HomeMy WebLinkAbout05-04-09 (2)J 15056041192
REV-1500 Ex (06-OS) OFFICIAL USE ONLY
PA Department of Revenue County Code Year FileNumber
Bureau of Individual Taxes INHERITANCE TAX RETURN
Po Box zeosot
Harrisburg, PA 17128-0801 RESIDENT DECEDENT ~ 21 08 0818
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
07 29 2008 06 24 1927
Decedent's Last Name Suffix Decedent's Frst Name MI
Allen Heath L
(If Applicable) Enter Surviving Spouse's Informatlon Below
Spouse's Last Name Suffix Spouse's Frst Name MI
Allen Eleanor M
Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
194 74 1087 REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
O 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death
prior to 12-13-82)
[~ 4. Limited Estate O 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required
death after 12-12-82)
~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT -This section must be completed. All Correspondence and Confldenflal Tax Informatlon Should be Directed to:
Name Daytime Telephone Number
Elyse E- Rogers, Esquire 717 612 5801
Frm Name (If Applicable)
Keefer Wood Allen 8 Rahal, LLP
Frst line of address
635 North 12th Street, Suite 400
Second line of address
City or Post Office State ZIP Code
Lemoyne PA 17043
Correspondent's a-mail address: erogers@keeferwood.com
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Under penalties of perjury, declarethatlhaveexaminedthisreturn,includingaccompanyingschedulesandstatements,andtothebestofmyknowledgeandbelief,
it is true, correct and com~ete. Declamation of the preparer other than personal representative is based on all information of which preoarer has anv knowledge.
DATE
See sc hed
635 N. 12th Sheet, Suite
e, PA 17043
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056041192 15056041192
~ ~~~
~~
Estate of: Heath L. Allen
Executor
Martin R. Allen Elyse E. Rogers
1 Tracey Drive 635 North 12th Street, Suite 400
Milltown, NJ 08850 Lemoyne, PA 17043
202-20-1355
Rev-1500 EX
Decedent's Name: Heath L. Allen
Decedent's Social Security Number
RECAPITULATION
1. Real estate (Schedule A) ......................................... 1,
2. Stocks and Bonds (Schedule B) .................................... 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ...... 3.
4. Mortgages & Notes Receivable (Schedule D) . • ......................... 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ......... 5.
6. Jointly Owned Property (Schedule F) O Separate Billing Requested ...... 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) f~ Separate Billing Requested ...... 7.
8. Total Gross Assets (total Lines 1-7) ................................ g,
0.00
1,226, 569.89
0.00
0.00
288,026.36
0.OD
1,338,339.59
2,852,935.84
9. Funeral Expenses & Administrative Costs (Schedule H) .................... 9.
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............... 10.
11. Total Deductions (total Lines 9 & 10) • • .............................. 11.
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.
14. Net Value Subject to Tax (Line 12 minus Line 13) ....................... 14.
138,018.95
6,118.00
144,136.95
2,708,798.89
151,957.33
2,556,841.56
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2)x.oo 1,731,627.56 1s.
16. Amount of Line 14 taxable
at lineal rate x .045 8 2 5, 214 • 0 0 1 s.
17. Amount of Line 14 taxable
at sibling rate X .12 D • D D 17.
18. Amount of Line 14 taxable
at collateral rate X .15 D • D D 18
19. TAX DUE .................................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
15056042193 1505604219
93
0.00
37,134.63
o•oo
0.00
37,134.63
O
Rev-1500 EX Page 3
Decedent's Complete Address:
Fle Number
21 08 0818
DECEDENTS NAME
Heath L. Allen DECEDENTS SOCIAL SECURITY NUMBER
202-20-1355
STREET ADDRESS
321 N. 28th Street
CIT+!
Camp Hill STATE
PA ZI P
17011
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit 0.00
B. Prior Paymerns 33,000.00
C. Discourn 1,736.85 Total Credits (A + B + C)
3. irnerest/Penalty if applicable
D. Irnerest 0.00
E. Penalty 0.00 Total Irnerest/Penalty (D + E)
4. If Llne 2 is greater than Line 1 + Line 3, erner the difference. This is the OVERPAYMENT.
FIII In oval on Pape 2, Une 20 to request a refund.
5. If Une 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the irnerest on the tax due.
(1)
37,134.63
(2) 34,736.85
(3) 0.00
(4)
(5) 2,397.78
(sA) 0.00
B. Erner the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 2,397.78
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedern make a transfer and: Yes No
a. retain the use or income of the property transfem:d;,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ,,,, ^
b. retain the right to designate who shall use the property transfem:d or its income : ......... .... ^
c. retain a reversionary irneresr or ............................................ .... ^
d. receive the promise for life of either paymerns, benefits or care? ........... .
2. If death occurred after December 12, 1982, did decedern transfer property within one year
of death without receiving adequate consideration? ................................ .... ® ^
3. Did decedern own an in trust for" or payable upon death bank accourn or security at his or her death? ^
4. Did decedern own an Individual Retirement Account, annuity, or other non-probate property
which contains a beneficiary designation? ...................................... .... ® ^
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving
spouse is three (3) peroern [72 P.S. Sect. 9118(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)
peroern [72 P.S. Sect. 9118(a)(1.1)(ii)]. The statue does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure
of assts 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 twerny-one years of age or younger at death to or for the use of a natural parern,
an adoptive parern, or a stepparern of the child is zero (0) peroern [72 P.S. Sect. 9118(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) peroern, except as noted
in 72 P.S. Sect. 9118(1.2) [72 P.S. Sect. 9118(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedern's siblings is twelve (12) percent [72 P.S. Sect. 9116(a)(1.3)]. A sibling
is defined, under Section 9102, as an individual who has at least one parern in common with the decedern, whether by blood or adoption.
REV -1503 EX+ (8-98)
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCETAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Heath L. Allen 21 08 0818
All property jointly-owned with right of survlvorhslp must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 BP PLC 41,557.67
2 Greif Inc 11,792.00
3 Harsco Corp 434,665.86
Dividend on above stock declared prior to decedent's death 1,737.06
4 Honeywelllntllnc 418,795.20
5 McDonalds Corp 118,913.76
6 Medco Health Solutions Inc 34,974.96
7 Merck & Co Inc 97,325.60
8 National Penn Bancshares Inc 66,807.78
TOTAL (Also enter on line 2, Recapitulation) I 1,226,569.89
(If more space is needed, insen additional sheets of the same size)
REV-1508 EX+(8-98)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHERITANCETAXRETURN PERSONAL PROPERTY
RESIDENTDECEDENT
ESTATE OF FILE NUMBER
Heath L. Allen 21 08 0818
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Scheduel F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Wachovia Bank Account 101060082805 12,289.45
Per 09/05/08 letter
Interest on above item accrued as of decedent's death 0.22
2 Highmark Premium Refund 10.76
3 Highmark Prescription Drug Plan Refund 62.93
4 Nantucket Golf Membership 264,000.00
$260,000 membership resignation plus refund of $4,000 for pro-rated 2008
annual dues
Per 09/10/08 letter
5 2003 Ford Taurus 6,160.00
6 Pro-rated Trustee fee for Gerald Englehart Trust 1,650.00
7 Pro-rated Trustee fee for Swab Trust C 1,160.00
8 Plaza 21 Realty Associates 2,693.00
See attachment
TOTAL (Also enter on line 5, Recapitulation) I 288,026.36
(If more space is needed, insert additional sheets of the same size) l
REV-7570 EX+18-88)
COMMONWEALTH OF PENNSYLVANIA
INH ERITANCE TAX RETURN
RESIDENTDECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF FILE NUMBER
Heath L. Allen 21 08 0818
This schedule must be completed and filed if the answerto any of questions 1 through 4 an the reverse side of the REV-1500 COVER SH EETis yes.
