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HomeMy WebLinkAbout02-02-10t ~ 15056041158 REV-1500 Ex cos-o5> OFFICIAL USE ONLY ' PA Department d Revenue County Code Year File Number Bureau of Individual Taxes 21 09 00875 Po eox z9osol INHERITANCE TAX RETURN Harrisburg, PA 17129-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 083-12-2477 02152009 07301923 Decedent's Last Name HAYMAKER Suffix Decedent's First Name DOUGLAS (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE - - REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW 1. Original Retum ^ 4. Limited Estate 0 6. Decedent Died Testate (Attach Copy of Will) ^ 2. Supplemental Retum ^ 4a. Future Interest Compromise (date of death after 12-12-82) ^ 7. Decedent Maintained a Living Trust (Attach Copy of Trust) MI B MI ^ 3. Remainder Return (date of death prior to 12-13-82) ^ 5. Federal Estate Tax Retum Required _ 8. Total Number of Safe Deposit Boxes ^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credft (date of death ^ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST t3E COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD t~E DIRECTED TO: Name Daytime Telephone Number CRAIG HAYMAKER 717-691-8600 Firm Name (If Applicable) First line of address 823 HIGHLAND COURT ~_ Second line of address ° i~r1 ~ Qi C! ~'3 City or Post Office State ZIP Code ~ ,~ _-: MECHANICSBURG PA 17050 ~ ~ ~, ~ ~~., "r"7 i .. Correspondent's e-mail address: ~ ~, ~'~' t Under penakies of perjury, I declare that 1 have examined this return, including accompanying schedules and statements, and to the best of my knowl~ end 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. Side 1 1 5056041 1 58 BM46473.000 15056041158 J REGISTER OF WILLS USE ONLY ~n,1 P O. BOX 8300 CAMP HILL, PA 17001.-830_0 PLEASE USE ORIGINAL FORM ONLY 'EstatB of DOUGLAS B. HAYMAKER Executors (Page 1) Name CRAIG HAYMAKER Address 823 HIGHLAND COURT 083-12-2477 MECHANICSBURG, PA 17050- Tax ID - - r ~ 15056042159 REV-1500 EX Decedent's Social Security Number 083-12-2477 u DecedenPa Name1-IATMAKER DOU GLA S B RECAPITULATION 1. Real estate (Schedule A) 1. O.OO 2. Stocks and Bonds (Schedule B) . 2. O.OO 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . 3. O.OO 4. Mortgages & Notes Receivable (Schedule D). . 4. O.OO 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ... 5. 60131.00 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ... . 6. O OO 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property . (schedule G) ~ Separate Billing Requested 7. 119264.00 8. Total Gross Assets (total Lines 1-7). a. 179395.00 9. Funeral Expenses 8 Administrative Costs (Schedule H) . 9. 15595.00 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I). 10. 422.00 11. Total Deductions (total Lines 9 & 10) . .. 11. 16017.00 12. Net Value of Estate (Line 8 minus Line 11) 12. 163378.00 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) . .. .. 13. O.OO 14. Net Value Sub)ect to Tax (Line 12 minus Line 13) .. .. 1 a. 163378.00 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers urtder Sec. 9116 (a>(1.z) x .o- 0.00 15. 0.00 16. Amount of Line 14~axable li l X ~ nea at rate . 163378.00 16. 