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HomeMy WebLinkAbout02-11-11J 1505607121 REV-1500 EX (06-05) PA Deparlrnent of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes PO BOX 280601 INHERITANCE TAX RETURN County Code Year File Number Hamsbu , PA 17128-0601 RESIDENT DECEDENT 2 1 1 0 0 6 3 8 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 0 4 9 2 4 1 9 8 5 0 6 0 6 2 0 1 0 0 9 1 8 1 9 3 2 Decedent's Last Name Suffix Decedent's First Name H E N R Y MI H A M I L T O N M (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE FILL IN APPROPRIATE OVALS BELOW REGISTER OF WILLS 1. Original Return ~ 2. Supplemental Retum 3 Re i 4 Limit d E . ma nder Return (date of death ri t . e state ~ 4a. Future Interest Compromise (date of d th p or o 12-13-82) ~ 5. Federal Estate Tax Ret OX 6. Decedent Died Testate (Attach Copy of Will) ~ ea after 12-12-82) 7. Decedent Maintained a Livin Trust g urn Required T ~ 8 9. Litigation Proceeds Received ~ (Attach Copy of Trust) 10 S l • otal Number of Safe Deposit Boxes . pousa Poverty Credit (date of death between 12-31-91 and 1-1-95) ~ 11 • Election to tax under Sec. 9113(A) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONF N ame ID ENTIAL TAX NFORMATION SHOULD BE DIRECTED T0: S U S A N H Daytime Telephone Number C Firm Name (If Applicable) O N F A I R 7 1 7 7 6 3 1 3 8 3 R E A G E R & A D L E R p C REGISTER OF WILLS US~C~NLY First line of address C J c~: ~ - -- .~ Q 2 3 3 1 M A R K E T S T R E E T ~ ~~ ~~ ~- - Second line of address -- ~ ~ ~ ra ': "'~ s . . r. ~ ~ i ,` , i ~ ~~ r .n: _ . C7 ~ City or Post Office ~~ 'Y~s c,~ C:.~ ~~j~,_ ~i -. C A M P H I L State ZIP Code ' ~ D FILED r~;_) Tt ~ L P A 1 7 0 1 1 `~'© Correspondent's a-mail address: SCONFAIRaREAGERALDERPC • COM Under penalties of pery'ury, I declare that I have examined this return, including acx;ompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATU ERSON RESPO IBLE FOR FILI G RETURN DATE ADDRESS _ ~ ~ ` / 625 MOUNTA-"~ SIGNATURE OF PREI D i nHrv rttPRESENTATIVE ~~:! _ .. 331 MARKET STREET PA~17007 ~ . PA 17011 CAMP HILL PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505607121 BOILING SPRINGS 1505607121 J (~ , `-h REV-1500 EX 1505607221 Decedent's Name: HAMILTON M• H E N R Y Decedent's Social Security Number RECAPITULATION D 4 9 2 4 1 9 8 5 1. Real estate (Schedule A) , , . , ..... ......................... ...... 1. 2. Stocks and Bonds (Schedule B) . .. , , . , , , , 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) 2 9 8 6 4 .6 5 ..... 3, 4. Mortgages 8 Notes Receivable (Schedule D) . , , , , . 5. Cash, Bank Deposits $ Miscellaneous Personal Property (Schedule E) .. 4. , , . , , 5 9 6 7 8 2 6. Jointly Owned Property (Schedule F) ^ Separate Billing Re u 7 t I . . 1 q . es ed .. nter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ..... 6. 2 6 `1 5 . 3 1 ^ Separate Billing Requested ' .. 8. Total Gross Assets (total Lines 1-7) . ..... 7, ] D 2 D 5. 4 4 ..................... 9. Funeral Expenses 8 Administrative Costs (Schedule H) ..... 8. 9 2 4 4 3. 6 1 . , , , ........ 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .... s. 9 0 2 3. 5 0 , , , , , . 11. Total Deductions (total Lines 9 & 10) 10 4 D 8. 7 3 .............. 12. Net Value of Estate (Line 8 minus Line 11) ....11. 9 4 3 2. 2 3 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not be 12 8 3 D 1 1 ' 3 8 en made (Schedule J) .............. .... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ~ ~ ~ 14. 8 3 0 1 1, 3 8 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICAB LE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x.o 0 . 0 0 16. Amount of Line 14 taxable 15. D . D D at lineal rate X .045 8 3 0 1 1, 3 B 17. Amount of Line 14 taxable 16. 3 7 3 5 . 5 ], at sibling rate X .12 D . D D 18. Amount of Line 14 taxable 17' 0 . D D at collateral rate X .15 ^ D D 19. Tax Due ... 18 D. 0 0 ........................................... ..1s. 3 7 3 5. 5 1 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L Side 2 1505607221 1505607221 REV-1500 EX Page 3 Decedent's Complete Address: File Number DECEDENTS NAME 21 10 HAMILTON M- HENRY STREET ADDRESS 408 HUNTINGTON AVENUE CITY E N O L A STATE PA Tax Payments and Credits: 1• Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3,636.90 186.78 3. InteresUPenalty if applicable Total Credits (A + B + C ) D. Interest E. Penalty 0638 ZIP 17025 (1) 3,735.51 (2) 3, 823.68 4. If Line 2 is greater than Line 1 +Line 3, enter the difference. This is the OVERPAYMENT.Total InteresUPenalty (D + E) (3) Fill in oval on Page 2, Line 20 to request a refund. 0 . D D 5. If Line 1 +Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. (4) 88.17 (5) 0. DD B. Enter the total of Line 5 +SA. This is the BALANCE DUE. (5A) (5B) D . 