net Value of Tax Return (11) - i9 X70 On 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) 58 3,2 74.00 14. Net Value of Estate Subject to Tax c14) 583,274.00 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 21,716.00 X 00 _ .00 C15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 5 61, 558.00 X 045_ 25,270.00 17. Amount of Line 14 at Sibling rate 18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 _ •0 0 19. Principal Tax Due - .00 TAX CREDITS: (19)= 25,270.00 PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 02-06-2003 CD002142 1,236.84 08-05-2003 CD002873 23,500.00 .00 533.00 TOTAL TAX CREDIT 25,269.84 BALANCE OF TAX DUE .16 INTEREST AND PEN. .00 TOTAL DUE .16 ~ IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YoU Mev uc n~~r A orr~~.ir ..~_ __..__ ~ `~ ion -~ BUREAU OF INDIVIDUAL TAXES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX DIVISION DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 E% pFP (01 -03) DATE 12-22-2003 ESTATE OF BRODERICK JANET g DATE OF DEATH 11-09-2002 .FILE NUMBER 21 02-1098 JERED L HOCK ESQ ~ COUNTY CUMBERLAND 3211 N FRONT ST ACN 101 PO BOX 5300 Amount Remitted HBG PA 17110 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETA_IN LOWER PORTION FOR YOUR RECORDS ~ ------------------- REV-1547 EX AFP CO1-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR --------------------------------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BRODERICK JANET G FILE N0. 21 02-1098 ACN 101 DATE 12-22-2003 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN N0. O1 1. Real Estate (Schedule A) C1) .0 0 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) 1,10 9 00 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion 4. Mortgages/Notes Receivable (Schedule D) (4) .00 of this form with your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) •0 0 tax payment. (6) .00 7. Transfers (Schedule G) c7) .00 8. Total Assets ca) 1, 109.00 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) .0 0 10. Debts/Mortgage Liabilities/Liens (Schedule I) (lo) .00 11. Total Deductions 12. Net Value of Tax Return (11) pp 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) 1,109:00 14. Net Value of Estate Subject to Tax (14) 584,383.00 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Lane 14 at Spousal rate (15) 21,938.00 X 00 _ .00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 562,445.00 X 045 = 25 310.00 17. Amount of Line 14 at Sibling rate (17) .00 X 12 _ ~ 18. Amount of Line 14 taxable at Collateral/Class B rate C18) .00 X 15 _ •0 0 19. Principal Tax Due - .00 TAX CREDITS• (19)= 25,310.00 PAVMCMT ..~_____ DATE NUMBER 02-06-2003 CD002142 08-05-2003 CD002873 11-14-2003 CD003233 INTEREST/PEN PAID C-) 1,236.84 .00 .29- AMOUNT PAID 3,500.00 533.00 40.45 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 25,310.00 .00 .24 .24 IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY RF niic w ~rrn.~., ,.~_ __..__ V U<<W V11Ullll L..V U11 l.Y 1\Cyl~l.. \..l Vl YY111~ Hanover and High Street Carlisle, PA 17013 Phone:(717) 240-6345 Date: 9/24/2004 HOCK JERED L ESQ P O BOX 5300 3211 NORTH FRONT STREET HARRISBURG, PA 17110 RE: Estate of BRODERICK JANET G File Number: 2002-01098 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 11/09/2004 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, f .~ F ~, ~,A'~ GLENDA FARMER STRASBAUGH REGISTER OF WILLS cc: File Personal Representative(s) Judge , - I v- REV -1500 EX + (6-00) OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA REV-1500 DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN F!l NUMBER /):J J 01 ,; HARRISBURG, PA 17128-0601 RESIDENT DECEDENT ' I COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Broderick Janet G 360-10-2547 DECE- DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE DENT 11/09/2002 10/07/1921 WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Michael J. Broderick 3. Remainder Return CHECK ~' Original Return ~' Supplemental Return B (date of death prior to 12-13-82) APPRO- 4. Limited Estate 4a. Future Interest Compromise 5. Federal Estate Tax Return Required ~ate of death after 12-12-82) PRIATE 6. Decedent Died Testate 7. ecedent Maintained a living Trust 0 8. Total Number of Safe Deposit Boxes (Attach copy of Will) \:ttach a copy of Trust) BLOCKS 9. Utigation Proceeds Received 10. pousal Poverty Credit (date of death between ~ 11. Election to tax under Sec. 9113(A) 12-31-91 and 1-1.95) (Attach SchO) tHi$_IiQ!lMj)$mlll;jPQM!!~lttliii~U~p~~~J;$Q!lili~iMiil!M!I!iI~i!tIQlljgll!J!!\iijbj!l~ijll.!l@n NAME COMPLETE MAILING ADDRESS COR- Jered L. Hock, Esquire 3211 N. Front St. ; PO Box 5300 RE- FIRM NAME (If Applicable) Harrisburg, PA 17110-0300 SPON DENT Metzger Wickersham TELEPHONE NUMBER 717-238-8187 OFFICIAL USE ONLY 1. Real Estate (Schedule A) (1) 140,000 2. Stocks and Bonds (Schedule B) (2) 370;9<t1 3. Closely Held Corporation, Partnership or Sole.Proprletorship (3) 0 cO; ~ ',I 4. Mortgages & Notes Receivable (Schedule D) (4) 0 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 111,704 , 6. Jojnt~ Owned Property (Schedule F) I 0 , Separate Billing Requested (6) 0 RECA- PITULA- 7. Inter-Vivos Transfers & Miscellaneous nON Non-Probate Property (Schedule G or L) (7) 0 8. Total Gross Assets (total Lines 1-7) (8) 622,644 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 33/920 10. Debts of Decedent, Mortgage liabilities, & LIens (Schedule I) (10) 5,450 11. Total Deductions (total Lines 9 & 10) (11) 39,370 12. Net Value of Estate (Line 8 minus Line 11) (12) 583,274 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax (13) 0 has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 583,274 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amount of Line 14 tal<ableat the spousal tal< rate, or transfers under Sec. 9116 (a)(1.2) 21,716 X .0 0 (15) 0 TAX 16. Amount of Line 14 tal<ableat lineal rate 561,558 X .0 0.045 (16) 25,270 - COMPU- 17. Amount of Line 14 tal<ableat sibling rate 0 X .12 (17) 0 TATION 18. Amount of Line 14 tal<able at collateral rate 0 X .15 (18) 0 19. Tax Due (19) 25,270 20. 0 1.~eKHe!!~'fYOij_MdUIl$tI!l!lAI!eR!iiI!!rIijANQ'i!j!!!PI\YM~NTI n o 5 ........~w!il!$$Qm;tQl',N$Wl*lI\UiQQe$TIPN$ON~e~l\N!:ll!eeH~~jijrl;.jNtHliM. o PA15001 NTF 29755 Copyright 2000 Greatland/Nelco LP - Forms Software Only , Estate of Name Address Tax ID 360-10-2547 Executors (Page 1) Michael J. Broderick 113 parkview Road New Cumberland, PA 17070- 322-16-0097 PA REV-1500 EX (6-00) D d C I Page 2 ece ent s omDlete ress: STREET ADDRESS 113 parkview Road cumberland County CITY I STATE I ZIP New Cumberland PA 17070 Add Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 25,270 o 23,500 1/237 Total Credits (A + B + C) (2) 24,737 3. Interest/Penalty if applicable D. Interest E. Penalty o o Totallnterest'Penalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT o o 533 o 533 ,:,0:'::,;:,::":;,::,:,:,:,:,:,:,:::,:,:,,,:,:,:,:,:,co:,::':::::::'::,:::::,:,::'::"::::":::":::::::::::::::;:;:::;:;:::;:;:::;"';';':';:;':';:;':';:;':';:;':';:;':":;':';:;':';:;':';:;"":;';':';:;' :';,"";":;':":":';';"';"';';';,;';":;';,',;';:":';:,,:';:"::;:'::":'::,;:,,:,;),;:,:::,:;:::,:;):;:,::,,:;::",,:::,,:::,,:,,:'::": ,.,.,.:.,.:.,.,.:.,.,.:.,.:-:.,.:.:-:.:-,-:.,-:-:-:-:-,.:.:-:-,-:.:-,.:.,-:.,.:.:.,.,.,.,.,.,.:.,.,.:.,.,.,.,.,.,.",.,.,:,.;.,.,.;.,:,.,.,:,...::,.:.:::...:.,.:.,.,'.""':':"'''::''''::''''':'''':::'' '''::''-''::''':'::''..:::.:.,::.,.,.:.,.-.:.,.,,:....,:,'.,.:.,...,.....:.":,:".:.:...:",,,:::,'-..:,'..-:::..-:::-.-..:;:..,:,,-..:;:-,.:::-.-,.:-: .......................PLEAsE ANSWER THE FOLLOWING...aUES T10NSBY.PLACINGAN 1. "X" IN THE APPROPRIATE BLOCKS Did decedent make a transfer and: a. retain the use or income of the property transferred; b. retain the right to designate who shall use the property transferred or its income; c. retain a reversionary interest; or. d. receive the promise for life of either payments, benefits or care? 