ITEM
NUM DESCRIPTION OF PROPERTY
INCLUDE NAME OFTRANSFEREE,RELATIONSHIPTODECEDENT&
DATEOFTRANSFER. ATTACH COPYOFDEED FOR REAL ESTATE
DATE OF DEATH
VALUE OF ASSET
%OFDEC'S
INTEREST
EXCLUSION
(IFAPPLICABLE)
TAXABLE
VALUE
1 Deferred Compensation Plan 151,957.33 100 151,957.33
Beneficiary: Wilson College
Per 12/12/08 a-mail
2 Keefer Wood Allen & Rahal, LLP, 401 kPlan - 1,168.38 100 1,168,382.26
The Standard Retirement Services, Inc.
Beneficiary: Decedent's surviving spouse,
Eleanor Allen
3 $5,000 cash 1/10/08 and $2,500 cash 5/9/08 to 7,500.00 100 3,000.00 4,500.00
Decedent's son, Martin R. Allen
4 $5,000 cash 1/10/08 and $2,500 cash 5/9/08 to 7,500.00 100 3,000.00 4,500.00
Decedent's daughter, Barbara J. Allen
5 $5,000 cash 1/10/08 and $2,500 cash 5/9/08 to 7,500.00 100 3,000.00 4,500.00
Decedent's daughter, Melissa A. Smith
6 $5,000 cash 1/20/08 and $2,500 cash 5/9/08 to 7,500.00 100 3,000.00 4,500.00
Decedent's son, Heath L. Allen, II
TOTAL (Also enter on line 7, Recapitulation) I 1,338,339.59
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+(10-08)
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENTDECEDENT
ESTATE OF FILE NUMBER
Heath L. Allen 21 08 0818
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMC)l1NT
A.
1
2
3
4
B.
~.
FUNERAL EXPENSES:
Holmes-O.K. Lettershop, Inc, funeral memorial cards and thank you cards
Eleanor M. Allen -reimbursement for funeral expenses
Musselman Funeral Home -funeral expense
Eleanor M. Allen, reimbursement for payment to Terri Maclay for funeral
flowers
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) Martin R. Allen
Street Address 1 Tracey Drive
594.96
9,546.27
1,765.00
699.60
100,000.00
city Milltown State NJ zip 08850
Year(s) Commission Paid: 2009
2. Attorney Fees 20,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00
aaimant Eleanor M. Allen
street Address 321 N. 28th Street
city Camp Hill State PA zip 17011
Relationship of Claimant to Decedent SUrVIVlrtq SpOUSe
a. ~ Probate Fees ~ 907.00
5. I Accountant's Fees
6. Tax Return Preparer's Fees
7 Penn Dot 22.50
8 Keefer Wood Allen & Rahal, LLP -out of pocket expenses 400.00
9 Mark E. Hilbert & Assoc 350.00
10 Cumberland Law Journal, legal advertising 75.00
11 The Sentinel, legal advertising 158.62
TOTAL (Also enter on line 9, Recapitulation) 138,018.95
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX+(12-03)
COMMONWEALTH OF PENNSYLVANIA
INH ERITANCE TAX RETURN
RESIDENTDECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
Heath L. Allen 21 08 0818
Report debts Incurred by decedent prior to death which remained unpaid as of date of death, including unrelmbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Walborn Naugle Shambach Associates, preparation of 2007 Federal, PA, 3,730.00
local individual income tax returns and preparation of 2008 federal, PA, and
local declarations of estimated tax
2 Keefer Wood Allen & Rahal, LLP -out of pocket expenses incurred prior to 170.00
death
3 Eleanor M. Allen, reimbursement for payments to Terri Maclay ($699.60) 2,218.00
Dorothy Pascale ($400), Sue Keenee ($258), Sue Keenee ($150), Dorothy
Pascale ($294), and Griswold Care ($1116) for home medical care
TOTAL (Also enter on line 10, Recapitulation) ( 6,1 18.00
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX+(8-00)
SCHEDULE J
COM NH ERTANCETAXRETURNANIA BENEFICIARIES
RESIDENTDECEDENT
ESTATE OF FILE NUMBER
Heath L. Allen 21 08 0818
NUMBE
NAME AND ADDRESS OF PERSONS RECEIVING PROPERTY RELATIONSHIP TO DECEDENT
DO Not Ust Tru s AMOUNT OR SHARE
OF ESTATE
i TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 9116(a)(1.2)J
Eleanor M. Allen Surviving spouse 1,731,627.56
321 N. 28th Street
Camp Hill, PA 17011
Martin R. Allen Son 206,303.50
1 Tracey Drive
Milltown, NJ 08850
Heath L. Allen, II Son 206,303.50
623 South 48th Street
Philadelphia, PA 19143
Melissa A. Smith Daughter 206,303.50
123 West Barre Street, Apt 305
Baltimore, MD 21201
Barbara J. Allen Daughter 206,303.50
77 Arcadia Cove Road
Belgrade, ME 04917
ENTE R DOLLAR AMOUNTS FOR D ISTRIBUTIONS SHOWN ABOVE ON LINES 15 TH ROUG H 18, AS APPROPRIATE, ON REV-1500 COVE R SH EET
rr NON-TAXABLE DISTRIBUTIONS:
A SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1 Wilson College 151,957.33
1015 Philadelphia Avenue
Chambersburg, PA 17201-1285
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 151,957.33
(If more space is needed, insert additional sheets of the same size)
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OF
HEATH L. ALLEN
I, HEATH L. ALLEN, of the Borough of Camp Hill, Cumberland
County, Pennsylvania, do make, publish and declare this to be my Last Will and
Testament, hereby revoking all Wills and Codicils by me heretofore made.
ITEM I: Family Information. I am married to
ELEANOR M. ALLEN, and all references to my wife in this Will are to her. I have
four children: BARBARA J. ALLEN, HEATH L. ALLEN II, MELISSA A. SMITH
and MARTIN R. ALLEN. These are described in this Will as "rny children," or as "a
child of mine." Any person born to or adopted by issue of mine is to be included as
issue of mine. Provided, however, no adopted person shall benefit under this Will
unless the order or decree of adoption is entered before the adopted person attains
the age of twenty-one (21) years.
ITEM II: Death Taxes. I direct that all inheritance
and estate taxes becoming due by reason of my death, whether payable by my
estate or by any recipient of any property, shall be paid by the Executor out of the
residue of my estate, as an expense and cost of administration of my estate, except
that no taxes shall be charged against any gift qualifying for the marital or
charitable deduction in my estate. The Executor shall have no duty or obligation to
obtain reimbursement for any such tax so paid, even though on proceeds of
insurance or other property not passing under this Will.
ITEM III: Debts and Final Expenses. I direct the
Executor to pay the expenses of my last illness, my legally enforceable debts, and
my funeral expenses from the residue of my estate as an expense and cost of
administration of my estate.
Pagel (CL~
ITEM IV: Tangible Personal Property.
(a) If Wife Survives. If I die before my wife, ELEANOR M.
ALLEN, I give to her all my tangible personal property, including but
not limited to, all of my household furniture and furnishings, books,
pictures, jewelry, silverware, automobiles, wearing apparel and all
other articles of household or personal use or adornment and all
policies of insurance thereon.
(b) If Wife Predeceases. If I survive my wife, I may leave a
written list in my safe deposit box or elsewhere disposing of certain
items of my tangible personal property. The Executor shall dispose of
items of my personal property as specified in the written list. If no
written list is found in my safe deposit box or elsewhere and properly
identified by the Executor within thirty (30) days after the probate of
my Will, it shall be presumed that there is no other statement or list.
Any subsequently discovered list shall be ignored. I give any property
of the type described in paragraph (a) and not set forth in a written list
to my children, to be divided among them as they shall agree. Should
there be no agreement, this property shall be divided among my
children by the Executor in as nearly equal portions as is deemed
practical in the discretion of the Executor, having due regard to their
personal preferences.
