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HomeMy WebLinkAbout02-0235GENERAL POWER OP ATTORNEY I, LESTER W. FLEISHER, dO hereby apDoint my sister, ARLENE A. FLEISHER, as my attorney-in-fact with power to transact any business at all in my name as though I myself were acting. This ~?ower includes, but is not limited to, th~ following: 1. To write checks, and to execute and deliver payment and withdrawal orders on any acco~qts that I may have with any bank or other similar institution, and to deliver the checks or money paid or withdrawn to any person, ~roup of persons, or associations; and to endorse check~ or other instruments for deposit or collection; 2. To take ail lawful steps to recover, collect and receive any amounts of m~ney now or hereafter owing or payable to me, and to compromise and execute raleases or other sufficient discharges for them; trust; To withdra%4 and receivu the income or corpus of any benefit; 4. To sue and settle suits of any kind in my name or for my 5. To buy, sell, mortgage, hypothecate, or grant security interests in any kind of tangible or intangible Dersonal proDerty; 6. To sign, assign or endorse any security issuud by any corDoration, bank or other organization and to exercise any rights with respect thereto that I may h~ve~ 7. To lease, sell, release, convey, extinguish or mortgage any interest in real property on such terms as may be deemed advisable; and to manage, repair, improve, maintain, restore, build or develop such property; 8. To purchase or otherwise acquire any interest in and acquire possession of real property and to accept all deeds and other assurances in the law for such I)roperty; ARNOLD & SLIKE, ATTORNEYS-AT-LAW, 2109 MARKET STREET, CAMP HILL, PA 17011 ~. Ta sQxs~CUtrS, deliver and acknowledge dads, deeds of trust, oovenants~, indentures, agree®nts, r€~rt~aq~~s, hy~tbeoat~.Qn~, ~sil~.s of lad~,nc~, balls, ~a+ands, n©tes, receipts, evid,~naas of +debts, 1•e?llf3StSs3r<3 seed stzti.si~actisans t,~f ~tortg8ga, ~ud.c~merlt, ground runts and rather debts; ~.~?. Tca enter my safe d.eptasit bscaxes and tca seen new safe ~la~ac~sit boxes, and to as3c1 to ar r~saove any of the contsents of gray such ~cafsv de~aosit boxe~+, and to cls~sa cant any of they ~aoxaa, lI. `I'a r~c-rraw money far rry zreccaunt can ~~r,atevez tearttts and c:onr~itians ~ra~ rae ~:ie~s~mec~ ac3visa}.'la, including the right to borrow ~aoney can a1a~v irrsurarrce *acalicies issued ors my life for arry ~ur~acase~, and to ~sledga, ~a~sigrr anri s3e2iti-er such. '~t3licisr~ as securit~r, .12. Tc~ ~ra~~are, exa+vute and file all tax returns requiredE tra be mace lay ri1e~, tc~ pey tare taxers due, tt3 ro3,lect any rr3funds, to r~3.gzi ~raivers eacteardirac t?xe pe~rior3 for the a~sessmRrrt ~f such texas ar d>eficienrias in th€am, to gigxr conresrts to the imr±~+ediate assassx~tent of deficiencies and acceptaxrces of ~ra~casc~d a~rc~rass~ssrnc~nts: to e~xeaute +vlvging ac~xaents, ansl to eargaQe arac~ aa~?ne~int atts~rns~ys tca rs~prs~-wtI<3nt Ise iai acannectisan with and matters aris~.nc~ h~efar~~ env fe~:era~., state or local taxing agency; " 13. ~xa di~c~.a.il~ arrv irxterest ir3 r?r>~»~~rt~, ~~xnd to clam. an elective share of ~:tr~: estate of my dec:eaaed., sx~causc~:; 14. 'bra rensaurrce fiduciary ~asitiana: 15. Tcj arrange for rnY entrance t4 as-rd dare at gray :xos~aital, nursing home, health center, conval+e;ace~.lt hcame, ret3.rer~ent home, ar similar izrstitutican, arzci to arrange for, cansant ta, ~a~.ive and tsaratainatse any and all medical and. surgical pracadures on my behalf, including the ainistratican +~f dru«s, and to ~~av all hills far zny Gsr~,F 26, ~+a create a trust fr~r xny benrrf~.t ante to nzak~s ~-dc~itions tea an +existing trust for my benefit, Tf mgr attcarnagr--~.n~-fact named a~v® shall be or b+eccaane unab3.e ©r urrr>:illing tca serve or tca coratixrua to serve, then I a~apdint in :aer ,Mead ran as her suca~iascar zny sister, Eva P. T'leishar. ~ub~ect to the foregoing, T authorise :nv attorney--in--fact t4 appo~.xat a substitut+s ar ARNOLD & SLIKE, ATTORNEYS-AT-LAW, 2109 MARKET STREET, CAMP HILL, PA 17011 success©r tc~ act as attorney-ixz-fact with the saw powers as though named by me irz this Power of Attorney. I do hereby r~.tii'y and confirm a.I1 that any a.tt4rney-in-fact and a eu~astitute or s-uccrossor shall lawfully do, or cause to be done, bey virtue 4f t~zis Power c,f ~:ktc~rn~sy. ~'li~.s nnwt¢~r of .