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HomeMy WebLinkAbout08-12-09 5056041158 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN 21 0 8 12 61 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 211-18-2919 11122008 11191928 Decedent's Last Name SMITHERS Suffix Decedent's First Name DEAN (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix SMITHERS Spouse's Social Security Number 171-28-8985 FILL IN APPROPRIATE BOXES BELOW ^X 1. Original Retum ^ 4. Limited Estate ^X 6. Decedent Died Testate (Attach Copy of Will) ^ 9. Litigation Proceeds Received Spouse's First Name DELORES THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS ^ 2. Supplemental Return ^ 4a. Future Interest Compromise (date of death after 12-12-82) ^ 7. Decedent Maintained a Living Trust (Attach Copy of Trust) ^ 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) MI MI M ^ 3. Remainder Return (date of death prior to 12-13-82) ^ 5. Federal Estate Tax Return Required ~ 8. Total Number of Safe Deposit Boxes ^ 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST f3E COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD f3E DIRECTED TO: Name Daytime Telephone Number LOWELL R. GATES, ESQUIRE 717-731-90 ~ -.. Ca ~"' `" .:3 _. Firm Name (If Applicable) ~ REGISTEROFr LS USE OdL.Y ~~.~ :> , .±~' GATES, HALBRUNER, HATCH & GUISE, P • C • ~ ~ ~~ - - m ~' `-~= - -- ~ First line of address ~ `_~~~ ~ ~ ~ ~ , IU _,, "~" ~ ' `' 1013 M U M M A c; c:-a --~ -- _... ~ . Second line of address . r~ -~ ~ ~ ~ ~ ~' r ` . SUITE 100 ~"' ~~~ ' or Post Office State Cit ZIP Code DATE FILED y LEMOYNE PA 17043 Correspondent's a-mail address: L• G A T E S a~ G A T E S L A W F I R M• C O M Under penalties of perjury, I declaro that I have examined this return, including accompanying schedules and statements, and to the beat of my knowledge and belief, it is true, correct and complete. Declaration of preparor other than the personal representative is based on all information of which preparor has any knowledge. a SIGNATUR ft50~/E FOR F NG RETURrI~~~~~~~~~ DAT~~, /O~ 7 MAR ADDRESS TREET AMP HILL, P T PLEASE USE Side 1 D© 15056041158 6M46473.000 15056041158 Estate of DEAN SMITHERS Executors (Page 1) Name F&M Trust Company Address 3907 Market Street Camp Hill, PA 17011- Tax ID 23-0570230 Name Lisa S. Campbell Address 20 Shippensburg Road East Berlin, PA 17316-9123 Tax ID 163-54-9865 Name Delores M. Smithers Address 5 Alliance Drive Apt. 302 Carlisle, PA 17013- Tax ID 171-28-8985 211-1$-2919 15056042159 REV-1500 EX Decedent's Social Security Number 211-18-2919 o®cedenYs Names M I T H E R S D E A N RECAPITULATION 1. Real estate (Schedule A) 1 • 0 • 0 0 2. Stocks and Bonds (Schedule B) . . 2. 0 • 0 0 3. Closely Held Corporation, Partnership or Sde-Proprietorship (Schedule C) . 3. 0 • 0 0 4. Mortgages 8~ Notes Receivable (Schedule D). . 4. 0 . 0 0 5. Cash, Bank Deposits S Miscellaneous Personal Property (Schedule E) . . 5. 0 • 0 0 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested . 6. 5 8 5 2 5.0 0 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested . 7. 0 • 0 0 8. Total Gross Assets (total Lines 1-7). . 8. 5 8 5 2 5.0 0 9. Funeral Expenses & Administrative Costs (Schedule H) . . 9. 2 4 3 3 6.0 0 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) . 10. 2 5 4.0 0 11. Total Deductions (total Lines 9 8~ 10) . 11. 2 4 5 9 0.0 0 12. Net Value of Estate (Line 8 minus Line 11) 12. 3 3 9 3 5.0 0 13. Charitable and Governmental Bequests/Sec 9113 Tnists for which an election to tax has not been made (Schedule J) • 13• 0 . 0 0 14. Net Value SubJect to Tax (Line 12 minus Line 13) 14. 3 3 9 3 5.0 0 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 15 0 (a)(1.2) X .0 33935.00 . 0.0 16. Amount of Line 14 taxable at lineal rate x .015 0.0 0 16. 0 • 0 0 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17. 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0. 0 0 18. 0. 0 0 19. TAX DUE 19. 0 • 0 0 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15056042159 sMasas2.ooo 15056042159 J REV-1500 EX Page 3 1'lnnerlont'e ~_mm~loto Arirl~occ• File Number ai. nA i.ar...i. DECEDENTS NAME M TH R AN STREET ADDRESS A CITY AR S STATE ZIP Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 0 • 0 0 2. Credits/Payments A. Spousal Poverty Credit 0 • 0 0 B. Prior Payments 0 • 0 0 C. Discount 0 • 0 0 Total Credits (A + B + C) (2) 0 • 0 0 3. Interest/Penalty if applicable D. Interest 0 • 0 0 E. Penalty ~ • ~ ~ Total InteresUPenalty (D + E) (3) 0 • 0 0 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in box 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) 0 • 0 0 A. Enter the interest on the tax due. (5A) 0 • 0 0 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0 • 0 0 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: ^ ^ a. retain the use or income of the property transferred; x b. retain the right to designate who shall use the property transferred or its income; ^ X c. retain a reversionary interest; or ^ X d. receive the promise for life of either payments, benefits or care? ^ X 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 net 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 (0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exemot 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 use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(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) percent, 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 twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 6M4871 1.000 REV-1502 EX + (11-08) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER DEAN SMITHERS 21 08 1261 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the rolevant facts. Real property that Is jointy~owned with right of survfvorehip must be disclosed on Schedule F. swasas 2.00o If more space is needed, insert additional sheets of the same size. REV-1503 EX f (698) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER DEAN SMITHERS 21 08 1261 All property jointly-owned with right of survivorship must be disclosed on Schedule F. 3W4696 1.000 (If more space is needed, insert additional sheets of the same size) REV-1507 EX + (s-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES & NOTES RECENABLE ESTATE OF FILE NUMBER DEAN SMITHERS 21 08 1261 All properly jointly-0wned with right of survivorship must be disclosed on Schedule F. 3wasAC t.ooo (If more space is needed, insert additional sheets of same size) REV-1508 EX + (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, 8c M~SCi. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF FILE NUMBER DEAN SMITHERS 21 08 1261 Include the proceeds of litigation and the date the proceeds were received by the estate. 3W46AD 1.000 (If more space is needed, insert additional sheets of the same size) REV-1509 EX+ (8-98) COIMAONWEA LTH OF f'EIVNSY LVA NIA INHERITA NCE TA X RERJRN RE.SIDB~ff DECEDB~f'f SCHEDULEF JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER DEAN SMITHERS 21 08 1261 If an asset was made Joint within one year of the decedent's date of death, it must be reported on Schedule C~ SURVIVINGJON~fTTENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDEtVT A Smithers, Delores M I5 Alliance Drive, Apt. 302, Carlisle, PA 17013 Surviving Spouse JOINTLY-OWNED PROPERTY: REM NUMBER LETTER FOR JOIN TENANT DATE ~ ~ JOINT DESCR~fION OF PROPH~IY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DvNH~ ROExNU ~BER. ATTACH DEED FOR DATE QF DEATH VALUE OF ASSET % OF DE(`,p'$ AVTEREST DATE OF DEATH - VALUE OF DECEDBVTS NJTI3~EST 1 A 10/16/2006 Members 1st Federal Credit Union Holiday Club Account #41812-02 100 50.0000 50 2 A 5/24/2004 Members 1st Federal Credit Union Savings Account #245230-00 20,913 50.0000 10,456 3 A 6/17/2002 Members 1st Federal Credit a Union Account #41812-11 Checking Account 5,405 50.0000 2,702 4 A 6/17/2002 Members 1st Federal Credit Union Holiday Club Account #41812-02 90,469 50.0000 45,234 5 A 6/17/2002 Members 1st Federal Credit Union Account #41812-00 Savings Account 166 50.0000 83 TOTAL (/~Iso enter on line 6. Recapitulation) I $ 58 , 525 (IF more space is needed, insert additional sheets of the same size) 3W48AE 1.000 REV-1510 EX ~ (Cr98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER DEAN SMI THERS 21 0 8 12 61 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. ITEM NUMBS DESCRIPTION OF PROPERTY INCXLOE THE WWIEDFTFETRANSFEREE, THEIR RELATIONSFAP TO DECEDEMr APA TFE DATE OFTRAIVSFER. ATTPCHACAPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION IF APPI.iCABLE TAXABLE VALUE ~ • None TOTAL (Also enter on line 7, Recapitulation) I $ 0 (If more space is needed, insert additional sheets of the same size) 3W46AF 1.000 REV-1511 EX+(10-06) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER DEAN SMITHERS 21 08 1261 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~. Hoffman-Rothman Funeral Home ~ Crematory, Inc. 9,031 2 Clergy 175 Total from continuation schedules ~ 1,853 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) ~6M Trust Com~ank et al Street Address 3907 Market Street City Came Hill State PA Zip 17011 Year(s) Commission Paid: Waived 2. Attorney Fees 7 , 5 0 0 3. Family Exemption: (If decedent's address is not the same as Gaimant's, attach explanation) 3 500 Claimant Delores M. Smithers Street Address 5 Alliance Drive, Apt. 302 City Carlisle State PA Zip 17013 Relationship of Claimant to Decedent SURVIVING SPOUSE 4. Probate Fees 7 4 5. Accountant's Fees 6. Tax Retum Preparer's Fees 7. 