7352.00 17. Amount of Line 14 taxable at sibling rate X .12 O.OO 17• O.OO 18. Amount of Line 14 taxable at collateral rate X .15 O.OO 18• O.OO 19. TAX DUE 1 s. 7352.00 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15056042159 snnesasz.ooo 15056042159 <~EV-1500 ESC Page 3 Fib Number Decedent's Complete Addresa~ 77 f1t] nna7~ DECEDENTS NAME HAYMAKER DOUGLAS B sTREET ADDRESS 801 N HAN V R T ET CUMBERLAND COY STATE ZIP CARLISLE Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit O.OO B. Prior Payments 0,00 C. Discount 0.00 (1) 7352.00 3. InteresUPenalty if applicable D. Interest 72.00 E. Penalty 0.00 Taal credi<a (a + s + c) (z> 0.00 Taal InteresUPenalty (D + E> (3) 72.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. FIII in box on Page 2, Line 20 to request a refund. (4) O OO 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the Tax DUE. (5) 7424.00 A. Enter the interest on the tax due. (5A) 0,00 B. Enter the total of Line 5 + 5A This is the BALANCE DUE. (58) 7424.00 Make Check Payable to: 1~GISTER OFW11.it..S, 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; 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? .... .. ... ..... ® ^ 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)]. Far dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or Tor the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)J. 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 beneTiciary. 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. Jj9116(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+t&!ie) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA I CASH, BANK DEPOSITS, 8t MISC. INF~RITANCE TAX RETURN RESIOENr ~ECEOENT PERSONAL PROPERTY ESTATE OF FILE NUMBER DOUGLAS B. HAYMAKER __ 21 09 00875 Include the proceeds of litigation and the date the proceeds were received by the estate 3W46AD 1.000 (If more space is needed, insert additional sheets of the same size) Rt_V-1510 EX i (8-99) COAM~AONVVEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS 8 MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER DOUGLAS B. HATMAI~R 21 09 00875 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 NUMBE DESCRIPTION OF PROPERTY R~C1117ET1£1YNEOFTf£TWWBFEREE.TF£IRREIATION&1PTOOECEDBirMD R TFE64TEOFTRN$$t.ATiPp1ACOPYOFThEOEmFORRFALESTATE DATE OF DEATH VALUE OF ASSET °~OF DECdS INTEREST EXCLUSION ~FAPPUCAe~E TAXABLE VALUE ~• HARTFORD LIFE ANNUITY 92,264 100.0000 0 92,264 2 TRANSFERS WITH ONE YEAR OF DEATH 27,000 100.0000 0 27,000 TOTAL (Also enter on line 7, Recapitulation) I S 119 264 (It more apace is needed, insert additional sheets of the same size) 3W48AF 1.000 REV-151, EX: 1,0-05, SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES St INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER DOUGLAS B. HATMAI~R 21 09 00875 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. PENNSULA MEMORIAL PARK 4,502 2 OMNI NEWPORT NEWS HOTEL 335 Total from continuation schedules ?,858 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address Cib State Zip _ Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as Gaimant's, attach explanation) Claimant Street Address 4. 5. 6. 