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES. YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 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 tlian the personal representative is based on information of which preparer has any knowledqe. SIG TURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE -e - Yes No ~ I B ~ ~ o 7-.2tP-O) ADDRESS 113 Parkview SIG New Cumberland, PA 17070 DATE ? ADDRESS 3211 N. Front St.; PO Box 5300 Harrisburg, PA 17110-0300 00 "" spouse [72 P.S. Ii 9116 (a) (1.1) (I)]. For dates of death on or after January 1, 1995, the tax rate is imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 19116 (a) (1.1)(li)}. The statute nn",!': not p.llp.mot a transfer toa 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 0% [72 P.S. 19116(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 4.5%, except as noted in 72.P.S. 1 9116(1.2) [72 P.S. !i9116(aX1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 69116(a)(1.3)]. A sibling is defined, under Section 9102, as an individuai who has at least one parent in common with the decedent, whether by blood or adoption. o PA15002 NTF 29756 Copyright 2000 Greatland/Nelco LP - Forms Software Only REV-1502EX+ (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Janet G. Broderick All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. SCHEDULE A REAL ESTATE FILE NUMBER ITEM NO. 1. DESCRIPTION House and 1/3 lot located at 113 Parkview Road, New Cumberland Borough, Cumberland County, Pennsylvania, assessed at $152,550, Tax Parcel 26-24-0809-224, with common level ration of 1.01. See also Deed Book 213-666. Carried at $140,000 fair market value because of age and physical condition of premises. VALUE AT DATE OF DEATH 1 140,000 9 PA 15021 NTF 10871 Copyright 1999 Greatland/Nelco LP - Forms Software Only TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 140,000 -, - -- ~ /--#/J /./p~ i/V,Lr..:;7 -,-,...--" ~-/V'_:--:-/G.'__ j;! 4.Hj? ?&I?ff/'< ",' <? / / ~ 9';1 /::? 51 /l/ / /r'/J' s: r;:? ":" > // 5/ "<-'-1:.:: 11 / (J.v --:-0 r r vP~ ... .-r;;:; t1;/;:~O/?(Jf""<- . ~ <~",,,-"'.o /V c/."^ ;- /r/Y-<d/ --~ "_ /I-T/ /'Y/l'~1'/ /V~ ' . ,.<S7#.e /-/.~?-O fi " _ -. /;- / ,I ..;/1// ;ZpP'" . ",. !?p,;!pIYb /?/.#k?/1' p..,,;7d . .r/-'/i If'/fl ;C!/?f{ I/P 1,1/ Parcel No. DEED THIS DEED made this day of December 1999, BETWEEN MICHAEL J. BRODERICK and JANET G. BRODERICK, husband and wife, of New Cumberland, Cumberland County, Pennsylv~nia, hereinafter called "GRANTORS", AND JANET G. BRODERICK, of New Cumberland, Cumberland County, Pennsylvania, hereinafter called "GRANTEE": WITNESSETH: That in consideration of One and 00/100 Oaf/ar ($1.00), in hand paid, the receipt whereof is hereby acknowledged, the Grantors do hereby grant and convey to the said Grantee, her heirs and assigns, ALL THAT CERTAIN pie'ce or parcel of land, situate in the Borough of New Cumberland, Cumberland County, Pennsylvania, bounded and described as follows: BEGINNING at a point on the Westerly line of Park View Road, 560 feet measured $outhwardly al(:mg said line from the Southerly line of Drexel Hills Boulevard, and at the Southerly line of Lot No. 9, Block~Q", on the hereinafter mentioned Plan of Lots; thence Southeastwardly along said line of Park View Road, by a curve to the left having a radius of 270 feet, an arc distance of 82.83 feet to a point; thence South 63 degrees 54 mirjutes West along the Northerly line of Lot No. 11, Block "Q", 125A feet to a pCiint;~henceby lands now or formerly of Drexel Hills Land Company, and along the center line of th.eright-of-way of the American Telephone and Telegraph Company, North 21 degrees 12 minutes West, .122.37 feet to a point; thence North 81 degrees 28 minutes 30 seconds East along the Southerly line, of Lot No.9, Block "Q", 133.8 feet to a point, the Place of BEGINNING. E!EING,Lot No. 10, Block"Qu, on the Plan of Section 6, Drexel Hills, said Plan being r.ecoraed in the Office of the Recorder of Deeds in and for Cumberland County, in Plan Book 14, Page 19.: "1' . . ." HAVING THEREON ERECTED a dwelling known as 113 Park View Road, New Cumberland, Pennsylvania. ;~ ' BEING the same property which Robert B. Failor, Sheriff of the County of Cumberland, and Commonwealth of Pennsylvania, by his Deed dated July 14, 1969, and recorded July 17,'f969, in the Office of the Recorder of Deeds in and for Cumberland County, in Deed Book "H", Volume 23, Page 662, granted and conveyed unto Michael J. Broderick and Janet G. Broderick, husband and wife, Grantors herein. transfer tax. This is a transfer from husband and wife, to wife, and is, therefore, exempt from realty AND the Grantors hereby covenant and agree that they will warrant specially the property hereby conveyed. IN WITNESS WHEREOF, said Grantors have hereunto set their hands and seals the day and year first above written. Signed, Sealed and Delivered In the Presence of: " 'I ii' ,; 1,1 'I ; "\1,' li;i . J;';j'~ . . , , ! '1 ' ! I : ~ Michael J. Broderick , ,," <A.~t I Qf ;, j::'il",i " ' -Ianet G. Broderick I;' :ii , ~ I~ ,t' i' I:";; 'I' m" '.'>. , ~~"':' j' :~',~,-,' ,.-).'."" POMMONWEACTH 9FpENNSYLVANIA ' if-I', (: ;:'!ii!~ -r' i::' :':,j i< ;'i, : ',' : Cq>UNTY OF CUMBERLAND ) : ss. ) I') " ,., , , --, ,11. " ,,' " On this, the day of December 1999, before me, the undersigned officer, Personal/yappeared Michael J. Broderick and Janet G. Broderick husband and wife knownto tri~ (or satisfactorily proven) to be the persons whose names are subs~ribed to the within i~strument anpabknoWledged that they executed the same for the purposes therein contained. , ' . , IN WITNESS WHEREOF, I hereunto set my hand and official seal. 2 I 'I' '1;" I' I , , 1',1 . . I do hereby certify that the precise residence and complete post office address Qf.the within named Grantee is 113 Parkview Road, New Cumberland, Pennsylvania 17070. Date: Attorney for Grantee COMMONWEALTH OF PENNSYLVANIA ) : ss. COUNTY OF CUMBERLAND ) RECORDED on this Office of the said County, in Deed Book day of , Page , 1999, in the Recorder's Given under my hand and seal of the said office, the date above written. Recorder , 3 REV-1503EX+ (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Janet G. Broderick SCHEDULE B STOCKS & BONDS FILE NUMBER All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NO. 11. DESCRIPTION VALUE AT DATE OF DEATH Arneritrade Account #774455668 Cash Holdings 5,000 2 27.8 Shares Fidelity Cash (NAV $1.00) CUSIP: 315994103 28 3 4,570.278 Shares Fidelity Ginnie Mae (NAV $11.18) CUSIP: 31617K105 51,096 Dividend accrued on 11/09/2002 56 4 19 Shares MetLife 515 5 Schwab Securities Account #1782-6297 Consisting of cash, Schwab One accrued interest, Armstrong Holdings, Corn Products IntI., Intel, Select Medical, and Trust Co. of New Jersey City, as per statement received. 19,983 Dividend accrued on 11/09/2002 46 6 45,088.09 Shares T. Rowe Price Services, Inc. Account #1018372653-4 45,088 Dividend accrued on 11/09/2002 17 7 11,819.72 Units The Vanguard Group Short-term Bond Index Fund 121,034 8 11,914.12 Shares The Vanguard Group GNMA Fund, Account #9897478574 128,077 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 370,941 9 PA 15031 NTF 10872 Copyright 1999 Greatland/Nelco LP - Forms Software Only REV-1504 EX + (1-97) SCHEDULE C CLOSELY-HELD CORPORATION PARTNERSHIP or SOLE-PROPRIETORSHIP COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Janet G. Broderick Schedule C-1 or C-2 (Including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a sole-propiertorship. See instructions for the supporting information to be submitted for sole-proprietorships. FI LE NUMBER ITEM NO. 1. DESCRIPTION VALUE AT DATE OF DEATH 9 PA 15041 NTF 10873 Copyright 1999 Grealland/Nelco LP - Forms Software Only TOTAL (Also enter on line 3, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) o REV-1507 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE D MORTGAGES & NOTES RECEIVABLE FILE NUMBER Janet G. Broderick All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NO. DESCRIPTION 1. VALUE AT DATE OF DEATH 9 PA 15071 NTF 10874 Copyright 1999 Greatland/Nelco LP - Forms Software Only TOTAL (Also enter on line 4, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) o REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Janet G. Broderick Include proceeds of litigation & date proceeds were received by the estate All prop jointly-owned with right of survivorship must be disclosed on 5ch. F. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FI LE NUMBER ITEM NO. 11. DESCRIPTION VALUE AT DATE OF DEATH TlAA CREF - longterm care annual premium refund 2,547 2 The Vanguard Group Traditional IRA, Prime Money Market Fund 52,634 3 The Vanguard Group Prime Money Market Account #9897478574 56,523 9 PA15081 NTF 10875 Copyright 1999 Grealland/Nelco LP - Forms Software Only TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 111,704 REV -1509 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Janet G. Broderick SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. B. C. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH Include name of financial institution and bank ITEM FOR MADE account number or similar identifying number. DATE OF DEATH DECD'S VALUE OF JOINT NO. TENANT JOINT Attach deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. TOTAL (Also enter on line 6, Recapitulation) $ 0 9 PA 15091 NTF 10876 (If more space is needed, insert additional sheets of the same size) Copyrighl1999 Greatland/Nelco LP - Forms Software Only REV -1510 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Janet G. Broderick SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV -1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY %OF ITEM INCLUDE NAME OF THE TRANSFEREE, THEIR DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE RELATIONSHIP TO DECD & DATE OF TRANSFER. NO. ATTACH COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) 1. TOTAL (Also enter on line 7, Recapitulation) $ 0 9 PA15101 NTF 10877 Copyright 1999 Greatland/Nelco LP - Forms Software Only (If more space is needed, insert additional sheets of the same size) REV-1511EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Janet G. Broderick SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NO. A. 1. 1 DESCRIPTION AMOU NT FUNERAL EXPENSES: Cumberland Valley Memorial Gardens - interment 4,305 2 Ellen Myers - reimbursement for necessary expenses relating to funeral 51 Total from continuation pages 10,517 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN No. of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. 3. AttorneyFees Metzger, Wickersham, Knauss & Erb, P. C. (estimated) Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Michael J. Broderick Street Address 113 Parkview Road CityNew Cumberland State PA Zip 17070 Relationship of Claimant to Decedent SURVIVING SPOUSE 14,000 3,500 4. Probate Fees 398 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Cumberland Law Journal - publication of Estate Notice 75 2 Register of Wills - Short Certificats 12 3 Reserve for closing 75 4 Reserve for filing Account 125 Total from continuation Dages 861 9 PA15111 NTF 10878 Copyright 1999 Greatland/Nelco LP - Forms Software Only TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 33,920 Item No. 3 4 5 6 Schedule H part 1 (Page 2) Estate of: Janet G. Broderick Description Amount Gingrich Memorials - monument 1,800 Joan Broderick - reimbursement for necessary expenses relating to funeral 38 Parthemore Funeral Home 8,549 St. Theresa Church - funeral luncheon 130 Total (Carry forward to main schedule) 10,517 Schedule H part 2 (Page 2) Estate of: Janet G. Broderick Item No. Description Amount 5 Reserve for filing Inventory 10 6 Reserve for filing Releases 21 7 Reserve for tax preparation 500 8 Richard Miller - accountant bill for preparation of Decedent's income tax 150 9 The Patriot News - publication of Estate Notice 180 Total (Carry forward to main schedule) 861 REV-1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Janet G. Broderick Include unreimbursed medical expenses. ITEM NO. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FI LE NUMBER DESCRIPTION AMOUNT 1. 1 Ambulance - debt of decedent 75 2 Decedent's share of federal income tax on income-producing assets, accrued as of DOD 5,012 3 Decedent I 5 share of state income tax on income-producing asset, accrued as of DOD 363 9 PA15121 NTF 10874 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insen additional sheets of the same size) 5,450 Copyright 1999 Greatland/Neleo LP - Forms Software Only . REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES Janet G. Broderick NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] ~ 1. oan M. Broderick Morgan Avenue almyra, NJ 08065 2 ~ichael J. Broderick L13 parkview Road ~ew Cumberland, PA 17070 3eneral Bequests: 21,7~6 3 ~usan J. Brooks ~89 Webber Road ~partanburg, SC 29307 FILE NUMBER RELATIONSHIP TO DECEDENT Do Not Ust Trustee(s) Daughter Surviving Spouse Daughter AMOU NT OR SHARE OF ESTATE 1/3 remainder of probate property after life estate and 1/3 of TOD (transferrable on death) assets 21,716 1/3 remainder of probate property after life estate and 1/3 of TOD (transferrable on death) assets ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 18 AS APPROPRIATE ON REV-15oo COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRiBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II n ENTER TOTAL NON-TAXABLE DISTRIBS. ON LINE 13 OF REV-l50e COVER SHEET $ (If more space is needed, insert additional sheets of the same size) o e PA15131 Copyrighl20QO Greatland/Nelc.o LP . Formos. Software Only NTF 33293 Estate of: Janet G. Broderick Item No. Description 4 Ellen L. Myers 15 Laurel Oak Drive Boiling Springs, PA 17007 Schedule J part 1 (Page 2) Relation Amount Daughter 1/3 remainder of probate property after life estate and 1/3 of TOD (transferrable on death) assets Total (Carry forward to main schedule) o COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN REV - 1514 EX + (1-97) ESTATE OF Janet G. Broderick This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to 5-1-89, actuarial factOrs for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found 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. ........................................;.............iii)i){i.~w'Fel$s~ti;;;~ie Deed 01 Trusl Other (Check Box 4 on Rev-15llO Cover Sheet) FILE NUMBER NEAREST AGE AT TERM OF YEARS LIFE ESTATE IS DATE OF DEATH PAYABLE NAME(S) OF LIFE TENANT(S) DATE OF BIRTH Michael J. Broderick 05/05/1921 82 gg Ufe or 0 Term of Years o Ufe or Term of Years o Life or Term of Years Term of Years 1. Value of fund from which life estate is payable $ 108,692 2. Actuarial factor per appr~riate table Interest table rate - - U 3 112% 0 6% 3. Value of life estate (Line 1 multiplied by line 2) 010% ~ Variable Rate 0.1998 3.680 % $ 21,716 . .. ... . .... ..... ..... ......;...;-:...:-:.-.;.:~-:.:::-:-:.:... ..............................}}.}}iANNIlllTYJN$I$Rl$s:m!IllALcULAtlON(}}.I........ ::-:;:::;::::-:;:;:::;:;:;::::::::::::::;::::::::::::::;:})}~::;:::::;:;:::;}::::}}/::\:;::?:;::t~:?::;:;:::::;:;::: ...............,...,...... ........ ..,.....un._.......... .........-... NAME(S) OF NEAREST AGE AT TERM OF YEARS ANNUITANT(S) DATE OF BIRTH DATE OF DEATH ANNUITY IS PAYABLE n Life or n Term of Years n Life or 0 Term of Years n Life or 0 Term of Years n Life or 0 Term of Years 1. Value of fund from which annuity is payable $ 2. Check appropriate block below and enter corresponding (nUmbeB Frequency 01 payout -- 0 Weekly (52) B Bi-weekly (26) Monthly (12) o Quarterly (4) 0 Semi-annually (2) Annually (1) Other ( ) 3. Amount of payout per period o o $ o 4. Aggregate annual payment, Line 2 multiplied by Line 3 5. Annuity Factor (see instructions) Interest table rate 0 3 1/2% 0 6% 0 10% o o Variable Rate 0.000 % 0.0000 6. Adjustment Factor (see instructions) 7. Value of annuity -- If using 3 1/2%,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 Une 6) + line 3 0.0000 $ o $ o NOTE: 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 and 17. (If more space is needed, insert additional sheets of the same size) 9 PA15141 NTF 10881 Copyrighl1999 Grealland/Nelco LP - Forms Software Only COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE M FUTURE INTEREST COMPROMISE REV -1647 EX+ (9-00) ESTATE OF Janet G. Broderick This schedule Is appropriate only for estates of decedents dying after December 12, 1982. This schedule is to be used for all future interests where the rate of tax which will be applicable when the future interest vests in possession and enjoyment cannot be established with certainty. Indicate below the type of instrument which created the future interest and attach a copy to the tax return. (Check Box 4a on Rev-1500 Cover Sheet) FI LE NUMBER nWiII n Trust n Other I. Beneficiaries NAME OF AGE TO BENEFICIARY RELATIONSHIP DATE OF BIRTH NEAREST BIRTHDAY 1. 