1 Cumberland-Goodwill Fire Rescue 214 2 Cumberland Law Journal - Publication 75 Total from continuation schedules 1,914 7W48AG 1.000 TOTAL (Also enter on line 9, R~ (If more space is needed, insert additional sheets of the same size) 24,336 Estate of: DEAN SMITHERS Schedule H Part 1 (Page 2) 21 08 1261 Item No. Description Amount 3 Pianist 75 4 Soloist 50 5 Funeral Accommodations for family 239 6 Transportation from Chapel Pointe 9 7 Gingrich H. Memorials - Engraving Inscription 130 8 Family Transportation for Funeral 1,350 Total (Carry forward to main schedule) 1,853 Estate of: DEAN SMITHERS Schedule H Part 7 (Page 2) 3 PA Department of Revenue - Estimated fiduciary tax payment 4 F&M Trust Company - monthly fees through 05/22/2009 5 The Sentinel - Legal Publication of Estate Administration 21 08 1261 49 1,529 336 Total (Carry forward to main schedule) 1,914 REV-1512 EX+(12-08) SCHEDULE Pennsylvania DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER DEAN SMZTHERS 21 08 1261 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unn3imbursed medical expenses. 8W46AH 2.000 If more space is needed, insert additional sheets of the same size. REV-1513 EX+(11-08) SCHEDULE J Pennsylvania DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER DEAN SMITHERS 21 08 1261 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS [indude outright spousal distributions, and transfers under Sec. 2116 (a) (1.2).) 1 Eiv'TER DOUL<+R A~~IOL'NTS FOR DISTRIBUTIONS SHOlM~: ABOVE Off! LINES 15 THROUGH ? 8 OF R.EV-? 5Q0 COVER SHEET, AS APPROPRIATE. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 2113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN 1 ~ I See Attached B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 _ TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. ~ S 0 If more space is needed, insert additional sheets of the same size. BW46A1 2.000 Estate of: DEAN SMITHERS Schedule J Part 2A (Page 1) Item No. Description 1 2 3 4 5 Members 1st Federal Credit Union Holiday Account #41812-02 Members 1st Federal Credit Union Savings Account #245230-00 Members 1st Federal Credit Union Checking Account #41812-11 Members 1st Federal Credit Union Savings Account #41812-05 Members 1st Federal Credit Union Savings Account #41812-00 21 08 1261 Amount 50 10,456 2,702 45,234 83 Estate of Dean Smithers Pennsylvania Inheritance Tax Return Form REV-1500 EXHIBIT A Copy of the Certified Death Certificate of the Decedent his is to certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records in accordance with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953. Military Status I.,~~ HtOSt43 REV 11lZ008 TYPE !PRINT IN PERMANENT BtJ1CK INK 0 Z WARNING: It is illegal to duplicate this copy by photostat or photograph. ~' D Frank Yeropoli State Registrar 1641743 No. NOV 2 5 2~ Date COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (See instructions and examples on reverse] STATE FILE NUMBER I. Name d Dacetlam (First, nYddk, ~1, suNrxl 2. Sex 3. Soda) $ecwNy NumbN 4. Date d Deem (tdorKh, day, year) Dean Smithers Male 211 - 18 - 2919 Nov. 12, 2008 8. Age (tut &nhday) llnrfer I year Under I day 6. DNa d Bade (MOnm, day. Year) 7. Birthplace (City and sbk a brags cauwy) Be. Plsce d Deam (Check only one) aroxns Darr tlovs -wxrles HaspNal: Omaf. 81 Yra Nov. 19, 1926 Milroy, PA ^Inpaaerrt ^ERIt7ulpNieM ^DOA ®Nursirrg dome ^Residsraa ^Omer-spedty. ~. Country of Deam &. CN Bao, wp. d Death 8d. FacfNly Name (N red instilulian, ryva least and numbed 9. Was Deeadent d Hispanic Origin? [$ No ^ Vas t 0. Rase: American ardiart, 8bek, WMIe, rllt:. Cumberland Carlisle Chapel Pointe at Carlisle (a yt:. ,p.ay cub.n. M.xican. tirona Rkan. etc) (sP"'"'~ Whit e 11. Decstled's theta tion Kind d work d ente most d lib. Do tell stab 12. wu Deadenl ever M the 73. DepdeM's Ed;uation (SpacNy ordy highest grade cartp btad) t4. Martial Bbtus: Married, Never kbrried, 15. Swvivfng Spo use (N w8a, give maiden name) Ked d Work Kurd dBusiness / Wusay U.S. Armed Faces? Ekmenlary / $ecoMery (0-12) CoNage I t-4 a Sa) WidwRd. Divorced (Sperifyj Manager Telephone Co. ~Y.a ^No 2+ Married Delores Divert 16. Decedent's Ma7irg Address (Baser. city f town. swe, zip coda) 5 Alliance Drive Apt. 302 DactWanl's ad Decadent Atlual Residence iTa. Stale ~1e in e t 7c. ^ Yes, Deadenl Lived'n Twp. Tdwnani ? , Carlisle PA 17013 p "d'® ~a ~asaN~wilMn Carlisle „~~,1, Cumberland D ~ , ~,y~,e u a i 18. Fafhefs Name (First middb, last. suh"a) George I. Smithers 19. Momer'S Name (First, mlddb. maden sternarrre) Mary Catherine Krickbaum 20s. Intamant's Name (Type /Print) 20b. hlorntards MiRng Address (Basel, dT ! bwn, stile, zip coda) Delores Smithers 5 Alliance Dr., Apt.302, Carlisle, PA 17013 2ta. McNnod of Dlsposltltn t ^ Cremation ^ Dorvlon 210. DrNe d Dispoalam (Moriln, daY• YaMI 21c. Place d Disposttbn (Name d cemetery. cramsbry a Omer plea) 21d. Locatkn (City /town. stab. >1P code) ® Burial ^ Removal Irom gate i Was Crematlon a Oonatlon AulMrtzed ^ omen-sP~r 1 byMedk.lExamaMrleeronee? ^vs^No Nov. 15 2008 Mechanicsbur Cemeter Mechanicsbur PA 17055 22aSignakisdFUneral ervic ~ ee(apersonactingassuch) zzb.ticrosetdumber 2zcNameandAedressdFacifry Hoffman-Roth Funeral Home & Crematory, Inc. - _ 18425 219 N. Hanover St., Carlisle, PA 17Q13 Compeb NMns 23ac ordy when cantly"ng 2 7 best d my krtowbdge, de tad N Nre Mtrs a and red. (Signakxe and aNs) 23b. license Number ~ 23c. Oab Signed (Morih, day, year) physkien is not avatlabb at Ime d Oeam ro anNy cause d deem f ~ Ci- / ~ ~'• (_._ ~ ~ Item6 24-28 muss fk competed by Pe'so'r 24. Time d Death 25. PfOnpatd ad (Mmm, dsy, yeNl 28. Was Case Rele~~n,,e//d ro Medea E xamner f Coroner for a Ra Omer than Cremation a Dmaaon7 who prortouices death. Q j7~ A M, / 1 (r/ C/ ^ Yes ~No ~ Approximate inwwt: CAUSE OF DEATN (See ine4uellons end examples) Pan N: Enter dMr '1' 28. ad Trr~o Use CorerihW to Death? Nam 27. Pall I: Enter the t:hain d events -diseases, inNries, a conpigaons - MI drsctly Wuatd tlnt dsatln. DO NOT enter lerrtital events suds as urdac anent, r OnsN Io Deem but not rcsulmg ro dr! underlying cause gi+en h Part I. ~ Yes ^ Probably resprelory anent, w vemrkrAar IipriNNion wnlrarl 6ttowklg 1M Niologyr. list only one cause pr ndt tie. ' , r ^ No Urdutown UIMEp1ATE CAVSE ((Fxra dsease a MM ~~,-, ~.1 r wtdNdn resuNing h rkNh) _~ a. ~ SCE I L L/"'~CJ/.I Ql•yt ~( (~•^~l r•}yr ~~ 29. It Female: ~] Due to la as a mrtsequarta r NN pregwd wlmir pall year nard at time d death ^ P'a SeQuer~Odly kst condhbrrs. it ury. b. k/s.s/i~J ~~ /"'rte-~~-~t O$C.(f~'~[S S / S i ~~'t~~Cs' g ba~np ro the cause kneed on Ise a. Due b (a as a consequence et): r UNDERLYING CAUSE r b E b ~ ^ Not pregnant, but pregnant within 42 days n r e (disease a injury mat iniaated me c ' d m LAST ' d ~ . S P~/~~~r4 JS d deem artg n a ) everus resr Due b (a as a consequence dl: i ^ Nd pregnant. OrA pregnant 43 days l0 1 year betas death d. r unknown it pregrure wihin me past year 30a. Was an Autopsy 300. were Autopsy Findhgs 3 t. Manner d Oeam 32a. Date d t"R'ry (Mordh, day, year) 320. Describe How aMu'Y Ctcurrrtd 32c. Pbee d 1 ''gay Homt, Farm, Street, Factory. ~ Psnormed? Availade Prior to Corrrpkaon d Cause d Dram? ~Nawral ^ Homicide OlFa:e Bui1dug . ek. (Spectly) ^ Yes ~ No ^ Yes it 1 No ' ^ AcddeM ^ Pendng awesNgation 32d. Time d Mpay 32e. Injury at Wont? 321. N Transpatakm aytxy (Bpecilyl ^ P 32g. location d lrMuy (Blreel dry I town. slab) t 2 ^ Sucide ^ Could Nd be Debmfvred ^ Yes Q No edesuian ^ der 7 Operate ^ Passenger M OIMr - Sytsdry: 33a. CarWiw (check only one) 37b. Signs Title of Certiler ~~ • Cenilylrg physkbn (Phrysican ce^.ilying cause d deem wAwn another pnYsicien nos pronouncnd deem ar4 conyMNad Item 23) To the best d my krnowkdge, death occurred due to the cause(s) arM mariner as stated_ _ _ _ _ _ _ _ ------------------------- • Pronouneing and cenltying physician (Physician Dom pronouncing asm and artKyirtg b cause d deem) 33c. Liavue r 33d. Date Sgned (Mmm, day, year) To Ne best d my knowledge, death occunM N Me elms, date, and plea, and due to the cause(s) and mrurcr y stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • Medical Examiner / Laonar dS Q Q .>! ~-- '~ 2 O On the balls d examinatbn and / a bvestigNlon, in my opblon, desN accurrcd at the time, data, and piece, and due to the cause(s) and manner as s1Ne4 ^ 3 Name and ass of Person Who Completed Cause d Death (rem 2>) Type r Pmt A^ 35. Registrar's Sig ~t~.