7. City State Zip Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Retum Preparer's Fees None 400 2,500 TOTAL (Also enter on line 8 Recapitulation) ~ S 15 7W48AG ,.000 (If more space is needed, insert additional sheets of the same size) Estate of: DOUGLAS B. HAYMAKER 21 09 00875 Schedule H Part 1 (Page 2) Item No. Description Amount 3 WEYMOUTH FUNERAL HOMES 7,656 4 REV STEPHEN NICHOLLS 200 Total (Carry forward to main schedule) 7,858 REV-1512 EX * (12-OB) Pennsylvania SCHEDULE I oEPARTbENrOF REVENUE DEBTS OF DECEDENT, 9V~ERITANCE TAX RETURN MORTGAGE LIABILITIES ~ LIENS RESOEHr aECEOErrr ESTATE OF FILE NUIIIBER DOUGLAS B. HAYMAKER 21 09 00875 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimburaed medical expenses. 8W46AH 2.000 If more space is needed, insert additional sheets of the same size. f;EV-1513 EI(+ (11-08) Pennsylvania OEPARTNENf OF REVENUE INHERITANCE TAX RETURN RESIOENTDECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER ~~~ ~ L1 V 7 VVO/7 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEMNG PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 2116 (a) (1.2).] 1. DOUGLAS HAYMAKER, JR 3410 AVENIDA DEL PRESIDENTE APT 20 SAN CLEMENTE, CA 93672 One Third of Residue: 54,459 Son 54,459 2 CRAIG HAYMAKER 823 HIGHLAND COURT MECHANICSBURG, PA 17050 One Third of Residue: 54,459 Son 54,459 3 JOHN HAYMAKER 3070 LEEDS GARDEN LANE ALPHARETTA, GA 30022 One Third of Residue: 54,459 Son 54,459 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 1 8 OF REV-1500 COVER SHEET, AS APP ROPRIATE. [) NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBtJIIONS UNDER SECTION 2113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN 1. B. CHARRABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON UNE 13 OF REV-1500 COVER SHEET. S 0 8W46AI 2.000 " "'~'~ ayaw ~a ~ieeueu, n~seir narnuvna~ sneers or me same size. LOCAL REGtSTF~~-~'S CERTtt=tCATt4ht Qt= CE/~TFt WARNING: It is Illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $.6.OD' This is .to certify that the information here giv.,en a correctly copied`from an original Certificate of Deat duly filed with me as ::Local ,i~iegistrar: The origin certificate wiYl he forwarded ` to' the >atate Vit< Records Office for permanent. ding. ~~_ ~ , _ i.IblwaCerdai~Fre,b16M.Ye.e,lfa) 28a 3.Sn4W8eae(lYltgher 1.oraaeebPbab•rpXYe"r1 Do 'las B. Hatmaker~ Sr. Male OB3'` -:12~--2477 Februa 15, 2099' ~ .. ie:Plw dCrIKIClrec cir ~ ~ ~. ~~ ._ >.. w,eraa ~r Si1P:F+dBY1geP) uiwrt Irtlriey '6.CaedBM ltbnlr -: : 7i iMYbrot~ w"` °" ~"` " July 30, 1923 SchenedtadyY NY "°'0M°` nb.~; $5 _ pbvw.e, Oa+/ualpe~::^oa ~ ^webrbe ^o,ne~ sir,- m. 16. Ceunyd Caen ec Cti•, Bao, Trp.aown ldFdil'N.rInM Yritlao peetleaend lbnbM B. Wee Ceadea diWlWo Qlyb? $$NO ^Ya ,0.11ec¢: Nnakn YY tiBrrk: M~Y•re °C~nberland N. Middleton ' Church of God 'N. ursrg -Home m ceded ~ ,. 1ti DeeretlYirr, drat eap pWd Ik.CorMetae ta:wuo.aeb+wxin ll. ts. CBOewnrr Etlua4m fspMlh a+YhlpMav~cr~brd) u. Mrlld auieMnra: N.wr+wro: u. 5u~*rw 4vu.e ~a we uh+nxke, irniel geddlYe,k egtpnddsrrr/b}pey U&Msrd Faatl7 y/7(0.12).Crpe7,~a&);: -Wtbped, Clrarced (Arr~ ~ Shi : Mf 6w~ ^Yb . 4 Widowed uo~wrr.r+v~tlpa.~aYrbr~.rr..zoatl~~ ~ ii, aoa.~u,.ab N. Middleton ~,, sw. PA ~b°ioie'° nwi~ w. 801 N. Hanover. Street . , . . _. ' ' Garlisler PA 170.13 na. CJ ~o• o.w.+uae.w~ ~~° imca.ey Ciati~erland Y~urba clY/eae 1L FelpRltrm pinl eYiM, krL ~) 1/.Ilrph lrtr (Ru4!MN,wrlritaanrl >Benedfct Hatmaker: Dorothy fih tla lla..re tr.r(rYle /Pdl+l' _: zm. ttaaw.-~av~mw lava, ar/a.~. rrr• m ~l Craig Batmalcer 823 Highland.Ct, Mechanicsburg, PA 17050 2b.MrpAdCFparFm .. ^Ceilpem ^Denebn _. 