2. 3. 4. 5. II. For decedents dying on or after July 1, 1994, if a surviving spouse exercised or intends to exercise a right of withdrawal within 9 months of the decedent's death, check the appropriate block and attach a copy of the document in which the surviving spouse exercises such withdrawal right. n Unlimited rioht of withdrawal n Limited riQht of withdrawal III. Explanation of Compromise Offer: IV. Summary of Compromise Offer: 1. Amount of Future Interest ................. ................................ $ 0 2. Value of Line 1 exempt from tax as amount passing to charities, etc. (also include as part of total shown on Line 13 of Cover Sheet) . $ 0 3. Value of Line 1 passing to spouse at appropriate tax rate Check One 06%, 0 3%, 0 0% . . . . . . . . . . . . . . .... $ 0 (also include as part of total shown on Line 15 of Cover Sheet) 4. Value of Line 1 Taxable at lineal rate Check One 06%,04.5%. $ 0 (also include as part of total shown on Line 16 of Cover Sheet) 5. Value of Line 1 taxable at sibling rate (12%) (also include as part of total shown on Line 17 of Cover Sheet) $ 0 6. Value of Line 1 taxable at collateral rate (15%) (also include as part of total shown on Line 18 of Cover Sheet) . $ 0 7. Total value of Future Interest (sum of Lines 2 thru 6 must equal Line 1) .............. $ 0 o PA 16471 NTF33294 (If more space is needed, insert additional sheets of the same size) Copyright 2000 Greatland/Nelco LP - Forms Software Only REV-1649 EX+ (1-97) COMMONWEALTH OF PENNSVLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Janet G. Broderick Do not complete this schedule unless estate is making election to tax assets under Section 9113(A) of Inheritance & Estate Tax Act. If the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust. This election applies to the Bypass Trus t, Item Third of Will Trust(marltal, residual A, B, By-pass, Unlfled Credit, etc.). If a trust or similar arrangement meets the requirements of Section 9113(A), and: a. The trust or similar arrangement is listed on Schedule 0, and b. The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule 0, then the transferor's personal representative may specifically identify the trust (all or a fractional portion or percentage) to be included in the election to have such trust or similar property treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property is included as a taxable transfer on Schedule 0, the personal representative shall be considered to have made the election only as to a fraction of the trust or similar arrangement. The numerator of this fraction is equal to the amount of the trust or similar arrangement included as a taxable asset on Schedule O. The denominator is equal to the total value of the trust or similar arrangement. SCHEDULE 0 ELECTION UNDER SEC. 9113(A) (SPOUSAL DISTRIBUTIONS) FILE NUMBER PART A: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, which pass to the decedent's surviving spouse under a Section 9113 (A) trust or similar arrangement. DESCRIPTION VALUE House 140,000 Ameritrade 5,000 MetLife 515 TlAA CREF 2/547 PART B: Part A Total $ 148,062 Enter the description and value of all interests included in Part A for which the Section 9113 (A) election to tax is being made. DESCRIPTION VALUE 140,000 House Ameritrade 5,000 MetLife 515 TlAA CREF 2,547 9 PA 16491 NTF 10882 Part B Total $ (If more space is needed, insert additional sheets of the same size) 148,062 Copyright 1999 Greatland/Nelco LP - Forms Software Only ESTATE OF JANET G. BRODERICK SSN: 360-10-2547 DOD: 11/09/2002 DOB: 10/07/1921 Schedule 0 Note Except for the residence, Schedule A; the Ameritrade asset of $5000, the MetLife 19 shares of $515, Schedule B; and the TIAA CREF refund of $2547, Schedule E; all assets were transferable on death to the three daughters. 284968-1 LAST WILL AND TESTAMENT OF JANET G. BRODERICK I, JANET G. BRODERICK, of Cumberland County,Pennsylvania, do hereby make this my Last will and Testament, revoking any and all former wills and Codicils made by me. FIRST: I am married to Michael J. Broderick, and all references to my husband in this will are to him. I have three children: Susan J. Brooks (born June 7, 1952), Ellen L. Myers (born March 29, 1954), and Joan M. Broderick (born August 14, 1957). These and any other children born to or adopted by my husband and me are described in this will as "my children," or t as "a child of mine." Any person born to or adopted by a child of mine is described in this Will as "my issue." Provided, however, no adopted person shall benefit hereunder unless the order or decree of adoption is entered before such adopted person attains the age of twenty-one (21) years. SECOND: I give my tangible personal property and all casualty insurance that I am carrying on said tangible personal property to my husband, Michael J. Broderick, or, if he does not survive me, I give said property to my children to be divided w~f0: 6)dtAh~L {/ -1- .. . If 11 equitably among or between them as they may determine, or, if they are unable to agree, as my Executor shall determine. I have complete confidence that my husband and/or my Executor will honor any written instructions that I may leave with regard to said tangible personal property. Any such property not so distributed shall be sold, and the proceeds added to my residuary estate to pass as hereafter described. THIRD: If my husband, Michael J. Broderick, shall survive me, I bequeath to my Trustee, hereinafter named, IN TRUST NEVERTHELESS, cash, securities or other property in the amount specified below, to be known as the "Bypass Trust." (1) The bequest shall be $650,000, subject however, to Paragraphs (2) and (3) below. (2) The bequest shall increase or decrease, based upon the availability of my federal unified credit for estate and gift taxes and the maximum allowable federal estate tax credit for state death taxes (but only to the extent that the use of such state death tax credit does not increase the death tax payable to any state), whether due to statutory changes, lifetime gifts in excess of the federal unified estate and gift tax exemption-equivalent amounts, or any other transfer which -2- ~AAOf# 4~~ () , lIl" . affects the availability of my federal credits aforesaid. (3) The bequest shall decrease, even to zero, if necessary to reduce federal estate tax payable as a result of my death to zero, considering that my intention is to fund the Bypass Trust by using my available federal unified credit for estate and gift taxes and my federal estate tax credit for state death taxes and to eliminate federal estate tax on the balance of my federal taxable estate by using the federal estate tax unlimited marital deduction. FOURTH: I give, devise, and bequeath the rest, residue and remainder of my estate, real and personal, to my husband. Should he not survive me, I give, devise, and bequeath such rest, residue and remainder to my Trustee, hereinafter named, IN TRUST NEVERTHELESS, to be held, administered and distributed for all purposes as part of the Bypass Trust. FIFTH: The Bypass Trust shall be held, "administered and distributed as follows: (1) My Trustee shall pay to or apply for the benefit of my said husband all of the net income from the Bypass Trust in convenient installments in such shares and proportions as my Trustee in its sole discretion shall determine primarily for the ~4(€f;<f &~~A~-P/ -3- .. ..