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HomeMy WebLinkAbout11-18-10 • - r r 1505610140 REV-1500 ~` (°'-'°' PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year ', File Number Po Box 280601 INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 1 ',0 0 4 2 4 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 2 0 0 2 6 7 6 5 6 0 4 0 5 2 0 1 0 0 6 1 2 1 9 3 5 ~' Decedent's Last Name Suffix Decedent's First Name ~I MI G O O D R I D G E J R W I L L I A M II G (H Applicable) Enter Surviving Spouse's Information Below 'i Spouse's Last Name Suffix Spouse's First Name 'i MI G 0 0 D R I D G E H A R R I E T II M Spouse's Social Security Number ~i THIS RETURN MUST BE FILED IN DUPLICATE I~VITH THE REGISTER OF WILLS FILL INAPPROPRIATE OVALS BELOW ® 1. Original Retum ~ 2. Supplemental Retum ~ 3. Remainder etum (date of death prior to 12- 3-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Est to Tax Retum Required death after 12-12-82) ® 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Numb r of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election tot under Sec. 9113(A) ~ between 12-31-91 and 1-1-95) (Attach Sch O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATIO SHOULD BE DIRECTED T0: Name Daytime Telephon Number S T E P H E N L B L O O M 7 1 7 2 4 9 2 3 5 3 REGISTER O WILLS U3E ONLY First line of address ~ N o 6 0 W E S T P O M F R E T S T R E E T ~ 2 _~ i-r_ r ~ . , .C ~;.,~ :::.w3 Second line of address ~ .... -- - OD ~ , C:.3 ~ C"~ -. .-~ City or Post Office State ZIP Code ~RMLED = ?' ' ' C A R L I S L E P A 1 7 0 1 3 ~ ~_•~ a ~ ...~ ' Corresponderrt's e-mail addross: Urber penaltlea of perjury, I declare that I have examined this return, including accompanying schedules and statemeMa, and to the bea of riry knowledge and belief, it is true. coned and complete. Dederatlon Of preparer other than the personal representative is based on all information of which preps r has any knowledge. SIG TU E OF PER N RESPONSI E FOR FILING RETURN DATE ADDRESS 9 SILVER MAPLE DRIVE BOILING SPRINGS P A 17007 SIGNATURE OF~R~P/~IF,Jt OTHER THAN REPRESENTATNE DATE 60 WEST POMFRET STREET CARLISLE PIA 17013 PLEASE USE ORIf31NAL FORM ONLY , Side 1 1505610140 1505610140 J J 1505610240 REV-1500 EX Decedent's Social Security Number Decedent's Name: WILLIAM G- GOODRIDGE, JR 2 0 0 2 6 7 6 5 6 RECAPITULATION 1. Real Estate (Schedule A) ........................ . .................. 1 • 2 1, 2 2 0 6 3. 0 5 2. ...................................... Stocks and Bonds (Schedule B} . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. • 4. Mortgages and Notes Receivable (Schedule D) .......................... 4. • 7 0 4 ' S 4 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. • 7. Inter-Vivos Transfers & Miscellaneous N~Probate Property Re uested rate Billin Se l G 7 4 3 6 4 6 6. 2 4 .. , .... g q pa ) (Schedu e . 8. Total Gross Assets (total Lines 1 through 7) ............. , .. g. 5 5 9 2 3 3 . 8 3 9. Funeral Expenses and Administrative Costs (Schedule H) ............. ..... 9. 1 1 4 3 2 . 5 0 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ........ ..... 10. • 11. Total Deductions (total Lines 9 and 10) .......................... ..... 11. 1 1 4 3 2 . 5 0 12. Net Value of Estate (Line 8 minus Line 11) ....................... ..... 12. 5 4 ~ ~8 0 L • 3 3 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. 5 4 ~ ig 0 L • 3 3 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x .0 5 4 7 8 0 1 3 3 15. 16. Amount of Line 14 taxable at lineal rate X .0 0 0 0 16. 17 Amount of Line 14 taxable . at sibling rate X .12 0 0 0 17. 18 Amount of Line 14 taxable . at collateral rate X .15 0 0 0 1 g. 19. TAX DUE .................. .......................... ... ..... .. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 ,, 150561,0240 1,505610240 0. 0 0 0. 0 0 0. 0 0 0. 0 0 0. 