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Home My WebLink About04-0675PETITION FOR PROBATE and GRANT OF LETTERS Estate of Christine S. Mover a/so known as Deceased. Social Security No. 199-32-77~_ 5 The petition of the undersigned respectfully represents that: Your petitioner(s), who is/fi~e 18 years of age or older an the execut or in the last will of the above decedent, dated lqraxr~amh~a~ ?~: J.~q.~ and codicil(s) dated To: Register of Wills for the County of ~ in the Commonwealth of Pennsylvania named (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in ¢,m'~erland County, Pennsylvania, with her last family or principal residence at 210 Bic~ SDrinq Road, Newville, Pennsylvania 17241 (list street, number and muncipality) Decendent, then 96 years of age, died Juty 6 Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and presented herewith and the grant of letters theron. William S. Moyer 37 Cedar Circle Newville, PA 17241 codicil(s) E~stamen~ary (testamentary; administration c.t.a.; a~.ministration d.b.n.c.t.a.) OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and trUly administer the estate according to law. ¢ Sworn to or affi{rg~v, and subscribedf ~f~,,-,-~',.~f'~ ~/?/,~'/ga..-- before..L_n~ this )~--~ day of ~ ' Estate Of No. ~ , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW ~t ~ ~q o~D0~ ,in consideration of the petition on the reverse side h~of, sa~sfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated II and Letters -'~_~-k--~ ~x.~. ~,X ~ .re hereb gr.,ted toke' FEES Probate, Letters, Et¢ .......... $t~l .~ .O~ Short Certificates(6) -. ' .... $ .50. jd TOTAL __ Filed ...."~.?. !..Q ~=~ ~ ..... Re,stet of 'I1~9-~ % . John D. Killiant Esa. ID ~7080 . ATTORNE¥(Sup. Ct.I.D. No,) Kill,an' & Gephart 218 Pine St. PO Box 886 · AD SS Harrisburg, ~ 17108 717-232-1851 PHON~ his is to certify that the information here given is correctly copied from an original certificate of death duly filed ,,~ith mc Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 7 ~ P 't0414- ' No. Local ~egislrar _ __ __r'.(~,,~ JUL ? 200~ COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF HEALTH * VITAL RECORDS CERTIFICATE OF DEATH Minnie William S Moyer Crematory .gs PA LAST WILL AND TESTAMENT I, CHRISTINE S. MOYER, of 224 South Third Street, Lewisburg, Union County, Pennsylvania, 17837, being of sound mind and memory, do make, publish and declare this to be my last will and testament, hereby revoking all former wills by me at any time heretofore made. ITEM ONE: I direct my hereinafter named Executor or Alternate Executor to pay all my just debts and funeral expenses and in the event that I have not done so prior to my death, I direct my Executor or Alternate Executor to purchase and place a suitable marker upon my grave as soon as conveniently may be after my death. PART I ITEM TWO: I hereby nominate and appoint my son, WILLIAM S. MOYER, of 10 Crab Tree Lane, Lewisburg, Pennsylvania, 17837, Executor of this my last will and testament. ITEM THREE: I hereby nominate and appoi~ CORESTATES BANK, its successor or assign, of 239 Market Street, qLcwj_'sburg Pennsylvania, 17837, Alternate Executor of this my last will and testament in the event that my son, WILLIAM S. MOYER, shOuld predecease me or in the event he should fail to qualify or cease to act as Executor of this my last will and testament, for any reason whatsoever. PART II ITEM FOUR: I give, devise and bequeath all of my estate, both real, personal and mixed of whatsoever kind and wheresoever situate, as follows: 4.1 I give and bequeath any automobile which I may own at the time of my death unto my granddaughter, NANCY J. MOYER, of 119 Valley Heights, Williamsport, Pennsylvania, 17701. In the event my said granddaughter, NANCY J. MOYER should predecease me, then I direct that her share of my estate shall pass to the residue of my estate as an addition thereto. 4.2 I give and bequeath ail of my clothing unto THE SALVATION ARMY, of the Lewisburg service unit, Lewisburg, Pennsylvania, 17837. 4.3 I give and bequeath all of my jewelry unto my daughter-in-law, JOAN F. MOYER, of 10 Crab Tree Lane, Lewisburg, Pennsylvania, 17837. Should my said daughter-in-law, JOAN F. MOYER predecease me, then I give and bequeath ail of my jewelry unto my granddaughter, NANCY J. MOYER, of 119 Valley Heights, Williamsport, Pennsylvania, 17701; Any -2- 4.4 4.5 such items of my jewelry which my daughter-in-law, JOAN F. MOYER and/or my granddaughter, NANCY J. MOYER, decide not to retain shall be donated to the gift shop of the BUFFALO VALLEY LUTHERAN VILLAGE, 211 Fairground Road, Lewisburg, Pennsylvania, 17837. I give and bequeath my Haviland China unto my daughter-in-law, JOAN F. MOYER, of 10 Crab Tree Lane, Lewisburg, Pennsylvania, 17837. Should my said daughter-in-law, JOAN F; MOYER predecease me, then I give and bequeath my Haviland China unto my son, WILLIAM S. MOYER, of 10 Crab Tree Lane, Lewisburg, Pennsylvania, 17837. In the event my daughter-in-law, JOAN F. MOYER and my son, WILLIAM $. MOYER should predecease me, then I give and bequeath my Haviland China unto my grandson, JOHN S. MOYER, of 63 Elm Street. Apt. 216, Manchester, Connecticut, 06040. Should my daughter-in-law, JOAN F. MOYER, my son, WILLIAM S. MOYER and my grandson, JOHN S. MOYER predecease me, then I direct that my Haviland China shall pass to the residue of my estate as an addition thereto. I give and bequeath the sum of $500,000.00, less any advancements I have made during my lifetime, to my CHARITABLE REMAINDER UNITRUST, THREE LIVES, created November 7, 1996 in Which I am -3- 4.6 the Donor and Bucknell University is the Trustee, as an addition to that Trust in order to fully fund it. I give, devise and bequeath ail the rest, residue and remainder of my estate, both reai, personal and mixed, of whatsoever kind and wheresoever situate as follows: 4.6.1 One share to my grandson, JOItN S. MOYER, of 63 Elm Street, Apt. 216, Manchester, Connecticut, 06040. 4.6.2 One share to my granddaughter, NANCY J. MOYER, of 119 Vailey Heights, Williamsport, Pennsylvania, 17701. 4.6.3 One share to my son, WILLIAM S. MOYER, of 10 Crab Tree Lane, Lewisburg, Pennsylvania, 17837. 4.6.4 One share to my daughter-in-law, JOAN F. MOYER, of 10 Crab Tree Lane, Lewisburg, Pennsylvania, 17837. 4.6.5 In the event any of the above named residuary beneficiaries should predecease me, then I direct that their respective share shail pass to my surviving residuary beneficiaries. 4.6.6 Should all of my above named residuary beneficiaries predecease me, then I direct that my residuary estate shall pass to my CHARITABLE REMAINDER UNITRUST, THREE LIVES, -4- created November 7, 1996 in which I am the Donor and Bucknell University is the Trustee as an addition to that Trust. ITEM FIVE: I hereby authorize and direct my Executor or Alternate Executor without being required to furnish bond, to sell and dispose of ail or any part of my reai estate, in whatsoever state situate, at public or private sale or sales, for such prices or considerations and upon such terms and conditions as my said Executor or Alternate Executor may deem best, and by proper deed or deeds, conveyances in law, to be duly executed, acknowledged and perfected, to grant and convey the same to the purchaser or purchasers thereof, her, his or their heirs and assigns, free from ail liability for or on account of the application of the purchase money. ITEM SIX: All federai, state and other death taxes payable on the property forming my gross estate for those purposes, whether or not it passes under this will, shail be paid out of the principai of my probate estate just as if they were my debts, and none of those taxes shail be charged against any beneficiary. This provision shall not apply to any property over which I have a generai power of appointment for federai estate tax purposes. -5- IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my last will and testament typewritten on~ ( ~7 ) sheets of paper this ~ ~ day of 1996. WITNESS: Christine S. Moyer ..~". ],7~..~ (SEAL) SIGNED, SEALED, PUBLISHED and DECLARED by the above named Testatrix, CHRISTINE S. MOYER, as and for her last will and testament, in our presence, who, at her request, in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses in attestation thereof. residing at -6- ACKNOWLEDGMENT AND AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) ) SS: COUNTY OF UNION ) We, CHmSTINE S. OYER, , and ~y~c~c~c~ ~, ~oc~Je.l'- , Testatrix and the wimesses, 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 wimesses, in the presence and hearing of the Testatrix, signed the Will as wimess and that to the best of their knowledge the Testatrix was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. g~/~~ ~. ~ ~ (SEAL) Christine S. Moyer ~ Witness (SEAL) Subscribed, sworn to and acknowledged before me by CHRISTINE S. MOYER, the Testatrix, and subscribed and sworn to before me by .~or~mid. 8.0e[emarn , and [~to.~n~ 0. ~o~c~J~t-- , wimesses, this &~-~D day of ~_.m~. ~v~Y'~~- , 1996. My Commission Expires: /' l~ota~y P_~blic -7- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: CHRISTINE S. MOYER Date of Death: July 6, 2004 Will No.: 2004 - 00675 Admin. No.: To the Register: I certify that Notice of Beneficial Interest required by Rule 5.6(a) of the Orphans, Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on July 7, 2004: Name: Address: William S. Moyer 37 Cedar Circle Newville, PA 17241 Joan F. Moyer 37 Cedar Circle Newville, PA 17241 John S. Moyer Nancy J. Moyer Notice has now been given to all Rule 5.6(a) except. Date: (&; Sigr Nam( 9132 Joyce Lane Hummelstown, PA 17036 119 Valley HeiSts D~ive>,~:, ,,i~!: Williamsport, P/A 177Q~ ~i:./ './ )ersons entitled thereto Under atone J ' : John D. Killian Address: Telephone: Killian & Gephart 218 Pine Street Harrisburg, PA 17108 (717)232-1851 Capacity: X Personal Representative Counsel for Personal Representative THOMAS W SCOTT JANE GOWEN PENNY TERRENCE J. McGOWAN J. PAUL HELVY MICHAEL J. O'CONNOR HEATHER M FAUST STEVEN K. BAINBRIDGE THE LAW FIRM OF KILLIAN & GEPHART, LLP 218 PINE STREET P. O. BOX 886 HARRISBURG, PENNSYLVANIA 17108-0886 TELEPHONE (717) 232-1851 FAX NO. (717) 238-0592 www.killiangephart.com October 1, 2004 Of Com~sel: JOHN D. KILLIAN SMITH B. GEPHART Register of Wills of Cumberland County Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 RE: Estate of Christine S. Moyer Date of Death: July 6, 2004 Will No.: 00675-2004 Dear Sir or Madam: Attached is a check in the amount of Two Thousand ($2,000.00) dollars as early payment for Inheritance Tax in the above listed estate. Enclosure Very truly yours, THE LAW F~RI~ Of KllLIAN & GEPHART HARRISI~URG~ PENNSYLVAI~II~ 17108-0886 i70i3+330i 00.370 Register of Wills of Cumberland County Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 i,,,lth,,ili ...... ll,,il,,,Ih,,ll,ll,,,,,,ill,l,,l,h,,,li,I 0 0 U d Z O~uj ~mZ ~-. Z 0 Zm mOm O~ ~z~ ~0~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENTOFREVENUE BUREAU OFIND~VlDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128 0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11 96) NO. CD O04461 MOYER WILLIAM S 37 CEDAR CIRCLE NEWVILLE, PA 17241-9483 ........ fold ESTATE INFORMATION: SSN: 199-32-7765 FiLE NUMBER: 2104- 0675 DECEDENT NAME: MOYER CHRISTINE S DATE OF PAYMENT: 10/04/2004 POSTMARK DATE: 10/01/2004 COUNTY: CUMBERLAND DATE OF DEATH: 07/06/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $2,000.00 REMARKS: CHECK//113 SEAL TOTAL AMOUNT PAID: $2,000.00 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS Inre: : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF CHRISTINE S. MOYER, DECEASED : NO. 2004-00675 : ORPHAN'S COURT DIVISION INVENTORY Willliam S. Moyer, being duly sworn according to law, deposes and says that he is Executor of the Estate of Christine S. Moyer late of West Pennsboro Township, Cumberland County, Pennsylvania, deceased and that the within is an inventory made by him, the said assets of the entire estate of said decedent, consisting of all the personal property, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death and that the decedent owned no real estate at the time of death. ~ . ~ 1'7~"., <I h/ William S. Moyer, xecutor Date of Death: July 6,2004 Social Security No.: 199-32-7765 John D. Killian, Esquire Attorney J.D. No. 7068 Killian & Gephart 218 Pine Street Harrisburg, PA 17101 -, C) N Telephone: 717-232-1851 ) " Estate of Christine S. Moyer Estate Inventory Valued as of Date of Death Cash & Cash Equivalents Cash on Hand $ 110.39 Green Ridge Village 337.01 Janney Montgomery Scott Alliance Money Market Act. 25,588.35 M&T Certificate of Deposit 11,510.61 M&T Certificate of Deposit 11,499.36 Reader's Digest 25.63 Total Cash & Cash Equivalents $ 49,071.35 No. of Shares Stocks 6,000 Altria Group Inc $ 297,000.00 Dividend at Date of Death 4,080.00 400 American IntI Group 28,498.00 2,700 Bellsouth Corp 69,592.50 600 Electronic Data Systems 11,205.00 1,000 Equitable Resources 51,585.00 1,600 Exelon Corporation 52,920.00 1,600 Exxon Mobil Corp 71,872.00 200 General Motors 8,959.00 400 Honeywell IntI. Inc. 14,188.00 600 JC Penny Company Inc 21,924.00 400 M&T Bank Corp 34,978.00 600 Mellon Financial Corp 17,154.00 60,722.306 Muniyield pennsylvania 870,563.28 5,000 SBC Communications Inc. 120,725.00 17,000 SunBancorp Ioc 368,475.00 Page 1 (1) Estate Inventory No. of Shares Stocks 2,600 verizon Communications $ 93,626.00 1,400 Vodafone Group 30,485.00 Dividend at Date of Death 279.58 Total Stocks $ 2,168,109.36 Par Value Bonds, Debentures & T-Bills 5,000 Allegheny Co Pa High Ed Bldg Auth Rev Community College PJ $ 5,000.00 Interest at Date of Death 111.63 Bethlehem PA ASD FSA 16,044.45 Interest at Date of Death 168.75 Bethlehem PA ASD Rfdg FGIC Coupon 20,993.80 Interest at Date of Death 347.22 50 Coatesville PA Water Auth GTD 5,400.00 Interest at Date of Death 70.31 200 Council Rock PA Sch Dist FGIC UT 20,629.80 Interest at Date of Death 134.58 100 Delaware Pa Auth Hospital Rev Crozer Chester Med Ctr 10,100.00 Interest at Date of Death 30.92 150 Lehigh County Hospital Auth. 15,880.05 Interest at Date of Death 110.50 250 Lewisburg Pa ASD Rfdg 25,979.75 Interest at Date of Death 395.05 Lycoming County pa Auth Cllg Revenue PA Tech 5,118.65 Interest at Date of Death 3.65 100 Monroe County Pa Hosp. Auth Rev Rfdg Pocono Med Ctr Series A 10,750.00 Interest at Date of Death 7.12 Page 2 (2) Estate Inventory Par Value Bonds, Debentures & T-Bills Montgomery County Pa Higher Ed & Hlth Auth Hosp Rev Abington Hospital Interest at Date of Death 10,000 PA Housing Fin Agy S/F Mtg Interest at Date of Death 20,000 Pa St First Series LT GO Interest at Date of Death 25,000 Pa State Pub Sch Bldg Auth Interest at Date of Death 20,000 Philadelphia PA Water & Wastewater Rev Ser A/KH3 Interest at Date of Death 5,000 Philadelphia Pa Airport Rev Series A Interest at Date of Death 10,000 Philadelphia PA Gas Works Rev Fifthteenth Ser FSA Interest at Date of Death 5,000 Philadelphia Pa Gas Works Rev fifthteenth Ser Subser 3 Interest at Date of Death 20,000 Philadelphia PA Sch Dist Series A Interest at Date of Death 10,000 Philadelphia PA Water & Wastewater Rev Interest at Date of Death 20,000 Phildelphia PA Sch District Ser B coupon Interest at Date of Death 15,000 Pittsburgh PA Water & Sewer Interest at Date of Death Page 3 (3) $ 20,356.60 99.65 10,163.10 147.78 21,076.00 97.22 26,107.00 558.00 10,500.00 215.20 5,221.50 16.77 10,000.00 219.58 5,038.65 113.02 19,590.00 250.69 10,600.00 215.28 21,135.40 277.08 17,550.00 377.60 Estate Inventory Par Value Bonds, Debentures & T-Bills 10,000 Pittsburgh PA Sch Dist FSA $ 10,236,80 Interest at Date of Death 164.93 10,000 Pocono Mtn PA Sch Dist 10,267.40 Interest at Date of Death 67.29 10,000 Pocono Mtn Pa sch Dist Series A UT 10,065.60 Interest at Date of Death 72.25 15,000 pottsgrove pa sch Dist 15,228.30 Interest at Date of Death 178.80 20,000 Snyder County PA Higher Ed Susquehanna Univ 20,360.20 Interest at Date of Death 13.19 10,000 South Park PA Sch Dist 10,113.70 Interest at Date of Death 70.80 10,000 Southeastern PA Trans. 10,374.80 Interest at Date of Death 182.20 15,000 Union County Pa Hospital Rev Evangelical Community Hospital 15,100.50 Interest at Date of Death 12.19 Total Bonds, Debentures & T-Bills $ 419,711.30 Tangible Personal Property Furnishings/personal property $ 185.00 Furnishings/personal property 48.00 Jewelry 1,284.68 Total Tangible Personal Property 1,517.68 Miscellaneous Page 4 (4) Estate Inventory Miscellaneous PA Dept of Revenue $ 176.00 Total Miscellaneous $ 176.00 No. of Units Mutual Funds Charitable Remainder Uni Trust $ 30,219.00 3,801.861 One Group Ultra Short Term Bond 37,372.29 Total Mutual Funds 67,591.29 Total Inventory $ 2,706,176.98 Page 5 (5) REV-1500EX{I>OO) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG. PA 17128-0601 REV.1500 INHERITANCE TAX RETURN RESIDENT DECEDENT I- Z W C ~ W C DECEDENrS NAME (LAST, FIRST, AND MIDDLE INITIAl) Moyer Christine 0A1E OF IlEA 111 (MM-DD-YEAR) DA1E OF BIRTH (MM-DD-YEAR) 7/6/2004 9/6/1907 (IF APPLICABLE) SURVMNG SPOUSES NAME (LAST, FIRST, AND MIDDLE INITIAL) W t-- ",Sn ..,"'''' w"-'-' :r90 ..,_...J ...., ~ 00 1. Original Return o 4. L1m"ed E.... D 6. Decedent Died Testate (Attach copy of Will} D 9. litigation Proceeds Received TH($.$~Cfl0ItMj)$1f1E'M' NAME John D. Killian, Bsq. ~IRM NAME (If Applicable) Killian & Gephart TELEPHONE NUMBER 717-232-1851 s !'1M)!) OFFCtN.. USE ONLY FILE NUMBER 21 04 0675 ___ YEAR MJWER COUNTY CODE SOCIAL SECURIlY NUMBER 199-32-7765 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER D 2. Supplemental Retum 0 3. Remainder Retum (date of death prtorto 12-13-82) D 4a. Future Interest Compromise (date of death after 12-12-82) 0 5. Federal Estate Tax Return Required D 7. Decedent Maintained a LMng Trust (Attach copy of Trust) L 8. Total NumberofSateOeposlt Boxes o 10. Spousal Poverty Credn (dele of deelh belw8fln 12-31",,1 m:l1_1-G/S) 0 11. Election to tax under Sec. 9113(,6..)(.6,\\8<:IIScIl0) ... % '" " % o .. .. ~ Harrisburg, pa 17101 1. Real Estate (Schedule A) (1) (2) 2. stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or SoIe-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) Z 6. JO Owned Property (Schedule F) (6) 0 5 Separate Bitnng Requested 7. Inter-Vivos Transfers & MIscellaneous Non-Probate Property (7) ::l (Schedule G or L) t: 0- 8. Total Gross Assets (total Lines 1-7) . <t U l:! 9. Funeral Expenses & AdministratNe Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage LJabllnles, & Lferls (Sdledule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Une 11) 13. Charitable and Governmental BequestslSec 9113 Trusts for'o'tltllch an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES 15. Amount of Line 14 taxable at the spousal tax 0 % rate, or transfers under Sec. 9116 (aX1.2) x .0 0 -= 16. Amount of Line 14 taxable at lineal rate 2,593,379 x .0 .. t-- ::> 0 0- 17. Amount of Line 14 taxable at sibling rate x.12 :Ii 0 0 .., 18. Amount of Line 14 taxable at collateral rate )(.15 X .. 19. Tax Due t-- 20. [!] CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~(15) 45 (16) (17) (18) (19) o om::w.. USE ONLY 2,625,193 o o 50,765 o 1,.,,_,1 43,219 (8) 21,525 2,130 (11) (12) (13) (14) 2,719,177 23,654 2,695,523 102,144 2,593,379 o 116,702 o o 116,702 >:0, U"U~I;;:J:Q ANS~~e; 3W4645 ,.ow yJ Decedent's Complete Address: STREET ADDRESS 210 Big Spring Road CWllberland cny I STA1E I ZIP Newville PA 17241- Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credtt B. Prior Payments C. Discount (1) 116,702 o 122,000 6,100 3. Interest/Penalty if applicable D. Interest E. Penalty Total Credtts (A + B + C) (2) 128,100 o o Total Interest/Penalty (0 + E) (3) o 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request. refund (4) 11,398 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) o A. Enter the interest on the tax due. (SA) o B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58) 0 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;. . . . . . . . . . . . . . . 0 ~ b. retain the right to designate who shall use the property transferred or its Income; . 0 ~ c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . D ~ d. receive the promise for life of either payments, benefits or care? . . . . . . . . . 0 [] 2. If death occurred after December 12, 1982. did decedent transfer property within one ye8( of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . ..!!J 0 3. Did decedent own an oin trust for~ or payable upon death bank account or security at his or her death? [!] 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. D [j IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penelties of peJjury, I declare that I tlaveexamlned this return, Includll1g accompanying schedules and stateme!