- ~ medical care, education, support and maintenance in reasonable comfort of my said husband, taking into consideration to the extent my Trustee deems advisable, any other income or resources of my said husband known to my Trustee, considering that my husband is the primary object of my bounty. (2) My Trustee may pay to or apply for the benefit of my said husband such sums from the principal of the Bypass Trust in such shares and proportions as in its sole discretion shall be necessary or advisable from time to time for the medical care, education, support and maintenance in reasonable comfort of my said husband, taking into consideration to the extent my Trustee deems advisable, any other income or resources of my said husband known to my Trustee, considering that my husband is the primary object of my bounty. (3) In addition to the income and discretionary payments of principal from this Trust, there shall be paid to my said husband during his lifetime from the principal of this Trust upon his written request during the last month of each fiscal year of the Trust an amount not to exceed during such fiscal year the amount of Five Thousand Dollars ($5,000) or five percent (5%) of the aggregate value of the principal of the ~AAefE&~-L/~ -4- " ilL .. "~ ~. Bypass Trust on the last day of such fiscal year without reduction for the principal payment for such fiscal year, whichever is greater. This right of withdrawal is noncumula- tive, so that if my said husband does not withdraw, during such fiscal year, the full amount to which he is entitled under this paragraph, his right to withdraw the amount not withdrawn shall lapse at the end of that fiscal year. (4) My husband shall have a special power to appoint all or any portion of the Bypass Trust during his lifetime by written document, delivered to my Trustee, referring expressly to this Article, or by Will, validly executed and attested referring expressly to this Article, among such other person or perSons hereinafter named or described absolutely or in trust, as he may indicate. My aforesaid husband shall have no power to appoint the principal of this fund or income accumulated thereon to himself, his estate, to his creditors, or to the creditors of his estate. My Trustee may rely upon an attested Will probated in any state that otherwise meets the requirements of this Paragraph. (5) In default of the exercise of such power of appointment by my said husband, or insofar as any part of the C}~.pf ~ I!W~ -5- " III 1l Bypass Trust shall not be effectively appointed, then upon the death of my said husband, the entire remaining principal of the Bypass Trust, or the part of such trust not effectively appointed shall be distributed to my children, per stirpes. SIXTH: If any share hereunder becomes distributable to a beneficiary who has not attained the age of twenty-five (25) years, then such share shall immediately vest in such benefici- ary, but notwithstanding the provisions herein, my Trustee shall retain possession of such share in trust for such beneficiary until such beneficiary attains the age of twenty-five (25) years, using so much of the net income and principal of such share as my Trustee deems necessary to provide for the proper medical care, education, support and maintenance in reasonable comfort of such beneficiary, taking into consideration to the extent my Trustee deems advisable any other income or resources of such beneficiary or his or her parents knoWn to my Trustee. Any income not so paid or applied shall be accumulated and added to principal. Such beneficiary's share shall be paid over and distributed to such beneficiary upon attaining the age of twenty-five (25) years, or if he or she shall sooner die, to his or her executors or administrators. I recommend that my Trustee fb/f/~-f~0J~AL~;! -6- III - consider distributing all income from such share to such beneficiary when such beneficiary attains the age of twenty-one (21) years. My Trustee shall have with respect to each share so retained all the powers and discretions had with respect to the trusts created herein generally. SEVENTH: If any beneficiary and I should die under such circumstances as would render it doubtful whether the benefi- ciary or I died first, then it shall be conclusively presumed for the purposes of this my Will that said beneficiary prede- ceased me. EIGHTH: (1) I name Michael J. Broderick as my Executor. If he is unable or unwilling to serve, I name Susan J. Brooks, of Spartanburg, South Carolina, Ellen L. Myers of Boiling Springs, Pennsylvania, and Joan M. Broderick of Palmyra, New Jersey as my Co-Executrices. I direct that my Executor or Co- Executrices, herein referred to as my Executor regardless of number or gender, serve without bond in any jurisdiction in which called upon to act. (2) I name Ellen L. Myers of Boiling Springs, Pennsylvania as my Trustee. If she "is unable or unwilling to serve, I name Joan M. Broderick of Palmyra, New Jersey as my SJ#4~pf/ 0;~AL/;I -7- -...a ..---...-... substituted Trustee. If she is unable or unwilling to serve, I name Susan J. Brooks of Spartanburg, South Carolina as my substituted Trustee. I direct that my Trustee, herein referred to as my Trustee regardless of number or gender, serve without bond in any jurisdiction in which called upon to act. (3) Except as otherwise provided herein, if my Executor or Trustee or any successor as herein defined should fail to qualify as Executor or Trustee hereunder, or for any reason should cease to act in such capacity, the successor or substitute Executor or Trustee shall be some bank or trust company with trust powers, which successor or substitute Executor or Trustee shall be designated in a written instrument filed with the court having jurisdiction over the probate of my estate and signed by my husband or if he fails to act, signed by the court having jurisdiction over the Trust. The situs of the Trust may be transferred to the situs of such successor or substi tute Trustee by designation in the written instrument aforesaid. (4) For services as Executor and Trustee, my Executor and Trustee shall receive reasonable compensation. QI1A/pM~ ISMu/;! {I -8- .... -"'.6:lIl!! NINTH: (1) I give to any Executor and to any Trustee named in this will or any Codicil hereto or to any successor or substitute Executor or Trustee all of the powers enumerated in this will and all of the powers applicable by law to fiduciaries in the Commonwealth of Pennsylvania and in particular through the pennsylvania Probate, Estates and Fiduciaries Code, as effective and as in effect on the date hereof, during the administration and until the completion of the distribution of my estate, and until the termination of all trusts created in this Will or any Codicil hereto and until the completion of the distribution of the assets of such trusts. I direct that all such powers shall be construed in the broadest possible manner and shall be exercisable without court authorization. (2) In determining the federal estate and income tax liabilities of my estate, my Executor shall have discretion to select the valuation date and to determine whether any or all of the allowable administration expenses in my estate shall be used as federal estate tax deductions or as federal income tax deductions and shall have the discretion to file a joint income tax return with my husband. My Executor shall have the authority to make a QTIP election or a reverse QTIP election ~AAPI- )YJI3~A;J -9- r> i. with respect to any trust created under this Will and shall have the discretion to allocate the $1,000,000 Generation Skipping Tax exemption as he deems appropriate. (3) If at any time any trust created hereunder (or any share thereof if the trust shall have been divided into shares) shall be of such value that, in the opinion of my Trustee, the administration expense of holding the assets contained therein in trust is not justified, my Trustee, in its absolute discretion, may terminate such trust and distribute the trust property to the person or persons then entitled to receive or have the benefit of the income therefrom or the legal representative of such person. If there is more than one income beneficiary, my Trustee shall make such distribution to such income beneficiaries in the proportion in which they are beneficiaries or if no proportion is designated in equal shares to such beneficiaries. (4) My Executor and Trustee are authorized and em- powered to acquire and to retain, either permanently or for such period of time as my