0 D Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred; Yes No . retain the right to designate who shall use the property transferred or its income; ~~•~ ~ X c. retain a reversiona interest; or ~~•••••••~•~•••••~•••••-•-..... ................... ry .......................... d. receive the promise for life of either payments, benefits or care? .. • • - ~ • • ~ • • • ~ • • ~ ~ -"' • •' """' .................................................. ^ X 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death O without receiving adequate consideration? _ .......................... ................... ^ X 3. Did decedent own an "in trust for" or payable upon death bank account or securit at his or her deaths 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .......................................... ........................................................ o a IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF TH E RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the survivin s u is three (3) percent (72 P.S. §9116 (a) (1.1) (i)]. g po se For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0 rcent [72 P.S. §9116 (a) (1.1) (ii)J. The statute does nom pt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets an filing a tax return are still applicable even if the surviving spouse is the only beneficiary, ) ~ d For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)]. P The tax rate im osed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half 4.5 72 P,S. §9116(1.2) (72 P.S. §9116(a)(1)], ( )percent, except as noted in The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)], A siblin is Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. g defined, under REV-1503 EX + (6-98) SCH COMMONWEALTH OF PENNSYLVANIA EDULE B INHERITANCE TAX RETURN STOCKS & BONDS RESIDENT DECEDENT ESTATE OF MAMILTON M • HENRY FILE NUMBER All ro Z1 10 0638 P party jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE ~~ GE/FULTON STOCK OF DEATH 9,861.50 2• FULTON DIVIDEND 3.15 TOTAL (Also enter on line 2, Recapitulation) ; (If more space is needed, insert additional sheets of the same size) 5 ~ 8 6 4.6 5 REV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCN EDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY HAMILTON M. HENRY .FILE NUMBER InGude the proceeds of litgation and the date the 21 10 0 6 3 8 All property jointlyowned with right of survivorship must be disc used on Schedu a F. ITEM NUMBER ~• METRO BANK - CHECKING #512002064RIPTION VALUE AT DATE OF DEATH 3801 PAXTON STREET, HARRISBURG, PA 17111 6,669.48 2• FUNERAL REIMBURSEMENT 2,OD0.00 3• CASH ON HAND 25.00 4• PERSONAL PROPERTY 500.00 5• COUNTY BURIAL AWARD 100.00 6• COMCAST REFUND 73.73 7• AUTO POLICY REFUND - ERIE INSURANCE 229.D0 8• HOMEOWNERS INSURANCE POLICY REFUND 81.00 TOTAL (Also enter on line 5, Recapitulation) S (If more space is needed, insert additional sheets of the same size) 9 ~ 6 7 8 - REV-1509 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT '.STATE OF HAMILTON M. HENRY SCHEDUL EF JOINTLY-OWNED PROPERTY n If an asset was made joint within one year of the decedents date of death, it must be reported on Schedule G! SURVNING JOINT TENANT(S) NAME ADDRESS A. SHERRY L• MILLER 625 MOUNTAIN ROAD BOILING SPRINGS, PA 17007 B C JOINTLY-OWNED PROPERTY: LETTER ITEM FOR JOINT NUMBER TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIM IDENTIFY ILAR ING NUMBER ATTACH DEED FOR JOINTLY-HELD REAL ESTATE ~• A 8/2008 . MEMBERS 1ST FEDERAL CREDIT UNION -CHECKING 5000 LOUISE DRIVE 2' A MECHANICSBURG, PA 17055 8/2008 MEMBERS 1ST FEDERAL CREDIT UNION-SAVINGS 5D00 LOUISE DRIVE 3• A MECHANICSBURG, PA 17055 8/2008 METRO BANK - SAVINGS 3801 PAXTON STREET HARRISBURG, PA 17111 KELATIONSHIP TO DECEDENT DAUGHTER DATE OF DEATH ~ OF DECD'S DATE 0- F DEATH VALUE OF ASSET INTEREST VALUE OF DECEDENT'S INTEREST 1,562.34 50. 781.17 3,021.46 50• 1,510.73 806.81 50. 403.41 TOTAL (Also enter on line 6, RecaDitulationl c (ir more space is needed, insert additional sheets of the same size) 695. REV-1510 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF HAMILTO ITEM NUMBER 1. SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY • HENRY FILE NUMBER This schedule must be Completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV- 500 COWER S EET is ~ESCRIr'TION OF RROPERTY yam' INCLUDE THE NAME OF THE TRANSFEREE, THEIR RBATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER ATTACH A COPY OF THE DEED FOR REAL ESTATE. SUNAMERICA - IRA BENEFICIARY - SHERRY L• MILLER DATE OF DEATH °~ OF DECD'S VALUE OF ASSET INTEREST 7D,205.44 1DD- EXCLUSION TAXABLE VALUE 7D,2D5.44 TOTAL (Also enter on line 7 Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 7 D REV-1511 EX + (10.06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF • HENRY SCHEDULE H FUNERAL EXPENSES 8 ADMINISTRATIVE COSTS FILE Debts of decedent must be reported on S he edu a Ile II ITEM NUMBER DESCRIPTION A• FUNERAL EXPENSES: ~• RICHARDSON FUNERAL HOME, INC• AMOUNT 4,742.00 B• ADMINISTRATIVE COSTS: ~ • Personal Representative's Commissions Name of Personal Representative (s) Street Address City State Zip