HomeMy WebLinkAbout04-0749' Register of Wills of Cumberland County, Pennsylvania
Estate of
PETITION FOR GRANT OF LETTERS
ANN M. EBERLY also known as E. ANN EBERLY
Deceased
Social Security No. 187-14-2217
MARONETTA F. MILLER
(COMPLETE "A" OR "B" BELOW:)
[~ A. Probate and Grant of Letters and aver that Petitioner is the Successor Executrix named in the Last W'ii'l of the De~ent,
dated"~;~ptember 10,
1999 and Codicil dated February 21, 2003.
Stale relevant £1rctltlt$1all¢¢s, eg. relllltlCia6Oll, death of executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the
victim ora killing and was never adjudicated incompetent: NONE
B. Grant of Letters of Administration
(db nc ~ a: pClldCllle lite; duranle absentia; duranle ~inorilate}
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse {if anT) and heirs:
Name Relationship Residence I
Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at 116 Old Mill Road, Lower Allen
Township, Cumberland County, Camp Hill, Pennsylvania 17011
Decedent, then 82 years of age, died July 25, 2004, in Harrisburg, Dauphin County, Pennsylvania.
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property .................................................................................................................................... $600,000.00
(If not domiciled in PA) Personal property in Pennsylvania ............................................................................................................... $000000000
(If not domiciled m PA) Personal property in County ......................................................................................................................... $000000000
Value of real estate in Pennsylvania ....................................................................................................................................................................................... $150,.000000
Total ..................................................................................................................................................................................................................... $750.000.00
Real Estate situated as lbtlows: 116 Old Mill Road, Camp Hill, Pennsylvania (Lower Allen Township)
~'~'~elbre, Petitioner respectfully requests the probate of the last Will presented with this Petition and the grant of letters in the appropriate form to the undersigned:
[ } ~ Sign atuv-e.~., "xx~ Typed or printed name and residence ]
//-x/'/ ~ )/ ,~,~ 24 Victoria Way, Camp Hill, PA 17011 One West High Street
1076221 8/12/04
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner above-named swears and affirms that ~tements in the foregoing Petition are tree and correct to the best of the
knowledge and belief of Petitioner and that, as personal representat~ the Decedent, Petitioner will w~ltn~tmly admimster the estate
according to law. x~ ~
Sworn to and affirmed and subscribed
before me this 1~~'t day of
August, 2004.
Estate of E. Ann Eberly also known as Ann M. Eberly, deceased
Social Security No: 187-14-2217 Date of Death: July 25, 2004
AND NOW, August ]~ 2004, in consideration of the Petition on the reverse side hereon, satisfactory
proof having been presented before me,
IT IS DECREED that Letters Testamentary are hereby granted to Maronetta F. Miller in the above estate
and that the instrument dated September 10, 1999 and Codicil dated February 21, 2003 described in the Petition be
admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters ........................... $ qt q 6, ®
Short Certificates..(6)... $
Renunciation .......
Affidavit ( ) .................$
Extra Pages (l~) ............ $
Codicil ...........
oo
JCP Fee ........................ $
Inventory ....................... $
Other ............................ $
TOTAL ................ $ x~-3 ~ 50
107622 1 8/12/04
Attorney:
I.D. No:
Address:
Telephone:
Donn L. Snyder
06858
Penn National Insurance Plaza
2 North Second Street, Seventh Floor
Harrisburg, PA 17101
(717) 257-7552
Register of Wills of Cumberland County, Pennsylvania
Estate of Ann M. Eberly,
Deceased
RENUNCIATION
The undersigned, Betsy Eberly Dunn, hereby renounces her right to administer the estate
and respectfully request that Letters Testamentary be issued to Maronetta F. Miller.
Witness our hand and seal this ~" ~
,.~ day of July, 2004.
Sworn to or affirmed and subscribed
bef~re~,~ this ~_~ day of July 2004.
No't a'ry P'~blic
BET Sy ~z'~~LylT~ ~7._~ ~
57379 3 7/30/04
Register of Wills of Cumberland County, PennsylVania
Estate of Ann M. Eberly,
Deceased
RENUNCIATION
The undersigned, Donn L. Snyder, hereby renounces her right to administer the estate and
respectfully request that Letters Testamentary be ~ed to Maronetta F. Miller.
Witness our hand and seal this '~ day of July, 2004.
?
Sworn to or affirmed and subscribed
before me this J0~ day of July 2004.
Notadal Seal
Lori A. B. Zerbe, Notary Public
City Of Harrisburg, Dauphin County
My Commission Expires Jan. 7, 2006
Member, Pennsylvania Association Of Notades
57379 3 7/30/04
his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
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 photo~tat or photograph.
Fee for this certificate, $2.00
10528377
No.
Local Registrar
JUL 2, 7 2004
Date
NAME OF OECEDENT (F~r s~. Mid<lie. L~;iI
'- E. Ann Eberly
82 v,.. .
m. Dauphin
,,~ Claims Examiner
116 Old Mill Road
,,. Camp Hill, PA 17011
,.. Edward Maginnis
~ Betsy E. Dunn
8u.alt~l Cramm.~ [] Remova~#omS~ateE~
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECqI~D~
CERTIFICATE OF DEATH
a. fem~le 3. 187 -- 14 -- 2217
November 1 , HO~ITAL
[,. 1921 ,. DuBois, PA '~ ~'~'~
Harrisburg ,d. Harrisburg Hospital [,.~,.~. ~.~ ~.,~.
,,~.Health Insurance
white
OECEDENT'S
ACTUAL ,T,.Sla~__ Pennsylvania o~ ,z,.~ .,....,,.,:.~,~,:,i. Lower Allen
,~. c~ Cumberland ~? ,Td.O N,,
,,. Dinah Reah
la~.3701 P~int Clear Drive, Ocean Springs, MS 39564
Ola,L July 29, 2004 [~211ing Green Memorial Park [,[dgwer Alien Twp., PA 17011
~l~l~U~tl~ F U~.~,AL ~RVI~E L~:EN~EE OR PE R.~3N ~TI~ AS SUCH ILICENSE .UUaE. 'NAME ~NO AOORE~ OF ~AC,UrV Par t
,,,.o,. ·, I I nemore t.t-t ~ ~, Inc
~ ~31~4V~X~ ~ ~ ~,~ FS 012 849 L P '
~ .... ~.~ ~2.~ ._ . ~ - ,,~. .0. Box 431, New Cumberland PA 17070-0431
e~,~~te I ~E ~ (~ AS A C~SEQUE~E ~ I
On the ~lil Of exlminll~n I~ iAvestigalion, in my opinion, dellh ~curted al Ihe lime. date and place and due to the cause s and -
First Codicil to Last Will and Testament
of
Ann M. Eberly
I, Ann M. Eberly, of the Township of Lower Allen, County of CUmberlar~ and
Commonwealth of Pennsylvania declare this to be a Codicil to my Will dated Sept~ber 10,~ ....
1999.
FIRST: I hereby revoke Article Tenth of my Will in its entirety and in lieu
thereof substitute the following:
"TENTH: Appointment of Fiduciaries: I appoint my daughter, Betsy Eberly Dunn,
Executrix of this Will. Should my daughter, for any reason, fail to qualify or cease to act as
such during the administration of my estate, I appoint Donn L. Snyder Executor. Should Donn
L. Snyder fail to qualify or cease to act as such, I appoint Maronetta F. Miller Executrix.
Each successor executor shall serve with the same duties, powers and discretion as if originally
appointed.
I appoint my daughter, Betsy Eberly Dunn and Donn L. Snyder, Co-Trustees of
any trusts established under my Will dated September 10, 1999. Should either one, for any
reason, fail to qualify or cease to act as such during the administration of any such trust, I
appoint Maronetta F. Miller, Successor Trustee of all trusts established under said Will, to
serve with the same duties, powers and discretion as if originally appointed.
95570.1 2~27/03
No Trustee who is a beneficiary or who owes a legal duty of support to a
beneficiary shall participate in any discretionary decision relating to the right of such
beneficiary in or to principal or income or in any determination of such beneficiary's
incapacity. In such cases the decision of the other Trustee shall control.
My Co-Trustees shall be entitled to compensation for services rendered in
accordance with Standard Schedule of Charges in effect from time to time during the period
over which services are rendered.
No Executor or Trustee named herein shall be required to give bond or furnish
sureties in any jurisdiction. Whenever the word "Executor" or the word "Trustee" is used in
this Will, the word shall include both the singular and the plural, unless the context indicates
otherwise."
SECOND: In all other respects I ratify, confirm and republish my Will dated
September 10, 1999.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this 21st day of
February 2003.
ANN M. EBERLY
(SEAL)
SIGNED, SEALED, PUBLISHED AND DECLARED by the above named
Ann M. Eberly, the testatrix, as and for a First Codicil to her last Will dated September 10,
95570.1 2/19/03 -2-
1999, in the presence of us who, at her request, in her presence and in the presence of each
other, have hereunto subscribed our names as witnesses.
WITNESS
WITNESS
ADDRESS
ADDRESS
95570.1 2/19/03 -3-
COMMONWEALTH OF PENNSYLVANIA :
i ss
COUNTY OF CUMBERLAND :
We, Ann M. Eberly, the testator, and (-.3 ~ ~ l~ [~ C[ L ' ~ (' ~ ' I 5 ~ [ ~
and ~li [/~ ~ ,~ ~. (~ ~ ~,, , the witnesses, whose names are signed to the foregoing
instrument, being first duly sworn, do hereby declare to the undersigned authority that Ann M.
Eberly, the testator, signed and executed the instrument as and for her First Codicil to her last
Will dated September 10, 1999, and that the testatrix signed willingly, and that she executed it
as her free and voluntary act for the purposes therein expressed, and that each of the witnesses,
in the presence and hearing of the testator, signed the Codicil as a witness and that to the best
of the witnesses' knowledge the testator was at that time over eighteen years of age, of sound
mind and under no constraint or undue influence.
Ann M. Eberly
Witness
Witness
Subscribed, sworn to and ac~owledged before me by Ann M. Eberly, the
testator, and subscribed and s~to before me by
,the witne~~2Pt day of February 2003.
and /
Not~blic
NOTABIAL SEAL
Maronetta F, Mil~er, Notary Public
Harrisburg, PA Dauphin Gounty
~.~o.~ 2ngm 4 My Gommiss~on ~pi~es .lam 9, 2004
LAST WILL AND TESTAMENT
OF
ANN M. EBERLY
I, ANN M. EBERLY, of Cumberland County, Pennsylvania, declare'this to
my Will and revoke all prior Wills and Codicils.
First: Tangible Personal Property: I give all of my tangible personal
property, including any automobiles, together with all insurance on such property, to my
husband, SEIBERT D. EBERLY, JR., if my husband survives me by thirty days; otherwise I
give such property to my daughter, BETSY EBERLY DUNN, if she survives both my husband
and me, or if she does not survive my husband and me, to my daughter's children as survive
both my husband and me, to be divided as they shall agree. If there be no agreement, or if any
child is a minor, such property shall be divided as my Executor, in my Executor's sole
discretion, deems appropriate. Any of such property to which a minor would thus become
entitled which my Executor thinks unsuitable for such minor's use shall be sold and the
proceeds thereof added to the share of my residuary estate held for the benefit of such minor.
Any of such property to which a minor ~us becomes entitled and which is not sold iliay be
retained by the Trustee, without bond, during the minority of such child or may be delivered to
the person having custody of such child. The receipt of the person having custody shall be a
complete release of my Executor and Trustee. My Executor shall pay, as an expense of
settling my estate, the costs of packing, storage, shipping and insurance incurred in connection
with the distribution of the gifts of tangible personal property made above.
Second: Trust for My Grandchildren: If my husband, SEIBERT D.
EBERLY, JR. predeceases me, I give my Trustee the sum of One Hundred and Fifty Thousand
Dollars ($150,000) to hold in trust for the benefit of a class composed of the children of my
daughter, BETSY EBERLY DUNN, (the children of my daughter shall be hereinafter referred
to individually as "grandchild" and collectively as "grandchildren" for purposes of this Will
and shall only mean the natural or adopted children of my daughter) living at my death or born
thereafter but before the time the division of this trust into equal shares is directed as follows:
Until my youngest living grandchild who lives to attain age twenty-two attains that age, the
Trustee shall pay or apply so much of the net income and principal for the support, health and
education of my grandchildren, in such manner and in such amounts, which need not be equal,
as in the sole discretion of the Trustee, is proper. As soon as there is no living grandchild of
mine under age twenty-two, the Trustee shall divide the balance of principal into as many
equal shares as there shall be grandchildren of mine then living and shall:
a. Hold one such share in trust for the benefit of each living
grandchild and pay to, or apply for the benefit of, such grandchild the entire net income
from such share or the balance thereof and also so much of the principal as, in the sole
discretion of the Trustee, is necessary for the support, health and education of such
grandchild. In the exercise of these powers, the Trustee may, but shall not be required
to, consider the other resources of such grandchild. There shall be paid to such
grandchild from the principal of such share or the balance thereof: (i) one-third thereof
upon attaining age twenty-two; (ii) one-half of the balance thereof upon attaining age
twenty-six; and (iii) the entire undistributed balance thereof upon attaining age thirty.
b. If any grandchild shall have attained any of such respective ages
at the time when such share is directed to be established for such grandchild, or at the
time when any share is added thereto, the Trustee shall then distribute to such
grandchild such part or parts or all, as the case may be, of such share or of such added
share as is directed to be paid to such grandchild upon attaining such respective ages.
c. If any grandchild for whose benefit the Trustee holds a share in
trust under subparagraph b. hereof dies before attaining age thirty, the Trustee shall
distribute the principal to such grandchild's issue living at the time of such grandchild's
66566.1 8/18/99 -2-
death, per stirpes; or if none, to my issue then living, per stirpes; provided, however,
that any amount payable under this subparagraph c. to a grandchild of mine for whom
at that time the Trustee holds a separate share hereunder shall be added to the share for
such grandchild for administration and distribution as part thereof.