0 0 J REV-1500 EX Page 3 •Decedent's Complete Address: File Number 21 10 0424 DECEDENTS NAME WILLIAM G. GOODRIDGE JR STREET ADDRESS 9 SILVER MAPLE DRIVE CITY STATE ZIP BOILING SPRINGS PA 17007 Tax Payments and Credits: ,. Tax Due (Page 2, Una 19) 2. CreditslPayments A. Prior Payments _ B. Discount 3. Interest 4. ff Line 2 is greater than Line 1 + Line 3, enter the difffference. This is the OVERPAYMENT. Ffll in oral on Page 2, Una ZO to request a refund. 5. ff Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (3) (4) (5) Make check payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE 1. Did decedent make a transfer and: Yes a. retain the use or income of the Property transferred : ...................................................................... ^ b. retain the right to designate who shall use the property transferted or its income; ............................... ^ c. retain a reversionary interest; or ................................................................................................ d. receive the promise for life of either payments, benefits a cane? ....................................................... 2. ff death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate considerationT ....................................................................................... ^ 3. Did decedent own an'intrust for• orpayable-upon-death bank account or security ~ his or her death? ......... ^ 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? .................................................................................................. BLOCKS No f3 F3 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT A~ PAMtT OF THE RETURN. For dates of death on or after July 1,1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for a use of the surviving spouse 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan.1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving ~e is 0 percent p2 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirem is for disdosure of assets and filing a tax return are still applicable even ff the surviving spouse is the only benefidary. For defies of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the u of a natural parent, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)]. • The tax rattr imposed on the net value of transfers to or for the use of the decedent's lineal benefidaries is 4.5 percent, exce t 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 decedenPs siblings is 12 percent [72 P.S. §9116(a~(1.3)]. A sibling is defined, unde Section 9102, as ~ individual who has at least one parent in common with the decedent, whether by blood or adoption. Total Credits (A + B) (2) . ~...r_.--T. _.._ _..___ _.-__ KtV-1 b03 tR + (8-86) SCHEDULE B COAANONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERRANCE TAX RETURN RESIDENT DECEDENT ' ESTATE OF FILE IAIMBER ~, WILLIAM G. GOODRIDGE JR 21 10 0424 ' All properly joMtly-owned with riSM of survhronhip must be disclosed on ScheduN F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 429 SHARES OF PFIZER STOCK 7,022.73 $16.37 X 429 = $7,022.73 2. PNC INVESTMENTS -ACCOUNT NUMBER 45309997 59,056.60 MUTUAL FUNDS 3.. EDWARD JONES -ACCOUNT NUMBER#501-04805-1-4 55,983.72 STOCKS AND MUTUAL FUNDS TOTAL (Also enter on line 2, Recapitulation) S 122 063.05 (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (6-98) COMIAONWEALTH OF PENNSYLVANW INHERRANCE TAX RETURN SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER WILLIAM G. GOODRIDGE_, JR 21 10 0424 ~I proof ude the of aM the dale o on-hi must be dbcfosed n Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PNC INVESTMENTS -ACCOUNT NUMBER 45309997 39.62 MONEY MARKET ACCOUNT 2.. EDWARD JONES -ACCOUNT NUMBER 501-04805-1-4 664.92 CASH AND MONEY MARKET TOTAL (Also enter on line 5, Recapitulation) ~ 704,.E {If more space is needed, insert addifbnal sheets ~ the same alas) REV-1510 EX+ (08-09) ' Pennsylvania DEPARTWENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY FILE 21 This schedule must be oDmpiebsd and filed 'rf the answer to any of