~~ttc~rrzc~y s?~all not bP affc~cte~. t1y my pPzysical or n~entsl rlis~a~~ilit~l or incapacity ar 1-.~y uncertainty ~:~ to whether T am ttea~ or~ alive, anr~ it may k:e accepted anc~ rel.ic~ u~~n by any©ne to r~rhnri it is Paresentec~ urtil such parson wither (i) rgc:z~ives written notice of rwv©cati.an ~.~;~ ma or a ruardi~n Cor similar fiauciary) of my ¢:staLe, or (ii) ~:zas r~c,tu~l know2ecic~e of r.^y c?eatlz. ~4y s ~~orrn~T_~.:~-f~ut ,hall ~:,~: erlYi~:3.e~~3 to rea~ona~~~.:~ cor~aaensatian i~car services performed ~Iereunciur, ~~~ ~~ITPd~SS ~1~I~:~'.Ta~~F, azzd it~ztend.isz~ i:n 'rye ~.s~a~.l,r ~x~une~ ~iere.by, ~ ~ 1 ;have signed this Pflwer of Attorney this ._.._._..._..~._ ".~' ;~~~~"~ ~~ day of 'WI'TN~:SS ;, Luster tit. ~° e s er ~` , ,, ,~'? ~ ARNOLD & SLIKE, ATTORNEYS-AT-LAW, 2109 MARKET STREET, CAMP HILL, PA 170!1 C~C:~ALT~i €}F Prr~3~CLVAYdI~? ~S. Cat7~t~'Y ®F CU~~RL~iNI~ D O ~n t~ti~, the ~/ ,~,,,_ ~.ay of 19~5r b~s~or~ +, #:Iz~ uFxcieraic~s~~cl ©f~ic~r, ~~r.ac+nally ~~~a~ar~d LLST~R ~~t. FLTT~~iER, ltx7fltrfT1 #~c~ m~ {ar s~t~.s~'act©ri j2~r z~rcav~n) tc~ 3a~ tkz~ r~~rsnn~.q~yl•-r~s~: ~a..m}e~ i>;~ t• d,,~ .~Lti +.~Gr~S.~~C~ L~} :'.~'t~' ~T.i. i+Ei ITL .~I. I~St~r I~S~~.I~t / n~..:1~. t~Ci.M\T~..CI~Vi~l.i~'~~ ~L"A e.'~ L Sim.. ~•X.~~iwt~i[ ith~ same fc~r tCie Aaur~?o~~s therein ~ozat~in~d. Z~ t~'I~„~~5~ '~d~iE~`..~;U~`, ~ x~avt~ 3~e~r~:unt~ yet :ny h%~n~ ~°znc3 ~a~fic4.ai seal. j ~~ ~~ Caatarv public rHEtMA S. McCAUSCIN, NOTARY PUBC(C MY Commission Expires July 3, JJ~d . Camp Hill, pq Cumberland County ~._ ~._< ARNOLD & SLIKE, ATTORNEYS-AT-LAW, 2109 MARKET STREET, CAMP HILL, PA 170! 1 .-.J REV-1500 EX(06-05) P A Department of Revenue Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 15056041103 OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT d.. \ 6~ b~~~ ENTER DECEDENT INFORMATION BELOW Social Securi!Y Number Date of Death 703-07-1354 04032007 Date of Birth 10031920 Decedent's Last Name LESTER W. Suffix Decedent's First Name FLEISHER MI (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW D 1. Original Return o 4. Limited Estate D 6. Decedent Died Testate (Attach Copy of Will) D 9. Litigation Proceeds Received Supplemental Return D D 3. Remainder Return (date of death prior to 12-13-82) Future Interest Compromise (date of death after 12-12-82) Decedent Maintained a Living Trust (Attach Copy ofTrust) Spousal Poverty Credit (date of death D 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number BRYAN S. BREIDIGAM 717-520-1105 o 2. 04a. [!] 7. 010. 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes Firm Name (If Applicable) HERSHEY TRUST COMPANY REGISTER.9F WILLS USE ,:ONLY First line of address 100 MANSION ROAD EAST f',,) Second line of address -..., PO BOX 445 City or Post Office HERSHEY State ZIP Code PA 17033 QATE FILED ....- Correspondent's e-mail address: BBREIDIGAM@HERSHEYTRUST.COM Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. Sr-ONSIBI,.E FOR FILING RETURN ~ S 00 MANSION OAD EAST, HERSHEY, PA 17033 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056041103 6W4647 2.000 15056041103 .-.J -.J 15056042104 REV-1500 EX FLEISHER LESTER W. Decedent's Name: Decedent's Social Security Number 703-07-1354 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. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E). 4. Mortgages & Notes Receivable (Schedule D). . . . . . . . . . . . . . 4. . 5. 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 0 Separate Billing Requested 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . 9. Funeral Expenses & Administrative Costs (Schedule H). 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). 11. Total Deductions (total Lines 9 & 10). . . . 12. Net Value of Estate (Line 8 minus Line 11) . 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . 14. Net Value Subjectto Tax (Line 12 minus Line 13) . 6. . 7. . 8. . 9. 10. 11. 12. 13. 14. 23557.35 622703.46 646260.81 18108.96 9121.35 27230.31 619030.50 619030.50 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 .0_ 16. Amount of Line 14 taxable at lineal rate X .0_ 17. Amount of Line 14 taxable at sibling rate X .12 37 4 4 . 