ITEM V: Residue. I give the residue of my estate, not
disposed of in the preceding portions of this Will, as follows:
(a) At~nlicable Credit Amount To Issue. To be divided into as
many equal parts as there are then living children of mine and then
deceased children of mine represented by then living issue, a fraction
of the residue. The numerator of the fraction shall be a sum equal to
the largest amount that can pass free of Federal estate tax under my
Will by reason of the applicable credit amount and the state death tax
credit (provided that the use of this credit does not require an increase
in state death taxes) allowable to my estate but no other credit and
after taking account of dispositions under other items of this Will and
Page 2 ~~_
property passing outside of this Will which do not qualify for the
marital or charitable deduction and after taking account of charges to
principal that are not allowed as deductions in computing my Federal
estate tax. The denominator of the fraction shall be the value of my
residuary estate. For purposes of establishing this fraction, the values
finally fixed in the Federal estate tax proceeding relating to my estate
shall be used. I recognize that the numerator of such fraction may be
zero (0), in which case no property shall pass pursuant to this
provision.
Notwithstanding the foregoing, not more than fifty (50%)
percent of the residue shall pass pursuant to this paragraph (a), unless
it passes to them because my wife has predeceased me, or as a result of
the qualified disclaimer of part of the marital gift set forth in
paragraph (b) of this ITEM.
The Executor shall distribute one (1) share to each living
child and one (1) share to the then living issue of each deceased child,
per stirpes.
(b) Marital Gift. The balance of my residuary estate shall be
paid to my wife, ELEANOR M. ALLEN, if she survives me. If she does
not survive me, this share shall be divided into as many equal parts as
there are then living children of mine and then deceased children of
mine represented by then living issue. The Executor shall distribute
one (1) share to each living child and one (1) share to the then living
issue of each deceased child, per stirpes.
(c) Protective Provisions for Young Beneficiaries. If any
issue of a deceased child has not attained the age of thirty (30) years at
the time of distribution, then notwithstanding the foregoing, the share
of the beneficiary who has not attained that age shall be held by
HERSHEY TRUST COMPANY, as Trustee, IN TRUST, for his or her
benefit, to be administered and distributed as provided in ITEM VI.
Page 3 ~ L ~
ITEM VI: Trust for Youna Beneficiaries. In each Trust
established for a beneficiary under the age of thirty (30) years (each the
"Beneficiary" of the Trust for his or her benefit):
(a) Net Income. The Trustee shall pay to the Beneficiary in
convenient, at least annual, installments so much of the net income as
the Trustee, in the discretion of the Trustee, considers necessary for
the proper support, maintenance, health care and education, including
college or other post-secondary education, of the Beneficiary. Income
not distributed shall be accumulated and added to principal.
(b) Principal. The Trustee shall also pay to or for the benefit
of the Beneficiary so much of the principal as the Trustee, in the
discretion of the Trustee, considers necessary for the proper support,
maintenance, health care and education, including college or other
post-secondary education, of the Beneficiary.
(c) Termination of Trust. Upon the attainment of the age of
twenty-five (25) years by the Beneficiary, the Trustee shall pay to the
Beneficiary one-half of the principal of his or her Trust. Upon the
attainment of the age of thirty (30) years by the Beneficiary, the Trust
shall terminate and the Trustee shall pay to the Beneficiary the
remaining assets of the Trust.
(d) Death before Termination. Should the Beneficiary die
before final distribution of the assets of his or her Trust, the Trust
shall terminate and the Trustee shall pay the assets of the Trust to the
then living issue of the Beneficiary, per stirpes. However, if any issue
has not attained the age of twenty-five (25) years at the time of
distribution, the Trustee shall continue to hold the share for that issue
as Custodian under the Pennsylvania Uniform Transfers to Minors Act
for the benefit of that issue.
(e) Trust Without Beneficiaries. If before final distribution of
the assets of any Trust established for my issue, there is no living
beneficiary of that Trust, it shall terminate. The assets of the Trust
Page 4 ~ I, A,-
shall be paid to the then living issue, on a per stirpital basis, of the
nearest deceased ancestor (with issue living at the time of distribution)
of the Beneficiary who is me or my issue. However, if there is then in
existence any trust created under this Will for the benefit of that issue,
the share which would have been distributed to that issue shall be
added to the principal of his or her trust, to be administered and
distributed as provided in this Will.
(fj Failure of Issue. In the event I am not survived by my
wife or any issue, or if there are no issue of mine surviving upon the
termination of any trust, the residue (or principal) shall be divided in
two (2) equal parts. One part shall be paid to those persons who would
then be entitled to my estate under the intestate laws of Pennsylvania
then in effect as if I had died at that time intestate. One part shall be
paid to those persons who would then be entitled to my wife's estate
under the intestate laws of Pennsylvania then in effect as if my wife
had died at that time intestate owning that part of my estate.
ITEM VII: Spendthrift Clause. No part of the income or
principal of any Trust created by this Will shall be subject to attachment, levy or
seizure by any creditor, spouse, assignee or trustee or receiver in bankruptcy of any
beneficiary prior to his or her actual receipt of income or principal distributed. The
Trustee shall pay the net income and the principal to the beneficiaries specified by
me, as their interests may appear, without regard to any attempted anticipation,
pledging or assignment, and without regard to any claim or attempted levy,
attachment, seizure or other process against the beneficiary.
ITEM VIII: Administrative Powers. In addition to the
powers granted at law, the Executor and the Trustee shall each possess the
following powers, each of which shall be construed broadly and may be exercised
without court approval, but in a fiduciary capacity only:
(a) Retain Investments. To retain any investments I have at
my death, including specifically those consisting of stock of any bank
even if I have named that bank as the Executor or Trustee.
Page 5 1-~ L ~j_.
(b) Var~Investments. To vary investments, to make loans,
and to invest in bonds, stocks, notes, real estate mortgages or other
securities or in other property, real or personal, without being
restricted to so-called "legal investments", and without being limited
by any statute or rule of law regarding investments by fiduciaries.
(c) Division of Assets. In order to divide the principal of a
Trust or for any other purpose, including final distributions, the
Executor and Trustee are authorized to divide and distribute personal
property and real property, partly or wholly in kind, and to allocate
specific assets among beneficiaries and Trusts so long as the total
market value of each share is not affected by the division, distribution
or allocation in kind. The Executor and Trustee are each authorized to
make, join in and consummate partitions of lands, voluntarily or
involuntarily, including giving of mutual deeds, or other obligations,
with as wide powers as an individual owner in fee simple.
(d) Sell Assets. To sell either at public or private sale real
and personal property severally or in conjunction with other persons,
and to consummate sale(s) by deed(s) or other instrument(s) to the
purchaser(s), conveying a fee simple title. No purchaser shall be
obligated to see to the application of the purchase money or to make
inquiry into the validity of any sale(s). The Executor and Trustee are
authorized to execute, acknowledge and deliver deeds, assignments,
options or other writings as necessary or convenient to any of the
power conferred upon the Executor and Trustee.
(e) Encumber Real Estate. To mortgage real estate, and to
make leases of real estate.
(~ Borrow Money. To borrow money from any person,
including the Executor or Trustee, to pay indebtedness of mine or of
my estate, expenses of administration or inheritance, legacy, estate
and other taxes, and to assign and pledge assets of my estate or any
Trust established by this Vt~ill.
Page 6 1~ L l~
(g) Pav Costs. To pay all costs, taxes, expenses and charges
in connection with the administration of my estate or any Trust
established under this Will.
(h) Distributions without Court Order. To make
distributions of income and of principal to the proper beneficiaries,
during the administration of my estate, with or without court order, in
such manner and in such amounts as the Executor deems prudent and
appropriate.
(i) Vote Stock. To vote shares of stock which form a part of
my estate or any Trust established under this Will, and to exercise all
the powers incident to the ownership of stock.
(j) Reorganize. To unite with other owners of property
similar to property in my estate to carry out plans for the
reorganization of any company whose securities form a part of my
estate.
(k) Disclaim. To disclaim any interest in property which
would devolve to me or my estate by whatever means, including but
.not limited to the following means: as beneficiary under a will, as an
appointee under the exercise of a power of appointment, as a person
entitled to take by intestacy, as a donee of an inter vivos transfer, and
as a donee under athird-party beneficiary contract.
