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HomeMy WebLinkAbout03-19-09 (3)1505604],046 REV-1500 EX (05-04) -vFFtc~gLUSE osaL~ PA Department of Revenue Bureau of Individual Taxes County Code Year File Number Dept.28oso1 .INHERITANCE TAX RETURN '' Harrisburg, PA 17128-0601 RESIDENT. DECEDENT z~ 2.` ~ ©~ B`' ~ : fl-3 <; ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth -~ , ,.~«-- ~ _ _ ..~~ Decedent's Last Name Suffix Decedents First Name MI ,... _ .:_ ' ~ ~ ~ p~ . .; (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI .,..:. e., .. ..... _, ,. , ., . i 4 ?' ~ ~ + Spouse's Social Security Nun~br~r ""r '~ THIS RETURN MUST BE FILED IN DUPLICATE-WITH THE a . ~. ~ ~ ~' ;.~. ~,~ ~ REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death O 4. Limited Estate ~ 6. Decedent Died Testate (Attach Copy of Will) O 9. Litigation Proceeds Received O 4a. Future Interest Compromise (date of death after 12-12-82) O 7. Decedent Maintained a Living Trust (Attach Copy of Trust) O 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) prior to 12-13-82) O 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes O 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number ~- ~~~ ._ - ~ ~ .. .. ~, ~,. ~.,, „9.. ~ ~ .~ . , . Firm Name (IfApplic~hle) ''O''""' ~~.,., REGISTER OF WILLS USE ONLY h. .. yen*np?N~ws~ n. .. .,. ..&,~y,~.. _ _ - . First line of address ,.-~ rv Second line of address I ' ~ ? ~ ~ City Or Post Office Mate ZIP r ~~e ~ DA E ILED _ ,~., ..r r,., ,.. - ~ ~ _ ., ~,,,..~«a, rte. k. . ,i ~~ r :_ .. F ~ -- . -_ ,~ Correspondents a-mail address: ~- ~ - ~ ..~ t~1 ~ o -~, Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RE O BLE FOR FILING RETURN DATE ~31i`~/~©~g ~~ .,rte..---~.~ T- ADDR~ / / ! ~4R7~o ST ~4/rJ~ /L t~ r~'/`~- / O !~ 38~ ~- SIGNATURE OF PREPARER OTHER THAN REPRES NTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY 15056041046 Side 1 15056041046 J , REV-1500 EX Page 3 File Number Decedent's Complete Address: -- STREETADDRESS _ - i - --- - - __ -- _- --- CITY r- ` 'STATE Z`IP t Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) ~- 1 ~- ~ ~ ~ ~ 2. CreditslPayments A. Spousal Poverty Credit _____ _________- B. Prior Payments _ __ -- C. Discount - - - Total Credits (A + B + C) (2) ~ 3. Interest/Penalty if applicable D. Interest __ _____ _ _____ E. Penalty __ - ---- Total InterestlPenalty (D + E) (3) Z ~ Z- Co . 2 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. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) `Z 1 -L ~ ~ 3 JC A. Enter the interest on the tax due. - (5A) -~. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Z t Z. Co .~ ~ Make Check Payable fo: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE AP PROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :.................................................................................... ...... ^ b. retain the right to designate who shall use the property transferred or its income : ...................................... ...... ^ c. retain a reversionary interest; or .................................................................................................................... ...... ^ ^ d. receive the promise for life of either payments, benefits or care? ................................................................ ...... 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ........................................................................................................ ...... ^ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ........ ...... ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .................................................................................................................. ...... ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. '. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the ne~value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (O) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exemat a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(x)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(x)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(x)(1.3)]. Asibling isdefined, under Section 9102, as ao.individual who has at least one parent in common with the decedent, whether by blood or adoption. 15056042047 REV-1500 EX - ' s Name: Decedent RECAPITULATION - -- -- --.: , _ 6 t 1. Real estate {Schedule A). • • • • - • 1 { 4 •, 2. ............... Stocks and Bonds (Schedule B) ....................... . 2. tom' 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .... . 3. ~, ~. , 4. 9 9 ( ) ............................ Mort a es /3< Notes Receivable Schedule D 4 . , , .. `" ~J~~ 1 ~~ ~ q'~ ~ , ' 5. Cash, Bank De osits & Miscellaneous Personal Pro ert Schedule E 5. 7 ~ '~ a s 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ...... . 6. '! ;' ,_ F 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property O Se crate Billin Requested....... (Schedule G) P 9 . 7. a , '• ,,. , ~ , 8 _ ,~ ~~T~- '%{~~a E ~ m ~` ~¢ '~ ~- ~• ~ ~ 8. Totat Gross Assets (total Lines 1-7) ................................... . . ~ 9 3 6 ~ ~ 9 S 9. Funeral Expenses BAdministrative Costs (Schedule H) .................... . , i .~ i ~ r i ;, ~ 10. Debts of Decedent, Mortgage Liabilities, & Liens {Schedule I) ............... . 10. ', ~ . ~ •` ' r., ~. r,~ 11 fi ~ j ' ~ D • -- 11. Total Deductions (total Lines 9 & 10) .................. . ....... . . • • ... " . ~ • _ ~. ,. _, .r. k1'r„n. ~ i I ^ 12. Net Value of Estate (Line 8 minus Line 11) ..............'............. - . . 12. ~- ~ ~! ', ;• 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which ~ - ~~ an election to tax has not been made (Schedule J) ....................... . 13. ,; ~ ' z ~ ' 14. Net Value Subject to Tax (Line 12 minus Line 13) ....................... . 14. ,.. ~ ~ .'~; TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or • _ , LL a a£ ~ s Yransfers under Sec. 9116 ~ ~ ~ 15. i ~ ~ 16. . t --~ + ~ Amount of Line 14 taxable ~ ~ ~ t ~ k C ~ ~ ~ i ~ 16 ~ ~, ~ ~ . ~~ ~ ' ~ I •• ~~ ° j at lineal rate X .0 , ) t_,~ „~ ~ ~ ~ ~ ~ . ~ ~ 17. Amount of Line 14 taxable ~; ~ i i t ~ ~;~ at sibling rate X .12 ~ ,s ~ ~ ~=~ Y ~, ~ ~ 1~ _ ` , 18. t ~ ( ~ a ~ Amount of Line 14 taxable ~ ' ! • . ' ' ~ 18 ~ ~ z ~ < ?~, . ,~, at collateral rate X _15 ? s ,. 19 19. TAX DUE ........................................................ . ~„, ~ 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT A ~ Side 2 15056042047 15056042047 REY~7508 EK • 11Ai) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. ~.