02 18. Amount of Line 14 taxable at collateral rate X .15 615 2 8 6 . 4 8 15. 16. 17. 18. 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 19. 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056042104 6W4648 2.000 449.28 92292.97 92742.25 D 15056042104 -.J REV-1500 EX Page 3 Decedent's Complete Address: File Number DECEDENTS NAME FLEISHER LESTER W. STREET ADDRESS 302 MESSIAH CIRCLE CITY I STATE I ZIP MECHANICSBURG PA 17055-8620 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 92742.25 68000.00 3578.84 Total Credits (A + B + C) (2) 71578.84 3. InteresUPenalty if applicable D. Interest E. Penalty .00 Total Interest/Penalty (D + E) (3) 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) 21163.41 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT 21163.41 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; . . . . . . . . . . . . . . b. retain the right to designate who shall use the property transferred or its income; c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . d. receive the promise for life of either payments, benefits or care? ........ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? . 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes [K] [K] ~ o o o No o B D o [K] D 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. 99116 (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. 89116 (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. 99116(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. 99116(1.2)[72 P.S. 99116(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. 99116(a)( 1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 6W4671 1.000 COMMONWEAL TH OF PENNSYLVANIA DEPARTIv1ENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 2B060 1 HARRISBURG, PA 1712B-060 1 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT COMPANY HERSHEY TRUST PO BOX 445 HERSHEY, PA 17033 -------- fold ESTATE INFORMATION: SSN: 703-07-1354 FILE NUMBER: 2102-0235 DECEDENT NAME: FLEISHER lESTER W DATE OF PAYMENT: 07/03/2007 POSTMARK DATE: 07/03/2007 COUNTY: CUMBERLAND DA TE OF DEATH: 04/03/2007 NO. CD 008366 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $68,000.00 I I I I I I I I TOTAL AMOUNT PAID: $68,000.00 REMARI<S: HERSHEY TRUST COMPANY CHECI<# 90799 INITIALS: CJ SEAL RECEIVED BY: TAXPAYER GLENDA FARNER STRASBAUGH REGISTER OF WillS REV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Fleisher Lester W. FILE NUMBER 21-02-0235 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 1 PNC Bank Checking Acct # 51-4002-0655 Accrued interest to date of death VALUE AT DATE OF DEATH 23,438.55 8.99 2 United American Insurance Company - refund of premium 109.81 6W46AD 1.000 TOTALlAlso enter on line 5, RecaDitulation\ $ (If more space is needed, insert additional sheets of the same size) 23,557.35 REV-1511 EX + (10-06) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Fleisher Lester W. FILE NUMBER 21-02-0235 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: David M. Myers Funeral Home Second & Walnut Sts Newport, PA 17074 13,433.90 B. ADMINISTRATIVE COSTS: 1 . Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees Saidis, Flower & Lindsay 780.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 1,200.00 7. 8 9 10 11 The Patriot News - trust advertising Cumberland Law Journal - trust advertising Hershey Trust Company - fiduciary services 4/1/07 - 8/31/07 Inheritance Tax Return - filing fee Miscellaneous filing fees (estimate) 199.98 75.00 2,205.08 15.00 200.00 6W46AG 2.000 TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ 18,108.96 REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Fleisher Lester W. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21-02-0235 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. Messiah Village - balance due per statement 3/31/07 VALUE AT DATE OF DEATH 7,446.20 2 Alert Pharmacy Services - balance due per statement 3/31/07 114.85 3 Hershey Trust Company - fiduciary services to 3/31/07 473.31 4 Capital Area Health Assn - balance due per statement 4/23/07 81. 35 5 Alert Pharmacy Services - balance due to 4/3/07 21. 