(1) Tax Returns. To prepare, execute and file tax returns of
any type required by applicable law, including but not limited to filing
a joint tax return with my surviving spouse, and to snake all tax
elections authorized by law.
(m) Employ Advisors. To employ custodians of property,
investment or business advisors, accountants and attorneys as the
Executor or Trustee deems appropriate, and to compensate these
persons from assets of my estate or trust, without affecting the
compensation to which the Executor and Trustee are entitled.
Page 7 1 ~ L A
(n) Divide Trusts. To divide any Trust created in this Will
into two or more separate Trusts so that inclusion ratio for purposes of
the generation-skipping transfer tax shall be either zero or one, in
order that an election under Section 2652(a)(3) of the Internal Revenue
Code may be made with respect to one of the separate Trusts, or for
any other reason.
(o) Allocate Expenses. To allocate administrative expenses
to income or to principal, as the Executor or Trustee deems
appropriate. However, no allocation to income shall be made if the
effect of the allocation is to cause a reduction in the amount of any
estate tax marital deduction or estate tax charitable deduction.
(p) Adiust Basis. To make any adjustment to basis
authorized by law, including, but not limited to increasing the basis of
any property included in my estate, whether or not passing under this
Will, by allocating any amount by which the bases of assets may be
increased. The Executor shall be under no duty and shall not be
required to allocate basis increase exclusively, primarily, or at all to
assets which pass as part of my probate estate as opposed to other
property for which a basis adjustment is allowable. The Executor shall
allocate basis increase equitably among those beneficiaries receiving
property as a result of my death, but shall not be liable to any person,
nor subject to removal or surcharge, for any reasonable allocation of
basis increase.
(q) Compromise Claims. To compromise claims.
(r) Terminate Trust. To terminate any trust, if in the
opinion of the Trustee, the expense of administration of the trust is not
justified. Upon termination, the Trustee shall distribute the trust
property to the person(s) then entitled to receive or have the benefit of
the income therefrom. If there is more than one current income
beneficiary, the Trustee shall distribute trust assets to the income
beneficiaries in the proportion in which they receive income, or if no
proportion is designated, in equal shares to the income beneficiaries.
Page 8 ~"'~ L
This power may only be exercised by a Trustee who is an independent
Trustee, and this power shall be ineffective to the extent that the effect
of the power is to vest in any Trustee or beneficiary a general power of
appointment.
(s) Other Acts. To do all other acts in his or her judgment
necessary or desirable for the proper and advantageous management,
investment and distribution of the estate and Trusts established under
this Will.
ITEM IX: Accounting. The Trustee, on an annual
basis, shall provide each income beneficiary who has attained the age of eighteen
(18) years, and the Guardian of the person of any income beneficiary who has not
attained the age of eighteen (18) years, statements showing transactions of each
Trust established for the benefit of that beneficiary. The beneficiary, or the
Guardian of the person of such beneficiary, may waive this right to receive an
annual accounting. The Trustee may, at any time, settle any account, or questions
concerning the administration of any Trust established under this Will, by
agreement with the then qualified beneficiaries (as that term is defined in the
Pennsylvania Uniform Trust Act) of the Trust, if legally competent, or if not legally
competent, with the Guardian of the person of the beneficiary, the legally
competent spouse of the beneficiary, or the oldest legally competent relative of the
beneficiary who would take a portion of the estate of the beneficiary were the
beneficiary to die at that time intestate under the laws of the Commonwealth of
Pennsylvania. Any settlement made in accordance with this Item shall bind all
persons who have an interest in the Trust, and shall constitute a release and
discharge of the Trustee with respect to transactions specified in the settlement.
ITEM X: Distributions to or for Beneficiaries. The
Trustee is authorized to distribute principal and/or income in any one or more of the
following ways if the Trustee, in the discretion of the Trustee, considers the
beneficiary unable to apply distributions to the beneficiary's own best interests, or if
the beneficiary is under a legal disability:
(a) To Beneficiary. Directly to the beneficiary;
Page 9 f-~f ~. ~
(b) To Guardian or Conservator. To the legal guardian or
conservator of such beneficiary;
(c) To Custodian. To the Trustee, or to another person
selected by the Trustee, as custodian under the Pennsylvania Uniform
Transfers to Minors Act as to a beneficiary under the age of twenty-
five (25) years;
(d) To a Relative. To a relative of the beneficiary, to be
expended by that relative for the benefit of the beneficiary; or
(e) Direct Expenditure. By directly applying distributions for
the benefit of the beneficiary.
ITEM XI: Merger of Trusts. Should my wife,
ELEANOR M. ALLEN, by Will or Agreement of Trust, establish Trusts similar to
the Trusts I have established for the benefit of my issue, the Trustee of each Trust
created in this Will shall have the right to merge it with the similar Trust created
by my wife for the same beneficiaries. If merged, the Trustee shall operate the
merged Trusts as a single Trust.
ITEM XII: Survival. Any person who has died within
thirty (30) days of my death, or under such circumstances that the order of our
deaths cannot be established by proof, shall be deemed to have predeceased me.
Any person (other than myself) who has died at the same time as any beneficiary
under this Will, or in a common disaster with that beneficiary, or under such
circumstances that the order of deaths cannot be established by proof, shall be
deemed to have predeceased that beneficiary.
ITEM XIII: Trust Situs. The initial situs of each Trust
created under this Will shall be the county where I am domiciled at the time of my
death. The Trustee may determine, from time to tune, to change the situs of any
Trust established under this Will. However, no change in situs shall be effective
until written notice is provided to the living beneficiaries of the Trust.
Page 10 r--{ 1, I~
ITEM XIV: Executors and Trustees. I make the
following provisions with respect to Executors and Trustees:
(a) Initial Executor. I appoint my wife, ELEANOR M.
ALLEN, to be the Executrix, herein referred to as the "Executor."
(b) Successor Executors. In the event that my wife is unable
or refuses to serve as Executor, I appoint my son, MARTIN R. ALLEN,
and my attorney, ELYSE E. ROGERS, to serve as Co-Executors,
herein collectively referred to as the "Executor." If my son, MARTIN
R. ALLEN, is unable or unwilling to serve as Co-Executor, I appoint
my daughter, MELISSA A. SMITH, to serve as Co-Executor. If she is
unable or unwilling to serve as Co-Executor, I appoint my son, HEATH
L. ALLEN II, to serve as Co-Executor. If he is unable or unwilling to
serve as Co-Executor, I appoint my daughter, BARBARA J. ALLEN, to
serve as Co-Executor. I name my children in inverse order of age.
(c) Trustee. I appoint HERSHEY TRUST COMPANY to
serve as Trustee of any Trust established for the benefit of issue of a
deceased child.
(d) Power to Remove Trustee. My youngest living child shall
have the power to remove HERSHEY TRUST COMPANY as Trustee of
any trust created under this Will, provided he or she first names
another institutional Trustee which accepts the appointment.
(e) Method of Appointment and Removal. Each appointment
or removal of a Trustee shall be in writing and shall be filed with the
court in the jurisdiction which is the situs of the Trust. The written
instrument shall be signed by the person having the power to make the
appointment or removal.
(f) Temporary Trustee. Each Trustee shall have the power
to designate a temporary Trustee by an instrument in writing
delivered to such temporary Trustee. The temporary Trustee shall
serve as such only during the legal incapacity of the appointing
Page 11 ~l L. ~1
Trustee, or, during such period of time as the appointing Trustee in
writing designates, and upon the expiration of that time, or at such
time as the legal incapacity of the appointing Trustee ceases, the
appointing Trustee shall once again become the Trustee.
(g) Acceptance of Office. A Trustee shall be deemed to have
accepted the office of Trustee as to Trust property only to the extent it
accepts that property by written instrument delivered to the Executor.
