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Home My WebLink About04-15-11t 1505610143 REV-1500 Ex (°'-'°' OFFICIAL USE ONLY PA Department of Revenue Pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE PO 80X.280601 INHERITANCE TAX RETURN 21 10 0 7 8 0 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 173 03 9801 07 14 2010 O1 25 1911 Decedent's Last Name Suffix Decedent's First Name MI NEUBER ADOLPH (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 REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW (X~ 1. Original Return ~ 2. Supplemental Return J 4. Limited Estate ~ qa. Future Interest Compromise (date of death after 12-12-82) L ~ 6 Decedent Died Testate r ll ~ Decedent Maintained a Living Trust (Attach Copy of Will) C J (Attach Copy of Trust) r ~~ 9. Litigation Proceeds Received C~ 10. Spousal PovertY Credit (date of death between 12-31 ~J1 and 1-1-95) ~ ~ 3. Remainder Return (date of death _ prior to 12-13-82) ~_~ 5. Federal Estate Tai; Return Required ~ _ 8. Total Number of Safe Deposit Etoxes ~ ~ 11. Election to tax under Sec. 9113(A) _ _ (Attach Sch O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number JAMES W APPEL 717 394 0521 First line of address 33 NORTH DUKE STREET Second line of address City or Post Office State LANCASTER pA Correspondent's a-mail address: ZIP Code `- 176022842 -~~ .~ ,. -, _.,. -~ C.:_} ~.,. ~ ~i,aer penan:tes or penury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative Is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLssE FOR~~FILpI G RETURN DATE • ISL~.G/ ~'f?~ Jane N. Eshelman ._ ' ADDR ~ / ~ /~ 737 West North Street Carlisle PA 17013-2227 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE - --.. ~~ James W. Appel ADDR 4 y~ /Z ~ ~ / 33 North Duke Street, Lancaster, PA 17602-2842 Side 1 ~, 1505610143 1505610143 PA Inheritance Tax Return Signature of Additional Fiduciaries ESTATE OF FILE NUMBER Neuber, Adolph 21-10-0780 Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based) on all information of which preparer has any knowledge. Signature #2 Name Address1 Address2 City, State, Zip Date James B. Eshelman 737 West North Street Carlisle, PA 17013-2227 J 1505610243 REV-1500 EX Decedents Name: N@Uber, Adolph RECAPITULATION 1. Real Estate (Schedule A) ..................................................................................... .. 1. 2. Stocks and Bonds (Schedule B) ........................................................................... .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)....... .. 3. 4. Mortgages & Notes Receivable (Schedule D) ...................................................... .. 4. 5~ Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............. .. 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested........... . 6. 7. Inter-Vivos Transfers & Miscellaneous -Probate Property ~ (Schedule G) Separate Billing Requested........... . 7. 8. Total Gross Assets (total Lines 1-7) ................................................................... .. g. 9. Funeral Expenses & Administrative Costs (Schedule H) ...................................... . 9. 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ............................. . 10. 11. Total Deductions (total Lines 9 & 10) .................................................................. . 11. 12. Net Value of Estate (Line 8 minus Line 11) ......................................................... . 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .............................................. . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................. . 14. TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .00 15. 16. Amount of Line 14 taxable at lineal rate X .045 94 9 , 350.0 9 16. 17. Amount of Line 14 taxable at sibling rate X .12 0 . 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 0 . 0 0 18. 19. Tax Due ............................................................................. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L,~, 1505610243 Decedent's Social Security Number 173 03 9801 873,000.70 96,180.89 48,000.00 1,017,181.59 61,258.37 6,573.13 67,831.50 949,350.09 949,350.09 0.00 42,720.75 0.00 0.00 42,720.75 1505610243 REV-1500 EX Page 3 File Number 21-10-0780 Decedent's Complete Address: DECEDENT'S NAME Nember, Adolph STREET ADDRESS ---- - -_-- -- -- 737 West North Street CITY STATE ZIP Carlisle PA 17013-2227 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 40,185.00 (1) 42,720.75 3. Interest 2,115.00 Total Credits (A + B) (2) 42,300.00 (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2 Line 20 to request arefund -- --- ------ - --- - 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 42.75 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: Yes No a. retain the use or income of the property transferred :............................................................................... ~ ! x;Jl ~_ , b. retain the right to designate who shall use the property transferred or its income :.................................. [] i~x.] c. retain a reversionary interest; or ............................................................................................................... ~_] ~x~ d. receive the promise for life of either payments, benefits or care? ........................................................... ~] ~] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .................................................................................................................... ~i L l 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?....... ~ _~ ~_] x 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................ - ~ - ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PARJ L x~ T OF THE RETURN. For dates of death on or after July 1, 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the; surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 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 percent [72 P.S. §9116 (a) (1.2)]. . The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. . The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Rev-1503 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER Neuber, Adol h 21-10-0780 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM CUSIP NUMBER NUMBER DESCRIPTION 1 526.416 shares of Vanguard Health Care Fund 2 520.77 shares of Vanguard Windsor II Fund Investor 3 500 shares of Altria Group Inc. 4 1,151 shares of Bank of America Corporation 5 250 shares of Berkshire Hathaway Inc. CI B 6 1,860 shares of BlackRock Municipal Income Trust II 7 1,500 shares of BlackRock MuniVest Fund, Inc 8 865 shares of Camden National Corporation Accrued dividend on Item 8 through date of death 9 475 shares of Citigroup, Inc. 10 3,970.211 shares of First Eagle Overseas Fund CI A 11 750 shares of Gabelli Global Gold, Natural Resources & Income Trust Accrued dividend on Item 11 through date of death 12 1,350 shares of General Electric Co. Accrued dividend on Item 12 through date of death 13 400 shares of Harris PFD Capital Ser A 7.375% VALUE AT DATE UNIT VALUE OF DEATH 115.22 60,653.65 22.83 11,889.18 21.26 10,630.00 15.57 17, 921.07 79.485 19,871.25 14.185 26,384.10 9.86 14,790.00 29.80 25,777.00 216.25 4.215 2,002.13 20.30 80,595.28 15.675 11,756.25 105.00 15.18 20,493.00 135.00 24.86 9,944.00 Total of Continuation Schedules I See attached a es TOTAL (Also enter on Line 2, Recapitulation) 873,000.70 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev-1503 EX+ (6-98) SCHEDULE B STOCKS & BONDS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Neuber, Adolph 21-10-0780 ITEM CUSIP NUMBER NUMBER DESCRIPTION UNIT VALUE VALUE: AT DATE OF DEATH 14 1,380.859 shares of Legg Mason Special Inv Trust CI C 27.40 37,835.54 15 400 shares of McDonald's Corp. 70.57 ~ 28,228.00 16 1,650 shares of Nicholas-Applegate Convertible & Income 9.185 15,155.25 Fund i i 17 3,320 shares of Nuveen Municipal High Income Opportunity ~ 12.95 42 994.00 Fund , 18 4,485.156 shares of Oppenheimer International Diversified 10.53 47 228.69 Fund CIA , 19 900 shares of Philip Morris International, Inc. I 49.345 44,410.50 20 900 shares of Procter 8 Gamble Co. 62.395 56,155.50 21 3,624.279 shares of Royce Total Return Fund Consultant i 11.20 40,591.92 22 2,350 shares of Susquehanna Bancshares, Inc. 9.12 Ij 21,432.00 23 213.456 shares of Vanguard Total Stock Market Index Fund 27,18 ~ i 5,801.73 24 31395WLS4 $50,000 Freddie Mac Ser 3002 CL EA 5.00% Maty: 8/15/2034 10.2909 5 145 45 - Factor: . 