39 6 Messiah Village - balance due per statement 4/30/07 484.60 7 Hershey Trust Company - preparation of 2006 federal and state individual income tax returns 450.00 8 Capital Area Health Assn - balance due per statement 6/29/07 49.65 6W46AH 1.000 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 9,121.35 REV-1510 EX + (6-98) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT EST ATE OF Fleisher Lester W. FILE NUMBER 21-02-0235 ITEM NUMBER 1. 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. DESCRIPTION OF PROPERTY I=UlE TIE N'lME OF TIE TRANSFEREE. THEIR RELATIONSHP TO DECEDENT AND TlE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. Lester W. Fleisher Revocable Trust Agreement dated 8/21/2000 Comprised of the following assets: 197 shs PNC Financial Services Cusip: 693475105 $71.785 / sh 1,753.768 shs Gartmore Nationwide Fund Cl D Cusip: 366648434 $19.36 / sh 25,000 pv Federal Farm Credit Banks 2.95% due 6/12/08 Cusip: 31331QT98 Value: 97.65625 Accrued interest to date of death 64 units Common Trust Fund - Equity REIT $293.99988 / unit Distribution payable 3/31/07 128 units Common Trust Fund - Value Equity $440.86296 / unit Distribution payable 3/31/07 408 units Common Trust Fund Fixed Income $994.67004 / unit Distribution payable 3/31/07 54,788.85 units Temporary Investment Fd $1.00 / unit Accrued interest to date of deatt 2 Agway Inc Employee Retirement Plan. Beneficiary: Arlene Fleisher 3 PNC Bank (Burial Reserve Acct) Certificate # 000031000169672 Accrued interest to date of death DATE OF DEATH VALUE OF ASSET 14,141. 65 33,953.95 24,414.06 18,815.99 56,430.46 405,825.38 54,788.85 3,744.02 8,284.13 % OF DECD'S INTEREST 100% 100% 100% 100% 100% 100% 100% 100% 100% EXCLUSION (IF APPLICABLE' TAXABLE VALUE 14,141. 65 33,953.95 24,414.06 227.40 18,815.99 63.61 56,430.46 72.09 405,825.38 1,690.78 54,788.85 19.74 3,744.02 8,284.13 231. 35 TOTAL (Also enter on line 7, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 622,703.46 REV-1513 EX+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Fleisher Lester W. NUMBER I 1 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Arlene A. Fleisher (Schedule G, Item #2) Mechanicsburg, PA RELATIONSHIP TO DECEDENT Do Not List Trustee(s) FILE NUMBER 21-02-0235 AMOUNT OR SHARE OF ESTATE Sister 3,744.02 0.00 Nephew 123,057.30 Nephew 123,057.30 Nephew 123,057.30 Niece 123,057.29 Niece 123,057.29 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 6W46A11.000 2 Lester W. Fleisher Trust under Agreement for the benefit of the following: Arlene A. Fleisher (discretionary interest) Eva P. Fleisher (deceased) Harvey Fleisher (1/5 trust remainder) 26 Champions Bend Circle, Houston, TX David Fleisher (1/5 trust remainder) 513 Carriage Dr, Tyler, TX Steven Fleisher (1/5 trust remainder) PO Box 5112, Longview, TX Karen Wilkens (1/5 trust remainder) 3439 Kilrush Dr, Arlington, TX Sheryl Hamilton (1/5 trust remainder) 2992 FM 1377, Princeton, TX B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space IS needed, Insert additional sheets of the same size) SAIDIS, iHUFF & MAS LAND ATIORNEYSoAToLAW 2109 Market Street Camp Hill, PA REVOCABLE TRUST AGREEMENT .J I ?1- day of .r~'t1 L,t~ () 2000 by and between LESTER W. FLEISHER of the Borough of Camp Hill, Cumberland THIS AGREEMENT made this County, Pennsylvania, and by ARLENE A. FLEISHER, Attorney-in-fact for Lester W. Fleisher hereinafter called "settlor" and HERSHEY TRUST CO., of 100 Mansion Road East, Hershey, Dauphin County, Pemlsylvania, hereinafter called "trustee," WITNESSETH: WHEREAS, settlor desires to create a revocable trust of certain assets for the purposes hereinafter contained; NOW, THEREFORE, in consideration of the mutual convenants contained herein, settlor intends to assign, convey, transfer, set over and deliver to trustee certain assets of settlor to have and to hold the same and any other assets which the trustee may hereafter at any time hold or acquire hereunder, all of which assets being hereinafter referred to collectively as the trust estate, IN TRUST, nevertheless, for the following uses and purposes and subject to the terms and conditions hereinafter set forth. I Trustee shall hold, maintain, invest and reinvest the trust estate for the benefit of settlor. It shall collect the income therefrom and first pay any expenses ofthe