HomeMy WebLinkAbout06-13-11t -•
~ ~ 1505610148
REV-1500 Ex (°'-'°~
PA Department of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
Po Box 2eosol INHERITANCE TAX RETURN 21 1 ], 0 515
Harrisburg, PA 17128-06°1 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYW
524-16-31,96 04222011 03221918
Decedent's Last Name Suffix Decedent's First Name M I
JACKSON DAISY g
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name M I
Spouse's Social Security Number
FILL IN APPROPRIATE BOXES BELOW
1. Original Return
^ 4
. Limited Estate
6. Decedent Died Testate
(Attach Copy of Will)
^
9. Litigation Proceeds Received
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
^ 2. Supplemental Return
^ 4a. Future Interest Compromise (date of
death after 12-12-82)
^ 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
^ 10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
VICKY ANN TRIMMER 717-620-2440
First line of address
PERSUN 8~ HEIM, PC
Second line of address
PO BOX 659
City or Post Office
MECHANICSBURG
State ZIP Code
PA 1,70550659
^ 3. Remainder Return (date of death
prior to 12-13-82)
^ 5. Federal Estate Tax Return Required
0 8. Total Number of Safe Deposit Boxes
^ 11. Election to tax under Sec. 9113(A)
(Attach Sch. O)
REGISTER OF ~{I~LS USE ONL
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Correspondent'se-mail address: VATRIMMERaPERSUNHEIM • COM
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the personal representative is based ~~ au ~.,f~n„~+~~., .,f,.,i,c..t, .,.e...,.,.. ~..... __.. ~___._,_,_
ADDRESS
DENNI
SIGNATiUF
DATE
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0. JACKS N 82 FAIRWAY DRIVE, CAMP HILL PA 1701
OF REP ER TER THAN REPRESENTATIVE ~^ DATE
VICKY ANN TRIMMER PO BOX 659, MECHANICSBURG, PA 1,7055
PLEASE USE ORIGINAL FORM ONLY
L, 1505610148
Side 1
9M4647 4.000
1505610148
t
K
REV-1500 EX
150561D24B
Decedent's Social Security Number
524-16-31,96
Decedent's Name: D A C Y
RECAPITULATION 9
1. Real Estate (Schedule A)
1 D • D D
2. Stocks and Bonds (Schedule B) . 2 D • D D
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)
, 3 D • D D
4. Mortgages and Notes Receivable (Schedule D)
4
0.00
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) 5. 8 , 3 7 9 • D 0
6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested g D • D D
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ~ Separate Billing Requested 7. 17 ~ 8 4 9 • D D
8. Total Gross Assets (total Lines 1 through 7) 8 18 2 , 2 2 ~ . f1 ~
9. Funeral Expenses and Administrative Costs (Schedule H), .9
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I)
10.
11. Total Deductions (total Lines 9 and 10) , 11,
12. Net Value of Estate (Line 8 minus Line 11) 12
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) , . 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) , 14
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers un~er Sec. 9116
16. Amount of Line 14 t xable
0 4~
at lineal rate x
.
1, 7 9 ,15 4. 0 0 1 s
17.
Amount of Line 14 taxable .
at sibling rate X .12 D • D D
18.
Amount of Line 14 taxable 17.
at collateral rate X .15 D • D D 18.
19. TAX DUE
19.
20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
150567,0248
9M4648 4.000
1505610248
2,996.00
78.00
0, 074 • 00
179,154.00
0.00
1,79,1,54 •00
o.Do
8, 062.00
0.00
0.00
8,D62.00
a
J
t
i3~V-1500 EX Page 3
3. Interest
File Number
Total Credits (A + B) (2)
8, 062.00
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in box on Page 2, Line 20 to request a refund.
(3> 0 •0 0
(4 )
0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) ~ • ~ 0
Make check payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ® ^
b. retain the right 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 after Dec. 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 security at his or her death? ^
4. Did decedent own an individual retirement account, annuity, or other non-probate property, which
contains a beneficiary designation? ^
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after Juty 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is
3 percent [72 P.S, §9116 (a) (1.1) (i)J.
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S. §91 16 (a) (1.1) (ii)J. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an
adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)J.
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in
72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)J.
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)J. 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.
9M4671 2.000
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) (1) 8 , 0 6 2.0 0
2. Credits/Payments
A. Prior Payments 7 , 6 5 9.0 0
B. Discount 4 ~ ~ • ~ ~
t ~
REV-1508 EX+ (11-10)
pennsylvania SCHEDULE E
DEPARTMENTOF REVENUE CASH, BANK DEPOSITS, & MISC.