08742370 , . Accrued interest on Item 24 through date of death ~ 20.35 25 31397HYS1 $25,000 Freddie Mac Series 3329 Class TD 6.250% Ma ty 62.43724 15 609 31 3/15/2037 -Factor: .53948711 , . Accrued interest on Item 25 through date of death I 78 21 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev-1503 EX+ (6-98) COMMONWEALTH OF PENNSYL`/ANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS continued ESTATE OF FILE NUMBER Neuber, Adolph 21-10-0780 ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 26 36966RF35 $150,000 General Electric Cap Corp Internotes 5.650% Maty: 99.259 148,888.50 12/15/2024 Accrued interest on Item 26 through date of death 702.33 27 $25,000 Lancaster County PA Hosp Auth Rev Rfdg Hlth Sys 93.632 23,408.00 Lancaster General-B B/E 4.50% Maty: 3/15/2036 i Accrued interest on Item 27 through date of death ~ 371.88 28 $25,000 Southern Lehigh PA School District Ser AA FSA U. 101.459 25,364.75 T B, E 4.50% Maty: 9/1 /2026 Accrued interest on Item 28 through date of death 415.63 TOTAL (Also enter on Line 2, Recapitulation) 873,000.70 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev-1508 EX+ (8-98) ,~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Neuber, Adol h 21-10-0780 .,~~ NwNesny wmay-ownea wren me ngnt of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION 1 American Express Travelers Check 2 Cash 3 Cash 4 Cash 5 MS-SB Municipal Money Market Fund CL A 6 TD Bank Checking account 22113552 7 Wachovia Bank checking account ...3917 8 Personal property - PA -appraised value 9 CenturyLink -refund overpayment 10 Kiplinger Letter -refund 11 Medicare Part D Coverage Gap Rebate 12 PA Department of Revenue -refund - 2010 income tax overpayment VALUE AT DATE OF DEATH 100.00 835.12 17.00 600.00 83,561.71 2,079.63 6,038.36 1,925.00 16.21 208.86 250.00 549.00 TOTAL (Also enter on Line 5, Recapitulation) I 96,180.89 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) ~~_L~2 ~~ ~ fi~ ~1on CoYnPa APPRAISAL CERTIFICATE I hereby certify that, upon request for valuation of the personal property of Adolph Neuber Estate of Carlisle, Pennsylvania, I have personally and physically inspected the personal property for the purpose of appraising its fair market value as of July 14, 2,010. The information and values contained in this report are based upon my experience as an auctioneer and appraiser. Personal Property Adolph Neuber ~ 1 Watercolors by Helen Cleland Watercolor by KJW 2 large watercolors by Helen Cleland 2 Harry Book oil paintings Rotary International past president club pin Paul Harris Fellow pin- Rotary Rotary Tie pin c.1960 Atomic Clock Radio Clock Luggage Lock Box Table Lamp Souvenirs from Cuba Total: Submitted Karl Boltz, Auctioneer/Appra' e Boltz Auction Company 1390 Columbia Ave., #200 Lancaster, Pa. 17603 Ph. 717-330-6691 $14~ $10.00 $200.00 $200.00 $25.00 $25.00 $5.00 $5.00 $5.00 $5.00 $5.00 $10.00 $10.00 $1925.00 Rev-1510 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF Neuber, Adolph ~ 21-10-0780 SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY THE DATE OF TRANSFER.SATTACFi ACOPY OF T~E DEED ~OREREAL ESTATDE DATE OF DEATH VALUE OF ASSET °r° OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 1/8/10 Cash gift to Elizabeth Southwick 11,000.00 100.000% 3,000.00 8,000.00 2 1/8/10 Cash gift to Naomi Nolte 11,000.00 100.000% 3,000.00 8,000.00 3 1/8/10 Cash gift to Ronald Southwick 11,000.00 100.000% 3,000.00 8,000.00 4 1/8/10 Cash gift to Sara Leone 11,000.00 100.000% 3,000.00 8,000.00 5 1/8/10 Cash gift to Scott Leone 11,000.00 100.000% 3,000.00 8,000.00 6 1/8/10 Cash gift to William Nolte 11,000.00 100.000% 3,000.00 8,000.00 TOTAL (Also enter on Line 7, Recapitulation) (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. 48,000.00 Form PA-1500 Schedule G (Rev. 6-98) REV-1151 EX+ (10-06) p ,H p COM INNER TANCE T~ERET~RNANIA RESIDENT DECEDEN SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Neuber, Adolph 21-10-0780 Debts of decedent must be reported on Schedule I. ITEM N MBER DESCRIPTION AMOUP~T A. FUNERAL EXPENSES: See continuation schedule(s) attached 12,984.45 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio Yearlsl Commission paid 2. Attorney's Fees APPEL & YOST LLP 38,093.50 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00 Claimant Jane N. Eshelman Street Address 737 West North Street city Carlisle state PA zip 17013-2227 Relationship of Claimant to Decedent Chlld 4. Probate Fees 742.