~Oislr,~,p, r L 38 Date Filed (MOmh, daY• year) ! v ' ~ fA1 ~T~ ~~ ~! . r I '~ I 1 I d 1 I I ~ I - ~ .~ , l3 ~ 4~ E~ 7~Z~r ~ ~9ri2fr,~u~ ~°~4 /73 Zo asposNion Permit No. t k~ ~ L~ Estate of Dean Smithers Pennsylvania Inheritance Tax Return Form REV-1500 EXHIBIT B Copy of the Last Will and Testament of Dean Smithers Dated March 11, 2005 LAST WILL AND TESTAMENT OF DEAN SMITHERS I, DEAN SMITHERS, now of 21 Helen Avenue, Mechanicsburg, Cumberland County, Pennsylvania 17055, do publish and declare this to be my Last WiII and Testament, hereby revoking all other prior wills and codicils made by me. FIRST: Family Background and Appointment of Executor. (A) Family and Background Information. I am currently married to DECOKES M. SMITHERS. The children of my previous marriage to MARGARET J. SMITHERS (deceased) are SANDRA K. TERRY and LISA S. CAMPBELL. Throughout this Will, SANDRA K. TERRY and LISA S. CAMPBELL will be referred to as "my children". The word "issue" will include my children as well as my other descendants. (B) Appointment of Executor. I appoint as my Co-Executors (alI hereinafter referred to as Executor or Executor(s) under this Will), the following named persons or corporations to serve without bond and without being required to account to any Court: Executor: DECOKES M. SMITHERS, LISA S. CAMPBELL, and COMMUNITY TRUST COMPANY, now of 3907 Market Street, Camp Hill, Pennsylvania, or the survivor of them to act jointly only. (C) Inter Vivos Trust. The inter vivos trust agreements referred to in this Will are entitled "THE SANDRA K. TERRY TRUST," dated October 24, 2001, by and between myself, DEAN SMITHERS, as Settlor, and COMMUNITY TRUST COMPANY, as Trustee, as now in effect or as may hereafter be amended, and "THE LISA S. CAMPBELL TRUST,"dated October 24, 2001,by and between myself, DEAN SMITHERS, as Settlor, and COMMUNITY TRUST COMPANY, as Trustee, as now in effect or as may hereafter be amended. Any reference throughout this Will to these trusts outlined in this Article FIRST (C), shall obligate the Executor and/or Trustee to divide any assets hereunder into separate and equal shares, with one share being distributed to the Trustee of THE SANDRA K. TERRY TRUST, dated October 24, 2001, and the other share being distributed to the Trustee of THE LISA S. CAMPBELL TRUST, dated October 24, 2001, to be held according to the terms of such Trusts. f ,. ~'~, - __ LAST WILL AND TESTAMENT OF DEAN SMITHERS PAGE 2 SECOND: Funeral and Last Illness Expenses; Taxes. (A} Expenses of Funeral and Last Illness. I direct my Executor to pay my funeral expenses and the expenses of my last illness from my estate. (B) Taxes. I direct my Executor to pay any and all estate, inheritance, succession, legacy, transfer and other death taxes or duties, by whatever name called, including any and all interest and penalties thereon, imposed under the laws of any jurisdiction by reason of my death upon or with respect to any and all property included in my gross estate for the purpose of such taxes, whether such property passes under or outside of this Will. Without any apportionment otherwise required bylaw and without being prorated or apportioned among or charged against the respective devises, legatees, beneficiaries, transferees, or other recipients of any such property or charged against any property passing or which may have passed to any of them, I direct that any taxes so paid shall be charged against my residuary estate. My Executor shall not be entitled to reimbursement for any portion of any such taxes from any such person. The foregoing provisions of this Article SECOND shall not apply to such portion or portions of said taxes, interest and penalties which may be required to be paid, or are. actually paid or reimbursed, by the Trustee of the Trust described in Paragraph FIRST (C), above. THIRD: Tangible Personal Proper .Except for those items excluded below and those items enumerated in the Letter of Instruction, I bequeath all my tangible personal property, including but not limited to clothing, jewelry, heirlooms, furniture, household furnishings, personal effects, motor vehicles, and all other similar articles, which 1 own, and the insurance thereon, to my children, SANDRA K. TERRY and LISA S. CAMPBELL, living at the time of my death, to be divided among them as they may select in as nearly equal shares as is practical, provided, however, that my wife, DECOKES M. SMITHERS, shall retain a life estate in all of my tangible personal property to use at her discretion so long as she chooses, for the rest of her natural life, keeping in mind the remainder interest herein. After the death of my wife, DECOKES M. SMITHERS, my tangible personal property shall be distributed to my children, SANDRA K. TERRY and LISA S. CAMPBELL. My wife, DECOKES M. SMITHERS, may choose to distribute various items of my tangible personal property to my children, SANDRA K. TERRY and LISA S. CAMPBELL, at her discretion, during her lifetime. My wife, DECOKES M. SMITHERS, and I will prepare a separate, signed list of tangible personal property detailing our respective ownership interests therein. This list shall be considered a supplement to this Last WiII and Testament, and shall have the same force and effect as the within document. ~~ _~~ .~~. LAST WILL AND TESTAMENT OF DEAN SMITHERS PAGE 3 Notwithstanding any other provisions in this Article THIRD, I may leave a separate, dated and unsigned Letter of Instruction, which I shall place with my Will, containing directions as to the ultimate disposition of certain of the property bequeathed under this Article THIlZD, and such Letter of Instruction shall determine the distribution of such items. FOURTH: Residuary Estate. (A) I devise and bequeath all of the rest, residue and remainder of my estate, real, personal and mixed, of whatever nature and wherever situated to which I am legally or equitably entitled, in equal shares, to the then-acting Trustee of the Trusts described. in Paragraph FIRST (C) of this Will, to be held, administered and distributed pursuant to the terms thereof, as the same may be amended from time to time. By this devise and bequest of my residuary estate I hereby exercise all Powers of Appointment I possess at the time of my death except any power of appointment which I possess under the Trusts described in Paragraph FIRST (C) of this Will. (B) Upon my death and if I am survived by my wife, DECOKES M. SMITHERS, and provided that we were married at the time of my death, I hereby acknowledge, validate, and institute the letter dated July 30, 2002, exercising the Broad Special Power of Appointment granted tome in Article Seventh (C) of THE MARGARET J. SMITHERS BY-PASS TRUST, u/w. In doing so, I hereby specifically remove the residence and real property known and numbered as 21 Helen Avenue, Mechanicsburg, Pennsylvania 17055, or any subsequent residence purchased by the Trust in its stead, from THE MARGARET J.SMITHERS BY-PASS TRUST, u/w, and direct the same to the Trustee hereinafter named, in trust described in Article FOURTH (B) & (C), for the benefit of the Beneficiary, DECOKES M. SMITHERS, for the following uses and purposes: (1) DECOKES M. SMITHERS shall be permitted to remain and reside at the residence for the rest of her natural life, if she so chooses, or if she is no longer physically and/or mentally able, in the determination of the Trustee. (2) DECOKES M. SMITHERS shall have no ownership rights in the property. (3) Upon the death of DECOKES M. SMITHERS, the residence shall be sold, and the proceeds therefrom shall be distributed, in separate and equal shares, to COMMUNITY TRUST COMPANY, as Trustee for TI3E LISA S. CAMPBELL TRUST and TI3E SANDRA K. TERRY TRUST, respectively, to be administered in accordance with the respective terms thereof. / ~~ ~~ . ~ ~~ LAST WILL AND TESTAMENT OF DEAN SMITHERS PAGE 4 (C} Upon my death and if I am survived by my wife, DECOKES M. SMITHERS, and provided that we were married at the time of my death, and provided further that THE MARGARET J. SMITHERS BY-PASS TRUST owns real estate at the time of my death, I hereby acknowledge, validate, and institute the letter dated July 30, 2002, exercising the Broad Special Power of Appointment granted to me in Article Seventh (C) of THE MARGARET J. SMITHERS BY-PASS TRUST, u/w. In doing so, I hereby specifically appoint one-third (1/3} of the non-real estate principal contained in THE MARGARET J. SMITHERS BY-PASS TRUST, u/w, to the Trustee hereinafter named, in trust described in Article FOURTH (B) & (C), for the benefit of the Beneficiary, DECOKES M. SMITHERS, for her lifetime, together with any other assets received by the Trustee, for the following uses and purposes: (1} This Trust is established for the purpose ofimproving the quality of life ofthe Beneficiary, DECOKES M. SMITHERS, for and during all the term of her natural life. As the result of