Year(s) Commission Paid: 2. AttomeyFees REALER & ADLER, PC 3. Famiry Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address Ciry State Zip Relationship of Claimant to Decedent 4• Probate Fees CUMBERLAND COUNTY REGISTER OF WILLS 5• Accountant's Fees s• Tax Retum Preparers Fees ~• LEGAL ADVERTISEMENT - CUMBERLAND LAW JOURNAL 8• LEGAL ADVERTISEMENT - JOURNAL PUBLICATIONS TOTAL (Also enter on line 9 Recapitulation) I S (If more space is needed, msert additional sheets of the same srze) 4,000.00 127.50 75.00 79.00 9,023. REV-1512 EX + (12.03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS HAMILTON M. HENRY FILE NUMBER Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, inc uding uDnreimbursed medical ex en ITEM p ses. NUMBER DESCRIPTION VALUE AT DATE ~• ELECTRIC - PPL ELECTRIC UTILTIES OF DEATH 271.99 2• CREDIT CARD BILL - DISCOVER 3• PHONE BILL - VERIZON 92.02 44.72 TOTAL (Also enter on line 10 RP~aniti ~las,,,,~ ~ 3 (If more space ~ needed insert additional sheets of the same size) r REV-1513 EX + (g.~p) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT c~r~r~ .. -~~~.~ yr HAMILTON M- HENRY SCHEDULE J BENEFICIARIES NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY j, TAXABLE DISTRIBUTIONS pndude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1• SHERRI L• MILLER 625 MOUNTAIN ROAD BOILING SPRINGS, PA 17007 2. MICHAEL R- HENRY 19 BIG OAK ROAD DILLSBURG, PA 17019 3• JIMMY H. HENRY 408 HUNTINGTON AVENUE ENOLA, PA 17025 FILE NUMBER 21 10 0638 RELATIONSHIP TO DECEDENT AMOUNT OR SH Do Not List Trustee(s) OF ESTATE Lineal I 76,270.96 Lineal 3,370.21 Lineal I 3,370.21 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION. TO TAX IS NOT BEING MADE 1. I B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. 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) REV-1500 Discount, Interest and Penalty Worksheet Discount Calculation Total Amount Paid within three calendar months of the decedent's date of death: 3,636.90 Discount: 186.78 Interest Table Penalty Calculation If the decedent's date of death was on or before March 31, 1993, insert the applicable amount: Total Balance Due on January 17, 1996: Penalty: \;Ntserver\SConfair\WPWin\WII-IS\HenryH Will.wpd March 22, 2004 C7 r.s °- -r; LAST WILL AND TESTAMENT ~ ~ ~-~ ~ ~~~ ~~' .D~ C . ~) :. ~Z~ ~ - .~~~ ~~~Y~ ca .. HAMILTON M. HENRY /~ ~ - ~ ~' ~' =` ' - -_ __, Co) _ _ ~ J _ _ r, 1 ~'x~ I, HAMILTON M. HENRY, of Enola, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereb make Testament, hereby revoking any and all prior Wills and Codicils thereto by meeat anytime her tofore lmadea 1. FAMILY. 1.1 Identification of Family. I declare that I am married to VIVIAN M. HENRY and that there are three (3) children of this marriage whose names are SHERRI L. MILLER, MICHAEL R HENRY and JIMMY H. HENRY. 1.2 Definition of Family Terms. As used in this Will, the term " my spouse" shall mean only VIVIAN M. HENRY. As used in this Will, the terms "my child" or "my children" refers to all my natural children and adopted children. As used in this Will, the term "issue" refers to all lineal descendants of the indicated person of all generations, with the relationship of parent and child at each generation determined by the definition of "child/childr'en"set forth in this paragraph. Z. PAYMENT OF BURIAL EXPENSES AND DEBTS. I authorize my executor to pay all the expenses of (1) a funeral or memorial service; (Z) the internment of my remains, including the costs of a gravesite, if necessary; and (3) the installation and inscription of a suitable marker at, and perpetual care of, the gravesite. I further direct my executor to pay all of my debts that my executor in his or her sole discretion may allow as claims against my estate. 3. DISPOSITION OF TANGIBLE PERSONAL PROPERTY. 3.1 Disposition to S ouse. I give all of my tangible personal property of every kind and description, including, but not limited to, books, pictures, clothing, articles of household or personal use or adornment, household furnishings and effects, and automotive vehicles and their accessories, but excluding any money, evidences of indebtedness, documents of title, and securities and property used in connection with the operation of any trade or business, to my spouse. 3.2 Alternative Disposition. If my spouse does not survive me by more than sixty (60) days after the date of my death, and any of my children survive me, I direct my executor to divide my tangible personal property into two parts. The first part shall contain all items that my executor determines, to be of no present or future value or use to my children. The second part shall contain the balance of the property. My executor shall dispose of the first part by ~~~~. 