Third: Residue: I give, devise and bequeath all the residue of my estate, of
whatever nature and wherever situated, to the Trustee hereinafter named. If my husband,
SEIBERT D. EBERLY, JR., survives me (and for purposes of this Article my husband shall
be deemed not to have survived me if the order of our deaths cannot be established by proof),
my residuary estate, together with any other property which may be added hereto, shall be
divided into two separate shares, Share A and Share B.
Share A shall consist of the smallest fractional share of this trust estate which,
when added to the value of all other items in my gross estate which are eligible for the marital
deduction and which pass or have passed to my husband under other provisions of this Will
except Share B or otherwise, shall reduce the federal estate tax payable, after application of all
available credits (to the extent that their use will not increase death taxes on my estate), to the
lowest possible figure. In establishing such fractional share: (1) the computation shall be based
on final federal estate tax values and funding shall be determined on the date or dates of
distribution; (2) only assets that are eligible for the marital deduction shall pass to Share A;
and (3) any property which may at any time form part of this trust estate and which is not
subject to federal estate tax in my estate shall be disregarded in calculating the fractional shares
hereunder and shall be allocated to Share B, unless some other allocation is directed.
Share B shall consist of the balance of this trust estate after setting apart Share A
and after payment from this balance of death taxes as hereinafter provided. If my husband
fails to survive me, Share B shall consist of the entire trust estate. If my husband (or my
66566.1 8/18/99 -3-
husband's executor, administrator, guardian or agent acting under a power of attorney)
disclaims part or all of my husband's interest in Share A, such disclaimed portion shall pass to
Share B and my husband shall retain my husband's interest in Share B as augmented by the
disclaimed property.
A. MARITAL DEDUCTION SHARE A. The Trustee shall distribute
Share A to my husband, SEIBERT D. EBERLY, JR., absolutely.
B. NON-MARITAL DEDUCTION SHARE B. The Trustee shall pay to
my husband, SEIBERT D. EBERLY, JR., for life, the following from Share B:
a. The net income, quarterly or more frequently.
b. In addition, so much of the principal as the Trustee other than my
husband, in the Trustee's sole discretion, deems proper for the support, health and
education of my husband. In the exercise of this power, the Trustee may, but shall not
be required to, consider the other resources of my husband.
c. In addition, so much of the principal as my husband, from time to
time during my husband's lifetime, requests in writing delivered to the Trustee, not to
exceed in any calendar year the greater of Five Thousand Dollars ($5,000) or five
percent (5 %) of the value of the principal at the end of such year. Such right shall be
non-cumulative.
Upon the death of my husband, or upon my death if my husband fails to survive
me, the Trustee shall distribute the balance of Share B to my daughter, BETSY EBERLY
DUNN, if she is then living. If my daughter, BETSY EBERLY DUNN, is not then living, the
Trustee shall divide the same into as many equal shares as there are grandchildren of mine then
living and grandchildren of mine then deceased represented by issue then living and shall
distribute one such share to each grandchild of mine then living and one such share, per
stirpes, to the issue then living of each such grandchild then deceased. If I have no issue living
at the time of my husband's death, or upon my death if my husband does not survive me, the
Trustee shall divide the then remaining balance into as many equal shares for each of my
daughter's husband, WILLIAM JACKSON DUNN, my nephew JOHN C. MUTH, my
nephew RICHARD MUTH, and my niece MARILYN MARTIN as are then living and shall
distribute one such equal share to each of them then living.
Fourth: Minority Provision: Any income or principal (other than tangible
personal property) which becomes distributable to a minor (and for purposes of this Will, the
66566.1 8/18/99 -4-
term "minor" shall refer to a person under age twenty-one) shall be held in a trust fund by the
Trustee during minority. The Trustee shall apply such amounts of income and principal as the
Trustee, in the Trustee's sole discretion, deems proper for the support, health, education and
welfare of such minor and shall accumulate any unexpended balance of income. Such amounts
may be applied directly or may be paid to the person with whom such minor resides or who
has the care or control of such minor, without the intervention of a guardian. The Trustee
shall not be obliged to supervise or inquire into the application of such amounts by such
person, and the receipt of such person shall be a complete release of the Trustee. Should any
such fund, in the sole opinion of my Executor or Trustee, be or become too small to warrant
continuing such fund in trust, or should its administration be or become impractical for any
other reason, my Executor or Trustee, in the Executor or Trustee's sole discretion, may pay
such fund, absolutely, to the parent or other person maintaining said minor or may deposit
such fund in the minor's name in an interest-bearing account in a financial institution of the
Executor or Trustee's choosing, payable to the minor at majority. If such minor dies before
attaining age twenty-one, such fund shall be distributed to such minor's estate.
Fifth: Disability Provision: If any beneficiary shall, in the sole opinion of
the Trustee other than such beneficiary, become mentally or physically incapacitated, the
Trustee may apply the share to which such beneficiary is otherwise entitled hereunder for such
beneficiary's support, health and welfare, directly, without the intervention of a guardian.
Sixth: Protective Provision: All principal and income shall, until actual
distribution to the beneficiary, be free of the debts, contracts, alienations and anticipations of
any beneficiary, and shall not be liable to any levy, attachment, execution or sequestration
while in the hands of my Executor or Trustee.
66566.1 8/18/99 -5-
Seventh: Perpetuities Saving Clause: I direct that, in any event, if any trust
created under this Will has not already terminated by its terms, it shall terminate at the
expiration of twenty-one years after the death of the survivor of my husband and the last
surviving issue of mine who was living at the time of my death. The principal shall then be
distributed to my then living issue, per stirpes.
Eighth: Tax Clause: All estate, inheritance, succession and other taxes,
imposed or payable by reason of my death, and any penalties thereon, with respect to all
property comprising my gross estate for death tax purposes, whether or not such property
passes under this Will, (except any such tax on any qualified retirement plan benefits or
Individual Retirement Account benefits included in my estate, all of which taxes shall be
apportioned pro rata against and paid by the person, persons or trust in possession thereof or
benefited thereby) shall be paid out of and charged generally against the principal of Share B,
after setting apart Share A, without apportionment or right of reimbursement; provided,
however, that no asset which is exempt from any state death tax shall be used for the payment
of such tax and no asset which is exempt from federal estate tax shall be used for the payment
of such tax or to satisfy any obligations of my estate. Such taxes shall be paid at such time or
times as may be deemed advisable.
Ninth: Powers of Fiduciaries: In addition to the powers given by law, my
Executor and Trustee, and any successors, without any order of court and in the sole discretion
of the Executor and Trustee, may:
advisable.
investments.
a. Retain any real or personal property, as long as deemed
b. Invest in any real or personal property without restriction to legal
66566.1 8/18/99 -6-
c. Subscribe for stocks, bonds or other investments; join in any plan
of lease, mortgage, merger, consolidation, exchange, reorganization, foreclosure or
voting trust and deposit securities thereunder; and generally exercise all the rights of
security holders or employees of any corporation.
d. Register securities in the name of a nominee or in such manner
that title will pass by delivery.
e. Vote securities in person or by proxy, and in such connection
delegate discretionary powers.
f. Repair, alter, improve or lease, for any period of time, any real
or personal property, and give options for leases.
go
security, exchange or
or exchanges.
Sell at public or private sale, for cash or credit, with or without
partition any real or personal property, and give options for sales
h. Borrow money from any person, including any fiduciary, and
mortgage or pledge any real or personal property.
i. Disclaim any interest or power granted to me under any
instrument or by operation of law.
j. Employ custodians, accountants, investment advisors and other
agents and pay their proper charges in addition to fiduciary commissions.
k. Pay administration expenses, including, without limitation,
interest on death taxes ("administration expenses") from principal or income, including
income otherwise payable to charity; provided, however, that no allocation of
administration expenses to income shall be made that would prevent any assets from
otherwise qualifying for the federal estate tax charitable deduction.
1. Use administration expenses as deductions for federal estate tax
purposes or fiduciary income tax purposes or partly for each, without making
adjustments between principal and income in consequence of the exercise of such
discretionary power.
m. File joint income tax returns with my husband and pay a portion
of such tax, and consent to gifts made by my husband and pay a portion of any gift tax
thereon.
n. Compromise claims.
o. Divide any trust hereunder, which division may be made on a
non-pro rata basis, into two or more separate and independent trusts and make any
66566.1 8/18/99 -7-
principal distributions otherwise authorized hereunder from the trusts on a non-pro rata
basis.
p. To the extent that any asset which is exempt from Pennsylvania
inheritance tax would otherwise be allocated to any trust hereunder containing property
not exempt from such tax, divide any trust hereunder into two trusts, in all respects
identical, except that one trust shall contain only property exempt from the
Pennsylvania inheritance tax and the other trust shall contain only property not exempt
from said tax; and my Executor and Trustee may make any principal distributions
otherwise authorized hereunder from the two trusts on a non-pro rata basis.
q. Add to the principal of any trust created hereby any property
received from any person by Deed, Will or in any other manner.
r. At any time merge any trust hereunder with any other trust held
by my Executor, whether created by me or by any other person by Will or Deed, if the
terms of the trust are then substantially similar and held for the primary benefit of the
same person or persons.
s. Make distributions without the consent of any beneficiary, in cash
or in specific property, real or personal, or an undivided interest therein, or partly in
cash and partly in such property and do so, except as otherwise specifically provided
elsewhere herein, without regard to the income tax basis of specific property allocated
to any beneficiary (including any trust) and without making pro rata distribution of
specific assets.
t. Exercise all power, authority and discretion given hereby, after
the termination of any trust created herein until the same is fully distributed.
u. Fund or divide any trust or trust share hereunder at any time into
two separate trusts or shares in order that the federal generation-skipping transfer tax
("GST") inclusion ratio for each trust or share shall be either 0 or 1, and exercise any
discretionary powers over principal or income against either one or the other or both of
the two trusts or shares in such manner as, in the opinion of the Trustee, will lessen
federal transfer taxes.
v. Give any beneficiary (other than my husband) of any trust or trust
share hereunder, at any time prior to the death of such beneficiary, a testamentary
general power of appointment, as defined in Section 204 l(b) of the Internal Revenue
Code of 1986, as amended, or successor provisions (the "Code"), over all or any
portion of any trust or share established hereunder for benefit of such beneficiary if the
possession of such power by said beneficiary, in the opinion of the Trustee other than
such beneficiary, would lessen federal transfer taxes and be in the best interests of the
beneficiary. The Trustee may give a beneficiary such general power by a written
notification to such beneficiary of such award, which shall contain such information as
to the scope of the general power and the method of its exercise as the Trustee other
66566.1 8/18/99 -8-
than such beneficiary shall deem appropriate. The effective exercise of such power, to
the extent of such exercise, shall be deemed to control the disposition of the appointed
property.
w. To the extent possible, satisfy any distribution hereunder which
qualifies for the special generation assignment rule of Section 2651(e) of the Code from
GST non-exempt assets and divide any trust hereunder for multiple beneficiaries into
separate trusts for one or more of said beneficiaries in such a manner that certain
distributions from one or more of such trusts will thereby be protected from GST by the
special generation assignment rule and make such equitable adjustments in the
continuing interests of the other beneficiaries in the remaining trust share or shares as
the Trustee shall deem appropriate.
x. Make distributions for the benefit of skip persons (as defined in
Section 2613(a) of the Code) to which they are otherwise entitled hereunder for medical
and tuition expenses directly to the provider of the services and from assets which are
not GST exempt, if any.
y. Satisfy any transfer which would otherwise be deemed a taxable
termination, a taxable distribution or a direct skip, for generation-skipping transfer tax
purposes, out of the principal of such trust share or shares created hereunder which are
GST exempt, and satisfy any distributions which would not be deemed a taxable
termination, a taxable distribution or a direct skip, for generation-skipping transfer tax
purposes, out of the principal of such trust share or shares created hereunder which are
not GST exempt. In addition, the Trustee, in the Trustee's sole discretion, may fund
one or more of such trust shares created hereunder for one or more beneficiaries with
disproportionate amounts of GST exempt or GST non-exempt property. Such equitable
adjustments in the continuing interests of the other beneficiaries in the remaining trust
share or shares shall be made under such circumstances as the Trustee shall deem
appropriate.
z. Allocate any of my federal exemption from GST, as provided in
Section 2631 of the Code, available at the time of my death to any property as to which
I am the transferor under the provisions of Section 2652(a) of the Code, including any
property transferred by me during my life, and to elect out of any deemed allocation or
revoke any prior election out.
My Executor and Trustee may make, but shall not be required to make, any
adjustment of the amount distributed to any beneficiary who would have received a greater or
lesser amount if my Executor or Trustee had made a different or contrary decision in reference
to any of the above matters. I exonerate my Executor and Trustee from any liability arising
66566.1 8/18/99 -9-
from any exercise or failure to exercise these powers, provided their actions (or inactions) are
taken in good faith.
For purposes of interpretation of this document, with respect to a gift to any
descendant of mine, any condition of survivorship shall be construed to mean survival by 90
days, and if any such descendant of mine shall fail to survive me by 90 days, such descendant
of mine shall be deemed to have predeceased me.