the natural physical and mental deteriorations of her age and infirmities, the Beneficiary, DECOKES M. SMITHERS, suffers, or may suffer, from substantial mental and physical disabilities and requires additional medical care. She may be entitled to benef t from various governmental programs which provide for her basic or supplemental care. It is the purpose of this Trust to provide the Beneficiary, DECOKES M. SMITHERS, with a higher quality of life beyond that which would be provided by these public entitlement programs and to provide her with a proper funeral and burial. (2) My intent in creating this Trust is that the Trustee use the Trust created herein to promote the happiness, welfare and benefit of the Beneficiary, DECOKES M. SMITHERS, through income and principal distributions, without in any way reducing the services or financial assistance and basic maintenance, support, medical or dental care which the Beneficiary may receive without charge from any local, state or federal government agency or department thereof, and without using any portion of the Trust income or principal to reimburse any local, state or federal government agency or department thereof for basic maintenance, support, medical or dental care received by the Beneficiary. My intent is that the Trust income and principal is not to be considered income, assets, nor resources of the Beneficiary, for any purpose, including but not limited to, the determination of income, assets or resources as stated in any rules or regulations set forth in any local, state or federal government agency or department thereof. In the event the Trustee is requested by any department or agency to release principal or income of the Trust to or on behalf of the Beneficiary to pay for equipment, medication or service which other organizations or ,. -~~ ,~, LAST WILL AND TESTAMENT OF DEAN SMITHERS PAGE 5 agencies are authorized to provide, or in the event the Trustee is requested by any department or agency administering such benefits to petition the Court or any other admuustrative agency for the release of Trust principal or income for this purpose, the Trustee shall deny such request and is directed to defend at the expense of the Trust estate, any contest or other attack of any nature. (3) The Trustee shall distribute to the Beneficiary, DECOKES M. SMITHERS, or expend and apply for her benefit, so much of or all of the income and principal of this Trust, as the Trustee, in its sole and absolute discretion, determines to be advisable for the Beneficiary's special needs for happiness and comfort to achieve the purpose of the Trust herein set forth. The "special needs" which the Trustee may provide to the Beneficiary, DECOKES M. SMITHERS, include but are not limited to spending money, additional food, clothing, gifts on his birthday and major holidays, small appliances that would provide the Beneficiary with entertainment or amusement, computer equipment, camping excursions, vacations, athletic contests, movies, trips, money to purchase appropriate gifts for relatives and friends, any recreational items that would be of use to her and other monetary requirements to enhance her self-esteem or situation. "Special needs" shall also include medical and dental expenses, annual independent check-ups, rehabilitation and physical therapy equipment, programs of training, education, treatment, physical therapy and rehabilitation, private residential care, eye glasses, transportation (including vehicle purchase), maintenance, and insurance (including payment of premiums of insurance on the life of the beneficiary) and other requisites for maintaining the good health, safety, and welfare of the Beneficiary when, in the discretion of the Trustee, such requisites are not being provided by any public agency, office, or department of any state or of the United States. Nothing herein shall preclude the Trustee from purchasing those services and items which promote the Beneficiary's happiness, comfort and welfare. The Trustee shall also have authority in its absolute and sole discretion to make gifts to any community residence in which the Beneficiary may be residing. (4) The Trustee may, in its discretion, use trust principal andlor income for expenses relating to the real estate owned by the trust, including such expenses as real estate taxes, insurance, maintenance and repairs. Any net income not expended for or applied to the special needs of the Beneficiary, DECOKES M. SMITHERS, and/or for the real estate, shall be accumulated and added to the Trust principal. (5) The Trustee shall have no obligation to expend Trust assets for the ~[ .~.~ ~ ~- ~~~~~ LAST WILL AND TESTAMENT OF DEAN SMITHERS PAGE 6 Beneficiary's special needs, but if the Trustee, in its sole discretion, decides to expend Trust assets, under no circumstances should any amounts be paid to, or reimbursed to, the federal government, any state, or any governmental agency for any purpose, including for the care, support, and maintenance of the Beneficiary. This Trust is created expressly for the Beneficiary's extra and supplemental care, maintenance, support and education in addition to, and over and above the benefits he otherwise receives or may receive as a result of handicap or disability, from any local, state or federal government, or from any other private agency, any of which provides service or benefits to persons with disabilities. It is my express purpose that this Trust be used only to supplement other benefits that the Beneficiary may receive. (6) Because the Beneficiary may be dependent on the support and aid of others, the Trustee shall, in the exercise of its best judgement and fiduciary duty, seek support and maintenance for her, or request the guardian of the Beneficiary to seek support and maintenance for her, from all available public resources, including, but not limited to, Social Security Administration benefits, the Supplemental Security Income Program (SSI), any such supplemental income program offered by or through the Commonwealth of Pennsylvania, the Old Age Survivors and Disability Insurance or successor programs, U.S. Civil Service Commission benefits, Medicaid, and Federal Social Security Disability Insurance (SSDI), and any other comparable programs, state, federal, or local. The Trustee shall take into consideration applicable resource and income limitations of any public assistance programs for which the Beneficiary is eligible when determining whether or not to make any discretionary distributions. In carrying out the provisions of this Article, the Trustee shall be mindful of the probable future needs of the remaindermen of this Trust. If necessary, the Trustee may seek appropriate authority to collect, expend, and account for separately all such governmental assistance benefits, but shall not commingle them with these Trust assets. In addition, in making distributions for the special needs of the Benef ciary, the Trustee shall take into consideration the applicable resource limitations of the public assistance programs for which she is or may become eligible. (7) The Trustee shall regard this Trust as existing for the welfare and benefit of the Beneficiary, DECOKES M. SMITHERS. Accordingly, the Trustee shall exercise its discretion as to disbursements and investments with this standard in mind. Consistent with the purpose of this Trust, I may establish a life plan to be periodically updated, signed and dated. It is intended that the Trustee read the life plan and use it as guidance in administering this Trust according to the terms set forth herein. In no event shall the life plan be binding ,,: ~~~:.