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HomeMy WebLinkAbout05-14-1015056041125 --~ REV-1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box 2sosol RESIDENT DECEDENT Harrisbur , PA 17128-0601 FORMATION BELOW OFFICIAL USE ONLY County Code Year File Number ~ ~ ~ Cj LI~~c 1 ENTER DECEDENT IN Date of Birth Social Security Number Date of Death 1 9 1 4 6 1 7 7 7 0 9 0 7 2 0 0 9 0 6 0 9 1 9 5 4 Decedent's Last Name H A V I L A N D Suffix Decedent's First Name C H E R Y L (If Applicable) Enter Surviving Spouse's Information Below Suffix Spouse's First Name Spouse's Last Name Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS MI A MI FILL IN APPROPRIATE OVALS BELOW l Return t ^ 3. Remainder Return (date of death ^ 1. Original Return ^ a 2. Supplemen prior to 12-13-82) te t d E ^ 4a. Future Interest Compromise (date of ^ 5. Federal Estate Tax Return Required s a ^ 4. Limite death after 12-12-82) B Decedent Died Testate Q 6 ^ 7. Decedent Maintained a Living Trust ~ oxes 8. Total Number of Safe Deposit . (Attach Copy of Will) Received d ^ (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death ^ nder Sec. 9113(A) 11 a s ^ 9. Litigation Procee between 12-31-91 and 1-1-95) O) Attach Sch BE DIRECTED T0: THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIA Lay ml U O O CORRESPONDENT - D ber ne Num elepho e T Name S T A N L E Y J L A S K O W S K I r"'~ 7 1 7 ©3 2 "~6 6 1-~; ~.~ -.- ;- _; -~ _ ,~ LS US~~NLY 4--~ -~ REGISTER ~ Firm Name (If Applicable) ~ C A L D W E L L & K E A R N S r- -~ _ _ ~; ~ I ~:; .~~ ~ -, First line of address ~: _-t ~ -o - r d 3 6 3 1 N O R T H F R O N T S T R E E T -~ « :: ~ ~~~ Second line of address :cr to `~~ ~-Ti L~ City or Post Office H A R R I S B U R G State ZIP Code P A 1 7 1 1 0 DATE FILED __ Correspondent's a-mail address: S18SkOWSkI Ckle al.net Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has a DATEWIedge. SIGNATURE OF P R ON RESPONSIBLE FOR FILING RETURN `,_ ~ , . I . ` f., ADDRESS a UNION CITY CA 94587 3 9 0 TROPI`~ANA WAY DATE SI F EP R HE THA REPRESE TATIVE ~ U uw~ ~' ~~~ u ~'~ /~ c° -a~__ ADDRESS HARRISBURG PA 17110 3631 NORTH FRONT STREET PLEASE USE ORIGINAL FORM ONLY Side 1 1,5056041125 15056041125 15056042126 REV-1500 EX Decedent's Social Security Number Decedent's Name: CHERYL A. HAVILAND 1 9 1 4 6 1 7 7 7 RECAPITULATION 1. Real estate (Schedule A) .................................. .. 1 2. Stocks and Bonds (Schedule B) ............................... .. 2 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 4. Mortgages & Notes Receivable (Schedule D) .................... .. 4. 3 3 7 1 , 9 6 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) .. ... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .... ... 6. 7 3 5 8, 1 9 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property 3 3 6 7 2 9 (Schedule G) ^ Separate Billing Requested .... ... 7. , 8. Total Gross Assets (total Lines 1-7) .................. ... 8. 1 4 0 9 7, 4 4 9. Funeral Ex enses & Administrative Costs Schedule H g. 1 3 7 1 0 , 7 2 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . ....... .. 10. 1 9 2 1 , 4 6 .................. 11. Total Deductions (total Lines 9& 10) . 11. 1 5 6 3 2, 1 8 12. Net Value of Estate (Line 8 minus Line 11) ................ ....... .. 12. - 1 5 3 4 7 4 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 5 3 4 7 4 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15 Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 0 0 0 15 0, 0 0 (a)(1.2) X.o _ . 16. Amount of Line 14 taxable 0 0 0 0, 0 0 at lineal rate X .0 _ 16 17 Amount of Line 14 taxable 0 0 0 17 0 0 0 at sibling rate X .12 . 18 Amount of Line 14 taxable 0 0 0 0 0 0 at collateral rate X .15 18 0 , 0 0 ..................................... 19. Tax Due ....... ..19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15056042126 15056042126 File Number PEV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME CHERYL A. HAVILA_ND ____ _ STREET ADDRESS _ _ C/O CHERYL A. HAVILAND ______ 44_15 WERTZ_VILLE ROAD _ __ - STATE ZIP 17025 CITY pA ENOLA Tax Payments and Credits: (1) o.oo 1. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C) (2) 0.00 3, InteresUPenalty if applicable D. Interest E. Penalty Total InteresUPenalty (D + E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) 0.00 Fill in oval 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. (5) 0.00 (5A) A. Enter the interest on the tax due. (5B) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AG ENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes o 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 a c. retain a reversionary i ..................................................................................... 'nterest or ^ ^ receive the promise for life of either payments, benefits or care? ................................................. d ...... . 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death ...... ^ ^ without receiving adequate consitleration? ................................................................................. Did decedent own an 'intrust for" or payable upon death bank account or security at his or her death? ... 3 ...... ^ . 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 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)]. 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. REV-1508 EX + (6-98? SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT FILE NUMBER ESTATE OF 0 0 CHERYL A. HAVILAND Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION NUMBER ~, Penn National Insurance Company -refund of unused personal property insurance premium 2. The Middletown Home -refund of resident overpayment 3. ITrustmark -final payment, disability policy (pro-rated) 4. Mutual of Omaha -premium refund 5. IComcast Cable -cancellation of cable TV, refund 6. I Hospice of Central PA -Deposit for Carolyn Croxton Slane Hospice Residence TOTAL (Also enter on line 5, Recapitulation) I $ (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 72.00 80.36 640.00 26.18 53.42 2, 500.00 3,371.96 REV-1509 ~X + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE F JOINTLY-OWNED PROPERTY RESIDENT DECEDENT FILE NUMBER ESTATE OF 0 0 CHERYL A. HAVILAND If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME A. Joyce Giovannoni e c 390 Tropicana Way Union City, CA 94587 ADDRESS LATIONSHIP TO DECEDENT Sister JOINTLY•OWNED PROPERTY: oi, DF DATE of DEATH LETTER DATE E DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH VALUE OF ASSET DECD'S VALUE OF INTEREST DECEDENT'S INTEREST ITEM FOR JOINT MAD ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DENTIFYING NUMBER NUMBER TENANT JOINT . I 72 748 8 50. 4,374.36 11/9/82 PSECU share account#0191461777-01 . , 1. A. 2 IA. 111 /9/82 I PSECU check account #0191461777-54 5,967.66 50. ~ 2,983.83 TOTAL (Also enter on line 6, Recapitulation) I $ 7 358.19 (If more space is needed, insert additional sheets of the same size) RF_V-1510 EX. + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN EDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY RESIDENT DEC FILE NUMBER ESTATE OF 0 0 CHERYL A. HAVILAND 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 OF DECD'S EXCLUSION TAXABLE ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH ~0 VALUE THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST uF APPLICABLE) NUMBER 3,367.29 100. 3,367.29 1, PSECU Roth IRA Certificate, P.O.D. to beneficiary: Joyce Giovannoni, sister (Exhibit#1) 357,004.63100. 357,004.63 0.00 2. State Employees Retirement System to beneficiary: Joyce Giovannoni, sister (Exhibit #2) 5,108.86 100. 5,108.86 0.00 3. Commonwealth Deferred Compensation Plan, Great West Retirement Services - to beneficiary, Joyce Giovannoni, sister (Exhibit #3) TOTAL (Also enter on line 7 Recapitulation) ~ $ 3, 367.29 (If more space is needed, insert additional sheets of the same size) PSEC~ October 26, 2009 Account # 0191XXXXXX CARL G WASS CALDWELL & KEARNS ATTORNEYS AT LAW 3631 N FRONT ST HARRISBURG, PA 171 ]0-1533 Dear MR WASS: The following is the status of CHERYL A HAVILAND's account with PSECU as of the date of death. Joint Owner's Name JOYCE GIOVANNONI Date of Death 09.07.2009 Date of Birth 06.09.1954 Share Description Open date Balance Accrued Dividend S O1 Regular Shares 11.09.1982 $8,747.95 $0.77 S 04 Checking 11.09.1982 5,967.57 .09 CSO 60 Month Roth Certificate ** 04.16.2007 3,367.29 1.64 ** JOYCE G10VANNONI designated IRA beneficiary The dividend earned from January 1, 2009 through the date of death was $26.35. The decedent had no loans with us. W e do not have safe deposit boxes for our members. if you have any questions, please