Executor or Trustee may determine,' any assets, including the capital stock of any closely held corpora- tion, whether such assets are or are not of the character ~4<J ~ ~JaU'/ -10- Ii approved or authorized by law for investment by fiduciaries and whether such assets do or do not represent an overconcentration in one investment. (5) My Executor and my Trustee are authorized and empowered to disclaim any interest, in whole or in part, of which I, my Executor, or my Trustee, may be the beneficiary, devisee, or legatee, by executing an appropriate instrument (in accordance with section 2518 of the Internal Revenue Code of 1986, as amended and supplemented, or such similar section as may then be in effect) . (6) My Executor and Trustee are authorized and em- powered to sell at public or private sale, or exchange, and to encumber or lease, for any period of time, any real or personal property and to give options to buy or lease any such property. Additionally, my Executor and Trustee are authorized and em- powered to compromise claims, to borrow from anyone (including a fiduciary hereunder) and to pledge property as security therefor, to make loans to and to buy property from anyone (including a fiduciary or beneficiary hereunder); provided that any such loans shall be adequately secured and at a fair interest rate. ~4/~f~ ,g~AA/~ -11- I,. (7) My Executor and Trustee are authorized and em- powered to allocate property, charges on property, receipts and income among and between principal or income, or partly to each, without regard to any law defining principal and income. TENTH: No person who at any time is acting as a trustee or co-trustee (if any) hereunder shall have any power or obligation to participate in or to exercise any discretionary authority that I have given to my Trustee to pay principal or income to such person, or for his or her benefit or in relief of his or her legal obligations. Such discretionary authority shall be exercised solely by a disinterested co-trustee. ELEVENTH: No interest of any beneficiary under this Will, any Codicil hereto, or any trust created herein, shall be subject to anticipation or to voluntary or involuntary alien- ation. TWELFTH: All estate, inheritance, succession and other death taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property comprising my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid out of the residue of my estate, as if such taxes were expenses of ~~P-f:/I~JAf~~ -12- ..... . administration, without apportionment or right of reimbursement. I authorize my Executor and Trustee to pay all such taxes at such time or times as deemed advisable. IN WITNESS WHEREOF, I have set my hand and seal on this my Last Will and Testament this 3rd day of December 1999. cPi!!/I-~ 4~L,;f(s~) JANET G. BRODERICK SIGNED, SEALED, PUBLISHED, and DECLARED by JANET G. BRODERICK as and for her Last will and Testament, on the day and year last above written, in the presence of us, who, at her request, in her presence, and in the presence of each other, all being present at the same time, have her,:,unto subscribed ~ ~ our names as wltnesses: -13- lID. SELF-PROVING AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF CUMBERLAND WE, Janet G. Broderick, and Wayne M.Pecht Stefanie A. Morrison and Patricia D~ Olyarnik 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 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 will as witness and 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. Witness ~~~ Witness Subscribed, sworn to, and acknowledged before me by Janet G. Broderick, the Testatrix, and subscribed and sworn to before me by Wayne M. Pecht Patricia.D. Olyarnik Stefanie A. Morrison and , witnesses, this 3rd day of December 1999. ..\\t~~\ Ill, "'. '/' ",o;~' ...... I ". ..\....",:. '~ '(/ "'''' .,' ...-} t'. ." ~.~'.""" /)-. ":';:./;,. l,';"~~(;"'lh;'/,oi'j. (I, ._,...JJ -.n ~ !:~(<<~.~;~~f~j,)~:;~ ~r~pu~U I . -," '.- I, ~-~""":f,'1f'~'.' _..... ~ //' ""...-""- JJ .~.-;;..'S~~ ,- ':,~ /..:1 ~';:'-;":;:;i'" '1"4- -'I t'^.J ,.~ JIIIIHI.I."'" "# Cynthia IN'I1a~al Seal \ll ,Mill Be;ro uC':;~a,ry Public ~o" 'e- r and County .\" ~prr.~~.Jan. 24, 2000 ~500EX(&OOI COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1 500 INHERITANCE TAX RETURN RESIDENT DECEDENT f- Z w C w CJ w C DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) roderick DATE OF DEATH (MM-DD-YEAR) G OFFICIAL USE ONLY 11 - 10/tJ - 5 ot- _____ FILE NUMBER 11 o CjB Janet DATE OF BIRTH (MM-DD-YEAR) 11/09/2002 10/07/1921 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL) roderick, Michael J. w ~ ",_<Il ,,0:'" w"-" ,,00 ,,0:...> "-lD "- <0: D D D D 9. litigation Proceeds Received THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO, NAME COMPLETE MAILING ADDRESS 1. Original Return W 2. Supplemental Return D 4a. Future Interest Compromise (dale 01 death after 12-12-82) COUNTY CODE YEAR NUM8ER 4. Limited Estate 6. Decedent Died Testate (Attach copy of Will) D D 7. Decedent Maintained a Living Trust (Attach copy 01 Trust) 10. Spousal Poverty Credit (dale 01 dealh between 12-31-91 and 1-1-95) [K] 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Anach Sch SOCIAL SECURITY NUMBER 360-10-2547 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER D 3. Remainder Return (date of death prior to 12-13-8 D 5. Federal Estate Tax Return Required ... Z w C Z ~ '" W '" '" C " ered L. Hock, Esquire FlAM NAME (If Applicable) etzger Wickersham TELEPHONE NUMBER 717-238-8187 3211 N. Front St.; PO Box 5300 Harrisburg, PA 17110-0300 1. Real Estate (Schedule A) o (1) 2. Stocks and Bonds (Schedule B) 1,109 12) OFFICIAL USE ONLY 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) o 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) o 14) 15) o z o ~ ::l f- 0: <C CJ w a: 16 . Jointly Owned Property (Schedule F) D Separate Billing Requested 7. InterNivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or l) o 161 1,109 9. Funeral Expenses & Administrative Costs (Schedule H) (9) o 10. Debts of Decedent. Mortgage Liabilities. & Liens (Schedule I) (10) o 11. Total Deductions (total lines 9 & 10) 12. Net Value of Estate (line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES 15. Amount of line 14 taxable at the spousal tax 222 Z rate, or transfers under Sec. 9116 (a)( 1.2) 0 ;:: 16. Amount of line 14 taxable at lineal rate 887 g 0 "- 17. Amount of Line 14 taxable at sibling rate :; 0 0 " 18. Amount of line 14 taxable at collateral rate ~ 19. Tax Due X.O 0.00115) x.0~(16) 8. Total Gross Assets (total lines 1-7) x .12 (11) o x.15 (12) 1,109 20. D CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < (13) o (14) 1,109 o 40 (17) o (18) o (19) 40 HASPXXNUMBER Estate of Name Address Tax ID 360-10-2547 Executors (Page 1) Michael J. Broderick 113 Parkview Road New Cumberland, PA 17070- 322-16-0097 Decedent's Complete Address: STREET ADDRESS 113 Parkview Road Cumberland County CITY 1 STATE I ZIP New Cumberland PA 17070- Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 40 o o o Total Credits (A + 8 + C) (2) o 3. Interest/Penalty if applicable D. Interest E. Penalty .45 o Total Interest/Penalty (D + E) (3) .45 4. If Line 2 is greater than Line 1 + Line 3. enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) o 5. If Line 1 + Line 3 is greater than Line 2. enter the difference. This is the TAX DUE. (5) 40.45 A. Enter the interest on the tax due. (5A) o B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check to: REGISTER OF (58) 40.45 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? . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0 Did decedent own an nin trust for" or payable upon death bank account or security at his or her death? D Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiarydesignation7. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. rn D IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES. YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury. I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowl-.dge and belief. it is true. correct and c:omptate. Declaration of praparer other than the personal representative is baaed on all information of which praparer hes any knowledge. D D D D DO DO DO DO 3. 