Should a Trustee refuse to accept property, the Executor shall have the
power to select another person to serve as Trustee, or to divide any
Trust created by this Will so as to permit one person (or persons) to
serve as Trustee with respect to some Trust property and another
person (or persons) to serve as Trustee with respect to other Trust
property.
(h) Resignation. Any Trustee may resign upon ninety (90)
days written notice to the then income beneficiary and each adult sui
juris remainder beneficiary of the Trust; provided, however, that the
resignation shall not become effective until and unless at least one
person is then serving as Trustee of the affected Trust.
(i) Delegation. Any Trustee may delegate investment and
related management functions to another Trustee, provided the other
Trustee accepts the delegation in writing. To the extent accepted, the
delegating Trustee shall be relieved of responsibility for the
investment decisions of the Trustee to whom investment and related
management functions were delegated.
(j) Responsibility. No Trustee shall be responsible for the
acts or omissions of any other Trustee.
(k) Duty to Investigate. In the absence of actual knowledge
of a breach of trust, or information concerning a possible breach of
trust that would cause a reasonable person to inquire, a successor
Trustee is under no duty to examine the accounts and records of any
predecessor Trustee, or to inquire into the acts or omissions of such
Page 12 )~
predecessor, is not liable for any failure to seek redress for any act or
omission of such predecessor, shall have responsibility only for
property which is actually delivered to the Trustee by such predecessor
and shall have all of the powers conferred upon a Trustee hereunder. .
(1) Compensation. The Executor and Trustee shall have the
right to receive reasonable compensation for services rendered and
reimbursement for reasonable expenses.
(m) Security. The Executor and Trustee are specifically
relieved from the duty of filing bond or entering security.
IN WITNESS WHEREOF, I have set my hand and seal to this, my
Last Will and Testament, consisting of this and the preceding twelve (12) pages, at
the end of each page of which I have also set my initials for greater security and
better identification this z 3 r1, day of ~ ~ , 200 .
1 ~.~-~ C.. (SEAL)
HEATH L. ALLEN
We, the undersigned, hereby certify that the foregoing Will was signed,
sealed, published and declared by the above-named Testator as and for his Last
Will and Testament, in the presence of us, who, at his request and in his presence
and in the presence of each other, have hereunto set our hands and seals the day
and year first above written, and we certify that at the tune of the execution
thereof, the Testator was of sound and disposing mind and memory.
(SEAL) Residing at ~~~ //7.1~' ~~
~ ~.~6~ ~ to
` (~-• (SEAL) Residing at
~ ~ ~ ass
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA )
n ~ ) SS:
COUNTY OF X•~-- )
I, HEATH L. ALLEN, Testator, 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.
~l~t.. L_ , ~,..` (SEAL)
HEATH L. ALLEN
Sworn to and subscribed before
me this ,~~rct day of ~'~
2aD$•
Notary Pu lic
My Commission Expires:
(SEAL)
COMMONWEALTH OF PENNSYLVANIA
NOTARIAL SEAL
CYNTHIA J. RULE, Notary Public
Lemoyne Boro., Cumberland County
Commission E fires February 3, 2012
*y~
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA )
SS:
COUNTY OF ~~s' )
We, and l~/~~1i :~ ~. Gt/i~~/7 ,
the Witnesses whose nam are signed to the attached or foregoing instrument,
being duly qualified according to law, do depose and say that we were present and
saw Testator, HEATH L. ALLEN, sign and execute the instrument as his Last Will
and Testament; that Testator signed willingly and that he executed said Will as his
free and voluntary act for the purposes therein expressed; that each of us in the
hearing and sight of the Testator signed the Will as Witnesses; and that to the best
of our knowledge the Testator was at that time eighteen (18) or more years of age,
of sound mind and under no constraint or undue influence.
fitness
Witness
Sworn to and subscribed before
me thisc~rd day of ~~
20 ~ ~'
Notary Public
My Commission Expires:
(SEAL)
COMMONWEALTH OF PENNBYLYANIA
NOTARIAL SEAL
CYNTHIA J. RULE, Notary PubNc
Lemoyne Boro., Cumberland County
M Commission Expires Fet>ru 3, 2t?t2
R~ f: .
E
'~ ~'1 ll .J
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
m ~.
IN RE: g __ ~'
ESTATE OF HEATH L. ALLEN, NO. 2008-00 ~ o ~' `~{=~
DECEASED ~ ~:
~7 C I ~~ E^,^n _
..... ~ r-- ,~-~-~
DISCLAIMER ~~ N ~-- .~ -_
The undersigned, ELEANOR M. ALLEN (the "Disclaimant"), being the
wife of HEATH L. ALLEN, intending to be legally bound, makes the following
disclaimer:
Disclaimant hereby disclaims all right, title and interest
she may have to receive that portion of the residue of the
Estate of Heath L. Allen (who died on July 29, 2008)
which would pass pursuant to the provisions of Item V (b)
of the Last Will and Testament dated May 23, 2008,
because of the application of the limitation in Item V (a)
that not more than fifty (50%) percent of the residue shall
pass to the then living issue of Heath L. Allen. This
Disclaimer shall be construed so as to omit the second
paragraph thereof which provides "not withstanding the
foregoing, not more than fifty (50%) percent of the residue
shall pass pursuant to this paragraph (a)...."
It is Disclaimant's intention that the maximum amount
that can be sheltered from Federal Estate Tax by reason
of the applicable credit amount allowable to the Estate of
Heath L. Allen will pass pursuant to the provisions of
Item V (a) to the beneficiaries identified in Item V (a} of
the Last Will and Testament of Heath L. Allen.
Disclaimant does reserve the right to the balance of the
marital gift set forth in Item V (b) of the Will.
This Disclaimer is irrevocable and unqualified.
IN WITNESS WHEREOF, the undersigned has set her hand and seal
this ~ day of ~vve~ ~ ~,. , 2008.
~ ~ ~. ~,~~
~~
Witness
~.
ELEANOR M. ALLEN
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF ~
On this, the day of ~~.~-~~--~ , 2008, before me, a Notary Public,
the undersigned officer, personally appeared ELEANOR M. ALLEN, known to me
(or satisfactorily proven) to be the person whose name is subscribed to the within
instrument, and acknowledged that she executed same for the purposes therein
contained.
IN WITNESS WHEREOF, I hereunto set my hand and notarial seal.
Nota Public
My Commission Expires:
(SEAL)
COMMONWEALTH OF PENNSYLVANIA
NOTARIAL SEAL
CYNTHIA J. RULE, Notary Public
Lemoyne Boro., Cumberland Coun
My Commission Expires Februa 3, 212
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX111-96)
NO. CD 010443
ROGERS ELYSE EVELYN ESQUIRE
KEEPER WOOD ALLEN & RAHAL
635 N 12TH STREET STE 400
LEMOYNE, PA 17043
fold
ESTATE INFORMATION: SsN: 202-20-1355
FILE NUMBER: 2108-0818
DECEDENT NAME: ALLEN HEATH L
DATE OF PAYMENT: 10/23/2008
POSTMARK DATE: 10/22/2008
COUNTY: CUMBERLAND
DATE OF DEATH: 07/29/2008
REMARKS:
OCT 2 4 2008
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
101 ~ $ 33, 000.00
TOTAL AMOUNT PAID:
533,000.00
CHECK#1006
INITIALS: CJ
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
TAXPAYER
Janney Montgomery Scott
Date of Death: 07/29/2008 Estate of: Estate of Heath Allen
Valuation Date: 07/29/2008 Account: 92268
Processing Date: 09/09/2008 Report Type: Date of Death
Number of Securities: B
File ID: Allen, Heath Estate Janney Montgomery Scott
Shares Security Mean and/or Div and Int Security
or Par Description High/Ask Low/Bid Adjustments Accruals Value
1) 682 BP PLC (055622104)
SPONSORED ADR
New York Stock Exchange
07/29/2008 61.89000 59.98000 H/L
60.935000 41,557.67
2) 200 GREIF INC (397624107)
CL A
New York Stock Exchange
07/29/2008 59.99000 57.93000 H/L
58.960000 11,792.00
3) 8908 HARSCO CORP (415864107)
COM
New York Stock Exchange
07/29/2008 51.54000 46.05000 H/L
48.795000 434,665.86
Div: 0.195 Ex: 07/11/2008 Rec: 07/15/2008 Pay: 08/15/2008 1,737.06
4) 8244 HONEYWELL INTL INC (438516106)
COM
New York Stock Exchange
07/29/2008 51.54000 50.06000 H/L
50.800000 418,795.20
5) 2016 MCDONALDS CORP (580135101)
COM
New York Stock Exchange
07/29/2008 60.00000 57.97000 H/L
58.985000 118,913.76
6) 732 MEDCO HEALTH SOLUTIONS INC (584050102)
COM
New York Stock Exchange
07/29/2008 48.20000 47.36000 H/L
47.780000 34,974.96
7) 3040 MERCK & CO INC (589331107)
COM
New York Stock Exchange
07/29/2006 32.47000 31.56000 H/L
32.015000 97,325.60
8) 5044 NATIONAL PENN BANCSHARES INC (637138108)
COM
The NASDAQ Stock Market LLC
07/29/2008 13.62000 12.87000 H/L
13.245000 66,807.78
Total Value: $1,224,832.83
Total Accrual: $1,737.06
Total: $1 ,226,569.89
Page 1
This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions,
please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.1.0)
Fax Transmittal
""8~
Wacha•ia Bulk N.A.
