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HomeMy WebLinkAbout10-30-0815056041125 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number Po Box 280601 '' 1 0 8 0 1 4 4 _ Harrisburo PA 17128-0601 RESIDENT DECEDENT `' ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 6 0 1 6 1 3 2 0 0 2 0 2 2 0 0 8 0 8 2 1 1 ~9 1 5 Decedent's Last Name Suffix Decedent's First Name MI R E N S H A W K E T U F; A H L (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ' Q 1. Original Retum ~ 2. Supplemental Return ~ 3. Remainder Retum (date of death 4. Limited Estate ~ 4a. Future Interest Compromise (date of prior to 12-13-82) Q 5. Federal Estate Tax Return Required OX 6 De d t Di d T death after 12-12-82) 0 . ce en e estate (Attach Copy of Will) ~ 7. Decedent Maintained a Living Trust Att h C 8. Total Number of Safe Deposit Boxes ( ac opy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) LvKRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone~Number ~~' J A M E S T B A L D W I N 5 7 0 7 4.^'2 8 -5. 0 -$:' Firm Name Qf A licabl ~ `- ; pp e) B A L D W I N & B A L D W I N First line of address 4 2 S O U T H F R O N T S T R E E T Second line of address City or Post Office M I L T O N State ZIP Code DATE FILED _ ,~ P A 1 7 8 4 7 Correspondent's e-mail address Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of m know) it is true, correct and complete. Declaration of preparer other than the personal representatNe is based on all information of which pr arer has any knowledge. lief, ~1 NATURE QF PERSON ~jSPONSIBLE FOR F NG RET N ~~~ DAT ~tbl. ~ ~ ~ r-'! ~~> "v~'~ 1.1.x, / ~ r'~ J; ~ ~ ~ ~U~j~G' c/o 42 SOUTH FRONT STF~ET ~ MILTON PA 17847 ~w urtt car NREPARER OTHER THAN R~ENTATIyE DATE ~~ F+--s"a ~ 0 - p ESS ~ ~ O t~ 42 SOUTH FRONT STREET MILTON PA 17847 PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056041125 1.5056041125 ~ y 1, 15056042126 REV-1500 EX Decedent's Social Security Number Decedent's Name: KETUR.AH L. RENSHAW 1 6 0 1 6 1 3 2 0 RECAPITULATION 1. Real estate (Schedule A) ........................................ 1- 2. stocks and Bonds (Schedule B) ....................... . .. . . . . .... 2. 1 6 1 9 7 7 3 , 0 9 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages 8 Notes Receivable (Schedule D) ................ ........ 4. 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ....... 5. ~ ~ 2 8 3 9 2 . 3 5 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. 3 0 0 5 • 8 0 7. Inter-Vnros Transfers 8 Miscellaneous Non-Probate Property {Schedule G) ~ Separate Billing Requested ....... 7. 0 • 0 0 8. Total Gross Assets (total Lines 1-7) . . . . . . . . . . . ....... . .. 8 2 3 5 1 1 7 1 • 2 4 9. Funeral Expenses & Administrative Costs {Schedule H) .... . . . . . . .. . .. . g, 1 6 1 0 8 1 • 9 6 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .... ........ 10. 1 3 2 2 3 , 2 4 11. Total Deductions (total Lines 9 & 10) .. . . . . . . .. . . ........ ... 11 1 7 4 3 0 5 , 2 0 12. Net Value of Estate (Line 8 minus Line 11) .... . ... . . .. . . ... . ... . . .. 12. 2 1 7 6 8 6 6. 0 4 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) . .... . . . . . . . . ..... 13. 1 1 1 0 0 0 ~ 0 0 14. Net Value Subject to Tax (Line 12 minus Line 13) .... . . . . . . . .. . . . . . 14 2 0 6 5 8 6 6. 0 4 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 16. Amount of Line 14 taxable at lineal rate X .045 0. 0 0 16. 0. 0 0 17. Amount of Line 14 taxable at sibling rate X .12 0, 0 0 17. 0, 0 0 18. Amount of Line 14 taxable at collateral rate x .1 S 2 0 6 5 8 6 6. 0 4 18 3 0 9 8 7 9 9 1 . 19. Tax Due ......................................... .......19. 3 0 9 8 7 9. 9 1 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 L 15056042126 15056042126 REV-1500 EX Page 3 decedent's Complete Address: File Number 21 08 0144 DECEDENT'S NAME KETURAH L. RENSHAW STREET ADDRESS WOODS AT CEDAR RUN, APT. 215, 824 LISBURN ROAD CITY STATE ZIP CAMP HILL PA 17011 Tax Payments and Credits: 1_ Tax Due (Page 2 Line f9) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments 295.000.00 C. Discount 15.494.00 3. Interest/Penalty if applicable D. Interest E. Penalty (1) 309.879.91 Total Credits (A + B + ~C) (2) 310,494.00 Total Interest/Penalty (D + I~ ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. (3) 0.00 (4} 614.09 (~ 0.00 (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use ar income of the property transferred :................................................. b. retain the right to designate who shall use the property transferred ar its income : .................... c. retain a reversionary interest; ar ................. d. receive the promise for life of either payments, benefits ar care? ........................................... 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate considaration? ............... ............................................................ 3. Did decedent own an 'in trust for' ar payable upon death bank account ar security at his ar her death? 