\ts., lK\d tQ the bMt of my knowledge and tJellef, ills true, correct and complete. Oeclal"atlon of preparer other than me personal representatlWlls besed on alllnformstlon ofwhlch preparer has er'Iy knowledge. SIGNATI.R~ OF PERSON RESPONSiBlE FOR FILING REnJRN OATE .r Newville, PA 17241 REPRESENTATIV ~~ 218 Pine st Harrisburg, PA 17101 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 ofUle surviving spouse Is 3% [72 P.S.~ 9916 (al (1.1) ('1I. 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 suNtYing spouse Is 0% (72 P.S. ~ 9116 (8) {1.1) {Ii}] The statute does not exempt a transfer to a sUNMng spouse from tax, and the statutory l'8Qulrements for dIsclosure of assets and filing a tax retum are still applicable even If the surviving spouse is the only beneflclary. For dates of death on orefter July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child f'.Aenty-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 0% [72 P.S.!3 9116(a)(1.2)). The tax rate imposed on the net value of transfers to or brthe use of the decedent's lineal beneficlarles Is 4.5%, except as noted In 72 P.S. ~ 9116(1.2) {72 P.S. 59116(a)(1)1. The tax rate Imposed on the net value of transfers to or ror the use of the dececlent's sIblings Is 12% (72 P.S.!3 9116(a)(1.3)). A sibling is defined, under Section 9102, 8S an individual who has at least one parent In common with the decedent, mether by blood or adoptIon. ~W4646 1.000 . REV-1503 EX + (6-98) COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE B STOCKS & BONDS FILE NUMBER Christine S. Moyer 21 04 0675 All property Jolntly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER ceSCRlPTlON l.A1legheny Co Pa High Ed Bldg Auth Rev Community College PJ CUSIP, Ol729BBAl VAlUE AT DATE OF DEll. TH 5,000 Interest accrued to 7/6/2004 112 5,000 - Unit value 100.00 4.7% Coupon 2 6,000 Shares Altria Group Inc CUSIP, 02209S103 297,000 Dividend accrued on 7/6/2004 4,080 3 400 Shares American Intl Group CUSIP, 026874107 28,498 4 2,700 Shares Bellsouth Corp CUSIP, 079860102 69,593 5 Bethlehem PA ASD FSA CUSIP, 087365RW8 16,044 Interest accrued to 7/6/2004 169 15,000 - Unit value 106.963 5% Coupon 6 Bethlehem PA ASD Rfdg FGIC Coupon CUSIP, 087365KK5 20,994 Interest accrued to 7/6/2004 347 20,000 - Unit value 104.969 5\ Coupon 7 Coatesville PA water Auth GTD CUSIP, 190706AR2 5,400 Total from continuation pages 2,177,957 3W46961.ooo TOTAl (Also enter on line 2-, Recapitulation) $ {If more space is needed, Insert additional sheets of the same size) 2,625,193 Schedule B (Page 2) Bstate of, Christine S. Moyer Item No. Description Value at Date of Death Interest accrued to 7/6/2004 70 5,000 - Unit value 108.00 6.25\ Coupon 8 Council Rock PA Sch Dist FGIC UT CUSIP, 222263FL4 20,630 Interest accrued to 7/6/2004 135 20,000 - Unit value 103.149 4.85\ Coupon 9 Delaware Pa Auth Hospital Rev Crozer Chester Med Ctr CUSIP, 246006KZ2 10,100 Interest accrued to 7/6/2004 31 10,000 - Unit Value 101.00 5.3\ Coupon 10 600 Shares Blectronic Data Systems CUSIP, 285661104 11,205 11 1,000 Shares Bquitable Resources CUSIP, 294549100 51,585 12 1,600 Shares Bxelon Corporation CUSIP, 30161NI0l 52,920 13 1,600 Shares Exxon Mobil Corp CUSIP, 30231GI02 71,872 14 200 Shares General Motors CUSIP, 370442105 8,959 15 400 Shares Honeywell Intl. Inc. CUSIP, 438516106 14,188 Total (Carry forward to main schedule) 241,695 Schedule B (Page 3) Estate of: Christine S. Moyer Item No. Description Value at Date of Death 16 600 Shares JC Penny Company Inc CUSIP: 708160106 21,924 17 Lehigh County Hospital Auth. CUSIP: 524805ZV3 15,880 Interest acorued to 7/6/2004 111 15,000 units @ 105.867 coupon 5.20\ 18 Lewisburg Pa ASD Rfdg CUSIP, 528174F03 25,980 Interest accrued to 7/6/2004 395 25,000 units @ 103.919 Coupon 5.125\ 19 Lycoming County Pa Auth Cllg Revenue PA Teoh CUSIP: 550802EK4 5,119 Interest accrued to 7/6/2004 4 5,000 units @ 102,373 Coupon 5.25\ 20 400 Shares M&T Bank Corp CUSIP: 55261FI04 34,978 21 600 Shares Mellon Financial Corp CUSIP: 58551A108 17,154 22 Monroe County Pa Hosp. Auth Rev Rfdg Pocono Med Ctr Series A CUSIP: 610773BA7 10,750 Interest acorued to 7/6/2004 7 10,000 units @ 107.50 Coupon 5.12\ Total (Carry forward to main schedule) 132,301 Schedule B (Page 4) Estate of: Christine S. Moyer Item No. Description Value at Date of Death 23 Montgomery County pa Higher Ed & Hlth Auth Hosp Rev Abington Hospital CUSIP: 613604SA6 20,357 Interest accrued to 7/6/2004 100 20,000 units. 101.783 Coupon 5.125\ 24 60,722.306 Shares Muniyleld Pennsylvania CUSIP: 62630V109 870,563 25 3,801.861 Shares One Group Ultra Short Term Bond CUSIP: 681939237 37,372 Short Term Bond Fd Cl Ilell 26 PA Housing Fin Agy S/F Mtg CUSIP: 7087913Gl 10,163 Interest accrued to 7/6/2004 148 10,000 units. 101.631 Coupon 5.60\ 27 Pa St First Series LT GO CUSIP: 709141KH6 21,076 Interest accrued to 7/6/2004 97 20,000 units. 105.38 Coupon 5.00\ 28 Pa State Pub Sch Bldg Auth CUSIP: 8573216L2 26,107 Interest accrued to 7/6/2004 558 25,000 Units. 104.428 Revenue Pittsburgh ASD Coupon 4.70\ 29 Philadelphia PA Water & Wastewater Rev Ser A/KH3 CUSIP: 717893KH3 10,500 Total (Carry forward to main schedule) 997,041 Bchedule B (Page 5) Estate of, Christine B. Moyer Item No. Description Value at Date of Death Interest accrued to 7/6/2004 215 20,000 Units @ 105 Ber A Coupon 5.00% 30 Philadelphia Pa Airport Rev Series A CUBIP, 717817DB6 5,222 Interest accrued to 7/6/2004 17 5,000 units @ 104.43 Coupon 5.75% 31 Philadelphia PA Gas Works Rev Fifthteenth Ber FBA CUBIP, 717823TL2 10,000 Interest accrued to 7/6/2004 220 10,000 units @ 100 Coupon 5.10% 32 Philadelphia Pa Gas Works Rev fifthteenth Ber Bubser 3 CUBIP, 717823TN8 5,039 Interest accrued to 7/6/2004 113 5,000 units. 100.773 Coupon 5.25% 33 Philadelphia PA Sch Dist Series A CUSIP, 717880Z76 19,590 Interest accrued to 7/6/2004 251 20,000 Units. 97.95 Series A Coupon 4.75% 34 Philadelphia PA Water & Wastewater Rev CUBIP, 717893KF7 10,600 Interest accrued to 7/6/2004 215 10,000 Units. 106 Ber A Coupon 5.00% Total (Carry forward to main schedule) 51,481 Schedule B (Page 6) Bstate of, Christine S. Moyer Item No. Description Valus at bate of Death 35 Phildelphia PA Sch District Ser B coupon CUSIP, 717880S90 21,135 Interest accrued to 7/6/2004 277 20,000 Units. 105.677 Coupon 5.25' 36 Pittsburgh PA Water & Sewer CUSIP, 725304AS8 17,550 Interest accrued to 7/6/2004 378 15,000 Units. 117 Arth Rev Crossover RPDG Coupon 7.25' 37 Pittsburgh PA Sch Dist FSA CUSIP, 725276M71 10,237 Interest accrued to 7/6/2004 165 10,000 Units. 102.368 FSA UT Coupon 4.75' 38 Pocono Mtn PA Sch Dist CUSIP, 730436TAO 10,267 Interest accrued to 7/6/2004 67 10,000 Units. 102.674 Series A Coupon 4.75' 39 Pocono Mtn Ps Sch Dist Series A UT CUSIP, 730436QM7 10,066 Interest accrued to 7/6/2004 72 10,000 Units. 100.656 Series A UT Coupon 5.10' 40 pottsgrove Pe Sch Dist CUSIP, 738278GU8 15,228 Interest accrued to 7/6/2004 179 Total (Carry forward to main schedule) 85,621 Schedule B (Page 7) Bstate of: Christine S. Moyer Item No. Description Value at Date of Death 15,000 Units @ 101.522 RFDG Ser A Coupon 5.30% 41 5,000 Shares SBC Communications Inc. CUSIP: 7S387G103 120,725 42 Snyder County PA Bigher Bd Susquehanna Univ CUSIP: 833453CB1 20,360 Interest accrued to 7/6/2004 13 20,000 Units @ 101.801 RFDG Revenue Coupon 4.75% 43 South Park PA Sch Dist CUSIP: 839198GS1 10,114 Interest accrued to 7/6/2004 71 10,000 Units @ 101.137 Coupon 5.00% 44 Southeastern PA Trans. CUSIP: 842035BN3 10,375 Interest accrued to 7/6/2004 182 10,000 Units @ 103.748 AuthSpec Rev Series A Coupon 5.25% 45 17,000 Shares SunBancorp Inc CUSIP: 866634108 368,475 46 Union County Pa Bospita1 Rev Evangelioal Community Bospital CUSIP: 906460BB5 15,101 Interest accrued to 7/6/2004 12 15,000 Units @ 100.67 Bospital Proj A Coupon 5.85% 47 2,600 Shares Verizon Communications CUSIP: 92343V104 93,626 Total (Carry forward to main schedule) 639,054 Schedule B (Page 8) Estate of: Christine S. Moyer Item No. Description Value at Date of Death 48 1,400 Shares Vodafone Group CUSIP: 92857W100 30,485 Dividend accrued on 7/6/2004 280 PLC New sponsored ADR Total (Carry forward to main schedule) 30,765 ....................==.a...=============..==..=a=========================================~==================== DATE COST OR LONG TERM ACCRUED CASH 0.0.0. - ~ - -DEiCRIPTION- - - - ACQUIRED SOLD PROCEEDS OTRI!R GAINI INTEREST RECEIVED INTEREST BAS IS -LOSS RECEIVED PROH SALE ACCRUED -------------------------------------------------------------------------------------------------------------- Ik Alle(heny Cty Hleher Ed n 07-01-04 07-11-04 5100.00 5000.00 100.00 fil00.00 111. 63 IK LyCUMln. Cty Colleee 07-06-04 07-21-04 fil59.05 5116.61 40.40 18 .23 5177.28 3.IS IOk Bethlehea Area Sch Dlot 07-06-04 10-12-04 20979.40 20993.60 -14.40 122.22 21101. 62 347.22 IOk Delaware Cty Hoopltal 01-06-04 10-12-04 10000.00 10100.00 -100.00 176.61 10176.61 30.92 ..IOk' No.roe Cty HOlP Authority 01-01\-04 to-12-04 10232.10 10'50.00 -511.30 1411 .06 10380.1' 7.12 20k Pa State HBIA 07-06-04 10-12-04 21600.00 210'6.00 524.00 372.22 21912.22 97.22 Ik Coateevllle Water Revenue 07-06-04 09-1S-08 5220.00 5400.00 ...180.00 134. 5& 6364.5& 10.31 Ilk Lehl,h Cty GeaeralPurpooe 07-06-04 09-14-04 15923.66 16880.05 43. eo 264 . 33 16186.11 110.60 10k Pbiladelphla Wator . Sewr 01-06-04 09- 14-04 10650.30 10600.00 SO.30 63.89 10114.19 215.2& 10k Philadelphia Water . Sewer 01-06-04 09-14-04 10610.30 10500.00 110.30 63.69 10714.19 216.26 16k Ullon Cly Hoepltal Auth 01-06-04 09-03-04 UUO.OO 15100.50 n.so 161&0.00 12.19 10k Council Rock school D1Bt. 01-0&-01 06-2&-04 20404.10 20629.80 -22&.00 211.08 20681. 86 134.66 16k Plttobureh Water' Sewer 01-06-04 08-25-04 11&63.50 11560.00 13.50 640.13 18104.23 377.60 IOk Pocono HtnSchool Dlot. 01-06-04 06-26-04 10150.10 10261..0 -116.70 138.64 10289.24 67.29 ISk Pottoerove school Dlot. 01-06-04 01-26-04 16024.30 15226.30 -204.00 296.13 16322. 43 178.61 3607.6'1 one arp Ultra Sht TlM 07-06-04 0&-20-04 37429. .. 37829.31 0.13 37429. .. 