~ SSW N ~r;~ r po ~3c~x -z„50, S~.~C~p~eo4~„ ~ T .~ to u v~ ~-~~ ~ `r "~. ® t ~~. ~ ~ w~.~_.~r ~ ~':y~ C~nAw~tiD ~ i c~~~~~~~~g ~ t ~ ~ ~2~4 7 M~,~ e y T 'J ~, `'\ ~~ - ~wC 'N~ ~T g~ ~G. , ~ u~c~o N Y 1'-t'Z ~l0 .~ ~,. ~ ~ ~ ~ffiv ~ 4 ~ ~ r C~ p'~-°-'Q -~O: s t TOTAL (Also enter on line 5, Recapitulation) I S 5 q , i ~ ~ ~ ~~ ~ (If more space is needed, insert additional sheets of the same size) vxxs~r~wNn~vx A Tradition of Excellence ORRS P.O. Box 250 o Shippensburg, PA 17257 Date 5/23/08 Primary Account Enclosures ~n~~~~u~~~~unn~~n~~~~~~~~~n~n~~~~~i~~~n~~~n~~~n~~~~ ~_ 003511 0.4804 AT 0.346 TR00016 Alvah L Stockslager _ 1911 Dartmouth St Camp Hill PA 17011-3832 Building? Buying? Remodeling? We can help! 1.888.ORRSTOWN - orrstown.com 0 N 0 0 v N O m O 0 0 r, 0 0 c7 o .-+ o~ ~ N r-1 (`7 O OD O ~") r, ~~ ~o ~~ o .-+ Account Title C HECK I N G A C C O U N T S Alvah L Stockslager Platinum Money Market Account Arcot)nr Number 147000332 Previous Balance 22,779.71 Deposits/Credits .00 Checks/Debits .00 Service Fee .00 Interest Paid 31.87 Current Balance 22,811.58 Check Safekeeping Page 1 147000332 Statement Dates a/2R/08 thru 5/7.6/08 Days In The Statement Period 29 Average Ledger 22,779.71 Average Collected 22,779.71 Interest Earned 31.87 Annual Percentage Yield Earned 1.78°s 2008 Interest Paid 236.93 Deposits and Additions Date Description Amount 5/26 Interest Deposit 31.87 Daily Balance Information Date Balance Date Balance 4/28 22,779.71 5/26 22,811.58 Interest Rate Summary A 4/27 1.990000% 5/01 1.740000°s THANK YOU FOR BANKING WITH ORRSTOWN BANK TRUST COMMUNITY OFFICES IN FRANKLIN, CUMBERLAND, FULTON AND HUNTINGDON COUNTIES www.tmtrustonline.com ***************AUTO**3-DIGIT 170 1924 0.8870 AT 0.346 12 1 39 I~~~III~~~III~~~~~~ii~~~ll„II~I~~I~~~II~~~I~I~„II,~~II~~I~II 497 ALVAH L STOCKSLAGER 1911 DARTMOUTH ST CAMP HILL PA 17011-3832 STATEMENT OF ACCOUNT 34-69654 STATEMENT PERIOD FROM THROUGH 05-08-08 06-08-08 PAGE 1 of 3 ENCLOSURES 3 5 GO CLUB CHECKING WITH INTEREST ACCOUNT: 34-69654 BEGINNING DEPOSITS/ CHECKS! SERVICE ENDING BALANCE NUMBER CREDITS NUMBER DEBITS FEES BALANCE 2,018.43 4 3, 300.19 3 4,165.43 .00 1,153.19 • ACCOUNT INTEREST INFORMATION INTEREST PAID THIS YEAR 1.50 ACTIVITY DATE DESCRIPTION CREDITS DEBITS BALANCE 05-08 BEGINNING BALANCE 2,018.43 05-12 RETL ITNET TFR FROM 00077900000 2,000.00 CKG #70-83599 4,018.43 05-15 CHECK 257 00500002814 3,596.00 OS-15 CHECK 258 00500000043 153.85 268.58 OS-16 US TREASURY 220 00077900000 300.00 TAX REFUND 051608 ~ooooc0996 IRS 5 68.5 8 05-19 RETL ITNET TFR FROM 00077900000 1,000.00 CKG #70-83599 1,568.58 05-22 CHECK 259 00500002115 415.58 1,153.00 06-06 INTEREST CREDIT .19 1,153.19 06-08 ENDING BALANCE 1,153.19 CHECK NO AMOUNT 257 3, 596.00 TOTAL NUMBER OF CHECKS CHECKS * -denotes missing check number in sequence R -denotes returned check CHECK NO AMOUNT CHECK NO 258 153.85 ~ 259 3 TOTAL AMOUNT OF CHECKS a 4,165.43 *** ANNUAL PERCENTAGE YIELD EARNED DISCLOSURE FROM 5-08-08 THROUGH 6-OS-08 *** ANNUAL PERCENTAGE YIELD EARNED .15 AVERAGE DAILY COLLECTED BALANCE 1,486.35 WTEREST EARNED .1g AMOUNT 415.58 DIRECT F&M TRUST -LINCOLN WAY EAST OFFICE INQUIRIES TO: 1712 LINCOLN WAY E CHAMBERSBURG, PA 17201-3348 TELEPHONE : 717-264-9414 ~usr COMMUNITY OFFICES IN FRANKLIN, CUMBERLAND, FULTON AND HUNTINGDON COUNTIES www.fmtrustonline.com STATEMENT OF ACCOUNT 34-69654 STATEMENT PERIOD FROM THROUGH 05-08-08 06-08-08 ***************AUTO**3-DIGIT 170 1924 0.8870 AT 0.346 12 1 39 PAGE 2 of 3 497 ALVAHLSTOCKSLAGER 1911 DARTMOUTH ST CAMP HILL PA 17011-3832 ENCLOSURES 3 5 SERVICE FEE BALANCE INFORMATION FROM 5-08-08 THROUGH 6-08-08 AVERAGE LEDGER BALANCE 1,486.35 AVERAGE COLLECTED BALANCE 1,486.35 MINIMUM LEDGER BALANCE 268.58 MINIMUM COLLECTED BALANCE 268.58 MONEY MANAGEMENT ACCOUNT PERSONAL 70-83599 BEGINNING DEPOSITS/ CHECKS/ SERVICE ENDING BALANCE NUMBER CREDITS NUMBER DEBITS FEES BALANCE 26,261.25 1 30.82 2 3,000.00 .00 23,292.07 ACCOUNT INTEREST INFORMATION INTEREST PAID THIS YEAR 260.50 DATE DESCRIPTION 05-08 BEGINNING BALANCE 05-12 RETI INTERNET TFR TO 00077900000 CKG #34-69654 05-19 RETL INTERNET TFR TO 00077900000 CKG #34-69654 06-06 INTEREST CREDIT 06-08 ENDING BALANCE ACTIVITY CREDITS DEBITS BALANCE 26,261.25 2,000.00 24,261.25 1,000.00 30.82 *** ANNUAL PERCENTAGE YIELD EARNED DISCLOSURE FROM 5-08-08 THROUGH 6-08-OS *** ANNUAL PERCENTAGE YIELD EARNED 1.49 AVERAGE DAILY COLLECTED BALANCE 23,855.00 INTEREST EARNED 30.82 b SERVICE FEE BALANCE INFORMATION FROM 5-08-08 THROUGH 6-08-08 AVERAGE LEDGER BALANCE 23,855.00 AVERAGE COLLECTED BALANCE MINIMUM LEDGER BALANCE 23,261.25 MINIMUM COLLECTED BALANCE 23,261.25 23,292.07 23,292.07 23, 855.00 23, 261.25 DIRECT F&M TRUST -LINCOLN WAY EAST OFFICE INQUIRIES TO: 1712 LINCOLN WAY E CHAMBERSBURG, PA 17201-3348 TEl_EPHON E: 717-264-9414 TRUST CHAMBERSBURG BOILING SPRINGS MARION MONT ALTO NEWVILLE SHIPPENSBURG WAYNESBORO CARLISLE A~.vAH rr sroacsu-cae ~ 257 ~~~~ FAYET7EVQL{PA F/iII ~~ Dnn 41__'__ ~~lanr~~ MamEn~f -~„may ~ ~. ~n~AQa ~yti~ ~.,,,,~~~ °rati,~ a _.. ,~, ~:031304306C 34~69654~ 0257 ~Op` 05/15/2008 257 $3.596.00 ALyA}1LS000ICS[.ACER -m°-3° 258 ierweaEOOn. F~1fELIE\OIlEPA 17II3 „~, F;~ ~:~r~.:i~ e~~ ~~, E: m s -__ - ~ $ X53 yra - ,K~.., 4r~_:~v~~ S ~~ ~~ J ~ ~,..,~ a .._ ~ - ~:0 3 1304 306~: 34M69654r 0258 JOOOOO~~~Sr• 05/15/2008 258 $153 ALVAHLSIUCICSL uscu~noi A[~'R ~ 259 FA7fkT~EYiZEM VR3 ,o.. ~R'-~~ `per V Y~ h,~N ~ ''k1T"~QrC W d g' O C Dtitw6 8 ~`. ~w ~ ~ 1D ~:031304306~ ..__ _ ,____ 34~69654a 0259 POD $415 ACCOUNT: 3469654 PAGE: 3 of 3 U lvl~t One M & T Plaza, Buffalo, New York 14240 Chambersburg Main February 1, 2008 _ 3659 _ ALVAH L STOCKSLAGER - IRREVOCABLE BURIAL ACCOUNT 145 CAMEO DR FAYETTEVILLE PA 17222-1089 Re: CD Account Renewal Confirmation Dear Alvah L Stockslager, Thank you for renewing your CD account with M&T Bank. Please review the following information regarding your account: Account Number: Current Account Balance: Renewal Date: Maturity Date: Term: Interest Rate: Annual Percentage Yield: Daily Percentage Rate: 31003911191135 $ 11,698.27 01/19/08 01/19/13 60 Months 2.470 2.50 0.00676 (NOTE: This letter is issued 10 days after the renewal date. The current account balance reflects any activity during that 10-day period, including any deposits, withdrawals, and interest paid.) On the next maturity date, we'll automatically renew your account for a similar time period, unless you advise us otherwise prior to that date. If you have any questions regarding your account, please call the 1VI&~T "Telephone Banking Center at 716-626-1900 or 1-800-724-2440. Thank you for banking with M&T Bank. Sincerely, M~.ehe.