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Home My WebLink About03-0664 Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS also known as , Deceased Social Security No. Petitioner(s), who is/are 18 years of age or older, apply(les) for: (COMPLETE "A" OR "B" BELOW:) A. Probate and Grant of Letters and aver that Petitioner(s) is/are the executd_~_x named in the Last Will of the Decedent, dated February 7, 2000 and codicil(s) dated N/A State relevant circumstances, e.g., renunciation, death of executor, etc. Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: N/A B. Grant of Letters of Administration (c.t.a., d,b.n.c.t.a.: pendente lite; durante absentia; durante mirx~dtate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last,family or pr~ipal residence {list street, ~umber and municipality) ~ ~ -- -- - ] ' Decedent, then ~¢] years ofage, died ~ll.i~.~" ?../~-z_~ro ,~, ,at ~.. (Location)~/'~t'~'J~ Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property (If not domiciled in PA) Personal property in Pennsylvania ............................. $ ~=t.-O...~.~ (If not domiciled in PA) Personal property in County .................................. $ Value of real estate in Pennsylvania ........................................................... $ Total ........................................................................... $ / Real Estate situated as follows: . Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: I Signature Typed or pdnted name and residence , _ ~'~ ~ ~ ~'?~-~--~ 1~.~'~-~-~ Mary Holmes Dague I 732 West South St., Carlisle, PA 17013 Form RW-1 Page 1 of 2 (Dauphin County - Rev, 9/92) PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF THE ESTATE IS NOT COMPLETED, FILE A 6.12 FORM YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Adeline W. Holmes Date of Death: August 2, 2003 Will No. 2003-0664 Admin. No. 21-2003-0664 · 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 complete: _. 3. If the answer to No. I is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes [--] No [~ b. The separate Orphans' Court No. (if any) for 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 attached to this report. Date: //~ ~a,~. a~q" ;~ ~, ~ Signature / Peter J. Ress]er Name (Please type or print) 3401 North Front Street, P.O. Box 5950 ~ ..~. Address Harrisburg, PA 17110-0950 ::::~: (717) 232-5000 ~ Telephone Capacity: [] Personal Representative [] Counsel for Personal Representative 410896vl ~j~ Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) and afffirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to and affirmed and subscribed '~-/'/( ~:~','~/ .-./~,.,7~//~ ~_~..~ ~,~~ ---, before me this I I -~ ~ Mary-~ol~s Degas d~ of Ad. L,L,ST 20 _. OF REGISTER Estate of Adeline W. Holmes ,Deceased No. _/~/_ also known as Social Security No: O~'¢ '- 3~'" ~,~"'-~ Date of Death: I Z. - ' AND NOW, C'L,,.,V ~. Gl. ~k;~) ,200_...~, in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters [] Testamentary [] of Administration (c.t.a.; d.b.n.c.t.; pendents lite; durante ab~entia; durante minofltate) are hereby granted to Mary Holmes Daque in the above estate and that the instrument(s), if any, dated February 7, 2000 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. Letters ........................... $ & 55. ~-~ /L~ ~ Short Certificate(s) .......... $ i,~ 00 ~.~ [¢ Register of Wills Renunciation .................. $. -.___- Affidavit() ................. $ ~('~ Extra Pages ( ) ............ $ j~_~ '~ Codicil ..........................$ JCP Fee ........................ $ ~).(') _(~) Attorney: Peter J. Ressler, Esquire Inventory & Tax Forms... $. I.D. No: 6844 Other ............................$ Address: 3401 North Front Street Harrisburg, PA 17110-0950 TOTAL ................ $ ~=,,~..~. ~ ~ Telephone: 717-232-5000 DATE FILED: ~ I l 105.805 REV 9/86 This is to certify that the information here given is correctly copied f~rom an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 No. Date H105 143 Rev. 2/8? COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS .,.T CERTIFICATE OF DEATH NAME OF DECEDENT (First. Middle. Last) STATE Fff-E NUMBER ~' Adeline W. Holmes Iz. Female ~ ~ ~ ' 4 A · 2,' 2~ sb. ~rl~d s~ ~rlis (sv~) DECEDENTS 17a. Stole ~A ~o~wald H~ AC~AL FATHER'S N~E (First, ~le, Lest) ,8. ~ank Olin ~itc~ MO~ER'S N~E (Flint. Mid~, Maiden Sumac) Helen Gilroy Laurence ~g~er o=~ s~) 2~3 St. Jo~ ' s Ce~te~ Gull ford, Corm ~ . . I(~ ~th Day Year) CAUSE (Disease or inju~ c. PERFORMED? AV~LE PRIOR TO ATE OF INJURY TIME OF INJURY ~ IN N~E AND ADDRESS OF PERSON ~O COMPLIED ~eba~s~ex~nat~a~nves~ga~nmy~p~n~n~dea~cur~a~het~me~d~te~ndp~a~e~andduet~thec~usea(~)and (Item27)Ty~p~ ~ ~ ,I ~' ~ ~$EOF~TH OF ADELINE W. HOLMES I, ADELINE W. HOLMES, of the Borough of Carlisle, Cumberland County, Pennsylvania, declare this to be my last Will, hereby revoking all prior wills and codicils. FIRST: The expenses of my last illness and funeral shall be paid from my estate. SECOND: I give and bequeath all clothing, jewelry, household goods, personal effects, automobiles and all other tangible personal property not otherwise specifically bequeathed which I may own at the time of my death (except any securities and cash on hand or on deposit), in shares of substantially equal value to my daughters, HELEN HOLMES and MARY HOLMES DAGUE, if both are living at the time of my death, otherwise all to the survivor thereof. The division is to be made in any manner as they shall agree or, if they shall fail to agree upon a division within six months after the date of my death, as my Executor shall determine. I may leave a memorandum (which is not to be a part of this Will) listing some of the items of tangible personal property which I may wish certain persons to have and I request (but do not require) that my wishes as set forth in the memorandum be observed. All reasonable costs of safeguarding, insuring, packing, storing, and delivering each item of tangible personal property shall be paid as expenses of administration of my estate. THIRD: I give and devise the residue of my estate, real and personal, to the then acting Trustee under my inter vivos Agreement of Trust dated October 25, 1991, as amended, and heretofore executed by me as Settlor and as Trustee, to be added to the principal held thereunder. In any instance where a share in my estate would be distributable to a beneficiary of such trust when received by the Trustee, my Executor may make distribution directly to such beneficiary. FOURTH: In addition to powers vested in them by law, my Executors and their successors shall have the following powers, applicable to all property held by them, including all property held for minors, effective without the order of any court and until actual distribution of all such property. (a) To retain any property received by them including the stock of any corporate fiduciary acting hereunder; (b) To sell real estate for any purpose, publicly or privately, for such prices and on such terms and as they deem proper, without liability on the purchasers to see to application of the purchase moneys; (c) To compromise controversies; (d) To distribute in cash or kind or partly in each at valuations i~Lxed by them; (e) To hold investments in the name of a nominee; and (f) To borrow money from and sell property to the trust referred to in Item THIRD hereof even though they are also acting as Trustees thereunder. FIFTH: I appoint my Trustee under the Agreement of Trust referred to in Item THIRD hereof as Guardian to hold for minors ail property for which other provision is not made in this Will or said Agreement and which is payable by law to a guardian appointed by my Will. SIXTH: All taxes, interest and penalties thereon payable by reason of my death with respect to property comprising my gross estate, whether or not passing under this Will, shall be paid from the principal of my residuary estate, provided however, that my Executors may cail upon the trust referred to in Item THIRD hereof to pay such taxes, interest and penaities attributed to the extent the amount distributable to such trust under Will before taxes. Taxes on future interests may be prepaid. SEVENTH: Any beneficiary hereunder who dies at the same time as me, within ten (10) days of me, or under circumstances wherein it shall be difficult or impossible to determine who died first shall be presumed to have predeceased me. EIGHTH: I appoint my daughter, MARY HOLMES DAGUE, as Executrix (herein referred to as my "Executor") of this my will. In the event my said daughter cannot act or continue to act as Executrix for any reason, I appoint my daughter, HELEN HOLMES to act as Executrix in her place. No fiduciary acting hereunder shall be required to post bond or enter security in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this '~ ~f' day of_~~.~ ,2000, to this and the preceding three (3) Page 3 pages, and I have also placed my initials on each preceding page for better identification and greater security. SIGNED, SEALED, PUBLISHED and DECLARED by the above-named Testatrix, ADELINE W. HOLMES, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses: ?'~/J'J~'~-~'5! L~~~ Residing at ~ ~~ ~J~,/~ ~'~ ,~ Residi~n_gat ~.~1/ A~'/zJ/,.~i/ ?~.. k ~/ ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA · · SS. COUNTY OF [,b~t,.