21t.DW tl.DYPerial Moat eHSYw) tic Rtlrd grptlllmpMedaerMd{,u~e-eyaarr q~c) _ Yte tcerm pylbpn, rr4.ap wde) .. • ~ a.w p r~t~err ,,,,,c,,.tua,.w.w,~w,are Peninsula Menarial Cemetery > ,Newport Newsy YA owr= < pyr.ebrla.a.r/araraT D»r^r+e !s -dlrnWBrNs, eergreri,) :- 27b.IlalrNndet ~ 2a w.e.ndAda.aar.eili• Hoffman-ROt}~ FUII@]:'81 HOn~e'&-CrelOatOryi Il1C. . - 013144E . - ip,p27eree/rheneai)Yq ~ 2~a. To Mbtl,amy YlboarnOaM`r.d,r.b lru bera lsaa.e~~) ZL.Lkaw lNmMr 29c. pr80rtl MaYt~d~x YAM rtl,w.rwdw.ae.nb ~ ::w/aratlrt. I'' I , irl426eW tr aeeprr tYPgm 21.lbr dCwi ': ffi. 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( pC /J t ^Ytl C7~ ^Yea ^tb ^~dpY ^"'^~~"~°" azan..aMw aza.bl+rawcnrr av.anrpvp~M~nfsataYJ szataatmdMuYp~.~ilam.mr! ^sWddr ^ardramo.watpd - ^ror ^bo ^ntsraada ^vewaiw ^ ~ odeaaoby- aiCrlritlrekalYar) ~ ~ ~ ~:. d~lupobumddaYhmea~oplardtYn2:1) awdbYAr/rnrntrp e MY - C ~ p ~ ~ ai•:Slprbp rblMp ~~ D r• N r MWM7 r~i ~ ri O To YrpUreM(ttsbd/r, elirraeetlndetl b,Maw)rrrwrrtlrrN.,_____._____..____'____..__________ , __, ~` , ~~ll+// I ..i,ortl,dnp ndeeeilleppryeleYr RlMrtl 6tl,panaiunY lrri eebaeiiilpbtlw deMd - ^ Jtc lbrix NuMer-: - -. ~ 3dtl.OW 9prd hart MY.YW Yo ip terlrry tlopbtlir, dreN OeM,Wdir irp,err, end Pbtl.end apb Ne eapNel ere nwnruarrd.______________. __ i.Ibd Esasr,C.orpr M D o2 s 2 ~' ~ ~ ~ 2 - (~ - z av ~ anbetlrdeeebteNmeM/abeee~4bary agam,dwnoaandaae lele,err. eatl prx•eM eueblr auaefe)endmwrraarwl ^ C E G 7 l a /V i a et.Nmn vdrEew pl Anonwro~ aTrr ys Wt~ YW ~./a e... ! 14w a : ! L v d S g Cw wed Irmb mA Yerl t 1 p r y - ~ egWn s en 5. ~ l~11 laI l 10I . ~ 3375 Ch,.l~~~- p%(_ („q„r(,~,.,,~ A i~3~K Drpoetbn Amdl ro. V taSp~.J I -I, 38162.001/33685 11/11/94 mak LAST WILL AND TESTAMENT OF DOUGLAS BLAXLAND HAYMAKER JoNBS, BLEC1~(AN, WOLTZ & BELLY, P.C. boo Thimble Shods Blvd. Pos[ Of6a Bar 12888 Newport News, VA 23612,2888 (804) 873.8000 I, DOUGLAS BLAXLAND HAYMAKER, a resident, of Newport News, ,_ ,,-. Virginia, do make, publish and declare this to bye .my Last Will and Testament, hereby revoking all wills and codicils heretofore made by me. ARTICLE I FAMILY MEMBERS My wife, Barbara Berry Hatmaker, is living at the time of the execution of this will. We have three (3) children by our marriage, namely: Douglas B. Hatmaker, Jr., John D. Hatmaker and Craig W. Hatmaker. The word "issue" whenever used herein shall mean lawful descendants, whether natural or legally adopted. ARTICLE II ADMINISTRATIVE AND FUNERAL EXPENSES I direct my Executor to pay or provide for payment of my administrative and funeral expenses, including the cost of a suitable memorial, as soon as practicable after my death. ARTICLE III DEATH TAXES I direct that all estate, inheritance, succession, transfer or other taxes imposed by reason of my death upon property passing under or outside this will and made payable under the laws of the United States; this State or any other state or country be paid out of the general funds of my estate as an administrative expense, without apportionment. 