1 Hamilton M. Henry \\Ntserver\SConfair\WPWin\WILLS\HenryH Will.wpd March 22, 2004 sale, abandonment, destruction, or gift to any charity or person. The proceeds of any sale shall be added to my residuary estate. All property in the second part I give to my children who survive me, in substantially equal shares, to be divided among them as they shall agree. If any child is a minor, the guardian of the person appointed for that child must agree to the division. If no agreement is reached within (60) days after my death, all property in the second part shall be divided among all my children in such manner as my executor shall direct. The decision of my executor shall be conclusive and binding on all persons interested in my estate. Any item of personalty passing to a minor under this Section 3.2 may be delivered to the minor or to any person to hold for the minor, as my Executor thinks advisable, and the receipt by any such persons, including the minor; shall constitute a full and complete discharge to my Executor. 4. DISPOSITION OF RESIDUARY ESTATE. 4.1 Disuosition to S ouse. All of the rest, residue and remainder of the property that I own at the time of my death, both real and personal, and of every kind and description, wherever situated, to which I may be legally or equitably entitled at the time of my death (my "residuary estate"), I give outright and absolutely to my spouse, if she survives me. 4.2 In the event my spouse is not living on the sixtieth (60) day after the date of my death, I leave all the rest, residue and remainder of the property that I own at the time of my death, both real and personal, and of every kind and description, wherever situate, to which I may be legally or equitably entitled at the time of my death (my "residuary estate") in equal shares to my children, PROVIDED THAT, if any of my children shall predecease me leaving issue who survive me, then I leave the share of that deceased child to his or her issue, who survive me, per stirpes; PROVIDED, however, that if such grandchild shall then be under the age of twenty-five (25), my trustee shall hold that grandchild's share in a separate trust for the benefit of that grandchild, to be administered and distributed as provided in Article 4.3 of this Will. In the event that all of my children shall predecease me and none leave issue who survive me, then I leave the remainder of my estate to: 4.3 Trust for Grandchildren. In the event any of my grandchildren who are entitled to a share pursuant to Section 4.2 above are under the age of twenty-five (25) years, his or her share shall be held IN TRUST. My Trustee shall invest and manage any such share as a separate trust and make distribution as follows: i. Until such grandchild shall reach the age oftwenty-one (21), my trustee shall pay to or apply for the benefit of that grandchild so much of the net income of the trust as my trustee shall deem necessary or advisable to provide for that ~~ 2 Hamilton M. Henry \Wtserver\SConfair\WPWin\WILLS\HenryH Will.wpd March 22, 2004 grandchild's support, maintenance, health and education (including higher or special education). My trustee shall accumulate any income not so distributed and shall add the same to principal at least annually. ii. After that grandchild reaches the age of twenty-one (21) and until that child shall reach age twenty-five (25), my trustee shall pay to or apply for the benefit of such grandchild all of the net income of the trust in quarterly or more frequent installments. iii. I authorize my trustee to pay or apply principal of the trust, at any time, to or for the benefit of such grandchild, even to the point of exhausting trust principal, in such amounts as my trustee, in its absolute discretion, deems necessary or advisable to provide for the support, maintenance, education and health of such grandchild. For example, but not by way of limitation, my trustee may pay or apply trust principal, in my trustee's absolute discretion, for basic maintenance and support; elementary or secondary education; post- secondary technical or vocational training; college, postgraduate, and professional study; and assistance in connection with marriage, acquisition and furnishing of a home, and commencing a business or profession. In determining the amount of principal to be disbursed, my trustee shall take into consideration any other resources available to such grandchild. iv. Upon such grandchild reaching age twenty-one (21), one-half of the trust principal shall be distributed to such grandchild by my trustee. v. Upon such grandchild reaching age twenty-five (25), the trust for such grandchild shall terminate and my trustee shall distribute to such grandchild all of the trust assets remaining on hand. vi. If a grandchild dies before reaching age of twenty-five (25), and is survived by issue, my trustee shall distribute the trust principal to such deceased grandchild's then living issue, per stirpes. vii. If a grandchild dies before reaching age twenty-five (25), and is not survived by issue, my trustee shall distribute the trust of that child in equal shares to my issue, or in the event an issue is not living, then to that deceased issue's then. living children, per stirpes. viii. If at any time my Trustee in it's discretion determines that the size of such beneficiary's trust share does not warrant holding such share in trust, my Trustee may, in full discharge of it's duties herein, without formal court accounting, pay the remaining principal and income to the Guardian of the person of such beneficiary who is a minor or may deposit it in an interest bearing or investment account in the name of such beneficiary, payable to the I a-~1.