questions 1lhnwgh 4 on page three of the REV-1500 fsyes. REM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE 7'RANSFERff, THEIR RELATIONSFNP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE DATE OF DEATH VALUE OF ASSET 96 OF DECD'S INTEREST XC FAaP LUSION UCAa<E) TAXABLE VALUE 1. EDWARD JONES -ACCOUNT NUMBER 501-90580-1-4 361,748.64 100.00 361,748.64 I RA BENEFICIARY: HARRIET M. GOODRIDGE 2. AXA EQUITABLE -CONTRACT NUMBER 301 611 165 74,717.60 100.00 74,717.60 ANNUITY BENEFICIARY: HARRIET M. GOODRIDGE TOTAL Also enter on Line 7, lation S 436 466.24 ff more space is needed, use additlonal sheets of paper of the same size. o~„ , ~„ ~,.~ ,,,, „~, ' Pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUfti1BER i WILLIAM G. GOODRiDGE, JR 21 10 0424 Decedents debts must be nponted on Schedule L I! ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representathre(s) Street Address ChY State ZIP Year(s) Commission Paid: 2, AtlomeyFees: IRWIN 8r McKNIGHT, P.C. 10,800.00 3, FamYy Exempifon: (If decedents address is rat the same as cleimanCs, attach explanation.) Claimant Street Address City State ZIP Relatlonship of Claimant tiD Decedent 4• probate Fees: REGISTER OF WILLS 252.50 5. Accountant Fees: 6. Tax Return preparer Fees: PATRICIA A. ROSENDALE, CPA 350.00 7. REGISTER OF WILLS -FILING FEE 30.00 Tta'TAL (Also enter on Line 9, Recapitulation) i 11 432.50 it more space s neeaea, use aaomonai sneers of paper m the same size. { REV-1512 F,(+ (12-08) ' pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8 LIENS WILLIAM G GOODRIDGE JR - z~ ~~ u4z4 I -- Roportdebts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbu medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION - OF DEATH 1. TOTAL (Also enter on Lute 10, RecapitulatlDrt) I S ff more speoe b needed, insert addfBonel sheers of the same size. ~ REV-1513 EX+ (01-10) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: _. _. __ _ _ _. __ _. _.. _.. _.. - -- _. - __. -r __ _. ___ _. __ _. SCHEDULE J BENEFICIARIES NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS (Indude ouUight spousa;dLstritwUons and transfers under Sec. 91 i6 (a)) (1.2)). 1. HARRIET M. GOODRIDGE 9 SILVER MAPLE DRIVE BOILING SPRINGS, PA 17007 1TIONSHIP TO DECEDENT Do Not List Trus<tea(s) Spousal ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1 IUNT OR SHARE OF ESTATE 547,801.33 DER AS APPROPRIATE. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. If more space is needed, use additional sheets ~ paper of the same size. 1 s1DATAPYEIN7]f93fq.8.N~.~1 i ~ LAST WILL.~ND TESTAMENT I, WII.,LIAM G. GOODRIDGE, JR., of South Middleton Township, Cumb d County, Pennsylvania, being of sound and disposing mind and memory, do hereby make, publi and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or dicils by me made. rrR I direct that all my legally enforceable debts, funeral expenses, testam expenses and all inheritance taxes shall be paid to the extent possible from the assets held or under ITEM FIVE hereof as soon as practicable after my decease and as part of the administratio of my estate. I have informed my personal represemative and additional family memo that it is my desire that my body be buried at Odd Fellows Cemetery in Shenandoah, Pennsylvania. Furthermore, I have informed my personal representative and additional family members that I o not wish to donate any organs of my body. ~ ITEM TWO In the event my beloved spouse, HARRIET M. GOODRIDGE, shall pred or fail to survive me by thirty (30) days, then I give such items of personalty as are itemized ' a certain list attached hereto to the persons named thereon, which list is signed and dated by eat the end thereof. I further direct my Executor(rix}, after consultation with any heir or heirs of mine wha survive me, and in~ his or her own discretion, to choose such articles remaining fro my tangible personal property (exclusive of cash, stock certificates, bonds, and all other tangibl evidences of intangible