38162.001/33685 11/11/94 mak ARTICLE IV TANGIBLE PERSONAL PROPERTY I bequeath to my wife, Barbara Berry Hatmaker, if she survives me, all tangible personal property, including personal effects and household furnishings, and any automobiles owned by me at my death, and all policies of insurance relating to such property. If my wife does not survive me, I bequeath all of the aforesaid property in equal shares to my children, per stirnes. The property passing under this Article does not include assets held by me primarily for business or investment purposes. In the sole discretion of my Executor, I authorize my Executor to distribute said property to them in kind, even though one or more of them may be under twenty-one (21) years of age, hold all or any part of a beneficiary's share for his or her benefit until he or she reaches age twenty-one (21) years, deliver all or any part to a friend, relative, guardian, or person with whom he or she may be residing, without further responsibility, or sell all or any part and add the net proceeds therefrom to my residuary estate to be disposed of as hereinafter ded. JoNfs, BLSCf~II~SAN, Q/OLTZ 8c KFLLY, P.C. ~ 600 Thimble Shout Blvd. i Pott Office Bo: 12888 Newport Neat, VA 23611,2888 (804) 8738000 I request that my family honor any written memorandum that I may leave regarding the disposition of any particular items of my tangible personal property. This request is precatory and not mandatory.. ARTICLE V RESIbUARY ESTATE All the rest, residue and remainder of my property, real and personal, tangible and intangible, wheresoever situate and howsoever held, I give, devise and bequeath to my wife, Barbara Berry Hatmaker, if she survives me. If my wife predeceases me, or if we should die in a -2- 38162.001/33685 11/11/94 mak ~ JoNPS, liL7:QDdAld, ~ WOLTZ & 1CELd.Y, P.C. j 600 Thimble Shwlt 73hd. Post 06a 1Soz 72888 Newport Newt, VA 2367b2888 (804) 873.8000 common disaster, then I give, devise and bequeath my residuary estate in equal shares to each child of mine who is living at my death and to the then living lawful issue, collectively, of each child of mine who predeceases me, such issue to take ,per stirnes the share which their ancestor, the deceased child of mine, would have taken if alive, subject only to the provisions hereinafter made with respect to the share of an individual under the age of twenty-one (21) years. ARTICLE VI INDIVIDUAL UNDER TWENTY-ONE {21) YEARS If under the foregoing provisions an individual under the age of twenty-one (21) years shall become entitled to any share of my estate, then notwithstanding anything herein to the contrary I give, devise and bequeath such individual's share to my Executor as Trustee, with all the powers and authority hereinafter conferred upon my Executor, to pay to or expend for the benefit of such individual, with or without the ' intervention of a guardian, so much of the net income and principal of his or her share as in the sole discretion of the Trustee is deemed necessary for his or her health, education and support, adding to the principal of his or her share any income not so paid or expended, until ae or she attains twenty-one (21) years of age, at which time he or she shall be entitled to receive his or her share free of any trusts. This provision shall not be construed to postpone the vesting of any share of my estate in such individual, but shall have only the effect of postponing his or her uncontrolled enjoyment thereof before reaching age twenty-one (21) years. No surety shall be required on the bond of the Trustee. -3- 38162.001/33685 11/11/94 mak ARTICLE VII APPOINTMENT OF EXECUTOR A. I nominate and appoint