Tenth: Appointment of Fiduciaries: I appoint my husband, SEIBERT D.
EBERLY, JR., Executor of this Will. Should my husband, for any reason, fail to qualify or
cease to act as such during the administration of my estate, I appoint my daughter, BETSY
EBERLY DUNN, Executor of this Will to serve with the same duties, powers and discretion
as if originally appointed.
I appoint ALLFIRST BANK (formerly known as DAUPHIN DEPOSIT BANK
AND TRUST) Trustee of any trusts established under Article SECOND of this Will for the
benefit of my grandchildren. I appoint my husband, SEIBERT D. EBERLY, JR., Trustee of
all other trusts established hereunder. Should my husband, for any reason, fail to qualify or
cease to act as such during the administration of any such trust, I appoint my daughter, BETSY
EBERLY DUNN, Trustee of all trusts established hereunder, except any trust established
under Article SECOND, to serve with the same duties, powers and discretion as if originally
appointed.
ALLFIRST BANK shall be entitled to compensation for its services as Trustee
in accordance with its Standard Schedule of Charges in effect from time to time during the
period over which its services are rendered.
66566.1 8/18/99 - 10-
The majority of all beneficiaries to whom current trust payments may or must be
distributed, or the natural or legal guardians of such beneficiaries, as the case may be, shall
have the power to request in writing the removal of the Corporate Trustee then in office and
the appointment of another Corporate Trustee. Then, and as often as it shall occur, the
Corporate Trustee so designated hereunder to be appointed in the writing shall, upon filing
written acceptance of the trust, become Corporate Trustee hereunder and the Corporate Trustee
then in office shall thereupon be removed.
If at any time there is a change in the Federal estate tax laws such that any trust
created hereunder will be includable in my husband's estate solely by reason of my husband's
position as sole Trustee with respect to such trust, then, and in that event, the successor
Trustee named herein shall become a Co-Trustee with my husband. In that event, no Trustee
shall participate in any discretionary decision relating to the right of such Trustee, as
beneficiary, or in any determination of such beneficiary's incapacity. In such cases the
decision of the other Trustee shall control. No Executor or Trustee named herein or appointed
as provided below shall be required to give bond or furnish sureties in any jurisdiction.
Whenever the word "Executor" or the word "Trustee" is used in this Will, the word shall
include both the singular and the plural, unless the context indicates otherwise.
IN WITNESS WHEREOF I have hereunto set my hand and seal this J 0 J~dday of
1999.
ANN M. EBERLY
SIGNED, SEALED, PUBLISHED and DECLARED by the above named
ANN M. EBERLY as and for her last Will and Testament, in the presence of us, who, at her
66566.1 8/18199 -1 1-
request, in her presence and in the presence of each other, have hereunto subscribed our names
as witnesses.
WIT SS-
I~~W~SS, ~ ~~-.
ADDRESS
ADDRES~
66566.1 8/18/99 - 1 2-
COMMONWEALTHOF
COUNTY OF
PENNSYLVANIA ·
· SS
DAUPHIN
We, ANN M. EBERLY, the testator, and
and .~on,n L.. ~n~de~", the witnesses, whose names are signed to the foregoing
instrument, being first duly sworn, do hereby declare to the undersigned authority that the
testator signed and executed the instrument as her last Will and that she signed willingly, and
that she executed it as her free and voluntary act for the purposes therein expressed, and that
each of the witnesses, in the presence and hearing of the testator, signed the Will as a witness
and that to the best of the witnesses' knowledge the testator was at that time over eighteen
years of age, of sound mind and under no constraint or undue influence.
ANN M. EBERLY J,.---~-
Witnest~ ~
Subscribed, sworn to and acknowledged before me by ANN M. EBERLY, the
testator, and subscribed and sworn to before me by
and
the witnesses, t is/C) . ay ' , 1999.
~lotar~_~lic - --
NOTARIAL SEAL
Maronetta E Miller, Notary Public
Harrisburg, PA Da. uphir~ 'County
My Commission:, ~-!x!:,4res J~r~ 10, 2000
66~66. ~ 8,8,99 - 13-
IN RE: ESTATE OF
E. ANN EBERLY,
a/k/a ANN M. EBERLY
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
No. 21-04-0749
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
Date of Death:
To the Register:
E. ANN EBERLY, A/K/A ANN M. EBERLY
JULY 25, 2004
I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court
Rules was served on or mailed to the beneficiaries of the above-captioned estate on August 19,
2004:
Name
Betsy E. Durra
Address
3701 Point Clear Drive, Ocean Spring, MS 39564
Notice has been given to all persons known to the undersigned to be entitled thereto
under Rule 5.6(a)
Donn L. Snyder, Esq~ui.r-e~
Saul Ewing LLP
Post Office Box 1291
Harrisburg, PA 17108-1291
Attorney for Estate
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 004411
MILLER MARONETTA F
24 VICTORIA WAY
CAMP HILL, PA 17011
........ fold
ESTATE INFORMATION: SSN: 187-14-2217
FILE NUMBER: 2104-0749
DECEDENT NAME: EBERLY ANN M
DATE OF PAYMENT: 09/22/2004
POSTMARK DATE: 09/22/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 07/25/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 830,000.00
REMARKS:
COMMERCE BANK
TOTAL AMOUNT PAID:
930,000.00
SEAL
CHECK# 1011
INITIALS: CCP
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT, 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
CD
REV-1162 EX(11-96)
OO4659
EWING SAUL LLP
C/O DONN SNYDER ESQ.
P O BOX 1291
HARRISBURG, PA 17108-1291
fold
ESTATE INFORMATION: SSN: 187-14-2217
FILE NUMBER: 2104-0749
DECEDENT NAME: EBERLY ANN M
DATE OF PAYMENT: 11/23/2004
POSTMARK DATE: 11/23/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 07/25/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $8,259.03
REMARKS:
SAUL EWING LLP
TOTAL AMOUNT PAID'
$8,259.03
SEAL
CHECK//1022
INITIALS' SK
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
REV-1500 EX (6-(30)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
21 04 749
COUNP( CODE YE,fl~ NUMBER
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECUREY NUMBER
Z EBERLY, E. ANN A/K/A AATN M. EBERLY 187-14-2217
t"l DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPUCATE WITH THE
I.U REGISTER OF VVlLLS
O 07-25-2004 11-01-1921
ILl (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
[] 1. Odginal Return
[] 4. Umited Estate
[] 6. Decedent Died Testate (Attach copy of Will)
[] 9. Litigation Proceeds Received
[] 2. Supplemental Retum
] 4a. Future Interest Compromise (date of death after 12-12-82)
[] 7. Decedent Maintained a Livimj Trust (AtUchcapy efTrusl)
[] 10. Spousal Poverty Credit (date of death between 12.31-91 and 1-t-95)
] 3. Remainder Return (date of death palm' to 12-13-82)
[] 5. Federal Estate Tax Return Required
i 8. Total Number of Safe Deposit Boxes
[] 11. Election to tax under Sec. 9113(A) (Attach Sch O)
THIS SE~ION MUST BE COM pLETED. ALL CORRESPONDENCE AND CONFIDE~ TAX INFORMATION SHOULD BE DIRECTED TO:
NAME I COMPLETE MAILING ADDRESS
DONN L. SNYDER, ESQUIRE I P.O. BOX 1291
FIRM NAME (If Applicable) HARRISBURG, PA 17108-1291
SAUL EWING LLP
TELEPHONE NUMBER
717.257.7552
1. Real Estate (Schedule A) (1) 150, 000. O0
2. Stocks and Bonds (Schedule B) (2) 6 2 3,
3. Closely Held Corporation, Partnership or Sole-Propd~orship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 2 2, 12 8. 8 7
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
[] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 1 7 5, 3 40. 1 8
(Schedule G or L)
8. Total Gross Assets (total Lines I - 7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Malgage Liabilities, & Liens (Schedule I) (10)
11. Total Beductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11 )
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an electien to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Une 13)
(8)
75,091.98
12,298.83
(11)
(12)
(13)
(14)
OFFICIAL USE ONLY
970, 924.86
87,390.81
883,534.05
883,534.05
SEE INSTRUCTIONS FOR APPUCABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(a)(1.2) O. 00 X .0 O0 (15)
16. Amount of Une14 taxable at lineal rate 883, 534. 05 X .0 45 (16)
17. Amount of Une 14 taxable at sibling rate X .12 (17)
18. Amount of Une 14 taxable at collateral rate X .15 (18)
19. Tax Due (19)
20. [] I CHECK HERE IFYOU ARE REQUESTING A REFUND OF AN OVERPAYMENT J
0.00
39,759.03
39,759.03
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < :
STF PA42021 F. 1
Decedent's Complete Address:
ISTREET ADDRESS 116
C~Y CAMP HILL
ISTATE PA I ZIP 17011
OLD MILL ROAD
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
30,000.00
1,500.00
Interest/Penalty if applicable
D. Interest
E. Penalty
0.00
0.00
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 a refund
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.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE,
(1)
Total Credits (A + B + C) (2)
Total Interest/Penalty (D + E)
(3)
(4)
(5)
(SA)
(5B)
39,759.03
31,500.00
0.00
0.00
8,259.03
0.00
8,259.03
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLO~NG 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; ........................................ [] []
b. retain the dght to designate who shall use the property transferred or its income; ................... [] []
c. retain a reversionary interest; or ....................................................... [] []
d. receive the promise for life of either payments, benefits or care? ............................... [] []
2. If death occurred alter December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .................................................. [] []
3. Did decedent own an "in trust for" or payable upon death bank account or secudty at his or her death? ..... [] []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
""-:.: contains a beneficial}/designation? ....................................................... I~1 i---i
'qF THE ANSWER TO AI~OF-T. HE~,OVE QUESTIONS IS YES. YOU MUST COMPLETE SCHEDULE G AND FILE~-~AS PART~F
THE
RETURN.
Unde~p,enallties,of perju~, I declare that I have e~mine~ this return, including accompanying schedules and statements and to the best of my knowledge and bel el, t s true, correct and complete.
Decrla~ation of ~'reparer other than the personal r~preser~ative is. based on all information of which preparer has any knowledge.
S[G~'E OF PERSON R,ES, PONSI~,.LE F~R FI~IN'G R,~ET)JRN DATE
/(DDRES~.v , / ~, -
24 VI~RIA WAff. CAM~HI .X53L~__PA 17011
SIGNATURE~ P~EPARER~R THA~EPRES~NTATIVE DATE
I/l (/\. 11-22-04
sox 1291, 17108-1291
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. §9116 (a) (1.1)(i)].
.,or d.at.es, 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'% [72 RS. §9116 (a) (1.1) (ii)].
ne statu~e does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even
if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive
parent, or a stepparent of the child is 0% [72 RS. §9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedenrs lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 RS. §9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedenrs siblings is 12% [72 RS. §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.
STF PA42021F.2
REV-1502 EX + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
E. ANN EBERLY
SCHEDULE A
REAL ESTATE
I
FILE NUMBER
21-04-749
All real propa'ty owned solely or as a tenant in common must be reported at fair market vaJue. Fair market value is defined as the price at which property would be exchanged between a
willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of s~rvivomhip
must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
116 OLD MILL ROAD
CAMP HILL, PA 17011
TOTAL (Also enter on line 1, Recapitulation)
VALUE AT DATE
OF DEATH
150,000.00
$ 150,000.00
(If more space is needed, insert additional sheets of the same size)
STF PA42021F.3
REV-1503 EX + (1-97) (I)
COMMONWF_ALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
E. ANN EBERLY
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
21-04-749
All propaty jointJy-ow~ed with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
o
DESCRIPTION
FIRST COMMONWEALTH FINANCIAL CORP.
26,556.4784 SHARES @ $12.515 PER SHARE
U.S. SERIES EE BOND #Rl18139938EE
DATED 11-94 FACE AMOUNT $200.00
FIRST COMMONWEALTH FINANCIAL CORP.
2,678 SHARES @ $12.515 PER SHARE
ANHEUSER-BUSCH CO.
4,955 SHARES @ $51.545 PER SHARE
SMITH BARNEY CASH
TOTAL (Also enter on Fine 2, Recapitulation)
VALUE AT DATE
OF DEATH
332,348.34
153.76
33,515.17
255,405.47
2,033.07
$ 623,455.81
(If more space is needed, insert additional sheets of the same size)
S'IF PA42021F.4
REV-1508 EX + (1-97) (I)
COMblON~LTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
I
FILE NUMBER
21-04-749
hdude the proceeds of litigation and the date the proceeds were received by t~ estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule R
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
2
3
4
5
6
7
8
9
10
11
12
NET PROCEEDS FROM AUCTION OF PERSONAL ITEMS
COMMONWEALTH OF PA - UNCLAIMED PROPERTY
REIMBURSEMENT OF TAXES PAID
M&T CHECKING ACCOUNT
OHIO CASUALTY - REFUND
COMCAST - REFUND
PATRIOT NEWS - REFUND
NEW YORKER - REFUND
PRUDENTIAL INSURANCE
PPL - REFUND
MEMBERS 1ST FEDERAL CREDIT UNION - CLOSE ACCOUNT
COMMERCE BANK
5,950 01
511 92
188 69
8,781 96
199 00
53 16
80 81
35 83
6,217 57
26 37
63 55
20 00
TOTAL (Also enter on line 5, Recapitulation) $ 2 2,12 8.8 7
(if more space is needed, insert additional sheets of the same size)
STF P^,~202~F.9
REV-1510 EX + (1-97) (I)
SCHEDULE G
INTER-VIVOS 'IRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMOI, N/F_ALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
E. ANN EBERLY 21-04-749
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY % OF
~ INCLUDE Tl.(~ NNaE OF THE TRANSFEREE, TI-FJ R RE).ATIONSHIP l'O D(ECEDENT AkO TkE DATEDATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
NUMBER OF TRANSFER. Al'rACE A COPY OF T:.-E DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE)
1. M&T IRA - #35004201745815 127,302.38 100% L27,302.3~
2. SMITH BARNEY IRA - #724-65734-19-334 48,037.80 100% 48,037.8(
TOTAL (Also enter on mine 7, R~apitulation) $ 1 7 5,3 4 0.1 1
(If more space is needed, insert additional sheets of the same size)
STF PA42021 F.11
REV-1511 EX + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
E. ANN EBERLY
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21-04-749
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
1.