~ J "l ~~~ 3 Hamilton M. Henry ---~ \\1Ntserver\SConfair\WPWin1WILLS\HenryH Will.wpd March 22, 2004 beneficiary upon obtaining the age of twenty-five (25), and upon such payment or deposit the Trustee shall be relieved of all liability in connection with such fund. 4.4 Trustee's Judgment Final. The judgment of the trustee as to the amount of payments or applications of principal or income pursuant to this Article shall be final and conclusive on all persons interested, or who may become interested, in the trust estate. On making any payments or applications of principal, the trustee shall be fully released and discharged from all further liability or accountability. 4.5 Spendthrift Pr. ovisions. No beneficiary of this trust shall have any right or power to sell, assign, convey, mortgage, pledge, anticipate, hypothecate, or otherwise dispose of any right, title, or interest that the beneficiary may acquire in the income or principal of the trust estate until the income or principal has actually been paid over to the beneficiary by the trustee. Nor shall the income or principal of the trust estate, or any part of it, or any interest of any beneficiary under this Will be liable for, or to any extent subject to, any debts of any kind or nature incurred or contracted by any beneficiary, either before or after my death. Any right granted to a beneficiary to receive or withdraw assets of the trust estate, either principal or income, for the beneficiary's own use and benefit shall not be available for the satisfaction of any claims of the creditors of the beneficiary. Any right of receipt or withdrawal shall be suspended and may not be exercised by any beneficiary on the filing of a proceeding in bankruptcy in which the beneficiary is debtor. The suspension shall be continued during bankruptcy proceedings and shall be restored only after the entry of a final order of discharge of the beneficiary as debtor. 4.6 Rule Against Perpetuities. If any provision of this Will should be void on account of the rule against perpetuities or any other rule of law pertaining to such trusts, then the trust herein provided shall continue in force for the full period permitted by law and on the day prior to the expiration of such full period, my trustee shall make distribution of any remainder of the trust estate to the persons herein named who would be entitled to take distribution upon termination of the trust. 4.7 Joining of Trusts. If at the termination of any trust created under this Will any part of the trust principal is to be distributed to a person who shall then be the beneficiary of any other trust created under this Will, I direct that such person's part of the trust principal be added to his or her trusf, to be administered and distributed as an integral part thereof. 5. POWERS OF ADMINISTRATION. 5.1 Grant of Powers. My executor, in the administration of my estate, and my trustee, in the administration of the trust under this Will, (my "fiduciaries") shall have the powers and authorities set forth in this Article 5. These powers and authorities maybe exercised by my executor and tnzstee in their sole and absolute discretion, without the permission or order of any court. These powers shall be supplementary to those conferred by law, including, but ~~ _--(~ 4 Hamilton M. Henry \\Ntserver\SConfair\WPWin\WILLS\HenryH Will.wpd March 22, 2004 not limited to, those set forth in Title 20, Chapter 33, of the Pennsylvania Consolidated Statutes. 5.2 Retention of Assets. My fiduciaries shall have the power to retain any or all property of my estate or trust, however received and acquired, for so long as they deem appropriate. This power maybe exercised even though the property may not be of the type authorized by law for investment, and even though the retention may leave a disproportionately large amount of the value of my estate invested in one type of property. 5.3 Transfer of Assets. My fiduciaries shall have the power to sell, transfer, and convey any property, of whatever nature, including real property, and wherever situated, that I may own at the time of my death, or that may come into my estate or into the trust corpus at or after my death. The sale, transfer, or conveyance may be by public or private sale, at such time, on such terms and conditions, including selling price and credit, in such manner, and for any reason that my fiduciaries deem appropriate, including, but not limited to, the purpose of obtaining net proceeds to be distributed to my residuary beneficiaries. 