~ ~~~ - '~ LAST WILL AND TESTAMENT OF DEAN SMITHERS PAGE 7 upon the Trustee or otherwise diminish the Trustee's discretion as described herein. (8) The Trustee shall exercise reasonable diligence. However, the Trustee shall not be liable for any acts or omissions done or performed in good faith. (9) The Trustee shall not be required to make an accounting to any public official except to the extent otherwise required by law. The Trustee shall, however, keep and maintain complete and open accounts of the Trust principal and income and any expenditures from the Trust. Anyone having an interest in the Trust shall have a right to inspect the accounts at reasonable times and with reasonable notice to the Trustee. All discretion conferred on the Trustee shall be absolute and unlimited, and its exercise by the Trustee shall be conclusive and binding on all persons. (1Q) The Trustee shall pay reasonable burial expenses including a suitable and proper grave marker for the Beneficiary, DECOKES M. SMITHERS. (11) Upon the death of the Beneficiary, DECOKES M. SMITHERS, this trust shall terminate. Upon termination, the remaining trust estate shall be distributed as follows: (a) One-half ('/2} of the remaining trust estate shall be distributed to COMMUNITY TRUST COMPANY, as Trustee of THE LISA S. CAMPBELL TRUST, to be administered in accordance with the terms thereof. (b} One-half ('/~} of the remaining trust estate shall be distributed to COMMUNITY TRUST COMPANY, as Trustee of THE SANDRA K. TERRY TRUST, to be administered in accordance with the terms thereof. (D) After taking into consideration the terms of Paragraphs (B) and (C), above, the Trustee is directed to distribute the entire remaining balance of the principal and accrued income of THE MARGARET J. SMITHERS BY-PASS TRUST, u/w, equally between and directly to (1) Community Trust Company, Trustee of THE SANDRA K. TERRY TRUST, dated October 24, 2001; and, (ii}Community Trust Company, Trustee of THE LISA S. CAMPBELL TRUST, dated October 24, 2001, to beheld and administered according to the terms of the Trusts. - ~ ~J~ LAST WILL AND TESTAMENT OF DEAN SMITHERS PAGE 8 FIFTH: Appointment of Trustee and Successor Trustees. (A) Nomination. I nominate, constitute and appoint COMMUNITY TRUST COMPANY, now of 3907 Market Street, Camp Hlll, Pennsylvania 17011, to act as Trustee of all Trusts created by my Will. (B) Compensation. The Trustee shall receive as his compensation for the services performed hereunder that sum of money, based on an hourly charge or percentage rate, which the Trustee normally and customarily charges for performing similar services during the time which he performs these services. (C) Removal of Trustee. A majority of the current beneficiaries may remove a Trustee, at any time or times, with or without cause, upon thirty (30} days' written notice given to the Trustee. Upon the removal of the Trustee, a successor Trustee shall be appointed in accordance with the terms set forth in Paragraph FIFTH (D). (D) Appointment of Successor Trustee. The Trustee may resign at any time upon thirty (30) days' written notice given to the current beneficiary or benef curies (including a beneficiary's natural or legal guardian or legal representative), hereunder. Upon the death, resignation, removal or incapacity of the Trustee, a successor trustee may be appointed by a majority of the current beneficiaries. Any successor trustee shall be a financially sound and competent corporate trustee or my issue. Any successor trustee thus appointed, or, if the Trustee shall merge with or be consolidated with another corporate fiduciary, then such corporate fiduciary, shall succeed to all the duties and to all the powers, including discretionary powers, herein granted to the Trustee. SIXTH: Powers of Trustee and Executor. In addition to the powers and duties as may have been granted elsewhere in this Will, but subject to any limitations stated elsewhere in this Will, the Executor and Trustee shall have and exercise exclusive management and control of the Estate or Trusts, respectively, and shall be vested with the following specific powers and discretion, in addition to the powers as maybe generally conferred from time to time upon them bylaw: (A) In the management, care and disposition of the Trusts or Estate, the Trustee and Executor, respectively, shall have the power to do all things and to execute such instruments, deeds, or other documents as may be deemed necessary or proper, including the following powers, all of which maybe exercised without order of or report to any Court: ,.. ~~ ~' ' LAST WILL AND TESTAMENT OF DEAN SMITHERS PAGE 9 (1) To sell, exchange or otherwise dispose of any property at any time held or acquired hereunder, at public or private sale, for cash or on terms, without advertisement, including the right to lease for any term notwithstanding the period of the Trust, and to grant options, including any option for a period beyond the duration of the Trust; except that, in lieu of any binding shareholder agreement orbuy/sell agreement to the contrary, the Executor and Trustee shall not be permitted to sell the stock or any other ownership interest in any business owned by me, or my spouse, or held in trust, at my death, without first offering the same for sale to my children, or without next offering the same to the corporation or business represented by such ownership interest for redemption. (2) To invest all monies in such stocks, bonds, securities, mortgages, notes, choses in action, real estate or improvements thereon, and any other property as the Trustee or Executor may deem best, without regard to any law now or hereafter enforced limiting investments of f duciaries, except that the Trustee or Executor may not invest in any securities issued by the corporate Trustee or Executor, or issued by a parent or affiliate company of such Trustee or Executor. (3) To retain for investment any property deposited with the Trustee or Executor hereunder; except that the Trustee or Executor may not retain for investment any stock in the corporate Trustee or Executor, or in a parent or affiliate company of such Trustee or Executor. (4) To vote in person or by proxy any corporate stock or other security and to agree to or take any other action in regard to anyreorganization,rnerger, consolidation, liquidation, bankruptcy or other procedure or proceedings affecting any stock, bond, note or other security. (5} To use attorneys, real estate brokers, accountants and other agents, if such employment is deemed necessary or desirable, and to pay reasonable compensation for their services. (6) To compromise, settle or adjust any claim or demand by or against the Trusts or Estate and to agree to any rescission or modification of any contract or agreement affecting the Trusts or Estate. (7) To renew any indebtedness, as well as to borrow money, and to secure the same by mortgaging, pledging or conveying any property of the Trusts or Estate, including the /L ~.~, ~''~S f-~-~~~ LAST WILL AND TESTAMENT OF DEAN SMITHERS PAGE 10 power to borrow from the Trustee at a reasonable rate of interest. (8) To retain and carryon any business in which the Trusts or Estate may acquire an interest, to acquire additional interest in any such business, to agree to the liquidation in kind of any corporation in which the Trusts or Estate may have an interest and to carry on the business thereof, to join with other owners in adopting any form of management for any business or property in which the Trusts or Estate may have an interest, to become or remain a partner, general or limited, in regard to any such business or property and to hold the stock or other securities as an investment, and to employ agents and confer on them authority to manage and operate the business, property or corporation, without liability for the acts of such agent or for any loss, liability or indebtedness of such business if the management is selected or retained with reasonable care. (9) To register any stock, bond or other security in the name of a nominee, without the addition of words indicating that such security is held in a fiduciary capacity, but accurate records shall be maintained showing that such security is a Trust or Estate asset and the Trustee or Executor shall be responsible for the acts of such nominee. (B) Whenever the Trustee or Executor is directed to distribute any Trust principal or Estate assets in fee simple to a person who is then under twenty-f ve (25) years of age, the Trustee or Executor shall be authorized to hold such property in Trust for such person until he/she becomes twenty-five (25) years of age, and in the meantime shall use such part ofthe income and the principal of the Trusts or Estate as the Trustee or Executor, respectively, may deem necessary to provide for the proper support and education of such person. (C) In making distributions from the Trusts or Estate to or for the benefit of any minor or other person under a legal disability, the Trustee or Executor need not require the appointment of a guardian, but shall be authorized to pay or deliver the same to the custodian of such person, to pay or deliver the same to such person without the intervention of a guardian, to pay or deliver the same to a legal guardian of such person if one has already been appointed, or to use the same for the benefit of such person. (D) In the disbursement of the Trusts or Estate and any division into separate trusts or shares, the Trustee or Executor shall be authorized to make the distribution and division in money or in kind, or both, regardless of the basis for income tax purposes of any property distributed or divided in kind, and the distribution and division made and the values established by the Trustee or Executor shall be binding and conclusive on all persons taking hereunder. The Trustee or Executor ~~J , ~ `~ ~~-,J-- `~:`~~~~ LAST VE'ILL AND TESTAMENT OF DEAN SMITHERS PAGE 11 may in malting such distribution or division allot undivided interests in the same property to several trusts or shares. (E) The Trustee and Executor shall be authorized to lend or borrow, including the right to lend to or borrow from any