2.
3.
4.
8.
9
10
11
12
13
14
15
FUNERAL EXPENSES:
PARTHEMORE FUNERAL HOME
ROLLING GREEN - ENGRAVING
WEST SHORE COUNTRY CLUB
BETSY E. DUNN - REIMBURSEMENTS - COST OF AIRLINE
TICKETS FOR DAUGHTER OF DECEASED
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
NamedPersonalRepresentative(s) MARONETTA F. MILLER
Sodai Secudy Numbe~s) l EJN Number d Personal Repraser~iv~s)
S~reetAddress 24 VICTORIA WAY
Ch, CAMP HILL State PA
Year(s) Commission Paid: 2 0 0 4 - 2 0 0 5
AttomeyFees- SAUL EWING LLP
Family Exemption: (If decadent's address is not the same as claimant's, attach explanation)
Claimant
zipl7011
Street Address
City State Zip
Relationship of Claimant to Decedent
~obateFees- REGISTER OF WILLS
Accountant's Fees
Tax Return Preparer's Fees
CUMBERLA_NT) LAW JOURNAL - ADVERTISE GRANT OF LETTERS
SENTINEL - ADVERTISE GRANT OF LETTERS
NET EXPENSES FROM SALE OF REAL ESTATE
REGISTER OF WILLS
M&T - INVENTORY SAFE DEPOSIT BOX
MODULAR SYSTEMS - MOVING EXPENSES
PPL
PA WATER
PA WATER
TOTAL (Also enter on line 9, Recapitulation) i $
6,073.62
221.00
759.51
1,834.63
29,127.75
29,127.75
538.50
75.00
122 63
1,817 67
6 00
40 00
5,300 00
26 37
16 16
5 39
75,091.98
(If more space is needed, insert additional sheets of the same size)
$IF PA42021 F, 12
REV-1512 EX + (1-97) (I)
COMMONV~LTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
E. ~ EBERLY
SCHEDULEI
DEBTS OF DECEDEN
MORTGAGE LIABILITIES,&LIENS
I
FILE NUMBER
21-04-749
Include unreimbumed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
VISA
PPL
PA WATER
TRUGREEN CHEMLAWN
LOWER ALLEN TOWNSHIP - SEWER & TRASH
SARAH WILLIAMS - AIDE
SARAH WILLIAMS - REIMBURSEMENT
MCI
SAUL EWING LLP - COSTS ADVANCED
NAPOLI LAi~DSCAPING
EBERLY MILLS CHURCH
VICTOR COHEN, DMD
SAUL EWING LLP
SAUL EWING LLP
M&T - OUTSTANDING CHECKS AS OF DATE OF DEATH
SAUL EWING LLP
NAPOLI LANDSCAPING
MCI
TOTAL (Also enter on line 10, Recapitulation) $
678 42
63 03
27 09
90 71
73 55
1,555 00
234 83
70 86
140 56
381 60
7 34
7 95
1,469 00
2,076 04
1,231 27
3,797 50
360 40
33 68
12,298.83
(If more space is needed, insed additional sheets of the same size)
STFPA42021F. 13
REV-1513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHEPJTANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
E. ANN EBERLY
SCHEDULE J
BENEFICIARIES
I
FILE NUMBER
21-04-749
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
[.
TAXABLEDISTRIBUTIONS[includeoutdghtspousaldistdbutions, andtmn~m
underS~.9116(a)(1.2)]
BETSY E. DUNN
3701 POINT CLEAR DRIVE
OCEAN SPRINGS, MS 39564
WILLIAM DUNN, JR., THOMAS DUNN &
DARIEN DUNN - 3701 POINT CLEAR DRIVE
OCEAN SPRINGS, MS 39564
DAUGHTER
GRANDSONS
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINE,<
RESIDUE
150,000.00
15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
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)
S"rF PA42021F.14
LAST WILL AND TESTAMENT
OF
ANN M. EBERLY
I, ANN M. EBERLY, of Cumberland County, Pennsylvania, declare this to be
my Will and revoke all prior Wills and Codicils.
First: Tangible Personal Property: I give all of my tangible personal
property, including any automobiles, together with all insurance on such property, to my
husband, SEIBERT D. EBERLY, JR., if my husband survives me by thirty days; otherwise I
give such property to my daughter, BETSY EBERLY DUNN, if she survives both my husband
and me, or if she does not survive my husband and me, to my daughter's children as survive
both my husband and me, to be divided as they shall agree. If there be no agreement, or if any
child is a minor, such property shall be divided as my Executor, in my Executor's sole
discretion, deems appropriate. Any of such property to which a minor would thus become
entitled which my Executor thinks unsuitable for such minor's use shall be sold and the
proceeds thereof added to the share of my residuary estate held for the benefit of such minor.
Any of such property to which a minor ~us becomes enfitied and which is not sold may be
retained by the Trustee, without bond, during the minority of such child or may be delivered to
the person having custody of such child. The receipt of the person having custody shall be a
complete release of my Executor and Trustee. My Executor shall pay, as an expense of
settling my estate, the costs of packing, storage, shipping and insurance incurred in connection
with the distribution of the gifts of tangible personal property made above.
Second: Trust for My Grandchildren: If my husband, SEIBERT D.
EBERLY, JR. predeceases me, I give my Trustee the sum of One Hundred and Fifty Thousand
Dollars ($150,000) to hold in trust for the benefit of a class composed of the children of my
daughter, BETSY EBERLY DUNN, (the children of my daughter shall be hereinafter referred
to individually as "grandchild" and collectively as "grandchildren" for purposes of this Will
and shall only mean the natural or adopted children of my daughter) living at my death or born
thereafter but before the time the division of this trust into equal shares is directed as follows:
Until my youngest living grandchild who lives to attain age twenty-two attains that age, the
Trustee shall pay or apply so much of the net income and principal for the support, health and
education of my grandchildren, in such manner and in such amounts, which need not be equal,
as in the sole discretion of the Trustee, is proper. As soon as there is no living grandchild of
mine under age twenty-two, the Trustee shall divide the balance of principal into as many
equal shares as there shall be grandchildren of mine then living and shall:
a. Hold one such share in trust for the benefit of each living
grandchild and pay to, or apply for the benefit of, such grandchild the entire net income
from such share or the balance thereof and also so much of the principal as, in the sole
discretion of the Trustee, is necessary for the support, health and education of such
grandchild. In the exercise of these powers, the Trustee may, but shall not be required
to, consider the other resources of such grandchild. There shall be paid to such
grandchild from the principal of such share or the balance thereof: (i) one-third thereof
upon attaining age twenty-two; (ii) one-half of the balance thereof upon attaining age
twenty-six; and (iii) the entire undistributed balance thereof upon attaining age thirty.
b. If any grandchild shall have attained any of such respective ages
at the time when such share is directed to be established for such grandchild, or at the
time when any share is added thereto, the Trustee shall then distribute to such
grandchild such part or parts or all, as the case may be, of such share or of such added
share as is directed to be paid to such grandchild upon attaining such respective ages.
c. If any grandchild for whose benefit the Trustee holds a share in
trust under subparagraph b. hereof dies before attaining age thirty, the Trustee shall
distribute the principal to such grandchild's issue living at the time of such grandchild's
~§615. I g/15/99
-2-
death, per stirpes; or if none, to my issue then living, per stirpes; provided, however,
that any amount payable under this subparagraph c. to a grandchild of mine for whom
at that time the Trustee holds a separate share hereunder shall be added to the share for
such grandchild for administration and distribution as part' thereof.
Third: Residue: I give, devise and bequeath all the residue of my estate, of
whatever nature and wherever situated, to the Trustee hereinafter named. If my husband,
SEIBERT D. EBERLY, JR., survives me (and for purposes of this Article my husband shall
be deemed not to have survived me if the order of our deaths cannot be established by proof),
my residuary estate, together with any other property which may be added hereto, shall be
divided into two separate shares, Share A and Share B.
Share A shall consist of the smallest fractional share of this trust estate which,
when added to the value of all other items in my gross estate which are eligible for the marital
deduction and which pass or have passed to my husband under other provisions of this Will
except Share B or otherwise, shall reduce the federal estate tax payable, after application of all
available credits (to the extent that their use will not increase death taxes on my estate), to the
lowest possible figure. In establishing such fractional share: (1) the computation shall be based
on final federal estate tax values and funding shall be determined on the date or dates of
distribution; (2) only assets that are eligible for the marital deduction shall pass to Share A;
and (3) any property which may at any time form part of this trust estate and which is not
subject to federal estate tax in my estate shall be disregarded in calculating the fractional shares
hereunder and shall be allocated to Share B, unless some other allocation is directed.
Share B shall consist of the balance of this trust estate after setting apart Share A
and after payment from this balance of death taxes as hereinafter provided. If my husband
fails to survive me, Share B shall consist of the entire trust estate. If my husband (or my
t~§(~. 1 8/18199
-3-
husband's executor, administrator, guardian or agent acting under a power of attorney)
disclaims part or all of my husband's interest in Share A, such disclaimed portion shall pass to
Share B and my husband shall retain my husband's interest in Share B as augmented by the
disclaimed property.
A. MARITAL DEDUCTION SHARE A. The Trustee shall distribute
Share A to my husband, SEIBERT D. EBERLY, JR., absolutely.
B. NON-MARITAL DEDUCTION SHARE B. The Trustee shall pay to
my husband, SEIBERT D. EBERLY, JR., for life, the following from Share B:
a. The net income, quarterly or more frequently.
b. In addition, so much of the principal as the Trustee other than my
husband, in the Trustee's sole discretion, deems proper for the support, health and
education of my husband. In the exercise of this power, the Trustee may, but shall not
be required to, consider the other resources of my husband.
c. In addition, so much of the principal as my husband, from time to
time during my husband's lifetime, requests in writing delivered to the Trustee, not to
exceed in any calendar year the greater of Five Thousand Dollars ($5,000) or five
percent (5 %) of the value of the principal at the end of such year. Such right shall be
non-cumulative.
Upon the death of my husband, or upon my death if my husband fails to survive
me, the Trustee shall distribute the balance of Share B to my daughter, BETSY EBERLY
DUNN, if she is then living. If my daughter, BETSY EBERLY DUNN, is not then living, the
Trustee shall divide the same into as many equal shares as there are grandchildren of mine then
living and grandchildren of mine then deceased represented by issue then living and shall
distribute one such share to each grandchild of mine then living and one such share, per
stirpes, to the issue then living of each such grandchild then deceased. If I have no issue living
at the time of my husband's death, or upon my death if my husband does not survive me, the
Trustee shall divide the then remaining balance into as many equal shares for each of my
daughter's husband, WILLIAM JACKSON DUNN, my nephew JOHN C. MUTH, my
nephew RICHARD MUTH, and my niece MARILYN MARTIN as are then living and shall
distribute one such equal share to each of them then living.
Fourth: Minority Provision: Any income or principal (other than tangible
personal property) which becomes distributable to a minor (and for purposes of this Will, the
8/18/99 -4-
term "minor" shall refer to a person under age twenty-one) shall be held in a trust fund by the
Trustee during minority. The Trustee shall apply such amounts of income and principal as the
Trustee, in the Trustee's sole discretion, deems proper for the support, health, education and
welfare of such minor and shall accumulate any unexpended balance of income. Such amounts
may be applied directly or may be paid to the person with whom such minor resides or who
has the care or control of such minor, without the intervention of a guardian. The Trustee
shall not be obliged to supervise or inquire into the application of such amounts by such
person, and the receipt of such person shall be a complete release of the Trustee. Should any
such fund, in the sole opinion of my Executor or Trustee, be or become too small to warrant
continuing such fund in trust, or should its administration be or become impractical for any
other reason, my Executor or Trustee, in the Executor or Trustee's sole discretion, may pay
such fund, absolutely, to the parent or other person maintaining said minor or may deposit
such fund in the minor's name in an interest-bearing account in a financial institution of the
Executor or Trustee's choosing, payable to the minor at majority. If such minor dies before
attaining age twenty-one, such fund shall be distributed to such minor's estate.
Fifth: Disability Provision: If any beneficiary shall, in the sole opinion of
the Trustee other than such beneficiary, become mentally or physically incapacitated, the
Trustee may apply the share to which such beneficiary is otherwise entitled hereunder for such
beneficiary's support, health and welfare, directly, without the intervention of a guardian.
Sixth: Protective Provision: All principal and income shall, until actual
distribution to the beneficiary, be free of the debts, contracts, alienations and anticipations of
any beneficiary, and shall not be liable to any levy, attachment, execution or sequestration
while in the hands of my Executor or Trustee.
Seventh: Perpetuities Saving Clause: I direct that, in any event, if any trust
created under this Will has not already terminated by its terms, it shall terminate at the
expiration of twenty-one years after the death of the survivor of my husband and the last
surviving issue of mine who was living at the time of my death. The principal shall then be
distributed to my then living issue, per stirpes.