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 1,900.00 7. Other Administrative Costs 4,037.92 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 51,258.37 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ---- ESTATE OF FILE NUMBER Neuber, Adolph 21-10 0780 ITEM NUMBER DESCRIPTION AMOUNT Funeral Ex enses 1 James B. Eshelman -reimbursement -gift certificate for funeral speaker 100.00 2 James B. Eshelman -reimbursement -gift certificate for funeral musician 50.00 3 James B. Eshelman -reimbursement -drop-in gathering -Maine 227 26 4 James B. Eshelman -reimbursement -funeral luncheon -Lancaster 682.53 5 Kearney A. Snyder Funeral Home, Inc. -funeral services 11,924.66 H-A 12,984.45 6 Other Administrative Costs Antique Treasures Group Shop -Personal property appraisal fee 300.00 7 Appel 8~ Yost LLP -- reimbursement -payment to Register of Wills for short certificates (3) 12.00 8 Appel 8~ Yost LLP -- reimbursement -payment to Register of Wills for fee for oath of 20 00 Executors . 9 Appel 8~ Yost LLP -- reimbursement - payment to Register of Wills for Exemplification of 40 00 Record for Maine probate . 10 Appel & Yost LLP -- reimbursement -payment to Register of Wills for short certificates (3) 12.00 11 Appel 8~ Yost LLP -reserve -final costs/fees 500.00 12 Bruce Gamage, Jr. Antiques -jewelry appraisal fee 100.00 13 Central Maine Power -balance due 64.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF Neuber, Adolph FILE NUMBER 21-10-0780 ITEM NUMBER DESCRIPTION AMOUNT 14 Central Maine Power -balance due 64.00 15 Central Maine Power -balance due 64.00 16 Central Maine Power -balance due 64.00 17 Central Maine Power -balance due 64.00 18 Central Maine Power -balance due (January & February) 208.00 19 Central Maine Power -balance due (March) 104.00 20 Crandall, Hanscom 8 Collins, P.A. -reimbursement -copies from Knox County Registry of Deeds 9.50 21 Crandall, Hanscom 8~ Collins, P.A. -reimbursement -recording fee -Knox County Registry of Deeds 16.00 22 Crandall, Hanscom & Collins, P.A. -reimbursement -recording fee -Knox County Probate Court 578.00 23 Crandall, Hanscom 8< Collins, P.A. -reimbursement -copies -Knox County Probate Court 3.00 24 Cumberland Law Journal -estate notice 75.00 25 James B. Eshelman -reimbursement -gasoline/tolls - 8/10-8/17/10 trip to Maine re probate 176.36 26 James B. Eshelman -reimbursement -lunch with Atty E. Collins re Maine probate 46.36 27 James B. Eshelman -reimbursement -smoke detectors for Maine condo for sale 33.58 28 James B. Eshelman -reimbursement -postage 5.54 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF Neuber, Adolph FILE NUMBER 21-10-0780 ITEM NUMBER DESCRIPTION AMOUNT 29 James B. Eshelman -reimbursement -gasoline - 8/25-9/7/10 trip to clean out Maine house 439.60 30 James B. Eshelman -reimbursement -payment to Marion McMahan -cleaning Maine house prior to sale 110.50 31 James B. Eshelman -reimbursement -payment for hotel on trip to Maine house 125.66 32 James B. Eshelman -reimbursement -payment for meal on trip to Maine house 19.10 33 James B. Eshelman -reimbursement -payment for U-Haul rental for trip to Maine to empty house prior to sale 133.00 34 James B. Eshelman -reimbursement - payment to Lowe's for repairs to Maine house prior to sale 25.88 35 James B. Eshelman -reimbursement - payment to plumber for repairs to Maine house prior to sale 40.00 36 James B. Eshelman -reimbursement -gasoline - 1/14-1/18 trip to clean out Maine house prior to sale 154.26 37 James B. Eshelman -reimbursement -payment for meals on 1/11 trip to Maine house 81.50 38 James B. Eshelman -reimbursement -payment for motels on 1/11 trip to Maine house 215.88 39 TD Bank Checking account 22113552 -closing adjustment 20.00 40 The Sentinel -estate notice 113.20 H-B7 4,037.92 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 EX+ (12-08) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Neuber, Adolph 21-10-0780 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE ' OF DEATH 1 Appel & Yost LLP -attorney fee -for services prior to DOD 1,155.00 2 Care -balance due 15.00 3 Care -balance due 15.00 4 Central Maine Power -balance due 64.00 5 CenturyLink -balance due 25.45 6 Cumberland Goodwill EMS -balance due 87.00 7 FairPoint Communications -balance due 14.46 8 Heritage Foundation -pledge payment 20.00 9 Heritage Foundation -pledge payment 20.00 10 Heritage Foundation -pledge payment 20.00 11 James B. Eshelman -reimbursement -payment to GM Credit Card -balance due 641.12 12 James B. Eshelman -reimbursement -payment of 2010 taxes due 3/15/2010 (plus interest) 2 398 10 for Owls' Head, Maine , . 