INHERITANCE TAX RETURN
RESIDENT DECEDENT PERSONAL PROPERTY
ESTATE OF:
FILE NUMBER:
Daisy B. Jackson 21 11 0515
Include the proceeds of litigation and the date the proceeds warp .P~p~~a~ h„ stio ems,,«e
u~~vo~~ c.uuu it more space is needed, use additional sheets of paper of the same size.
~ ~
REV-1510 EX + (08-09)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS AND
MISC. NON-PROBATE PROPERTY
:STATE OF --
FILE NUMBER
Daisy B. Jackson 21 110515
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
DESCRIPTION OF PROPERTY
ITEM ~NCU,OETFEt~4MAEOFTFETRANSFEREE,THEIRRELATIONSMPTODECEDENTAND DATE OF DEATH %OFDECD'S EXCLUSION TAXABLE
UMBE T-EDATEOFTRANSFER.ATTAGiAC.OPYOFTFEDEEDFORREALESTATE. VALUE OF ASSET INTEREST IF APPLICABLE VALUE
~~ Jackson Family Irrevocable
Trust dated 10/1/2002 173,849 100.0000 0 173,849
Decedent retained an income
interest while not in a long
term care facility. No right
existed to access principal for
any reason.
9W46AF 2.000
TOTAL (Also enter on line 7, Recapitulation) $
173,84
If more space is needed, use additional sheets of paper of the same size.
RltV-1511 EXa ~10-09)
Pennsylvania
' DEPARTMENTOFREVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
c~ i n i c ~r FILE NUMBER
Daisy B. Jackson 21 11 0515
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
~. Memorial Service 333
2 Funeral Lunch 200
Total from continuation schedules 250
B.
1
ADMINISTRATIVE COSTS:
Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
City
Year(s) Commission Paid:
State ZIP
2. Attorney Fees: 2 , 0 0 0
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees:
90
5. Accountant Fees:
6. Tax Return Preparer Fees:
7.
1 Legal Notices 123
TOTAL (Also enter on Line 9 Recapitulation) I $ 2 996
swasA~ 2.00o If more space Is needed, use addltlonal sheets of paper of the same size. ~
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Estate of: Daisy B. Jackson
Schedule H Part 1 (Page 2)
I tem
No. Description
3 Transportain of remains for burial
21 11 0515
Amount
250
Total (Carry forward to main schedule) 250
REV-1512 EX + (12.08)
' pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES 8~ LIENS
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
Daisy B. Jackson 21 11 0515
Report debts incurred by the decedent prior to death that remained unpaid at the date of death. including linrQirnh~~-¢nrl mnrlin~l e.,..,..,~,...
uW46AFi 1.000 Ir more space is needed, insert additional sheets of the same size.
R~V-1513 EX+ (01-10)
' pennsylvania SCHEDULE J
DEPARTMENrOF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF:
FILE NUMBER:
Dais B. Jackson 21 11 0515
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
~ TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).)
1. Dennis O. Jackson
50~ of Residue: 89,577 Son 89,577
2 Deanna G. Haskell
0~ of Residue: 89,577 Daughter 89 577
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE.
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REGISTER OF WILLS
CUMBERLAND COUNTY
PENNSYLVANIA
CERTIFICATE OF
GRANT OF LETTERS
No. 207 ~- 0055 PA No. 2~- ~ ~- 0575
Estate Of : DAISY B JACKSON
(First, Middle, Lastl
Late Of : EAST PENNSBORO TOWNSHIP
CUMBERLAND COUNTY
Deceased
Social Security No: 524-76-3796
WHEREAS, on the 2 7th day of April 2 011 an instrument dated
June 21st 2002 was admitted to probate as the last will of
DAISY B JACKSON
(First, Middle, Last1
late of EAST PENNSBORO TOWNSH/P, CUMBERLAND County,
who died on the 22nd day of Apri 1 2 011 and,
WHEREAS, a true copy of the wi I1 as probated i s annexed hereto .
THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wi 11 s in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters TESTAMENTARY to:
DENNIS O JA CKSON
who has duly qualified as EXECUTOR(R/X)
and has agreed to administer the estate according to law, all of which
fully appears of record in my office at CUMBERLAND COUNTY COURT HDUSE,
CARLISLE, PENNSYL VANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 27th day of April 20 ~ 1.
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LAST WILL AND TESTAMENT 1 ~ ~ ~
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DAISY B. JACKSON _
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I, DAISY B. JACKSON, now of 118 Wesley Drive, Mechanicsburg, Cumberland
County, Pennsylvania, 17055, do publish and declare this to be my Last Will and Testament,
hereby revoking all other prior wills and codicils made by me.