~j . I, ADELINE W. HOLMES, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. ADELINE W. HOLMES Sworn to and subscribed before me this ~ day of 'i~b,-~, ./ ,2000. Not~ fublic My Commission Expires: (SEAL) Melisa M. Lmas, No~ Public Hards~ Oa~ n C~n~ My Comm ssion E~res ~t. 13, ~ M~ber, P~ns~an~ Ass~iaa~ of ~s AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF OA u.P ~i 1~,~ : i~/4'~.;/rT~,..~nd ~~ (. /,~/~) ,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 Testatrix, ADELINE W. HOLMES, sign and execute the instrument as her Last Will and Testament, that Testatrix signed willingly and that she executed said Will as her free and voluntary act for the purposes therein expressed; that each of us in the heating and sight of the Testatrix signed the Will as Witnesses; and that to the best of our knowledge the Testatrix was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. . -,/1 Sworn to and subscribed before me this ~-~h day of , .ooo. Notary Public My Commission Expires: ~ Nota~a~ Sea~ ~ M,e. iis.a M. Lucas, Notaq/Public I .. _Harrfsburg, Dauphin Counly (SEAL) L.~c°mm~;~ior~ ~×~.~ o~t. ,3, ~ooa ~'~"~ ~n n ns V~ 'a~i~l ASSOCJatJoi~ Ot Notaries :212020 1 METTE, EVANS & WOODSIDE ATTORNEYS AT LAW HARRISBURG, PENNSYLVANIA 17110-O950 ORI61NAL CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Adeline W. Holmes Date of Death: August 2, 2003 Will No. Admin. No. 21-03-0664 To the Register: I certify that notice of estate administration 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 August 19, 2003: Name Address Ma~_ Holmes Dague 732 West South St., Carlisle, PA 17013 Helen Holmes 8 Goodluck Dr., Bayview, NJ 08721 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None. Date: August 19, 2003 f~e~'~i ~ ~' ~ · ~ignature Peter J. Ressler, Esquire Name 3401 North Front Street Harrisburg, PA 17110 Address ~.-~ (717) 232-5000 .... : Telephone -~' Capacity: Personal Representative x Counsel for Personal Representative :334562 I COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE REV-11 62 EX(11-96) BUREAU OF ~NDIVIDUAL TAXES DEPT, 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 003164 RESSLER PETER J 3401 NORTH FRONT STREET HARRISBURG, PA 17110 ACN ASSESSMENT AMOUNT CONTROL NUMBER ........ fold 101 $5,300.00 ESTATE INFORMATION: SSN: 056-38-5658 FILE NUMBER: 2103-0664 DECEDENT NAME: HOLMES ADELINE W DATE OF PAYMENT: 10/23/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 08/02/2003 TOTAL AMOUNT PAID: $5,300.00 REMARKS: MARY HOLMES DAGUE C/O PETER J RESSLER CHECK//109 INITIALS: JA SEAL RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS REV-1500 EX (6-00) OFFICIAL USE ONLY COMMONWEALTH OF DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN F,LENUMBER HARRISBURG, PA 17128-0601 21 -- 2_900--3 --0664 RESIDENT DECEDENT oou oOOE DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER ~ Holmes Adeline W 056-38-5668 Z , LLJ DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE U.I 08/02/2003 I 03/01/1914 REGISTER OF WILLS I/,I (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 1.1.1 ~ ~ 2. Supplemental Return I- 1. Original Return ~ 3. Remainder Return (date of death prier to 12-13-82) L___J 4, Limited Estate I I 4a. Future Interest Compromise (data of death after 12-12-82) L~ 5. Federal Estate Tax Return Required ~g b~ 6. Decedent Died Testate (Attach copy of Will) b~ 7. Decedent Maintained a Living Trust (Attach copy of Trust) 8. Total NumberofSafe Deposit Boxes n~ O. L.~ 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death bet .... 12-31-91and1-1-95) U 11. Election to tax under Sec. 9113(A)(AttachSchO) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: z NAME COMPLETE MAILING ADDRESS LU zo Peter J. Ressler, Esquire ~.O FIRM NAME(IfApplicable) 3401 North Front Street -' P.O. Box 5950 = Metre, Evans & Woodside oO TELEPHONE NUMBER Harrisburg, PA 17110-0950 717-232-5000 1. Real Estate (Schedule A) (1) 0 0 0 OFFICIAL USE ONLY 2. Stocks and Bonds (Schedule B) (2) 0 00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 0.00 4. Mortgages & Notes Receivable (Schedule D) (4) 0 00 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 154,337 23::~ Z 6. Jointly Owned Property (Schedule F) 0 00 0 (6) ! ~-- ~ Separate Billing Requested '~ 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) , · 553 0 97 62 ::~ (Schedule G or L) ~,3 707~434.85 gl: 8. Total Gross Assets (total Lines 1-7) (8) O UJ 9, Funeral Expenses & Administrative Costs (Schedule H) (9) 21,390.15 10. Debts of Decedent, Modgage Liabilities, & Liens (Schedule I) (10) 3 8 5 . 0 0 11. Total Deductions (total Lines 9 & 10) (11 ) 2 1,7 7 5. 1 5 12. Net Value of Estate (Line 8 minus Line 11) (12) 685 ~ 659.70 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) (13) 0 o 00 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 685,659.70 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax 0.0 0 0.0 0 Z rate, or transfers under Sec. 9116 (a)(1.2) x .00 __ (15) o ~ 685~659 70 30,854.69 < 16. Amount of Line 14 taxable at lineal rate · x.045 (16) -' 0 00 0.00 a. 17. Amount of Line 14 taxable at sibling rate ' x.12 (17) o 0 00 0.00 C) 18. Amount of Line 14 taxable at collateral rate ' x .15 (18) I.-- 19. Tax Due (19) 30,854.69 > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 2W4645 1.000 Decedent's Complete Address: S~,E ET ADDRESS Thornwald Homes 442 Walnut Bottom Road CITY I STATE JZlP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 30,854.69 2. Credits/Payments A. Spousal Poverty Credit 0. O0 B. Prior Payments 5 f 300. O0 C. Discount 278.95 Total Credits (A + B + C) (2) 5,578.95 3. Interest/Penalty if applicable D. Interest 0.00 E. Penalty 0. O0 Total Interest/Penalty (D + E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page I 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) 25,275.74 A. Enter the interest on the tax due. (5A). O. 00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 25., 27,5,74 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ....................... [--~ b. retain the right to designate who shall use the properly 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 tn~e, correct and complete. Declaration of preparer other than the personal representative is based on alt information of which preparer has any knowledge. SIGNATURE OF~ERSON RESPONSIBLE FOR FILING RETURNn DATE ADORESS 73~ WesVSouth Street Carlisle', PA 17013 SIGNATURE.(;~F PREPARER OTHER THAN REPRESENTATIVE DATE ADORESS34~lVN~th Front Street P.O. Box 5950 Harrisburg, PA 17110-0950 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 30/0 [72 P.S.§ 9916 (a) (1.1) (i)]. For dates of death on or after Jan uary 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the sur~ving spouse is 0% [72 P.S. § 9116 (a) (1.1) (ii)] The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. § 9116(a)(1.2)]. The tax rate im posed 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. § 9116(1.2) [72 P.S. § 9116(a)(1 )]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% (72 P.S. § 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 2w4646 1.ooo REV-1508 EX + (1-9~, ~ SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF FILE NUMBER Holmes, Adeline W 21-2003-0664 Include the ~roceed s of litigation and the date the proceeds were received by the estate. All property jointJy-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. M&T Bank Checking Account #10565507 154,337.23 TOTAL (Also enter on line 5~ Recapitulation) $ 154,33?. 23 2W46AD 2.oo0 (If more space is needed, insert additional sheets of the same size) REVo1510 EX + (1-97) SCHEDULE G COMMONWEALTH OF PENNSYLVANIA INTER-VIVOS TRANSFERS & INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Holmes~ Adeline W 21-2003-0664 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. DESC~II-' HON OF PROPER'fY % OF ITEM i INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DATE OF DEATH DECD'S EXCLUSION DECEDENTAND THE DATE OF TRANSFER. ATTACH A COPY OF THE TAXABLE VALUE NUMBER DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (~F APP!JCABLE) 1. The Adeline W. Holmes Family 521,097.62 100.00 0.00 521,097.62 Trust established under Agreement dated October 25, 1991; Adeline W. Holmes was settlor and trustee. See attached trust agreement and amendments thereto. Trust assets consisted of Merrill Lynch Investment Account #812-11T61 2 Tranfer of cash made to 11,000.00 100.00 3,000.00 8,000.00 decedent' s son-in-law, Brian Gately, within one year of death 3 Transfer of cash made to 11,000.00 100.00 3,000.00 8,000.00 decedent ' s son-in-law, Laurence Dague, within one year of death 4 Transfer of cash made to 11,000.00 100.00 3,000.00 8,000.00 decedent' s daughter, Helen Holmes, within one year of death 5 Transfer of cash made to 11,000.00 100.00 3,000.00 8,000.00 decedent' s daughter, Mary Holmes Dague, within one year of death TOTAL (Aisc enter on line 7, Recapitulation) $ 553,097.62 (If more space is needed, insert additional sheets of same size.) 2W46AF 2.000 REV-1511 EX + (1-97) SCHEDULE H FUNERAL EXPENSES & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN AD M IN ISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Holmes, Adeline W 21-2003-0664 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: Hoffman-Roth Funeral Home, Carlisle, PA 155.44 1. 