my wife, Barbara Berry Hatmaker, as Executor of this my Last Will and Testament. If my wife is for any reason unable or unwilling to serve, then I nominate and appoint my son, Craig W. Hatmaker, as successor Executor. Should he be for any reason unable or unwilling to serve, then I appoint my son, Douglas B. Hatmaker, Jr., as successor Executor. B. My Executor shall serve without fee, but shall be reimbursed for reasonable expenses incurred in the administration of my estate. C. I request that no surety be required on the bond of my Executor, and I direct that an appraisement of my estate be waived. ARTICLE VIII FIDUCIARY POWERS To the extent not in contravention with any other provisions of this will, my Executor shall have, in addition to all of the powers granted by law, all the powers set forth in Section 64.1-57 of the Code of Virginia, as amended, which powers are incorporated in whole in this my Last Will and Testament. ARTICLE IX WAIVING OF ACCOUNTINGS I hereby direct that my Trustee shall not be required to file annual accountings with a court as otherwise provided by Virginia law. ~~y~ ~, JONES, BLECHMAN, WOLTZ & KELLY, P.C. 600 Thimble Shod: Blvd. _ 4 _ Pott Office Boz 12888 Newport Neva, VA 23612-2888 (804) 873-8000 38162.001/33685 11/11/94 mak ARTICLE X CONSTRUCTION OF TERMS Where appropriate to the context, pronouns or other terms expressed in one number and gender shall be deemed to include any other number and gender. Tax-related terms shall be construed in the context of the federal revenue laws in effect at my death. IN WITNESS WHEREOF, I sign, seal, publish and declare this instrument to be my Last Will and Testament, this 14th day of November 1994, at Newport News, Virginia. F L) DOUG BLAXLAND HAYMAKER We, the undersigned, do hereby certify that the testator has signed, sealed, acknowledged and declared the foregoing as and for his last will, in the presence of us, three competent witnesses, all present together at the same time, who, in his presence and at his request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses on the day and year above written. ~~ ~ . ~~j residing at _r~~ ~a>L~ _ \~ A ..--~ E,L ~ ?Ullel~["~c1 residing at ~GcYX`n~ i(.7~2~ f ~.~ , ' / .(~ZQ/ residing at C JONFS, ByLECHMAN, WOLTZ ac gEI3.Y, P.C. 600 Thimble SbosL Blvd. Putt Office Banc 12888 Newport News, VA 23612-2888 (804) 873.8000 -5- 38162.001/33685 11/11/94 mak ~- JoNFS, sLECfm1AN, WOLTZ & B.ELi.Y, P.C. 600 Thimble Shoal Blvd. Post Off~ee Box 12888 Newport News, VA 23612-2888 (804) 873.8000 (COMMONWEALTH OF VIRGINIA CITY OF NEWPORT NEWS, to wit: Before me, the undersigned authority, on this day personally appeared DOUGLAS BLAXLAND HAYMAKER, ~ Elizabeth D. Gordon , Vicki L.Hudson and Madelyne M. Miller known to me to be the testator and the witnesses, respectively, whose names are signed to the attached or foregoing instrument and, all of these persons being by me first duly sworn, DOUGLAS BLAXLAND HAYMAKER, the testator, declared to me and to the witnesses in my presence that said instrument is his Last Will and Testament and that he had willingly signed or directed another to sign the same for him and executed it in the presence of said witnesses as his free and voluntary act far the purposes therein expressed, that said witnesses stated before me that the foregoing