Eighth: Tax Clause: All estate, inheritance, succession and other taxes,
imposed or payable by reason of my death, and any penalties thereon, with respect to all
property comprising my gross estate for death tax purposes, whether or not such property
passes under this Will, (except any such tax on any qualified retirement plan benefits or
Individual Retirement Account benefits included in my estate, all of which taxes shall be
apportioned pro rata against and paid by the person, persons or trust in possession thereof or
benefited thereby) shall be paid out of and charged generally against the principal of Share B,
after setting apart Share A, without apportionment or right of reimbursement; provided,
however, that no asset which is exempt from any state death tax shall be used for the payment
of such tax and no asset which is exempt from federal estate tax shall be used for the payment
of such tax or to satisfy any obligations of my estate. Such taxes shall be paid at such time or
times as may be deemed advisable.
Ninth: Powers of Fiduciaries: In addition to the powers given by law, my
Executor and Trustee, and any successors, without any order of court and in the sole discretion
of the Executor and Trustee, may:
advisable.
investments.
a. Retain any real or personal property, as long as deemed
b. Invest in any real or personal property without restriction to legal
66566. I 8/1g:99 -6-
c. Subscribe for stocks, bonds or other investments; join in any plan
of lease, mortgage, merger, consolidation, exchange, reorganization, foreclosure or
voting trust and deposit securities thereunder; and generally exercise all the rights of
security holders or employees of any corporation.
d. Register securities in the name of a nominee or in such manner
that title will pass by delivery.
e. Vote securities in person or by proxy, and in such connection
delegate discretionary powers.
f. Repair, alter, improve or lease, for any period of time, any real
or personal property, and give options for leases.
g. Sell at public or private sale, for cash or credit, with or without
security, exchange or partition any real or personal property, and give options for sales
or exchanges.
h. Borrow money from any person, including any fiduciary, and
mortgage or pledge any real or personal property.
i. Disclaim any interest or power granted to me under any
instrument or by operation of law.
j. Employ custodians, accountants, investment advisors and other
agents and pay their proper charges in addition to fiduciary commissions.
k. Pay administration expenses, including, without limitation,
interest on death taxes ("administration expenses") from principal or income, including
income otherwise payable to charity; provided, however, that no allocation of
administration expenses to income shall be made that would prevent any assets from
otherwise qualifying for the federal estate tax charitable deduction.
I. Use administration expenses as deductions for federal estate tax
purposes or fiduciary income tax purposes or partly for each, without making
adjustments between principal and income in consequence of the exercise of such
discretionary power.
m. File joint income tax returns with my husband and pay a portion
of such tax, and consent to gifts made by my husband and pay a portion of any gift tax
thereon.
n. Compromise claims.
o. Divide any trust hereunder, which division may be made on a
non-pro rata basis, into two or more separate and independent trusts and make any
8/18199
principal distributions otherWise authorized hereunder from the trusts on a non-pro rata
basis.
p. To the extent that any asset which is exempt from Pennsylvania
inheritance tax would otherwise be allocated to any trust hereunder containing property
not exempt from such tax, divide any trust hereunder into two trusts, in all respects
identical, except that one trust shall contain only property exempt from the
Pennsylvania inheritance tax and the other trust shall contain only property not exempt
from said tax; and my Executor and Trustee may make any principal distributions
otherwise authorized hereunder from the two trusts on a non-pro rata basis.
q. Add to the principal of any trust created hereby any property
received from any person by Deed, Will or in any other manner.
r. At any time merge any trust hereunder with any other trust held
by my Executor, whether created by me or by any other person by Will or Deed, if the
terms of the trust are then substantially similar and held for the primary benefit of the
same person or persons.
s. Make distributions without the consent of any beneficiary, in cash
or in specific property, real or personal, or an undivided interest therein, or partly in
cash and partly in such property and do so, except as otherwise specifically provided
elsewhere herein, without regard to the income tax basis of specific property allocated
to any beneficiary (including any trust) and without making pro rata distribution of
specific assets.
t. Exercise all power, authority and discretion given hereby, after
the termination of any trust created herein until the same is fully distributed.
u. Fund or divide any trust or trust share hereunder at any time into
two separate trusts or shares in order that the federal generation-skipping transfer tax
("GST") inclusion ratio for each trust or share shall be either 0 or 1, and exercise any
discretionary powers over principal or income against either one or the other or both of
the two trusts or shares in such manner as, in the opinion of the Trustee, will lessen
federal transfer taxes.
v. Give any beneficiary (other than my husband) of any trust or trust
share hereunder, at any time prior to the death of such beneficiary, a testamentary
general power of appointment, as defined in Section 2041(b) of the Internal Revenue
Code of 1986, as amended, or successor provisions (the "Code"), over all or any
portion of any trust or share established hereunder for benefit of such beneficiary if the
possession of such power by said beneficiary, in the opinion of the Trustee other than
such beneficiary, would lessen federal transfer taxes and be in the best interests of the
beneficiary. The Trustee may give a beneficiary such general power by a written
notification to such beneficiary of such award, which shall contain such information as
to the scope of the general power and the method of its exercise as the Trustee other
61J166. I 8/18199 -8-
than such beneficiary shall deem appropriate. The effective exercise of such power, to
the extent of such exercise, shall be deemed to control the disposition of the appointed
property.
w. To the extent possible, satisfy any distribution hereunder which
qualifies for the special generation assignment rule of Section 2651(e) of the Code from
GST non-exempt assets and divide any trust hereunder for multiple beneficiaries into
separate trusts for one or more of said beneficiaries in such a manner that certain
distributions from one or more of such trusts will thereby be protected from GST by the
special generation assignment rule and make such equitable adjustments in the
continuing interests of the other beneficiaries in the remaining trust share or shares as
the Trustee shall deem appropriate.
x. Make distributions for the benefit of skip persons (as del'reed in
Section 2613(a) of the Code) to which they are otherwise entitled hereunder for medical
and tuition expenses directly to the provider of the services and from assets which are
not GST exempt, if any.
y. Satisfy any transfer which would otherwise be deemed a taxable
termination, a taxable distribution or a direct skip, for generation-skipping transfer tax
purposes, out of the principal of such trust share or shares created hereunder which are
GST exempt, and satisfy any distributions which would not be deemed a taxable
termination, a taxable distribution or a direct skip, for generation-skipping transfer tax
purposes, out of the principal of such trust share or shares created hereunder which are
not GST exempt. In addition, the Trustee, in the Trustee's sole discretion, may fund
one or more of such trust shares created hereunder for one or more beneficiaries with
disproportionate amounts of GST exempt or GST non-exempt property. Such equitable
adjustments in the continuing interests of the other beneficiaries in the remaining trust
share or shares shall be made under such circumstances as the Trustee shall deem
appropriate.
z. Allocate any of my federal exemption from GST, as provided in
Section 2631 of the Code, available at the time of my death to any property as to which
I am the transferor under the provisions of Section 2652(a) of the Code, including any
property transferred by me during my life, and to elect out of any deemed allocation or
revoke any prior election out.
My Executor and Trustee may make, but shall not be required to make, any
adjustment of the amount distributed to any beneficiary who would have received a greater or
lesser amount if my Executor or Trustee had made a different or contrary decision in reference
to any of the above matters. I exonerate my Executor and Trustee from any liability arising
66566.1
from any exercise or failure to exercise these powers, provided their actions (or inactions) are
taken in good faith.
For purposes of interpretation of this document, with respect to a gift to any
descendant of mine, any condition of survivorship shall be construed to mean survival by 90
days, and if any such descendant of mine shall fail to survive me by 90 days, such descendant
of mine shall be deemed to have predeceased me.
Tenth: Appointment of Fiduciaries: I appoint my husband, SEIBERT D.
EBERLY, JR., Executor of this Will. Should my husband, for any reason, fail to qualify or
cease to act as such during the administration of my estate, I appoint my daughter, BETSY
EBERLY DUNN, Executor of this Will to serve with the same duties, powers and discretion
as if originally appointed.
I appoint ALLFIRST BANK (formerly known as DAUPHIN DEPOSIT BANK
AND TRUST) Trustee of any trusts established under Article SECOND of this Will for the
benefit of my grandchildren. I appoint my husband, SEIBERT D. EBERLY, JR., Trustee of
all other trusts established hereunder. Should my husband, for any reason, fail to qualify or
cease to act as such during the administration of any such trust, I appoint my daughter, BETSY
EBERLY DUNN, Trustee of all trusts established hereunder, except any trust established
under Article SECOND, to serve with the same duties, powers and discretion as if originally
appointed.
ALLFIRST BANK shall be entitled to compensation for its services as Trustee
in accordance with its Standard Schedule of Charges in effect from time to time during the
period over which its services are rendered.
66~66.1 8/18199
-10-
The majority of all beneficiaries to whom current trust payments may or must be
distributed, or the natUral or legal guardians of such beneficiaries, as the case may be, shall
have the power to request in writing the removal of the Corporate Trustee then in office and
the appointment of another Corporate Trustee. Then, and as often as it shall occur, the
Corporate Trustee so designated hereunder to be appointed in the writing shall, upon filing
written acceptance of the trust, become Corporate Trustee hereunder and the Corporate Trustee
then in office shall thereupon be removed.
If at any time there is a change in the Federal estate tax laws such that any trust
created hereunder will be includable in my husband's estate solely by reason of my husband's
position as sole Trustee with respect to such trust, then, and in that event, the successor
Trustee named herein shall become a Co-Trustee with my husband. In that event, no Trustee
shall participate in any discretionary decision relating to the right of such Trustee, as
beneficiary, or in any determination of such beneficiary's incapacity. In such cases the
decision of the other Trustee shall control. No Executor or Trustee named herein or appointed
as provided below shall be required to give bond or furnish sureties in any jurisdiction.
Whenever the word "Executor" or the word "Trustee" is used in this Will, the word shall
include both the singular and the plural, unless the context indicates otherwise.
IN WITNESS WHEREOF I have hereunto set my hand and seal this ] 0 ~day of
~~~.a' 1999.
ANN M. EBERLY ,k~-
SIGNED, SEALED, PUBLISHED and DECLARED by the above named
ANN M. EBERLY as and for her last Will and Testament, in the presence of us, who, at her
-11-
request, in her presence and in the presence of each other, have hereunto subscribed our names
as witnesses.
WmiESS
ADD. REss - (j ~.,
ADDRESS
-12-
COMMONWEALTHOF
COUNTY OF
PENNSYLVANIA ·
· SS
DAUPHIN
We, ANN M. EBERLY, the testator, and ']",e re; L~nn nale..+~' I
and bor~,~ L. ~;n~tlee-, the witnesses, whose names are signed to the foregoing
instrument, being first duly sworn, do hereby declare to the undersigned authority that the
testator signed and executed the instrument as her last Will and that she signed willingly, and
that she executed it as her flee and voluntary act for the purposes therein expressed, and that
each of the witnesses, in the presence and hearing of the testator, signed the Will as a witness
and that to the best of the witnesses' knowledge the testator was at that time over eighteen
years of age, of sound mind and under no constraint or undue influence.
ANN M. EBERLY - J.~..__
C~566, I 8118/g9
Subscribed, sworn to and acknowledged before me by ANN M. EBERLY, the
testator, and subscribed and sworn to before me by
/,
Notar blic
~ "" ' · '., Notary Public
~ My Commiss[~,~ Expires Jan I0 ~000
-13-
First Codicil to Last Will and Testament
of ...
Ann M. Eberly
I, Ann M. Eberly, of the Township of Lower Allen, County of Cumberland and
Commonwealth of Pennsylvania declare this to be a Codicil to my Will dated September 10,
1999.
FIRST:
thereof substitute the following:
I hereby revoke Article Tenth of my Will in its entirety and in lieu
"TENTH: Appointment of Fiduciaries: I appoint my daughter, Betsy Eberly Duan,
Executrix of this Will. Should my daughter, for any reason, fail to qualify or cease to act as
such during the administration of my estate, I appoint Dorm L. Snyder Executor. Should Doan
L. Snyder fail to qualify or cease to act as such, I appoint Maronetta F. Miller Executrix.
Each successor executor shall serve with the same duties, powers and discretion as if originally
appointed.
I appoint my daughter, Betsy Eberly Duma and Dorm L. Snyder, Co-Trustees of
any trusts established under my Will dated September 10, 1999. Should either one, for any
reason, fail to qualify or cease to act as such during the administration of any such trust, I
appoint Maronetta F. Miller, Successor Trustee of all trusts established under said Will, to
serve with the same duties, powers and discretion as if originally appointed.
95~-?0. I 7./27/03 1
No Trustee who is a beneficiary or who owes a legal duty of support to a
beneficiary shall participate in any discretionary decision relating to the right of such
beneficiary in or to principal or income or in any determination of such beneficiary's
incapacity. In such cases the decision of the other Trustee shall control.
My Co-Trustees shall be entitled to compensation for services rendered in
accordance with Standard Schedule of Charges in effect from time to time during the period
over which services are rendered.
No Executor or Trustee named herein shall be required to give bond or furnish
sureties in any jurisdiction. Whenever the word "Executor" or the word "Trustee" is used in
this Will, the word shall include both the singular and the plural, unless the context indicates
otherwise."
SECOND: In all other respects I ratify, confirm and republish my Will dated
September 10, 1999.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this 2P~ day of
February 2003.
ANN M. EBERLY
... (SEAL)
SIGNED, SEALED, PUBLISHED AND DECLARED by the above named
Ann M. Eberly, the testatrix, as and for a First Codicil to her last Will dated September 10,
1999, in the presence of us who, at her request, in her presence and in the presence of each
other, have hereunto subscribed our names as witnesses.