4. Did decedent own an Individual Retirement Account, annuity, ar other non-probate properly which contains a beneficiary designation? ...................... ............................................................... Yes No ........... ^ a ........... ^ X^ ........... o a .......... ^ a .......... o a ......... ^ a .......... ^ . 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on ar after July 1, 1994 and before January 1,1995, the tax rate imposed on the net value of transfers G~ ar for the use of the surviving spouse is three (3} percent [72 P.S. §9116 (a) (1.1) n]. For dates of death on ar after January 1, 1995, the tax rate imposed on the net value of transfers to ar for the use of the survning spouse is zero (0) percent [72 P.S. §9116 (a} (1.1) (i)]. The statute does not exempt a transfer to a srxvnring spouse from tax, and the statutory requirements far 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 ar after Juty 1,2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age ar younger at death to ar far the use of a natural parent, an adoptive parent, ar a stepparent of the child is zero (O) percent (l2 P.S. §9116(a)(1.2)j. The tax rate imposed on the net value of transfers to ar for the use of the decedents lineal beneficiaries is four andone-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) (/2 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to ar for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood ar adoption. REV-1503 EX + (6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER KETURAH L. RENSHAW 21 08 0144 All properly joiMlyowned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. 29,481.487 shares of Delaware Tax-Free Pennsylvania Fund Class A, in the name of 237 031.16 Keturah L. Renshaw (Valued at $8.04 per share) , 2. 1,119.183 shares of Delaware Large Cap Value Fund Class A, in the name of 19 406.63 Keturah L. Renshaw (Valued at $17.34 per share} , 3. 2,960 shares of John Hancock Sovereign Investors Fund, in the name of 51 888.80 Keturah L. Renshaw (Valued at $17.53 per share) , 4. Pershing LLC Customer Cash account #5LP-073348, in the name of 8 362.83 Keturah L. Renshaw , 5. 2,891.608 shares of Phoenix Focused Value Fund Class A, in the name of 48 145.27 Keturah L. Renshaw (Valued at $16.65 per share} , 6. 9,879 shares of PPL Corp Common Stock, in the name of 488 121.39 Keturah L. Renshaw (Valued at $49.41 per share) , 7, 512 shares of PPL Corporation common stock, Wells Fargo Shareowner Services, 25 242.88 account #3068912330 (Valued at $49.3025 per share) , 8. 2,174.489 shares of T. Rowe Price Growth stock, in the name of Keturah L. Renshaw 67 191 71 (Valued at $30.90 per share) , . 9. 827.585 shares of T. Rowe Price Tax Free Income Fund, in the name of 8 255 74 Keturah L. Renshaw (Valued at $9.9757 per share) , . 10. 152.00 shares of Wachovia Corp (NEW) common stock, in the name of Keturah L. 5 891 52 Renshaw (Valued at $38.76 per share) , . 11. 45,066.765 shares of Putnam Pennsylvania Tax Exempt Income Fund-A in the n , ame of Keturah L. Renshaw (Valued at $9.14 per share) 411,910.23 12. 15,136.756 shares of Seligman Pennsylvania Municipal Fund Class A, in the name of 118 823 53 Keturah L. Renshaw (Valued at $7.85 per share) , . 13. Series E and EE United States Savings Bonds in the name of Keturah L. Renshaw 39 501 40 ( See attached listing) , . 14. Series HH Bonds US Savings Bonds in the name of Keturah L. Renshaw, 18 bonds in 90 000 00 t he face amount of $5,000 each , . TOTAL (Also enter on line 2, Recapitulation) ~ S 773.09 REV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER KETURAH L. RENSHAW 21 08 0144 Include the proceeds of litigation and the date the proceeds were received by the e~atate. All property Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH _ t. U. S. Treasury, Social Security payment for January 964.00 2. State Employees' Retirement System Pension check for February 1 & 2 58.21 3. The Woods at Cedar Run, refund of unused rent for Decedent 1,168.79 4. Verizon, refund from the last month's telephone bill for Decedent 14.10 5. Sovereign Bank, Checking Account #0035071989 97,249.22 in the name of Keturah L. Renshaw 6. Sovereign Bank, Money Market Account #8513075201 577,625.58 in the name of Keturah L. Renshaw 7. Personal property belonging to Decedent in assisted living room 250.00 8. Sovereign Bank, Certifrcate of Deposit #1995543061 51,062.45 in the name of Keturah L. Renshaw TOTAL (Also enter on line 5, Recapitulation) ~ E 728 392.35 (If more space is needed, insert additional sheets of the same size) REV-1509 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER KETURAH L. RENSHAW 2'I 08 0144 ff an asset was made joirrt within one year of the decede~'s date of death, it must 6e reported on Schedule G. SCHEDULE F JOINTLY-OWNED PROPERTY SURVMNG JOINT TENANT(S) NAME I ADDRESS (RELATIONSHIP TO DECEDENT A. Neta S. Schafer 1301 South Glencoe Road New Smyma Beach, Florida 32168-8438 cousin e Andrea K. Jeffries c JOINTLYAWNED PROPERTY: 6105 Leewood Drive Alexandria, VA 22310 niece REM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE: OF DEATH VALUE OF ASSET % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTERESI 1. A. 1/1983 Series EE Savings Bond M2289031EE in the name of 2,299.60 50. 