trusts which I may have established during life or by will at an adequate rate of interest and with adequate security, and upon such terms and conditions as the Trustee or Executor shall deem fair and equitable. ()~ The Trustee and Executor shall be authorized to sell or purchase at the fair market value as determined by the Trustee or Executor, any property to or from my estate, the estate of my spouse, or any trust created by me or my spouse during life or by Wiil, even though the same person or corporation may be acting as Executor of my estate or the estate of my spouse or as Trustee of any of my other trusts. (G} The Trustee and Executor shall have discretion to determine whether items should be charged or credited to income or principal or allocated between income and principal as the Trustee or Executor may deem equitable and fair under all the circumstances, including the power to amortize or fail to amortize any part or all of any premium or discount, to treat any part or a1i of the profit resulting from the maturity or sale of any asset, whether purchased. at a premium or at a discount, as income or principal or apportion the same between income and principal, to apportion the sales price of any asset between income and principal, to treat any dividend or other distribution of any investment as income or principal, or apportion the same between income and principal, to charge any expense against income or principal or apportion the same, and to provide or fail to provide a reasonable reserve against depreciation or obsolescence on any assets subject to depreciation or obsolescence, all as the Trustee and Executor may reasonably deem equitable and just under all the circumstances. (~ If at any time the total fair market value of the assets of any trust established or to be established hereunder is so small that the corporate Trustee's annual fee for administering the trust would be the minimum annual fee set forth in the Trustee's regularly published fee schedule then, in effect, the Trustee in its discretion shall be authorized to terminate such trust or to decide not to establish such trust, and in such event the property then held in or to be distributed to such trust shall be distributed to the persons who are then or would be entitled to the income of such trust. If the amount of income to be received by such persons is to be determined in the discretion of the Trustee, then the Trustee shall distribute the property among such of the persons to whom the Trustee is authorized to distribute income, and in such proportions, as the Trustee in its discretion shall determine. r~;~,. Ca-jS -z t LAST WILL AND TESTAMENT OF DEAN SMITIIERS PAGE 12 (I) When the authority and power under this Will are vested in two (2) or more Executors or Trustees, the authority and powers are to be held jointly or individually by the Executors or Trustees, respectively. (~ The Trustees shall be subject to the Uniform Prudent Investor Act (the "UPIA") as if the UPIA had been enacted in the Commonwealth of Pennsylvania in the form promulgated bythe Commission on the Uniform State Laws in its exercise if any power to manage and invest the assets of the trust. The Testator desires that the Executor and Trustees, consistent with the standards of the UPIA, continuously assess the appropriate investment risk tolerance of the trust beneficiaries, and then invest the trust assets seeking the maximum total return at that level of risk. The Testator believes, consistent with modern portfolio theory, that the estate and trust total investment return will be determined primarily by the trust's asset allocation; not market timing or active management in security selection. The Testator believes that the estate and trust should diversify its investments with regard to assets classes and individual securities to avoid uncompensated risk. The Testator does not intend to prohibit the Executor or Trustees from engaging in active management of estate or trust assets where the Executor or Trustees reasonably believe active management can aid in achieving the desired balance between risk and return. The Testator directs that any Executor or Trustee, in managing and investing the assets of the trust estate, establish, in writing, an appropriate investment policy statement. The investment policy statement shall be reviewed and updated at least annually. The Executor and Trustees may retain professional investment counsel of the Executor's and Trustees' choice; provided, however, a counsel so selected shall be either registered as an investment adviser with the U.S. Securities and Exchange Commission or a state chartered or national bank with f duciary powers. If investment counsel is retained, the Executor and Trustees shall abide by the counsel's decision but shall not be held Liable or otherwise surcharged for losses directly attributable to investments made on the investment counsel's advise. While the Executor or Trustees retain investment counsel, the Executor and Trustees shall not be required to review trust investments or take action on trust investments unless the Trustees receive written instructions from investment counsel. The Executor and Trustees shall have the power exercisable in their discretion to discharge such investment counsel and to employ other counsel or to administer the trust without such counsel. Consistent with the standards of the UPIA, the Executor and Trustees shall have the responsibility to prudently select any investment counsel, to periodically review the performance of any investment counsel and to take appropriate action if apprized of facts clearly indicating that counsel is not ~, ~~-s ~~ _ -~ ~~~ LAST WILL AND TESTAMENT OF DEAN SMITHERS PAGE 13 performing competently. The Executors and Trustees shall not be liable to any beneficiary or to any heir for the Executor's or Trustees` acts or failure to act, except for willful misconduct or gross negligence, in directing the investments of the trust. SEVENTH: Rights and Liabilities of Executor and Trustee. (A) No bond or other security shall be required of any Executor. (B) This instrument always shall be construed in favor of the validity of any act or omission by any Executor, and any Executor shall not be liable for any act or omission except in the case of gross negligence, bad faith or fraud. Specifically, in assessing the propriety of any investment, the overall performance of the entire Estate shall be taken into account. (C) Each Executor shall be entitled to receive reasonable compensation for services actually rendered to my estate, in an amount the Executor normally and customarily charges for performing similar services during the time which he/she performs the services. EIGHTH: Tax Elections. (A) In determining the estate, inheritance and income tax liability relating to my Estate, the Executor's decision as to all available tax elections shall be conclusive on all concerned. In accordance with IRC Section 2632(a) and without regard to whether a Federal estate tax return is actually f led, my Executor shall allocate so much of the Federal Generation Skipping Transfer (GST) exemption amount as will fully exempt any generation skipping transfer which may occur under this Will. (B) The Executor may, in its discretion, determine the date as of which my gross estate shall be valued for the purpose of determining the applicable tax payable by reason of my death. (C) The Executor may, in its discretion, decide whether ail or any part of certain deductions shall be taken as income tax deductions (even though they may equal or exceed the taxable income of my estate and whether or not claimed or of benefit on my estate's income tax return) or as estate tax deductions when a choice is available; and in the event that all or any part of such deductions are taken as income tax deductions, no adjustment of income and principal accounts in my estate shall be made as a result of such decisions. -,~. LAST WILL AND TESTAMENT OF DEAN SMITHERS P A C~F 14 NINTH: Spendthrift Provision. No beneficiary shall have the power to anticipate, encumber or transfer his or her interest in the estate in any manner other than by the valid exercise of a power of appointment. No part of the estate shall be liable for or charged with any debts, contracts, liabilities or torts of a beneficiary or subject to seizure or other process by any creditor of a beneficiary. TENTH: Definitions and General Provisions. (A) Survival. Any benef ciary who dies within sixty (60} days after my death shall be considered not to have survived me. (B) Captions. The captions set forth in this Will at the beginning of the various articles hereof are for convenience of reference only and shall not be deemed to define or limit the provisions hereof or to affect in any way their construction and application. (C) Children. As used in this Will, the words "child" and "children" shall