2 Guilford Funeral Home, Connecticut 5,472.46 3 Shelley Brothers, Connecticut - engraving headstone 95.40 4 Funeral flowers 330.57 5 Mary Holmes Dague - travel expenses to escort body 315.34 for burial in Connecticut B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 0.0 0 Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees Name: Mette, Evans & Woodside 14,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 0.00 Claimant Street Address City State __ Zip Relationship of Claimant to Decedent 4. Probate Fees 3 0 0.0 0 5. Accountant's Fees 0.00 6. Tax Return Preparer's Fees 0.00 7. Cumberland Law Journal - advertise legal notice 75.00 8 The Sentinel - advertise legal notice 98.69 9 Boyer & Ritter, CPA - preparation of 2003 personal 385.00 income tax returns 10 Joseph Holmes Dague - moving expenses to remove 150.00 decedent' s personal effects 11 Mary Holmes Dague, Executrix - reimbursement for 12.25 TOTAL (Aisc enter on line 9, Recapitulation) $ 21,390.15 2W46AG 2.000 (If more space is needed, insert additional sheets of same size) Page 2 Estate of: Holmes, Adeline W 21-2003-0664 Schedule H, Part B -- Administrative Costs Item No. Description Amount 11 telephone expense related to estate administration TOTAL. (Carry forward to main schedule) ...... 0.00 REV-1512 EX + (1-97) SCHEDULE I COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN RESIDENT DECEDENT MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Holmes, Adeline W 21-2003-0664 Include unreimbum~ m~ical expenses. I~M NUMBER DESCRIPTION AMOUNT 1. PA Department of Revenue - balance of 2003 personal income 385.00 taxes TOTAL (Also enter on line 10, Recapitulation) $ 385.00 2W46AH 2.000 (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Holmes, Adeline W 21-2003-0664 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. Dague, Mary Holmes Daughter 334,829.85 732 West South Street Carlisle, PA 17013 2 Holmes, Helen Daughter 334,829.85 8 Good Luck Drive Bayville, NJ 08721 3 Dague, Laurence Son-in-law 8,000.00 732 West South Street Carlisle, PA 17013 4 Gately, Brian Son-in-law 8,000.00 8 Good Luck Drive Bayville, NJ 08721 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00 2W46AI 1 000 (If more space is needed, insert additional sheets of the same size) OF ADELINE W. HOLMES I, ADELINE W. HOLMES, of the Borough of Carlisle, Cumberland County, Pennsylvania, declare this to be my last Will, hereby revoking all prior wills and codicils. FIRST: The expenses of my last iJlness and funeral shall be paid from my estate. I give and bequeath'all clothing, jewelry, household goods, L effects, automobiles and all other tangible personal property not otherwise specif~'qally bequeathed which I may own at the time of my death (except any securities and ca,,on hand or in shares of substantially equal value to my daughters, HELENH, OLMES if both are living at the time of my death, otherwise~to the thereof. The division is to be made in any manner as they shall agree or, if they shall fail to agree upon a division within six months after the date of my death, as my Executor shall determine. I may leave a memorandum (which is not to be a part of this Will) listing some of the items of tangible personal property which I may wish certain persons to have and I request (but do not require) that my wishes as set forth in the memorandum be observed. Page 1 All reasonable costs of safeguarding, insuring, packing, storing, and delivering each item of tangible personal property shall be paid as expenses of administration of my estate. THIRD: I give and devise the residue of my estate, real and personal, to the then acting Trustee under my inter vivos Agreement of Trust dated October 25, 1991, as amended, and heretofore executed by me as Settlor and as Trustee, to be added to the principal held thereunder. In any instance where a share in my estate would be distributable to a beneficiary of such trust when received by the Trustee, my Executor may make distribution directly to such beneficiary. FOURTH: In addition to powers vested in them by law, my Executors and their successors shall have the following powers, applicable to all property held by them, including allproperty held for minors, effective~thout the order of any court and until actual distribution of all such property. (a) To retain any property ~eived by them including the stock of any corporate fiduciary acting hereunder; (b) To sell real estate for any purpose, publicly or privately, for such prices and on such terms and as they deem proper, without liability on the purchasers to see to application of the purchase moneys; (c) To compromise controversies; (d) To distribute in cash or kind or partly in each at valuations fLxed by them; (e) To hold investments in the name of a nominee; and Page 2 (f) To borrow money from and sell property to the trust referred to in Item THIRD hereof even though they are also acting as Trustees thereunder. FIFTH: I appoint my Trustee under the Agreement of Trust referred to in Item THIRD hereof as Guardian to hold for minors all property for which other provision is not made in this Will or said Agreement and which is payable by law to a guardian appointed by my Will. SIXTH: All taxes, ~terest and penalties thereon payable by reason of my death with respect comprising my gross estate, whether or not passing under this Will, paid from the principal of my residuary estate, provided however, that my Executors may call upon the trust referred to in Item THIRD hereof to pay such taxes, interest and penalties attributed to the extent the amount distributable to such trust under Will before taxes. Taxes On future interests may be prepaid. SEVENTH: Any beneficiary hereunder who dies at the same time as me, within ten (10) days of me, or under circumstances wherein it shall be difficult or impossible to determine who died first shall be presumed to have predeceased me. EIGHTH: I appoint my daughter, MARY HOLMES DAGUE, as Executrix (herein referred to as my "Executor") of this my will. In the event my said daughter cannot act or continue to act as Executrix for any reason, I appoint my daughter, HELEN HOLMES to act as Executrix in her place. No fiduciary acting hereunder shall be required to post bond or enter security in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~fe day of ~~,-~ ,2000, to this and the preceding three (3) Page 3 pages, and I have also placed my initials on each preceding page for better identification and greater security. /~/ (SEAL) ADELINE W. HOLMES SIGNED, SEALED, PUBLISHED and DEC~D by the above-named Testatrix, ADELINE W. HOLMES, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in the presence of each other, have hereunto subscribed our nsmes as witnesses: ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA · I, ADELINE W. HOLMES, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified acco~g to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. /~/ (SEAL) ADELINEW. HOLMES Sworn to and subscribed before me this day of ,2ooo. Notary Public My Commission Expires: /$ ~/~ '~'~ (SEAL) AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA : : SS. · We, ~TE~ J./'~e~'~:~ , and '-~/~ /~ ~7-T~ , the Witnesses whose names are signed to the attached or foregoing instr~ment, being duly qualified according to law, do depose and say that we were present and saw Testatrix, ADELINE W. HOLMES, sign and execute the instrument as her Last Will and Testament, that Testatrix signed willingly and that she executed said Will as her free and voluntary act for the purposes th,;rein expressed; that each of us in the hearing and sight of the Testat~ signed the Will asWitnesses; and that to the best of our knowledge the Testatrix was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. Witness ~ Witness Sworn to and subscribed before me this __ day sooo. Not~ Public My Commission Expires: (SE~) :212020 1 TRUST AGREEMENT made this~ day of , 1991, by and between ADELINE W. HOLMES of Madison, Connecticut, hereinafter referred to as the "Settlor," and ADELINE W. HOLMES, hereinafter referred to as the "Trustee" W I TNE S SETH : WHEREAS, the Settlor desires to create a trust of certain securities and cash, the said securities and cash being described in Schedule A attached hereto; and WHEREAS, the Settlor or another person or persons, may hereafter desire to deposit with the Trustee other cash, property or securities, or may wish to add to the trust by gift, devise or bequest under the terms of a Last Will and Testament, in which event such additional cash, property or securities shall be listed on additional schedules to be attached hereto; NOW, THEREFORE, the Trustee agrees to hold said securities and cash and any other property which the Settlor or any other person may hereafter place or cause to be placed under this Agreement, by any means whatever, with consent of the Trustee (hereinafter referred to as the Trust Property), ATTORNEY JEANN R. TERRAZZANO, P.O. DRAWER 327, GUILFORD, CT 06437 and to manage, invest and reinvest said property in trust for the following uses and purposes: ARTICLE I This Trust shall be known as the ADELINE W. HOLMES FAMILY TRUST. ARTICLE II During the lifetime of the Settlor, the Trustee shall receive, hold and manage the Trust Property and shall invest and reinvest any property, and shall collect the income, if any, and proceeds thereof and shall pay over to or for the benefit of the Settlor during her lifetime so much of the annual net income and such amount or amounts of principal as the Settlor may request from time to time. If the successor Trustee receives written notice from a licensed physician stating that the Settlor is unable to make such a request due to illness or the infirmities of advanced age of the Settlor, or if for any other reason the Settlor cannot make such a request, the