~e Cc,Qe-Nee~an Michele Cole- Hector Customer Service Manager CONREN RNRCSI REV-1511 EX+ (12-99) ,,r COMMONWEALTH OF PENNSYLVANIA {NHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES 8~ ADMINISTRATIVE COSTS ESTATE OF F4LE NUMBER Debts of decedent must be reported on Scfiedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. ~ e~ s el F~v ~~~. ~1ov~ne S ~C~r,O.~'9UrC~vvY~ ~'°~ i t ?QCD.$5 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)IEIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees C~9 vw~P-Vi,~dA.~..b ~~ «'=T`" ~ ~ ~~" ~ '~ '~"' } ~ ~ ~. 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. f '-1 O ~~ TOTAL (Also enter on line 9, Recapitulation) I $ ~ t `~.~ ~ z gjr (If more space is needed, insert additional sheets of the same size) MBTB,anl~ One M tc T Plau, Buffalo, New Yort 14]4(1 Chambersburg Main May 23, 2(3062 1766 ALVAH L STOCKSLAGER IRREVOCABLE BURIAL ACCOUNT 1911 DARTMOUTH ~T CAMP HILL PA 17011 Re: CD Account Closing Notice Account # 31003911191135 Dear Alvah L Stockslager, We are writing to confirm that on 05/22/08, your CD account was closed or transferred. At that time, the balance was $11,796.85. We'd like to remind you that M&T Bank is committed to providing you with solutions to all your financial needs. To find out more about the many ways we can help you with those needs, simply stop by any M&T Bank office or call the M&T Telephone Banking Center at 716-626- l 900 or 1-800-724-3222. Or if you'd like, visit the M&T website at www.mandtbank.com. Thank you for banking with M&T Bank. Sincerely, M~.che~.e Ca.Qe-Nec~ah Michele Cole-Hector Customer Service Manager REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER 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' (~LV~N S-~o~.KS ~GEQ - -~ ~ - S ~o N ~ ~ ~Z o ~ ~ w ~ ~. ~ ~ ~ ~ cZ Z cc~-r~-'P ~~ L ~~ ~ ~ Pf ~ ~ o ~ ~ AA } '-' ~~ ~- I 3 ~l ~ w ~- Q, ~ ~ G R.~N ~ ~ ©rs ~ ~~ C ~ 0.W~,~13 ~~ ~~~ vt~ d ~~ t -~ ~~0 1 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THR OUGH 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. 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 size) REGISTER OF WILLS CUMBERLAND COUNTY PENNSYLVANIA CERTIFICATE OF GRANT OF LETTERS No . 2008- 01034 PA No . 21- 08- 1034 Estate Of : AL VAH L STOCKSLAGER r (First, Middle, Last/ Late Of : CAMP HILL BOROUGH CUMBERLAND COUNTY Deceased Social Securi ty No: 196-14-0996 WHEREAS, on the 16th day of October 2008 an instrument dated July 19th 1978 was admitted to probate as the last will of AL VAH L STOCKSLAGER (First, Middle, Lastl 1a to of CAMP HILL BOROUGH, CUMBERLAND County, who died on the 20th day of May 2008 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: AL VlN STOCKSLAGER who has duly qualified as EXECUTOR(R/X) and has agreed to administer the estate according to law, all of which fully appears of record in my office a t CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYL VANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 16th day of October 2008. ~~ ~ ~ egister of Wills ] , / C'G~ i ' Depu **NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) (_' W T L L -: ~.:'> - - f) ~ - _ ~` OF :;--- ...