10k Ilyder Cty H1,ber 1!4 07-06-04 06-06-08 20150.00 20360.20 -210.20 106.66 20255.66 13.19 10k Southeaotern Trano Auth 07-06-04 06-06-04 10360.00 10374.10 -24.60 233.33 10683.33 162.29 10k Plttobureh Sch Olot. 01-06-01 01-06-04 10000.00 10236.80 -236.80 211.11 10211 .11 164.93 20k Philadelphia SchOOl Dlot. 01-06-04 08-06-04 20950.00 2113&.40 -165.40 379.1'7 21329.11 277.06 10k Holt'OIl8r, Cty HI~her Ed 01-06-04 08-02-04 20COO.OO 20356.60 "3.40 20400.00 99.66 10k Philadelphia aao Worko 07-06-04 06-02-08 JOOOO.OO 10000.00 0.00 10000.00 219.66 10k Pb11adelphla seh Dlotrlct 0'-05-04 07-21-04 19140.60 19690.00 -H9.40 303.47 19844.07 260.69 10k South Park sch Dlotrlet 07-06-04 07-21-04 10096.90 10113.70 -14. eo 9'.61 10197.61 70.13 Ilk LaN10bure Area seh Dlot. 01-06-04 07-21-04 26668.00 26979.76 -291.75 466.23 26164.23 396.06 It Pa Rouel., Pi.alee A,oBey 01-06-0C 10-01-01 5000.00 5061.55 -a..&6 6000.00 73.69 It Pa HOue._. FIftalce A.ency 07-06-0C 10-01-04 6100.00 S081.55 18.46 lUOO.OO 13.89 Ilk leCbleh.. Area Sch DIet 07-06-04 11...01-04 16011.46 16044.41: 2'.00 39.66 16111. 03 168.16 Ik Philadelphia Airport Rev 01-06-08 11-01-04 5062. 86 5221.50 -159.05 111.01 6113.46 16.77 Ik Phlladelphla aa. worko Rev 07-06-04 11-01-04 4'&5.30 5036.65 -73.36 61.61 6033.11 113.02 16k State PubliC School 8ld, 01-06-04 11-01-04 25979.75 26101.00 912.75 366.75 27336.61 661.13 10k Pocoao Hta Pa seh Diet. 07-05-04 11-15-04 10000.00 10066.60 -65.60 10000.00 72.26 1772Hu81 Yield pa I'.ured 01-06-01 11-16-04 27269.35 25313.90 118&.46 27269.36 ---------------------...--------------------------...--.......----------------...--------------------------------------- JOrAL FOR TAX RETURNS...... ... ...... .... '76464.14 47'796.26 668.8' 4990.16 4'3464.32 U29.56 ..........=..==..===.====================s=:.=a=.=..===.=.a=:==:............=:...........:...........=..==...= U109t-8 OB Jaaney HonteOll8ry Scott alc WP07 6061-1092 be'ore "eo tate acct" eotabUohed. 5100.00 10tt-8 OB JaBB~y HoBteaaery Scott alc WP07 4419-6736 eotate aeCOUB' 473364 .14 ---------- laleo aeDouBted for....................................................................... 476464 .14 REV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE. TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Christine S. Moyer FILE NUMBER 21040675 Include the proceeds of litlgstlon and the dste the proceeds were received by the estate. All property Jolntlv-own.d with the riaht of 8urvlvorshlp mUlt be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Cash on Band 110 2 Furnishings/personal property 185 3 Furnishings/personal property 48 Thrift Shop prices. Clothing sold at Thrift Shop 4 Green Ridge Village 337 Adjustment/Refund from Final Bills 5 Janney Montgomery Scott Alliance Money Market Act. 25,588 Account WP07 4419-5736 6 Jewelry 1,285 11 pieces of jewelry 7 M&T Certificate of Deposit 11,511 CD #31003911264338 8 M&T Certificate of Deposit 11,499 CD #31003911275038 9 PA Dept of Revenue 176 2003 PA Income Tax applied to 2004 estimated tax due. 10 Reader's Digest 26 Refund of subscription 3W46AD 1.000 TOTAl.. (Also enter on line 5 Recaollulationl $ (If more space is needed, Insert additional sheets ofthe same size) 50,765 moyacct3 CHRISTINE S. MOYER 199-32-7765 CASH ON HAND AT DATE OF DEATH PAGE ..1 2004 =============~=====;==============================================;===== Total cash beIng kept for her use... 110.39 Deposited to her account at Janney Montgomery Scott by transfer from the account of WillIam S. Moyer which IS also at Janney. WS Moyer then retaIned the cash. ------------------------------------------------------------------------ ------------------------------------------------------------------------ CERTIFICATES OF DEPOSIT M&T BANK-LEWISBURG BRANCH At death there were 2 certIfIcates of deposit -31003911275038 origInally Issued by Northern value 12/31/03............ 11232.02 interest 1/1/04-7/6/04.... 267.34 interest 7/7/04-7/21/04... 20.40 PAGE :; outstanding Central Bank March 4. 1991 -31003911264338 originally Issued by Northern Central Bank Feb.25, 1996 value 12/31/03............ 11230.59 interest 1/1/04-7/6/04.... 280.02 interest 1/1/04-1/21/04... 22.34 23009.91 42.74 ======================================================================== DETAIL ASSOCIATED WITH CHECK #101 PAGE.4 WRITTEN ON JULY 28, 2004 TO WILLIAM S. MOYER funeral medical legal Egger Funeral Borne Graham Medical ClInic Green Ridge Village* Pinker & ASSOCIates Register of Wills Hartzell Eye ContinuIng Care RX Scott Zimmerer-Sr MinIster Lois Martin-Assoc.MinIster Judith Blee-Organlst Christ's Lutheran Church Watsontown Cemetary Assoc. 1095.00 10.06 662.56 7.31 1261.00 12.00 1140.13 Total. . . . 100.00 40.00 75.00 100.00 300.00 --------------------------- total ck 1710.00 1832.06 1261.00 4803.06 --------- --------- ( /. " /~"/I'" (~. (/ . /~"/I'" Watchmakers . Jewelers 21 Dickinson Avenue . Carlisle, PA 17013-2903 (717) 249-3928 . Fax (717) 243-2623 . Toll Free 1-877-476-4877 August 2, 2004 APPRAISAL To Whom It May Concern: This is to certifY the following described items of jewelry part of the estate of Christine Moyer, who prior to her recent death, resided at 37 Cedar Circle, Newville, P A 17241 have current cash values as listed: I, Ladies three stone diamond ring set with a center stone weighing approximately .50 carats the remaining two stones each weighing approximately .33 carats all being brilliant (round) cut diamonds the mounting being of 14 karat white gold equipped with the Finger Fit knuckle adjustment feature, value.. .............. ................... ............................... ............ ..... .................. $950.00 ~. 2. Ladies three stone diamond ring set with a center stone weighing approximately .45 carats f the remaining two stones each weighing approximately .025 carats all being brilliant (round) cuts the I ... mounting being of 14 karat white gold equipped with the Finger Fit knuckle adjustment device, i value ....... ....... ............ ........... ........ ........... ........... ..... ...... ..... ...................... ......$192.50 ;, ~~ I ,. l\ I~ " : 3. Ladies 18 karat white gold wedding ring, value (SCTlIpgoldvaluconly) .......$15.18 ~~ //~- 7. t.f? 4. Ladies opal ring set with an oval shaped black opal of doublet (layered) structure said stone measuring 9mm by IOmm chipped at one end and also cracked in several places set in yellow gold, value ....................................... ......... ......................................................... ........$35 .00 5. Ladies yellow gold plated Bulova watch fitted with a Speidel yellow gold plated wrist band, not in running condition, value .............................................................................$5.00 6. Ladies yellow gold pedant necklace the pendant being square shaped measuring diagonally two inches, of pierced filigree construction with gold plated neck chain, value.$25.00 7. Ladies yellow gold plated pendant necklace the pendant consisting of a double leaf design with an overall length of 1.50 inches set with one simulated pearl having a diameter of 6mm fitted with a 36 inch gold plated chain, value ........................................................................$7.00 8. Ladies hexagon shaped "snowflake" pendant necklace the pendant having a longest cross section dimension of 35mm the interior section of the pendent being composed of a 6 prong white gold plated faceted star shaped area intended to resemble a snowflake the frame of the pendant and 20 inch chain being yellow gold plated, value ................................................................$10.00 9. Ladies silver coin shaped pendant necklace the pendant being 26mm in diameter embellished on both sides by cardinal birds the pendant being unmarked as to quality so probably only silver plated and fitted with a 24 inch sterling silver neck chain, value ..................................$10.00 10. Ladies round sterling silver pendant measuring 32mm in diameter engraved with a message and fitted with a 24 inch sterling silver neck chain, value ..................................$25.00 11. Ladies 24 karat yellow gold plated hexagon shaped pendant having a longest cross section measurement of 28mm the base metal of the pendant being sterling silver fitted with a ring for a chain but having no chain, value ..................................................................................$10.00 OVERALL TOT AL.............................. $1,284. 68 Line & Line Jewelers ~~~o HUds REV-1510 EX + (6-98) SCHEDULE G INTER.VlVOS TRANSFERS & MISC. NON.PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE. TAX. RETURN RESIDENT DECEDENT ESTATE OF Christine S. Hoysr FILE NUMBER 04 21 0675 This schedule must be completed and filed jf the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ~OF PROPERlY ITEM 1M::Ll.DETl-E N6NE OFTl€TRANSFEREE, TI-lEIR RELATlON5HP TO OECEOEN1' Af'I) DATE OF DEATH % OF DECD'S EXClUSION TAXABLE NUMBE' iI-E OATEOFTRANSFERATTAQiACOf'( OF TI-E OEEO FOR REAL ESTATE VALUE OF ASSET INTEREST '""'''-ICA6lE\ VALUE 1. Charitable Remainder Uni Trust 30,219 100.000 0 30,219 Value of Decedent's Life Bsta.te I.nterestl Trust . initially established 11/6/1996. 2. Jdn S. ~, Q.au.h..u 7,r:rJJ 3,r:rJJ 4,r:rJJ 13i.rlidly, Oristnas, CUUll:SlULdL.i.Ol Gifts 3. N3lu{ J.~, ~ 6,r:rJJ 3,r:rJJ 3,r:rJJ 13i.rlidly, 01risl:Iras Gifts 4. Jean F. ~ ~-in-law 6,r:rJJ 3,r:rJJ 3,r:rJJ , -. ------. 13i.rlidly, Chri.sliras Gifts 5. Wi.UianS.~,S:n 6,r:rJJ 3,r:rJJ 3,r:rJJ 13i.rlidly, 01risl:Iras Gifts TOTAL (Also enter on line 7, Recapitulation) $ 43,219 (If more space is needed, Insert additional sheets of the same size) 3W46AF1.000 CHRISTINE S. MOYER 210 Big Spring Road (Swaim Health Center) NEWVILLE, PA. 17210 ~. December 07, 2003 William S. Moyer 37 Cedar Circle Newville, Pa. 17241-9483 Dear Bill, As discussed this afternoon, please arrange to issue checks to the individuals listed below in the amounts c k. If. indicated: --;T;- IJOhn S. Moyer f'blrthday, December 8...................$1,000.00 \John S, Moyer f' Christmas, December 25............. 1,000.00 II ~ Nancy J. Moyer f'Christmas, December 25........... 1,000.00 lis' Joan F. Moyer f'Christmas, December 25............. 1,000.00 /1" William S. Moyer f'Christmas, December 25........ 1 000 00 Total................................................................ .$5,000.00 Sincerely, ~;l.