Loading...
HomeMy WebLinkAbout10-26-09 (3)J 1505607120 REV-1500 ~ (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN 2 1 0 9 0 0 5 7 6 PO BOX.280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 204 03 6402 06 16 2009 04 09 1922 Decedent's Last Name Suffix Decedent's First Name MI GEISE GEORGE H (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL INAPPROPRIATE OVALS BELOW X^ 1. Original Return 4. Limited Estate g, Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE VWItH THE REGISTER OF WILLS 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12-12-82) ~. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. be~ueenP2-3191 audit (dat9e5'f death 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 1 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch. O) ~~nrct~rvnuthli -THIS SECTION MUST BE C( Name RICHARD W. STEWART Firm Name (If Applicable) JOHNSON DUFFIE First line of address 301 MARKET ST. Second line of address PO BOX 109 City or Post Office LEMOYNE Daytime Telephone'I Nlumber (717) 761 4540 State ZIP Code PA 17043-0 ~~ r-r-i `~ ~~ r-, , r_ I,~ ~.c~ ~;~ C".-' C-) _.~_~ r ~...yx f~T'3t ~., ;~_? -f~ REGISTER OF WILLS USE ONLY ~,~ ;._. _7 G-.~ ~~~ ~ c;~ 7 ~ -~ _. --~ r~ti~ ~.~ C~'1 DATE IiL~F~ ~ ~ i ~ ~ ~~. Ina f~a ~~ Correspondent's a-mail address: Under pen a of perjury, I deGare that I PATRICIA G. PROVANCE 1841 BAMBERG AVENUE, THE VILLAGES, FL 32162 ~~ - ~ - Z~ SIGNATURE OF P EPARER OTHER THAN REPRESENTATIVE DATE RICHARD W. STEWART ADDRESS 301 Market St., Lemoyne, PA 17043-0109 Side 1 1505607120 1505607120 accompanying schedules and statements, and to the best of'fn knowledge and belief, representative Is based on all information of which preparer hag any knowledge. 1505607220 REV-1500 EX Decedent's Social Security Number Decedent's Noma: GEORGE H. G E I S E 2 0 4 0 3 6 4 0 2 RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 1,160.88 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4. 5• Cash, Bank De osits ~ Miscellaneous Personal Pro e ) P p rty (Schedule E ................ 5. 1 , 1 2 0 , 5 3 9 . 0 2 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ............. 7. 5 5 7, 2 7 8. 0 5 8. Total Gross Assets (total Lines 1-7) ....................................................................... g. 1, 6 7 8, 9 7 7 9 5 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 15,675.40 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 51.95 11. Total Deductions (total Lines 9 & 10) ...................................................................... 11. 1 5 , 7 2 7 . 3 5 12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12, 1 . 6 6 3 , 2 5 0 . 6 0 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................................................. 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ................................................. 14, 1 , 6 6 3 , 2 5 0 . 6 0 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 .00 0. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable 1, 6 6 3, 2 5 0. 6 0 at lineal rate X .045 16. 7 4, 8 4 6. 2 8 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. 7 4. 8 4 6. 2 8 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 L 1505607220 1505607220 J _. - - -- REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-09-00576 DECEDENT'S NAME GEORGE H. GEISE STREET ADDRESS 5225 WILSON LANE, APT. 4121 CITY STATE ZIP MECHANICSBURG PA 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. InteresUPenalty if applicable D. Interest E. Penalty 65,000.00 3,421.05 Total Credits (A + B + C) (1) 74,846.28 (2) 68,421.05 (3) (4) (5) 6,425.23 (5A) (56) 6,425.23 Total InteresUPenalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Llne 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :.................................................................................. x b. retain the right to designate who shall use the property transferred or its income :.................................... ^ c. retain a reversionary interest; or .................................................................................................................. ^ ^x 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 "intrust 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? ...................................................................................................................... ^x ^ 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 exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 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)]. 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. Rev-1603 EX+ (8-88) SCHEDULE B STOCKS ~ BONDS COAMONVIIEALTH OF PENNSV WANIA INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER GEISE, GEORGE H. 21-09-00576 All property jolndy-owned with right or survivorship must bs dlsclossd on Schedule F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 3 -x200.00 Series EE Bonds dated 1989, 1990 and 1,160.88 1992; - 3 - 5100.00 -Series EE Bonds dated 1989, 1990 and 1992. See attached for date of death values. TOTAL (Also enter on Line 2, Recapitulation) 1.160.88 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) /~• O W y-' ~ ~ N Q rn~ N ~ ~~ N < CEO 0 ~~ C •~ ac i -a C O m n m V t • « s Z ~ L ~ D O O O O N N ~ m a~+r r o r o N o N o N o N 0 ~'~ ~ N N N ~V N N ~ N N (~ N ~ ~ Ri r r r r O O ~ LL ~~ rn rn rn rn rn rn d m 0 0 0 0 0 0 '+-'++ _~ 0 N 0 N 0 N 0 N 0 N 0 N ~ ~ ~ ~ ~ ~ ~ 0 0 0 0 0 0 Z o o ~ 0 0 0 ~ (O (O M M r r d N N M M ~ si } ~ tC7 ~ tn tn ~ o ~ o ~ o ~; o o o o o 0 ~ p 0 0 0 0 0 0 ~ ~ ~ ~' ' ~t N N ~ N ~ N r O) CO d) O m ao 'v' ao ~ ri ~ ~ tO M N ~ N ~t 6~R r r N r N `V' N N ~ N ~ ~,,, N r O) 00 O) GO w ao v ao r: c~i ~ m co oo ~ ~n r~ v ~ gym.. r ~ r r C 0 0 0 0 0 0 0 0 0 0 0 0 y 0 0 0 0 0 0 V . O r ~ ~ O r tn O -- ` a `~' ~ O) O O O N N 4/ d CO GD O) O) O O 7 a+ O O O) O O O) r r r r r r N D ~ N ~ N ~ N ~ N ~ r ~ r r r r r 0 0 d Z i d N 0 0 0 0 0 0 O 0 N 0 r 0 r 0 N 0 r 0 N C 69 d 0 w °' ~ w w w w w w ~, w w w w w w Z r N M V ~ O ~ o O O t0 d ~ ~ o m ~ _ 0 ~ ~ d C O O m v •L a w 0 I- o~ ~ o `O >~ C N ~ H O h ~ _~ a~i ~'o~ ~~ ~a »..y~a> T N C a O~~'L t0 U V1 y pCp ~ L+L~+Up 'o «~ ai a ~ ~ y L a i ~'aN ~Z ~ti"'L ., 2 a_aaio = y w C.r y O O «~ a v~~E°? oaw,mm ~~ c axi •° COOx(p W N U~M ~~ x .- W.rny~ cOi V1 W G) fC •C 3 ~ ~ ~ a aw~'oc co~c'- ~Z-p o.a i.Vl~~N Xa~~ ~ W ~~ ~ • ~~ l4a ~ >, 3 C cW m m~ -Z~~2 a . ~ L .C ~ ~ _ cy 14~°m U N O `p ~ ~=aa ~ a'~j~C O _C y hL ~ C y•y XU V a~°i 33uJ • o LLI LLI o `ww5 ~ooL a y y y ~ •~ C1 t0 ~ `- U Quin m ~mm~ ~' ~' y a C O O O O ~ aa• ~ • .• 0 N m a a C Rev-1508 EX~ (8-88) COM~AONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, ~ MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER GEISE, GEORGE H. 21-09-00576 InGude the proceeds of litigation and the date the proceeds were received by the estate. All property jolMlyowned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Allstate -automobile insurance refunds. 56.17 2 Allstate -tenants policy refund. 137.00 3 Asbury Communities - (Bethany) refund. 175.16 4 Bethany Village -refundable entrance fee 74,462.00 5 Dr. Kilmore -refund 20.00 6 Highmark -refund 49.46 7 Merrill Lynch -Investment Account No. 872-28491 -Date of death value. plus 835,128.28 accrued dividends and interest. 8 National Geographic -subscription refund 14.17 9 Outdoor News -subscription refund. 9.30 10 PNC Bank -Certificate of Deposit - No. 31200339057 -Date of death balance, plus 100,625.63 accrued interest. 11 PNC Bank -Checking Account No. 50-0489-4155. -Date of death balance, plus 3,791.40 accrued interest. 12 PNC Bank -Money Market Account No. 50-0579-8288 -Date of death balance, plus 101,221.20 accrued interest. 13 The Patriot-News -subscription refund. 174.25 Total of Continuation Schedule See attached page TOTAL (Also enter on Line 5, Recapitulation) 1.120,539.02 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) ~ A ~ ~ ~. a ~_~ o ~ v o ~ -,, _cNr, o 0 0 ~* ~• ~ o n v ~p 0 ° N v ~: ~ ~ ~ 0 0 , o p s ~p ° ° ° ° ~ H N (hD .. .. -. o o o o ~ A N Nvn =~ W p~ OD W N n ~ [U NOn lnm ~ ~ LU N~n Cdr N ~ Cf ~ O O O .~.a ~ ~ 3 o~y~fn ~ p , owv ~Z-' owm ~Z ~ ONN~~~y C ~ cD w~ G Z o O O~~ Z o O~~ O o~~ r L*. p N N N O O O p O N~ fn~ O O N3 DmO N ~ N~ ~ p 0 O N 0 N~ W~ O CD 3 OOO CO CO CD Cp o O CD m Cp om ~ ~~ g --~ CO O ova mD A v~o o Cp ow o-~ A o0 o o~n m~ w~ r.-. o ~ ~ D D o ~ ~ ~ m o ~ ~ o ~ o Cn ~ ~ ~ ~ ~ D,OZ°rn D,m~rn ~ rn y~ y~o A D N o~v~ rn (D < Z N o~. ya' W< Z N o~Dn ~ W<~ (7 N o~ ~ ~~ Z v o 0 t0 v ~m Om o o v~G CO ~~ Oc~o cnv~0 ° 0 ;~ ~m o cnvCn-p o O 0 0~ ~v~ ~ N Opp 00 N~ Z7 O~ ~~ IjN. N~ Oy 0~ N.rN,.N Opp O D~ O pOj A li 0 CO O O .? A ~ N~ N o y ~ 0 0 0 0 o a o ~ W O v A A c i, 0 0~ o ~ 0 0 o ~ 0 ~~ D ~~ o G7 ~ ~ ~ ~ N o A ~ _ D N c00 O J ,OAD r ~ O COO J N ~ ~ ,Ni. ~ o° o 0 o W Q: Z ~ N ~ m C 3 ~, y ~ o D~ ~ a ~ ~ ~ o ~• a ~ CO CD O O Cn 'J A OD C y d 3 = ~ ~ .~ O COD J N ~ ~ ~ -~-~ N Ul N CO O ~p ~ Q . . .. .. ~ r. O O O O y p ~ `~ .. ~ rn ~0~ N CD Uj Q° O m ~ v . ~~ n ~ ~ m ca A O ~ J n ~ m _ ~ p S ~ ~ K - + •_ .C O O O N C Q ~ (n CT C Ji y ~, m (D N 7 A A A v c0 N ~ O ~ N ~ 1 v ? 0~ n W CNJ7 W ~ O CD `G ~e .~+. D L7 ^^ y C~~ m ~ N v ~, ~ ~ o o -~ v c~ ~ ~ ~r ~D ~ N ~D s~ O N .... O v0 lp v O v D~ C~ f7 O C --~ CJt N ~ N N O CNfl rt O A COO O O UVi p p S ~ O N . O O O . A O O I~~ O O O O O O O O ~ y N ~ rn~ ~m~ ~m f°°~ ~m °° ~ ~ a0\~m l°~°~ ~m °'~ ~ ~m C e'er. rn~~ erne'-_ a°~~~~ om ~ ~ ~ ~~ ~r p ~~ D O -~~ ~ ~ D D ~~ p ~~ <O -'per -12 O wpm rZ y ~ o° p~ o° ~ o° ~ o° ~ o° ~ o° Z ~ o ° v~~=~ 'Df/> ' p C o co~D~ ~ o oNOo o 0~0 o o ~ CO ° o ~° ~ rn o 'v N \ . <° ,~<Z m ~ m =!tn~ o~ m ST.~7 Si ~ o o °7C ~ oT ~ o oDo \ p N3~ ~ N~DD C 3 ~ ~(nOx ~~ X m ~~ x m ~~ X ~m ~~ X ~Z ~O o orn D~co oy ~Z 0 mnn x D rn mco X Z rn mco x Z rn mco X Z rn mco X Z rn <o X p 0 ~-7o~S ~° T D o ~ o-=D ~' Cn ~ ~.~~~ ~, 3 n ~ -~ ° j o c rn D ~ O m ~ ~ 2 ~~~ N t° e ~ O 3 ~ N f° O 7 p N fp ~ O 7~ N f0 O m 7 ~ N (° O ' ~ ~ I (O N p C~ Z O) T V < 1N . 0. ~< O7 O < O CD O lA<c0 CD ~ O D m CD O Z c0 O CD ~ co fD O O ~ o (D Z c o0 \ ~ oN fnc 00 ` m ~S ' ' ~ ~p ~1 m .Z] Z m Cn~7 m p .Z7 = .Z7 Z cD ~N ~ D 'U O 7 I .Z7 N ~ O N °~ ~ O COO O O N <A O O O ~~ V O W N A ~ A W < O Cn O CD W N W '~ O CT N~ ~ Cn C)7 ~ ~' CT N~ to CJi W~ ~ C I7 ~ j ~ O O A O ~ CD V O O ,0 ` 0 0 T~ O ~ O O O O v O vp O ~I 0 ~ ~ T ~ T ~ L o `~ '< `G `G r c O O O O v 0 ~ O O ~ O ~ O ~ O ~ O ~ W ~ ~ O O O ~ W O (O (O O CD O CD N W N N O O N N -. O .... ~ S 0 0 0 O 0 D O o O w ~ y °o o° °o °o o° o ~ W _ N _ O s ~ A ~ ~ O W ~ W O Owo OOD N O ~ O O O O O O O O O O O ~ O V O Q C S 2 2 S S 2 ~ ~ ~ r r r r r r cp O -,, D ~ ~ W _ N _ O ~ ~ ~ ~ A ~ a ~ H 3 ~ ~ , V O CO U1 A ~ Q1 N O O CT O O CJi O O O O ~ O ~ O ~ 3 3~ ^ O O O O O O O O N ~ ~~ N CA v n W ~ ~ -' ~ ° ~ A d ~ 3 ~ ~ o ~ a A O Iv v .~ ~ C w oo to to to ~ A ~ 3 C%1 '~' V OOD N ~I OND W p Q Vl lb N -~ A CJ~ W Oo N CD J O fD IP O ~ l7 C N ~ p j 0- ~ O ~ ~ O O ~ O V r y~ C J1 ~ ~ `G w v O ~ vD v ~ `~' v n O .~ p N N .~ A OND W --` O N C ~ CD ~ A ~ N O CJ7 O OD CO ~ A A N N .. V C I 00 O O O p C ~ N A y ~ N ~~~ W ~c zD rn~~W ;c c~ ~~G~D ~~~~ ~~~~ ~v, Ac ~~i~ v; Nc ~~ ~ r rn~~W jc c~ o~mm ~c f.DD o~'T'iD ~c c~ p N ~D eD m ~ rn~ pn N-_ T~ rn~ ?n N-C7T~ D)~ O~ N- D)~ ZZ N n ~ o~ z_Z N C7 ..D Doti Zn N- T~ rn~ C0 N- ~Z °)w ~~ N- n C ~ O~IZ]] c°D~ n0 OTI-~ coop DO OTI n coop 2D O~ ~m ~D pN ~- ~m ~D rZ ~ 7C W O ~l .Z7 oc 00 O T oc D< O 'C'I O (7 oc ~tD p c«'~ a pp C~ a r c~ o. D Z c° ~ r- c ~ r- ~, p co Q Zv n CO p_ C~ D co Q y Z O w = ai O~ y oD `~ pz < `~ oz v v ~,~ y ~ c1 mn m v me ' ~ y ~ zvZ ~ z~ Dm < Dm O cn c n zZ v, -i ~ D- I w ~ ~v o ~ o ~Z o ~~ m~ m-~i 'i o OZ O b ~rr-X o y~ a = aC~ D a~ ln-1 fn-~ A Qr ~ a0~ QmZ '~ ~ ~ D `~m~ tai ~ccn ~ 'a-D< .QmZ .6 O D m D Z DDp ~~ ~~ D D z DDS z m D v coo p D p '~ m N fCr1 N ~ ~ D 0 p ~ A O ~ p ~ O A Z~ Z~ O p ~ p ~ N N D ~ O ~ ~~ m D V ~ ~ o ~ ? ~ ~ N ~ ~ ~ ~ ~ v ~ W ~ ~ ~ ~ m ~ m --i -- ~ c m c z z o v ~ ~ x S D N N O ~I O O O CD W r C ~I N O ~ N N ~ O F ~ 00 O O 'O O p 0 O ~ Z ~ W W ~ 0 ~ O Q. C ~ O -w D 3 ~ v ' Q- O N ~7 O IV OD ~ N -' N O 'ti' 3 O O O O N O ~ O O Cn O ~ ~ 7 :rt ^ O O O O O O O O p t9 H ~ N W v ' ' < v ~d C> 3 C ~ ~ ~ y rt ~ N ~ _A O ~ (.17 W O ~ p f/1 A ~ ~ U7 ~ ~ W CND --' ~ V N cD CD CT W ~ N O N n C < -' W 0017 . W W V O ~ fjl ODD fOJi G f ~. } <D `G A 0 0 0 ~~ n< ~ o~ ~~ 'c ~ m v v v a - o c ._ ~ O w W rt O 0D W o N iv ~ O A O ~ 3 .. ~ V c o 0 o ° I u' ~ d ~ W N 0 0 0 ~ H A D ~ ~ ~ ~ DD ~ ~ ~ ~ ~ rn ~ Z ~ (~ ~ m ~ ~ rn~ ~~ - X ~m -riZ ='D r. rn~ nm n C Z N - - r O N - ~ T~ r ° m ~ r z N - r ~ o ~'I C7 ~' ~ a '~ Z c D~ a c n~ f 17Z a n D ~~ Z ; D() Z~ a{ a ~ y D ~ N~ Z 7l N ~ ~ T Z C ~ rn n m vr~- ° ° n ~ W r ~nD r' °07 °- my ' K ~ ~ .~ Z D cD ~ Z C Z D Z D D ~ v u i a ~ O i w v O A `~° v ~ ~ ~ W 1 N T O p ~ W v v W O O ~ `~ O N Q S A f ~ ~ ~,, r o 0 07 m o ~ ~ °o W C ~ ~ ~ ~ ~ ~ 3 ~ t~ O A ~ ~ n ~ Cfl W C N d C O O 0 (D O !D 3 ~ ~ p 0 O O ~ N ~ ~ .. N T W 0 fa V ~ ~ ~ ~ W W N ~ ~ ~ 0~0 V N ~ DD ~ v ' a < ~~ Cf 3 C Q' pt ~ N '* N ~ W N N ~ 0 N p7 O 7 ,0 ~ ~ y ~ ~ 007 W O W ~. y~ fCD `G -~ ~~, ~ r • ~~~~ ~ O ~~ ~~, LE~IDtH@'~~Ig WAY July 22, 2009 Law Offices of Johnson., Duffle Cynthia S Huber 501 Market St PO Box 109 Lemoyne, 17046 . RE: Name: George H Geise SSN: 204-03-6402 DOD: 06-16-2009 Dear Ms. Huber; In response to your request for Date of Death (AOD) balances for the customer noted above, our records show the following: ' Certificate of Deposit Account # 31200339057 Established; 03-17-2009 GEORGE H GEISE DOD balance: $100,421.19 + 204.44 accrued interest Interest paid 01-01-2009 three 06-16-2009 $421.19 YTD Checking Account Account # 5004894155 Established: 06-05-2007 GEORCrE H GEISE DOD balance: $3,791.09 + 0.31 ~ accrued intez~est Interest paid 01-01-2009 thru 06-16-2009 $0.68 ' Savings Account Account # 5005798288 Established; 11-28-2008 GEORGE H GEISE DOD balance: $101,073,02 + 148.18 accrued interest . Interest paid 01-01-2009 thru 06-16-2009 $1,973.02 YTD Page 1 of 2 D u i. L L L V V 7 I V• J V n~~i i it v u n it n T I L ~ V J G I T I Safety Deposit Boa The decedent maintained safe deposit box # 30 GEORGE H GEISE located at: __ ~. V. VJV! ~ ~ L i Bethany Village 325 Wesley Dr Mechanicsburg, PA 1705.5 717-691-4087 Please note that this office provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings). We do not process amy financial transactions or provide statements. If you need assistance with any of these items, please call 1-888-PNC-BANK (.l-$$8-762 2265) or stop by your local PNC Baztk branch office. Sincerely, National Financial Services Center PNC Bank, N.A. Member FDIC Page 2 of 2 Rev-1808 EJ(~ (8-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COATAONWEALTH OF PENNSYLVANIA INNERITANCE TAX RETURN continued RESIDENT DECEDENT ESTATE OF FILE NUMBER GEISE, GEORGE H. 21-09-Op576 ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 14 1992 Chevrolet Lumina Sedan 4D -Mileage - 63,000 600.00 15 Man's pocket watch -Hampden open face style -Circa 1919 -Appraised value - 75.00 copy of appraisal attached. 16 Miscellaneous household items -decedent's apartment at Bethany -Village. 4,000.00 TOTAL (Also enter on Line 5, Recapitulation) I 1,120,539.02 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-7500 Schedule E (Rev. 6-98) MUNN'S JEWELRY APPRAISAY; "°""„"`" ESTATE ~ FAIR MARKET VALUE ~ a '.;.-~ We estimate the value(s) as listed for estate purposes only using fair market value guidelines. The following item(s) have been carefully examined and verified as accurately as possible within the normal and reasonable gemological ranges without the use of gemstone removal or damaging tests. Carat weights are estimated by volumetric formula unless otherwise noted. Prepared For: Estate of George H. Geise Patricia G. Provance, Exec. Item Description: Men's pocket watch, Hampden open face style, mechanical movement three hand with a sixty second sub dial. Case and lid consist of 14k rolled gold plate. With gold plated twelve inch chain attached. Circa 1919 per cataloged production dates. Movement # 3535373 Aviator-double roller, 19 jewel. Note: watch is in working condition. Fair Market Value of this Item ................... $ 75.00 7 C eted by; Christopher C. Munn September 8, 2009 Note: Precious metal market price: Gold $1,005.00/oz.('1~ Platinum $1,282.00/oz.(T') *Unless noted, carat weights estimated by formula, no stone removal. Value excludes tax. Photo of item attached to original document. 17iis is not an offer to purchase or replace articles. _ C ~ ` ~~ 1203 Market Street Lemoyne, PA 17043 ~.~'r} (717) ~g': ax (717)-7E' 6.:". 1-877-D1 ~ , ,c x4_ .?x. ~!. ,d: .: ~l ~.z-' _ Rev-1810 tJ(+ (8.86) SCHEDULE G INTER-VIVOS TRANSFERS ~ MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TA% RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER GEISE, GEORGE H. 21-09-00576 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 NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 Merrill Lynch -Individual Retirement Account 156,101.16 156,101.16 No. 872-70591 -Date of death balance, plus accrued dividends. Beneficiaries: Patricia Provance and Caroline Geise, daughters. See attached for investments and date of death values. 2 Revocable Trust Agreement dated 1119/1998, 401,176.89 401,176.89 between Bernice M. Geise, - Settlor, (DOD: 1/21/1998) and George H. Geise and Patricia Provance, Trustees f/b/o George H. Geise. Remainder beneficiaries - Patricia Provance and Caroline Geise, daughters. Date of death value, plus accrued interest and dividends. Copy of Trust Agreement attached. List of assets comprising the Trust are attached. (Estate of Bernice M. Geise -Cumberland County No. 21-98-00413) TOTAL (Also enter on Line 7, Recapitulation) I 557,278.05 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) N~ 0 7 N 7 mono vam• °maey mon nam°e~ no'otl u M b p b J r„f ~ E° Y K a t k ni ~ rtlmil° o Ir Is ~' > o h7 C O w o e o n n~rn yo <OIC O M u m d~ooa on°' M G y xy u ~ C u p i 0 O ? M y p w w p w S w °50~ gG~ panrr pgnpu~f ~ F M 7 0 0 w R tl o 0 O u 20 p b' m H M R M nsMpn~ •~. C d p Ybin V•aA C IC MbM o aronl+ a~u p M G 0 R m M M 7Yrt•O K 4 p w°ropo no-o N M M Y p `~ p u O r< G y O rr r r o M 0. t~7 eR O N O • ~Sy 7 C e O 4Fpp L1 N Y O w M 9 O J d e F°+ iip H Z W M~ • W 1* Y N oW Y~ G L~n,yytC ~'CK o error h mprtp p zzG~tn~a ® X G W m W P O K E ~ l+ Z o gng o Yr ~ n I"- g ° a '1~-I n ^ D O ~ ~ p 0 K (F7 p O W pp R A "J pGp K rT M M ~ K o P. A N o M M u 1°lyn eo~ p M M ro~C Y D O D R M p o K 1 H A r r 0. i b H o N m r o b o b b b r b b b r s In b a i n In 1 C H K W O It a O J A N U N Vi b b W (9 b b O r O N W 1 m W 1 N •• ~ n p u J r q N N 4 N 4 b b m n b b b W r 9N N 1 b O I m J W 'i1 p N O r N O N r O P N O W b b m r r J b b m r O W N O N N 1 'y' O 1 O N 1 N J O r 1,1 ro ~ ~ r a I ~ Y m q r r r r 7 7 ,s ° J i y< M p s o o W o o i n o r i C~ R J r W N W W J 1 Ea W N N N O b N I W p r o W 0 J 0 O 0 O 0 Vi 0 O I 0 1 " n ~ ~ ` ~ < r m r ~ ~ ~ m o ~ r ~ ( ~ ~ x Y m x y ~y ~ ~ p x ~ y ~b M O O 7 ~ r'C y 5 G'1 w x 1 P m o N C 1 i ~ m~ d . n. my O~N7. R M 7 q y ~Y H'!. n m1 ~ X7~ I ! / I m 1' ~ l[yl ~ Y n Q n ~ 1 a ~ W K ~ 1~ i ro n ( ~ eg O r ~ O M ro. O \ 10 y ~ + C ~ fz] 1 O p. u ~ N p ~ i z Y ~ N O ~ ~ ' H El Fy ~ ~ n xe~ ~ n 1 rn x o m o \ OI 0 e. 0 el 0 m 0 m 0 T 0 a 0 1 d ro o. I .~' 94 o ro m \ r r \ m r \ r \ r \ r \ r ~ \ r \ I H N r 1 !i n H F NI FI n oI \ m N m a m a a m a l N7 O p u C R 'A b r ~ r I tl ~ 1F 1 ® ro m y ~ m O t I M yx ~ M Gm.. O O O a O FG 1 I ~ ~ ° M y IHHI~ J O o yy NN O I 1 m N O H r F'1 l9 1 H r N r r r a r F+ 1 hi Q~ O "1~ W O m a a r H O r N J W 1 Stl $ O b b In 0 b W r 0 N u+ 0 m m 0 O o 0 ro ~ D o 0 b 0 0 b o 0 O l n IU u+ 1 hl H 0 l o O O O O O N O O O O 1 NN 1 W m CI a r x r r m W I ~A b UI 01 o N N m O~ O O M m O O b o O J I M O 1 n N I l9 o a o 0 0 w 0 0 0 0 1 1 1 I 0 0 0 0 0 0 0 0 o o m m o o 0 0 0 0 0 l 0 1 I 1 • 1 1 1 Ir11 N IrII 1 r r N r r 1 m a I C 01 N 1 b r a r b m r 1 77 r 1 m l s r m N a O !t ~1 1 N I 1•I O r N I 01 1 1 N 01 O1 W N J A b O m O b W J O N I H OI 1 Y. I r m l m O O A N W W O b I m o 1 0 o a a N o In o In 1 1 o ti I I \ C N a N j 1 j y y' W i a i H GG w i u i ro a I ~ ~ ~ ~ ~ M K ~ ~ . i ~ ~ r ~ q I r ] 1 y e g Q C C ~ ~ Q a ~y . O O O P G 1 N r o~ ~o~ p~ REVOCABLE TRUST AGREEMENT THIS AGREEMENT OF TRUST, executed in duplicate this (4t4 day of ~,~„.,, ~ 1998, between Bernice M. Geise, of 1710 Warren Street, New Cumberland, Cumberland County, Pennsylvania, (hereinafter called Settlor), and George H. Geise and Patricia Provance, Pennsylvania (hereinafter called Trustees), WITNESSETH: WHEREAS, Settlor has transferred to Trustees all of the property set forth in Schedule A attached hereto; and WHEREAS, Settlor may from time to time transfer to the Trustees certain property; and NOW 'IT~REFORE, Settlor hereby establishes with Trustee a trust known as The Bernice M. Geise Revocable Trust consisting of the property set forth in Schedule A, together with all other property, real or personal that may be added to the trust and including the proceeds of any policies of life insurance in which the Trustees is named as beneficiary- (such property, additions and proceeds being hereinafter called principal) to be held by the Trustees, IN TRUST, for the following uses and purposes: FIRST: During the lifetime of the Settlor: A. The Trustees shall pay the net income to the Settlor in such periodic installments as the Trustee shall find convenient, but at least as often as quarter-annually. B. The Trustees may apply the net income of this Trust for the support of the Settlor should she by reason of age, illness, or any other cause, in the opinion of the Trustee, be incapable of disbursing it and Trustee is further authorized to expend or apply from the principal of this Trust such sums . as they, in their sole discretion, may from time to time think advisable for the support of Settlor to maintain her in the station of life to which she is accustomed at the creation of this Trust or during illness or 1 emergency. C. The Trustees shall pay so much of the principal of.the Trust up to the eritire amount of principal to the Settlor as the Settlor shall request in writing. D. If the Settlor is, in the opinion of the Trustees, disabled by reason of age, illness or any other cause, the Trustees may, but is not required to, apply for Settlor's husband's benefit as much of the net income and principal of this Trust as Trustees may think advisable for Settlor's husband's support to maintain him in the standard of living to which he is accustomed at the creation of this Trust, taking into account his other readily available assets and sources of income. SECOND: Upon the death of the Settlor, Trustees shall hold all of the principal hereof as a separate trust under this Article SECOND for the following uses and purposes: A. To pay the net income therefrom to Settlor's husband, George H. Geise, for and during his lifetime in such periodic installments as Trustees shall fmd convenient, but. at least as often as quarter- annually. B. As much of the principal of this Trust as Trustees, other than George H. Geise, in their sole discretion, may from time to time think advisable for the support of Settlor's husband to maintain him in the station of life to which he is accustomed at Settlor's death, or during illness or emergency, shall be either paid to him or else applied directly for his benefit by Trustees after taking into account his other readily available assets and sources of income. C. Trustees may apply the net income of this Trust for the support of Settlor's husband, George H. Geise, should he by reason of age, illness or any other cause, in the opinion of Trustees, be incapable of disbursing it. D. In addition to the above provisions, Settlor's husband shall have the power to direct Trustees to pay to him or to apply out of principal in each yeaz, including the year of Settlor's death an amount not in excess of the greater of Five Thousand ($5,000.00) Dollars or five (5%) percent of the then 2 aggregate value of the trust principal. This power is non-cumulative and can be exercised only by an instrument in writing signed by Settlor's husband and delivered to Trustees. E. Upon the death of the Settlor's husband; George H. Geise, or upon the Settlor's death, if her husband predeceases her, Trustee shall distnbute the then remaining principal and any accumulated or undistnbuted income to the Settlor's then living issue, per stirpes. F. Should any person entitled to distnbution from the Trust be, in the opinion of the Trustees, incapable of disbursing it because of age, illness or other cause, and should it be impossible or inadvisable, in the opinion of the Trustees, for such share to be awarded to such person or distributed to another for such person's benefit, the share of such person shall be held, IN FURTHER TRUST, and Trustees shall accumulate the income and shall apply from time to time such portions of income, accumulated income, and principal as it thinks proper for that person's support and education (including education in college, trade school, or graduate school) without regard to his or her parent's ability to provide for such support and education, or to make payment for these purposes without. further responsibility to the beneficiary or the beneficiary's parent, or to any person taking care of the beneficiary. Any principal or income not so applied shall be distributed to the beneficiary when he or she becomes of age or competent, or to the personal representative of the beneficiary's estate in case of death during minority or before becoming competent. THIRD: The interests of the beneficiaries hereafter shall not be subject to anticipation or to voluntary or involuntary alienation. FOURTH: Trustee shall have the power, but not the duty, to make such expenditures out of the principal allocated to the Trust as they in their uncontrolled discretion, may consider desirable in order to facilitate the settlement of Settlor's estate. In exercising such power, Trustee may pay, in whole or in part, any or all of the following items: the expenses of Settlor's last illness and burial, including cost of gravemarker, her debts; her income taxes; the death taxes or any or all property included in her gross estate for tax purposes; and all other items in connection with the settlement of her estate. Any such items maybe paid directly by Trustees or the funds for their payment may be paid directly by .Trustees or the funds for 3 their payment may be transferred by Trustees to Settlor's or Settlor's husband's estate shall be required to reimburse Trustees for any funds so paid or transferred. All such death taxes on present or future interests shall be paid at such time as Trustees may think proper, regardless of whether such taxes are then due provided that any postponed taxes on future interests in the residuary trust hereof shall be charged against the principal of the particular share with respect to which the taxes are imposed.. FIFTH: Trustees shall have the following powers in addition to those vested in them by law and by other provisions of this Trust, applicable to all property, whether principal crr income, including property held for minors, exercisable without court approval, and effective until actual distribution of all property. A. To retain any or all of the assets of this Tnist, real or personal, including stock of Trustee or its parent holding company, without regard to any principle of diversification. B. To invest in all forms of property, including stock, common trust funds and mortgage investment funds whether operated by Trustee or others, without restriction to investments authorized for Pennsylvania fiduciaries, as it deems proper, without regard to any principle of diversification. C: To sell a public or private sale, to exchange or to lease for any period of time, any real or personal property and to give options for sales, exchanges or leases for such prices and upon such terms and conditions as they deem proper. D. To allocate receipts and expenses to principal or income, or partly to each, as Trustees, other than George H. Geise, from time to time thinks proper in their sole discretion. E. To compromise any claim or controversy: F. To distnbute in cash or kind or partly each G. To hold property in its name without designation of any fiduciary capacity or in the name of a nominee or unregistered. 4 SIXTH: Trustees shall have no duty to pay any premiums on the life ~n~TM~nce policies subject hereto and the companies issuing such policies shall have no responsibility to see to the fulfillment of this trust or the application of the proceeds of such policies and Trustees shall have no duty to bring suit upon any of the life insurance policies subject hereto unless it holds funds hereunder out of which it may be indemnified against all costs, legal fees and other expenses of suit. SEVENTH: Settlor reserves to herself the following rights (each of which may be exercised by Settlor alone whenever and as often as Settlor may wish): A. All rights now or hereafter vested in Settlor as the owner and the insured under the life insurance policies subject hereto, including, but not limited to, the rights to change beneficiaries, to borrow on policies either from the issuing companies or from other institutions or other persons, to assign and pledge policies for any loan, and to receive dividends and all other payments available to the owner and the insured; and B. The right by an instrument in writing, intended to take effect during Settlor's lifetime signed by Settlor and delivered to Trustee to revoke or amend this Agreement in whole or in part provided that the duties, powers and liabilities of Trustee shall not be substantially changed without its written consent. EIGHTH: Subject to the approval of Trustees, anyone may add property, real or personal, to the principal of this trust by deed, will or otherwise. NINTH: The situs of this Trust, for administrative and accounting purposes, shall be in the County of Cumberland and Commonwealth of Pennsylvania, and all questions pertaining to the construction or validity of the provisions of this instrument shall be governed by the laws of the Commonwealth. TENTH: In the event that Patricia Provance fails to qualify or ceases to act as Trustee, the Settlor's daughter, Caroline Geise, shall serve as Co-Trustee in her place. In the event both of the Settlor's said daughters fail to qualify or cease to act as Co-Trustees, the last Co-Trustee to serve should designate a 5 successor Trustee in writing which designation shall become effective by filing said written designation with the Clerk of the Orphan's Court. If no designation is filed by either of Settlor's said daughters any Judge of the Orphan's Court Division of the Court of Common Pleas may designate said successor Co- Trustee. IN WITNESS WHEREOF, Settlor and Co-Trustees have hereunto set their hands and seals the day and year first above written. ;~~~d2~ witness ~~ ~~ ~. witness -~~ ~Y~ witness 6 COMMONWEALTH OF PENNSYLVANIA ss: COUNTY OF CUMBE~I,AND On this the ~ ~ ~ir` day of January, 1998, before me, the undersigned officer, personally appeared Bernice M. Geise, lrnown to me or satisfactorily proven to be the person whose name is subscribed to the foregoing instrument, and acknowledged that she executed the same for the purposes therein contained. IN my hand and official seal. Notarial Seal ` Darla C. Pamrer, Notary Public `/ Lemoyne Boro, Cumbeland Couniy ( (~ My Commission Expires Dec. 29, 2001 I 1`. ~~' Member, Pennsylvania Association of Notaries Notary Public COMMONWEALTH OFPENNSYLVANIA COUNTY OF CUMBERLAND ss: On this the l~~day of January, 1998, before me, the undersigned officer, personally appeared George H. Geise, lmown to me or satisfactorily proven to be the person whose name is subscribed to the foregoing instrument, and aclrnowledged that he executed the same for the purposes therein contained. IN WITNESS WI~REOF, I hereunto set my hand and official seal. Notarial Seal Darla C. Parmer, Notary Public Lemoyne Boro, Cumberland County My Commission F~cpireS Dec. 29, 2001 Member, Pennsylvarli8 ABB801lt1Of1 of NOk41198 1 ~~ Notary Public COMMONWEALTH OF PENNSYLVANIA COUN'T'Y OF CUMBERLAND ss: On this the'~~ day of January, 1998, before me, the undersigned officer, personall a eared Y PP Patricia Provance, lmown to me or satisfactorily proven to be the person whose name is subscnbed to the foregoing instrument, and aclQiowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Notarial Seal 1 Darla C. Parmer, Notary Public 111 Lemoyne Boro, Cumberland County NO Public My Comnssion Expires Dec. 29, 2001 ~' Member, Pennsylvania Associa#ion of Notaries 7 .~ rn w s ~aa v ~" ~ i 4 ~ -~ o co m o ~ ~ ~i `~tn~ '~~'' ~ ~ X J ~ r o ~ ~ o m ~ ~ C: ~ ~: N a O~: ~' __ o , Ch ~ •' ,: a ~:: o d( co T V •, K ~ O v a N :; d :, o :, 4 0 a c V Q 0 d 0 W ~~>::~ ~' :;'~ cn :,:~:c o :'~ .':c ':~. ;iC 0 0 0 o' ~r 0 ~~~ om~ a fl7 " z O N ~ ~ ri ; N c°D~^~n~i ~^ ~~•: ~ -'~ gym; ' ~ fl 'ti u i o $ D: © W ~~acn ~m gyn. ~~ ~s~.: a~~ ~ ~ ,~ 0 ~ 0 m ..~ ~ ~~ ~.b: O~ ~D!. ~ p ~,., ; U9 ems' p „ ~ a ~ :; ~! ~ -J •. 4 ~ ~ ~.: ~. .~ ~ :; v, m ~::' 'n • : . r W'; ~~~ •'.' w O O W w oa 0 W 0 Q W cn w 4 L D b~ D ~ ° ~ m N ~ v ~i ~ ~' ~ D o y °° ~ ~~~ m o ~ ~ ~- ~ ~ O ~ N ~ ' ~ q ~o~n~ ~ ~ rnp ~7~ vtcpn N C1 ~ ~~~ ~ , ~ ' CJ 'L" ~-- _ '~ cn p0 o~ 0~ O ~ o` ~ ~ O ..r `G `J ~ ~ `~. '~ o ~ i`'~ C~ d ~ AOCQ7 _ o m ,n N i 4b c0 cSJ ° ~ ~ ~' ~~ o~ ~~ to m N ~ N s o ; ; ~ . , O T •Y • ~ ~ v ~ ~ v ~ • ~ o ~ B ~ i 4 ~ i V sip ~ ~ ~ N U ~ ~_ ~ ~ S ~ O ~ fR SU p Q ~ + ~ . ~~m ~ , ~ ~ ~ ~ ~~ ° ~ ~ a, ~ ~ ~ m ~ o o. ~ ~ ~ m Q2 ~ .7 ~ ~. ~ ~ o ~ ~ N ~ '• ~~ ~ ~ w. /il ~ .. yam roz ~ -o ~' a ~ ' rn ~' ~' a ~ `~, ~~ ~' ~ ~ m 0 N - C/) rn ~~ { ~ ~~~ w ~ tp ~ S ? W ,P ~ ~ w o ~~ rn w to a.. ~~ ~~ ..., . •-~ ~. *C ~° N w ~a 0 Q G7 W tG Cf A ~a o G7 O ~+ ~ ~. ~ ' ~ ~. ~ ~ ~m -~ -n C.; ~ ~: C:: ~; as w, ~ :; ~o ~:. W' ~i N w 0 A G7 O -~~ ~. ,~ z ~ ~ ~ r.,~ m O -~- Q. ~: ~: ~• ~•. ~a ~': N i ~ i ~•. ~~: ~s :: rn:: .r.:. v ..i O 0 c> ~ i o ^~I ~ c°o0 ,Z• ~ O ~ ~n ~mD rr~ ~ 'v ~,m~; ty ~ cn ?< ~ ~ x; ~ ~: ~w N --s N J . ~ N~ D Q, O ,; C rv ~, y .. N O qy O O O N Q C7 d 4 O W W O 0 O Q n mca O O 4 .a b 0 c S ~D~ ?>~•< N~ m ~ to C o ~ `~ ~. ~ ©: ~ ~: ~ ~: ~•. Q': Ott .; W: ~•: CTI :. ~~ O ~: ..a N aD .a N '~! ~~„ N W Q 0 O 4 N au O 4 Q D a H O ~ -mod ~ y 0 ~ t~'> C ~ ~ ~ --i -i ~ € s 3~ ~ ~ tr ~c ~rr~~~ !~ ~ S LL i m C C ~ ~ .. .. V m r w b~ w m y 0 0 0 i o c o ~' ~ ~ ~ ~ ~ m M w Si w p ~ i ~ ~Li n ~ 0 ~ ~ D n p C ~- j K ~. ~ ~ .. y O [o ~ O .., N ~p oz~na a'cb? m ~ GO w ~ o~ ~ ~ ~ a~z ~~ a ~ z o ~ m n ~ r ~ c7 z %T~ ~ A p o D A a w T a~ r O ~ Z ~. ~ Y7' N O ~ ~ G ~ N /~ ~ .•.. A ipo O 4 D ~ ti ~ b1 ^- V1 ro ~ REV•1161 EX+112.88) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES ~ INRESDENTDECEDENTR" ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER GEISE, GEORGE H. 21-09-00576 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION NUMBER AMOUNT A. FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid 5,464.79 2. Attorney's Fees Johnson Duffie 7,500.00 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 922.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1,788.61 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 15,675.40 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-"1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER GEISE, GEORGE H. 21-09-00576 ITEM NUMBER DESCRIPTION AMOUNT Funeral Exaenses 1 Airtran Airways -Orlando to Harrisburg and return. 359.20 2 Bethany Village -memorial gathering. 316.37 3 Hampden Inn -room charges. 271.48 4 Myers-Harner Funeral Home -funeral expenses 2.761.00 5 Tavern on the Hill -Funeral Meal 1.756.74 H-A Subtotal 5,464.79 Other Administrative Costs 6 Atlas Van Lines -furnishings removed from Bethany to Delaware 1,487.61 7 Cumberland Law Journal -advertising letters. 75.00 8 Munn's Diamond Gallery -watch appraisal. 50.00 9 Register of Wills -file Inventory and Inheritance Tax Return. 30.00 10 The Patriot-News -advertising letters 146.00 H-B7 Subtotal 1,788.61 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-'500 Schedule H (Rev. 6-98) Rev-1572 EXa (8-98) CONMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMIBER GEISE, GEORGE H. 21-09-00576 Include unrolmburoed medical expenses. i~~ niv~e Mace a neeUea, aaamonal pages or the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA•1500 Schedule I (Rev. 6-98) -~ REV-~sts t:X+ tt>-ooh COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE fNUMBER VL1~7 C, VCVRVC A. 21-09-0 0576 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT SHARE OF ESTATE (Words) AMOUNT OF ESTATE ($$$) Do Not Ust Trustee s I~ TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] 1 Caroline L. Geise Daughter Tangible 217 Baynard Boulevard Personalty; Wilmington, DE 19803 One-half Residue 2 Patricia G. Provence Daughter Tangible 1841 Bamberg Avenue Personalty; The Villages, FL 32162 One-half Residue Total Enter dollar amounts for distributions shown above on lines 5 through 18, as appropri ate, on Rev 1500 cgver sheet III NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTA L OF PART II - ENTER TnTnl IUnN_TAYARI C nicTO~oi iTin~~c ~.~ ~ ~.~~ .....~ ..~. , . ___ __..__ _..~__ _ _ _ - - -- ---- - - - - ..vv vvvcn an c i V.YV Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-M 500 Schedule J (Rev. 6-98) __ r r '1 \ ~ Y . ~-- _ ~.....~.~..~, ~ • 1 .rte \ ~ ~ - ~ L .~ f. _! __~1~ ~: __! ~~ f-y~~T ,/.- 1 '~ y tit ~` -.' a .%. ~ - - _ _ I / ~ ~tt~# i11 end c~e~tttment of BE1tNICE M. GEISE I, BERNICE M. GEISE, of the 1710 Wazren Street, New Cumberland, Cumberland County, and Commonwealth of Pennsylvania, declaze this to be my last Will and revoke any Will previously made by me. ITEM I. I bequeath my automobiles, household and personal effects, and other tangible personalty of like nature (not including cash or securities), together with any existing insurance thereon, to my husband, GEORGE H. GEISE, if he survives me by thirty (30) days. Should my husband, GEORGE H. GEISE, not be living on the thirty-first (31st) day after my death, I bequeath such tangible personalty and insurance thereon to such of my children as aze living on the thirty-first (31st) day after my death, to be divided among them by my executor with due regard for their personal preferences in as nearly equal shazes as practical. ITEM II. I devise and bequeath the residue of my estate of every nature and wherever situate, including any property over which I shall have any power of appointment, to GEORGE H. GEISE and PATRICIA PROVANCE, as Trustees, to be added to and thereafter treated. as a part of that certain revocable trust created by me on January _1998, to have and to hold, IN TRUST, for any uses and purposes and subject to the terms and provisions thereof; including any alterations or amendments thereto, or any other inter vivos trust which may thereafter be substituted therefor. ITEM III. I appoint PATRICIA PROVANCE, guardian of any property which passes, either under this Will or otherwise, to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so, provided that this appointment of a guardian shall not apply to property distributable to a minor for whom I have otherwise made special provision and provided further that this appointment of a guardian shall not supersede the right of any fiduciary+ in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have the power to use principal as well as income from time to time for the minor's support and education (including college education, both graduate and undergraduate) without regazd to his or her pazent's ability to provide for such support or education and to make payment for these purposes, without further responsibility to the minor or to the minor's parent or to any person taking care of the minor. ITEM IV. All federal, state and other death taxes payable because of my death, with respect to the property forming my gross estate for tax purposes, whether or not passing under this Will, including any interest or penalty imposed in connection with such tax, shall be considered a part of the expense of the administration of my estate and shall be paid from my residuary estate without apportionment or right of reimbursement provided that any taxes on the revocable trust created by me on January ~, 1998, may be paid from the assets of that trust as provided therein. ITEM V. My executors and guardian shall have the following powers in addition to those vested in them by law and by other provisions of my Will, applicable to all property, whether principal or income, including property held for minors, exercisable without court approval, and effective until actual distribution of all property: A. To retain any or all of the assets of my estate, real or personal, including any shares of stock or other securities I may own of the corporate fiduciary or its successors, or of a holding company controlling the corporate fiduciary or its successor, without restriction to investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to any principle of diversification. B. To invest in all forms of property (including stock or other~securities of the corporate fiduciary or its successor, or of a holding company controlling the corporate fiduciary nor its successor, and common trust funds and mortgage investment funds whether maintained by my corporate fiduciary or its successors or others), without restriction to investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to any principle of diversification. C. To sell at public or private. sale, to exchange, or to lease for any period of time, any real or personal properly and to give options for sales, exchanges or leases, for such prices and upon such terms or conditions as they deem proper. D. To allocate receipts and expenses to principal or income ar partly to each as they from time to time think proper. E. To borrow from, or sell to, the trustee under my inter vivos trust mentioned above, even though such trustee maybe my executor. F. To join with my husband, GEORGE H. GEISE, or his personal representative in filing a joint income tax return without requiring him or his estate to indemnify my estate against liability for the tax attributable to her income and to consent to any gifts made by my husband during my lifetime being treated as having been made one-half by me for purposes of the federal gift tax law. ITEM VI. I 2ppoint my husband, GEORGE H. GEISE, Executor of this my last Will. Should my husband, GEORGE H. GEISE, fail to qualify or cease to act as Executor, I appoint PATRICIA PROVANCE Executrix of this my last Will. Should both of the foregoing fail to quajlify or cease to act, I appoint my daughter, CAROLINE GEISE, Executrix of this my last Will. ITEM VII. I direct that my executors and guardian shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand this ~ ~i ~ day of Jan , 1998. (SEAL) Bernice M. Geise SIGNED, SEALED, PUBLISHED AND DECLARED, by Bernice M. Geise, the Testatrix above named, as and for her Last Will and Testament and in the presence of us, who, at her request, in her presence and in the presence of each other, have subscnbed our names as witnesses. Witness :mow c~~9x.C., ~ Address Witness Addr/els~sG~ ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA :SS: COUNTY OF CUMBERLAND I, Bernice M. Geise, Testatrix, whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby aclrnowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. .~... ~ ~y ;vim,`-~ BERNICE M. GEI$E Sworn to or affirmed and aclmowledged before me, by Bernice M. Geise, the Testatrix, this ~~ day of January, 1998. Notarial Seal Darla C. Parmer, Notary Publ~ Lemoyne Born, Cumberland County MY Commission Expires Dec, 29, 2001 Member, PsnnsyNania Associeti0lt Ot NOtwrl.e l / ~~¢ Notary Pubic My commi$sion expires: (SEAL) AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA :SS: COUNTY OF CUMBERLAND We, ~ , c.L.4.~ C~1 S-tc~~..~ and ~ ,~~~i~,~?'' e witnesses whose names are signed to the foregoing instrument, being dul}~'qualified according to law, do depose and say that we were present and saw the Testatrix sign and execute the foregoing instrument,as her Last Will and Testament; that he signed willingly and that he executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our lmowledge, the Testatrix was at that time at least 18 years of age, of sound mind and under no constraint or undue influence. Sworn o or affirmed and subscribed to be ~k me by ~lu 1a f (~ V~ • J Tcu~l~i i ~ and ~~'~! A -~n- (; ~' ,witnesses, ttus ~ day of January, 1998. Noffirial Seal Darla C. Partner, Notary Public Lemoyne t3oro, Cumberland County My Commission E~ires Dec. 29, 2007 Member, Pennsylvania Assodation of Notaries ~c~Q,e~~ 1'c Notary Public My commission expires: TO Register of Wills Office Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 SUBJECT: Estate of George H. No 21-09-00576 FROM JOHNSON, DUFFIE, STEWART & WEIDNER Attorneys at Law P.O. Box 109 Lemoyne, PA 17043 (717) 761-4540 Fax• (717) 761-3015 DATE: October 23, 2009 Enclosed for filing in the above-captioned Estate are the following: ~~ `-ri-~ c~ _ - ,=: . =~ - c~ ~ 'c-'' ---+ :; ~ ' ,' 1. Original and copy of Inventory. ~~~~~ rv . J ' 2. Original and copy of Inheritance Tax Return. ;? °1 -= a ~ Check in the amount of $30.00, filing charges. 3 ` ~ t ~ T ~ 4 + 1 '~ . Check in the amount of $6,425.23, Inheritance Tax. 4 ' ~--- ~ ~- ' ~~ . and the stamped Inventory to me in the en t i d- . velope provide s p Please forward the rece ~ ~ Thank you. SIGNED: Cindy Hubler, Estate Administration P t~:~ ~ E1t'F (,~' ~Ua~~~ ~' ~~.~ 209 OCi Zb ~P~ !~~ 49 ~~ ~~~ ~~. n ~~. ,. ~ o ~~ ov ~oo N ~ I .- • M uuu111 N f ~~ Q ~`y~N N ~~ ~LL M ~ V' ~_ Np Q l~.l W)~fYOYY~~• N L .. F F h F o 4 a 0 6 ~ ~~~,, o ~'w OM O ~ o M L1i ..a .~-~ W N W~ H Q~.r l~ OUWcMn N>+a~''1 aHO~ a~ao ~o`~~ UW W N ~ oAOa 0 w~Ha Haan V~WJN ~°~~a ~ U ~ U O ` W N A~ ~ ~