~q'ITNESS
ADDRESS
ADDRESS
2/19/03
-3-
COMMONWEALTH 'OF PENNSYLVANIA ·
· SS
COUNTY OF CUMBERLAND ·
We, Ann M. Eberly, the testator, and '~ ~ a ac~. L. ~ C e ,'$ e ,~
and ~J; Iii c, ,~, ~-. [~ ~ ~ ~ , the witnesses, whose names are signed to the foregoing
instrument, being ftrst duly sworn, do hereby declare to the undersigned authority that Ann M.
Eberly, the testator, signed and executed the instrument as and for her First Codicil to her last
Will dated September 10, 1999, and that the testatrix signed willingly, and that she executed it
as her free and voluntary act for the purposes therein expressed, and that each of the witnesses,
in the presence and hearing of the testator, signed the Codicil as a witness and that to the best
of the witnesses' knowledge the testator was at that time over eighteen years of age, of sound
mind and under no constraint or undue influence.
Ann M. Eberly --'
Witness
Witness
Subscribed, sworn to and acknowledged before me by Ann M. Eberly, the
testator, and subscribed and sSvo~o before me by
and ! , the witnesse~xtMs'~21 day of February 2003.
95570.1Zt19103
4
NOTARIAL SEAL
Maronetta F. Mil!er. Nolary Public
Harrisburg, PA Dauphin County
My Commission Ezpir~s Jan19, 2004
A. Settlement Statement
U.S. Department of Housing
and Urban Development
OMB Approval No. 2502-0265
B ._:.............~ p e of Loan
1. [] FHA 2. I'-'] FmHA 3. [] Cony. Un/ns. 5. rNel~m~e~ 7. Loa~Num~'
4. ~ VA 5. ~ Cony. Ins.
C. Note: ~is fo~ is furn~h~ [o gna you a statement off a~ual seUlement ~s~. ~ounts paid ~o and by the settlement agent are
sho~. Ilems ma~ '~.o.c.)' ~m pa~ ou~ide ~osing; ~ey am sh~ hem for info,at/anal pu~ses and not
included in the totals.
Eberly's Mill Church of G~ Estate of Ann M. Eberly ~o Chu~hes of God, Home Missions
Maronetta F. Miller, Executrix Council of the E. Penn. Conference, Inc.
115 Creek Rd. 2 No~h Second St., 7~ fl. 900 S. AHington Ave., Rm 213
Camp Hill PA 17011 Haffsburg PA 17101 Harrisburg PA 17109
O. P~ L~ I H. ~ ~ Michael J. Crocenzi
I
116 Old Mill Dr. P~ ~ s.,,~
Goldbe~ Ka~man, P.C. 9/17/20~
Camp Hill PA 17011 Ha~sbu~ PA 17108
~o,: ~ 1~/17~004
J. Summary of Borrower'l TranlacUon K. Summary o! Seller's Transaction
100. Gross Amount Due From Bon'm~r 400. Gross Amount Due To Seller
101. Contract sales pdce
102. Personal propert~
lO3. Settlement charges to bon'ow~ (fine 14002
104.
150,000.00
2,677.00
404.
105. 405.
AdJuatmenta for Itama paid b~ leltar In advance
lO0. citynow, taxes 9/17120040 12/31/2004
107. County taxes 9/17/20040 12/31/2004
108. Assessments Io
1o9. sewer 9/17120040 9130/2004
81.95
96.38
10.36
110. to
111. Ia
112. to
113. to
114. to
115. to
120. (]roll Amount Due From Bo,'rower
152,865.69
401. Coulracl sales i:wice I 150,000.00
402. Per, anal property
403.
Adjustments for Items paid__by, seller In advance
405. City/town taxes 9/1 7/20040 12/31/2004
407. Count/taxes 9/17/2004o 12/31/2004
408. Assessmenis to
4o~. sewer 9/17/20040 9/3012004
410. to
411. to
412. to
413. to
414. lO
415. to
420. Gross Amount Due To Seller
81.95
96.3~
10.36
150,188.69
200. Amounls Paid By Or In Behalf Of Borrower
600. Reductions In Amount Due To Seller
201. Delx)alt o~ earnest maneY
202. Prthctpal amount of new toan{sI
203. Existing loan(s} taken subjec~ to
204.
205.
206.
207.
208.
209.
Adjustments for Item. unpaid b), seller
210. Cia/town taxes to
211. County taxes to
212. Assessments to
213. School tax 7/112004 to 9/17/2004
214. to
215. to
216.
217.
5f000.00 501. Excess deposit (see Inslrucltona)
120,000.00 502. Settlement charges to salter (line 14002
503. Existing loan(s) laken subject to
504. Pa}off ol first mollg_age loan
505. Pa}offal'second me,gage loan
506.
507.
508.
509.
Adjustments for Itema unpaid by' seller
317.67
510. City, lawn taxes to
511. Count/taxes to
$12. Asseasmenis to
513. School tax 7/1/2004 to 9/17/2004
514. to
515. to
510. to
517. Io
5,000.00
1,500.00
317.67
218. 1o 516. to
219. to 519. lo
220. Total Paid By/For Borrower 125,317.67 620. Total ReducOon Amount Due Seller 6,817.67
300. Cash At Settlement From/To Borrower $00. Cash At Settlement To/From Seller
301. (3ross Amount due tram IXaTOW~ (1toe 1202 152,865.69 5o~. (]ms .mount due to seller (line 4202 150.188,6;
302. Less amount paid by/to~ berrm~e~ {line 220) 125,31 7.67) 502. Less reductions In amL due seller ~]lna 620) 6,817.61
303. Cash [] From [] ToBorrower 27,548.02 603. Cash [] To [] FromSeltar 143,371.0;
SUBSTITUTE FORM 1099 SELLER STATEMENT
The information contained in Blocks E, G, H, and I and on line 401 (o~, line 403 and 404) is/mix,ant lax In~o~matton end ia being ~umlshed to Ule Intamal Revenue
Service. I1 you are requfred to me e retom, a neg~gence pana~ ~ olher ~anoUon wa be imposed on you if this Item is required to be reported arid the IRS determines
that it has not been reputed, if ~ rea~ estata la ~ pdadpal mstdonue, file From 2116, Sale a' Exchange or Principal Reek:lance. to~ arty gain, with your Income tax
tatum; f~ other IrensacflJons, com~e the applicable parts ~ Form 4797. Form 6232 end/~" Schedule Do Faun 10402. You are required to provkle the Setllement Agent
(named above) with your cern'ecS taxpayer Iden§ficaUon number, if you do nol provide the Se01ement Agent ~ your eon'ecS taxpayer IdenlificaUon number, yo~ may be
subject to civil o~ c~mtoal penalties imposed by law. Under panalllee o~ perjury, I cell/ay that lite number Mmwa on itda statement is my con'ect taxpay~w idenUfica f/on number.
(Selleds Signature)
L. SeUlam,~nt Charges
700. Total Sales/Broker', Commie. Ion bi,ad on price $ 1 50~000.00
Division of Commission (tine 700} as
701. $ Io
702. $ Io
0'00t
Paid From
Burrower's
Funds Al
Seltiement
Paid From
Settees
Funds At
Seltiemenl
703. Commission paid at SelUement
704.
600. Item, Payable In Connection With Loan
801. Loan Origination Fee
802. Loan Discount
803. Appraisal Fee
804. Credit Report
805. Lendef*s Inspection Fee
120,000.00
120,000.00
to
806. Mortgage Insurance Appticalidn Fee to
807. Assumption Fee
808.
809.
810.
811.
812.
813.
900.
llama
Reclulrad By Lander To Be Paid la Advance Exciude last da,/In calcs- line 001
g01. Interest lr~m to (~$ /day
902. Mo~gage Insurance Premium fur mo~th. Io
903. Hazard Insurance Premium
904.
years to
905.
1000. Relar~al Deposited With Lender
1001. Hazard insurance 1 morllhsa"h~
per
morlth
1002. Modgage Insurance 1 months(~$ Per month
1003. Cit'/F,,,;,i~=,~7 taxes 1 months<~$ per month
1004. Count/p~o~=,~), taxes I month.s per month
1005. Annual assessmen~ I months~$ pe~ month
1006. 1 months~$ per month
1007. 1 mouthers per month
1008. A~, m;=;e Accounting Adjustment
1100. Title Chargee
1101. Selt;~,~er,; Or ctosin~ lee to
1102. Abstract Or fltie ~,:,~ to
1103. Title ex&~i.&Uon Io
1104. Tltie Ina~r&,-,.e ~,,,~ to Ionni Abstract
11os. Documenl p,-e~:e~,~ for mortgage Jo Dissinger & Dissinger
1106. Notory fees to
1107. At;o,~.eZ'a fees to
1108. Title Insurance to
1109. Lender's coverage $
1110. Owner's cov~,a~e $
1111.
1112.
1113.
1200. Cov~rna,ant ;.~v,..';,,t) and Transfer Charges
1201. ~'CC~flgfeee: Deed $ 38.50; ~g~e S
~202. Ci~/~n~t=~a;m,,Fs: O~ $ 1,500.00; ~;qe
1203. State~sta~s: D~ $ 1,500.00 ;~gage
1204.
650.00
450.00
)
)
1,500.00
1205.
1300. AddlUonal
1301. Surge), to
302. Pest Insp~.;;,.~ to
1303.
1304.
1305.
1308,
1307.
1308.
1400. Total Satt:;r~,~;. Chargal (ii~;.~.i on lines 103, Section J and M2, SacUon K)
i 2,677.00
~'~... CERTIFICATION
'o= ,:.... .I....t al, .nd
£1/'~- Estate/o~f An~ IV~ E b/rly./c//o sas,er n /~ ber~y.~_ I~lil, ~3~u rch of ~iod BOrrower
! J/--EL~.~,..~',.P/-,//(/LL.-~' s.,., ! ~ ~ ...~o,,~ ~n Bor~,
·
~icnael J. ~roce~i [ ~ ~ ~ ~
1,500.00
~IRST COHMONNEALTH FINANCIAL CORP
]IRECT STOCK PURCHASE PLAN
ANN EBERLY
].16 OLD HILL DR
CAMP HILL PA 17011
STATEMENT OF ACCOUNT
Tile Bank al' New Yo~k, Administrator
P.O. Box 1958
Newark, NJ 07101-9774 SEQ#
Answers to many questions and requests are
available by visiting The Bank of New York's
website at: http:/Istockbny.com or
Email at: Sharaowners~bankofny.com
1-800-.~2q,-qq.R8
Company Number 1003
Account Number 0000].81016
Record Date
Payment Date
Next An~cipated Investment Date WEEKLY
O~
003387
· CURRENT DIVIDEND PURCHASE INFORMATION
Plan Record Date Position
Rate Gross Dollars Service Tax Nat Dollars
-?,~;cl By You In Cerliltcate Form Held By Plan Tote/ Paid Fees Wil~neid Reinvested
Admkis ~'ator
0 2&200.2072 2&200.2072 .1600 q192.05 .00 .00 q].92.0~
YEAR-TO-DATE TRANSACTIONS
~n~llon Date ~s~on Descripllon ~an=~n Oo~=s PrEs ~r Shoe ~§on Sh~es ~ Sh~es Held By Adtnin~a~r
BALANCE FORWARD 25575.2087
i/16/Oq ' PLAN DIVIDEND - .............. 4092.03 15'.0684 313.1240 25888.3327
-~/15/0q PLAN DIVIDEND q[q2.1$ '~3.28Iq ~1~.8745' '26200=2072
~7/15/0q PLAN DIVIDEND q192.0~ 11.766q 356.2712 26556.q784
THE P~[CE IN THE TRANSACT[ON SUMMARY REFLECTS THE lOX DISCOUNT FROI4 THE FAIR
MARKE] PR[CE ON SHARES PURCHASED ~[TH DIVIDENDS. REM[NDE~: TO FURTltER EXPEDI'E
YOUR ]RANSACT[ON REQUEST, USE THE TEAR OFF STUB ATTACHED BELOW.
YEAR-TO-DATE SUMMARY
GROSS DIVIDENDS TAXES WI'rHHELD
12426.19 .00
CASH CONTRIBUTIONS t SERVICE FEES
.00 { .00
12426.19 347,194.09
TRANSACTION REQUEST FORM - PLEASE KEEP THIS FORM FOR FUTURE REQUESTS
Sol Plan Shares (~t~ Numt:~ e~ Whole shares)
If "Ar is entered. Par~ipal~n in ~a [dan vSII be L~ Mark rhJ~ box and
terminated. Shares will be sold subject to the comp/eta the othersfde
Terms and Condillon$ Detailed in the Plan. of form. Do not Sign
Issue Plan Shares (Enter N~ber of Whole shares) the C~eJr~--ate(s}
If 'Ar is entered. Par~ipalion in the plan ~.al be
terminated. A cerlit~cate .",'~ be issued ~n
R~,;istered holder(e} name.
OplianaJ Cash Coneit~jtion Amo,~t Enclosed
- All Paymen~ mu~t be in U.S. Dallas
Drawn on a U.S. Bank ~ Paya~e to
The Ba~k of New York.