trust, including trustee's reasonable expenses incurred in performance of its duties and reasonable compensation to the ,;1-" trustee for its services. Trustee shall pay such part of the income and principal as the trustee, in its discretion, believes is necessary and proper for the suppOli and maintenance of settlor, and may disperse such amounts in anyone of the following ways: A. To that person or corporation who is taking care of or has custody of the settlor; B. Directly to the settlor; SAIDIS, iHUFF & MASLAND AITORNEYS'AToLA W 2109 Market Street Camp Hill, PA C. To any creditor of settlor for his benefit. II Upon the death of settlor, this trust shall continue for the benefit of settlor's sisters, Arlene A. Fleisher and Eva P. Fleisher so long as either of them is living, the same powers and duties as were the case while settlor was living and as are set forth in Paragraph I, hereinbefore stated. In addition therefore trustee shall have the discretion to accumulate the income if it is not necessary for the support of settlor's sisters, or to allocate the net income equally among the remainder beneficiaries hereinafter stated. When settlor and his sisters are deceased, this trust shall terminate and the balance then remaining, including any accumulated and undistributed income, shall be paid to the following named nieces and nephews, the share of deceased niece or nephew to be paid to his or her issue per stirpes. A. Harvey Fleisher, 26 Champions Bend Circle, Houston, TX 77069 B. David Fleisher, 513 Carriage Drive, Tyler, TX 75703 C. Steven Fleisher, P.O. Box 5112, Longview, TX 75608 D. Mrs. Karen Wilkins, 3439 Kilrush Drive, Arlington, TX 76014 E. Mrs. Sheryl Hamilton, 2992 FM 1377, Princeton, TX 75407-2128 III No interest in income or principal shall be assignable by, or available to anyone having a claim against, a beneficiary before actual payment to the beneficiary. IV Trustee shall have the power but not the duty to make such expenditures out of this trust as, in its discretion, it may consider desirable in order to facilitate the settlement of the estate of SAIDIS, SHUFF & MASLAND ATTORNEYS'AT'LAW 2109 Markel Street Camp Hill, PA settlor. In exercising such power, trustee may pay in whole or in part any of the following items: the expenses of last illness and burial, including cost of gravemarker; debts; income taxes; death taxes on any and all property included in the gross estate for tax purposes; and all other items in connection with the settlement of the estate. Any such items may be paid directly by trustee or the funds for their payment may be transferred by trustee to the executor or the administrator of the said estate, and neither such executor or administrator nor any beneficiary of such estate shall be required to reimburse trustee for any funds so paid or transferred. v Settlor hereby reserves, exercisable whenever and as often as settlor may wish while settlor is living, the power to withdraw all or part of the principal, to add to the trust upon approval and acceptance by the trustee, and to revoke or alter this trust in whole or in part by writings other than a Will delivered to the trustee, but not to increase the responsibilities of the trustee without its written consent. VI Any corporation resulting from any merger, conversion or consolidation to which Hershey Trust Co. may be a party or any corporation otherwise succeeding generally to all or the greater part of the assets and business of Hershey Trust Co. shall be the successor to it as trustee hereunder without the execution nor filing of any paper or any further action on the part of any party hereto or beneficiary thereunder. VII This instrument shall be construed and administered in accordance with the laws of the Commonwealth of Pennsylvania. The validity of the trust hereby created shall be determined in accordance with the laws of the Commonwealth of Pennsylvania. SAIDIS, iHUFF & MASLAND ATTORNEYS-AT-LAW 2109 Market Street Camp Hill, PA VII! My trustee hereinafter named shall have the following powers and duties, in addition to those vested in it by law and other provisions of this Will: A. To retain any or all of the assets of this trust, real or personal, including its own stock, without