personal property) as he or she believes will be useful to such heir or h ' or desirable for him or her or them to have, either from a sentimental point of view or otherwise, d to deliver such articles to such heir or heirs or among such heirs in equal or unequal shares as etermined by the further exercise of his or her discretion, provided no other heir objects to the di 'bution. Page 1 of 7 Pages t , r If my beloved spouse, HARRIET M. GOODRIDGE, is living thirty (30) days a4fter my death, then I give, devise and bequeath all the rest, residue and remainder of my estate, both real and personal property, unto my said spouse, absolutely. If my said spouse does not so 've me, then I give, devise and bequeath all of my estate, both real and personal property, urrto m Trustee to be held or distributed by such Trustee under ITEM FIVE hereof. ITEM FOUR In the event my said spouse shall disclaim all or any portion of any devise ~ to my spouse under the foregoing ITEM TI~tEE, then the amoum otherwise payP by my Trustee under ITEM FIVE hereof. For purposes of the Trust established un hereof my said spouse shall not be deemed to have predeceased me by virtue exercise of the right to disclaim set forth herein. ITFMEI~~ RFSIDLTARY AND DTSCL. TMFR TR T4T My Trustee shall hold the assets received under ITEMS THIZEE and FOUR for the following purposes: A. My Trustee shall pay the nex income, at least quarter-annually, to my s In addition, my Trustee in my Trustee's sole discretion, may invade the principal o the proper and adequate support of my spouse. B. My Trustee shall fiuther pay to my spouse, annually, such sum from 1 the Trust as my spouse may request in writing, provided, however, that said sum n the ' of Five Thousand Dollars ($5,000.00) or five percent (5%) of the aggrega time of said request, of the principal of the Trust hereunder. C. Upon the death of my spouse, my Trustee shall distribute the princil to my children, WILLIAM 7. GOODRIDGE, ROBERT P. GOODRIDGE, LINDA MARK C. GOODRIDGE and JAMES T. GOODRIDGE, in equal shares, absol~ fervent hope that whenever possible any monies received by operation of this educate my grandchildren. bequest made e shall beheld ITEM FIVE my spouse's iereof, if any, ouse, for life. the Trust for ~e principal of ry not exceed value, at the tl of the Trust J. O'BRIEN, :ely. It is my ~h be used to ~' Page 2 of 7 Pages D. In the event that any of my said children shall fail to survive my spo shall leave issue surviving, then such deceased child's share shall be held try my Tru income therefrom shall be used for the support, maintenance and education (incl limited to, elementary, secondary, undergraduate, graduate and post-graduate) of th deceased chdd. My Trustee shall also use as much of the principal as it shall deem d purposes. My Trustee shall distribute absolutely the principal of such share of such to the issue of such deceased child per stirpes as each shall attain the age of twemy- In the event that any of my children shall fail to survive my spouse and me and n surviving, then my Trustee shall distribute such deceased child's share to my t THOMAS E. HUGHES, absolutely. I PO R OF EXEGLTTOR ~NT~ TRL7STEE In addition to the powers conferred by case law, by statute, and by other my Executor(rix) and Trustee and their successors, shall have the following dig applicable to all property held by them which powers shall be effective without and shall exist until final distribution. A. To retain any property of any nature received by them for whatever deem advisable; B. To invest and reinvest all or any part of said property in such stocks, b trust funds, securities, accourns, certificates of deposit (including, but not limited to, common true funds, securities, accourns or certificates of deposit of the Trustee) or real or personal, as in their discretion they shall deem proper, without regard to stela property which a fiduciary may purchase; C. To sell, transfer, exchange