call 234-0404 in Han~isbur or our toll-free number, (800) 237-7328. At the menu prompt, enter 6 and then extension 2227. Sincerely, Jo~olbin IV ember Service Representative Finance Support Unit Pennspivania State Employees Credit linior: Main Address: 1 Credit Union Place, Harrisburg, PA 17I 10-~99U • 7 i 7.'Z34.8484 8UG237.7:,2E Mailing Address: PO. Box 6701 3, Harrisburg, PA 1 71 06-701 3 • 71 7.7772 i 00 (TDD) 800.47. i 967 (TDD; g~seee;.eon This cred'd union Is federally insured by the National Credls Union Adminrstraiior. Cquol Gpportumty Mende RXNTRTT 1 COMMONWEALTH OF PENNSYLVANIA STATE EMPLOYEES' RETIREMENT SYSTEM 30 NORTH THIRD ST STE 150 HARRISBURG, PA 17101-1716 r ,` ; 1-800-633-5461 www.sers.state.pa.us JOYCE GIOVANNONI 390 TROPICANA WAY U1vION CITY CA 9458`1 Re: CHERYL A HAVILAND SSN: 191-46-1777 Dear Beneficiary: December 1, 2009 SE J ,~ ,_ ~, % /y` tip, ~' G~ We are writing to you regarding the above named account. The enclosed forms must be completed by you, according to the printed instructions; before we can proceed with the processing of this account for payment. Please note: The Retirement Code does not provide for the payment of interest on the principal sum of a death benefit. Please read the enclosed information pertaining to the recent change in the Federal tax law. Also, please complete and return all applicable forms to our office as soon as possible. To aid you in making selection decisions, the following information is provided: Death Benefit Payable to you: Taxable Portion: Non Taxable Portion: $35 7,004.63 $356,369.27 $635.36 If you have any questions or need assistance, please contact the field office nearest you at 1-800-633-5461. Sincerely, ~.~u. ~~. Debra G. Murphy, Director Benefits Determination Division Enclosures EXHIBIT 2 BEN65 Great-West Retirement Services ,~ PO Box 173764 r' ~: Denver. CO 80217-3764 _.~ ~~ \ ~' ~f ~ ~ January 11.2OlU JOYCE GIOVANNONI 390 TROPICANA WAY UNION CITY CA 94587 RE: ACH Cc-ntirmation `-~°„°"°°„~'~,`, °~ rred f D i~~~~~~~.~a~~a~~~: e e Compensation err - ~` Plan Number: yK~)7~-~ 11 Plan Name: Conunntlwealth oi~ Pennsy[~°ania l)elen~ed Cumpensuion Pru~~ram 'Che details fur your cun~ent distribution are summarized below. Please note that only the iu~~estment optiunis) from which funds were drawn art displayed, including the ending value. A tas li~rm will he mailed to you by .lanuai-y 31st of next yeas'. and must be used in completin~~ your tax. return. SUMMARY OI~ T(?"T,11_S Total Withdrawal Amount $S,108'~6 'Total Available to All Receivers $S,It)K'bf~ ReCe1Ve1's Share of Proceeds 9>5,1 OK.i~6 CIALIFORNIA Tax Withheld ~'- l)_O(t INTERNAL REVENUE SERVICE "I~ax Withheld $- SlO.Kt) ACH Amount $4,597J? BL-FI - 9K97K-01 EMPLQYEE BEFORE T!~ Investment Be~innin~ ~ Uistrihution Unit/Share []nits/Shares ~ )h:ndirefi Option Value ~ Amount ~ Value ~ Distributed ~ ~,alue ~ ~ 55.1Oh.Hh ~'~~.1OS.K6 ._, ~618C, 2.2t-14?5'»~ '~ ti(, Uii Stable Value Fund - - __ -- --- _----- -- --- - --- ~,~ .!.)tl EXHIBIT 3 '`~ `'~~` Ixx ~rvi~r:..ac~F~cr~i 5ru r-,~~ ~n ~ ~ ~~ u~~rii~:,i„r?~~~~, r:.t: ~~ RF.V-1611 EX + (12-99) SCHEDULE H FUNERAL EXPENSES & COMMONWEALTH OF PENNSYLVANIA ADMINISTRATIVE COSTS INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF 0 0 CHERYL A. HAVILAND Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A FUNERAL EXPENSES: 10,485.72 ~, Neill Funeral Home 975.00 2_ Lotte's Catering -funeral luncheon g ADMINISTRATIVE COSTS: ~ Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address State Zip City Year(s) Commission Paid: 2,250.00 2 Attorney Fees Caldwell & Kearns, P.C. 3 Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address State ZIP City Relationship of Claimant to Decedent 4, Probate Fees Accountant's Fees 5. g, Tax Return Preparer's Fees (included ini attorney fees above) 7. TOTAL (Also enter on line 9, Recapitulation) I $ 13 710.72 (If more space is needed, insert additional sheets of the same size) REV-1512 EX + 112-03) SCHEDULE 1 DEBTS OF DECEDENT, COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS RESIDENT DECEDENT FILE NUMBER ESTATE OF 0 0 CHERYL A. HAVILAND Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. VALUE AT DATE ITEM OF DEATH NUMBER DESCRIPTION 170.01 1. Hershey Pharmacy 2. The Middletown Home 3, ~ Stanley Steamer 4, ~ Patriot