Balance Confitutation Services
P O Box 40028
Roauoke, VA 24022-7313
September 5, 2009
KEEPER WOOD ALLEY & RAHAL LLP
ATTN: CAY LE D SWINDLER
635 NORTH 12TH STREET SLtITE 400
LEMOYNE, PA 17043
Refe~eaice ID: 25650 L0
SITRJF,CT: Verification / ('cmfirmation of Account and Ralancc Information pmvidcd for:
Customer: IICATII L ALLCN (SSN# XXX-XX-1355)
Date of Dcsth: JWg 29, 2008
Demsit AccourR Information
Account Account llatc of llrnth Avcra¢c lh~ Maturtty lntcocst Accrncd Y'1'll llatc
Type Pinmlx.r Rxlance Ralance3 Opercd i)afe Rate Tntuast iaferostPaiA (:losai
CHECI{INa XRX}CXX)CXX2805 512,289.45 6/L7i2008 .OS S0.22 S0.45 8/15/2008
LEC3ALTIfLE: HEATH L?.LLEN
CIASINCt BALANCE: $12289.96
9/5/2008 3:20:39 PM PAGE 1/002 Fax Server
~~IGHMN2K.
Date: 08/12/2008
This Month
Gross payment amount 10.76
Net payment amount 10.76
0223561
* TEN. ~1ND 7 6/ 1 Q 0 DOLLARS
PAY
THE ESTATE OF HEATH L<ALLET
TO THE
oROER of 3 21 N 2 8TH STREET:
-CAMP'HILL PA 17011
IGHMN2K.
Date: 08/19/2008
This Month
Gross payment amount 62.93
Net payment amount 62.93
0224290
YL~SCL:1~7L.L:CJI1 LJL_Ut~ .t',:1:d1
Premium Refund_
* S I~£'I'~';-TWO
AND SF ,.
~3./ 1~3 Q"
PAV THE ESTATE OF HEATH ~"
TO THE
32T N 28TH
ST
oROER"oF
CAMP HILL PA 17011
,,.n>>~ ~on~~^ .~nsrn~r 1 Cf'1~^ (' 7f~C1.C7CA]u.
September 10, 2008
Ms. Elyse E. Rogers
Estate of Heath L. Allen
Keefer Wood Alien & Rahal
635 North 12th Street, Suite 400
Lemoyne, PA 17043
Dear Ms. Rogers,
Pursuant to the Bylaws of the Club, resigning members are entitled to
receive upon resignation of their membership an amount equal to 80%
of the amount by which the membership contribution paid by the
person who succeeds them as a member of the Club exceeds $75,000.
The amount of the current membership contribution for new members
is $400,000, resulting in a payment of $260,000 plus a refund of
$4,000 for prorated 2008 annual dues.
Sincerely,
THE BOARD OF DIRECTORS
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~ M&T Investment Group
213 Market Street, Harrisburg, PA 17101-2127
717 255 2059
August 27, 2008
Estate of Heath Allen
C/o Elyse Rodger Co-Executor
PO Box 11963
Harrisburg, PA 17108-1963
Re: Gerald F. Englehart T/W
Dear Ms. Rodgers:
Enclosed please find a Trust Funds Check in the amount of $1,650.00, representing the
final Co-Trustee's commission, per lettered dated August 21, 2008 from Robert Church.
Please feel free to contact me, if you have any questions.
S' erely,
andra L Lazor
Trust Administrative Assistant
Enclosure
Cc: Robert Church
SWAB TRUST C. ~,a~ /'/ G~i ~ 303
ELYSE E. ROGERS .TTEE
H EATH L ALLEN TTEE a-siata
15 N. 12TH ST. STE 400 t50
J~AOYNE, PA 17043-1225 1 DATE ~ L~' D~
DER OFE ~ec.~~/T 1 //'~ ~ 1 ETC. ~ ~ I ~ ~p O a~~71
},~, ~~,~C. Qom. ~~~~i~c~~~c~- ~~s e
(~-artes Schwab
PNC BANI(, N.A.
Philadelphia, PA
D3 L0OD053 . 703710755 Lu' 2 303
Estate of Heath L. Allen
Date of Death: July 29, 2008
SSN: 202-20-1355
Attachment to Schedule E
Decedent was a 13.75% partner in a partnership known as Plaza 21 Realty
Associates. This partnership sold all of its assets in June 2006. However, the
partnership was not dissolved at the time of Decedent's death as it is engaged in
litigation. The estimated fair market value of this asset is $2,693, the closing
capital account balance as of December 31, 2008.
Plaza 21 Realty Associates
1719 NORTH SECOND ST
HARRISBURG, PA 17102
Estate of Health L Allen
c/o Elyse E Rodgers
635 N 12th Street
Lemoyne, PA 17043
I...lII~~~III~~~~1~~1~~11~~1~1~1
Walborn Naugle Shambach Associates
1714 N. 2nd Street
Harrisburg, PA 17102
717-236-7912
February 16, 2009
CONFIDENTIAL
Estate of Health L Allen
c/o Elyse E Rodgers
635 N 12th Street
Lemoyne, PA 17043
Dear Partner:
We have prepared the enclosed copy of your Schedule K-1 for Plaza 21 Realty Associates
partnership. It contains your share of the partnership's items of income/loss, deductions, and
credits, and other information for the partnership's tax year ended December 31, 2008. These
items are to be reported on your federal income tax return; therefore, this schedule should be
retained with your tax records and documentation.
Also enclosed is state K-1 information, if applicable. This information should also be retained
with your tax records and documentation.
If you have any questions, or if we can be of assistance in any way, please call.
Sincerely,
Walborn Naugle Shambach Associates
PLA21 02/16/2009 2:44 PM
Partner# 12 ^ Final K-1 ^ Amended K-1
>:: .
Schedule K-1 2 0 ~ ~ '><~~€~l~~i~^j~s~;~r~>i
.~.