or otherwise dispose of, any part of said pry or on terms, publicly or privately, or to lease, even for a term exceeding five (5) years of any trust herein, without liability on the purchasers or lessees to see to the ap proceeds, and to give options for these purchases without the obligation to repudia~ of a higher offer; and me, but e and the net ling, but not issue of such rable for said eceased child ix {26) years. ~t leave issue lions hereof unary powers of airy court rod they shall nds, common locks, bonds, her property, ;s limiting the ~erty, for cash r the duration ication of the them in favor Page 3 of 7 Pages D. To execute and deliver any deeds, leases, assignments or other instruments as may be necessary to carry out the provisions of a~+ trust hereunder; ~! E. To borrow money, including the right to borrow money from a~r bank and to mortgage or pledge any. asset of the estate as security; F. To assume continuance of the status of any beneficiary with r d to death, marriage, divorce, illness, incapacity and the like in the absence of information eemed reliable without liability for disbursements made on such assumption; G. To pay firom the trust, or the income therefrom, all debts or claims ag~inat my estate, or any taxes or similar charges on my estate; H. To make any distribution hereunder either in kind or in money, or artially in kind and partially in money. Distribution in kind shall be made at the market vahre f the property distributed, and my Trustee, in my Trustee's absolute discretion, may cause the shat distributed to any distnbutee to be composed of property similar to or different from that distrib to any other distributee; I. To exercise any subscription right in connection with airy s~urity eld hereunder, to consent to or participate in arty recapitalization, reorganization, consolidation or merger of airy corporation, company or association, the securities of which may be held hereund , to delegate authority with respect thereto, to deposit investments under agreements, to pay ents, and generally to exercise all rights of investors; J. To invest in endowment, insurance or annuity policies on the lives f beneficiaries of any trust hereunder, K. To continue in any partnership, joint venture, joint ownership or then business enterprise of which I am a part at the time of my loth; L. To compromise claims; M. To cor~tirwe for whatever period of time as they shall deem necessary y ownership as a tenant in common or as a partner, in real estate or other property and to act as I uld have done had I been living; N. To lend money to my estate or to any trust created hereunder or to pur~hase from the estate or from any trust created hereunder, at the market value thereof at the time of purchase, any Page 4 of 7 Pages secanities or other property tendered to them by my estate or any trust created hereon and from time to time within a period of nine (9) months after my death; O. In the event that any amoums are payable hereunder or under an hereunder to a minor, or to a person otherwise under legal disability, or to a person to be an incapaatated person, but who, by reason of illness or mental or physical dis opinion of the fiduciary(ies) hereunder, unable to properly administer such amounts may be paid by the fiduciaty(ies} hereunder in his, her or their sole discretion in any ways as he, she or they may deem best: 1. Directly to such beneficiary; 2. To a legally appointed guardian of such beneficiary for the beneficiary; 3. beneficiary; 4. To a person having custody of such beneficiary for the at any time trust created ~t adjudicated rility is, in the such amounts 'the following of such of such By the fiduciary(ies) hereunder using such amounts directly't~ the benefit of such beneficiary. Evidence of the application of payment of an amount in such a manner shall be a and complete discharge of the fiduciary(ies) hereunder to the extent of such payment or app 'cation. This