13 James B. Eshelman -reimbursement - payment to Concord Group for insurance for Owls' 96 00 Head, Maine . 14 Wachovia Bank checking account ...3917 -outstanding check cashed after death 2,000.00 15 Wachovia Bank checking account ...3917 -service fee 2.00 TOTAL (Also enter on Line 10, Recapitulation) I 6,573.13 (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(FZev. 12-08) SCHEDULE J BENEFICIARIES (Part I, Taxable Distributions) ESTATE OF: Adolph Neuber 07/14/2010 173-03-9801 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 1 Jane N. Eshelman Daughter 737 West North Street Carlisle, PA 17013-2227 2 The Adolph Neuber Grandchildren Trust Trust Trustees: Jane N. Eshelman and James B. Eshelman 737 West North Street Carlisle, PA 17013-2226 Personal property and 1/2 Residue of Estate 1/2 Residue of Estate 475,530.55 475,530.55 Tota I 951.061.10 1 ..,_... '~`'°i-"~+-=sue--~° s~^_~ '~" ~t?+ - :~." ~` ~ _ _ s _ 'i" _. __ ._ 4. 1 •_ $i8/()I SPEC;~~I ' 3EQLF_;ST WILL WI :LI.~ C-F ADOLPH N:ELI:3ER I, ADOLPH NEUBER, presently of Owls Head, Maine, revoke any other VVi11s and Codicils which. I have made, and I make the following t~~ be my Last WiII and Testament. ARTICLE I DISPOSITION OF FURNITURE I give all my household furniture and furnishings, bo,oks,l:ableware and similar articles of ornament or use in my residence or usually kt;pt there to my daughter, JANE N. ESHLEMA.N if she survives me. If my daughter does not survive me, then. I order and direct my Executor to distribute such articles as I may designate by memoranda or markinl;s or codicils tc- the persons thereby designated, and I give full discretionary power to my Executor in respect tc, the rerriaining articles as to whether all or part shall be distributed to my grandchildren in such equitable rnanner as my Executor deems practicable or distributed as a part of my residuary estate in :kind or converted into cash, with any distribution in kind being charged against the share o:f the dis~tributee in my residuary estate. If any distributee is a minor when such articles are to be distributed to him or her, I authorize my Executor to deliver the articles to the person with whom the minor resides or who has the control or care of the minor, without bond, and I provide that the receipt of such person shall be a complete release to my Executor. ARTICLE II PERSONAL EFFECTS I give my j ewelry and other personal effects to such persons to my daughter, JANE N. ESHLEMAN, if she survives me. .. 8/8/OI SPECIFIC BEQUEST WILL ARTICLE III RESIDUARY ESTATE All my residuary estate (meaning the rest and residue of the property of every kind and wherever located, belonging to me at my death, but not meaning any property which I then have only a power of appointment), I give as follows. TRUSTEE I name my daughter, JANE N. ESHLEMAN, and my son-in-Law, JAMES ESHLEMAN, to be the Trustees of the trusts established and described below. If'both JANE and JAMES are unable, unwilling or cease to serve I name BANK OF LANCASTER C;OUNT'Y, N.A., Lancaster, Pennsylvania, to be Trustee. The Trustee shall serve without bond. ALLOCATION I allocate to the ADOLPH NEUBER GRANDCHILDREN Trust described below the lesser of one-half of the balance or the amount excludable from the federal generation skipping tax at the time of my death. I allocate to my daughter, JANE N. ESHLEMAN, the balance, if she is living, otherwise the balance shall also be added to the ADOLPH NEUBER GRANDCHILDREN Trust DESCRIPTION OF TRUST THE ADOLPH NEUBER GRANDCHILDREN TRUST The portion allocated to this Trust shall~be held by the Trustee under the following terms and conditions: a. With respect to a share allocated to a grandchild or to issue of a deceased child, the Trustee shall divide the share into as many separate parts as there are grandchildren or issue then Living of the deceased child, the division to be made per stirpes, and shall, with respect to each such