4. []J []J SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN J1~d M/wb~~ ADDRESS .... DATE ')J,.,- !tJ/ kOOJ. New Cumberland, PA ( 03 3211 N. Front St.; PO Box 5300 Harrisburg, PA 17110-0300 .. ......... ................. ........... .. ... ...-................. ................. ..... ........;.;.:.;.;.;.;...;.,.:.:.;.:.:.;.:.;.:.,.,.,...,.:."""""""":""':':-":;"'::::;":;':"':::::::'::"" ':":"""':":-:::':;:::';'::::;':::"':"'::'":':':'::::,:'::"::':',:,',:,::',',::',:,':',::':',:":""':":":""':;':'::::;:"::';"':':::"':':':'.::,:,:"::::,:,:;:,;",::,:,,::,;.;:;::,::;,:;:::,,~,,.:.:.'.-. ' -. 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 3% (72 P.S. ~ 9916 (a) (1.1) (ill. 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 0% (72 P.S. ~ 91 1 6 (a) (1.1) (il)) The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements tor 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 0% [72 P.S. ~ 91 16(a)(1.2)]. The tax rate impoSed on the net value oftransfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~ 9116{1.2) [72 P.S. ~ 91 16(a)( 1)J. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% (72 P.S. ~ 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has alleast one parent In common with the decedent whether by blood or adoption. HASPXXNUMBER REV-1503EX -(1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER Janet G. Broderick All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. MetLife Prior year dividend, received from New Jersey Unclaimed Property on Aug. 19, 2003. 25 2 40 Shares MetLife Received from New Jersey Unclaimed Property on Aug. 20, 2003, previously unknown to Executor and not included in Item 3.4. of the original Return. Carried at $27.10526/share, the appraisement value of each of the 19 original shares, for a total of $1084.21. 1,084 HASPXXNUMBER TOTAL (Also enter on line 2. Recapitulation) $ 1, 109 (If more space is needed. insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN REV-1514 EX+(1-97) Check Box 4 on Rev-1500 Cover Sheet FILE NUMBER Janet G. Broderick This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to 5.1-89. actuarial factors for single life calculations can be obtained from the Department of Revenue. Specialty Tax Unit. Actuarial factors can be found 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. o Will 0 Intervivos Deed of Trust D Other NAMElS) OF LIFE TENANT S L1FE< ESTATE INTEREST CALCULATION NEAREST AGE AT DATE OF BIRTH DATE OF DEATH TERM OF YEARS LIFE ESTATE IS PAYABLE Michael J. Broderick 05/05/1921 82 x Term of Years Term of Years 1. Value of fund from which life estate is payable 2. Actuarial factor per app~iate table Interest table rate - LJ 3 1/2% D 6% 3. Value of life estate (Line 1 multiplied by Line 2) Term of Years $ Term of Years 1,109 0.1998 o 10% [R] Variable Rate 3. 68 % $ 222 NAMElS) OF ANNUITANTlS) ANNUITY INTEREST CALCULATION NEAREST AGE AT DATE OF BIRTH DATE OF DEATH TERM OF YEARS ANNUITY IS PAYABLE Term of Years Term of Years 1. Value of fund from which annuity is payable $ 0 2. Check appropriate block below and enter corresponding (number) Frequency of payout- 0 Weekly (52) 0 Bi-weekly (2U Monthly(12) o Quarterly (4) 0 Semi-annually (2) 0 Annually (1ll]Other ( I 3. Amount of payout per period 4. Aggregate annual payment. Line 2 multiplied by Line 3 5. Annuity Factor (see instructions) Interest table rate 0 3 1/2% 0 6% 0 10% D Variable Rate % 6. Adjustment Factor (see instructions) 7. Value of annuity -If using 3 1/2%. 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 Une 6) + Line 3 Term of Years Term of Years o $ o o 0.0 $ o $ o NOTE 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 and 17. (If more space is needed, insert additional sheets of the same size) HASPXXNUMBER REV-1647 EX+(9-00) SCHEDULE M FUTURE INTEREST COMPROMISE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT (Check Box 4a on Rev-1500 Cover Sheet) ESTATE OF FILE NUMBER Janet G. Broderick This schedule is appropriate only for estates of decedents dying after December 12. 1982. This schedule is to be used for all future interests where the rate of tax which will be applicable when the future interest vests in possession and enjoyment cannot be established with certainty. Indicate below the type of instrument which created the future interest and attach a copy to the tax return. D Will D Trust D Other I. Beneficiaries AGE TO NAME OF BENEFICIARY RELATIONSHIP DATE OF BIRTH NEAREST BIRTHDAY 1. 2. 3. 4. 5. II. For decendents dying on or after July 1. 1994, if a surviving spouse exercised or intends to exercise a right of withdrawal within 9 months of the decedent's death. check the appropriate block and attach a copy of the document in which the surviving spouse exercises such withdrawal right. n Limited rinht of withdrawal n Unlimited riaht of withdrawal III. Explanation of Compromise Offer: IV. Summary of Compromise Offer: 1. Amount of Future Interest $ 0 2. Value of Line 1 exempt from tax as amount passing to charities. etc. (also include as part of total shown on line 13 of Cover Sheet) . $ 0 3. Value of Line 10sing touse aUropriate tax rate Check One 6%.3%,0%....... $ 0 (also include as part of total shown on Line 15 of Cover Sheet) 4. Value of Line 1 taxable at lineal rate Check one 06% 04.5%. $ 0 (also include as part of total shown on Line 16 of Cover Sheet) 5. Value of line 1 taxable at sibling rate (12%) (also include as part of total shown on line 17 of Cover Sheet) . $ 0 6. Value of line 1 taxable at collateral rate (15%) (also include as part of total shown on line 18 of Cover Sheet) . $ 0 7. Total value of Future Interest (sum of Lines 2 thru 6 must equal Line 1) $ 0 HASPXXNUMBER (If more space is needed, insert additional sheets of the same size) REV-1649 EX+{1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Janet G. Broderick Do not complete this schedule unless the estate is making the election to tax assets under Section 91 1 3(A) of the Inheritance & Estate Tax Act. If the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust. This election applies to the Trust (marital. residual, A. B, By-pass, Unified Credit, etc.) If a trust or similar arrangement meets the requirements of Section 9113(A), and: a. The trust or similar arrangement is listed in Schedule O. and b. The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule O. then the transferor's personal representative may specifically identify the trust (all or a fractional portion or percentage) to be included in the election to have such trust or similar property treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property is included as a taxable transfer on Schedule 0, the personal representative shall be considered to have made the election only as to a fraction of the trust or similar arrangement The numerator of this fraction is equal to the amount of the trust or similar arranaement included as a taxable asset on Schedule O. The denominator is eQual to the total value of the trust or similar arranClement. SCHEDULE 0 ELECTION UNDER SEC. 9113(A) SPOUSAL DISTRIBUTIONS FILE NUMBER PART A: Enter the description and value of all interests, both taxable and non-taxable, regardless of location. which pass to the decedent's survivina soouse under a Section 9113lAl trust or similar arranaement. DESCRIPTION VALUE MetLife 1,084 MetLife 25 Part A Total $ PART B: Enter the descriotion and value of all interests included in Part A for which the Section 9113 A ejection to tax is beina made. MetLife DESCRIPTION VALUE 1,084 MetLife 25 HASPXXNUMBEA Part B Total $ (If more space is needed, insert additional sheets of the same size) 1,109 ESTATE OF JANET G. BRODERICK SSN: 360-10-2547 DOD: 11/0912002 DOB: 10/07/1921 Supplemental Schedule 0 Note As indicated in preceding Schedules, New Jersey Unclaimed Property forwarded 40 Shares of Met Life and a prior dividend, as specified above, in late August 2003. Now that the Appraisement has been received from P A Department of Revenue, accepting calculations and factors submitted, a report is being made ofthese supplemental assets. 