~ - c: ALVAH L. STOCKSLAGER -_ ~,„ - -i _ -a~~ ~. I, ALVAH L. STOCKSLAGER, of R. D. 1, Fayetteville;"Pennsyl~nia, r~~ declare this to be my last will and I revoke all codicils which I made here- tofore. First: My wife, HAZEL M. STOCKSLAGER, and I own as tenants by the entirety all the furniture, rugs and other household effects situate in our home. Second: I give all of my estate, real and personal, to my wife if she survives me by thirty (30) days. Third: If my wife does not survive me or if my wife and I should die simultaneously or within thirty (30) days of each other, I give all of my ~1 ;-~ estate, real and personal, equally to my two children, SHIRLEY MIXELL, Fayette ~'~, ville, Pennsylvania; and ALVIN L. STOCKSLAGER, Camp Hill, Pennsylvania, per ..~;. .`~7' , stirpes. Fourth: My executor, for any purpose of administration or distribu ~ ` , ~ tion ma ~ y sell all or an of m ro ert real or Y Y P P Y~ personal, at public or pri- ~ vate sale, for cash or credit, and may execute deeds or bills of sale. No ,. ~ ~ ; purchaser is obliged to see to the application of the purchase money. s Fifth: All transfer, inheritance, estate, succession or other taxes payable by reason of my death s A hall be paid out of my estate as a general administra tion expense. Sixth: I direct the payment of my debts and medical, funeral and administration expenses from my estate as soon after my death as conveniently may be done. Seventh: I appoint my two children, SHIRLEY MIXELL and ALVIN L. STQCKSLAGER, co-executors of this will. Eighth: No fiduciary appointed in this will, and no duly appointed -1- successor, shall be required to give or enter into any bond or security in any jurisdiction. ~ •,, IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ day of July in the year 1978. .. ., ., _. ,: _ ~~G~i>:c.~, ~,~ ~. ~t' ~~ ~~'~~,._ ~--~._ (SEAT Alvah L. Stocks-~ger Signed, sealed, published and declared by the above as and for a last will in the presence of us, who have hereunto subscribed our names as witnesses at the request and in the presence of the above and in the presence of each other. r G ~, ~ ,.-~ -2- COMMONWEALTH OF PENNSYLVANIA ) SS: COUNTY OF FRANKLIN ) We, Alvah L. Stockslager, Hazel M. Stockslager, Martha B. Walker any Bonita R. McNew, the testator and the witnesses respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as his last will and that he had signed willingly (or willingly directed another to sign for him), and that he executed ,it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatox, signed the will as witnesses and that to the best of their knowledge the testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. ( _/ / ^ Testato~'~~ Witness ,.._ _--- ,~ / ~"~ t y Lr r•" ~ f (l._.2-s-r 1 ~, c/ r~ r'"..~J , ~ ..;" .r :~ ~\~ ,t' 7~) ('_ t.-!t W t") ~/ c-' ''~/~/~ - Witness ~~ ~ ~i ne ~ Subscribed, sworn to and acknow- ledged before me by Alvah L. Stockslager, the testator, and subscribed and sworn to before me by Hazel M. Stockslager, Martha B. Walker and Bonita R. McNew, witnesses, this <`,~~t~_ day of July, 1978. _ _ ~~~ l /j 7 1{ Notary Public dONlTA R. MCNEW, Notary Public Chambersburg, Franklin Co., P~, My Commission Expires October 2, 1978 -3-