5.4 Investment. My fiduciaries shall have the power to invest and reinvest any property in my estate or in the trust corpus in preferred and common stocks, bonds, notes, common trust funds (including any managed by any corporate fiduciary), interests in investments, trusts, mutual funds, leases, mortgages on propertywherever located, and, generally, in anyproperty and in proportions ofproperty as my fiduciaries deem advisable, even though the investments are not of the character or proportions authorized by applicable law for the investment of the funds. 5.5 Power to Borrow. My fiduciaries shall have the power to borrow money for any purpose, for any periods of time, and on any terms and conditions as they deem advisable (including the power to borrow from any corporate fiduciary), and to pledge, mortgage, or otherwise encumber any property in my estate or in the trust corpus to secure repayment of any loan, as well as the power to renew existing loans either as maker or endorser. 5.6 Power to Hold Property in Nominee Form. My fiduciaries shall have the power to hold any property in the name of a nominee or in bearer form. 5.7 Distribution in Cash or in Kind. My fiduciaries shall have the power to make distributions in cash or in kind, or partly in cash, in divided or undivided interests, as amended, or other applicable law, and to determine which assets shall be sold and which shall be distributed in kind, without notice to or consent by any beneficiary. 5.8 Distribution to Minors and Persons Under Disability. My fiduciaries shall have the power to make distributions or payments to or for the benefit of any beneficiary who is a minor, an incompetent, or who in the fiduciaries' judgment is incapacitated. The distributions or payments shall be made in any one or more of the following ways: (1) directly to the beneficiary; (2) directly to the creditor in paymen f the debts o 'expenses of ~' ~~~/~ 5 amilton M. Henry - _ ..._. \\IVtserver\SConfair\WPWin\WILLSVienryH Will.wpd March 22, 2004 the beneficiary; (3) to the guardian of the person or estate of the beneficiary; (4) to any custodial parent of a minor beneficiary; (5) to a custodian for the beneficiary under any law related to gifts to minors, including to my fiduciaries in that capacity; or (6) to any other person who shall have the care and custody of the person of the beneficiary. There shall be no duty to see to the application of funds so paid, provided due care was exercised in the selection of the person to whom the funds were paid, and the receipt of the person shall be full acquittance of the fiduciaries. 5.9 Continuation or Liquidation of Business. My fiduciaries shall have the power to continue or to permit the continuation of any business, incorporated or unincorporated, in which I may have any interest at the time of my death for any period of time, or to liquidate the business on any terms as they deem appropriate. This power includes, but is not limited to (1) the power to invest additional sums in any business, even to the extent that my estate or the trust corpus may be invested largely or entirely in the business, without liability for any loss resulting from lack of diversification; (2) the power to act as or to select other persons to act as directors, officers, or employees of any business, to be compensated without regard to being a fiduciary under this Will; and (3) the power to make any other arrangements in regard to any business as my fiduciaries shall deem proper. 5.10 Employment of Agents. My fiduciaries shall have the power to employ and pay the compensation of any and all attorneys, agents, custodians, attorneys-in-fact, experts, investment counsel, accountants, bookkeepers, or other agents or providers of services as my fiduciaries deem advisable in the administration of my estate. 5.11 Commissions. My fiduciaries shall have the power to take reasonable commissions on account at any time during the administration of my estate or of the trust without the approval of any beneficiary or of the court, but subj ect to allowance or disallowance on the settlement of the final accounts of my fiduciaries. 5.12 Third Party Reliance. No person or corporation dealing with my executor shall be required to see to the application of any property paid or delivered to my executor, or to inquire into either the authority of my executor to enter into any transaction or the expediency or propriety of any transaction entered into by my executor. 6. PAYMENT OF DEATH TAXES. 6.1 Payment of Estate Taxes. I direct that all federal and Pennsylvania estate taxes payable as a result of taxes assessed on property passing under this Will shall be paid from my residuary estate as a part of the expenses of the administration of the estate. 