issue and part, hold the same in trust no longer than permitted by the Pennsylvania Rule against Perpetuities, based upon the lives of descendants of mine living at the time of my death, and: 2 8/8/01 SPECIFIC BEQUEST WII.L i. During minority, use, apply and expend such part, both principal and income, with power to accumulate income for the grandchild's or issue's well-being in sickness or in health and education. ii. Upon reaching majority, pay the income to the grandchild or issue and use, apply and expend principal for the well-being of the grandchild or issue, his or her spouse or children in sickness or in health and his or her education. iii. Pay over to the issue such of the principal, in whole or in part, of his or her part as he or she may request without limitation or restriction upon reaching the age of thirty (30) years. iv. Pay over any principal then on hand upon the death of the grandcluld. or issue to the grandchild's or issue's issue then Living, and if the grandchild or issue has no issue, then pay over the same to the brothers and sisters then living of the grandchild or issue and to the issue of deceased brothers and sisters, the payments to the issue then living of deceased brothers and sisters to be made per stirpes, and if the grandchild or issue has no brothers and sisters or the issue of deceased brothers and sisters then living, pay over the same in equal shares to my issue then living, per stirpes; provided, however, that any payments made to persons under this Subsection (iv;i as are the currently beneficiaries of a Trust created under this instrument shall be made to the Trustee of such Trust to be held on the same terrris and conditions. ARTICLE V SOURCE OF PAYMENT OF TAXES All estate, inheritance and like taxes imposed on my estate by reason of my death, with respect to any property (whether disposed of by this Will or not, but specifically excluding the tax on any generation skipping transfer of which I may be the deemed transferor;) re uire:d to q be included in my gross estate for tax purposes at its fair market value, shall be borne by that portion of my residuary estate. 3 878/01 SPECIFIC-BEQUEST WILL ARTICLE VI SPENDTHRIFT PROVISION I direct to the fullest extent permitted by law that neither the income nor the principal of any Trust herein created shall in any way or manner be liable to the control or answerable for the debts, engagements or liabilities of any of the beneficiaries thereof, or liable for any charge, encumbrance, assignment, conveyance or anticipation by them. ARTICLE VII EXECUTOR I name my daughter, JANE N. ESHLEMAN, and my son-in-law, JAMES ESHLEMAN, to be Executors of my estate. I excuse any nonresident Executor or Trustee from filing any bond. ARTICLE VIII FIDUCIARY AUTHORITY I give to the Executor in the settlement of my estate and to the Trustee in the administration of the Trusts herein created, with respect to both real and personal property belnncr~,ncr to me at t1'!e tune of ~~ deu,,~'1 « nn ii~rv~ ; n ~+ .7 .. ..~1_ r. ~ ]'t• b b ~ ~i u~.qutt~•u In a2'ly lllaitilel allel lny UGQ.ul, 1'[1 Quulll(7R tU and not in limitation of all common law and statutory power, the following fiduciary powers, any or all of which may be exercised in discretion of the fiduciary and from time to time without the necessity of approval or leave of Court: (a) To sell, exchange, give options for or otherwise dispose of any property, at public or private sale, for cash or other consideration or on credit and upon such terms and for such consideration as they shall think fit and to transfer, grant and convey the same, free of all trusts. (b) To make such investments and reinvestments, including the acquisition of real estate, as a prudent person would make of their own property, having primarily in view the preservation of the value of their estate under economic conditions as they may change from. time 4 ___- ---- _ _ -Srsiar sPEC~rc ~QvEST wn;L _ _ _ ____ _ _ _ _ _ - - - -- -- to time and the amount and regularity of the income to be derived, without being limited to~ so-called "legal investments" for trust funds under the law of the Commonwealth of Peruzsylvania. (c) To take over and retain unconverted any investments, including investments in any corporate fiduciary and any other