include persons who are legally adopted and the issue of said persons, whether born in or out of wedlock, so long as any person born out of wedlock is acknowledged in a written instrument executed by the one of their natural parents who is a descendant of mine to be the child of said descendant. The word "issue" shall include descendants of all generations including adopted persons. A posthumous child shall be considered as living at the death of his parent. The birth to me or the adoption by me of a child or children subsequent to the execution of this Will shall not operate to revoke this Will. (D) Code. Unless otherwise stated, all references in my Will to section and chapter numbers are to those of the Internal Revenue Code of 1986, as amended, or the corresponding provisions of any subsequent federal tax la~~~s applicable to my estate. (E) Other terms. The use of any gender includes the other genders, and the use of either the singular or the plural includes the other. (F) Powers of Appointment are Exercised. By this Will I exercise any and all Powers of Appointment which I possess at the time of my death except any power of appointment which I possess under the Trust described in Paragraph FIRST (C), above. A~ f i ~-1 ---",~ LAST WILL AND TESTAMENT OF DEAN SMITHERS PAGE 15 IN WITNESS WHEREOF, I, DEAN SMITHERS, the Testator, have to this my Last Will and Testament, typewritten on sixteen (16}pages, including the Acknowledgment and Affidavit, set my hand and seal this ~ day of March, 20QS. ;~ -~_ DEAN SMITHERS Signed, sealed, published and declared by the above-named Testator, as and for his Last Will and Testament, in the presence of us, who have hereunto subscribed our names at his request, as witnesses hereto, in the presence of the said Testator, and in the presence of each other. Each of us further declares that he or she believes the Testator to be of sound mind and memory. The preceding instrument consists of this and fifteen (15) other consecutively numbered typewritten pages including the Acknowledgment and Aff davit. ~ ~ ~~ ~. t C~=~ U ~ J ~ ~~L !C_ (print ame) residing at - ~~ -1S ~u ~- ~ ~~ ' -~ residing at ~`Lg.~.~ct.: ~,~,:-e ~~.t .L~,, , '~'~ (print name) ACKNOWLEDGMENT AND AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS: The Testator and the witnesses whose names are signed and subscribed to the attached or foregoing instrument, being first duly sworn and qualified according to law, do hereby acknowledge, depose and say to the undersigned authority, that the Testator signed and executed the instrument as his Last Will in the presence of the witnesses; that he signed it willingly or willingly directed another to sign it for him; that he executed it as his free and voluntary act for the purposes therein expressed; that each of the witnesses were present and saw the Testator sign and execute the instrument as his Last Will; that each subscribing witness in the hearing and sight of the Testator 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. ~~~G"2v ~ . _ lc' t ~~ ~' Testator i ~ '~--'~ ;r, ~ C? ~~~~ Witness ~r 1C~.•~-~"~;- L~'~- ;iii -`t`1 - '~'~t C, ~. t-~ Witness Sworn to or affirmed, subscribed to, and acknowledged, before me by the above-named Testator and witnesses, this ~ t ~'` day of March, 2005. Notary Public My Commission Expires: ~if;~jj_-'; f;; . f ~ ~ 4~ ~-~~~~~IC ~~~ruyr~e B~-~;p, i u~'tz~~~t~~sC~ t; .'V ~-.r~rr., , -c;s;~lrt FXuf~~: /=;~ ~%t. 27, 2Gt~}6 :Y;w~-~;i:~ .=~SS~1i;i2tlf}(i (~ i`•10~3fiG-'S Estate of Dean Smithers Pennsylvania Inheritance Tax Return Form REV-1500 EXHIBIT C Copy of the Short Certificate Letters Testamentary issued on January 16, 2009 REGISTER OF WILLS CUMBERLAND COUNTY PENNSYLVANIA No . 2008- O ~ 26 ~ Estate Of : DEAN SM/THERS CERTIFICATE OF GRANT OF LETTERS PA No . 21- 08- 1261 /First, Midd/e, Last) Late Of : CARLISLE BOROUGH CUMBERLAND COUNTY Deceased Social Security No : 211-18-2919 WHEREAS, on the 16th day of January 2009 an instrument dated March 11th 2005 was admitted to probate as the last will of DEAN SMITHERS (First Midd/e, Lasil late of CARL/SLE BOROUGH, CUMBERLAND County, who died on the 12th day of November 2 0 08 and WHEREAS, a true copy of the wi I1 as probated i s annexed hereto . THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wi11s in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: F & M TRUST COMPANY and DEL ORES M SMI THERS and L7S~ S CAMPBELL who have duly qualified as EXECUTOR(R/X) and have agreed to administer the estate according to I aw, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, rn ~r r$LE PCPrn~~vt -i~~n~ IiHI ILr , L V/{r i L Y. .VIi"t. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 16th day of January 2009. * *NOTE* * ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) Estate of Dean Smithers Pennsylvania Inheritance Tax Return Form REV-1500 EXHIBIT D Documentation of Assets st 0 MEMBERS 1St FEDERAL CREDIT UNION Primary owner: Delores Smithers SAVINGS ACCOUNT: Account Number/Suffix 41812-00 245230-00 Date Account Established 01/22/1985 05/24/2004 Principal Balance at Date of Death $165.82 $20,912.63 Accrued Interest to Date of Death v $.04 ~ $6.30 Total Principal and Accrued Interest $165.86 $20,918.93 Name of Joint Owner Delores Smithers Dean Smithers Date Joint Ownership Established 06/17/2002 05/24/2004 CHECKING ACCOUNT: Account Number/Suffix 41812-11 Date Account Established 01!22/1985 Principal Balance at Date of Death $5,404.78 Accrued Interest to Date of Death / $.41 Total Principal and Accrued Interest $5,405.19 Name of Joint Owner Delores Smithers Date Joint Ownership Established 06/17/2002 INVESTMENT SAVINGS ACCOUNT: Account Number/Suffix 41812-05 ~ Date Account Established 10/01/1985 Principal Balance at Date of Death $90,468.72 Accrued Interest to Date of Death $42.31 Total Principal and Accrued Interest $90,511.03 Name of Joint Owner Delores Smithers Date Joint Ownership Established 06/17/2002 HOLIDAY CLUB ACCOUNT: Account Number/Suffix 41812-02 Date Account Established 10/16/2006 Principal Balance at Date of Death ~°'~ $100.04 Accrued Interest to Date of Death $.03 Total Principal and Accrued Interest $100.07 Name of Joint Owner Delores Smithers Date Joint Ownership Established 10/16/2006 VISA ACCOUNT: Account Number 4121449998418128 Date Account Established 12/15!1993 Balance on Date of Death $39.87 Joint Cardholder None Authorized User Delores Smithers LOAN ACCOUNT: Account Number/Suffix 41812-01 Date Loan Established 12/19/1986 Principal Balance at Date of Death $.00 Loan Type Personal Service Loan Name of Co-Borrower None M AifIBERS 1ST FEDERA CRE I UNION l ~. ~ ~-- Danielle Insurance Services Specialist July 2, 2009 Estate of: DEAN SMITHERS Date of Death: November 12, 2008 Social Security Number: 211-18-2919 5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283-2328 www.memberslst.org Estate of Dean Smithers Pennsylvania Inheritance Tax Return Form REV-1500 EXHIBIT E Documentation of Expenses Hoffman-Roth Funeral Home & Crematory, Inc. 219 North Hanover Street Carlisle, PA 17013 (717)243-451 1 November 18, 2008 Delores M. Smithers 5 Alliance Drive, Apt 302 Carlisle, PA 17013 The Funeral Service for Dean Smithers 15467-245 We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please feel free to contact us if you have any questions in regard to this statement. THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT, AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS. OUR SERVICE: Traditional Funeral Service Package $4150.00 FUNERAL HOME SERVICE CHARGES $4150.00 SELECTED MERCHANDISE: Whitmire ll Casket . . . . . . . . . . . . . . . . . . . . . . . Monarch Interment Receptacle , _ . THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE THAT YOU HAVE SELECTED Cash Advances Opening Grave-charged by the cemetery _ , Newspaper Obituary Notice- Sentinel , _ . Newspaper Obituary Notice -Patriot News _ . Certified Copies of Death Certificates , Flowers . TOTAL CASH ADVANCES AND SPECIAL CHARGES . Total Total Cost History 11 / 18/2008 Delores Smithers TOTAL AMOUNT DUE . 'his statement is net and payable in full within 30 days of receipt. $2270.00 $1120.00 $7540.00 $860.00 '~` 146.5 ~'_L~~"~- ~; ! ~`` '~ ~, 307.9 ~'- ; t' ~ $18.00 $159.00 $1491.46 $9031.46 $-8477. ~0 ~~"51],' .- t:_ ~~ i .. , ,~~,./'/ 1 ~ ~,~1 ~ ~, ~ ~ tL i v c . ~.,=~, Estate of Dean Smithers Date of Death: 11/12/2008 Funeral & Administration Expenses to be reimbursed to Delores M. Smithers Hoffinan-Rothman Funeral Home & Crematory, Inc. $ 9,031.46 Ministers 175.00 Pianist 75.00 Soloist 50.00 Funeral Accommodations (family) 239.10 Chapel Pointe -Transportation 9.00 Cumberland-Goodwill FireRescue - 214.00 Cumberland County Register of Wills 74.00 Total $ 9,867.56 • ~. v ~ O'J~ Funeral Services ~ ~~ ,. ~nc~exec~• ~j t'a;, HECK # ~ •.~ `~ CREDIT CARD ^ OTHER /1%CLI~ ! = FE``Q~~EAATED LAST BALANCE $ `"~;'° ~ ~~ ' ~MER~ ~y~, `~' ^ INTEREST ~ G,~ r ,y-"" ~'`°` ~ LATE PAYMENT '+r• C AR y rl ~ ~ ~Jyr ,~,. i"" SUB TOTAL ~4 ~ x Name of Deceased CREDITS _ ~,/ C~ LESS PAYMENT • ~ ~ ~ ..