1,149.80 Keturah L. Renshaw or Mrs. Neta S. Schafer 4. B. 2/1984 Series EE Savings Bonds M6244041EE and 3,712.00 50. 1,856.00 M6244042EE in the name of Keturah L. Renshaw or Andrea K. Jeffries TOTAL (Also enter on line 6, Recapitulation) /If mnre enare ie noerieri inenrf arLiifinnal ehen}c of 1ho camo easel S 3.005.80 REV-1511 EX + (10-06) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES $ IN R SIDENTED ~ DENTRN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER KETURAH L. RENSHAW 21 08 0144 Detrts of decederrt must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: t. Dale E. Ranck Funeral Home 3,412.17 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Lori Copley Doyle and Lynn F. Sheffer Executrices 56,000.00 Street Address 4516 Crooked Hill Road / 655 Hunters Lane city Harrisburg / Lewisberry state PA / PA Z;p 17110 Years} Commission Paid: 2008 + 2009 2. Attorney Fees Baldwin 8~ Baldwin, Estate Legal Fees 40,000.00 3. Family Exemption: (If decedents address is not the same as claimants, attach explanation) Claimant Street Address City State Zip _ Relationship of Claimant to Decedent 4• Probate Fees Cumberland County Register of Wills, Probate Will ($1,210.00;) 1,234.00 and 6 short certificates ($24.00) 5 Accountants Fees George J. Geib, C.P.A., Preparation of 2007 Income Tax Returns 500.00 s• Tax Return Preparers Fees Included in Attorney Fees 7. The Patriot-News Co., Advertising cost of legal notice 304 41 8. Cumberland Law Journal, Advertising cost of legal notice . 9. U. S. Postmaster, registeredMsured mailings 75.00 10. Funeral luncheon reimbursement to Lori Copley Doyle 28 37 11. Death Certificate for Annie Barner co-owner of bond 135.00 12. , Death Certificate for Diora H. Trutt, co-owner of bond 12.50 9 00 13. 5 Affidavit of Domicile forms for investments, notary fees . 25 00 14. Woods at Cedar Run, Rent for February . 2 635 00 15. Sue Tobias, Hair dresser , . 16. U. S. Treasury, 2007 Individual Income Tax Due per Form 1040 15.00 17. Bonnie K. Miller, Treasurer, 2008 Personal Income Tax 53,650.00 18. Death Certificate for Cleta R. White, Co-Owner of Bond 9 80 12 00 . Page 1 of 2'. S con's. (If more space is needed, insert additional sheets of the same size) _ Continuation of REV-15001nheritance Tax Return Resident Decedent KETURAH L. RENSHAW 21 08 0144 Decedent's Name Page 1 Fite Number Schedule H -Funeral Expenses St Administrative Costs - 67. ITEM NUMBER DESCRIPTION AMOUNT 19. Neuberger Berman, fees for cost basis data on investments 60.00 20. PA Department of Revenue, 2007 Form PA40 Income Tax Due 1,171.00 21. Evans Memorial, Cemetery marker and engraving 1,168.00 22. Reimbursement to Lynn Sheffer for storage unit and postage 175.71 23. Miscellaneous deduction as allowance for Accountant's fees, Court Approved Account, and Summary of Estate Escrow Filing fees, etc. 450.00 _ _ TOTAL SCHEDULE H-B7 ~ $161, 081.96 REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, ~ LIENS FILE NUMBER KETURAH L. RENSHAW 21 08 0144 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH Lori Cogley Doyle, Power of Attorney services ($10,125.00), lost wages ($2',913.24) 2. (Lori Cogley Doyle, Reimbursement for clothing and personal supplies for Decedent 13, 038.24 185.00 TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) REV-1513 EX + (g_pp~ COA~IAONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES __ ESTATE OF FILE NUMBER KETURAH L. RENSHAW 21 08 0144 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List T'rustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright sppoousal distributions, and transfers under Sec. 9116 (a) (1.2)I 1. Lori Cogley Doyle Collateral 4516 Crooked Hill Road One-Eighth equal share Harrisburg, PA 17110 of Residuary Estate 2. Lynn F. Sheffer Collateral 655 Hunters Lane One-Eighth equal share Lewisbeny, PA 17339 of Residuary Estate 3. Andrea Jeffries Collateral 6105 Leewood Drive One-Eighth equal share Alexandria, VA 22310 of Residuary Estate 4. Christine McMillian Collateral 139 Heritage Drive One-Eighth equal share Portsmouth, RI 02871 of Residuary Estate 5. Robert M. White, Jr. Collateral P O. Box 0707 One-Eighth equal share Ellicott City, MD 21041-0707 of Residuary Estate 6. John W. Cogley, Jr. named in the Will as Jay Cogley Collateral 2136 Worthington Avenue One-Eighth equal share Bethlehem, PA 18017 of Residuary Estate 7. Scott Cogley Collateral 5047 Ravenwood Road One-Eighth equal share Mechanicsburg, PA 17055 of Residuary Estate ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, O N REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BENNG MADE 1. 