successor Trustee is allowed in its sole discretion, to use and apply the net income and/or the prince, pal of the Trust Property from time to time for the support, comfort and welfare, including reasonable luxuries of the Settlor. Any net income not so paid or applied shall be accumulated and added to the principal periodically (but not 2 ATTORNEY JEANN R. TERRAZZANO, P.O. DRAWER 327, GUILFORD. CT 06437 less frequently than annually). In investing and reinvesting any property held by the Trustee during the life of the Settlor, the Trustee is requested to consult with the Settlor insofar as is practicable. The Trustee is hereby exonerated from any liability in connection with any action taken with Settlor's consent. ARTICLE III Upon the Settlor's death, if the liquid assets of her probate estate are insufficient to conveniently discharge all of the cash bequests, debts, claims, funeral and administration expenses, and taxes which become due and payable on account of her death, the Trustee is authorized and directed to pay to the executors or administrators of the Settlor's estate such sum or sums as such executors or administrators may request in writing to discharge the portion of such bequests, debts, claims, funeral and administration expenses and taxes which cannot be conveniently discharged by the assets of the Settlor's probate estate. The Trustee shall have no duty or obligation to inquire as to the correctness or as to the propriety of the payment, of any amount or amounts so stated in any such written request, or to see to the application thereof, by said executors or administrators, but payment to them shall be a full and complete discharge to the Trustee with respect to such 3 A'I-rORNEY JEANN R. TERRAZZANO, P.O. DRAWER 327, GUILFORD, CT 06437 payment or payments. ARTICLE IV The Trustee shall divide the Trust, as it is then constituted, into equal portions for children of the Settlor either living at the time or represented by then living issue. The Trustee shall forthwith pay over and distribute one such portion free of any trust, to the Settlor's daughter, HELEN HOLMES GATELY, if living, and shall set out one such portion in trust under Subparagraph A hereof for the Settlor's daughter, MARY HOLMES DAGUE, if living, and shall set one such portion in trust under Subparagraph B hereof for the then living issue, per stirpes, of each of said children who shall have previously died. A. As to the share for the Settlor's daughter, MARY HOLMES DAGUE, if living, the Trustee is directed to manage, invest and reinvest said property in the following manner: 1. For a period of five (5) years after the death of the Settlor, the Trustee shall pay to or for the benefit of said daughter the income of the principal of said Trust in quarter annual payments as nearly equal as may be practical and as much of the principal as the Trustee, in its sole discretion deems reasonable or necessary for her health, maintenance, support and education. 4 ATTORNEY JEANN R. TERRAZZANO, P.O. DRAWER 327, GUILFORD, CT 06437 2. At the end of the five (5) year period, the Trustee shall pay over to said daughter the principal then remaining, absolutely. 3. Provided, however, if at any time the principal of the Trust shall be of such size that the continuation of such trust is, in the Trustee's sole discretion, unwarranted, the Trustee may, in its sole discretion, terminate the trust in which event it shall pay over and distribute the balance trust to said daughter. 4. Provided further, however, that should said daughter die before receiving all of the principal from said Trust, then upon the death of said daughter, the Trustee shall pay over and distribute the remaining principal and undistributed income of said Trust to the descendants then living of said child, per stirpes, absolutely, subject to the terms of Subparagraph B hereof and in default of such descendants then living of such child, to the Settlor's descendants then living, per stirpes, absolutely, subject to the provisions of Subparagraph B of this Article. B. As to the per stirpes share of each of the issue of each deceased child of the Settlor, the Trustee is directed as follows: 1. The share of any of such issue, age 5 ATTORNEY JEANN R. TERRAZZANO, P,O, DRAWER 327. GUILFORD, CT 06437 twenty-five (25) years or older shall be paid over and distributed to him or her, free of any trust; the share of any remaining issue who shall not then have reached the age of twenty-five (25), shall be continued in trust and the Trustee shall pay to or expend for the benefit of each such remaining issue so much of the annual net income from his or her said share, and so much of the principal thereof as the Trustee, in its sole discretion, shall deem advisable for his or her health, support, maintenance and education and shall add to the principal of said share, and invest and distribute as a part thereof, any income therefrom not expended under the terms hereof. As each of such remaining issue shall reach the age of twenty-five (25) years, the Trustee shall pay over and distribute to him or her all of the balance of his or her said share, free of any trust. If any such remaining issue shall die before reaching the age of twenty-five (25) years, then upon his or her death, the Trustee shall pay over and distribute his or her said share, as then constituted, to the Settlor's then living issue, per stirpes, subject to the provisions of Subparagraphs A and B. 2. Provided further, however, if at any time the principal of the portion(s) or part(s) of the Trust pertaining to any issue of the Settlor shall be of such size that the ATTORNEY JEANN R. TERRAZZANO, P.O. DRAWER 327, GUILFORD, CT 06437 continuation of such trust is, in the Trustee's sole discretion, unwarranted, the Trustee may, in its sole discretion, terminate the trust or such portion or part, in which event it shall pay over and distribute the balance of such portion or part, free of any trust, to such issue. 3. Provided further, however, no interest of any beneficiary shall be subject to anticipation, to voluntary transfer without the written consent of the Trustee, or to involuntary transfer in any event. C. For all purposes of this Trust, in determining whether a person is a child or descendant of any other person, legal adoption, single or successive, shall not be equivalent in all respects to blood relationship. D. Upon the death of the Settlor, if she shall have no then living issue, or at any time prior to the complete distribution of all trusts, if the Settlor shall have no then living issue, the property as then constituted shall be distributed as follows: 1. The sum of ONE THOUSAND DOLLARS ($1,000.00) to the MADISON AMBULANCE ASSOCIATION, of Madison, Connecticut; 2. The sum of ONE THOUSAND DOLLARS ($1,000.00) to the GARDEN CLUB OF MADISON, of Madison, Connecticut (for the herb garden at the Madison Historical Society); ATTORNEY JEANN R. TERRAZZANO, P.O. DRAWER 327, GUILFORD, CT 06437 3. The sum of ONE THOUSAND DOLLARS ($1,000.00) to MADISON COMMUNITY SERVICES, of Madison, Connecticut; 4. The sum of ONE THOUSAND DOLLARS ($1,000.00) to WNET/THIRTEEN, of New York, New York; 5. The sum of ONE THOUSAND DOLLARS ($1,000.00) to the WOMAN AND FAMILY LIFE CENTER, of Guilford, Connecticut; 6. The sum of ONE THOUSAND DOLLARS ($1,000.00) to HOOD COLLEGE, of Frederick, Maryland; 7. The sum of FIVE THOUSAND DOLLARS ($5,000.00) to YALE NEW HAVEN HOSPITAL, of New Haven, Connecticut; 8. The sum of FIVE THOUSAND DOLLARS ($5,000.00) to LAHEY CLINIC MEDICAL CENTER, of Burlington, Massachusetts; 9. The balance of the property as then constituted should be distributed in equal shares as follows: (a) One-third (1/3) to MCGILL UNIVERSITY, of Montreal, Quebec, Canada, of which one-half (1/2) is to be used for the FACULTY OF ARTS, and one-half (1/2) to be used for CHEMICAL RESEARCH; (b) One-third (1/3) to UPSALA COLLEGE, of East Orange, New Jersey; (c) One-third (1/3) to the FRIENDS OF SCRANTON MEMORIAL LIBRARY, of Madison, Connecticut, (for the purchase of books); A3-FORNEY JEANN R. TERRAZZANO, P.O. DRAWER 327, GUILFORD, CT 06437 (d)Any of the foregoing bequests in ARTICLE IV Paragraph D, Subparagraphs 9(a) through 9(c), which shall lapse by reason of the failure of the institutions to be in existence, shall be divided equally among the other shares created by Paragraph D, Subparagraphs 9(a) through 9(c) of this Article. ARTICLE V In addition to any powers conferred by law, statute or case law, or by other provisions of this instrument, the Trustee hereunder shall have the following powers and authority: A. To receive additional property, real or personal, from any person at any time, by gift, devise or bequest, by designation of the Trustee to receive insurance proceeds, or otherwise. B. To retain, without liability for loss or depreciation resulting from said retention, any property, real or personal, received by the Trustee hereunder for such time as the Trustee shall deem advisable, although said property may not be of the character prescribed by law for the investment of trust assets and although it represents a large percentage of any trust established hereunder. C. To sell, grant options to purchase, exchange and alter assets of the trusts at any price which the Trustee ATTORNEY JEANN R. TERRAZZANO, P.O. DRAWER 327, GUILFORD, CT 06437 acting in good faith shall consider represents an adequate consideration in money or money's worth, and upon any terms