regard to any principle of diversification or risk. B. To invest in all forms of property, including stock, common trust funds and mortgage investment funds whether operated by it or others, without restriction to investments authorized for Pemlsylvania fiduciaries, as it deems proper, without regard to any principle of diversification or risk. C. To sell at public or private sale, to exchange, or to lease for any period oftime, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms or conditions as it deems proper. D. To allocate receipts and expenses to principal or income or partly to each as it from time to time thinks proper in its sole discretion. E. To make payment to the parents or guardians of any minor or incompetent beneficiary. F. To hold property in my name or in its name, or in the name of a nominee or umegistered. G. To lend to, or purchase from, my executor even though trustee may also be such executor. IX Trustee shall receive compensation for the performance of its functions hereunder in accordance with its standard schedule of fees in effect from time to time during the period over which its services are performed; provided that trustee agrees to calculate its fees based on the combined assets of this trust and identical trusts for Arlene Fleisher and Eva Fleisher and charge the propOliionate part of the fee to each trust. Consideration will be given to a reduction of trustee's fees depending on the type of investments authorized by Settlor. SAIDIS, 5HUFF & MASLAND ATIORNEYS'AT'LA W 2109 Market Street Camp Hill, PA IN WITNESS WHEREOF, the parties hereto have set their hands and seals the day and year first above written. WITNESS: c:::_\! J\JW'~~ jJ ~~/\J1}.)JU\___ ~~/Jj1-- ~:rU.j--SL-1 -,/ '-I T 'v IJ.' (J (\ ,J-P/.U U.>/l V;;' (j ')::s./AL..-{,J""'- (SEAL) Lester W. Fleisher ct/l ~AL n, frJ~'~~x:L-e1-~8E1\L) Lester W, Fleisher by his attorney-in-fact Arlene A. Fleisher ATTEST: HERSHEY TRUST CO. dI /J.*~BY~~~ HERSHEY TRUST COMPANY BRYAN S. BREIDIGAM, E.A. TRUST TAX MANAGER (717) 520-1105 bbreidigam@hersheytrusr.com October 31, 2007 Register of Wills Office Cumberland County Courthouse One Courthouse Square Carlisle, P A 17013 (~;. c. RE: Lester W. Fleisher, deceased File Number: 21-02-0235 Gentlemen: Hershey Trust Company served as trustee for Lester W. Fleisher during his lifetime. The trustee has prepared and enclosed two copies of the Pennsylvania Inheritance Tax Return. Additionally, enclosed are two checks. One check represents the tax due upon the filing of the return. The second check representing the filing fee due upon filing the return. If you have any questions regarding the return or payments, please contact me at 717-520-1105. Sincerely, ~ ~reidi . Enclosure 100 MANSION ROAD EAST · P. O. Box 445 · HERSHEY, PENNSYLVANIA 17033-0445. (717) 534-3225 · FAX (717) 520-1111 · www.hersheytrusLcom g o%-~ D~~\ ~Dp.~ ....0 0 ;e.~D~ $"~o~ >-d S g ~ )>.... ~ ...... ~ fFJ -{/:lDO -;3.A ~ ~ ~~~8 ~~ ~ ~ = -:. - - - =; .~ -= - ::: -": .-:, - :; ~ - - ::::: --: - - ~~ g~ ',:C ~ 0) ~ ~ ~ ~ '!2. ~ ~ 0 ~ ~ 'Z "'tl" .-1 r<l 0 FA ~; ~ ~ ~ d ~ ')i' (Jj) ~ ~ ~ ;; . () ~"'tl 0 -.l . o 0 ~ ~'o::l ~ b 0 'Id ~ ~ ?> ~~'r7) tJ\ ~ JZ.-4 tJ\~ ". .,.. ". .,.. '.L '-0- I.ft ,-. ;. (~ ~(. '8-, 1- ;. ~ 2 t:"_ , 1:3 : ~ _.,~,')'_...~'I!"r,~~, COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT, 280601 HARRISBURG, PA 1712B-060 1 ~"!'"" :>":::,>,' ~'''~.,_,~,!:";7!_ - _-~ REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT COMPANY HERSHEY TRUST PO BOX 445 HERSHEY, PA 17033 -------- fold ESTATE INFORMATION: SSN: 703-07 -1354 FILE NUMBER: 2102-0235 DECEDENT NAME: FLEISHER LESTER W DATE OF PAYMENT: 07/03/2007 POSTMARK DATE: 07/03/2007 COUNTY: CUMBERLAND DATE OF DEATH: 04/03/2007 NO. CD' 008366 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $68,000.00 I I I I I I I I TOTAL AMOUNT PAID: $68,000.00 REMARKS: HERSHEY TRUST COMPANY CHECK# 90799 SEAL INITIALS: CJ RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2B0601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT COMPANY HERSHEY TRUST PO BOX 445 HERSHEY, PA 17033 ---~---- fold ESTATE INFORMATION: SSN: 703-07-1354 FILE NUMBER: 2102-0235 DECEDENT NAME: FLEISHER LESTER W DATE OF PAYMENT: 11/02/2007 POSTMARK DATE: 