(Form 1065) ;><:::::;:::;:~:;;::.;::::>~>>L'~dtt(~~1'1~C3':~i
Department of the Treasury For calendar year 2008, or tax 1 Ordinary business income (loss)
Internal Revenue Service year beginning
ending 2 Net rental real estate income (loss)
Partner's Share of income, Deductions, * -1 550
Credits, etc. - See back of form and separate instructions. 3 Other net rental income (loss)
15 I Crediis
651108
OMB No. 1545-0099
16 I Foreign transactions
:<:~71~:t'~'~::>~<~z~~~:ilt~l`lt~tD]1r~i~.0[i~-<t~f~~E~3~t1gG~~f • ~::z::::::;>.;?:;;>;:::;s:.;;;:; g 4 Guaranteed payments
A Partnership's employer identification number
2 3- 2 4 518 9 8 5 Interest income
B Partnership's name, address, cHy, state, and ZIP code 13
Plaza 21 Realty Associates 6a Ordinary dividends
1714 NORTH SECOND ST
HARRISBURG PA 17102 sb Qualified dividends
7 Royalties
C IRS Center where partnership filed return
O den UT 8 Net short-term capital gain (loss)
D ^ Check if this is a publicly traded partnership (PTP) ga Net long-term capital gain (loss) 17 Allernalive minimum tax (AMT) items
::~:::~:~~Eii::::::::<::le#~r:~va~:>:.• .>gut::tie:::P~rEr~er :::::::::::::::::<::::>::;:::::>~:::«:::<:>
E Partner's identifying number
26-6500850 9b Collectibles (2B%) gain (loss)
F Partner's name, address, city, state, and ZIP code 9c Unrecaptured section 1250 gain
Estate of Health L Allen
c/o Elyse E Rodgers 10 Net section 1231 gain (loss) 18 Tax-exempt income and
nondeduc8ble expenses
635 N 12th Street 11 Other income (loss)
Lemo ne PA 17043
C
^
®
Limited partner or other LL
General partner or LLC
G
member-manager member
®
^
Foreign partner
Domestic partner
H
19
Distributions
I Wh
t t
tit
i
? Estate
f
thi 12 Section 179 deduction
a
ype o
en
s
y
s partner
r'
J P
ti
s)
rt
h
f
fit
d
it
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i
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a
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on
:
s s
are o
pro
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oss, an
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(see
ns
a
di
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13
Other deductions
Beginning
Profit 5
8 2 310 0 °~ n
ng
7 5 0 0 0 ~~°
13 20 other information
.
°
Loss 5.823100 ~~° .
13.75000 %
it
l 5
823100
C 75000 %
13 A 13
.
a
.
a
%
K Partner's share of liabilities at year end:
Nonrecourse $
............................
Dualified nonrecourse financing $ 14 Seli-employment earnings (loss)
.............
Recourse $
L Partner's capital account analysis: *See attached statement for additional information.
Beginning capital account $
..................
Capital contributed during the year $ 4 , 330
Current
year increase (decrease) $ -1 , 6 3 7
Withdrawals 8 distributions $ ( )
................
Ending capital account $ 2 , 6 9 3
Tax basis ^ GAAP ^ Section 704(b) book
Other (explain)
8
'
c
~
m
~
o
u_
For Paperwork Reduction Act Notice, see Instructions for Form 1065.
DAA
Schedule K-1 (Form 1085) 2008
Schedul{: K-1 (Form 1065) 2008 - Page 2
This list identifies the codes used on Schedule K-1 for all partners and provides summarized reporting information for partners who file
Form 1040. For detailed reporting and filing information, see the separate Partner's Instructions for Schedule K-1 and the instructions
for your income tax return. Code Report on
1. Ordinary business income (loss). Determine whether the income (loss) is J Work opportunity credit Form 5884, line 3
passive or nonpassive and enter on your return as follows. K Disabled access credit See the Partner's Instructions
Report on L Empowerment zone and renewal
Passive loss See the Partner's Instructions community employment credit Form 8844, line 3
Passive income Schedule E, line 28, column (g) M Credit for increasing research
Nonpassive loss Schedule E, line 28, column (h) activities See the Partner's Instructions
Nonpassive income Schedule E, line 28, column (j) N Credit for employer social security
and Medicare taxes Form 8846, line 5
2. Net rental real estate income (loss) See the Partner's Instructions O Backup wfthholding Form 1040, line 62
3. Other net rental income (loss) P Other credits See the Partner's Instructions
Net income Schedule E, line 28, column (g) 16. Foreign transactions
Net loss See the Partner's Instructions A Name of country or U.S.
4. Guaranteed payments Schedule E, line 28, column Q) possession
5. Interest income Form 1040, line 8a B Gross income from all sources Form 1116, Part I
6a. Ordinary dividends Form 1040, line 9a C Gross income sourced at partner
6b. Qualified dividends Form 1040, line 9b level
7. Royalties Schedule E, line 4 Foreign gross income sourced at partnership level
8. Net short-term capital gain (loss) Schedule D, line 5, column (f) D Passive category
9a. Net long-term capital gain (loss) Schedule D, line 12, column (f) E General category Form 1116, Part I
9b. Collectibles (28%) gain (loss) 28% Rate Gain Worksheet, line 4 F Other
(Schedule D instructions) Deductions allocated and apportioned at partner level
9c. Unrecaptured section 1250 gain See the Partner's Instructions G Interest expense Form 1116, Part I
10. Net section 1231 gain (loss) See the Partner's InsVuctions H Other Form 1116, Part 1
11. Other Income (loss) Deductions allocated and apportioned at partnership level
Code to foreign source income
A Other portfolio income (loss) See the Partners Instructions 1 Passive category
B Involuntary conversions See the Partner's InsVuclions J General category Form 1116, Part I
C Sec. 1256 contracts 8 straddles Form 6781, line 1 K Other
D Mining exploration costs recapture See Pub. 535 Other information
E Cancellation of debt Form 1040, line 21 or Form 982 L Total foreign taxes paid Form 1116, Part II
F Other income (loss) See the Partners Instructions M Total foreign taxes accrued Form 1116, Part 11
12. Section 179 deduction See the Partners Instructions N Reduction in taxes available for credit Form 1116, line 12
13. Other deductions O Foreign trading gross receipts Form 8873
A Cash contributions (50%) P Extraterritorial income exclusion Form 8873
B Cash contributions (30%) ~ Other foreign transactions See the Partners Instructions
C Noncash conVdbutions (50%) See the Partners 17. Alternative minimum tax (AMT) items
D Noncash contributions (30%) Instructions A Post-1986 depreciation adjustment
E Capital gain property to a 50%
organization (311%) B Adjusted gain or loss
See the Partners
F Capital gain property (20%) C Depletion (other than oil ~ gas) Instructions and
D Oil, gas, 8 geothermal-gross income tions for
G Contributions (100%) E OII, gas, & geothermal~leductions Form 6251
H Investment interest expense Form 4952, line 1 F Other AMT Items
I Deductions-royalty income Schedule E, line 18 18. Tax-exempt income and nondeductible expenses
J Section 59(ex2) expenditures See the Partners Instructions
K Deductions-portfolio (2~° floor) Schedule A, line 23 A Tax-exempt interest income Form 1040, line 8b
'
L Deductions-portfolio (other) Schedule A, line 28 B Other tax-exempt income s Instructions
See the PaMer
M Amounts paid for medical insurance Schedule A, line 1 or Form 1040, C Nondeductible expenses See the Partners Instructions
19. Distributions
line 29 A Cash and marketable securities
N Educational assistance benefits See the Partner's Instructions B Other property See the Partner's Instructions
O De ndent care benefits
pe Form 2441, line 14 C DisVibution subject to section 737
P Preproductive period expenses See the Partners Instructions
Q Commercial revitalization deduction 20. Other information
A Investment income
Form 4952, line 4a
from rental real estate activities See Form 8582 instructions
' B Investment expenses Form 4952, line 5
R Pensions and IRAs s Instructions
See the Partner C Fuel tax credit information Form 4136
S Reforestation expense deduction See the Partners Instructions