291503-1 SINCE 1888 3211 North Front Street P.O. Box 5300 Harrisburg,, PA 17110-0300 717-238-8187 Fax: 717-234-9478 April 13, 2004 Other Offices Colonial Park Mechanicsburg 717-652-7020717-691-5577 Millersburg Shippensburg 717-692-5810717-530-7515 Office of Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013-3387 Attn: Jackie Re: Estate of Janet G. Broderiek No. 21-02-1098 Dear Jackie: This confirms my call to you. You agreed that we could ignore the bill for an additional $70 in probate costs, because of prior payment. Accordingly, we will disregard your April 8 bill received here April 9. Thank you very much. Very truly yours, KERSHAM ~: :: , KNAUSS & ERB, P.C. Jered L. Hock : JLH/amm cc: Michael J. Broderick James F. Carl Edward E. Knauss, IV* Jered L. Hock Steven P. Miner Clark DeVere Milton Bemstein Bruce J. Warshawsky Francis J. Lafferty; IV David H. Martineau Andrew W. Norfleet Andrew C. Spears 302662-1 Young-Suh Koo * Board Certified in civil trial law and advocacy by the National Board of Trial Advocacy Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/24/2004 HOCK JERED L ESQ P O BOX 5300 3211 NORTH FRONT STREET HARRISBURG, PA 17110 RE: Estate of BRODERICK JANET G File Number: 2002-01098 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 11/09/2004 Your prompt attention to this matter will be appreciated. Thank You. S in.cerely,~ GLENDA FARNER STR3kSBAUGH REGISTER OF WILLS cc: File Personal Representative(s) Judge SINCE 1888 3211 North Front Street EO. Box 5300 Harrisburg, PA 17110-0300 717-238-8187 Fax: 717-234-9478 October 4, 2004 Other Offices Colonial Park Lancaster 717-652-7020 717-431-0131 Mechanicsburg Millersburg Ms. Glenda F. Strasbaugh 717-691-5577 717-692-5810 Shippensburg York Register of Wills 717-530-7515 717-843-0502 Cumberland County Courthouse. One Cou~house Square Carlisle, PA 17013-3387 Re: Estate of Janet G. Broderick No. 2002-01098 Dear Ms. Strasbaugh: Enclosed for filing is Stares Report Under Rule 6.12. So that I may be sure this mailing has been received and the filing completed, please stamp the extra copy of the Report with your clock-in stamp and return it to me in the pre-posted envelope provided. Thank you. Very truly yours, METZGER, WICKERSHAM, KNAUSS & ERB, P.C. Jered L. Hock JLH/amm Enclosures cc: Michael J. Broderick (w/enc.) James F. Carl Edward E. Knauss, IV* Jered L. Hock Steven E Miner Clark DeVere Francis J. Lafferty, IV David FI. Martineau Andrew W. Norfleet 312961-] Andrew C. Spears Young-Suh Koo * Board Certified in civil trial law and advocaoy by the National Board of Trial Advocacy STATUS REPORT UNDER RULE 6.17, Name of Decedent · Janet G. Broderick Date of Death- 11/09/2002 Will No. 2002-01098 Admin. No. Pursuant to Rule 6. 12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate' 1. State whether administration of the estate is complete- Yes × No ~ 2. If the answer is No, state when the personal representative reasonably believes that the administration will be i75 C~. -.~ complete · ::-: ' ~ 3. If the answer to No. 1 is Yes, state the following: c~ a. Did the personal representative file a final account with the Court ? Yes ~ No X b. The separate Orphans' Court No. (if anY ) for ,Ltl the personal representative's account is' c. Did the personal representative state an account informally to the parties in interest ? Yes × No. d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attache~l report~ Date' Signature .Jered L. Hock. Esauire Name (Please type or print ) 3211 N. Front St., PO Box 5300 Harrisburq PA 17110-0300 Address (717) 238-8187 Tel. No. Capacity- ~ Personal Representative × Counsel for personal representative THE PATRIOT NEWS THESUNDAY PATRIOT NEWS Proof of Publication Under Act No. 587, Approved May 16, 1929 Commonwealth of Pennsylvania, County of Dauphin} ss JOSEPH A. DENNISON being duly sworn according to law, deposes and says: That he is the Asst. Controller of The Patriot News Co., a corporation organized and existing under the laws of the Commonwealth of Pennsylvania, with its principal office and place of business at 812 to 818 Market Street, in the City of Harrisburg, County of Dauphin, State of Pennsylvania, owner and publisher of The Patriot-News and The Sunday Patriot-News newspapers of general circulation, printed and published at 812 to 818 Market Street, in the City, County and State aforesaid; that The Patriot-News and The Sunday Patriot-News were established March 4th, 1854, and September 18th, 1949, respectively, and all have been continuously published ever since; That the printed notice or publication which is securely attached hereto is exactly as printed and published in their regular daily and/or Sunday/ Metro editions which appeared on the 31st day(s) of December 2002 and the 7th and 14th day(s) of January 2003. That neither he nor said Company is interested in the subject matter of said printed notice or advertising, and that all of the allegations of this statement as to the time, place and character of publication are true; and That he has personal knowledge of the facts aforesaid and is duly authorized and empowered to verify this statement on behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolution unanimously passed and adopted severally by the stockholders and board of directors of the said Company and subsequently duly recorded in the office for the Recording of Deeds in and for said County of Dauphin in Miscellaneous Book "M", Volume 14, Page 317. PUBLIC A TION ;;;;; t ~,~,~.... Z~..~?;~)rx.,.~. /.,.. ~ ._~..,¢.~~.. COPY ;~;~";~"~;' ~ed/bef6re))ae~is 17(ffr1~o~ j~ 2003 ~.D. Nota~a ~/ /~- ~ . - / Terry L Russell Notary City Of Harrisburg, uaupnln L;0unty I // - / NO?ICE -- My Commission Expires June 6, 2006 I NOTARY PUBLIC JanetLettersG. Broderlck,TeetementarYLate of InBoroughthe Estateof New°f Member. Pennsylvania Association Of Nota~' commission expires June .6, 2006 Cumberland, Cumberland County, Pennsyl- ~van.la, .(leceased (died NOyember 9, 2002), nay,no oeen eranted to the unclersloned, all METZGER, WICKERSHAM, KN...~Jk~' & ERB persan$ Indebted fo said estate are requestect, '- ito m.ak.e Im. mecllate Payment and those hav- I AT'I'N: MICHAEL J. BRODERI~K~' n.g.c, la. lm.I .to present them without delay to: I -'~ II] ~'arl[VllW RM~d I ?'~ N"wo~Cumben""d, PAm?~ ~ HARRISBURG, PA. ~7110 Jerld L. Hock, ES(lUlre ] C-~ . ME?ZGEI~. WICKERSHAM~, KNAU$$ & I · R,,P.C.p.o.,o.,. ,~ Statement of Advertising COsts ..~.' -: ,' 3~11 North Front Sheet / ' Harrisburg, Pa 17110-03~0 · / TO TH E PATR I OT-N EWS CO., D r .... For publishing the notice or publication attache~ hereto on the above stated dates. :~ $ · :~112.44 Probating same Notary Fee(~ $ 1.75 Total $ 114.19 Publisher's Receipt for Advertising Cost The Patriot News Co., publisher of The Patriot-News and The Sunday Patriot-New.% newspapers of general circulation, hereby acknowledge receipt of the aforesaid notice and publication costs and certifies that the same have been duly paid. PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16, 1929), P. L. STATE OF PENNSYLVANIA : COUNTY OF CUMBERLAND : Roger M. Morgenthal, Esquire, Editor of the Cumberland Law Journal, of the County and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law Journal, a legal periodical published in the Borough of Carlisle in thc County and State aforesaid, was established January 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly issued weekly in the said County, and that the printed notice or publication attached hereto is exactly the same as was printed in the regular editions and issues of the said Cumberland Law Journal on the following dates, viz: DECEMBER 27, 2002, JANUARY 3, 10, 2003 Affiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. og~r M. Mbrgenthal, Editor Brodertck, Janet G., dec'd. SWORN TO AND SUBSCRIBED before me this Late of the Borough of New Cum- 10 day of JANUARY, 2003 berland. -- Executor: Michael d. Broderick, 113 earkview Road, New Cumber - ~-~ 2afl ~ ~~_~ land, PA 17070. Attorneys: Jered L. Hock, Esquire, - ' _ _. Metzger, Wickersham, Knauss & ......... Erb, P.C., P.O. Box 5300, 3211 North Front Street, Harrisburg, L0.~, ......... ~., ~; N:~ry Public PA 17110-0300. ,ai .............. , t,~<2i111 ~:~1[}~