:'-L REQUESTS MUST ISIGNATURE
E-_' SIGNED BY ALL
' ----;;STERED OY,'IqERS
ISIGNATURE
(MAKE NO MARKINGS BELOW THIS UNE)
0000181016
DIVIDEND ELECT1ON
(Mark tl~ boz and also
dec,on box bekr. v)
Reinvest M
it<~lfliona~ Purchase - Dividends
Autema~ Manila'/
D~ons. Mark t~ ~
~her ~e of ~o~ O~e~
A,'Jdress Charge I~1 Reinvest Oivider¢ls on
Mark th~ boz ar~ compiete Shares ~
~50.00 H[H[HUH PAYHENT
~[0,000.00 HAX[HUH PER [NVESTHEN'
~[Z0,000.00 HAX[HUH PER YEAR
DATE (DAYTIME TELEPHONE) NO.
1003 1002 5 00000005000
499 Mitch¢~ Koa& Millsboro, DE 19966 M~ Co~¢ D~'MB42
(~85) 502-4349
(,302)934-2955
Scp~emb~ 2, 2004
Saul Ewing
Attorneys At LaW
2 North Second Street
7th Floor
Harrisburg, PA 17101-1604
Re: ~
above-named decedent had on
Dear Sir or Madam:
Per your inquiry dated August 23, 2004, please be advised that at the time of death, the
deposit with this bank the following:
Checking Account
1. Type of Account
30186889
Account Number
Ownership (Names oJ)
AnnM Eberly, Joint Owner
Seibert D Eberly Jr, Joint Owner
Maronetta F Miller, POA
Opening Date
Balance on Date of Death
Accrued Interest
Total
8/28/64 closed 8/23/04
58,781.03
$ 0.93
...........................
Type of Account
Account Number
Ownership (Names oJ)
IRA
035004201745815
Ann M Eberly
Betsy E. Dunn, Beneficiary
Opening Date
Balance on Date of Death
Accrued Interest
12/2/82
$125,591.58
$ 1,710.80
$127,302.38
499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12
Saul Ewing
Attorneys At Law
2 North Second Street
7th Floor
Harrisburg, PA 17101-1604
Phone (888) 502-4349
Fax (302) 934-2955
September 2, 2004
Re: Estate of: Ann M. Eberl¥
Social Security: 187-14-2217
Date of Death: Jul}/25, 2004
Dear Sir or Madam:
Per your inquiry dated August 23, 2004, please be advised that at the time of death, the above-named decedent had on
deposit with this bank the following:
Type of Account
Account Number
Ownership ('Names od~
Opening Date
Balance on Date of Death
Accrued Interest
Total
Type of Accozaqt
Account Number
Ownership (Names oj)
Opening Date
Balance on Date of Death
Accrued Interest
Total
Checking Account
30186889'
AnnM Eberly, Joint Owner
Seibert D Eberly Jr, Joint Owner
Maronetta F Miller, POA
8/28/64 closed 8/23/04
$8,781.03
$ 0.93
...........................
IRA
035004201745815
Ann M Eberly
Betsy E. Dunn, Beneficiary
12/2/82
$125,591.58
$ L710.80
.........................
Type of Account
Box Number/Location
Ownership (Names o~
Opening Date
Safe Deposit Box
0000356 / Highland Park
Seibert D Eberly Jr
Arm M Eberly
1/25/94
Please be advised, there was no safe deposit box found for the above decedent.
For further account information, regarding ownership, closures and/or reimbursement of funds, please call the
West Shore Plaza Office # 717-255-2271.
Sincerely,
Nancy Clagett
Records Management
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
Estate of E. Ann Eberly'
also known as Ann M. Eberly
. Deceased
No. 21-04-0749
Date of Death July. 25, 2004
Social Security No. 187 - 14 - 2217
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all
of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that
the valuation placed opposite each item of said Tnventory represents its fair value as of the date of the Decedent's death, and
that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum
at the end of this inventory. I/We verify that the statements made in ~h~entory are true and correct. I/We understand that
false statements herein are made subject to the penalties of 18. Pa. C.S.'Se, ction 4904 relating to u~-~,q,.falsification to
authorities. I~ll,R
Nameof Dorm L. Snyder epresentative
Attorney: 'J Y ~LJ.~'~'-")~.'.~,/~'I ~.~1,
,.D.,o.: 068s8 x...
Address: 2 North Second. Street, ,7cn Floor Dated: No-~-r 22, 2004
Harrisburg, PA 1,7101
Telephone: ( ,71 '7 ) 25 ,7 - ,7524
REAL ESTATE:
See Schedule A
PERSONAL ESTATE:
See Schedule B
See Schedule E
(Attach Additional Sheets if necessary)
Description
Value
$150,000.00
$623,455.81
$ 22,128
.87
Total:
$795,584.68
110128.1
~EV-1502 E~( + (1-97) (I)
SCHEBULEA
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
E. ANN EBERLY 21-04-749
All real property owned solely or as a tenant in common must be repo~ted at feir mad(at value. Fair market value is defined as the price at which property would be exchanged between a
willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointJy-owned with right of survivorship
must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
116 OLD MILL ROAD
CAMP HILL, PA 17011
TOTAL (Also enter on line 1, Recapitulation) $
VALUE AT DATE
OF DEATH
150,000.00
150,000.00
(Ifmorespace is needed, inse~ additional sheets ofthesame size)
STFPA42021F.3
~EV-1503 E~( + (1-97)(I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
21-04-749
All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
o
FIRST COMMONWEALTH FINANCIAL CORP.
26,556.4784 SHARES @ $12.515 PER SHARE
U.S. SERIES EE BOND #Rl18139938EE
DATED 11-94 FACE AMOUNT $200.00
FIRST COMMONWEALTH FINANCIAL CORP.
2,678 SHARES @ $12.515 PER SHARE
ANHEUSER-BUSCH CO.
4,955 SHARES @ $51.545 PER SHARE
SMITH BARNEY CASH
332,348.34
153.76
33,515.17
255,405.47
2,033.07
TOTAL (Also enter on line 2, Recapitulation) $ 6 2 3,4 5 5.8 '[
(If more space is needed, insert additional sheets of the same size)
STF PA42021F,4
15,EV-150'8 E~( + (1-97) {I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
E. ANN EBERLY
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
I
FILE NUMBER
21-04-749
Include the proceeds d litigatio~ and the date the proceeds were received by the estate. All property jointly-owned with the right of sun~ivo~ship must be disclosed on Schedule E
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
2
3
4
5
6
7
8
9
10
11
12
NET PROCEEDS FROM AUCTION OF PERSONAL ITEMS
COMMONWEALTH OF PA - UNCLAIMED PROPERTY
REIMBURSEMENT OF TAXES PAID
M&T CHECKING ACCOUNT
OHIO CASUALTY - REFUND
COMCAST - REFUND
PATRIOT NEWS - REFUND
NEW YORKER - REFUND
PRUDENTIAL INSURANCE
PPL - REFUND
MEMBERS 1ST FEDERAL CREDIT UNION - CLOSE ACCOUNT
COMMERCE BANK
5,950 01
511 92
188 69
8,781 96
199 00
53 16
80 81
35 83
6,217 57
26 37
63 55
20 00
TOTAL
(Also enter on line ~,,.D~,,,.'Jr..H. I fl ~ ' '~""l"l'u'a"°n/'~': 2 2,12 8.8 7
(If more space is needed, insert additional sheets of the same size)
STF PA42021F.9
BUREAU OF INOIVIDU~i.E~w;'C:
INHERITANCE TAX DIVISION
PO BOX Z8D60l
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
700.' 1'1..1 n,
.,;"U' J ,. nl' 1-
,tF f': 18
h, i J
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
01-25-2005
EBERLY
07-25-2004
21 04-0749
CUMBERLAND
101
CI c'l:i
LL_' U\
Oprl-,!"J t'~ \1'(::
,I i....'.J
DONN L slIi'tlilnf EsQ
SAUL EWING
PO BOX 1291
HBG PA 17108
*'
REV-1541 EX 'FP [1l.84J
E
A
Allount Rellitted
I CHANGED
III
(21
(31
(41
(51
(61
(71
150.000.00
623.455.81
.00
.00
22.128.87
.00
175.340.18
(BI
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
RE.V' :m".Ei<..AFp..r~1":6'!')".N6i'.I.CE.'ij'F.i:NlI!ftYf~NCE.TAX.A.PPRAYsUl'itlt~..Ai:L'ij'WANCE.oii......-..........
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF EBERLY E A FILE NO. 21 04-0749 ACN 101 DATE 01-25-2005
TAX RETURN WAS: (X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held stock/Partnership Interest (Schedule C)
4. Hortgages/Notes Receivable (Schedule OJ
5. Cash/Bank Deposits/Mlsc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule FJ
7. Transfers (Schedule G)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subiect to Tax
NOTE: I~ an assessment was issued previously, lines
re~lect ~igures that include the total o~ ALL
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 at Sibling rate (17)
18. Amount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX TS:
DATE
09-22-2004
11-23-2004
NUHBER
CD004411
CD004659
INTEREST/PEN PAID I-I
1,578.95
.00
75,091.98
12.298.83
(111
1121
[131
[141
(91
(101
NOTE: To insure proper
credit to your account~
submit the upper portion
of this form with your
tax payment.
970,924.86
87.390 81
883,534.05
.00
883,534.05
14, 15 and/or 16, 17, 18 and 19 will
returns assessed to date.
.00 X 00 =
883,534.05 X 045 =
.00 X 12 =
.00 X 15 =
[191=
AHOUNT PAID
30,000.00
8,259.03
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
39,759.03
.00
.00
39,759.03
39,837.98
78.95CR
.00
78.95CR
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $l~ NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I ~ ~
~
STATUS REPORT UNDER RULE 6.12
Name of Decedent: E Ann Eberly a/k/a Ann M. Eberly
Date of Death: July 25, 2004
Register File No. 21-04-07749
Pursuant to Rule 6.12 of the uCourt Rules, I report the following
with respect to completion ofthe administration ofthe above-captioned estate:
1. State whether administration ofthe estate is complete: Yes --K- No
2. If the answer to #1 is No, state when the personal
representative reasonably believes that the administration
will be complete:
3. If the answer to # 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:
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 information accounts may
be filed with the Clerk ofthe Orphans' Court
and may be attached to this report. (attached)
Date: March 8, 2005
~~
SAUL EWING LLP
POST OFFICE Box 1291
Harrisburg, PA 17108-1291
717.257.7552
(1-'
54463.10 3/7/05.
J ~ ."I'lIt
112108.12/8/05
COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
ORPHANS' COURT DIVISION
COMMONWEALTH OF PENNSYLVANIA
ESTATE OF E. ANN EBERLY
LATE OF THE TOWNSHIP OF LOWER ALLEN
CUMBERLAND COUNTY, PENNSYLVANIA
FIRST AND FINAL ACCOUNT OF
BETSY E. DUNN, EXECUTRIX
Date of Death: July 25,2004
Estate No. 21-04-0749
Donn L. Snyder, Esquire
Saul Ewing LLP
Post Office Box 1291
Harrisburg, Pennsylvania 17108
717-257-7552
Attorney for the Estate ofE. Ann Eberly
COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
ORPHANS' COURT DIVISION
COMMONWEALTH OF PENNSYLVANIA
ESTATE OF E. ANN EBERLY
LATE OF THE TOWNSHIP OF LOWER ALLEN
CUMBERLAND COUNTY, PENNSYLVANIA
FIRST AND FINAL ACCOUNT OF
BETSY E. DUNN, EXECUTRIX
SUMMARY AND INDEX
PAGE PRINCIPAL
2 Receipts $971,003.81
4 Less Disbursements $126,558.84
6 Balance Before Distribution $844,444.97
Distribution to Beneficiaries $798,594.12
TOT AL PRINCIPAL BALANCE REMAINING
$45,850.85
INCOME
Receipts 6,149.16
Disbursements 0.00
TOTAL INCOME BALANCE REMAINING 6,149.15
COMBINED BALANCE REMAINING $52,000.00
FOR DISTRIBUTION
112108.1 2/8/05
Commerce Bank - Cash
112108.12/8/05
COMPOSITION OF BALANCE
$52,000.00
PRINCIPAL RECEIPTS
Inventory Filed
Per copy of Inventory Attached
Inheritance Tax Refund
$970,924.86
78.95
TOTAL PRINCIPAL RECEIPTS
$971,003.81
112108.12/8/05
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
OF INDIVIDUAL TAXES
.rANeE TAX DIVISION
.IX Z80601
.~ISBURG PA 171Z8-0601
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
DONN L SNYDER
SAUL EWING
PO BOX 1291
HBG
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
01-25-2005
EBERLY
07-25-2004
21 04-0749
CUMBERLAND
101
ESQ
'*
REV-1547 EX AFP 02-04)
E
A
Anount Relli Hed
PA 17108
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV :r!'2i"'.Ex.AFp..nr:6~r.NoT.icE.oF.iNHErtifANcE.TAx.APPRAIsi'f.i€NT:..ALLowANcE.oif.................
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF EBERLY E A FILE NO. 21 04-0749 ACN 101 DATE 01-25-2005
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Hortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
(1)
(2)
(3)
(4)
(5)
(6)
(7)
150,000.00
623,455.81
.00
.00
22,128.87
.00
175,340.18
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governnental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
(10)
75,091.98
12.298.83
(1lJ
(12)
(13)
(14)
NOTE: To insure proper
credit to your account,
subnit the upper portion
of this forn with your
tax paynent.