11/01/2007 COUNTY: CUMBERLAND DATE OF DEATH: 04/03/2007 NO. CD 008911 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $21,163.41 I I I I I I I I TOTAL AMOUNT PAID: $21,163.41 REMARKS: RECEIPT TO HERSHEY TRUST CO CHECK# 92690 SEAL INITIALS: AJW RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS ~ In the Court of Common Pleas of Cumberland County, Pennsylvania Orphans' Court Division In Re: Lester W. Fleisher, deceased No. 20~- ~?:{b: Late of Upper Allen Township, Cumberland County Petition for Settlement of Small Estate Pursuant to 20 Pa. Cons. Stat. ~ 3102 TO THE HONORABLE, THE JUDGES OF THE SAID COURT: The petition of The Hershey Trust Company respectfully states that: 1. Lester W. Fleisher ("Decedent") died on April 3, 2007, a resident of Upper Allen Township, Cumberland County, Pennsylvania. 2. Petitioner, whose address is 100 Mansion Road East, Hershey, P A, was the decedent's trustee and is also trustee and agent under power of attorney for the decedent~ sister and sole heir at law, Arlene A . Fleisher, a (non-adjudicated) incapacita@ ierson. ~ ~ z 3. Decedent never married and has no children. ~ P ~ ~ m - ~ . ::0 fJ1 ..c;,.U>^ 4. Decedent did not leave a will. 080 -0 8 " :x 5. Decedent was survived by the following person: Arlene A. Fleisher~edentT sister, an incapacitated person (non-adjudicated) who resides at Messiah Vi~g-;' Upp~ Allen Township, Cumberland County, PA. Arlene A. Fleisher is represented by her agent under power of attorney and Trustee, the Hershey Trust Company. 6. No person is entitled to the Family Exemption. 7. The property owned by Decedent and the value thereof is as follows: Cash on deposit at PNC Bank, in checking account #51-4002-0655, with a value on the date of death of Twenty-three Thousand Four Hundred Forty-seven and 54/1 OOths ($23,447.54) Dollars. 8. The following disbursements have been made from the estate prior to the filing of this petition: (None) 9. The names of all unpaid claimants of whom the petitioner has notice or knowledge are: (None) i:~;R j~") (~) ~:~~ ::-rj C:J ,-) (-) ":1 .,., ..,..- 'n ~'c-j ::-..::: n1 (:..?C) "n __J 10. The decedent established an inter vivos trust by agreement dated August 21, 2000, appointing the Hershey Trust Company as trustee. 11. Except for the bank account described at ~ 7, above, legal title to all of Decedent's assets is in his trustee, the Hershey Trustee Company. 12. Article II ofthe said trust agreement provides that, upon the death of the decedent, the trust shall continue for the benefit of his surviving sister, Arlene A. Fleisher, who is also his sole heir at law. 13. Article IV of the said trust agreement authorizes the trustee to pay the expenses of last illness and burial, debts, income taxes, death taxes on any and all property included in the gross estate for tax purposes, and all other items in connection with the settlement of the decedent's estate. 14. A Pennsylvania Inheritance Tax Return has been filed by the Trustee with the Register of Wills for Cumberland County, reporting taxable assets in trust, in the amount of $646,260.81. 15. The said Inheritance Tax Return reported on Schedule E the PNC checking account identified above as the sole probate asset. 16. Inheritance tax in the amount of $89,163.41 has been paid in full by the said Trustee. 17. All outstanding debts of the decedent, funeral and burial costs have been paid by the Trustee, and there are no known claims against the decedent's estate. 18. Twenty days' written notice of petitioner's intention to file this petition has been given to Hershey Trust Company, as personal representative of the Decedent's surviving sister and sole heir at law, Arlene A. Fleisher. WHEREFORE, Petitioner requests that the Court award the Estate of Lester W. Fleisher, deceased, as follows: 100% to Arlene A. Fleisher, c/o the Hershey Trust Company. Respectfully Submitted, SAID IS, FLOWER & LINDSAY I Dated: II /' <;{ / 07 t ~~ Thomas E. Flower Attorney ID # 83993 2109 Market Street Camp Hill, PA 17011 (717) 737 - 3405 In the Court of Common Pleas of Cumberland County, Pennsylvania Orphans' Court Division In Re: Lester W. Fleisher, Deceased No. 200'-- b%~ Late of Upper Allen Township, Cumberland County VERIFICA nON I,E. ( 't N\ -.S '-~rre-i d ij j).