News 5. Sunoco g, Hershey Medical Center 7. Harrisburg Pharmacy g, Advantage Ambulance 1,157.14 67.87 53.75 25.83 337.00 8.86 101.00 TOTAL (Also enter on line 10, Recapitulation) I $ 1 921.46 (If more space is needed, insert additional sheets of the same size) RED/-1513 EX + (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN mar nc~Ff1FNT ESTATE OF CHERYL A. HAVILAN NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY j TAXABLE DISTRIBUTIONS ilSecU 9116t( )h(1s~jiusal distributions, and transfers under 1. Joyce Giovannonl 390 Tropicana Way Union City, CA 94587 FILE NUMBER 0 0 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Sibling AMOUNT OR SHARE OF ESTATE 100% By survivorship or as designated beneficiary I ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 AS APPROPRIATE, ON REV-1500 COVER SHEET jj, NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 TOTAL OF PART II ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ (If more space is needed, insert additional sheets of the same size) LAST WILL AND TESTAMENT OF CHERYL ANN HAVILAND I, Cheryl Ann Haviland, of Middletown, Dauphin County, Pennsylvania, being of sound and disposing mind, do hereby make, publish and declare this to be my last Will and Testament , hereby revoking and making null and void all prior Wills and Codicils made by me at any time heretofore. ITEM I I direct that all my legally valid debts, funeral and administrative expenses, and debts incurred or payable because of my death, shall be paid by my Executrix, hereinafter named, from my residuary estate as soon after my death as practicable. All death taxes, including federal, state and other death taxes, 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 thereon, shall be considered an expense of administration of my estate, without apportionment or right of reimbursement. Taxes on future interests may be prepaid. ITEM II. I bequeath my household and personal effects, jewelry, automobiles, and other tangible personalty of like nature, in equal shares, to my two nieces, Christine Huffer and Patricia Rhoades, if they survives me by thirty (30) days. If they do not so survive me, but leave descendants who so survive me, such descendants shall receive, per stirpes, the share such niece of mine would have received had she so survived me. If either niece does not so survive me, and leaves no Page 1 of 8 Initials: i~N descendants who so survive me, such share shall lapse in favor of my other named niece, or her descendants who so survive me. ITEM III. I give, devise and bequeath all of the residue of my estate, whether real. personal, or mixed, and wherever situated, including any property subject to any power of appointment which I may now have or hereafter acquire, in equal shares, to my two nieces, Christine Huffer and Patricia Rhoades, if they survives me by thirty (30) days. If they do not so survive me, but leave descendants who so survive me, such descendants shall receive, per stirpes, the share such niece of mine would have received had she so survived me. If either niece does not so survive me, and leaves no descendants who so survive me, such share shall lapse in favor of my other named niece, or her descendants who so survive me. ITEM IV. The interest of beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation. ITEM V. I hereby appoint my niece, Christine Huffer, now of Enola, Cumberland County, Pennsylvania, as Executrix (the "Executrix"), of this, my Last Will and Testament. In the event of the refusal or inability of my niece to so serve, I then nominate and appoint my niece, Patricia Rhoades, now of Harrisburg, Dauphin County, Pennsylvania, to serve as Executrix. ITEM VI. Any property passing hereunder to a beneficiary who, at the time of my death, is under the age of twenty-five (25) (the "Beneficiary"), shall be held IN TRUST. by my Trustee, Initials:~~~ Page 2 of 8 hereinafter named, for the benefit of such Beneficiary, upon the terms and for the purposes and uses, as follows: A. My Trustee shall hold and invest the principal of the Trust corpus, collect the income (any income not so expended or applied to be accumulated and added to principal), and so much of the principal and accumulated income, as my Trustee shall deem necessary or advisable, in the sole and absolute