which the Trustee shall deem proper. D. To invest and reinvest from time to time all or any part of the trust in such stocks, common or preferred, common trust funds, bonds, debentures, notes, securities, life insurance and annuity contracts, or other real or personal property, including property located outside the State of Connecticut, either of the class or kind now or hereafter ordinarily approved or held to be lawful for the investment of trust funds, or not as the Trustee, in its absolute discretion, may select, and to make and change such investments from time to time according to its discretion. E. To lease property on any terms and conditions and for any term of years although extending beyond the period of any trust. F. To insure, improve, repair, alter and partition real estate; erect or raze improvements; grant easements; subdivide and dedicate to public use. G. To cause any of the investments which may be delivered to or acquired by the Trustee to be issued, held or registered in the name of the Trustee, in negotiable form, in the name of a nominee or in any form in which title will pass 10 ATTORNEY JEANN R. TERRAZZANO, P.O. DRAWER 327, GUILFORD, CT 06437 by delivery; and any corporation or its transfer agent may presume conclusively that said nominee is the actual owner of securities submitted for transfer. H. To exercise in person or by proxy, all voting, option, subscription, reorganization, consolidation, merger and liquidation rights, and all other rights and privileges of whatsoever nature incident, appurtenant or pertaining to securities in the trusts, and, in connection therewith, to enter into any covenant or agreement binding the trusts, and to purchase any new securities issued as a result of, or in connection with, any such act. I. To settle, 'compromise, contest or abandon claims or demands in favor of or against any trust, including claims arising out of any life insurance policy included in trust; and the discretion of the Trustee in this respect shall be conclusive and binding. J. To borrow money, assume indebtedness, extend mortgages and encumber by mortgage or pledge although extending beyond the period of any trust. K. To determine, in its absolute and uncontrolled discretion, whether any money or other property coming into its hands is part of the principal of the trust, or the gross income therefrom, or the net income available for distribution 11 thereunder, and to apportion between principal and income any loss or expenditures which, in its opinion should be apportioned and which to it may seem just and equitable, and any such determination as between principal and income so made by the Trustee in good faith shall be conclusive and binding upon all beneficiaries or other persons interested in the trust. L. To pay all lawful taxes including income taxes, all charges and other expenses properly incident to the management of the trust, out of principal or income as the Trustee, in its discretion, shall determine; to make returns for all federal and state taxes and to settle and compromise any and all claims which may from time to time arise in connection therewith. M. To make any divisions, payments and partial or final distributions pursuant to the terms of these trusts, using cash, securities or other property of whatever nature and in whatever proportions the Trustee in its judgment, shall deem appropriate, and the judgment of the Trustee shall be final. Except as otherwise provided the Trustee shall have absolute discretion, which shall not be subject to review, to distribute or allocate property without respect to income tax bases and in making any such distribution or allocation, the Trustee shall have no duty of impartiality. 12 ATTORNEY JEANN R. TERRAZZANO, P.O. DRAWER 327. GUILFORD, CT 06437 N. To hold the principal of two or more trusts created hereunder in one or more consolidated funds in which the separate shares shall have undivided interests. O. To pay any sum or sums due any minor hereunder directly to such minor, or to his or her parent or parents on his or her behalf, or to such other person or persons and in such manner as it may deem for such minor's benefit, and such payment shall be a full and complete discharge. P. To purchase and/or maintain and/or sell residential properties for occupancy, rent free, by any of the beneficiaries hereunder, and/or their spouses, and to pay all taxes and assessments, expenses of maintaining the properties, and premiums of insurance on such residences, including insurance to cover liability for accidents to persons on such properties, and to make such purchases or payments out of principal or income as the Trustee, in its sole discretion, shall determine. Q. To engage the services of competent legal, accounting and investment counsel to assist and advise it in the administration of the trust, and to pay for such services out of the principal or income as the Trustee, in /ts discretion, shall determine. R. To purchase and/or maintain life insurance or 13 ATTORNEY JEANN R. TERRAZZANO, P.O. DRAWER 327, GUILFORD, CT 06437 annuity contracts on the lives of any of the beneficiaries hereunder, or their spouses, or any person in whom a beneficiary shall have an insurable interest, and to pay the premiums thereon out of such beneficiary's portion of the principal or income as the Trustee, in its discretion, shall determine. S. To determine the market value of any investment of any trust for any purpose on the basis of such quotation, evidence, data or information as the Trustee may deem pertinent and reliable; to distribute in cash or in kind upon partial or final distribution. T. In general, to exercise every power and discretion in the management of any trust as the Trustee would have if it was the absolute owner thereof, and this general power shall not be limited in any way by the specific powers given herein. U. The Settlor recognizes that the Trustee is a subsidiary of Merrill Lynch & Co., Inc., and agrees that whenever the Trustee exercises discretion, the Trustee is authorized in its sole discretion to engage the services of Merrill Lynch & Co., Inc. or any of its direct or indirect subsidiaries or affiliates ("Affiliated Corporations"). The Trustee also is authorized to employ, and to delegate any of 14 ATTORNEY JEANN R. TERRAZ7..ANO, P.O. DRAWER 327, GUILFORD, CT 06437 its powers, to any agents, attorneys or accountants as it deems necessary or proper. As appropriate, the Trustee may pay for services rendered by such persons or by Affiliated Corporations from the trust property as an expense of trust administration. Without limiting this general authorization, the Trustee is specifically authorized to engage the services of Merrill Lynch Asset Management, Inc., an Affiliated Corporation, and Merrill Lynch, Pierce, Fenner & Smith Incorporated, an Affiliated Corporation, to: (i) Manage or advise on the investments of the Trust; (ii) Invest in mutual funds offered or managed by any Affiliated Corporations; and (iii) Act as broker or dealer to execute transactions and to provide other services with respect to trust property, including purchasing, in Trustee's discretion as fiduciary, any securities currently distrubuted, currently underwritten, or issued by Affiliated Corporations. In the management of trust property, the Trustee may receive credit or other compensation from any Affiliated Corporations for any services Trustee may perform; may exchange 15 ATTORNEY JEANN R. TERRAZZANO, P.O. DRAWER 327, GUILFORD, CT 06437 services with any Affiliated Corporations; and may cause or permit the trust property, or any part of it, to be held, maintained, or managed in accounts or deposits administered in any jurisdiction inside or outside the United States of America, and may hold any trust property in the name of its nominee or a nominee of any Affiliated Corporations. ARTICLE VI If any amount, whether of income or principal, payable in the Trustee's discretion, becomes payable from the Trust hereunder to a minor or other legally incompetent person or to a person who, although not adjudged legally incompetent, is by reason of illness or mental or physical disability unable in the opinion of the Trustee to administer such amount properly, then such amount may be applied by the Trustee for the benefit of such beneficiary in such manner as it deems advisable, whether by payment directly to such beneficiary or to any other person deemed suitable, and the receipt by the distributee shall be a complete discharge of the Trustee. ARTICLE VII The Trustee of the trusts shall render at least annually to each person who is then an income beneficiary under any trust created herein, a statement of account showing all receipts, disbursements and distributions of both principal and 16 ATTORNEY JEANN R. TERRAZZANO, P.O. DRAWER 327, GUILFORD, CT 06437 income from such trust since the last such statement. Unless such account is objected to in writing within sixty (60) days from the rendition thereof, such account shall be deemed approved as stated. The approval of such persons, or of their guardians or legal representatives, of such statement shall, as to all matters and transactions stated in the account or shown by it, be final and binding on all persons, whether or not in being, who are then or who thereafter may become entitled to share in either the income or principal of any trust created herein. Nevertheless, the Trustee shall at all times be entitled to obtain a judicial settlement of its accounts. All accountings shall be at the expense of the Trust. ARTICLE VIII A. ADELINE W. HOLMES shall have the power to resign. In the event of the death, resignation, incapacity or removal or failure to qualify of ADELINE W. HOLMES, MERRILL LYNC~ TRUST COMPANY shall act as successor Trustee. The corporate Trustee hereunder may resign as Trustee from the trusts hereby created at any time by giving at least thirty (30) days written notice of its intention to do so, delivered personally or by certified mail to the Settlor, if living, or if she has previously died, then to the Probate Court of the district where the Settlor was last domiciled. 