T Domestic production activities D qualified rehabilitation expenditures
(other than rental real estate)
See the Partner's Instructions
information
U Qual'rfied production activities income See Form 8903 instructions
Form 8903, line 7 E Basis of energy property See the Partners Instructions
V Employer's Form W-2 wages Form 8903, line 15
' F Recapture of low-income housing
credit (section 42(jx5))
Form 8611, line 8
W Other deductions s Instructions
See the Partner low-income housing
G
p
14. Self-employment earnings (loss) cedil
(othe~ Form 8611, line 8
Note. Ii you have a section 179 deduction or any partner-level deductions, see H Recapture of investment credit See Form 4255
the Partners instructions before completing Schedule SE. i Recapture of other credits See the Partners Instructions
A Nel earnings (loss) from J Look-back interest-completed
self-employment Schedule SE, Section A or B long-term contracts See Form 8697
B Gross farming or fishing income See the Partners Instructions K Look-back interest-income forecast
method
See Form 8866
C Gross non-farm income
15. Credits See the Partners Instructions L Dispositions of property with
A Low-income housing credit section 179 deductions
(section 42(j)(5)) from pre-2008 M Recapture of section 179 deduction
buildings See the Partners Instructions N Interest expense for corporate
B Low-income housing credit (other) partners
from pre-2008 buildings See the Partner's Instructions O Section 453(1x3) information
C Low-income housing credit (section P Section 453A(c) information See the Partner's
42Qx5)) from post-2007 buildings Form 8586, line 11 Q Section 1260(b) information
R interest allocable to production Instructions
D Low-income housing credit (other) expenditures
from post-2007 buildings Form 8586, line 11 S CCF nonqualified withdrawals
E Oudified rehabililalion ex enditures
P T Depletion information-oil and gas
~
(rental real estate) See the Partner's Instructions U Amortization of reforestation costs
F Other rental real estate credits V Unrelated business taxable income
G Other rental credks W Precontrlbution gain (loss)
H Undistributed capital gains credit Form 1040, line 68; check box a X Other information
I Alcohol and cellulosic biofuel fuels
credit Form 6478, line 9
DAA
PLA21 02!16/2009 2:44 PM
~~ Partner# 12
r se Workshe ~~
Anal sis of Partners K-1, Current Year Increase (Dec ea ) ~~:>~'>?~'~<`<>`~~;>
Y r~
Schedule K-~ ~>~>~~J!~s'%"~?#''
and endin
For calendar ear 2008, or tax ear be innin
Partnership Name Employer Identification Number
Plaza 21 Realt Associates 23-2451898
Partner's Name Taxpayer Identification Number
Estate of Health Z Allen 26-6500860
Items Included in Current Year Increase (Decrease):
Schedule M-2 Subtractions:
Items Included in Current Year Inc (Dec):
Net Income Per Books -1650
Total per Schedule K-1, Current Year Increase {Decrease) -1650
Page 1 of 1
J 0807212527
PA Schedule RK-1 (09-08)
2008 Resident Schedule of
PA S Shareholder/Partner/Beneficiary Pass Through Income, Loss, and Credits
Final N
2665008.60 ESTATE 0~ HEALTH L ALLEN
C/ 0 E L Y S E E R O D G E R S (individual=1, PA S Corp=2, All Other Corp=3, Owners 4
EstatelTrust=4, Partnership=5, LLC=6, Exempt Org.=7)
635 N 12TH STREET 5tockOwnership% ODDDO
Amended N
L E M O Y N E P A 17 0 4 3 Beneficiarys year end Distribution % O O D D D
Partner's % of:
PLAZA 21 REALTY ASSOCIATES Profit sharing OD582
HARRISBURG PA 17102 232451898 Loss sharing D0582
Capital
Fiscal Year N P (EstatelTrust=E, Partnership=P, PA S Corp =S, LLC=L) Ownership 0 0 5 8 2
Y General Partner or LLC Member-Manager N Limited Partner or Other LLC Member
1 PA Taxable Business Income (Loss) from Operations
_ 2 Interest Income
~ 3 Dividend Income
a 4 Net Gain (Loss) from the Sale, Exchange, or Disposition of Property
5 Net Income (Loss) from Rents, Royalties, Patents, and Copyrights
6 Income of/from Estates or Trusts
7 Gambling and Lottery Winnings (Loss)
8 Out of State Credits for Resident Partner or Shareholder. Submit statement
a 9 Total Other Credits. Submit statement.
>_ 10 Distributions of Cash, Marketable Securities, and Property -not including guaranteed payments
m 11 Guaranteed Payments for Capital or Other Services
a 12 All Other Guaranteed Payments for Services Rendered
~ 13 Guaranteed Payments to the Retired Partner
~ 1 A Distributions from PA AAA Liquidating N
a 15 Distributions of Cash, Marketable Securities, and Property
> 16 Nontaxable income or nondeductible expenses required io calculate owner's basis (submit
a supplemenial statement).
Note: Lines 17 through 20 are for information purposes only.
17 Owner's Share of IRC Section 179 allowed according to PA rules
'C
A 18 Owner's Share of Straight-Line Depreciation
a 19 Partner's Share of Nonrecourse liabilities at year-end
20 Partner's Share of Recourse Liabilities at year-end
NOTE: Amounts from this schedule must be reported on the appropriate PA Tax Return.
0807212527
1 0
2 13
3 0
4 D
5 -1650
6 0
7 D
8 0
9 D
10 D
11 0
12 D
13 0
14 0
], 5 D
16 0
17 0
18 D
19 0
20 0
D807212527 J
Page 1 of 1
Elyse E. Rogers
From: Elyse E. Rogers
Sent: Friday, December 12, 2008 9:31 AM
To: 'Jeff Zufelt'
Subject: RE: Heath Allen
Jeff' -
Thanks, you may have sent it out, I just. don't seem to have it.
Elyse
Elyse E. Rogers
Keefer wood Allen & Rahal, LLP
635 North 12th Street
Lemoyne, PA 17043
717-612-5801 direct
71.7-612-5805 fax
This message is intended only for the use of the person to whom it is addressed. It may
contain privileged. and confidential material. If you are not the intended recipient, please
know that the distx•ibution or use of this communication is strictly prohibited. If you have
received this in error, please notify me immediately by reply or by telephone, and delete
this message and all of its attachments immediately. Thank you.
From: Jeff Zufelt [mailto:jzufelt@wilson.edu]
Sent: Friday, December 12, 2008 9:25 AM
To: Elyse E. Rogers
Subject: RE: Heath Allen
Elyse - I am startled that you may not have received written confirmation of this, as
our procedure is to send confirmation with 24 hours of receipt. However, here are the
facts - on October 8th of this year we booked $151,957.33 from the deferred
compensation into our accounts at Wilson.
There actually was a delay here, as the company initially sent us an incorrect
amount, and we returned to them $6,000.
Please accept my apologies that you had to seek this information, and I hope it did
not create too much of an inconvenience for you. I will have written confirmation sent
to you by regular mail today.
Thank you again for your role in making this gift happen. If there is anything else I
can do for you, don't hesitate to ask.
I wish you the best of the season.
Jeff
12/12/2008
Tne~Standard®
Positively differerrt.
August 29, 2008
PERSONAL AND CONFIDENTIAL
Ms. Elyse E. Rogers, Esquire
Keefer Wood Allen & Rahal, LLP
635 North 12th Street, Suite 400
Lemoyne, PA 17043
RE: Keefer Wood Allen & Rahal, LLP 401(k) Plan
Dear Ms. Rogers:
This letter is being sent in response to your request dated August 26, 2008
regarding the account of Heath L. Allen in the above referenced retirement
plan.
Please be advised that the balance of Mr. Allen's account as of the date of his
death, July 29, 2008, was $1,168,382.26.
The beneficiary named for this account is Eleanor Allen, wife of Mr. Allen. She
is named as 100% beneficiary of the account.
In the event of Mrs. Allen's death before the account has been liquidated, Mr.
Allen has named Barbara Allen, Heath Allen II, Martin Allen, and Melissa Smith
as contingent beneficiaries in equal shares.
Please feel free to call if you have any questions or need additional information.
Sincerely,
~~~~
ene Bevan, A, QKA
R tirement Plan Consultant
4550 Lena Drive, Suite 101
Mechanicsburg PA 17055
te1717.591.8900 800.692.6282
fax 717.591.4093
Standard Retirement Services, InC.-NSU0Ytl12ry p1512fIGOtp Pln2fKA21 GfUUp. MK