970,924.86
87.390 81
883,534.05
.00
883,534.05
NOTE: I~ an assessment was issued previOUSly, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Anount of Line 14 at Spousal rate
16. Anount of Line 14 taxable at Lineal/Class A rate
17. Allount of Line 14 at Sibling rate
18. Allount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
(15) .00 X 00 = .00
(16) 883,534.05 X 045 = 39,759.03
(17) .00 X 12 = .00
(18) .00 X 15 = .00
(19)= 39,759.03
fAX CREDITS:
,,"'.."'..... \+J AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
09-22-2004 CD004411 1,578.95 30,000.00
11-23-2004 CD004659 .00 8,259.03
TOTAL TAX CREDIT 39,837.98
BALANCE OF TAX DUE 78.95CR
INTEREST AND PEN. .00
TOTAL DUE 78.95CR
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.l
PRINCIPAL DISBURSEMENTS
Schedule H Attached
Schedule I Attached
Register of Wills - Inheritance Tax
Register of Wills - Filing Fee
Saul Ewing LLP - Misc. Filings and Copies
P A Department of Revenue
Preparation of Individual Final Tax Returns
Preparation of Final Fiduciary Tax Returns
Total Disbursements
112108.12/8/05
$75,091.98
12,298.83
38,259.03
50.00
150.00
9.00
350.00
350.00
$126,558.84
.' ..
:1511 EX ~ (1"97)(1)
COMMONWEA1.TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21-04-749
ESTATE OF
E. ANN EBERLY
Debts of dececlent must be reported on Schedule I.
ITEM
NUMBER
A.
1.
2.
3.
4.
B.
1.
2.
3.
4.
DESCRIPTION
AMOUNT
FUNERAL EXPENSES:
PARTHEMORE FUNERAL HOME
6,073.62
ROLLING GREEN - ENGRAVING
221.00
WEST SHORE COUNTRY CLUB
759.51
BETSY E. DUNN - REIMBURSEMENTS - COST OF AIRLINE
TICKETS FOR DAUGHTER OF DECEASED
1,834.63
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
NameofPersonaJRepresentative(s) MARONETTA F. MILLER
Sodal Security Number(s) I EIN Number" Personal Representative(s) 193 - 42 - 9811
Street Address 24 VICTORIA WAY
City CAMP HILL Stale PA Zip 17011
Year(s) Commission Paid: 2 004 - 2 0 0 5
A1tomeyFees - SAUL EWING LLP
29,127.75
29,127.75
Family Exemption: (If decedenfs address is not 1I1e same as claimant's. attach explanation)
Claimant
Street Address
City
Relationship" Claimant to Decedent
Stale
Zip
ProbateFees - REGISTER OF WILLS
538.50
5. Accountanrs Fees
6. Tax Return Preparer's Fees
7.
8 .
9.
10.
11.
12.
13.
14.
15.
STFPA42021F.12
CUMBERLAND LAW JOURNAL - ADVERTISE GRANT OF LETTERS
SENTINEL - ADVERTISE GRANT OF LETTERS
NET EXPENSES FROM SALE OF REAL ESTATE
REGISTER OF WILLS
M&T - INVENTORY SAFE DEPOSIT BOX
MODULAR SYSTEMS - MOVING EXPENSES
PPL
PA WATER
PA WATER
75.00
122.63
1,817.67
6.00
40.00
5,300.00
26.37
16.16
5.39
TOTAL (Also enter on fine 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
75,091. 98
COMMONWEALTH OF PENNSY\.VANlA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF
E. ANN EBERLY
FILE NUMBER
21-04-749
Include unreimbursed medical expenses.
ITEM
NUMBER
1.
2.
3.
4.
5.
6.
7.
8 .
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
DESCRIPTION
VISA
PPL
PA WATER
TRUGREEN CHEMLAWN
LOWER ALLEN TOWNSHIP - SEWER & TRASH
SARAH WILLIAMS - AIDE
SARAH WILLIAMS - REIMBURSEMENT
MCI
SAUL EWING LLP - COSTS ADVANCED
NAPOLI LANDSCAPING
EBERLY MILLS CHURCH
VICTOR COHEN, DMD
SAUL EWING LLP
SAUL EWING LLP
M&T - OUTSTANDING CHECKS AS OF DATE OF DEATH
SAUL EWING LLP
NAPOLI LANDSCAPING
Mcr
AMOUNT
678.42
63.03
27.09
90.71
73.55
1,555.00
234.83
70.86
140.56
381. 60
7.34
7.95
1,469.00
2,076.04
1,231.27
3,797.50
360.40
33.68
STFPA42021F.13
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
12,298.83
Betsy E. Dunn IRAs
Betsy E. Dunn - Cash and Securities
(includes a portion of growth)
Betsy E. Dunn - Securities
(includes a portion of growth)
Eberly Trust
TOTAL
112108.12/8/05
PRIOR DISTRIBUTION
$175,340.18
367,743.94
105,510.00
150,000.00
$798,594.12
PROPOSED SCHEDULE OF DISTRIBUTION TO BENEFICIARIES
Betsy E. Dunn
Total to be Distributed
$52,000.00
$52,000.00
112108.1 2/8/05
INCOME RECEIPTS
Smith Barney
$6,149.15
11210812/8/05
COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
ORPHANS' COURTDNISION
COMMONWEALTH OF PENNSYLVANIA
ESTATE OF E. ANN EBERLY
LATE OF THE TOWNSHIP OF LOWER ALLEN
CUMBERLAND COUNTY, PENNSYLVANIA
PROPOSED SCHEDULE OF DISTRIBUTION
It is recommended that the pre-distribution of $798,594.12 and proposed distribution in
proceeds from sale of real estate, annuities and cash as follows totaling $ be approved as follows:
Betsy E. Dunn
$52,000.00
TOTAL
$52,000.00
112108.1218105
STATE OF MISSISSIPPI
COUNTY OF JaL.~so Y1
SS
Betsy E. Dunn, Executrix of the Estate of E. Ann Eberly, deceased, being duly sworn
according to law, deposes and says that the foregoing account is true and correct to the best of her
knowledge, information and belief, and that no persons claiming to be interested in said Estate as
creditors, legatee, next of kin or otherwise, have given notice of their claim to the deponent, in
writing or to Donn L. Snyder, her attorney, in writing.
~ f! ,JeU4/flJ
BETSY E. D
Sworn to and subscribed
before me this &.
day of "^ We h , 2005.
MISSISSIPPI STATEWIDE NOTARY PUBLIC
MY COMMISSION EXPIRES JAN. 11,.. ,009
BONDED THRU STEGALL NOTARY SeRVICE
112108.1 2/8/05
ESTATE SETTLEMENT AGREEMENT
This Agreement made this 2nd day of March, 2005, by and between Betsy E. Dunn,
Executrix of the Estate of E. Ann Eberly, and Betsy E. Dunn and Ann Eberly Family Trust, sole
beneficiaries of said Estate.
In accordance with the desire that the settlement and distribution of the Estate of E. Ann
Eberly be resolved as expeditiously as possible and without the delay of a formal Court accounting,
the undersigned, in consideration of the mutual covenants herein expressed, and of the sums
received, and intending to be legally bound hereby, agree that:
1. The said E. Ann Eberly died July 25,2004 testate.
2. The undersigned hereby agrees that the entire estate be distributed as set forth in the
Schedule of Distribution attached as Exhibit "A" and hereof made a part. Without intending to
limit the rights of remedies of the personal representative, the undersigned further agrees to
indemnify the personal representative and save her harmless against all liability, loss and expense
(including, but not limited to, costs and counsel fee) which the personal representative may incur,
whether due to the personal representative's negligence or otherwise, as a result of making the
above distributions without formal court audit or other formal estate administration.
3. The undersigned hereby forever fully release, compromise, settles and discharges
any and all claims, demands, actions or causes of action, legal or equitable, absolute or contingent,
vested or hereafter to accrue, which they may have against any other party hereto or against the
Estate of E. Ann Eberly, deceased or the personal representative thereof, by reason of any matte~,
cause or thing growing out of or relating to any property or assets of the said Estate of E. Ann
Eberly, or growing out of or relating to any act of the personal representative in her individual
handling of said Estate, even if attributable to negligence, and agrees that any period for the
\ \2\08. \ 2/8/05
f'
limitation of actions for the collection or any erroneous distribution or distributions shall commence
only at such time as the personal representative shall have obtained actual knowledge of such
erroneous distribution and that in no event shall the period of collection of any erroneous
distribution be less than two years after the actual discovery thereof by the personal representatives.
4. Copies of the prior Releases are attached hereto and made part of this Agreement.
5. The undersigned agrees to execute such additional releases as the personal
representative may submit in order to confirm his discharge from any further liability to the parties
in connection with said Estate.
6. This Agreement, shall be binding upon the undersigned, their heirs, next of kin,
personal representative, successors and assigns.
7. This Agreement may be signed in counter parts.
IN WITNESS WHEREOF the undersigned has hereunto set her hand and seal the day and
year first above written.
BETSY . D
Individually and s Executrix of the
Estate ofE. Ann berly
Sworn to and sub61bed
before me this
day of tv\Cl~ ulr\ ,2005.
~~
MISSISSIPPI STATEWIDE NOTARY PUBLIC
MY COMMISSION EXPiRES JAN. 11, '!:l;C:g
BONDED THRU STEGALL NOTARY SERViCE
112108.12/8/05
" t..
IN WITNESS WHEREOF the undersigned has hereunto set his hand and seal the day and
year first above written.
Sworn to and subscribed
before me this ~
day of ~O,.( CN\ ,2005.
~
Not IC'
~~~5~~f~~~~~~~!~ ~~~~E
BONDED THRU STEUI\I-L-
112108.1 2/8/05
. .
i'
IN WITNESS WHEREOF the undersigned has hereunto set his hand and seal the day and
year first above written. ~ ~ P
DODD L. Snyder, co:ob Trust
Sworn to and subscribed
before me this Ol,,^"
da1l1l!fJ005
Notary Public
Not~jridl Seal
Lori A. B Zerbe. Notary Public
City Of Harrd-d..if(j. Dauphin County
My~~rl~TljssiOn Expires .Jan 7, 2006
lembu, Pdll~s,/iva;1ia Association 01 Notaries
11210812/8/05
. .
COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
ORPHANS' COURT DIVISION
COMMONWEALTH OF PENNSYLVANIA
ESTATE OF E. ANN EBERLY
LATE OF THE TOWNSHIP OF LOWER ALLEN
CUMBERLAND COUNTY, PENNSYLVANIA
PROPOSED SCHEDULE OF DISTRIBUTION
It is recommended that the pre-distribution of $798,594.12 and proposed distribution in
proceeds from sale of real estate, annuities and cash as follows totaling $52,000.00 be approved as
follows:
Betsy E. Dunn
$52,000.00
TOTAL
$52,000.00
112108.12/8/05
IN RE: THE ESTATE OF
IN THE COURT OF COMMON PLEAS
E. ANN EBERLY, DECEASED
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
FILE NO. 22-04-0749
SATISFACTION AND AWARD
The undersigned, hereby acknowledge that Betsy E. Dunn, Executrix of the Estate of E.
Ann Eberly, deceased, has distributed to the undersigned cash in the amount of Eight Hundred Fifty
Thousand Five Hundred Ninety Four and 12/1 00 Dollars ($850,594.12) as full payment of all sums
due pursuant to the Estate ofE. Ann Eberly, directs and authorizes the Clerk ofthe Orphan's Court
Division to mark satisfied of record the award which may be made in his individual favor.
f) IN WITNESS WHEREOF, the undersigned has caused these presents to be executed this
i2L-dayof ~OYcYl ,2005.
Witness:
BETSY E. DUNN
~~av~
~ 2 I (J1.{MNU
No. 164-56-8424
112108.12/8/05
IN RE: THE ESTATE OF
IN THE COURT OF COMMON PLEAS
E. ANN EBERLY, DECEASED
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
FILE NO. 22-04-0749
SATISFACTION AND AWARD
The undersigned, hereby acknowledge that Betsy E. Dunn, Executrix of the Estate of E.
Ann Eberly, deceased, has distributed to the undersigned cash in the amount of One Hundred Fifty
Thousand Dollars ($150,000) as full payment of all sums due pursuant to the Estate of E. Ann
Eberly, directs and authorizes the Clerk of the Orphan's Court Division to mark satisfied of record
the award which may be made in his individual favor.
~ f) IN WITNESS WHEREOF; the undersigned has caused these presents to be executed this
~dayof_MQYcJr\ ,2005.
Witness:
EBERLY TRUST
~aA;~
~i-~
J#
EIN &4_ -/ ~1'3~
112108.1 2/8/05
j" co.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'*
BUREAU OF INDIVIDUAL..T~*E$
INHERITANCE TAX DIVISION
PO BOX Z80601
HARRISBURG PA 171Z8-0601
REV-16D7 EX iFP 112-D~1
F)
\)
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
02-28-2005
EBERLY
07-25-2004
21 04-0749
CUMBERLAND
101
E
A
DONN L SNYDER
SAUL EWING
PO BOX 1291
HBG
ESQ
Allount Rellitted
PA 17108
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, subllit the upper portion of this forll with your tax paYllent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
~~:r~~~.!5r.i~~..r81~.~J'........;..:rA~!~e1r~l5r.~'~~A~.b".Atl:60~...j(......................
ESTATE OF EBERLY E A FILE NO. 21 04-0749 ACN 101 DATE 02-28-2005
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF 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: 01-18-2005
PRINCIPAL TAX DUE:.
111111111111__......lllnH"UIIIIHIIIIIIIIIIIIIIII....IIIIIII..
39,759.03
PAYMENTS (TAX CREDITS):
~
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
09-22-2004 CD004411 1.578.95 30,000.00
11-23-2004 CD004659 .00 8,259.03
02-14-2005 REFUND .00 78.95-
TOTAL TAX CREDIT 39,759.03
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
.
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )