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Home My WebLink About12-15-09 (2)15056041158 REV-1500 Ex cob-o5> OFFICIAL USE oNLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes 21 D 9 0 3 8 2 PO BOX 280601 INHERITANCE TAX RETURN Harrisburg, PA 17126-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 195-07-6280 03302009 03051916 Decedent's Last Name HUZEY Suffer Decedent's First Name CLARA (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffer Spouse's First Name Spouse's Social Security Number FILL IN APPROPRIATE BOXES BELOW 1. Original Return ^ 4. Limited Estate a 6. Decedent Died Testate (Attach Copy of Will) ^ 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS ^ 2. Supplemental Return ^ 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) ^ 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) MI E MI ^ 3. Remainder Return (date of death prior to 12-13-82) ^ 5. Federal Estate Tax Return Required .D- 8. Total Number of Safe Deposit Boxes ^ 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST l3E COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number N LINDA J• LUNDBERG, VICE PRESIDENT 717-73D-5 _, - 7 = ~r1 r`°~ j`i s C Firm Name (If Applicable) - -= _'- t].S USF'ONLY c REGIS7EFf QFC{M PNC BANK, N • A • -- ~ ~ ~"`~',-~ ~~ '=- ~ ~~' First line of address E..~, ~- c"~ t ; ~ . '- ~A P 0 BOX 308 ~, -' '-.- Iv _~ ~- --i Second line of address -r,.l "~ -~' („a G~9 ri,rn~c ivV lr.: L)UtS t(J AN City or Post Office State ZIP Code ELECTRONIC MALFUNCTION WITH TIMECLOCK -THE CLOCK DATE ON CAMP HILL P A 17 D D 1- D 3 ~ THIS DOCUMENT IS 12 HOURS BEI IIND THE ACTUAL. TIME. LINDA • L U N D B E R G a P N C• C O M --xFctsT>~.R of azr~/cr.>xx o>~ oxrx~NS• cxT Correspondents e-mail address: „t „, ~n ~,,,,,.,. r -~ _ Under penaRies 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, corcect and complete. Declar~n of preparer other than the persor~al representative is based on all information of which preparer has any knowledge. PNC BANK, BY' ~\~U ADDRESS v ~, A 1~~\D~ ~ P 0 BOX 308 CAMP HILL, PA 17001-0308 SIGNATURE OF PREPARER OTHER THAN REPRESENTATNE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 15056041158 6M46473.000 15056041158 J~ J 15056(]42159 REV-1500 EX Decedent's Social Security Number 195-07-6280 Decedent s Name#~i U Z E Y C L A R A E -- REC APITULATION 1. Real estate (Schedule A) 1 ~ 0 . 0 0 2. Stocks and Bonds (Schedule B) . 2. 0 . 0 0 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) • 3• 0 • 0 0 4. Mortgages & Notes Receivable (Schedule D). 4. 0 . 0 0 5. Cash, Bank Deposits ~ Miscellaneous Personal Property (Schedule E) . 5. 3 4 9 3 , 0 0 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested 6. 0 . 0 0 7 Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property . (Schedule G) ~ Separate Billing Requested 7. 9 6 8 8 6 5. 0 0 8 Total Gross Assets (total Lines 1 7) 8. 9 7 2 3 5 8. 0 0 9. Funeral Expenses & Administrative Costs (Schedule H) • 9 • 3 9 615 • 0 0 10. Debts of Decedent, Mortgage Liabil'dies, ~ Liens (Schedule I). 10. 5 8 7 • 0 0 11. Total Deductions (total Lines 9 & 10) • 11 • 4 0 2 0 2 ' 0 0 12. Net Value of Estate (Line 8 minus Line 11) 12. 932156.00 13 Charitable and Governmental Bequests/Sec 9113 Trusts for which . an election to taz has not been made (Schedule J) . 13. 0 • 0 0 14 Net Value Subject to Tax (Line 12 minus Line 13) 1 a. 9 3 2156.0 0 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .OIL 0 • 0 0 15. 0 • 00 16. Amount of Line 14 taxable at lineal rate X .0'~-5 0. 0 0 16. 0. 0 0 17. Amount of Line 14 taxable at sibling rate X .12 17. 4 2 3 7 6. 0 0 5 0 8 5.0 0 18. Amount of Line 14 taxable at collateral rate X .15 1 g. 8 8 9 7 8 0. 0 0 13 3 4 6 7.0 D 19. TAX DUE 19. 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 138552.00 15056042159 15056042159 6M4648 2.000 REV-1500 EX Page 3 File Number na n~aa ueceaeni s wrn ~G~c r-u.,~ ~~~. - - - - - DECEDENTS NAME H Y ARA STREE? ADDRESS M A 0 TY C11.~, STATE ZIP ARLIS E Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit 0 • D 0 B. Prior Payments 12 3 5 0 0. 0 0 C. Discount 6 5 0 0. 0 0 Total CredRs (A + g + C) 3. Interest/Penalty if applicable D. Interest 0 ' 0 0 E Penalty 0 ' D 0 TotallnteresUPenaRy (D + E) 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. 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. (1) 138552.00 (2> 130000 • DO (3) 0 • D 0 (4) 0.0 D (5) 8552.OD (5A) 0.0 0 B. Enter the total of Line 5 + 5A This is the BALANCE DUE. (56) 8 5 5 2.0 D Make Check Payable to: REC~YSTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred; b. retain the right to designate who shall use the property transferred or its income; ~ X c. retain a reversionary interest; or X ^ d. receive the promise for life of either payments, benefits or care? 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . - X 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? . 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which ^ contains a beneficiary designation? IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not 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 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)J. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 6M4671 1.000 REV-1508 EX + (6-~) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, 8i MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER CLARA E. HUZEY 21 09 0382 Include the proceeds of Iftigation and the date the proceeds were received by the estate. AB property fointlyowned with fhe right of survivorship must be disclosed on Schedule F. ITEM I VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 ORRSTOWN BANK CHECKING ACCOUNT #108005499 2 PNC BANK, N.A. CHECKING ACCT #5140031274 3 US TREASURY - 2008 FORM 1040 REFUND 4 PA DEPT OF REVENUE - 2008 FORM PA-40 REFUND 5 HIGHMARK BLUE SHIELD - REFUND 6 CURRENCY FOUND IN DECEDENT'S WALLET 7 CHURCH OF GOD HOME - REFUND 8 SECURITY RARE COINS - PROCEEDS OF SALE OF (2)TWO DOLLAR BILLS 9 BLUECROSS BLUESHIELD - BENEFITS REFUND 10 ROWE'S AUCTION SERVICE - AUCTION PROCEEDS 444 1,655 7 92 354 24 13 70 5 1 135 3,493 3wasAD i.oo0 (If more space is needed, insert additional sheets of the same size) REV-1510 EX + (6-96) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER VIVOS TRANSFERS 8~ MISC. NON-PROBATE PROPERTY ESTATE OF r~~~ tvumocrc 21 09 0382 CLARA E. HUZEY 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 o EXCLUSION TAXABLE ITEM pd0 ~ rc T~{ NMAEOFTFETRANSFEREE, TF¢~R RELAT~ONSI9G TO DECEDENT AW DATE OF DEATH /o OF DECD~S JMBE TFEDATEOFTRMSFH2.ATTACHACOPYOFTNEDEEDFORREALESTATE. VALUE OF ASSET INTEREST ~~ REVOCABLE DEED OF TRUST DTD 06/10/76, AS AMENDED WITH CLIFFORD L. (DIED: 08/03/04) & CLARA E. HUZEY, SETTLORS WITH pNC BANK, N.A., TRUSTEE (SEE COPY OF INSTRUMENT & LIST OF ASSETS ATTACHED) 958,258 100.0000 Interest accrued to 3/30/2009 10,607 100.0000 TOTAL (Also enter on line 7, Recapitulation) I $ (If more space is needed, insert additional sheets of the same size) OI 958,258 10,607 9 3W46AF 1.000 ESTATE TAX SECURITIES VALUATION ACCOUNT: 3116753 Nana of Estate: CLARA E HUZEY DATE OF DEATH: Monday, March 30 2009 ITEM COSIP NO. SHARES/ DESCRIPTION PRICE HIGH/ASR LOW/BID MEAN SECURITY PAR VALUE DATE PRICE PRICE PRICE VALUE 1) 091927673 2,d25.5730 82.ACRROCK FDS 03/30 15.1900 15.19000 36,84d.45 IliDX EQTY INST 2) 091928263 4,166.4810 BI.ACRItOCK FDS 03/30 8.7200 8.72000 36,523.55 IAW DURATN INS 3) 09251M504 1,694.6880 BLACIOtOCpC EQIIITY DIVID FD 03/30 11.6400 11.64000 19,726.17 INSTL CL 4) 23339E731 4,940.7110 DWS INH'PS TR 03/30 9.9600 9.96000 49,209.48 SHTRM MUBDED S 5) 3133XRX88 50,000 FEDERAL HOME LOAN BANKS 03/30 106.8438. 106.6250 106.73440 53,367.20 CONS HD 4$13 Int. Frain: 03/06/2009 to 03/30/2009 6) 31359MPF4 50,000 FEDERAL NATL MTG ASSN 03/30 108.0938 107.9375 108.01565 54,007.63 CALL4.3751091512 Int. From: 03/15/2009 to 03/30/2009 7) 31359MZL0 50,000 FEDERAL NAIL MTG ASSN 03/30 105.9375 105.8750 105.90625 52,953.13 FR 4.754121510 Int. From: 12/15/2008 to 03/30/2009 B) 31359MZ30 50,000 FEDERAL NAIL MTG ASSN 03/30 108.0000 107.8750 107.93750 53,968.75 FR 56101511 Int. From: 10/15/2008 to 03/30/2009 9) 552983694 1,804.9660 MFS SER TR I 03/30 15.1200 15.12000 27,291.12 VALUE FD CL I 10) 72201M552 6,007.2950 PII4C0 FDS 03/30 10.1200 10.12000 60,793.83 TOTAL RTN FD P 11) 77957Y106 548.1220 ROBE T PRICE MID CAP VALUE FD 03/30 13.0000 13.00000 7,125.59 C06! 12) 912810DW5 130,000 UNITED STATES TREAS BDS 03/30 131.5625 131.5000 131.53125 170,990.63 07.2501 05/15/16 Iat. From: 11/15/2008 to 03/30/2009 13) 9128100X3 165,000 UNITED STATES TREAS HDS 03/30 134.0625 134.0000 134.03125 221,151.56 07.5001 11/15/16 Int. Frain: 11/15/2006 to 03/30/2009 ld) 912B10ED6 30,000 UNITED STATES TREAS BDS 03/30 144.7813 144.7188 144.75005 43,Q25.02 06.1251 08/15/19 Iat. From: 02/15/2009 to 03/30/2009 15) 999749252 70,679.2300 PNC DEL SWEEP DEPOSIT ADM 70,879.23 Grand Totals Total priacipal plus Accrued interest and dividends PAGE NO. 1 ACCRIIED CClB+D:NTS DIV/INT MOT FUND MOT FUND MOT FOND MOT FOND GVT AGENCY 138.69 GVT AGENCY 97.22 GVT AGENCY 699.31 GVT AGENCY 1,152.78 MOT FUND MOT FOND MOT FUND GVT AGENCY 3,540.68 GVT AGENCY 4,649.17 GVT AGENCY 296.27 32.62 MANUAL ---------------- ------------ 958,257.54 10,606.94 968,86d.46 This report was prepared using APPRAISE Var. 7.d.1 software, an EVALIIATION SERVICES, INC. product. Phone 201 78d 8500. Visit our web sites at WWW.APPRAISENJ.COM sad WWW.COSTHASIS.INFO. REV-1511 EX+ (10.06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES 8~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER CLARA E HUZEY 21 09 0382 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~ PARTMORE FUNERAL HOME- FUNERAL SERVICES 98 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name aF Personal Representative(s) PNC BANK, N. A. Street Address P O BOX 3 0 8 City CAMP HILL State PA Zip 17001-0308 Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address 4. 5. 6. 7. 1 2 City State Zip _ Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees REGISTER OF WILLS - SHORT CTFS IRWIN ~ MCKNIGHT - REIl~URSEMENT FOR LEGAL ADVERTISING Total from continuation schedules . 29,170 9,875 68 20 300 84 TOTAL (Also enter on line 9, Recapitulation) ~ $ 39 , 615 7W46AG 1.000 (If more space is needed, insert additional sheets of the same size) Estate of: CLARA E. HUZEY Schedule H Part 7 (Page 2) 3 ROWS' S AUCTION SERVICE - CONIIrIISSIONS 4 REGISTER OF WILLS - FEE FOR FILING INVENTORY ~ PA INH TAX RETURN 21 09 0382 47 37 Total (Carry forward to main schedule) 84 REV-15i2EX+(~2-OB) SCHEDULE pennsy{vania DEPARTNENTOF REVENUE DEBTS OF DECEDENT, NJHERITANCETAxRETURN MORTGAGE LIABILITIES $c LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER CLARA E. HUZEY 21 09 0382 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1• WILDEMAN ~ OBROCK - 2008 TAX SERVICE 500 2 CUMBERLAND GOODWILL FIRE RESCUE - TRANSPORT SERVICE 87 TOTAL (Also enter on Line 10, Recapitulation) ~ $ 587 awasAH z.ooo If more space is needed, insert additional sheets of the same size. REV-1513 EX+(11-08) SCHEDULE J Pennsylvania DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER CLARA E. HUZEY 21090382 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS [inGude outright spousal distributions, and transfers under Sec. 2116 (a) (1.2).] 1. ANN C. GRIBBEN 65 LINCOLN PLACE WALDWICK, NJ 07463-2140 7.143 of Residue: 66,584 Niece 66,584 2 PATRICIA E. BIALE 19 CALUMET AVENUE OAKLAND, NJ 07436 7.143 of Residue: 66,584 3 SANDY H. MACKIN 635 WILTSHIRE DRIVE STATE COLLEGE, PA 16803 7.143 of Residue: 66,584 Niece Niece ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. I[ NON-TAXABLE DISTRIBUTIONS: A SPOUSAL DISTRIBU110NS UNDER SECTION 2113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN L B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 66,584 66,584 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. swasAi z.ooo If more space is needed, insert additional sheets of the same size. Estate of: CLARA E. HUZEY Schedule J Part 1 (Page 2) Item No. Description 4 MARAGET D. JOYNT 430 FULTON STREET #400 WAVERLY, NY 14892 7.143 of Residue: 66,584 5 JOHN R. ZEILGLER 19 PERSONIUS ROAD PINE CITY, NY 14871 7.143 of Residue: 66,584 6 JAMES F. ZEIGLER RD 2, BOX 3232 CANTON, PA 17724 7.143 of Residue: 66,584 7 CHARLES D. ZEIGLER 6 RESTON DRIVE FREDERICKSBURG, VA 22406 7.142 of Residue: 66,575 8 BARBARA S. LAW 6352 GUILFORD ROAD CLARKSVILLE, NID 21029 9.09 of Residue: 84,733 9 WOODWARD R. SMITH 1821 GLEN RIDGE ROAD BALTIMORE, MD 21234 4.546 of Residue: 42,376 10 NORMA Z. SMITH 1821 GLEN RIDGE ROAD BALTIMORE, MD 21234 4.546 of Residue: 42,376 11 W. ROGER SMITH PO BOX 1305 EUFAULA, OK 74432 4.546 of Residue: 42,376 Niece Relation Nephew Nephew Nephew Niece Brother Sister-in-law Nephew 21 09 0382 Amount 66,584 66,584 66,584 66,575 84,733 42,376 42,376 42,376 Estate of: CLARA E. HUZEY Schedule J Part 1 (Page 3) Item No. Description 12 WOODWARD R. & NORMA Z. SMITH, TRUSTEES FBO JUDITH A SMITH D/T DTD 05/24/84 1821 GLEN RIDGE ROAD BALTIMORE, MD 21234 4.546 of Residue: 42,376 13 LUCILLE D. SMITH C/O PATRICLA SNYDER 1729 BECHT ROAD WILLIAM.SPORT, PA 17701 4.546 of Residue: 42,376 14 LINDA S. LORSEN .747 IARSEN ROAD WILLIAMSPORT, PA 17701 4.545 of Residue: 42,366 15 PATRICIA A. SNYDER 1729 BECHT ROAD WILLIAMSPORT, PA 17701 4.545 of Residue: 42,366 16 BRYAN K. FISHER 1119 EDEN ISLE DRIVE ST PETERSBURG, FL 33704-1707 4.545 of Residue: 42,366 17 KEVIN FISHER 326 OAK HILL DRIVE MIDDLETOWN, PA 17057 4.545 of Residue: 42,366 Niece Relation Sister-in-law Niece Niece Nephew Nephew 21 09 0382 Amount 42,376 42,376 42,366 42,366 42,366 42,366 LAST WILL AND TESTAMENT I, CLARA 'E'. HUZEY, of Carlisle, Cumberland County, Pennsylvania, do hereby make, publish and declare this to be my last will and testament, hereby revoking all wills heretofore made by me. 1. I direct my personal representative to pay all of my debts, funeral and administrative expenses as soon as convenient after my dacease. I direct that all inheritance #axoa imposed or payable by reason of my death and interest and penalties thereon with respect to all property, whether or not such property passes under this Will, shall be paid by my personal representative out of my estate. 2. I give, devise and bequeath all of my estate of every nature and wherever situate to my husband, Clifford L. Huzey, provided that he survives me by a period of sixty (60) days. 3. If my spouse does not survive me by a period of sixty (60) days, then I direct that all of my estate of every nature and wherever situate be added to the existing Trust created by me and my husband and modified by a Revocable Living Trust agreement, dated April 10, 1998, and by amendment dated September 13, 2002, and that all proceeds be distributed according to the terms of that Revocable Living Trust, as amended on_SeRtember 13, 2002, or any future amendments. 4. I nominate and appoint PNC Bank, N.A., its successors and / or assigns, to be the personal representative of my estate, to serve without bond. 5. I suggest that my personal representative retain the services of Harold S. Irwin, III, Carlisle, Pennsylvania in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this !~ day of September, 2002. ~~4~-~~~~c/ (SEAL) CLARA E. HUZEY Signed, sealed, published and declared by the above-named person as and for a last will and testament, in our presence, who at said person's request, in said person's presenCe and in the presence of each other have hereunto set our names as subscribing witnesses. Y~/~t~c~~~~./ (~/ ~ G e WE, CLARA E. HUZEY, HEATHER A. BARBOUR and RHONDA S. IRWIN, the testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her last will and that she had signed willingly, and that shs executed it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the will as a witness and that to the best of their knowledge the testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. ~~~~- ~-~ CLARA E. HUZEY ~ ~ HEATHER A. BARBO R r RHONDA S. IRWI COMMONWEALTH OF PENNSYLVANIA as: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by CLARA E. HUZEY, the testator herein, and subscribed and sworn to before me by HEATHER A. BARBOUR and RHONDA S. IRWIN, witnesses, this 13~' dad of September, 2002. Notarial Seat Public Harcid S. Irwin RI, Notary Carlisle Born, Cumberlandt 23, 002 My Commission Expires Sep sociation o9 N4t~ries vii t~~ Notary Public Member, Pennsylvania Ps OxRSTOwIv B~ ATrnditimi of Excellence Apri123, 2009 To: PNC Wealth Management Jennie L Cramer 4242 Carlisle Pike ' CampHill Pa 17011 From: Traci Yohe Orrstown Bank Customer Service Center PO BOX 250 Shippensburg, Pa 17257 Re: Estate of Clara E Huzey Date of death March 30, 2009 IT IS HERERBY CERTIFIED THAT THE ABOVE NAMED DECEDENT, ON THE ABOVE DATE, HAD THE FOLLOWING ACCOUNTS WITH ORRSTOWN BANK CHECKING ACCOUNT Account # Title of Account 108005499 Clara E Huzey SAVINGS ACCOUNT Account # Title of Account CERTIFICATE OF DEPOSIT Account # Title of Account Date opened Principal Accrued Interest 02104/00 444.17 0.00 Date opened Principal Accrued Interest Date Opened Principal Accrued Interest P.O. Box 250 • Shippensburg, PA 17257 • 717.530.3530 • 717.532.4143 fax We, CLIFFORD L. HUZEY and CLARA E. HUZEY, his wife, both being residents of Cumberland County, Pennsylvania (hereinafter referred to as 5ettlors); hereby transfer to PNC BANK, N.A., 4242 Carlisle Pike, P.O. Box 308, Camp Hill, Cumberland County, Pennsylvania 17011-0308 (hereinafter referred to as "Trustee"), the property as described on the attached Schedule A, and any and all further additions made hereafter, to be held in Trust upon the following terms: FIRST: This Revocable Living Trust as set forth herein shall modify and amend in its entirety the Funded Revocable Living Trust made by the Settlors dated June 10, 1976, and shall further amend and modify in its entirety any amendments to the aforementioned Funded Revocable Living Trust so that this instrument, together with any amendments hereto, shall be controlling in all respects from the date of this instrument. SECOND: Dispositive Provisions for our Benefit-During our lifetime: A. All of the net income shall be paid to us, or the survivor, on a monthly or quarterly basis, or as either of us may so direct in writing, or shall be paid or accumulated and added to principal, as either of us may direct in writing; B. As much of the principal, as either of us may direct in writing shall be paid to us or as either of us may otherwise direct; C. If, in the Trustee's opinion, both of us are at any time unable to act or to apply the payments to our own best interest and advantage, the Trustee REVOCABLE LIVING TRUST ~ 0 ^~ U ~~ may apply directly for our benef t as much of the income and/or principal as the Trustee may, from time to time, deem appropriate for our welfare, comfort, support or emergency needs, and may add to principal as much of the income as the Trustee deems advisable. D. The Trustee shall keep true and correct books of account, which books of account shall at all reasonable times be opened to the inspection of either of us or our duly appointed representatives}. The Trustee also shall render quarterly to me a detailed statement showing all receipts and disbursements on account of the Trust Estate and the manner and form in which the Trust Estate is invested at the time of the rendition of such statement. _ THIRD: Dispositive Provisions Upon both of our Deaths: The Trustee shall distribute whatever shall remain of principal and income from my Trust Estate as follows: A. One-Half (1/2) of the remaining Trust Estate shall be divided into eight (8) equal shares and be distributed in absolute to each of the following individuals: ANN GRIBBEN PATRICIA BIALE SANDY HUZEY MACKLIN MARGARET JOYNT MII,DRED JONES JOHN ZEIGLER JAMES ZEIGLER CHARLES ZEIGLER If any of the above individuals becomes deceased prior to the distribution of the Trust Estate, then in that event, their respective share shall be divided equally between the remaining surviving shares listed directly above. B. One-Half (1/2) of the remaining Trust Estate shall be divided into twelve (12) shares and be distributed in absolute to each of the following individuals: 2 shazes -BARBARA LAW 1 shaze - WOODWARD R. SMITH 1 shaze - NORMA Z. SMITH 1 shaze -ROGER SNIITH 1 share - NDTI'H SMITH 1 share -ROBERT W. SMITH 1 shaze - LUCII,LE SMITH 1 share -LINDA LOR5EN 1 share - PATRICIA SNYDER 1 share -BRYAN K. FISHER 1 shaze - KEVIl~T FISHER If any of the above individuals becomes deceased prior to the distribution of the Trust Estate, then in that event, their respective share shall be divided equally between the remaining surviving shares listed directly above. 3 C. No part of the income or principal corpus of the Trust Estate created hereunder shall be subject to attachment, levy or seizure by any creditor, spouse, assignee or trustee or receiver in bankruptcy of any beneficiary prior to his or her actual receipt thereof. The Trustee shall pay over the net income or principal to the parties herein designated, as their interest may appear, without regard to any attempted anticipation, pledging or assignment by_ any beneficiary of the trust created hereunder and without regard to any claim thereto or attempted levy, attachment, seizure or other process against said beneficiary. FOURTH: Right to Revoke and Amend: Either of us reserve the right to revoke or amend this Trust, in whole or in part, at any time and from time to time by an instrument in writing, delivered to the Trustee and intended to take effect during our lifetimes, except that the duties, powers and liabilities of the Trustee shall not be changed without its written consent. The Trustee reserves the right, at any time upon thirty (30) days advance written notice to Settlors, to resign the Trust and deliver the Trust Estate to either of us, after deducting therefrom their fees and any expenses then due and payable. FIFTH: Additions to Trust: Subject to the approval of .the Trustee, which approval may not be unreasonably withheld, ..either of us may add property, real and personal, to the principal of this Trust, by deed, Will or otherwise. 4 SIXTH: Trustee's Powers: In addition to the powers granted by law, the Trustee shall have the following discretionary powers, applicable to principal and income, which shall be exercisable without leave of court and shall be effective until distribution is actually made as provided hereunder: A. To accept and retain any or alI property; including stock or other securities of the Trustee or of a holding company controlling the Trustee; B. To invest in all forms of property (including, but not by way of limitation, real estate, all types of stocks, bonds, options, and participation's in common trust funds and money market funds); without being confined to investments prescribed by statute and without being required to diversify; C. To buy investments at a premium or discount; D. To hold property unregistered or in the name of nominee; E. To give proxies, both ministerial and discretionary; F. To compromise claims; G, To join in any merger, consolidation, reorganization, voting trust plan, or other concerted action of security holders, and to delegate discretionary duties with respect thereto; H. To borrow from PNC BANK, N.A. or from others, and to pledge real or personal property as security therefor; to loan cash or securities upon such terms and conditions as Trustee deems appropriate; 5 I. To sell at public or private sale for cash or credit or partly for each, to exchange, to improve, or to Lease for any period of time, any real or personal property; and to give options for sales, exchanges, or leases; J. To allocate any property received or charge incurred to principal or income or partly to each, without being obliged to apply the usual rules of trust accounting; K. To distribute in cash or in kind or partly in each.in accordance with the terms and conditions set forth herein; L. To retain any part of or all of my business interest held in this Trust as long as the Trustee considers it advisable to do so; and to conduct, alone or with others, any such business in which either of us is engaged, with all the powers of an owner or with respect thereto, including the power to delegate discretionary duties to others and to pay adequate compensation to any such person; to invest other property in such business, and to incorporate it to change its form. SEVENTH: Compensation: The Trustee shall be compensated in accordance with its standard schedule of charges in effect from time to time during the period of its services, and this compensation shall be paid from principal or income or partly from each in the sole discretion of the Trustee. EIGHTH: Non-Assignment: The principal and income of this trust shall be free from anticipation, assignment, pledge or obligation of Settlors and shall not be subject to any execution or attachment or to voluntary or involuntary alienation. 6 1~TINTH: Law Governing Trust: This Trust is created and accepted in the Commonwealth of Pennsylvania and shall in all respects be governed by its laws and shall have its silos at Cumberland County, Pennsylvania. . [THE REMAINDER OF THIS PAGE HAS BEEN INTENTIONALLY LEFT BLANK.] 7 IN WITNESS WHEREOF, Settlors has hereunto set his hand this ~~ K day of April, 1998, and the Trustee has executed this instrument by seal and by its authorized representatives. WITNESS: ~. ~ ~1 CLIF L. ~ UZEY y CLARA E. HUZEY "Settlors" ATTEST: SEN ~ c7a ~~ ~ P~~ iDEetl ~ . PNC BANK, N.A. By: ice) President "Trustee" 7DH5TOC¢nG1RVRT 8 COMMONWEALTH OF PENNSYLVANIA . SS: COUNTY OF CUMBERLAND On this, the ro' day of April, 1998, before me, a Notary Public in and for the said Commonwealth and County, personally appeared CLIFFORD L. HUZEY and CLARA E. HUZEY, his wife, known to be (or satisfactorily proven) to be the persons whose names are subscribed to the foregoing Revocable Living Trust and acknowledged that they executed the same for the purposes therein contained. WITNESS my hand and notarial seal. STATE OF PENNSYLVANIA COUNTY OF CUMBERLAND . SS: /~v ~' Notary Notarial Seal Roger B. Irwin, Notary Public Carlisle Boro, Cumberland County My Commission Expires Oct. 3, 2000 Member. Pennsylvania Association of Notaries On this, the ~'a "`day of April, 1998, before m e undersigned officer, personally appeared J<J1rlL`S /-~ ~~~ who acknowledged}~~ to be thel~t~ PNC BANK, N.A.. and that/>LG as suchl/~cE ~5 being authorized to do so, executed the foregoing Revocable Living Trust for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ~~~r~~ ~ ~ ..~ (SEAL) T Title of Officer Notar :I s2~; ~ Stevonna A. Cnl^cian. ~i,-;~>,^; c~ ~hlic j HampdenTwp. C;:n<1,- .: ..`C•- 1 ~ My Commission E;:i:~:r,, . ~"u.:_1::'.~_~(?0 ~t~lern0er, PennsYlva^ia As~c~~~a~~cr ~Ji ILa:crli:b 9 SCHEDULE A SCHEDULE OF PROPERTY This trust estate shall consist of all the property currently in the existing Revocable Living Trust set up with PNC BANK, N.A. as of the date hereof. 10 AMENDMENT TO REVOCABLE LIVING TRUST THIS AMENDMENT TO REVOCABLE LIVING TRUST, made as of this 13T" day of September, 2002, by and between CLIFFORD L. HUZEY, by his power-of- attorney, CLARA E. HUZEY, and CLARA E. HUZEY, individually, of Carlisle, Cumberland County, Pennsylvania, (hereinafter referred to as "Settlor"), and PNC BANK, N.A., of 4242 Carlisle Pike, P. O. Box 308, Camp Hill, Cumberland County, Pennsylvania, (hereinafter referred to as 'Trustee"), is intended to be an amendment to a certain Trust Agreement between the Settlor and the Trustee, dated April 10, 1998. ARTICLE 1-PURPOSE 1.01: This Amendment to Revocable Living Trust as set forth herein shall modify and amend the Revocable Living Trust made by the Settlor on April 10, 1998 (such April 10, 1-998 trust modifying and amending in its entirety the Trust of June 10, 1976 and amended February 3, 1997. ARTICLE tl. -MODIFICATION OF THIRD ARTICLE 2.01: The Third Article of said Revocable Living Trust shall be modified as follows: Subparagraph B. of said Article shall be modified to provide that the share of the Trust Estate to be distributed in absrlute to Judith Smith shall be instead distributed to Woodward R. Smith and Naomi Z. Smith, trustees for Judith Ann Smith under the Deed of Trust for the benefit of Judith Ann Smith, executed on May 24, 1984, in Baltimore, Maryland. ARTICLE III. -RATIFICATION OF TRUST AGREEMENT 3.01: In all other respects, the Revocable Living Trust between Settlor and Trustee, dated April 10, 1998, is hereby ratified and confirmed. IN WITNESS THEREOF, this Amendment to Revocable Living Trust has been signed by Settlor and the Trustees on the day and year first above written. ATTEST: BY: C~~~~ ~~~ CLIFFORD L. HUZEY, by his torney-in-fact CLARA E. HUZEY "SETTLOR" CLARA E. HUZEY "S LOR" PNC BANK, N.A. U A~r• ice) Pr sident "TRUSTEE" WITNESS: ry COMMONWEALTH OF PENNSYLVANIA . :SS: COUNTY OF CUMBERLAND On this, the (3~` day of September, 2002, before me, the undersigned officer, personally appeared CLIFFORD L. HUZEY, by his attorney-in-fact, CLARA E. HUZEY, and CLARA E. HUZEY, individually, his wife, known to me to be the person whose name Is subscribed to the within instrument and acknowledged that she executed same for the purposes therein contained. Notarial 5ea1 Harold S. InMn 111, Notary Public Carlisle Born, Cumberland County My Commission Expires Sept. 23, 2002 Member, Pennsylvania Association of Notaries COMMONWEALTH OF PENNSYLVANIA :SS: COUNTY OF CUMBERLAND On this, the /`S'am day of , 2002, before me, the unde signed offs er, o a eare ~ ,who acknowledged thatis the ~ pars r' j ~. of PNC Bank, N. ., a d th such and being authorized to do so,.~h~ executed the foregoing instrument for the purposes th~ contained. SEAL). ~ . , _ , ;= ' - , NOTARIAL SFJ~t. Pubtfc DENISE C. SULLENSERGER, Notary Hampden Twp., Cumberland County My COrttmisston Expires Nw. 22, 2:.044