paragraph shall be applicable to payments of income as well as principal. P. To employ agents, attorneys and proxies and to delegate to them su power as my personal representatives and Trustees consider desirable and to pay reasonable co pensation for such services as may be rendered by such agents, attorneys and proxies; Q. To conduct an inventory of any safe deposit box necessary to the ' 'stration of my estate. R. To do all other acts in their judgment necessary or desirable r the proper management, investment and distribution of my Estate. II ITEM SEVEN pRnTEGT_TVE PROVISIONS ~ All income or principal held for the use and benefit of the beneficiari of arty trust hereunder shall not be in any way or manner subject to anticipation, assignment, ledge, sale or .G.G. Page 5 of 7 Pages r transfer, nor shall any such interest, while in the possession of my Trustee, be liable Ifor or subject to the debts, contracts, obligations, liabilities or torts of any beneficiary, or tol attachments, executions or sequestrations under process of law. TTRM ET_GHT en~nnrri;~rr OF EXECi1TOR AN_n TRUSTEE I nominate, constitute and appoint my spouse, HARRIET M. GOODRIDG of my estate. In the event that my said spouse shall predecease me or fail to act as I appoint my son, ROBERT P. GOODRIDGE, as Executor of my estate. I nominate, constitute and appoint my spouse, HARRIET M. GOODRIDG] any trust cxeated l~exeunder. In the event that my spouse shall fail or be unwilling to as Trustee, then I appoint my son, ROBERT P. GOODRIDGE, as Trustee of a, hereunder. In the event that the said ROBERT P. GOODRIDGE shall be unwilling as Trustee, then it would be my desire that another of my relatives serve as position not be filled by a corporate trustee. W TVFR OF BOND I direct that neither my Executor(rix) nor my Trustee shall be required to file a jurisdiction to secure the faithful performance of their duties, nor shall they be require order or approval of any court for the exercise of any power or discretion set forth IN WITNESS WIdEREOF I have hereutrto set my hand and seal this l ~CC~YY1hQ,1' , 199 William G. Goodrid~e, 3r. SIGNED, SEAI~D, PUBLISHED AND DECLARED by the above-named for his Last Wdl a~ Testament, in the presence of us, who at his request, have our names as witnesses thereto, in the presence of the said Testator and of each Page 6 of 7 Pages as Executrix cecutrix, then as Tnistee of ~minue to act trust created unable to act and that such bond in any to obtain any this Will. ~~ day of stator, as and ;o subscribed _,,_- r COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF CUMBERLAND ) SS. I, William G. Goodridge, Jr., Testator, whose name is signed to the attar or foregoing instrument, having been duly qualified according to law, do hereby acknowledge I signed and eacecxrted the instrument as my Last Will; that I signed it willingly; and that I signed it my free and voluntary act for the purposes therein expressed. William G. ~oodrid~ze, Jr. Sworn or affumed to and a.clrnowledged before me by William G. Testator, this I6'}' day of '~('~;1~1'~.,~Q,r , 1998 Nomded seal Deeke 1. NYeum d uGo~ur~y Expires Feb. 2s, 280 Notary Public CO ~TH OF P iENNS tYLVANIA . SS. COUNTY OF CUMBERLAND ) We, ~. ~ QSYYI_ and 1'1~U'CIQ. Jr., the the vies whose names are signed to the attached or foregoing ins~umerrt, bei~ duly qualified according to law, do depose and say that we were present and saw William G. Go 'dge, Jr., the Testator, sign and execute the instrument as his Last Will; that the Testator signed and that the Testator executed it as his free and voluntary act for the purposes therein exp ;that each of us, in the hearing and sight of the Testator, signed the Will as witnesses; and that to the best of our knowledge the Testator was at that time 18 or more years of age, of sound min and under no constraint or undue influence. ~~ L,~vl~j `3~v Sworn or affnmed to and subscribed before me this ~ ~ day of 1~e:C! C,YYI~,Y 199 . ---, Hcfarial seal DNS L. Nys, Notary ~ub~u CarlWe Bono, CumtMSian~! Ce~:r.,,. My- Coexr~ion ~: xrlfH, ,:~ .. Member ppnngvh~~+~ ~.