~.d.l~ Christine S. Moyer . - ~ . ~ ~ ~ . CHRISTINE S. MOYER 210 BIG SPRING IlOAD CANNIACiE COURT NEWVILLE, PA 17241 IrclIne "hone 717.17l}.R494 May 05,2004 William S. Moyer 37 Cedar Circle Newville, Pa, 17241-9483 Dcar Bill, As. di~cUSF.cd. plca!;c arrange to issue the fo1\owing checks in recognition of upcoming birthdays in the months of May and June and (0 John in celebration of his new job. (l To my granddaughter, Nancy.r. Moyer in honor of her 361h birthday..........$5,OOO.OO .# /vJ' o To my daughler in law, Joan F. Moyer in honor of her 70th birthday...........$5,OOO.OO # ,*'1 o To my son, William S. Moyer in honor of his 69th birthday...........................$S,OOO,OO"" ''''1 o To my grandson, John S. Moyer in commemorafion of his ne\\' job... ....$5.000.00 ;I" /f'C :;e?, ~ Christine S, Moyer '--' , REV-1511 EX + (12-99) COMMCtN\IEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Christine S. Moyer SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21 04 0675 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAl. EXPENSES: 1. Christls Lutheran Church 100 2 Conrath Funeral Bome 705 Total from continuation pages 2,805 B. ADMINIS1RATIVE COSTS: 1. Personal Representative's CommIssions 7,500 Name of Personal Representative(s) Social Security Number{s) I EIN Number of Personal Representative(s) - - Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees 8,000 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 1,261 5. Accountant's Fees 6. Tax Return Preparer's Fees 500 7. 1 CUIIlberland County Reporter 75 2 CUIIlberland Register of Wills 100 3 Killian & Gephart 24 Total from continuation pages 455 TOTAL (Also enter on line 9, Recaoitulation) $ 21,525 3W46AG 1.000 (If more space is needed, insert additional sheets of the same size) Schedule B part 1 (Page 2) Estate of. Christine S. Moyer Item No. Description Amount 3 Egger Funeral Home 1,095 4 Judith Blee 75 5 Rev. Lois Martin 40 6 Rev. Scott Zimmnerer 100 7 Touchstone Memorials 1,195 8 WetsontoWll PA Cemetary Authority 300 Total (Carry forward to main schedule) 2,805 Schedule B part 2 (Page 3) Bstate of. Christine S. Moyer Item No. Description Amount 4 Line & Line Jewelers 5 Patriot News 6 The Sentinel Total (Carry forward to main schedule) 125 180 150 455 REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RE'TURN RESlDENT DECEDENT ESTATE OF Christine S. Mover SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 04 21 0675 Report debts Incurred by the decedent prior to death which remained unpaid as of the date of death, Including unrelmbursed medical expenses. I1'EM NUMBER / 1. Continuing Care Rx DESCRIPTION VALUE A T DATE OF DEATH 1,140 2 Graham Medioal Clinio 26 3 Green Ridge Village 326 4 Hartzell Eye Assooiates 12 5 Mobilex 10 6 Moffit Heart & Vasoular Services 14 7 william S. Moyer 37 Cedar Cirole Newville, PA 17241-9483 45 8 PA Department of Revenue 550 9 pinker Associates 7 3W46AH2.000 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same sIze) 2,130 REV-1513 EX-t- (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Christine S. Moyer NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)J 1 Joan .,. Moyer 37 Cedar Circle Newville, PA 172419483 2 John S. Moyer 9132 Joyce Lane Hummelstown, PA 170368308 3 Nancy J. Moyer 119 Valley Heights Drive Williamsport, PA 177011924 4 William S. Moyer 37 Cedar Circle Newville, PA 172419483 FILE NUMBER 21 04 0675 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not U.t Tru.tee(.) OF ESTATE Daughter-in-law Grandson Granddaughter Son 25% 25% 25% 25% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18. I>.S I>.PPROPRIA TE. ON REV-150D COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH I>.N ELECTlON TO TAX IS NOT BEING MADE 1 B. CHARrTABLE AND GOVERNMENTAL DISTRIBUTIONS Christine S. Moyer Charitable Remainder UniTrust - Distribution Green Ridge Village Buffalo Valley Lutheran Village 2 3 3W46A.11.000 TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space Is needed, Insert additional sheets of the same SIZe) $ 100,626 233 1,285 102,144 REV-1514 EX+ (12-03) SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN COMMONWEAL 1H OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Check Box 4 on EV.1500 Cover Sheet FILE NUMBER Christine S. Hoyer 21 04 0675 This schedule is to be used for all single life, joint or successive i~e estate and term certain calculations. For dates of death prior to 5-1-89, actuarial factors for single life calcuiations can be obtained from the Department of Revenue, Specia~y Tax Unn. Actuarial factors can be found in IRS Publication 1457, Actuariai Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99, and in Aleph Volume for dates of death from 5-1-99 and thereafter. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. o Will [!] Intervlvos Deed of Trust 0 Other LIFE ESTATE INTEREST CALCULATION NAME(S) OF LIFE TENANT(S) DATE OF BIRTH NEAREST AGE AT DATE OF DEATH TERM OF YEARS liFE ESTATE IS PAYABLE Christine S. Hoyer 9/6/1907 97 Term of Years Term of Years Life or 1. Value of fund from which life estate is payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2. Actuarial factor per ap~riate table. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Interest table rate- ~ 31/2% 0 6% 0 10% 0 Variable Rate 0.00000% 3. Value of life estate (Line 1 multiplied by Line 2) ............................. $ Term of Years Term of Years Term of Years 232.081 0.1302 30.219 ANNUITY INTEREST CALCULATION NAME(S) OF LIFE ANNUITANT(S) DATE OF BIRTH NEAREST AGE AT DATE OF DEATH TERM OF YEARS ANNUITY IS PAYABLE Term of Years Term of Years Term of Years L~eor 1. Value of fund from which annuny is payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2. Check appropriate block below and enter corresponding (number) . . . . . . . . . . . . . . . . . . . Frequency of paYQut -0 Weekly (52) D Si-weekly (2U Monthly (12) D Quarterly (4) 0 Semi-annually (2) 0 Annually (1) OOther ( ) 3. Arnount of payout per period ....................................... $ 4. Aggregate annual payment, Line 2 multiplied by Line 3 . . . . . . . . . . . . . . . . . . . . . . . . . 5. Annuity Factor (see instructions) Interesttablerate-O 3112% 06% 0 10% DVariabJeRateO.OOOOO% 6. Adjustment Factor (see instructions) ................................... 7. Value of annuity .If USing 3 1/2%, 6%, 10%, or if variable rate and period payout is at end of period, calculation is: Line 4 x Line 5 x Line 6 . . . . . . . . . . . . . . . . . . . . $ If using variable rate and period payout is at beginning of period, calculation is: (Line 4 x Line 5 x Line 6) + Line 3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ Term of Years 0.000 o o 0.0000 0.0000 o o NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Scheduies A through G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13 and 15 through 18. (If more space is needed. insert additional sheets of the same size) 3W46AJ3.000 CHARITABLE RllMAINDER VNITRUST THRllE LIVES VNITRUST AGREEMENT made this 7th day of November, 1996, between CHRISTINE STERNER MOYER, residing at 224 South Third Street, Lewisburq, Pennsylvania 17837 ("Donor"', and BUCKNELL UNIVERSITY, a pennsylvania educational corporation located at Lewisburg, Pennsylvania 17837 ("Trusteen). FUNDING OF TRUST 1. The Donor transfers and delivers to the Trustee twenty five thousand dollars ($25,000). This property and all receipts Of every kind shall be managed and invested by the Trustee as a single fund ("unitrustlr) within the meaning of Rev. Proc. 90-30, section 4, and section 664(d) (1) of the Internal Revenue Code of 1986 ("Coden). PAYMENT OF rmITRUST AMOUNT 2. (A) The Trustee shall pay to the Donor (in cash, in kind or partly in each) in each taxable year of the unitrust during her life a unitrust amount equal to five percent (5%) of the net fair market value of the trust assets valued as of the first business day of each taxable year of the unitrust (decreased as provided in paragraph 2(C) and increased as provided in paragraph 2(D). The unitrust amount shall be paid in equal quarterly installments (on the last day of March, June, September, and December, with the first installment to be due on December 31, 1996) from income and, to the extent income is insufficient, from principal. Any income of the unitrust for a taxable year in excess of the unitrust amount shall be added to principal. Notwithstanding any existing or hereafter enacted state law, no amount other than the unitrust amount may be paid to or for the use of any person other than an organization described in each of section 170 (b) (1) (A), section 170 (c), section 2055 (a) and section 2522(a) of the Code. However, an amount shall not be deemed to be paid to or for the use of any person other than an organization described in the aforesaid Code sections if the amount is transferred for full and adequate consideration. (8) (1) Upon the Donor's death, the Trustee shall make the payments provided by paragraphs 2(A), 2(C) and 2(n) to william S. Moyer, and Joan Moyer (hereinafter referred to as nthe Recipients") in equal shares during their lifetimes, the first payment to be made on the next quarterly payment date after Donor's death. There shall be no payment to Donor's estate for any amounts which have accrued since the last payment received by her. Upon the death of the first of the Recipients to die, the survivor of the Recipients shall be entitled to receive the payments provided by paragraphs 2(A}, 2(C) and 2(D). (2) The Donor hereby expressly reserves the power, exercisable only by her Will, to revoke and terminate the interest of the Recipients under this unitrust. If the Donor effectively exercises such testamentary power, for all purposes of this Agreement the Recipients shall be deemed to have predeceased the Donor. (C) The first taxable year of the unitrust begins with the date of this Agreement and shall end on December 31, 1996. Subsequent taxable years shall be on a calendar year basis. In the case of a taxable year which is for a period of less than 12 months (other than the taxable year in which the survivor of the Donor and the Recipients dies), the unitrust amount which must be distributed under paragraph 2(A) or 2(B) shall be such amount multiplied by a fraction the numerator of which is the number of days in the taxable' year of the unitrust and the denominator of which is 365 (366 if February 29 is a day included in the numerator) . In the case of the taxable year in which the survivor of the Donor and the Recipients dies, the