discretion of my Trustee, for the support, maintenance, medical care, and education (including college education, both graduate and undergraduate) of the Beneficiary, after taking into consideration other readily available assets and sources of income. During illness or emergency, my Trustee may either pay a distribution to the Beneficiary, or may make a distribution for the benefit of the Beneficiary. B. At the time the Beneficiary attains the age of twenty-one (21), the Trust pertaining to the Beneficiary shall pay the Beneficiary one-half of the principal and accumulated interest in the Trust. At the time the beneficiary attains the age of twenty-five (25), the Trust pertaining to the Beneficiary shall terminate, and my Trustee shall distribute that Beneficiary's share of the then remaining principal and accumulated or undistributed income to the Beneficiary. C. If the Beneficiary should die during the existence of this trust, it shat l be divided and then continued for the benefit of any then-living issue of the Beneficiary, per stirpes, with such beneficiaries being substituted for the Beneficiary for all purposes including distributions at ages twenty-one (21) and twenty-five (25). Page 3 of 8 Initials: ~ ~. If the Beneficiary should die before attaining the age of twenty-five (25) without leaving issue surviving as aforesaid ,then that Trust shall terminate and its assets shall be divided into as many equal shares as necessary regarding that Beneficiary's siblings. The Share shall be distributed to those remaining siblings, or their surviving issues, per stimes, living at the time of the death of said Beneficiary. Provided, however, that if a Trust established hereunder for any such Beneficiary exists at the time of such distribution, then such distribution shall be made to that Trust for such Beneficiary. ITEM VII. If a Trust is needed for the descendants of my niece, Christine Huffer, my niece, Patricia Rhoades is to be appointed as the Trustee for any assets passing hereunder to any Trust established for such minor descendants of Christine Huffer. If a Trust is needed for the descendants of my niece, Patricia Rhoades, my niece, Christine Huffer is to be appointed as the Trustee for any assets passing hereunder to any Trust established for such minor descendants of Patricia Rhoades. ITEM VIII. I direct that my Executrix and Trustee shall not be required to give bond or post any other security for the faithful performance of duties in any jurisdiction. ITEM IX. Any person who shall have died at the same time as me, or m a common disaster with me, or under such circumstances that it is difficult or impossible to determine who died first, shall be deemed to have predeceased me. Page 4 of 8 Initials: _ ITEM X. My Executrix and Trustee shall have the following powers in addition to those invested by law and by other provisions of my Will applicable to all property, whether principal or income, exercisable without Court approval, and effective until distribution of all property: ~,. To retain any investments I may have at my death so long as my Executrix or Trustee may deem it advisable to my Estate or Trust so to do~ B. To vary investments, when deemed desirable by my Executrix or Trustee, and to invest in such bonds, common trust funds, stocks, notes, real estate mortgages, or other securities or in such other property, real or personal, as my Executrix or Trustee deems wise, without being restricted to so-called "legal investments". C. In order to effect a division of the principal of my Estate or Trust, or for any other purpose, including any final distribution, my Executrix or Trustee is authorized to make said divisions or distributions of the personalty and realty partly or wholly in kind. If such division or distribution is made in kind, said assets are required to be divided or distributed at their respective values on the date or dates of their division or distribution. D. To sell either at public or private sale and upon such terms and conditions as my Executrix or Trustee may deem advantageous to my Estate or Trust, any or all real or personal estate or interests therein owned by my Estate or Trust severally or in conjunction with other persons or acquired after my death by Initials: Page 5 of 8 my Executrix or