17 A~rORNEY JEANN R. TERRAZZANO, P.O. DRAWER 327, GUILFORD, CT 06~.37 Upon notification by the resigning corporate Trustee, the Settlor, if living shall appoint a successor Trustee. Provided, in the event the Settlor is not then living, the Probate Court of the district where the Settlor was last domiciled shall appoint a successor corporate Trustee. If the individual Trustee hereunder resigns as Trustee from the trusts hereby created, she shall give at least thirty (30) days written notice of her intention to do so, delivered personally or by certified mail to the successor Trustee, if any, otherwise the Settlor shall appoint a successor Trustee. Any Successor Trustee shall have all the powers, immunities and discretions conferred upon the original Trustee. No Successor Trustee shall be liable or responsible for any acts or defaults of any predecessor Trustee in any way, or for any loss or expense from or occasioned by anything done or neglected to be done by any predecessor Trustee. B. As a matter of convenience to the Settlor, the individual and corporate Trustees hereunder may be changed at any time by the Settlor. After the Settlor's death, as a matter of convenience to the beneficiaries, with respect to each portion of the trusts, the corporate Trustee hereunder may be removed at any time by the guardian of the property of a minor who is then a permissible income beneficiary from such 18 ATTORNEY JEANN R. TERRAZZANO, P.O. DRAWER 327, GUILFORD, CT 06437 portion at the time of such change and by the adult person who is then a permissible income beneficiary from such portion at the time of such change, including the personal representative of any such person who is then legally incompetent. If any corporate Trustee is so removed, then the Probate Court of the district where the Settlor was last domiciled shall appoint a successor corporate Trustee. Such power shall be exercised by giving written notice to the then Trustee and to the Successor Trustee, and upon the acceptance of the trusts by the Successor Trustee and the transfer to the Successor Trustee of the property held hereunder, or portion thereof as the case may be, said then Trustee shall cease to be Trustee of such property, or portion, and the Successor Trustee shall become and thereafter be Trustee thereof, to serve in the same manner with the same powers. ARTICLE IX Reference herein to MERRILL LYNCH TRUST COMPANY, shall include any corporation or association which may succeed to its trust business. ARTICLE X This Agreement shall be construed and regulated in all respects by the laws of the State of Connecticut. 19 ATTORNEY JEANN R. TERRAZZANO, P.O. DRAWER 327, GUILFORD, CT 06437 ARTICLE XI Any individual and corporate Trustee shall be entitled to reasonable compensation. As to Merrill Lynch Company, for /ts services as Trustee under this Agreement, it may retain payment in accordance with its schedule of rates as published from time to time and as in effect as the time such compensation becomes payable. The Settlor understands that Affiliated Corporations, including Merrill Lynch Asset Management, Inc., Merrill Lynch Financial Data Services, Inc. and Merrill Lynch, Pierce, Fenner & Smith Incorporated, will receive payments from mutual funds in which the trust has invested, including payments for investment advisory or management fees, administrative and sub-accounting services, brokerage fees and commissions and payments for other expenses of the mutual funds. The Settlor agrees that these payments shall not offset fees as Trustee or any Affiliated Corporations receive from the trust property as an expense of administration. ARTICLE XII The Settlor expressly reserves to herself during her lifetime the power (i) to revoke the trust at any time by an instrument in writing delivered to the Trustee, (ii) to alter, amend, or modify this Trust Agreement at any time or from time to time by an instrument in writing executed by the Settlor and 2O ATTORNEY JEANN R. TERRAZZANO, P.O. DRAWER 327, GUILFORD, CT 06437 the Trustee, (iii) to withdraw from the trust any property forming a part of the trust, such power to be exercisable at any time or from time to time by written request to the Trustee. The powers reserved to the Settlor in this Article shall be personal to her and shall not be assignable nor extend to her personal representative, her estate, any beneficiary named herein or to any other person. Upon the death of the Settlor this trust shall be deemed irrevocable. IN WITNESS WHEREOF, ADELINE W. HOLMES has hereunto set her hand as Settlor and as Trustee and MERRILL LYNCH TRUST COMPANY, as successor Trustee, acting herein by its officer hereunto duly authorized has caused these presents to be executed in its name and behalf and its corporate seal to be hereunto affixed as of the day and year first above written. Witnesses: ADELINE W. HOLMES, Settlor 21 A~rORNEY JEANN R. TERRAZZANO, P.O. DRAWER 327. GUILFORD, CT 06437 Witnesses: Witnesses: MERRILL LYNCH TRUST COMPANY STATE OF CONNECTICUT) . IRU$1'O;FICSR Then tn~nere personally appeared ADELINE W. HOLMES, signer and sealer of the foregoing Instrument as Settlor and as Trustee, and acknowledged the same to be her free act and deed, before me. ~~_~o~~ssioner of the S.peri~~urt (Continued on Page 23) 22 ATTORNEY JEANN R, TERRAZZANO, P.O. DRAWER 327, GUILFORD, CT 06437 STATE OF ~~ Then and there personally appeared ~ ? ~ ~ ~--/ of MERRILL LYNCH TRUST COMPANY, signer and s~~o/f ]~'' theforegoing Instrument, and acknowledged the same to be free act and deed as 7/~ O~ , and the free act and deed of said Corporation, before me. IAItANTHA l, ~ IOTARY PUBLIC OF NEW ~ COMMISSION [Xlllli£$ JUNE 23 ATTORNEY JEANN R. TERRAZZANO, P.O. DRAWER 327, GUILFORD, CT 06437 SCHEDULE A NO ASSETS ARE BEING PLACED IN TRUST AT THE PRESENT TIME. ASSETS MAY IN THE FUTURE BE PLACED IN TRUST BY THE SETTLOR DURING HER LIFETIME OR BY TESTAMENTARY DISPOSITION. ATTORNEY JEANN R. TERRAZZANO, P.O. DRAWER 327, GUILFORD, CT 06437 FIRST AMENDMENT TO THE ADELINE W. HOLMES FAMILY TRUST TO: ADELINE W. HOLMES, as Trustee under a Trust Agreement dated October 25, 1991, with the Settlor, ADELINE W. HOLMES. .... Pursuant to the right reserved to me under ARTICLE XII of the above Trust Agreement, I amend that Trust Agreement as follows: FIRST: I hereby delete ARTICLE IV, and substitute the following: ARTICLE IV The Trustee shall divide the Trust, as it is then constituted into two equal portions one for each of the Settlor's daughters, HELEN HOLMES GATELY, and MARY HOLMES DAGUE. The share for HELEN HOLMES GATELY shall be distributed in accordance with Subparagraph A. The share for MARY HOLMES DAGUE shall be distributed in accordance with Subparagraph B. A. As to the share for the Settlor's daughter, HELEN 1 ATTORNEY JEANN R. TERRAZZANO. P.O. DRAWER 327, GUILFORD, CT 06437 HOLMES GATELY, the Trustee is directed to forthwith pay over and distribute such share, free of any trust, to the Settlor's said daughter. Provided, in the event said daughter is not then living, and if the Settlor's son-in-law, BRIAN GATELY, is then living, the sum of ONE HUNDRED THOUSAND DOLLARS ($100,000.00) shall be distributed to him free of any trust, if he was married to and not legally separated from said daughter at the time of her death. The balance of said daughter's share shall be distributed to her then living issue, per stirpes, if any, in accordance with the trust provisions under Subparagraph C hereof. Provided further, in the event said daughter has no then living issue, the balance of said share shall be added to the share for the Settlor's daughter, MARY HOLMES DAGUE and distributed in accordance with Subparagraph C hereof. B. As to the share for the Settlor's daughter, MARY HOLMES DAGUE, if living, the Trustee is directed to manage, invest and reinvest said property in the following manner: 1. For a period of five (5) years after the death of the Settlor, the Trustee shall pay to or for the benefit of said daughter the income of the principal of said Trust in quarter annual payments as nearly equal as may be practical and as much of the principal as the Trustee, in its sole discretion deems reasonable or necessary for her health, 2 A'I-I'ORNEY JEANN R. TERRAZZANO, P.O. DRAWER 327. GUILFORD, CT 06437 maintenance, support and education. 2. At the end of the five (5) year period, the Trustee shall pay over to said daughter the principal then remaining, absolutely. 3. Provided, however, if at any time the principal of the Trust shall be of such size that the continuation of such trust is, in the Trustee's sole discretion, unwarranted, the Trustee may, in its sole discretion, terminate the trust in which event it shall pay over and distribute the balance trust to said daughter. 