~ Funeral Home Bc Crematory, Inc. ~ "'"-~° - -- C.f ti 1 ~ 1~n --~- .~- NEW BALANCE $ `~~ T. _i :~- ~ ~ ' ' - vaa~~~ri~.^^u~~a,a-VVVlirrr~~ ~ ~~CI\CJ1..UC PO BOX 12910 PNILA, PA 19176-0910 Phone #: (800 367-0512 Federal Tax IQ: 23-2298422 DEAN SMITHERS 10732 WCS CGT0804697 NONE MEDICARE B 211182919A 10/21/2008 UNITED HEALTH CARE - [ 975533797 CGT0804697 DEAN SMITHERS 770 S HANOVER ST CARLISLE, PA 17013 CHAPEL POINTE 1 DUNWOOD DR DOCTOR'S APPOINTMENT INVALID COACH TX ROUNDTRIP AU999 1.0 130.00 130.00 MILEAGE A0999 6.0 1.75 10.50 ~. ~. ~. ~ ,l `~ +t r'i Total Charges 140.50 Total Credits U.OU $140.50 ~~~ `` Po Box 12910 ---~ ~--3~ ~^ ~ ~- =~ PHILA, PA 19176-09'{ 0 Phone #: (800} 367-0512 Federal Tax ID: 23-2298422 _~~, -. 1.-..~,J~: DEAN SMITHERS '• ~ _ , ~ ; ~ "...-~ . 10732 WCS ~~=- ~ • ~ ~ CGT0804462 NONE t-~, . _: MEDICARE B 211182919A ~ -~ -~-~ 10/07/2008 UNITED HEALTH CARE - [ 975533797 ~ `~ _ - .- CGTO8O4462 - CARLISLE REGIONAL MEDICAL CTR - - ~ CHAPEL POINTE DEAN SMITHERS .. -;. 770 S HANOVER ST ;~~ ~~~~~~``~`'```~ FRACTURE -HIP CARLISLE, PA 17013 t=°:~ ~' INVALID COACH TX 1 WAY MILEAGE 70:00 1.75 70.00 3.50 T~*.a! Credits 4.00 ., ._ .. - - - $73.50 --~~ RECEIPT FOR PAYMENT GLENDA FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17613 SMITHERS DEAN Receipt Date: 12/17/2008 Receipt Time: 14:56:12 Receipt No.: 1055110 Estate File No.: 2008-01261 Paid By Remarks: DELORES M SMITHERS AJW ------------------------ Receipt Distribution ----- Fee/Tax Description Payment Amount Payee Name PETITION LTRS TEST 20.00 CUMBERLAND COUNTY GENERAL FUN WILL 15.00 CUMBERLAND COUNTY GENERAL FUN SHORT CERTIFICATE 24.00 CUMBERLAND COUNTY GENERAL FUN JCP FEE 10.00 BUREAU OF RECEIPTS & CNTR M.D AUTOMATION FEE 5.00 CUMBERLAND COUNTY GENERAL FUN ---- Check# 5546 ----------- $74.00 - Total Received......... $74.00 ~.~ r~ SLEEP INN (PA055j Account: PA055 - 273331 ' ~~~' ,,, ,';~~ 5 EAST GARLAND DRIVE Date: 11/17/08 CARLISLE, PA i 701:1 USA Page: 1 of 1 Phone: (717) 249-8863 Room: 306 S3A Fax: (717) 249-8893 Arrival Date: 11 /14/08 17:38 gm.PA055@choicehotels.com veparture Daie: 11! i 7/08 09:43 Frequent Traveler ID: You were checked out by: EP `fou were G-~ecked in by: RD DIVEN, FRED 14555 93RD ST FELLSMERE, F L 32948 US Post Date Description Comment Amount 11 /14/08 ROOM CHARGE #306 DIVEN, FRED 71 99 11/14!08 SAFE W/LIMITED WARRANTY SAFE W/LIMITED WARRANTY 1.50 i 1 /14108 STATE TAX STATE TAX 4.41 11/14/08 OCCUPANCY TAX OCCUPANCY TAX 1.R0 11/15/08 ROOM CHARGE #306 DIVEN, FRED 71 99 11/15/08 SAFE W/LIMITED WARRANTY SAFE W/LIMITED WARRANTY 1.50 11 /15/08 STATE TAX STATE TAX 4.41 11!15!08 OCCUPANCY TAX OCCUPANCY TAX i 80 11/1F/l111 . .. ., C~vnnn vunovC ... ~ ~7nc ni~icni rncn .,,,., ~~.~.., ~ ~.~~ 7i.y9 11/16/08 SAFE W/LIMITED WARRANTY SAFE W/LIMITED WARRANTY 1.50 11 /16/08 STATE TAX STATE TAX 4.41 11 /16/08 OCCUPANCY TAX OCCUPANCY TAX 1.80 11/17108 VISA PAYMENT VISA PAYMENT -239.10 Acct: ""'""""""R128 Balance Due: O.OC If payment by credit card, I agree to pay the above total charge amount according to the card issuer agreement. ff paying by debit card, I understand that a hold may be placed against my checking account funds for up to 30 days, according to varying credit card issuers. x SLEEP INN (PA055j i 5 EAST GARLAND DRIVE CARLISLE, PA 17013 USA F.. .:, , : ~ _ :; r. - :~:. Phone: (717) 249-8863 Fax: (717) 249-8893 Room: 306 Arrival Date: 11/14/08 Departure Date: 11/17/08 Account: PA055 - 273831 Frequent Traveler ID: Approval Number: 685278 Card Type: VI Date: 11 /17/2008 Card Number: """'""""'8128 Total: 239.10 ~~~. If payment by credit card, I agree to pay the above total charge amount according to FRED DIVEN the card issuer agreement. If paying by debit card, I understand that a hold may be 14555 93RD ST placed against my checking account funds for up to 30 days, according to varying credit card issuers. FELLSMERE, FL 32948 US x Thank you for your business! Book your next reservation on choicehotels.com for the best Internet rates guaranteed. { ~ p ~~~~4/ ": at Carlisle ??0 S. HP.~lOVER. STREET, GaRL-SLE, PA 17(113 ~~~ ~~~ ~~ ~~~ Mr. Dean Smithers Delores Smithers 5 Alliance Dr., Apt. 302 Carlisle, PA 17013 . ~PI ~~ ~~ ~ . ,~ -~~., "1 DETACH AND RETURN THIS PORTION WITH YOUR REMITTANCE Form PB-01 QUESTIONS? CALL: (717) 249--1363 RESIDENT # UNIT STMT. DATE 13047 H-IO-B 12/01/2008 RESIDENT S Mi-. Dean Smithers TOTAL AMOUNT DUE $9.00 DATE DUE Upon Receipt ~ ~ ~~~~ AMOUNT REMITTED DATE DESGRiPTION iay~/ Units CHARGES CREDITS BALANCE Balance Forward 19.00 11/04/2008 Payment -Thank You!! 19.00 0.00 10/29/2008 Transportation ~,~~, ~1 J ~ ~~^ ~ 4 9.OU 9.00 ter. v,cxery ~ ~-~ e - ~ ~~G~~~ ~~ ~ ~~ ~ Grey. ~ ~'E p L.>ri ~r ~...F C bb ~~~ • ~ G. ~ RESIDENT # CURRENT OVER 30 OVER 60 OVER 90 OVER 120 TOTAL ANtOUNT DUE 13047 9.00 0.00 0.00 0.00 0.00 X9.00 REclnEnrr ~~nn~~ ris „t2 c ;th,,..,. FormPB-01 V I V I V I 1 v~l L_ lrlr. DGAn /Jlijl Gi a CHAPEL POINTE AT CARLISLE, 770 S. HANOVER STREET, CARLISLE, PA 17013 PROOF OF PUBLICATION State of Pennsylvania, County of Cumberland Lames Kleinklaus, Advertising Director, of The Sentinel, of the County and State aforesaid, being duly sworn, deposes and says that THE SENTINEL, a newspaper of general circulation in the Borough of Carlisle, County and State aforesaid, was established December 13~, 1881, since which date THE SENTINEL has been regularly issued in said County, and that the printed notice or publication attached hereto is exactly the same as was printed and published in the regular editions and issues of THE SENTINEL on the following days}: February 4, 2009, February 11, and February 18, 2009 COPY OF NOTICE OF PUBLICATION NOTICE LETTERS TESTAMENTARY for the Estate of DEAN SfiA1THERSr deceased, date of the Borough of Carlisle, Cumberland County, Pennsylvania,: having, been granted to the undersigned on January 16, 2009;.. ' All persons indebted to the Estate are requested to make; immediate payment and~those having.. claim's against the Estata are requested fo present thgm` for settlement without delay to: F & M Trust Company, Co-Executor 39Q7 Market Street Camp. Hill, PA 17011 Delores M. Smithers, Co-Executrix 5 Alliance Drive, Apt. 302 Carlisle, PA 17013 Lisa S. Campbell, Co-Executrix 20 Shippensburg Road East Berlin, PA 17316-91 ~3 Or To: LOWELL R. GATES, ESQUIRE Gates, Halbruner 8~ Hatch, P.C. 1013 Mumma Road, Suite 100 Lemoyne, PA 17043 Affiant further deposes that he/she is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statement as to time, place and character of publica~re true. Sworn to and subscribed before me this ~ ~ ~~ ~oa~ . . t! ~ Notary Public My commission expires: t«?MM~MWIAL"fH dF PENNSYLVANIA NOTARIAL SEAL BAMBI ANN HECKENCQRN, Notary Public Camp HiII Baro., Cumberland County My Commission Expires Janua 27, 2010 i ?~ ~,y ~ ~ ~'; ~ ~; CUMBERLAND LAW JOURNAL 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 Tele: (717) 248-3166 Fax: (717) 249-2663 February 13, 2009 Cumberland Law Journal is published every Friday by the Cumberland County Bar Association and is designated by the Court of Common Pleas as the official legal publication for Cumberland County and the legal newspaper for publication of legal notices. TO: Lowell R. Gates, Esquire Dean Smithers Estate RE: Legal advertisements must be received by Friday Noon. All legal advertising must be paid in advance. Make all checks payable to: Cumberland Law Journal. Advertisement inserted on the following dates: January 30, February 6, and February 13, 2009 Advertising Cost $ 75.00 Proof of Publication $ 0.00 Second Proof Request $ 0.00 Payment received $ 0 .00 Total Amount Due $ 75.00 Payment received by PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16, 1929), P. L.1784 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss. Lisa Marie Coyne, Esquire, Editor of the Cumberland Law Journal, of the County and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid, was established January 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly issued weekly in the said County, and that the printed notice or publication attached hereto is exactly the same as was printed in the regular editions and issues of the said Cumberland Law Journal on the following dates, V1Z: January 30, February 6, and February 13, 2009 Affiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. ~~ Lis arie Coyne, Editor SWORN TO AND SUBSCRIBED before me this 13 day of February, 2009 ~' Notary Smithers, Dean, deed. Late of the Borough of Carlisle . Co-Executors: F&M Trust Com- pany, 3907 Market Street, Camp Hill, PA 17011, Delores M. Smith- ers, 5 Alliance Drive, Apt. 302, Carlisle, PA 17013 and Lisa S NOTtiRi/~•L SEAL . Campbell, 20 Shippensburg Road ~E60l7AH A CCLLINS , East Berlin, PA 17316-9123. Nciary Public Attorneys: Lowell R. 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