0.00 1 2 3 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS Evangelical Community Hospital Building Fund Development Office, One Hospital Drive Lewisburg, PA 17837 American Bible Society Legal Department, 1865 Broadway New York, NY 10023-9980 Crystal Cathedral Ministries P. O. Box 100 Garden Grove, CA 92842 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space is needed, insert additional sheets of the same s¢e) 25,000.00 10,000.00 5,000.00 S 111.000.00 Continuation of REV-1500 Inheritance Tax Return Resident Decedent KETURAH L. RENSHAW Decedent's Name Page 2 Schedule J -Beneficiaries -1 21 08 0144 File Number NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP T'0 DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE I TAXABLE DISTRIBUTIONS (include outright spousal distributions) 8. Allison O'Brien Collateral 600 Gladstone Avenue One-Eighth equal share Baltimore, MD 21210 of Residuary Estate 9. Anna M. Stahl Collateral 5,000.00 858 Carpenter Road specific bequest per Milton, PA 17847 Item Three (i) of Will 10. Betty Herald Collateral 5,000.00 202 Fairview Avenue specific bequest per Milton, PA 17847 Item Three (j} of Will 11. Neta Schafer Collateral 5,000.00 1301 South Glencoe Road specific bequest per New Smyma Beach, FL 32168-8438 Item Three (k) of Will 12. Jessica Jeffries Collateral 20,000.00 6161 Edsall Road, Apt. 202 specific bequest per Alexandria, VA 22304 Item Three (r) of Will 13. Drew Cogley Go Scott Cogley Collateral 20,000.00 5047 Ravenwood Road specific bequest per Mechanicsburg, PA 17055 Item Three (I) of Will 14. Alex O'Brien Go Allison O'Brien Collateral 20,000.00 600 Gladstone Avenue specific bequest per Baltimore, MD 21210 Item Three (m} of Will 15. Jacob Jeffries Collateral 20,000.00 6105 Leewood Drive specific bequest per Alexandria, VA 22310 Item Three (n) of Will 16. Kirsten Sheffer c/o Lynn Sheffer Collateral 20 000.00 655 Hunters Lane , specific bequest per Lewisberry, PA 17339 Item Three (o) of Will 17. Devon Cogley Collateral 20 000.00 5047 Ravenwood Road , specific bequest per Mechanicsburg, PA 17055 Item Three (p) of Will 18. Meghan Cogley Collateral 20 000.00 2136 Worthington Avenue , specific bequest per Bethlehem, PA 18017 Item Three (q) of Will 19. Ashley McMillian Go Christine McMillian Collateral 20 000.00 139 Heritage Drive , specific bequest per Portsmouth, RI 02871 Item Three (s) of Will 20. Cpdy McMillian c/o Christine McMillian Collateral 20 000.00 139 Heritage Drive , specific bequest per Portsmouth, RI 02871 Item Three (t) of Will Continuation of REV-1500 Inheritance Tax Return Resident Decedent KETURAH L. RENSHAW 21 08 0144 Decedent's Name Page 3 File Number Schedule J -Beneficiaries - 26 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 4. March of Dimes 1,000.00 1275 Mamaroneck Avenue White Plains, NY 10605 5. Lebanon Valley College 25,000.00 101 North College Avenue Annville, PA 17003-1400 6. St. Andrew's United Methodist Church 25,000.00 102 Lower Market Street Milton, PA 17847 7. The Salvation Army 10,000.00 Legal Department, 440 West Nyack Road West Nyack, NY 10994 8. American Red Cross of Upper Northumberland County 10,000.00 560 Mahoning Street Milton, PA 17847 c~o~~ LAST WILL AND TESTAMENT I, KETURAH L. RENSHAW, of 200 Fairview Avenue, Milton Borough, Northumberland County, Pennsylvania, being of sound and disposing mind, memory, and understanding, do make, publish, and declaze this to be my Last Will and Testament, hereby revoking any and all Wills and Codicils by me at any time heretofore made. ITEM ONE I direct my Executrices, hereinafter named, to pay all my just debts, funeral expenses (including the costs of a suitable marker and/or the engraving of any existing mazker), costs of administration, and all inheritance taxes assessed against my Estate as soon after my decease as possible. ITEM TWO I order and direct that all of my personal effects, furnishings, and. family photographs and heirlooms shall be distributed to my family members by my Executrices and at their complete and sole discretion. If there aze any disputes regazding the same that can not be settled by my Executrices, then I order and direct that the Attorney(s) for my Estate aze to resolve said dispute(s) in a fair and equitable manner, with the decision(s) of said Attorney(s) to be final and legally binding. ITEM THREE I give and bequeath the following sums of money, to wit: LAW OFFICES OF BALDWIN & BALDWIN MILTON, PA (a) The sum of Ten Thousand ($10,000.00) Dollazs, or; two (2%) percent of the rest, residue, and remainder of my Estate, with the lesser figure of the two to be applicable and binding, to the American Bible Society, currently of New York, New York, as a charitable bequest for use in its general purposes. If the said American Bible Society is no longer in existence at the time of my death, then this bequest is to lapse and become null and void. (b) The sum of Five Thousand ($5,000.00) Dollars, or one (1%) percent of the rest, residue, and remainder of my Estate, with the lesser figure of the two to be applicable and binding, to the Crystal Cathedral Ministries, currently of Garden Grove, California, as a charitable bequest for use in its general purposes. If the said Crystal