6.2 Inheritance Tax. I direct that the Pennsylvania inheritance taxes payable as a result of my death, limited to taxes assessed on property passing under this Will, shall be paid out of my residuary estate and shall not be deducted or collected from any beneficiary under this Will or other transferee. Y"l 6 Hamilton M. Henry 1CNtserver\SConfair\WPWin\WILLS\HenryH Will.wpd March 22, 2004 7. APPOINTMENT OF TRUSTEE. 7.1 Appointment. I name, constitute, and appoint SHERRI L. MILLER as the trustee of any trust under Article 4 of this Will. If the trustee shall not serve as trustee for any reason or shall cease to serve as trustee for any reason, then her successor trustee shall be MICHAEL R HENRY 7.2 Resignation of Trustee. Any individual trustee may resign from the position of trustee by executing a written resignation and delivering it to the successor trustee. The date of the delivery of the resignation shall be the effective date of the resignation. No court action or other proceeding shall be necessary for the resignation of an individual trustee. 7.3 Disqualification of Trustee. A person shall be disqualified from acting as a trustee (1) if found by a court of competent jurisdiction to be incompetent; or (2) if, on receipt of a written request from an adult beneficiary, guardian or a successor trustee of the trust for a written certification from a qualified physician that upon examination the physician finds the person mentally or physically capable of properly handling his business affairs, the person does not obtain a written certification within thirty days after receipt of the request. 7.4 No Bond Re uired. No bond shall be required of any trustee or successor trustee named in this Will. 7.5 Rights of Successor Trustee. Every title, estate, right, authority and discretion vested in or conferred on any initial trustee under this Will shall likewise become and be vested in and maybe exercised by any successor trustee. 7.6 Trustee's Fees: My trustee shall be entitled to a reasonable and customary fee for serving in said capacity. 8. EXECUTOR. 8.1 Appointment. I name, constitute, and appoint SHERRI L. MILLER as executor of my estate. If my spouse shall not survive me, shall not serve as executor for any reason, or shall cease to serve as executor for any reason after appointment, MICHAEL R. HENRY shall act as executor in her place. 8.2 Bond Not Re uired. None of the individuals named in Section 8.1 shall be required to furnish a bond for the faithful performance of his or her duties as executor. !t 7 Hamilton M. Henry \UJtserver\SConfair\WPWin\WILLS\HenryH Will:wpd March 22, 2004 9. PRESUMPTION IN CASE OF SIMULTANEOUS DEATH. For the purposes of this Will, in determining whether a person has survived me or another person, (1) my spouse shall be deemed to have survived me unless it unmistakably appears by proof that she predeceased me; and (2) in all other cases, a person shall not. be deemed to have survived me or another person if he or she dies within sixty (60) days of my death or of the death of the other person. 10. LIABILITY OF TRUSTEE AND EXECUTOR. My executor and trustee shall not at any time be liable for mistake of law or of fact, or both law and fact, or errors of judgment, nor for any loss coming to any beneficiary under this Will, or to any other persons, except through actual fraud or willful misconduct on the part of the executor or trustee. My executor or trustee may, from time to time, consult with counsel with respect to the meaning, construction, and operation of this Will, particularly with respect to the appointments, allocations, and disbursements, and may act on the advice of counsel in all matters without incurring liability on account of his or her actions. 11. INTERPRETATION. 11.1 Will Not Contractual. My spouse and I are executing Wills at approximately the same time, in which each of us is the primary beneficiary of the Will of the other. These Wills are not being executed pursuant to any contract to make a Will or any contract not to revoke a Will. The Will of each of us is revocable at any time, whether before or after the death of the other spouse, at the sole discretion of the spouse making the Will. 11.2 Successors of Fiduciaries. All pronouns referring to an executor or trustee and the terms "executor" and "trustee" shall be construed to mean any person acting as my executor, co- executor, co-trustee, trustee, or administrator, as the case maybe. 11.3 Number and Gender. If required by the context of this Will, singular language shall be construed as plural, plural language shall be construed as singular, and the gender of personal pronouns shall be construed as either masculine, feminine, or neuter. 