^^ Notary Public Page 7 of 7 Pages CODICIL I, WILLIAM G. GOODRIDGE, JR., of South Middleton Township, Cum land County, Pennsylvania, being of sound and disposing mind and memory, do hereby make, p lish and declare this to be a Codicil to my Will dated December 1,1998. 1. I hereby nominate, constitute and appoint my daughter, LINDA J. O'B N, as a Co- Executor of myestate and Co-Trustee of any trust created under the aforesaid Will, o serve with my son, ROBERT P. GOODRIDGE, in the event my spouse, HARRIET M. GO RIDGE, shall predecease me or fail to act in either of such capacities. ~. 3. In all other respects, I hereby ratify and affirm my aforesaid Will dated D ber 1,1998. IN WITNESS WHEREOF I liavE hereunto set my ha~id and seal this 13~' day of January, 2009. William G. Goodridge, Jr. SIGNED, SEALED, PUBLISHED AND DECLARED by the above-nam Testator, as and for a Codicil to his Will dated December 1, 1998, in the presence of us, who at 's request, have hereunto subscribed our names as witnesses thereto, in the presence of the said T tator and of each other. ~~.. Page 1 of 2 Pages i ~_ ~ _ COMMONWEALTH OF PENNSYLVANIA ) ' ~ ~ SS. COUNTY OF CUMBERLAND ) I, WILLIAM G. GOODRIDGE, JR., Testator, whose name is signed to a attached or foregoing instrument, having been duly qualified according to law, do hereby owledge that I signed and executed the instrument as a Codicil to my Will dated'December 1,1998 that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein xpressed. William G. Sworn or affirmed to and acknowledged before me by WILLIAM G. GOODI~IDGE, JR., the Tes ~ 009. Na.wsw ~. t.. No.~. Moanr Pu~c ' ' No -Public i COMMONWEALTH OF PENNSYLVANIA ) . SS. COUNTY OF CUMBERLAND ) ~~ We, ~~i7eiYi and ~ the witnesses who a names are signed to theattached or foregoin instrument, bein duly qualified according to law, do depose and say that we were present and saw WILLIAM G. ODRIDGI;, JR., the Testator, sign and execute the instrument as a Codicil to his Will dated D ber 1, 1998; that the Testator signed willingly and that the Testator executed it as his free and oluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the Tes ator, signed the Codicil as witnesses; and that to the best of our knowledge the Testator was at that ' 18 or more years of age, of sound mind and under no constraint or uPdueja~ugnce,,.~- Sworn or affirmed to and subscribed ca~TM of ~NSnv~wu- Now sw c.~: r eannwion~~~ ~~, c:vsa~roa~ - ~s~~asa wuu.m a x~;aw~t~,a-~oa.a~ 3'~ dart of Page 2 of 2 Pages ~~~ + ~~~ + ~ = m .~ ~ ~ CC ~ O ~ ~°-~°~" U ~ ~ a r c a 3 ~ ~ r~ ~, LL a ~ ~ ~ ~~ I ~ ~ ~~ ~ ~ ~ ~ ~ ~ ~ ~ M g » ~ O 0 i g ~ ~ p$p~ (} ~ v a o E ~ Q ~~ $ V s . ~~ - ~ v ~ ~ c~ ~ _ ~' ~ y ` ~ .~ ~' ~ w ti ~ ~ ~ ~ _ ~ ~ ~ ~~ ~ U a _ ~~ a . ~ ~ ~ _ _ ~ ~: o. a y ~~ ~ ~ ~ ~ ~ : ~ . ~~ g ~ ~ ~ W. ~ ~ a ~ a , ~+ ~ ~ ~ o ~, ~ ,~ ~ 2 ~~~ 'O ..mac.. ~ "' ~ ~~ ~ ~ i : ~ V~ci ~~ V ~ ~ ~. ~ ~ y ~ C ~ gN ~~~~~.'~~~~~~I ~.. m m cn= ~ D ~ a ~ ~ ^ 8 ~~ ~~ yy~! ~~~ryZ~ "/ ~' K PFE Historical Prices ~ Pfizer, Inc. Common Stock Stock -Yahoo! Finance / Page 1 of 1 F Hi, Karen ' Sgn Out ' Help Preview Mail w/ Toolbar Yahoo) Mail _..... .. ~AH+C7C)-fe FINANCE Se j Web Search lsm,.,~,,,,~,,.,~s.,.,,..,, ,- _._.... Ilow i oslx Naadaq i o.brc HONE INVESTING NEWS ~ OPINION PERSONAL FINANCE NIY PORTFOLIOS ~T ~T~ F{nance Search Tue, Nov 16, 2010, 10:13AM EST - US taarkete a In b hrs and 4b mina Pfizer Inc. (PFE) At 9:SBAM E : ~ 8.66 • 0.09 (osb%1 I li _. ............._.............., GO Historical Prices t;t.t NIeWAeal Prka foe: _. '~ Sat Dab Range n DIY IStut Oeb; i Apr 5 2010 E9..lan 1, 2010 0 y Endt>,ae.:.Apr {' S zolo FJNIottNtly ~; DiYittmlda only Get Prices First ~ Previous ~ Next ~ Last Prices Date Open High Low Ciwe Vdume Adj Close' Apr 5,2010 17.14 17.14 16.85 18.90 88,750,200 18.37 Gore Prke adiw4ad tar dNidenda and