Cathedral Ministries is no longer in existence at the time of my death, then this bequest is to lapse and become null and void. (c) The sum of Twenty-five Thousand ($25,000.00) Dollars, or five (5%) percent of the rest, residue, and remainder of my Estate, with the lesser figure of the two to be applicable and binding, to St. Andrew's United Methodist Church, currently of Milton, Pennsylvania, as a charitable bequest for use in its general purposes. If the said St. Andrew's United Methodist Church is no longer in existence at the time of my death, then this bequest is to lapse and become null and void. LAW OFFICES OF BALDWIN 6 6ALDWIN MIL7DN, PA (d) The sum of One Thousand ($1,000.00) Dollars, or twenty-hundredths (0.20%) percent of the rest, residue, and remainder of my Estate, with the lesser figure of the two to be applicable and binding, to the March of Dimes, currently of Harrisburg, Pennsylvania, as a charitable bequest for use in its general purposes. If the said March of Dimes is no longer in existence at the time of my death, then this bequest is to lapse and become null and void. (e} The sum of Twenty-five Thousand ($25,000.00) Dollars, or five (5%) percent of the rest, residue, and remainder of my Estate, with the lesser figure of the two to be applicable and binding, to the Evangelical Community Hospital Building Fund, currently of Lewisburg, Pennsylvania, as a charitable bequest for use in its general purposes, and with said bequest to be specifically designated in memory of my parents, Mr. and Mrs. W. J. Raymond Rein. If the said Evangelical Community Hospital Building Fund is no longer in existence at the time of my death, then this bequest is to lapse and become null and void. (f) The sum of Twenty-five Thousand ($25,000.00) Dollars, or five (5%) percent of the rest, residue, and remainder of my Estate, with the lesser figure of the two to be applicable and binding, to the Lebanon Valley College, currently of Annville, Pennsylvania, as a charitable bequest for use in its general purposes, and with said bequest to be specifically designated in memory of my son, Lieutenant U.S.N. Craig H. Renshaw, Class of 1967. If the said Lebanon Valley College is no longer in existence at the time of my death, then this bequest is to lapse and become null and void. (g) The sum of Ten Thousand ($10,000.00) Dollars, or two (2%) percent of the rest, residue, and remainder of my Estate, with the lesser figure of the two to be applicable and binding, to the Milton, Pennsylvania Division of the Salvation Army, for specific use in the Borough of Milton, Pennsylvania and in the adjacent townships served by the Milton office, as a charitable bequest for use in its general purposes in this defined geographic area. If the said Milton, Pennsylvania Division of the Salvation Army is no longer in existence at the time of my death, then this bequest is to lapse and become null and void. (h) The sum of Ten Thousand ($10,000.00) Dollars, or two (2%) percent of the rest, residue, and remainder of my Estate, with the lesser figure of the two to be applicable and binding, to the American Red Cross of Upper Northumberland County, currently of Milton, Pennsylvania, for specific use in the Borough of Milton, Pennsylvania and in the adjacent townships served by the American Red Cross of Upper Northumberland County office, as a charitable bequest for use in its general purposes in this defined, geographic area. If the said American Red Cross of Upper Northumberland County is no lc-nger in existence at the time of my death, then this bequest is to lapse and become null and void. 2 (i) The sum of Five Thousand ($5,000.00) Dollars, or one (1%) percent of the rest, residue, and remainder of my Estate, with the lesser figure of the two to be applicable and binding, to Anna M. Stahl, currently of Milton, Pennsylvania. If the said Anna M. Stahl should predecease me, then this bequest is to lapse and become null and void. LAW OFFICES CF IALDWIN & BALDWIN MILTON, PA (j) The sum of Five Thousand ($5,000.00) Dollars, or one (1%) percent of the rest, residue, and remainder of my Estate, with the lesser figure of xhe two to be applicable and binding, to Betty Herald, currently of Milton, Pennsylvania. If'the said Betty Herald should predecease me, then this bequest is to lapse and become null and void. (k) The sum of Five Thousand ($5,000.00) Dollars, or one (1 %) percent of the rest, residue, and remainder of my Estate, with the lesser figure of the two to be applicable and binding, to my cousin, Neta Schafer, currently of New Smyrna Beach, Florida. If the said Neta Schafer should predecease me, then this bequest is to lapse and become null and void. (1) The sum of Twenty Thousand ($20,000.00) Dollars, or four (4%) percent of the rest, residue, and remainder of my Estate, with the lesser figure of the two to be applicable and binding, to my grandnephew, Drew Cogley, currently of Camp Hill, Pennsylvania, in the manner stipulated in Item Five of this, my Will. If the