11.4 Headings. All headings used in this Will to describe the contents of each article, paragraph, or other division are provided for convenience only and shall not be construed to be a part of this Will. ~~.C~~ Hamilton M. Henry -----L ~\Ntserver\SConfair\WPWin\WILLS\HenryH Will.wpd March 22, 2004 11.5 Governing Law. This Will shall be construed in conformity with the law of the Commonwealth of Pennsylvania. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of nine (9) typewritten pages, the first eight (8) which beaz my signature in the margin for the purpose of identification, this .~'~ day of `~~~ , 2004. V ~\ HAMILTON M. HEN , Signed, sealed, published and declared by the above-named Testator, HAMILTON M. HENRY, as and for his Last Will and Testament, in the sight .and presence of us, who, at his request, in his sight and presence and in the s' t and presence of each other, have hereunto subscribed our names as witnesses. Witness Address Witness Address i 7a~~ \\Ntserver\SConfair\WPWin\WILLS1HenryH Will.wpd March 22, 2004 COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ~ I, HAMILTON M. HENRY, THE TESTATOR, WHOSE NAME IS SIGNED TO THE FOREGOING INSTRUMENT, HAVING BEEN DULY QUALIFIED ACCORDING TO LAW, DO HEREBY ACKNOWLEDGE THAT I SIGNED AND EXECUTED THE INSTRUMENT AS MY LAST WILL AND TESTAMENT; THAT I SIGNED IT WII.LINGLY; AND THAT I SIGNED IT AS MY FREE AND VOLUNTARY ACT FOR THE PURPOSES THEREIN EXPRESSED. SWORN OR AFFIItMED TO AND ACKNOWLEDG D BEFORE ME BY HAMILTON M. HENRY, THE TESTATOR THIS Z. ~ DAY OF _ ~~-dc.~~~ , 2004. NOTARIAL SEAL CASSANDRA T. ROSENBAUM, Notary Public Camp Hill Boro, Cumberland County My Commission Expires December 4, 2004 ~ ~~ ~ /f NRY TESTATOR NOTARY PUBLIC COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS. WE, ~ a ~~ .., ~~ Cc.l~ ~,~~- AND 1~~-~c 5.~.. ~11.,. ~C:n THE WITNESSES WHOSE NAMES ARE SIGNED TO THE FOREGOING INSTRUMENT, BEING DULY QUALIFIED ACCORDING TO LAW, DEPOSE AND SAY THAT WE WERE PRESENT AND SAW THE AFORESAID TESTATOR SIGN AND EXECUTE THE INSTRUMENT AS HIS LAST WILL AND TESTAMENT; THAT HE SIGNED WILLINGLY AND THAT HE EXECUTED IT AS HIS FREE AND VOLUNTARY ACT FOR THE PURPOSES THEREIN EXPRESSED; 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 THE TIME EIGHTEEN (18) OR MORE YEARS OF AGE, OF SOUND MIND AND UNDER NO CONSTRAINT OR UNDUE INFLUENCE. SWORN OR AFFIRMED TO AND SUBSCRIBED TO BEFORE ME, THIS ~ DAY OF ~~,~-~ , 2004. ~ NOTARIAL SEAL CASSANDRA T. ROSENBAUM, Notary Public Camp Hill Boro, Cumberland County My Commission Expires December 4,2004 S ~. /~ ~_ CI .t~.~1 rl. ~1.~LC,~II~Zt-[,~~-,~- NOTARY PUBLIC 10 INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES A N D PO BOX 260601 TAXPAYER RESPONSE HARRISBURG PA 17128-0601 REV-1543 EX ~FP (08-08) FILE N0. 21 10-0638 ACN 10162864 DATE 11-03-2010 EST. OF HAMILTON M HENRY SSN 049-24-1985 DATE OF DEATH 06-06-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: SHERRI L MILLER REGISTER OF WILLS 625 MOUNTAIN RD 1 COURTHOUSE SQUARE BOILING SPRINGS PA 17007 CARLISLE PA 17013 TYPE OF ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. METRO BANK provided the Department with the information below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-pawed decedent, you were a point owner/beneficiary of this account. If you feel the information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Comwonwealth of Pennsylvania. Please call C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 627135130 Date 08-28-2008 To ensure proper credit to the account, two Established copies of this notice wust accowpany 8 0 6 . 8 1 payment to the Register of Wills. Make check Account Balance $ payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are wade within three AmOUnt Subject to Tax ~ 403.41 months of the decedent's date of death, Tax Rate ~( , 1Fj deduct a 5 percent discount on the tax due. Any Inheritance Tax due will becowe delinquent Potential Tax Due ~` 60.51 nine months after the date of death. PART TAXPAYER RESPONSE ~ m~~ ~~.; ~t~'S~iOr1D ~~~~~sNL~~~~ ~i~'F~3 ~~~ Tax .a~s~~; A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or check box "A" and return this notice to the Register of Wills and an official assesswent will be issued by the PA Department of Revenue. ONE BLOCK B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y to be filed by the estate representative. C. ~ The above inforwa ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART ~ below. PART If indicating a different tax rate, please state relationship to decedent: TAX RETURN - COMPUTATION LINE i. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due PART DATE PAID PAYEE OF TAX ON JOINT/TRUST ACCOUNTS `#'A~ "~~ `"'' 2 $ ~"~ r3 2_ 3 X ,, -~; Y~~...~~ 6 $ - :~'( '.r DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION TELEP -~~~` .. AMOUNT PAID DATE TOTAL (Enter on Line 5 of Tax Computation) S Under penalties of perjury, I declare that the facts I have reported above are t,r/ue, correOCtQand compl to the best of my know edge and belief . HOME C ~~ ~ ) o~~" 3 ~ ~1 I (~ -- ( WORK ( ~ l~ ~ ~~? S Job-~-~04I