property, including j ewelry, household furniture and furnishings and personal effects and our residence, even though such property by reason of its character, amount and proportion to the total would not be considered appropriate, except for this provision. (d) To borrow money and to execute promissory notes therefor, and to secure such obligations by mortgage or pledge. (e) To renew or compromise, on such terms as they think fit, any claims, including taxes, either in favor of or against me, my estate or the Trusts; and to pay claims upon such evidence as they think sufficient. (f) To employ such brokers, banks, custodians, investment counsel, attorneys, accountants and other agents and to delegate to them such of their ministerial duties, rights and powers and the right to vote shares of stock for such periods as they think fit and to keep assets in the name of a nominee without mention of the estate or trust in any instrument of ownership. {g) To pa*~icipate iln any ~lotir~g u ust, ~r~erger, reorgaY'LTZQL'll~, 1.1 0l consolidation and in connection therewith, to exchange any property held for other property. (h) To determine as to all sums of money and other things of value received, whether and to what extent the same shall be charged against principal or against income, including, without hereby limiting the generality of the foregoing language, power to apportion any receipt or expense between principal and income and to determine what part„ if any, of the actual income received upon any wasting asset or upon any security purchased or acquired at a premium shall be added to principal to prevent a diminution of principal upon the exhaustion or sale of the asset or the maturity of the investment. (i} In dividing my estate into shares or in distributing the same, to divide or distribute in cash, in kind, or partly in cash and partly in kind, as they think fit. Foi• purposes of division or distribution, to value property, reasonably and in good faith, and such valuation shall 5 ~,..m._._,~.~_ ,_.__... ___ _ _ - _ _ _ _ _ _ _ _ __ __ 87870x-SPECIFIC~BEQLTEST WILL be conclusive upon all parties. To whatever extent division or distribution is made in kind., they shall, as far as practicable, allocate approximately proportionate amounts of each kind of security or other property. (j) To divide any share or trust hereunder (whether upon initial distribution or prior or subsequent thereto) into two or more shares or trusts and each such share or trust shall have identical provisions; any such division into separate shares or trust shall be rrLade on .a fractional or percentile basis. (k) To use, apply and expend income directly to promote the well-being of the person entitled to the same in the event of such person's sickness, incapacity or unavailability. (1) To purchase and maintain insurances with respect to a beneficiary, including life, hospitalization and liability insurances. ARTICLE IX TERMINATION OF TRUST In the event, because of the size of a trust or share, it is not cost effective to have i~t sub}ect to administration by a corporate trustee, then in that event the Trust may be terminated and the proceeds distributed to the life beneficiary. The decision as to cost effectiveness may be made by tl1P T'r~ictPa, at 1tS d1SCretlon, or tide benelici~y riiay rC,gilCSt terrnlnatlon uj% pctltioll or nlotlotl tU COUrt. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my last Will and Testament this~Q~ ay of; ~~y~.~~`~~,.5/ ~~ ~ , 2001. ADOL NEUBER 6 - -- --sis~o r s~crFrc~sEQt~s~r~w~i;L _ _ _ _ . _ _ _ _ _ _ _ _ _ __ _ Signed, sealed, published and declared by ADOLPH NEUBER, the above named Testator, as and for his last Will and Testament, in the presence of us, who at his request anti in his presence and in the presence of each other, have hereunto subscribed our names as witnesses thereto. ~- 1 - ~ ~~ ...____ , ~~rsror-srgc~rc-s~QvESZ-~wrLZ ._.-~.------~_..~ -.