~1'\. , hereby verify that the statements made in the foregoing Petition are true and correct, to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S.A. S 4904, relating to llllswom falsification to authorities. DATED: N,hNrvvy-y I ,2007 l-kr s t\~ . -rr L{ iJ- ej) '''-ptt t1 Lf By:4- /d?:. ) Ir u...d-J[}..f n 0-,'\ o.S.: y NO\' 1 6 Z007 In the Court of Common Pleas of Cumberland County, Pennsylvania Orphans' Court Division In Re: Lester W. Fleisher, Deceased No. 200;.- ~35 Late of Upper Allen Township, Cumberland County ORDER OF DISTRIBUTION 1h AND NOW, this 1~ day of ~()'1lVW\~t,,( ,2007, upon consideration of the foregoing petition of The Hershey Trust Company, for settlement of a small estate pursuant to 20 P.S. S 3102, it is hereby ordered and decreed that the Estate of Lester W. Fleisher, in so far as it consists of funds on deposit at PNC Bank in the principal amount of less than Twenty-Five Thousand ($25,000) dollars, shall be distributed to the said Arlene A. Fleisher, in care of the Hershey Trust Company, as her personal representative. By the Court: \~ J. (2 C...:.(:::> ;':".2;5 i'-CO , '::,~ \~I? (/)7' .~(')O ")9-n ..,,- ;--' :9\ -0 )=--" \"'-' r.::;:) c:;:> --i -"" ~ N --1 .; !J ~ UJ ., v:> '" -n I-r, :-") ~~ ;::.:~,~ C) Cl' C') <;(, ~ In Re: LESTER W FLEISHER, DECEASED ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 21-02-0235 CERTIFICATE OF SERVICE OF ORDER ORDER DATE: 11/26/07 JUDGE'S INITIALS: MLE TIME STAMP DATE: 11/27/07 IN RE: ORDER OF DISTRIBUTION ~ , '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ " '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ " '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ '\ 'I 'I 'I , '\ 'I 'I 'I , 'I 'I 'I 'I , 'I " 'I 'I 'I , '1'1' , '\ 'I 'I , 'I 'I 'I 'I , 'I 'I 'I 'I 'I 'I 'I 'I , 'I , , 'I , 'I SERVICE TO: THOMAS E FLOWER ESO METHOD OF MAILING: ENVELOPES PROVIDED BY: 1i:8J USPS IDRRR D HAND DELIVERED D OTHER_ IZl PETITIONER o JUDGE o CLERK OF ORPHANS COURT MAILED: 11/27/07 "",."""""""""""""""""""""""""""""""""""""""""""""""""""""""""','" SERVICE TO: METHOD OF MAILING: ENVELOPES PROVIDED BY: o USPS DRRR o HAND DELIVERED o OTHER_ o PETITIONER o JUDGE o CLERK OF ORPHANS COURT MAILED: ~lD-!fMv~ Deputy Clerk of Orphans' Court COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE _ '1-', " ,. \-NOr-.rcE OF INHERITANCE TAX .',.APPRAI&EMENT, ALLOWANCE DR DI SALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX "\1 1\: ) 2 DATE ~lt i . ,- ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 02-11-2008 FLEISHER 04-03-2007 21 02-0235 CUMBERLAND 101 APPEAL DATE: 04-11-2008 ( See reverse side under Objections) Amount Remitted I l MAKE CHECK PAYABLE AND REMIT PAYMENT REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 "r'ip 1.;18' ?2 Lutj'",) t ;-' '- BRYAN S BREIDIGAM HERSHEY TRUST CO PO BOX 445 HERSHEY OF ('I . 'J\.. PA 17033 REV-1547 EX AFP (06-05) LESTER W TO: CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ------------------------------------------------------------------------------------------- REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF FLEISHER LESTER W FILE NO. 21 02-0235 ACN 101 DATE 02-11-2008 T AX RETURN WAS: (X) ACCEPTED AS F I LED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (S(hedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. 14. (1) (2) (3) (4) (5) (6) (7) (9) (10) CHANGED .00 .00 .00 .00 23,557.35 .00 622,703.46 (8) 18,108.96 9,121.35 (11 ) (12) Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) Net Value of Estate SUbject to Tax (13) (14) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 646,260.81 ?7.23D.31 619,030.50 .00 619,030.50 If an assessment was issued previouslY, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate NOTE: 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) 07-03-2007 CD008366 3,578.95 11-01-2007 CD008911 .00 (15) (16) .00 X .00 X 3,744.02 X 615,286.48 X AMOUNT PAID 68,000.00 21,163.41 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 00 045 = 12 15 (19)= .00 .00 449.28 92,292.97 92,742.25 92,742.36 .11CR .00 .11CR * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ,'\ IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. ~ IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)