4. Provided further, however, that should said daughter die before receiving all of the principal from said Trust, then upon the death of said daughter, the Trustee shall pay over and distribute the remaining principal and undistributed income of said Trust to the descendants then living of said child, per stirpes, absolutely, subject to the terms of Subparagraph C hereof and in default of such descendants then living of such child, to the Settlor's descendants then living, per stirpes, absolutely, subject to the provisions of Subparagraph C of this Article. C. As to the per stirpes share of each of the issue of each deceased child of the Settlor, the Trustee is directed as follows: ATTORNEY JEANN R. TERRAZZANO. P.O. DRAWER 327. GUILFORD, C'T 064.37 1. The share of any of such issue, age twenty-five (25) years or older shall be paid over and distributed to him or her, free of any trust; the share of any remaining issue who shall not then have reached the age of twenty-five (25), shall be continued in trust and the Trustee shall pay to or expend for the benefit of each such remaining issue so much of the annual net income from his or her said share, and so much of the principal thereof as the Trustee, in its sole discretion, shall deem advisable for his or her health, support, maintenance and education and shall add to the principal of said share, and invest and distribute as a part thereof, any income therefrom not expended under the terms hereof. As each of such remaining issue shall reach the age of twenty-five (25) years, the Trustee shall pay over and distribute to him or her all of the balance of his or her said share, free of any trust. If any such remaining issue shall die before reaching the age of twenty-five (25) years, then upon his or her death, the Trustee shall pay over and distribute his or her said share, as then constituted, to the Settlor's then living issue, per stirpes, subject to the provisions of Subparagraphs A through C. 2. Provided further, however, if at any time the principal of the portion(s) or part(s) of the Trust pertaining 4 A'I-I'ORN£Y JE. ANN R. TERRAZZANO, P.O. DRAWER 327, GUILFORD, CT 06437 to any issue of the Settlor shall be of such size that the continuation of such trust is, in the Trustee's sole discretion, unwarranted, the Trustee may, in its sole discretion, terminate the trust or such portion or part, in which event it shall pay over and distribute the balance of such portion or part, free of any trust, to such issue. 3. Provided further, however, no interest of any beneficiary shall be subject to anticipation, to voluntary transfer without the written consent of the Trustee, or to involuntary transfer in any event. D. For all purposes of this Trust, in determining whether a person is a child or descendant of any other person, legal adoption, single or successive, shall not be equivalent in all respects to blood relationshiP. E. Upon the death of the Settlor, if she shall have no then living issue, or at any time prior to the complete distribution of all trusts, if the Settlor shall have no then living issue, the property as then constituted shall be distributed as follows: 1. The sum of ONE THOUSAND DOLLARS ($1,000.00) to the MADISON AMBULANCE ASSOCIATION, of Madison, Connecticut; 2. The sum of ONE THOUSAND DOLLARS ($1,000.00) to the GARDEN CLUB OF MADISON, of Madison, Connecticut (for the 5 A"I-I'ORNEY JEANN R. TERRAZZANO, P.O. DRAWER 327, GUILFORD, CT 06437 herb garden at the Madison Historical Society); 3. The sum of ONE THOUSAND DOLLARS ($1,000.00) to MADISON COMMUNITY SERVICES, of Madison, Connecticut; 4. The sum of ONE THOUSAND DOLLARS ($1,000.00) to WNET/THIRTEEN, of New York, New York; 5. The sum of ONE THOUSAND DOLLARS ($1,000.00) to the WOMAN AND FAMILY LIFE CENTER, of Guilford, Connecticut; 6. The sum of ONE THOUSAND DOLLARS ($1,000.00) to HOOD COLLEGE, of Frederick, Maryland; 7. The balance of the property as then constituted should be distributed in equal shares as follows: (a) One-third (1/3) to MCGILL UNIVERSITY, of Montreal, Quebec, Canada, of which one-half (1/2) is to be used for the FACULTY OF ARTS, and one-half (1/2) to be used for CHEMICAL RESEARCH; (b) One-third (1/3) to UPSALA COLLEGE, of East Orange, New Jersey; (c) One-third (1/3) to the FRIENDS OF SCRANTON MEMORIAL LIBRARY, of Madison, Connecticut, (for the purchase of books); (d)Any of the foregoing bequests in ARTICLE IV Paragraph E, Subparagraphs 7(a) through 7(c), which shall lapse by reason of the failure of the institutions to be in ATTORNEY JEANN R. TERRAZZANO, P.O. DRAWER 327, GUILFORD, CT 06437 existence, shall be divided equally among the other shares created by Paragraph E, Subparagraphs 7(a) through 7(c) of this Article. SECOND: I confirm and readopt the remaining provisions of that Trust Agreement. I reserve to myself the right to amend further that Trust Agreement together with this Amendment thereto. IN WITNESS WHEREOF, I have set my hand as of the ////~ day of~~ , in the year One Thousand Nine Hundred and Ninety-Three. Witnesses: ADELINE W. HOLMES, Settlor The undersigned ac]~nowledges receipt of and consents to the foregoing Amendment as of the day and year last above written. Witnesses: ADELINE W. HOLMES, Trustee A'I-rORNEY JEANN R. TERRAZZANO, P.O. DRAWER 327, GUILFORD, CT 06437 Then ~ere ~rsonally appeared ADELINE W. HOLMES as Settlor and as Trustee, signer and sealer of the foregoing Instrument, and acknowledged the same to be her free act and deed, before me. issioner of the Superi~ 8 ATTORNEY JEANN R. TERRAZZANO. P.O. DRAWER 327. GUILFORD, CT 06437 SECOND AMENDMENT TO THE ADELINE W. HOLMES FAMILY TRUST To: ADELINE W. HOLMES, As Trustee under a Trust Agreement dated October 25, 1991, as amended on February 11, 1993, with the Settlor, ADELINE W. HOLMES. Pursuant to the right reserved to me under ARTICLE XII of the above Trust Agreement, I amend that Trust Agreement as follows: FIRST: I hereby revoke in its entirety my First Amendment to the Adeline W. Holmes Family Trust as executed on February 11, 1993, and substitute this Second Amendment to the Adeline W. Holmes Family Trust in lieu thereof. SECOND: I hereby delete ARTICLE IV of the original October 25, 1991 Adeline W. Holmes Family Trust and substitute the following ARTICLE IV. ARTICLE IV The Trustee shall divide the Trust, as it is then constituted into two equal portions, one for each of the Settlor's daughters, HELEN HOLMES, and MARY HOLMES DAGUE. The share for HELEN HOLMES shall be distributed in accordance with Subparagraph A. The share for MARY HOLMES DAGUE shall be distributed in accordance with Subparagraph B. A. As to the share for the Settlor's daughter, HELEN HOLMES, the Trustee is directed to forthwith pay over and distribute such share, free of any trust, to the Settlor's said daughter. Provided, in the event said daughter is not then living, and if the Settlor's son-in-law, BRIAN GATELY, is then living, the sum of ONE HUNDRED THOUSAND DOLLARS ($100,000.00) shall be distributed to him free of any trust, if he was married to and not legally separated from said daughter at the time of her death. The balance of said daughter's share shall be distributed to her then living issue, per stirpes, if any, in accordance with the trust provisions under Subparagraph C hereof. Provided further, in the event said daughter has no then living issue, the balance of said share shall be added to the share for the Settlor's daughter, MARY HOLMES DAGUE, and distributed in accordance with Subparagraph C hereof. B. As to the share for the Settlor's daughter, MARY HOLMES DAGUE, the Trustee is directed to forthwith pay over and distribute such share, free of any trust, to the Settlor's said daughter. Provided, in the event said daughter is -2- not then living, and if the Settlor's son-in-law, LAURENCE DAGUE, is then living, the sum of ONE HUNDRED THOUSAND DOLLARS ($100,000.00) shall be distributed to him free of any trust, if he was married to and not legally separated from said daughter at the time of her death. The balance of said daughter's share shall be distributed to her then living issue, per stirpes, if any, in accordance with the trust provisions under Subparagraph C hereof. Provided further, in the event said daughter has no then living issue, the balance of said share shall be added to the share for the Settlor's daughter, HELEN HOLMES, and distributed in accordance with Subparagraph C hereof. C. As to the per stirpes share of each of the issue of each deceased child of the Settlor, the Trustee is directed as follows: (i) The net income from each per stirpes share may, in the absolute and sole discretion of Trustee, be paid to or accumulated on behalf of each of Settlor's living grandchildren until they attain the age of twenty-one (21) years, at which time the income shall be paid to each grandchild for life, provided however, that each such grandchild shall have the right to withdraw one-third (1/3) of his or her share of the principal and accumulated income when he or she shall attain the age of twenty-five (25) years, one-half (1/2) of his or her remaining share of the principal and accumulated income when he or she shall attain the age of thirty (30) years, and the remaining balance of his or her share of the principal and accumulated income when he or she shall -3- attain the age of thirty-five (35) years. The rights of withdrawal may be exercised from time to time in whole or in part and the said rights of withdrawal shall be cumulative. THIRD: I confirm and readopt the remaining provisions of the Adeline W. Holmes Family Trust Agreement dated October 25, 1991. I reserve to myself the right to amend further that Trust Agreement together with this Amendment thereto. IN WITNESS WHEREOF, have set my hand as of the / o ~ day of WITNESSES: AI~ELINE W. HOLMES, Settlor The undersigned acknowledges receipt of and consents to the foregoing Amendment as of the day and year last above rewritten. WITNESSES: :208050 I 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Phone (302) 934-2909 F ax (302) 934-2955 October 31, 2003 Metre, Evans & Woodside Attorneys At Law 3401 North Front Street PO Box 5950 Harrisburg, PA 17110-0950 Re: Extate of Adeline W Holrnes Social Security: 056-38-5658 Date of Death: August 2, 2003 Dear Sir or Madam: Per your inquiry dated October 17, 2003, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking ,4ccount ,4ccount Number 10565507 Ownership (Names oJ) Adeline W Holmes Mary Holmes Dague Opening Date 09/26/94 Balance on Date of Death $154, 33Z 88 ,4ccrued Interest $ 4. 