aP><la• First ~ Previous ~ Next ~ Last t~ Downbad ip Eprradshest Currsngr in USD. copyryhl 0 2010 YNwol me. Aa rpMa naervee. Privacy Posey -About Our Ada - Terms of Ssrvles - CopyriphblP Pasty -Send Faadtaek-Yahoo) News NeMrotlc Quota era teaNittra tar NASW W. NYSE, and AmeK.Ses ako dsNY ~ for oUm e~tahanpaa. Al Monnarion provided "u b" for inrarmaGonal purpwss ony, not intended ror i~p purposes or advke. NelMar YMOOI nor eny d YalapendsM providers b pebN Wr ary Infomrtbnal errors, IneonpleMneu, or dNeys, or for am actlone Wren in rNianes on kltorntetbn eonuined h . aY aedsa&y the Yahoo) ills, you agree not b rsd4bbuN the tnfarnetlan Wind tMroin, RaN-Tons wntinuoua stnaNnp quoma m avaNaEN tlxagh our pnmfum seMa. You may tam sinaWrp on or oH. FuntlanenW company dale provdd try Capfgl ID. Historical chat data and daily updeha provided M Commodity SyaHms, Inc. (CSIi. 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' _ 7 ~ ; r G d ~ J ~ $~~ ~~~ W J ~ ~~a N m N O E0 II' C'! C O H H r- O a V 0 0~ ~.. .. a ~P ~ o ~ `~ E m . m m~ 30 ~~ y ~~ ~~ ~~ ~ ~~ ~ ~~ z m .o A ~' ~§ ~ L ~ ~N ~ ~ C t ~ N -~ p7 A ~ Or~ ~~ m ~ m~~ ~ ~ ~~ ~~o L~~ ~ r ~~~ -~i N L w ~ O U M M 0 m ~. T .~ L G 7 O V _m C N { .r e~ ~ Z N W O ~ W O W N a W ` N M2~ ~ ~. Y W` m m ~a ~ O o g ~ ~ ~ c 0. p m i ~ °U- v ~ o`. a °' a o a ~ d N ~ ~ W w ~„~ u~i~r' _ '' W Z=a~ ~~~~ ~NC.)i ~ ~ ado, $ .~ ~ ~ o m O~ O ~ ~ ~~ ~ ~ ~ c+f c~' ON Q ~ ~~ » ~ > ~ .= ~~ ~+ E~ O ~ ~ ~~ to ~ U m T t,` Q ~ ~~ ~~ ° o¢ W ~. .. a. ~ooZc~ .. $o ~c~Wa •~' Z C m ~ ~J~~ ~~ ~ ~ 30~~ a cn ~ om~8 3 O 00 C1 n c~Di 0 O~NyO, ~!, u~ 0 w 0 ~~ p r `~ ~..~ r ~ gN ~ o $~ E~ m .~ r m 30 T ~ H ~~ ~~ W ~m~ gN 70C ~~ m to ,~ $. ~, ~ o~m ~o~ o..~ ~~ ~~°_ > ~; •. m m ~ ~ y w ~~ ~~o ~ € c ; m ~ N ~ °~~ ~~ r 0 O. O p~ N C O V C L ~... AXA Equitsbia Accu~aulsto~ P.O. Sax 1547 qua, NJ 87096-1547 001513 AX050301 DD 9ISILVERBMAPLERDRIVEJR DOILIN(i SPRINBS PA 17007 T~ ~! ~' nxp 0ka16uEors uc., sole u dkh6umr ror nxa rya lif• Nrowana in corototlnn witl~ IM diprlx 6M'~IlCaii. 61tYbulo~Ll.C. ifld NfA 6qulhbM .a oanprit... Accumulator Plus (N~~ Contrail Number. 301611164 Contrail Date; May 01, 200.1 Name of Annuitant WILLIAM C3 CC Contrail Owner: WILLIAM G GC Your Represeritathre: CHARLES LIT Telephone: (800)762-6111 w you nwd aNMhno~, PwM oil t~A00~•7do-7771, orYiNt~ rY~Ne~ TH16 IB YOUR NOTICE THAT THE AXA EQUITABLE PROCEBSiNG OFFICE: Processed a rebalance trarlaler. Marrrh 01, 2010 No. 10060 03397 Page 1 of 1 JR JR IMplr!lMaliM! K tIN tna atfloa toll ins ad Effective Darts March 01,2010 Last Rsportsd Account Balance: 574,52464 on December 01, 2009 Currant Account Balance: 574,717 60 on March 01, 2010 ... ,. u .,:. , .,... ~ , .... , , ~ .: Tnnaa oebn Inlorlrgp ion UMornutbn as of Wrafi Oi, 2010 L~ ~ 13md t;,8~ Hllgidt at untie D unle vam. 881~0lZt EQIAAonayNlsdcat S92,T89.44 5130.70- 1,186.4961 II 528.005873 582,688.74 EQIBIadcHodc Inlw'ratlanel YeMN 58,945.04 5888.07- 5752.80+ 48.0256 26.0X, I 514.1672 ~, I 518.358183 58,408.77 E~CapYeMNPLUS 571,285.86 8144.25+ =58.88• 5.1808 27.0% 1,034.4014 I 510.875808 511,353.18 EUlladCaphxinc 511,285.81 5878.85+ 5789.47- 85.0240 27.076 1,222.7107 I 58.285288 511,359.18 RoMla P1ka (iroMi81 ~ I St odc 510,848.55 59.97- 593.59+ 7.1858 28.Q76 II 899.9418 513.016027 510,832.71 Grand 7'onl 574,524.64 5192.86+ 100.076 ' 574,717.80 ,~ ~.. ,• .._ ..:..._,_ .,~. ~ti. 5 _ _ ~ .., a. ~. rs off; ~:« - z3~Rr < :: WARNING FQR CONTRACTS WITH AN AU1'OI1rIA1'IC REBALANCING PROGRAM IN ixNECr: Performing a sub mount trsaafer or one time reallsocatioa while an automatic rebalancing progntm is is placx will NOT result in the automatic rebedanaag program bei>efag changed to retloct the new transfer implied pomaataBe bona. The subaccouat transfer or once-time reallocation shows above will revert to the current rebalancing allocations oa file for your contract unless we receive written instructions to cbanSe or terminate your automatic rebalancing program. 001513 AX050301 061524