Trustee, and to consummate said sale or sales by sufficient deeds or other instruments to the purchaser or purchasers, conveying a fee simple title, free and clear of all trust and without obligation or liability of the purchaser or purchasers to see to the application of the purchase money or to make inquiry into the validity of said sale or sales; also, to make, execute, acknowledge, and deliver any and all deeds, assignments, options, or other writings which may be necessary or desirable, in carrying out any of the powers conferred upon my Executrix or Trustee in this paragraph or elsewhere in my Will. E. To mortgage real estate, and to make leases of real estate for any period of time as my Executrix or Trustee may deem reasonable. F. To borrow money from any party to pay indebtedness of mine or of my Estate or Trust, expenses of administration, or inheritance, legacy, estate, or other taxes. G. To pay all costs, taxes, expenses, and charges in connection with the administration of my Estate or Trust. My Executrix shall pay expenses of my last illness and funeral expenses. H. To vote any shares of stock which form a part of my Estate or Trust, and to otherwise exercise all the powers incident to the ownership of such stock. Page 6 of 8 ~~ Initials: To compromise claims and to abandon any property which, in my Executrix's or Trustee's opinion, is of little or no value. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament, consisting of eight (8) typewritten pages, this ~ day of November, 2007. -, ~) (SEAL) Cheryl Ann Haviland We, the undersigned ,hereby certify that the foregoing Will was signed, sealed, published, and declared by the above-named Testatrix, Cheryl Ann Haviland, as and for her Last Will and Testament, in the presence of us, who at her request and in her presence and in the presence of each other, have hereunto set our hands ansa d Testatr~x was of sound and disposing mind and~memory t ~ ime of the execution t eof, the residing at 1100 Spring Garden Drive, Suite A David C. Miller, Jr. Middletown, PA 17057 residing at 1100 Spring Garden Drive, Suite A Middletown, PA 17057 hzab A.Schoppert Page 7 of 8 Initials: ~ COMMONWEALTH OF PENNSYLVANIA . SS: COUNTY OF DAUPHIN We, Cheryl Ann Haviland, the Testatrix, and David C. Miller, Jr. and Elizabeth A. Schoppert, the 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 she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of his/her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Subscribed, sworn to and acknowledged before me by the Testatrix, Cheryl Ann Haviland, and subscribed and sworn to before me by David C. Miller, Jr. and Elizabeth A. Schoppert, witnesses, this ~ day of November, 2007. (SEAL) COMMONWEAL7N OF PENNSYLVAIVIh NOTARIAL SEAL KATHY K. SEMfC, Notary Public Lower Swetara Twp., Dauphin County frFy Commission Expiros March 3, 2011 Page 8 of 8 1 Not Pu is Initials: - JAMES R. CLIPPINGER JAMES L GOLDSMITH P. DANIEL P. LT LAND JEFFREY T McGUIRE* STANLEY J A. LASKOW SKI DOUGLAS K. MARSICO BRETT M. ~A OODBURN MICHAEL D REED PAU'_A J. LEICHT ELIZABETH H. FEATHER KAREN W. MILLER DOUGLAS '+1. OBERHOLSER 'BOARD CER iIFIED CIVIL TRIAL ADVOCATE CALDWELL &KEARNS A PROFESSIONAL CORPORATION ATTORNEYS AT LAW 3631 NORTH FRONT STREET HARRISBURG, PENNSYLVANIA 1 7110-1 5 3 3 May 13, 2010 Glenda Fanner-Strausbaug, Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013-3387 RE: Estate of Cheryl A. Haviland Dear Ms. Fanner-Strausbaug: OF COUNSEL CARL G. WASS JAMES D. CAMPBELL JR. CHARLES J. DENARY. III THOMAS D.CALDWELL. JR. (1928-2001 RICHARD L. KEARNS RETIRED 717-232-7661 FAX. 717-232-2?66 thefirm~CKLegal.net Enclosed please find an original and two copies an Inheritance Tax Return regarding the above-referenced Estate. Kindly date and time-stamp an extra copy and return it to my attention in the self-addressed, stamped envelope that is provided for your convenience. Our firm check is enclosed for the amount of $15.00 to defray the filing costs of this Return. If you have any questions or require additional information, please contact. Very truly yours, Stanley J. A askowski Caldwell & Kearns, P.C. slaskowski@cklegal.net SJAL/se Enclosure 09380-001 /1(1221 ~ t~ .o -r - _,_, ~ ;~ -=- c~> ;- -~ r ;\ _l~J '..~ , _i `_~ _-{ -~ _¢ 0 xr .-c ~` -'O W Q ;; s -may `- ~, _} ._, ~?