unitrust amount which must be distributed under paragraph 2(A) or 2(B) shall be such amount mUltiplied by a fraction the numerator of which is the number of days in the period beginning on the first day of such taxable year and ending on the date of death of the survivor of the Donor and the Recipients and the denominator of which is 365 (366 if February 29 is a day included in the numerator). Notwithstanding the foregoing, the Obligation of the Trustee to pay the unitrust amount shall terminate with the regular quarterly installment next preceding the death of the survivor of the Donor and the Recipients, provided that if the Donor effectively e~ercises her testamentary power to revoke and terminate the interest of the Recipients, the obligation of the Trustee to pay the unitrust amount shall terminate with the payment next preceding the death of the Donor. (D) If the net fair market value of the unitrust is incorrectly determined by the Trustee for any taxable year, then within a reasonable period after the final determination of the correct value, the Trustee shall pay to the Donor or the Recipients, in the case of an undervaluation, or shall receive from the Donor or the ReCipients, in the case of an overvaluation, an amount equal to the difference between the unitrust amount properly payable and the unitrust amount actually paid. Any payments required to be made because of an undervaluation shall be paid to the person (or his or her estate) who received the underpayment. Any repayments required to be made because of an overvaluation shall be repaid by the person (or his or her estate) who received the overpayment. (E) In computing the net fair market value of the unitrust assets there shall be taken into account all assets and liabilities without reqard to whether particular items are taken into account in determining the income of the unitrust. All determinations of the unitrust's net fair market value shall be in accordance with generally accepted fiduciary accounting principles and any United States Treasury requirements governing charitable remainder unitrusts. In any conflict Treasury requirements shall prevail over generally accepted fiduciary, accounting principles and any inconsistent provisions of this Agreement. ADDITIONAL CONTRIBUTIONS 3. The Donor and others may, from time to time, add property acceptable to the Trustee to the unitrust. (A) If any additional contributions are made to the unitrust after the initial contribution in trust, the unitrust amount for the taxable year in which the assets are added to the trust shall be five percent (5%) of the sum of (a) the net fair market value of the trust assets (excluding the assets so added and any income from, or appreciation on, such assets) and (b) that proportion of the value of the assets so added that was excluded under (a) which the number of days in the period which begins with the date of contribution and ends with the earlier of the last day of the taxable year or the death of the survivor of the Donor and the Recipients bears to the number ot days in the period which begins on the first day of such taxable year and ends with the earlier of the last day in such taxable year or the death of the survivor of the Donor and the Recipients. The assets so added shall be valued at the time of contribution. (B) If any additional Contribution is made by WillI the obligation to pay the unitrust amount with respect to such additional contribution shall commence with the date of death of the person under whose Will the additional contribution is made, but payment of such unitrust amount may be deferred from such date of death to the end of the taxable year of the unitrust in which occurs the complete funding of the additional contribution. Within a reasonable period after such time, the Trustee shall paYI in the case of an underpayment, or shall receive from the Donor or the Recipients, in the case of an overpayment. the difference between any unitrust amounts actually paid to the Donor or the Recipients, plus interest, compounded annually, computed for any periOd at the rate of interest that the federal income tax regulations (Treasury Regulations) under section 664 of the Code prescribe for the trust for such computation for such periOd, and the unitrust amounts payable, determined under the method described in section 1.664- lea) (5) (ii) of the Treasury Regulations, plus interestl compounded annually, computed for any periOd at the rate of interest that the Treasury RegUlations under section 664 of the Code prescribe for the trust for such computation for such period. Any payments required to be made because of an underpayment shall be paid to the person (or his or her estate) who received the underpayment. Any repayments required to be made because of an overpayment shall be repaid by the person (or his or her estate) who received the overpayment. DISTRIBUTION TO CHARITY 4. (A) upon the first to occur of (a) the death of the survivor of the Donor and the Recipients, or (b) the death of the Donor if she effectively e~erci5es her testamentary power to revoke and terminate the interest of the Recipients or (c) the death of the Donor if upon her death, neither Recipient is living, the Trustee shall distribute all of the then income and principal of the unitrust, other than any amount due to the Donor or the Recipients, to the fOllowing charitable organizations, in the fOllowing shares: 40% to Bucknell University, to be added to the permanent endowment of the Earle L. and Christine S. Moyer Memorial Scholarship, established by separate agreement dated March 9, 1995 30% to Evangelical Hospital, Hospital Drive, Lewisburg, PA, to be added to its general endowment 30% to Christ Lutheran Church, 101 South 3rd St., Lewisburg, PA, to establish the Christine Sterner Moyer Trust, the income to be used for scholarships for deserving high school students who are members of Christ Lutheran Church and are pursuing a college or higher level of education (8) If any of the charities listed above in paragraph 4 (A) ("Remaindermen" 1 are not organizations described in each of section 170(b) (11 (A), section 170(c), section 2055(a) and section 2522(a) of the Code at the time when any principal or income of the unitrust is to be distributed to it, the Trustee shall distribute such principal or income attributable to that organization's share equally between those Remaindermen listed in paragraph 4(A) that are organizations described in each of Section 170 (b) (11 (AI, Section 170 (cl, Section 2056 (a) and Section 2522(a) of the Code. If none of the Remaindermen listed in paragraph 4(A) are organizations described in each of Sections 170 (b) (1) (A), section 170 (c), Section 2055 (a) and Section 2522(a) of the Code at the time when any principal or income of the unitrust is to be distributed to it, the Trustee shall distribute such principal or income to one or more organizations then so described as the Trustee shall select in its sole discretion and in such shares as it shall determine. TRUSTEE pnWERS 5. (A) In addition to the powers conferred upon it by law, the Trustee is authorized to retain the property described in Schedule "A,II or may sell the property, invest and reinvest the unitrust in any kind of property, without diversification as to kind or amount and without regard to the limitations imposed by law on investments, except that it may not invest in assets which do not have an objective, ascertainable market value, such as real estate or stock in a closely held corporation. Nothing in this Agreement shall be construed to restrict the Trustee from investing the unitrust assets in a manner which could result in the annual realization of a reasonable amount of income or gain from the sale or disposition of trust assets. (S) The Trustee shall not receive compensation for services rendered under this Agreement and no bond or other security shall be required of the Trustee in any jurisdiction. However, the Trustee shall have the power to employ and to delegate any of its discretionary and nondiscretionary powers to agents, including but not limited to, attorneys, investment advisers, appraisers, or accountants as it deems necessary and proper and to pay for such services from the trust property and allocate such costs equally between principal and income. PROHIBITED TRANSACTIONS 6. In creating this unitrust, Donor intends to obtain the full benefit of any income, gift and estate tax charitable contribution deductions to which she (and her estate) may be entitled under the Code and for the unitrust to qualify as a charitable remainder unitrust under section 664 of the Code and the regulations thereunder. Accordingly, this unitrust shall he interpretedt valued. managedt invested, administered and in all other respects governed consistent with the Donor's intent. without limiting the generality of the foregoing, the Trustee is prohibited (except for the payment of the unitrust amount to the Donor and the Recipients) from engaging in any act of self-dealing as defined in section 494l(d) of the Code, from retaining any excess business holdings as defined in section 4943(c) of the Code which would subject the unitrust to tax under section 4943 of the Cadet from making any investments which would subject the unitrust to tax under section 4944 of the Code, and from making any taxable expenditures as defined in section 4945(d) of the Code. If section 4942 of the Code is deemed applicable to the unitrust by reason of section 508(e) of the Code or otherwise, the Trustee shall make distributions at such time and in such manner as not to subject the unitrust to tax under section 4942 of the Code. TAXES 7. (A) No federal estate taxest state death taxes or any other estate, death or inheritance taxes ("death taxesl1) with respect to the unitrust shall be allocated to or be recoverable from the unitrust. The Donor imposes an obligation on her estate to pay any death taxes from sources other than the unitrust and agrees to so provide in her Will or in another way. This provision may be enforced by Bucknell University, in its capacity as Trustee or charitable remainderman. or by the Recipients, acting alone or together. (B) The Donor has provided for the payment of any death taxes from sources other than the unitrust. Nevertheless, if for any reason, the unitrust becomes liable for death taxes on the Donor's death, the life interest of the Recipients shall take effect only if the Recipients furnish the funds for payment of any death taxes for which the unitrust may be liable. If the Recipients fail to furnish those funds, the Recipients shall be deemed to have predeceased the Donor tor all purposes of this Agreement_ REVOCABILITY 8. This Agreement is irrevocable. LIMITED POWER OF AMENDMENT 9. The Trustee shall have the power to amend this Agreement for the sole purpose of complying with the requirements of section 664 of the Code and Treasury Regulations sections 1.664-1 and 1.664-3. GOVERNING LAW 10. This Agreement is made pursuant tat and shall be interpreted in accordance with, the laws of the Commonwealth of pennsylvania. However, in any conflict with section 664 of the Code, the regUlations thereunder or any other existing or hereafter promulgated legislative or Treasury requirements for the qualification of the unitrust and for the Donor'S obtaining the full benefit of any income, gift and estate tax charitable deductions to which she (and her estate) may be entitled, section 664 of the Code, the regulations thereunder and the legislative and Tre~sury requirements shall govern. TAXABLE YEAR 11. The taxable year shall be the calendar year. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date first above written. ~~~~?/)~ (L.S Christine Sterner Moyer, Donor BUCKNELL UNIVERSITY en t for Administration (Seal) COMMONWEALTH OF PENNSYLVANIA } } ss: COUNTY OF UNION: ) On the i'b:! day of)Jnu"IM.l-r, 1996, before me personally came CHRIS~INE STERNER MOYER, to me known to be the person described in and who executed the foregoing instrument, and acknowledged that she executed the same. (Seal) NOTARIAL SEAL VlCKIE B. SNYOE.R, Notaty Public lewllburg Bore, Union County, PA My Comml..ion Expires Sept 13, 1997 COMMONWEALTH OF PENNSYLVANIA ss: COUNTY OF UNION On the 7~ day of AlO",.,,,,,b<'"<, 1996, before me personally came Barry R. Maxwell. to_me known, who, being duly sworn, did depose and say that he resides in East Buffalo Township; that he is the Vice President for Administration of BUCKNELL UNIVERSITY, the corporation described in and which executed the above instrument: that he knows the seal of said corporation; that the seal affixed to said instrument was such corporate seal; that it was so affixed by order of the board of directors of paid corporation, and that he signed his name thereto by like order. (Seal) ~, /;. ~A Notary Publi NOTARIAL SEAL VICKIE S. SNYDER, NOlary Public lewllloorv Soro, Uniorr County, PI. My Commlllsion Expires Sepl13. 1997 Bucknell University Charitable Remainder Unitrust Disclosure Statement This disclosure statement has been prepared in order to infonn you about Bucknell University's charitable remainder unittust (hereafter, "CRUT" or "Trust" depending on context) program, including how such Trusts are invested by Bucknell and what infonnatlon yon may expect to receive, as well as to comply with the requirements of P. L. 104-62 and P. L. 104-63. Please read this fonn; retsin one copy for your records, and sign, date, and retum the other copy, using the business reply envelope enclosed, to: Office of Planned Giving Bucknell University Cooley Hall Lewisburg, PA 17837-9988 telephone: fax: 717/524-3200 717/524-3610 If you have any questions, please contact the planned giving staff at the address or telephone numbers shown above. I. Charitable Organization Bucknell University, a Pennsylvania educational corporation, located at Lewisburg, Union County, Pennsylvania (hereafter, "Bucknell" or "University," depending on context), serves as Trustee of Chatitable Remainder Unitrusts in which the University bas an irrevocable chatitable remainder interest. Bucknell qualifies as a public chatity, eligible to receive contributions which qnalify as deductible charitable gifts, and is exempt from taxation under each ofIRC ~~170(b)(1)(A)(ii), 501(0)(3), and 509(a)(I). As of June 30, 1996, when Bucknell's last fiscal year ended, the University's pooled endowment had a total fair market value of$191,818,284. The University's physical plant had a total replacement value of$315,000,000. Cash, accounts and loans receivable, temporary investments, deferred charges, inventories, and other non- endowment assets were valued at $29,220,000. Bucknell University is under the management, direction, government and supervision of a Board of Trustees which shall not exceed fifty in number. All vacancies may be filled from candidates selected by the Board Comntittee on Nominations, a two-thirds vote of all members present being necessary for elections. Regular Trustees shall be elected for renewable tenns of not more than five years. At least two but not more 1ha:n four members shall be designated Term Trustees who shall serve for three years. In addition, up to five alumni/so ttustees may be elected annually to membership for a term not exceeding five years. The a1umni/ae ttustees shall not be eligible for further election to the Board for at least one year after the expiration of his or her term. Finally, the Board may elect as many Emeritus Trustees as desired, but such trostees shall not have voting privileges. 2. ResponsIbIlIties, Payment and Investment When donors make gifts to Bucknell, as Trustee, to establish CRUTs, the donors' gifts are made to the Trust which is created with their contnbution. At the time the gift is made, the donor and the University agree, that as Trustee of the CRUT, the University will receive the donor's gift, use the gift to establish the Trust, and will thereafter each year make payments from the assets and earnings of the Trust calculated as that dollar amount representing a fixed percentage of no less than 5% of the net fair market value of the Trust assets The net fair market value of the Trust's assets, and the resulting required payments, will be recalculated on the first business day of each taxable year of the Trust. Suoh payments will be made in equal quarterly installments at Ihe end of each calendar quarter, or as otherwise provided in the Trust agreement. Bucknell may engage commercial ftmds managers, custodians, accountants, or other organizations or individuals (hereafter "custodians") to carry out all or part of its responsibilities as Trustee of the Trust. This in no way reduces or changes Bucknell's responsibilities as Trustee. I I Bucknell or its custodians may elect to invest the assets of the CRUT in c~on trost funds held by Bucknell or by the custodian, and may change the investm ts of the Trust from time to time, without prior notification to the donor. The goal of the University and the cnstodian will in all cases be to realize the greatest pos ible retom on investment commensurate with both security and stability of the Trost' vestment over the anticipated term of the Trust. . I If you are the donor of a CRUT which is held by Bucknell as Trostee, and w~ch currently is in operation, a separate sheet, attached to and incorporated in this discl~ure statement, will list the allocation of the assets of your CRUT among the in 'vidual assets and common funds currently available to our custodian. If you hav not yet funded a CRUT. you will, on request, be provided a statement of investm t allocation goals for the CRUT you propose. The obligation of Bucknell, as Trustee, and of any custodians hired by BUCknf' to make payments to the donor or other income beneficiary of this Trost is limited the assets of the Trust. No part of the University's assets held separately from this T st may be used for payments under the t= of this Trost. 3. Reports Provided by Bucknell University The donor who establishes a CRUT will, as soon as practicable after the gift i~' completed, be provided Bucknell's estimate of the income, gift, and estate tax deducti us which may he claimed as a result of the gift. This information is provided as a co esy, only, and must he checked and reviewed by the donor or by independent COunse retained by the donor before use as the basis for claiming a charitable gift. deductible der law. By the end of each March, each income beneficiary of a CRUT plan will be P~vided a completed copy of all reportiog fornlS required by the Internal Revenue S . ce; such forms will provide information required for income beneficiaries to report ccurately on the income paid to them from their CRUT, for the year just ended, on . err income tax returns. I 4. Fees ! Bucknell may reimburse itself from the CRUT for any administrative costs incWred in administering the CRUT, and/or for any investment management or other e~erlSes incurred in connection with administering the CRUT's assets, or preparing and ffiing any tax or other reports required for administration or operation of the CRUT. Said costs shall be allocated in a reasonable manner between principal and inconje. 5. Miscellaneous I CRUTs are exempt from registration under regulations of the Securities an~ Exchange Commission. I I By signing this form, I confirm that I have read and that I1we understand the in~rmation contained in this disclosure statement, and that it is applicable to the charitable ainder unitmst we have I have established effective November 7, 1996, with Bucknell niversity as Trostee and charitable remaindennan, and to which charitable remainder uni st this disclosure statement is appended: I Signature: r'L ,~~.