will was executed and acknowledged by the testator as his Last Will and Testament in the presence of said witnesses who in his presence and at his request and in the presence of each other, did subscribe their names thereto as attesting witnesses on the day of the date of said will and that the testator, at the time of the execution of said will, was over the age of eighteen (18) years and of sound and disposing mind and Sworn and acknowledged before me by DOUGLAS BLAXLAND HAYMAKER, the testator, and Elizabeth D. Gordon Vicki L. Hudson and Madelyne M. Miller witnesses, this 14th day of November , 1994. (SEAL) commission expires : 4/30/98 Notary Pub is -6- s't'AT+~E~ ~HtI~A.... ' ..:.:...' .;PAGE :,..'.....:. JAN.30-FEB.28,2009 1 OF 5 00 0 0630TH NM I17 zl is12~93A~ANtE ua8o z~~o~o9 Bh~ANc[ DOUGLAS B HAYMAKER C H E ck i z ti S BARBARA B HAYMAKER C~~ c k- 1 1 N H 823 HIGHLAND CT MECHANICSBURG PA 17050 CHeck 12.33 z'is`zooq ~A~ANCE ~3ooS. ~I { ~ 2 GpG.Gp C ~ z o00 . oo ) C I oc.Oo SE°IOS. ~ I .. < ..: .:::...... .:........:.::...:.SI.L.Ir.G:T:ED~A~~.t?UN.T. '..SU:I~MAR.x..::.. ::. ;:.. .:.:.... ? .:: ;.:..:; I ACCOUNT ACCOUNT INTEREST EARNED MATURITY ENDING TYPE NUMBER YEAR-TO-DATE DATE BALANCE I ~ MiT SELECT MITH INTEREST 000009839129658 4.14 55,086.13 MiT MARKET ADVANTAGE 015004210578405 56.42 0.00 TOTAL DEPOSITS 55,086.13 M&T SELECT WITH INTEREST ACCOUNT N0. 9839129658 II E 07 O1 02 02 02 02 02 02 D2 02 02 02 02 02 02 Lp FIA R :~::.'~~.L~:: BARBARA B NATMAKER CARROIL STREET OFFICE DOUGLAS B HAYMAKER BARBARA B HAYMAKER :. STATENEM'. P~RIaD ,' ~~~ JAN.30-FEB.28,2009 2 OF 5 11Y FSx'F 02-27-09 EDWARD JONES 9044 CCD 1,000.00 02-27-09 INTEREST PAYMENT 2.36 ENDING BALANCE 55,086.13 555,086.13 1233 02-24-09 100.00 1244 02-23-09 12,000.00 1245 02-17-09 12,000.00 1246 02-10-09 12,000.00 1247 02-25-09 4,502.40 1249 02-19-09 334.14 ANNUAL PERCENTAGE YIELD EARNED = D.04 MdT PARTICIPATES IN THE FDIC'S TRANSACTION ACCOUNT GUARANTEE PROGRAM (TAG), UNDER WHICH ALL BALANCES IN NON-INTEREST-BEARING TRANSACTION ACCOUNTS ARE FULLY GUARANTEED BY THE FDIC THROUGH 12/31/09. TA6 COVERAGE IS IN ADDITION TO AND SEPERATE FROM THE COVERAGE AVAILABLE UNDER THE GENERAL FDIC DEPOSYT INSURANCE RULES. MdT WILL ALSO HAKE ALL CONSUMER NOW ACCOUNTS (OTHER THAN POWER CHECKING) ELIGIBLE FOR COVERAGE UNDER TAC BUT TO DO SO, THE FDIC REWIRES MiT TO COMMIT TO PAY NO MORE TWIN .50% INTEREST THROUGH 12/31/09. THUS, MGT WILL PAY NO MORE THAN .50% INTEREST ON SUCH ACCOUNTS (OTHER THAN POWER CHECKING) THROUGH 12/31/09. °'' DOUGLAS B HATMAK M&T MARKET ADVANTAG '~i:~f'~G'~Si2z BARBARA 8 HAYMAKER ACCOUNT N0. 15004230578405 CARROLL STREET OFFICE Af`f`f111WT CIIMIIADV ~: >::~::~::~ ..a;..~ ::: ::::>::C y:....,. ., ...: ... ~. NO. AMOUNT N0. AMOUNT 55,057.31 0 0.00 , 0 11..99 0.00 Loden f~~l ,. I' S'fA1'~MENT OF PAYMENT cne~k No. 114739645 FOR: BENEFIT PROCEEDS FROM ACCOUNT N0. 711194500 C/O CRAIG HAYMAKER To change your withholding on future distributions, please contact Hartford Life. Withholding too little may result in tax penalties. 000350 ESTATE OF DOUGLAS HATMAK 823 HIGHLAND COURT MECHANICSBURG PA 17050 09/28/2009 GROSS AMOUNT 92,264.45 NET AMOUNT 92,264.45 Federal Taxable Amount 32,264.45 The Hartford Life Insurance Companies Attn: Individual Annuity Operations P.O. Box 5085 Hartford, CT 06104-5085 800-862-6668