35 Total ---~7-3-¢;-J-J-~ ....................... For further account information, closures and/or reimbursement of funds please call the Carlisle West Office at #717-240-6717. ~~tecoras.~danagemelt I,,,111,,,111,,,,,,11,,11,,,I,I1,,I,,,11,,,11,,,11,,,I,I1,,,11 =. , ***** ...... **AUTO**3-DIGIT 170 ~. ~ 225951 0001979 T13 P83 0.547 g ~ , YOUR FINANCIAL ADVISOR: Office Serving Your Account -,--,--, ADELINE W HOLMES TrEE CREIGHTON R HOOKER 157 CHURCH ST, 21 FLOOR --,-.-, UIA DTD 1012511991 Creighton_Hooker@ml.com NEW HAVEN CT 06510 BY ADELINE W HOLMES (203) 789-2375 FAMILY TR CIO M HOLMES DAGUE 732 W SOUTH ST For Client Service Questions Call: Review Your Statement Online at: CARLISLE PA 17013-2833 1-800-MERRILL (1-800-637-7455) www.rnlol.ml.com Total Value as of July 31, 2003 $~21,097.62 Asset Mlocation Summary Total Value Comparison (in $ thousands) 599 620 5S4 668 662 59t 579 556 521 Percent E3 Fixed Income 81 [] Cash/Money Accounts 19 Total 100 · £~timat~ A¢¢ru~ Intere,t not in¢ludod. M~¥ not r~flect all holdings. lotal Value includes cr~its, de,its, and chan~, in market ~alue. ~npric~d 8~uriti~ ~ro not ~nclu~d inlot, I ~ccount~ Includ~ in t~s Gains and Losses (uh$lrealized Account Type/ Total Value ($) Realized A~ount No. Account Name Managing Firm Page This Month La~ Month Sho~ Term Long Term $ho~ Term Long Term 812-11T61 ADELINE W HOLMES TTEE CMA 3 521,097 556,007 -5,51~ h,281 - 6,753 ~ Total 521,097 556,007 -5,51~ ~,281 - 6,753 Iii I IIII I IIII III I IIII I III I! II III IIII i II IIII II 825101100019780001 Select 1 Register of WillS of Cumberland County, Pennsylvania INVENTORY Estate of ADELINEW. HOLMES No. 21-2003-0664 also known as Date of Death August 2, 2003 late of the Borough of Carlisle, Cumberland County, PA , Deceased Social Security No. 056-38-5668 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. INVe verify that the statements made in this Inventory are true and correct. INVe understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Personal Representative: Attorney: Peter J. Ressler, Esquire Mary Holmes Dague, Executrix Address 3401 N. Front St., PO Box 5950, Harrisburg, PA 17110 Dated: Telephone: (717) 232-5000 DESCRIPTION VALUE Real Property: NONE Personal Property: 1. M&T Bank Checking Account #10565507 154,337.23 TOTAL 154,337.32 Attach Additional Sheets If Necessa?/ 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. 397556vl Fo~m RW-7 (Dauphin County) - Rev. 9/92 COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 003894 DAGUE MARY HOLMES 732 WEST SOUTH STREET CARLISLE, PA 17013 ACN ASSESSMENT AMOUNT CONTROL NUMBER ........ fold .......... 101 $25,275.74 ESTATE INFORMATION: SSN: 056-38-5658 FILE NUMBER: 21 03-0664 DECEDENT NAME: HOLMES ADELINE W DATE OF PAYMENT: 05/03/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 08/02/2003 TOTAL AMOUNT PAID: $25,275.74 REMARKS: CHECK# 114 INITIALS: JA SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONNEALTH OF PENNSYLVANIA BUREAU OF TNDTVTDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE TM DIVISION DEPT. 280601 ~RRISBURG, PA 17128-0601 NOTTCE OF TNHERTTANCE TAX APPRATSEHENT, ALLONANCE OR DTSALLONANCE OF DEDUCTTOHS AND ASSESSMENT OF TAX DATE 06-21-2004 ESTATE OF HOLMES ADELINE DATE OF DEATH 08-02-2005 FILE NUHBER 21 05-0664 COUNTY CUHBERLAND PETER J RESSLER ESQ ACN iOI METTE ETAL Amount Remitted PO BOX 5950 ' HBG PA 17110 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF HILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS L/NE ~ RETAIN LOWER PORTION FOR YOUR RECORDS REV-1547 EX AFP (01-05) NOT/CE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCT/ONS AND ASSESSMENT OF TAX ESTATE OF HOLMES ADELINE ~ FILE NO. 21 05-0664 ACN 101 DATE 06-21-2004 TAX RETURN NAS: (X) ACCEPTED AS FTLED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRA/SED VALUE OF RETURN BASED ON= ORIGINAL RETURN 1. Real Estate (Schedule A} (1} .00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B} (2} .00 credit to your account, $. Closely Held Stock/Partnership Interest (Schedule C) ($) .00 subm/t the upper port/on 4. Nor=gages/Notes Receivable (Schedule D) (4) .00 of this form ~ith your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 154~557.25 tax payment. 6. Jointly O~ned Property (Schedule F) (6} .00 7. Transfers (Schedule G} (7} 555~097.62 8. Total Assets (8) 707,454.85 APPROVED DEDUCT/ONS AND EXEMPTIONS: 21,590.15 9 Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H) (9) 10 Debts/Mortgage Liabilities/Liens (Schedule I) (10) 585.00 11 Total Deductions (11) ~].77~.]~ 12 Net Value of Tax Return (12) 685,659.70 13 Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) .00 14 Net Value of Estate Sub]ect to Tax (14) 685,659.70 NOTE= If an assessment ~as issued previously, lines 14, 15 and/or 16, 17, 18 and 19 ~ill reflect figures that lnclude the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of L/ne l~ at Spousal rate (15) .00 X O0 = .00 16. Amount of L/ne 1~ taxabZe at Lineal/Class A rate (16} 685,659,78x 04~= 50,854.69 17. Amount of L/ne 14 at Sibling rate (17) :~0 X 1~= .00 18. Amount of L/ne 14 taxable at Collateral/Class B rate (18) ..00 X I5~ .00 19. Pr/nc/pal Tax Due (1~= 50,854.69 TAX CREDITS: PAYMENT RECEIPT DTSCOUNT (+) AHOUNT PATD DATE NUHBER TNTEREST/PEN PATD 10-25-2005 CD005164 278.95 5,500.00 05-05-2004 CD00589~ .00 25,275.7~ BALANCE OF UNPAID INTEREST/PENALTY AS OF 05-04-2004 TOTAL TAX CREDIT I 50,854.69 * IF PAID AFTER DATE INDICATED, SEE REVERSE ( TF TOTAL DUE IS LESS THAN ~1, HO PAYMENT TS RE(~UTRED. FOR CALCULATTON OF ADDTTIONAL TNTEREST. TF TOTAL DUE TS REFLECTED AS A 'CREDTT' (CR}, YOU MAY liE DUE A REFUND. SEE REVERSE SIDE OF THTS FORM FOR [NSTRUCTTONS.) RESERVATION: Estates of decedents dying on or before December 12t 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the la~ful Class 8 (collateral) rate on any such future interest. PURPOSE OF NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of 2000. C72 P.S. Section 9140). PAYMENT: Detach the top portion of this Not/ce and submit with your payment to the Register of Wills printed on the reverse s/de. --Make check or money order payable to: REGISTER OF MILLS) AGENT REFUND CCR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvan/a Xnheritance and Estate Tax" CREV-1SI3). Applications are available at the Office of the Register of Mills, any of the 23 Revenue District Offices, or by caXling the special 24-hour answer/rig service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 (TT only). OBJECTLONS: Any party /n interest not satisfied with the appraisement, allowance, or disaXXo~ance of deductions, or assessment of tax C/ncluding discount or interest) as sho~n on th/s Notice must object within sixty C60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter de/ere/ned at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on th/s assessment should be addressed in wr/ting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone C717) 787-6SOS. See page 5 of the booklet '°Instructions for Inheritance Tax Return for a Res/dent Decedent" (REV-1501) for an explanat/on of administratively correctable errors. DISCOUNT: If any tax due is paid within three CS) calendar months after the decedent's death, a five percent CSX) discount of the tax paid is allowed. PENALTY: The 15~ tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not pa/d before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as /ndicated on this not/ce. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one C1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six C6X) percent per annum calculated at a da/ly rate of .000164. All taxes ~h/ch became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2004 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ 20X .000548 ~'~'~-1991 11~ .000S01 2001 9~ .000247 1983 16X .000438 1992 9~ .000247 2002 6~ .O00164 1984 11~ .000301 1993-1994 7~ .000192 2003 5X .000137 1985 13~ .000356 1995-1998 9~ .000247 2004 4~ .000110 1986 10~ .000274 1999 7X .000192 1987 10~ .000274 2000 7~ .000192 --Interest is calculated as follows: /NTEREST = BALANCE OF TAX UNPA/D X NUMBER OF DAYS DEL/NQUENT X DA/LY /NTEREST FACTOR -*Any Notice issued after the tax becomes delinquent w/ll reflect an interest calcuIation to fifteen C15) days beyond the date of the assessment. If payment is made after the interest computation date sho~n on the Notice, additional interest must be calculated.