-?U/~ ~ Date: ~ 1996 Priutname: CIJRJ$rJ,v" STEA/VER MoyeR. Christine Sterner Moyer Charitable Remainder Unitrust dated November 7, 1996 Trustee: Bucknell University Custodian as of November 7, 1996: Trust Company Bank Asset Allocation Schedule as of November 7, 1996: 30% SunTrust Equity Fuod 30% SuoTrust Equity Income Fuod 40% SuoTrust Income Fuod These common trust funds are controlled and managed by TRUSCO Capita! Management aod STI Capital Management, divisions of SunTruat, Incorporated. SunTrust Equity Fund June 30, 1996 Investment Objective: The SunTrust Equity Fund is designed to provide a diversified portfolio of high quality stocks with above average prospects for long-term price and eamings growth. Emphasis is placed on uncovering relative value in large and mediwn capitalization companies. Fundamental characteristics analyzed include profitability, eamings growth and return on equity. Shifts in stock sectors are made in order to take advantage of changing economic. cycles. Fund Facts: Market Value: Unit Value: Current Yield: Fund Manager: $495 million $51.28 1.76% Anthony Gray Top Ten Holdings: AT&TCorp General Electric Home Depot, Inc. Johoson & Johnson Chase Manhattan Corp. Proctor & Gamble Philip Morris Inc. Tyco Inti. L TD McDonald's Corp. Merck & Co. 2.43% 2.42% 2.30% 2.28% 2.18% 2.06% 2.06% 1.99% 1.91% 1.82% Industry Weighting: Consumer Staples: Techoology: Consumer Cyclical: Financial: Capital Goods: Basic Materials: Utility: Energy: 26.7% 16.4% 14.4% 11.2% 9.7% 8.9% 7.2% 5.5% 30.00% 25.00% i 20.00"- '" ] 15.00% .. , g 10.00% '" 5.00% 0.00% Investment Performance: IJSunTrust ElUpperGrowth .S&P500 One Year Seven Years Ten Years Solne: REPREN~d LinkedlO: llEl'Jl.ENaNlONDCHRT.xk Sun Trust Equlqr Income Fund June 30, 1996 Investment Objective: The objective of the SunTrust Equity Income Fund is designed to provide current income by structuring its investments in an attempt to maintain the portfolio yield at a level above the average dividend yield of the securities comprising the S & P 500 Index. Achieving such a yield is the primary consideration when purchasing securities. Capital appreciation is secondal)'. Fund Facts: Market Value: Unit Value: Current Yield: Fund Manager: Top Ten Holdings: BAT Holdings Bristol Myers S~uibb Grand Metropolttan lIT Industries General Signal ITT Hartford Group Maseo Corp. GTE Corp. Conagra Frontier Corp. $789 million $24.21 3.24% Mills Riddick 2.16% 2.08 2.08 2.03 2.02 1.99 1.98 1.60 1.57 1.56 Industry Weighting: Consumer Staples: Financial: Basic Materials: Utility: Consumer Cyclical: Energy: Capital Goods: Technology: 19.2% 18.5 16.7 15.4 15.0 8.2 3.6 3.4 Investment Performance: 30.00% []SunTrust iii Lipper Equity Income .S&P500 25.00% . j 20.00% 1; '" 1 15.00% -=i . l10.000/.. 5.00% 0._ One Year FivaYa8l'S Seven Years So"""" kBnENCB\l!qIyPaDd Linkod "', lU!FRBNCllIBONDCHltT Jdo .' .' SunTrust Income Fund June 30, 1996 Investment Objective: The SunTrust Income Fund's objective is to obtain a high total return through investments in investment-grade, fixed income securities. The fund is actively managed and reduces risk through diversification by maturity, quality, and sector. Fund Facts: Market Value: Unit Value: Current Yield: Yield to Maturity: Average Maturity: Duration: Fund Manager: $196.9 million $5.70 6.69% 6.97% 9.6 years 5.68 years Charles B. Leonard Portfolio Diversification by Quality: Treaswy/Agency: A AAA AA BAA 56.6% 29.1% 6.1% 4.1% 4.1% Portfolio Diversification by Market Sector: Government! Agency: Finance: Mortgage: Industry: Asset Backed: Cash; Utilities: 36.4% 28.3% 20.1% 9.4% 2.7% 2.1% 1.0% Investment Performance: ..00% ..00% ~ 7.00% '16.00% i 5.00% _ 4.00% i 3.000/. ~ 2.00% 1.00% 0.000/.. CSunTrost . Lehman GovI!Cap OneYsar Three Yews FrveYears Source: RBFlU!NCE\IuomP\md 1.InI<.od 10: RBFRENCH\lIONDCHRT.xIo ESTATE OF CHRISTINE S. MOYER 21-04-0675 Calculation of Valuation of Decedent's life interest in Charitable Remainder Unitrust (CRU): Assumptions: [1] Decedent's (nearest) age at death 97 [09/06/1907] [2] Date of valuation 07/06/2004 [3] Value of CRU on date of valuation $232,080.98 [4] Payout rate 5% [5] Payment Schedule Quarterly [6] Discount rate under IRC ~7520(a) for July, 2004 5% Calculations: [7] Adjustment factor for discount rate on [6] .981961 (Table F in IRS Publication 1458 (1999)) [8] Adjusted unitrust payout rate [4] X [7] 4.909805% [9] Interpolated remainder factor for values on lines [1] & [8] .86979 (Table U(1) in IRS Publication 1458 (1999) [10] Value of remainder interest of CRU ([3] X [9]) $201,861.72 [11] Value of Decedent's life interest ([3] - (10)) $ 30,219.26 ESTATE OF qOOSTINE S. MOYER 21-04-0675 Calculation of charitable deduction for distribution to Charitable Remainder Unitrust (CRU): Assumptions: [1] Ages of two beneficiaries of lead interest of CRU 69 [05/2711935] 70 [06/14/1934] [2] Date of gift (distribution) 08/25/2004 [3] Amount of gift (distribution) $242,360.41 [4] Payout rate 5% [5] Payment Schedule Quarterly [6] Discount rate under IRC ~7520(a) for August, 2004 4.8% Calculations: [7] Adjustment factor for discount rate on [6] (Table F in IRS Publication 1458 (1999)) [8] Adjusted unitrust payout rate [4] X [7] .971206 4.85603% [9] Interpolated remainder factor for values on lines [1] & [8] (Table U(2) in IRS Publication 1458 (1999) [10] Value of charitable portion of distribution to CRU ([3] X [9]) .41519 $100,625.61 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN *' REV-483 EX AFP (03-05) ,)' i j; , ,.< .,.v DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 07-12-2005 MOYER 07-06-2004 21 04-0675 CUMBERLAND 201 CHRISTINE S OFC:~ JOHN D KILLI~~GESQ KILLIAN & GEPHART 218 PINE ST HBG PA 17101 AlIOunt R..i tted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your t.x pay..nt. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES ~ ~~:'I~1!2.~~.11r!:~J......ii.Ab~eIr"~.~~!lDrf!~.lJftS.ls1f!~s1lfA,"............................ OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN .. ESTATE OF MOYER CHRISTINE S FILE NO.21 04-0675 ESTATE TAX DETERMINATION ACN 201 DATE 07-12-2005 1. Credit For State Death Taxes as Verified 38.612.36 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) 115.368.55 3. Inheritance Tax Assessed by Other States or Territories of the United States (Excluding Discount and/or Interest) .00 4. Total Inheritance Tax Assessed 115.368.55 5. Pennsylvania Estate Tax Due .00 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 -IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REqUIRED FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU NAY BE ~ 'S \L DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN *' DCrnDCfrl nrqr(: n= BUREAU OF INDIVIOOAL\,'lAXii~v u. , 'vv '.' INHERITANCE UX DllolISIO\!;:'--,'-":'T"'- ;-.:" < : PO BOX Z8D6DI ,"",",_".:' ;-- !-' ,'1 HARRIS8LRG PA 17128-0601 ~ - REY-7"U AFP U'-[5) ZOGS sc.:p -2 PH f?: 07 09-05-2005 MOYER 07-06-2004 21 04-0675 CUMBERLAND 202 APPEAL DATE: 11-04-2005 (See reverse side under Objections) Amount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT CHRISTINE S JOHN 0 ~ILLIAN ESQ KILLIAN & GEPHART 218 PINE ST HBG PA 17101 TO: REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, sub.it the upper portion of this form with your t.x pa~.nt. CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR FILES +- RE-V:736-EiCAFPTlii-:.-ozr----..-NifficE-ciniETEii'iiiifAiiiiN-ANP-ASSESSMENy---------------------------- OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER .. ESTATE OF MOYER CHRISTINE S FILE NO.21 04-0675 ESTATE TAX DETERMINATION ACN 202 DATE 09-05-2005 1. Credit FDr State Death Taxes as Verified 38,612.36 2. Pennsylvania Inheritance Tax Assessed (Excluding DiscDunt and/Dr Interest) 115,368.55 3. Inheritance Tax Assessed by Other States Dr TerritDries Df the United States (Excluding DiscDunt and/Dr Interest) .00 4. TDtal Inheritance Tax Assessed 115.368.55 5. Pennsylvania Estate Tax Due .00 6. AmDunt Df Pennsylvania Estate Tax PreviDusly Assessed Based Dn Federal Estate Tax Return .00 7. AdditiDnal Pennsylvania Estate Tax Due .00 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 -IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED Ill' FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CI), YOU HAY BE /<f\. DUE A REFUND. SEE REVERSE SIDE OF THIS FO~ FOR INSTRUCTIONS.' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX Z80601 HARRISBURG PA 171Z8-06Dl COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ~TO[Tl:l.NfttUqNCE TAX nATJ;MENTcOF ACCOUNT . . ~ ' 7.0C5 SE? ! 3 pn I: l;eATE ESTATE OF DATE OF DEATH FILE NUMBER ~, COUNTY ACN 0Icr::.( ''''/!...''-' \ JOHN D KILLIAN ESQ KILLIAN & GEPHART 218 PINE ST HBG ('c-c. "-.'i ('1\ *' REV-1607 EX AFP (03-05) 08-22-2005 MOYER 07-06-2004 21 04-0675 CUMBERLAND 101 Mount Renitt.d CHRISTINE S PA 17101 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE NOTE: To insure proper credit to your account, sub.it the upper portion of this forn with your tax p.~.nt. +- REV-1607 EX AFP (03-05) --+ RETAIN LOWER PORTION FOR YOUR RECORDS --------------------------------------------------------------------------- *** INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF MOYER CHRISTINE S FILE NO.21 04-0675 ACN 101 DATE 08-22-2005 THIS STATEMENT IS PROVIDED TO ADVISE OF TME CURRENT STATUS OF THE STATED ACN IN THE NANED ESTATE. SHOWN BELON IS A SunKARY DF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 07-05-2005 PRINCIPAL TAX DUE: 121,440.58 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 09-24-2004 CD004420 6,072.03 120,000.00 10-01-2004 CD004461 .00 2,000.00 08-02-2005 REFUND .00 6,631. 45- TOTAL TAX CREDIT 121,440.58 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 . SIDE FDR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRJ, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J ,/~ THOMAS W. SCOTT JANE GOWEN PENNY TERRENCE J. MCGOWAN MICHAEL J. O'CONNOR LINDA J. OLSEN JUSTIN D. BODOR THE LAW FIRM OF KILLIAN & GEPHART, LLP 218 PINE STREET P. O. BOX 886 HARRISBURG, PENNSYLVANIA 17108-0886 HEATHER M. FAUST (2000-2005) TELEPHONE (717) 232-1851 FAX NO. (717) 238-0592 www.killiangephart.com Of Counsel: JOHN D. KILLIAN SMITH B. GEPHART December 29,2005 Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle,PA 17013-3387 RE: Estate of Christine S. Moyer Dear Sir or Madam: Enclosed for filing is an original Status Report, Rule 6.12 and a copy to be date stamped and returned to me in the enclosed stamped envelope. Thank you for your attention to this matter. Very truly yours, tlttMi j~0 jJo~~ Corinne Eggert Woodhouse Enclosure STATUS REPORT UNDER RULE 6.12 Name of Decedent CHRISTINE S. MOYER Date of Death July 6, 2004 will No. 2004 - 00675 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No X b. The separate Orphans' Court No. (if any) for the personal representative's account is: NA c. Did the personal representative state an account informally to the parties in interest? Yes X No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: ;2-(2-<'(( OS John D. Killian, Esquire Name (Please type or print) C0 ':::_~ Killian & Gephart 218 Pine Street Harrisburq, PA 17101 Address (717) 232-1851 Tel. No. Capacity: Personal Representative X counsel for Personal Representative ~~.