said Drew Cogley should predecease me, then this bequest is to lapse and become null and void. (m) The sum of Twenty Thousand ($20,000.00) Dollars, or four (4%) percent of the rest, residue, and remainder of my Estate, with the lesser figure of the two to be applicable and binding, to my grandnephew, Alex OBrien, currently of Baltimore, Maryland, in the manner stipulated in Item Five of this, my Will. If the said Alex OBrien should predecease me, then this bequest is to lapse and become null and void. (n) The sum of Twenty Thousand ($20,000.00) Dollars;, or four (4%) percent of the rest, residue, and remainder of my Estate, with the lesser figure of the two to be applicable and binding, to my grandnephew, Jacob Jeffries, currently of Alexandria, Virginia, in the manner stipulated in Item Five of this, my Will. If the said Jacob Jeffries should predecease me, then this bequest is to lapse and become null and void. (o) The sum of Twenty Thousand ($20,000.00) Dollars, or four (4%) percent of the rest, residue, and remainder of my Estate, with the lesser figure of the two to be applicable and binding, to my grandniece, Kirsten Sheffer, currently of Lewisberry, Pennsylvania, in the manner stipulated in Item Five of this, my Will. If the said Kirsten Sheffer should predecease me, then this bequest is to lapse and become null and void. (p) The sum of Twenty Thousand ($20,000.00) Dollars, or four (4%) percent of the rest, residue, and remainder of my Estate, with the lesser figure of the two to be applicable and binding, to my grandniece, Devon Cogley, currently of Camp Hill, Pennsylvania, in the manner stipulated in Item Five of this, my Will. If the said Devon Cogley should predecease me, then this bequest is to lapse and become null and void. 3 (q) The sum of Twenty Thousand ($20,000.00) Dollazs, or four (4%) percent of the rest, residue, and remainder of my Estate, with the lesser figure of the two to be applicable and binding, to my grandniece, Meghan Cogley, currently of Allentown, Pennsylvania, in the manner stipulated in Item Five of this, my Will. If the said Meghan Cogley should predecease me, then this bequest is to lapse and become null and void. (r) The sum of Twenty Thousand ($20,000.00) Dollars, or four (4%) percent of the rest, residue, and remainder of my Estate, with the lesser figure of the two to be applicable and binding, to my grandniece, Jessica Jeffries, currently of Alexandria, Virginia, in the manner stipulated in Item Five of this, my Will. If the said Jessica. Jeffries should predecease me, then this bequest is to lapse and become null and void. (s) The sum of Twenty Thousand ($20,000.00) Dollars, or four (4%) percent of the rest, residue, and remainder of my Estate, with the lesser figure of the two to be applicable and binding, to my grandniece, Ashley McMillian, currently of Portsmouth, Rhode Island, in the manner stipulated in Item Five of this, my Will. If the said Ashley McMillian should predecease me, then this bequest is to lapse and become null and void. (t) The sum of Twenty Thousand ($20,000.00) Dollars, or four (4%) percent of the rest, residue, and remainder of my Estate, with the lesser figure of the two to be applicable and binding, to my grandnephew, Cody McMillian, currently of Portsmouth, Rhode Island, in the manner stipulated in Item Five of this, my Will. If the said Cody McMillian should predecease me, then this bequest is to lapse and become null and void. ITEM FOUR LAW OFFICES OF BALDWIN & BALDWIN MILTON, PA Under and subject to the directive contained in Item Two and the bequests described in Item Three of this, my Will, which directive and bequests aze to have priority and be controlling, I order and direct that the rest, residue, and remainder of my Estate, of whatsoever kind and nature and wheresoever situate at the time of my death, whether real property, personal property, or mixed property, is to be converted into cash. I give and bequeath the resulting net cash proceeds, which figure is to be derived after all costs, fees, expenses, inheritance taxes, and bills due and owing by my Estate have been fully paid, in equal shazes, to my niece, Andrea Jeffries, currently of Alexandria, Virginia; my niece, Christine MclVtillian, currently of Portsmouth, Rhode Island; my nephew, Robert M. White, Jr., currently Ellicott City, Maryland; my nephew, Jay Cogley, currently of Bethlehem, Pennsylvania; my nephew, Scott Cogley, currently of Camp Hi11, Pennsylvania; my niece, Lynn F. Sheffer, currently of Lewisberry, Pennsylvania; my niece, Lori Cogley Doyle, currently of Harrisburg, Pennsylvania; and my niece, Allison O`Brien, currently of Baltimore, Maryland. In the event that one or more of my aforesaid eight heir. (s) should predecease me, then the share of said deceased heir(s) is to go equally to my remaining heir(s) named in this Item Four of my Will, who must be living at the time of my death in order to inherit hereunder. 4 ITEM FIVE In the event that any share of my Estate should pass to my heirs, namely, Drew Cogley, Alex OBrien, Jacob Jeffries, Kirsten Sheffer, Devon Cogley, Meghan Cogley, Jessica Jeffries, Ashley McMillian, or Cody McMillian, as provided in Item Three (1), (m), (n), (o), (p), (q), (r), (s), and (t) of this, my Will, and if said heir(s) are under the age of twenty-four (24) years at the time of their respective inheritance, then and in such event said share(s) must be transmitted by creating separate and irrevocable, insured, interest bearing Certificates of Deposit, one for each applicable heir, with any local area Bank. Each Certificate of Deposit will be in the name of a different heir as qualified above, but all. Certificates of Deposit created hereunder shall be designated in care of my Estate and held by my Executrices or by my hereinafter named Attorneys (if applicable). The respective Social Security Numbers of my aforesaid heirs are to be used for income tax purposes, and all iinterest earned on each of said Certificates of Deposit must accumulate and be added to the principal of the applicable Certificate. The entire amount of principal and interest of the (:ertificate in the name of each applicable heir, as designated in care of my Estate, is to be fully paid to said heir(s) on the date that he, she, or they reach their twenty-fourth (24th) birthday. In the event that one or more of my above-referenced heir(s) should die before attaining the age of twenty-four (24) years, then I give and bequeath the Certificate(s) of Deposit in the name of said deceased heir(s), together with the entire amount of principal and accumulated interest, in equal portions, to my remaining heir(s) referenced in Item Three (1) through (t) inclusive of this, my Will, but subject, however, to the exact terms, conditions, and restrictions of any Certificate of Deposit which has been previously established herein for him, her, or them, if applicable. ITEM SIX I order and direct that all legacies and all shares and interests in my Estate, whether principal or income, while in the control of my Executrices or Attorneys for my Estate (if applicable), shall not be subject to attachment, execution, or sequestration for any debt, contract, obligation or liability of any legatee or beneficiary, and shall not be subject to pledge, assignment, conveyance, or anticipation, and the personal receipt of such legatee or beneficiary shall be the sufficient and only discharge of my Executrices or Attorneys for my Estate (if applicable). ITEM SEVEN LAW DFFICES DF 3ALDWIN S BALDWIN MILTON, PA All federal, state, and other death taxes payable because of my death, with respect to the property forming my gross Estate for tax purposes, whether or not passing under this Will, including any interest or penalty imposed in connection with such tax, shall be considered a part of the expense of the administration of my Estate and shall 'be paid from my residuary Estate without apportionment or right of reimbursement. ITEM EIGHT I nominate, constitute, and appoint my niece, Lori Cogley Doyle, currently of 4516 Crooked Hill Road, Harrisburg, Pennsylvania 17710, and my :niece, Lynn F. Sheffer, currently of 655 Hunters Lane, Lewisberry, Pennsylvania 17339, to be the Executrices of this, my Last Will and Testament. I direct that my said Executrices shall have full power and authority granted to fiduciaries under the Acts of Assembly in such case made and provided, and that they not be required to give Bond for the faithful performance of their duties as Executrices. In case of vacancy in said office by reason of the death, (or the refusal to serve) of either of the said Lori Cogley Doyle or Lynn F. Sheffer, then and in that event I appoint the remaining one of the two of them to serve as Executrix, without the requirement of a Bond. I further order and direct that my Executrices shall have full and complete discretion in the settlement of my Estate, but must abide by the terms and conditions set forth in this, my Will, and that no Order of Court will be required to sell or dispose of any of my assets, whether real property, personal property, or mixed property. ITEM NINE I order and direct that Baldwin & Baldwin, of 42 South Front Street, Milton, Pennsylvania, shall be employed as Attorneys in all matters in connection with the administration of my Estate and in carrying out the provisions established by this, my Will. My Attorneys are very familiar with my wishes, sentiments, and desires in accordance with said provisions of this Will. IN WITNESS WHEREOF, I, Keturah L. Renshaw, the Testatrix above-named, have hereunto set my hand and seal this 29th day of June, 2007. /( a~.,~~-~-~-~-~~ o~, ~ ~-~ (SEAL) Signed, sealed, published, and declared by the above Testatrix as and for her Last Will and Testament in the presence of us, who in the presence of said Testatrix, in the presence of each other, and at her request, have hereunto signed our names as witnesses. UW OFFICES OF ~ ~ BALDWIN &BALDWIN ~ ~A~ MILTON, PA f'YS' 6 COMMONWEALTH OF