______~_____~ AFFIDAVIT AND ACKNOWLEDGMENT STATE OF ~ /cam ) SS: COUNTY OF ~ /~i~/y~~~ ~ ) I, ADOLPH NEUBER, the Testator, whose name is signed to the attached Will, having been duly qualified according to law, do hereby acknowledge that I have signed and executed the instrument as my last Will; that I signed it willingly; and that I signed. it as my free and voluntary act for the purposes therein expressed. / _ W , rC / ~~~~~ ~ ~ ,the v~ritnesses whose names are signed to the attached instrument, eing duly qualified according to law, do depose and say that we were present and saw the Testator sign and execute the instrument as his last V~Till; that he signed willingly and executed it as his free and voluntary act for the purposes therein expressed; that we were present in the hearing and sight of the Testator, we 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. ~ ~ ~~. - With s ADOLP NEUBER Witness Acknowledged, affirmed and subscribed t by ADOLPH NEUBER the Testator, and affirmed to and subscribed by the witnesses thi~ay o ~~001. -~~ Notary Public f County Notarial Seal " Deeann M. Rivera, Notary Public - Lancaster, Lancaster County My Commission Expires Dec. 4, 2004 Member, Pennsylvania Association of Notaries - 8 CODICIL TO THE WILL OF ADOLPH NEUBER I, ADOLPH NEUBER, hereby declare the following to be a Codicil to my Will dated September 20, 2001. FIRST: I hereby amend my Will to add the following Specific Bequest provision: During my lifetime I began a planned giving program with my grandchildren. Beginning in December of 2002 I gave to each of my granddaughters and their husbands annual gifts, a portion of which, an annual sum of $11,000.00 (per family), was intended. to enable them to buy life insurance (whole life, universal life or term, as they choose) on their own lives (my granddaughters and/or the lives of their husbands), for the benefit of their families. I had hoped to continue this plan for 10 years . If my death has occurred before I have given these gifts for 10 years, I direct my Executor to distribute to my grandchildren named below, or their husband if they have predeceased me, a lump sum distribution equal to the sum of annual gift tax exclusion amount in effect the year of my death for each year remaining of the 10 years from December 2002 during which I had intended to make gifts, with the hope and expectation that they will use such sum to prepay or continue to pay insurance premiums. Sara Jane Leone, if living, otherwise Scott A. Leone, her husband Naomi Ruth Nolte, if living, otherwise William R. Nolte, her husband Elizabeth A Southwick, if living, otherwise Ronald A. Southwick, her husband SECOND: I hereby amend ARTICLES I, II, III and VII of my Will to correct the names of JANE N. ESHLEMAN and JAMES B. ESHLEMAN to be JANE N. ESHELMAN and JAMES B. ESHELMAN. LASTLY: In all other respects, I ratify and confirm my Will. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this Codicil 1:0 my Last Will and Testament this day of 2006. ~L ~ ~~~C~e~C.- I;SEAL ADOL H NEUBER Signed, sealed, published and declared by ADOLPH NEUBER, the above named Testator, as and for a Codicil to his last Will and Testament, in the presence of us, who at his request and in his presence and in the presence of each other, have hereunto subscribed c-ur names as witnesses thereto. ": i~ F~~ AFFIDAVIT AND ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA ) SS: COUNTY OF LANCASTER ) I, ADOLPH NEUBER, the Testator, whose name is signed to the attached Codicil, having been duly qualified according to law, do hereby acknowledge that I have signed and executed the instrument as a Codicil to my last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. \ -~ W - a " the witnesses whose names are signed t t e attached instrument, being duly qualified according to law, do depose and say that we were present and saw the Testator sign and execute the instrument as a Codicil to his last Will and Testament; that he signed willingly and executed it as his/her free and voluntary act for the purposes therein expressed; that we were present vl the hearing and sight of the Testator, we signed the Codicil 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. ~~ ~ ~~ ~ Witness ~~,r li ~s`~~ ~. Witness ., Testator Acknowledged, affirmed and subscribe to by ADOLPH NE ER, the Testator;/~ and affirmed to and subscribed by the witnesses this day of 2006. n ~~~~ Notary Public My commission expires: ®OMAAONWEALTH OF PENNSYLVANIA Notarial Seal Deeann M. Rivera, Notary Puf~lic Cky Of Lanoaster, Lancaster County 3 My Commission Expires Dec. 4, 2006 Member, Pennsylvania Association Of Notaries