PENNSYLVANIA, COUNTY OF NORTHUMBERLAND, ss: ON this, the 29th day of June, 2007, before me, a Notary Public, the undersigned LAW OFFICES OF BALDWIN ~ 6ALDWIN MILTON, PA officer, personally appeared Keturah L. Renshaw, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that she executed the same for the purpose therein contained, as and for her Last Will and Testament. IN WITNESS WHEREOF, I hereunto set my hand and Notarial seal. '~ L~ COMMONWEALTH OF PENNSYLVANIA Notarial seal Notary Public Linda S. frown, Notary Public Milton Boro, Northumberland County My Commission Expires June i$,2Q10 Member, Pennsylvania Association of Notaries 7 COMMONWEALTH OF PENNSYLVANIA, ) ss: COUNTY OF NORTHUMBERLAND, ) We, E. Terry Baldwin and James T. Baldwin, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Keturah L. Renshaw, the Testatrix, sign and execute the instrument as her Last Will and Testament; that the Testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix, signed the Will as witnesses; and that: to the best of our knowledge, the Testatrix was at the time eighteen (18) or more years of age, of sound mind, and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me by E. Terry Baldwin and James T. LAW OFFICES OF ALDWIN S BALDWIN MIL70N, PA Baldwin, witnesses, this 29th day of June, 2007. COMMONWEALTH OP PENNSYLVANIA Notarial Seal /~ Linda S. 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N N N N N N N N N N E o o:~~ ~~~~ o N 3 LLg _ a ;, z fo ~ - fo ao fv ao fo ao ao ao '. i o °o °o o° °o °o °o °o °o >_ Z o 0 c C ~ v a 0 0 0 0 0 i0 ~ m ' ~ - 'n ~ n ~~ n n fa0. n n ~ m Y ~ Cn C ~ ~ ~ fR ' M ~ M 4~i 4 rl ~ .v N H H H rl .~i ~-~~-i ~-i ti H ti aLi C O ~„~ ~ O O i .~ H H ~-f rl rl O fu M > m j q C V ~ W ~- Q CC G ~ O ~ O O o O O O O O O O O o O O O O O O O O O O O fp V ~ O ~ O I ~ i i O O O O O l i l ti ul ~ . p. ~ 0 C .~ R e . r ~- r rl w ~ = Q r i Q Hf i4 M M iA W iR iR . 0 NI F A J 0 O ~~ W W W W W W W W W w ~ Y ' ° b _ 7; Q a ~ W W W W W W W W W W >,I C - W., ~ fo o M R ~ ~ a rn a .i .i .i .y .i m~ va a ~o ~ N O C ~;I ~ fT M f+) M O O O O O O ~ R . ~ ~ a0 N M C) O ~ N N M M M M M I~ f~ n f~ f\ M O ^ A M ~ O m ~ ~ ' L N O C1 O O O O O O M ~, ~ , o ~ ~ w () ~ IA ~ N N N f ~: f N N N N N f ~~~ f p a a V1 O 00 0 0 N .--f .-~ M N O E. TERRY BALDWIN, ESO. JAMES T. BALDWIN, ESO. WM. W. BELFOR D, II (1947-1998) RALPH L. BELFOR D, SR. (1908-1949) Law ~ffces of BALDWIN &BALDWIN 42 SOUTH FRONT STREET MILTON, PA 17847 October 29, 2008 VIA Federal Express (Overnight} Cumberland County Courthouse Attention: Glenda Farner Strasbaugh, Register of Wills One Courthouse Square Carlisle, PA 17013 PHONE: (570) 742-8508 FAX: (570) 742-4113 r.a ,~ j - ,. ,w-.. ___ ' ,J _. ^ ') ,, ~ u, ~._ In Re: Estate of Keturah L. Renshaw: Social Security Number 160-16-1320; Died February 2, 2008; Cumberland County File No. 21-08-0144 Dear Glenda: You will find enclosed herewith for immediate processing the following items in reference to the above Estate, to wit: 1. Pennsylvania Inheritance Tax Return (in duplicate original) dated October 9, 2008. 2. Copy of the United States Estate Tax Return Form 706 dated October 9, 2008, which I understand will be forwarded by your office to the Pennsylvania Department of Revenue in Harrisburg. 3. Cumberland County Inventory dated October 9, 2008 listing the probate assets for this Estate in the total sum of $2,348,165.44. 4. Baldwin & Baldwin Trust Check #10337 dated October 29, 2008 payable to "Cumberland County Register of Wills" in the sum of $30.00, representing the filing fees for the Pennsylvania Inheritance Tax :Return and the Cumberland County Inventory. I am including with this letter aself-addressed, stamped envelope for you to send me the following items, to wit: A. My File Copy of the Pennsylvania Inheritance Tax Return showing the date and time of filing stamped on the front page. B. My File Copy of the Cumberland County Inventory showing the date and time of filing stamped on the front page. C. A separate receipt for the payment of $30.00 which is described in Item 4 above. Glenda Farner Strasbaugh, Cumberland County Register of Wills Page 2 October 29, 2008 Thank you for your expected cooperation in this matter, and please fe:el free to call me if you have any questions regarding the same. Very truly yours, BALDWIN & BALDWIN ~_~ James T. Baldwin JTB:td Enclosures V/fornilettJrecorder r } ~~ ~~ ~~ .~ - _ r ~~~ Q ~Ec ~I Z ~ ~am 1- r { ~ N W d= ~LL 9 O W ~ ~] ' o a _ ~ ~ LL `~ Q z _~~ ° _ ~ N 1~ N _ ~ ~ ~ F 67 E •2 ~ ~ CT~m gfdn ~ o _ ~1~ ~ a ~ ~ r .' a v o' z' z d F- ® oEa¢ ~„aa~ a e ~• ~ ~ V - y y y~ m 3~ O N 3~ u rn t ~ ~'~~„ ~a~~~ ~M w ~ N ~g o ^ - ~ ( W ~izEx cEdu° _ mN~ li ~n `m n C] ~ ~ a ^ ^ J tb ~ ~ Cd ~ ~ N m ~ R l _ O .? ~` ~ `~ C~ 0^ ~' ~ ~ o _ Q, r = _~ Li$ Z y m a S m °~o 4 ^ Gov o,~ d LL~ y >~oo ~N E~ V ^ .~ y ~y ~ ~' r a.-LL ~ ~yi a W liZC- e C~ . 0 s. __ J ~.- ~ ' fn m _. . • ~ ~ - _~~ - ~ ° ^ ^ L __ ./ • • W ~ ~ i1_. ~ ~ ~, '~` E . . t- d t.._• 1_. 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