FIRST: Family Background and Appointment of Executor.
(A) Family and Background Information. I am married to OLIVER L. JACKSON.
I have not been previously married. The children of our marriage are DENNIS O. JACKSON
and DEANNA G. HASKELL . Throughout this Will, OLIVER L. JACKSON will be referred
to as "my spouse" or "my husband," and DENNIS O. JACKSON and DEANNA G.
HASKELLwill be referred to as "my children." The word "issue" will include my children as
well as my other descendants.
(B) .A~pointment of Executor. I appoint as my Executor and successor Executrix
(all hereinafter referred to as Executor) under this Will, the following named persons to serve
without bond and without being required to account to any Court:
Executor: My son, DENNIS O. JACKSON.
Successor Executrix: My daughter, DEANNA G. HASKELL.
SECOND: Funeral and Last Illness Expenses; Taxes.
(A) Expenses of Funeral and Last Illness. Notwithstanding that my husband,
OLIVER L. JACKSON, survives me, I direct my Executor to pay my funeral expenses and the
expenses of my last illness from my estate.
(B) Taxes. I direct my Executor to pay any and all estate, inheritance, succession,
legacy, transfer and other death taxes or duties, by whatever name called, including any and all
interest and penalties thereon, imposed under the laws of any jurisdiction by reason of my death
upon or with respect to any and all property included in my gross estate for the purpose of such
taxes, whether such property passes under or outside of this Will. Without any apportionment
..
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LAST WILL AND TESTAMENT
OF
DAISY B. JACKSON
PAGE 2
otherwise required by law and without being prorated or apportioned among or charged against
the respective devises, legatees, beneficiaries, transferees, or other recipients of any such property
or charged against any property passing or which may have passed to any of them, I direct that
any taxes so paid shall be charged against my residuary estate. My Executor shall not be entitled
to reimbursement for any portion of any such taxes from any such person.
THIRD: Tangible Personal Property. Except for those items excluded below and
those items enumerated in the Letter of Instruction, I bequeath all my tangible personal property,
including but not limited to clothing, jewelry, heirlooms, furniture, household furnishings,
personal effects, motor vehicles, and all other similar articles, which I own, and the insurance
thereon, to my children, DENNIS O. JACKSON and DEANNA G. HASKELL, to be divided
among them as they shall select in as nearly equal shares as is practical. Tangible personal
property shall not include: (1) any and all property used by me in any business, (2) cash on hand
or on deposit in banks, (3) stock or securities, (4) any type of evidence of indebtedness, and (5)
any life, health or accident insurance policies.
If there is any disagreement as to distribution, I direct my Executor to make such
distribution. The decision of my Executor shall be final and binding. Any items not selected or
any items which my Executor considers unsuitable for my children may be distributed or sold in
the sole discretion of my Executor and, if sold, the net proceeds therefrom shall be added to the
residue of my estate. Any such article allocated to a minor may, as my Executor deems advisable,
either be delivered to the minor or to any person to safeguard on behalf of the minor,.
Notwithstanding any other provisions in this Article THIRD, I may leave a separate, dated
and unsigned Letter of Instruction, which I shall place with my Will, containing directions as to
the ultimate disposition of certain of the property bequeathed under this Article THIRD, and such
Letter of Instruction shall determine the distribution of such items.
FOURTH: Specific Bequests. I hereby leave all of my diamond rings to my daughter,
DEANNA G. HASKELL, and an sum of money equal to the appraised value of my diamond
rings to my son, DENNIS O. JACKSON.
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LAST WILL AND TESTAMENT
OF
DAISY B. JACKSON
PAGE 3
FIFTH: Residuary Estate. I devise and bequeath all of the rest, residue and remainder
of my estate, real, personal and mixed, of whatever nature and wherever situated to which I am
legally or equitably entitled, to my children, DENNIS O. JACKSON and DEANNA G.
HASKELL, to be divided among them as they shall select in as nearly equal shares as is practical,
per stirpes. If and in the event that any of my children predecease me without leaving surviving
issue, then I leave the rest, residue and remainder of my estate to the survivor of my children, in
equal shares, per stipes.
By this Will, I have made the decision to exclude my husband, OLIVER L. JACKSON,
from a share in my estate.
SIXTH: Powers of Executor. In addition to the powers and duties as may have been
granted elsewhere in this Will, but subject to any limitations stated elsewhere in this Will, the
Executor shall have and exercise exclusive management and control of the Estate and shall be
vested with the following specific powers and discretion, in addition to the powers as may be
generally conferred from time to time upon the Executor by law:
(A) In the management, care and disposition of the Estate, the Executor shall have the
power to do all things and to execute such instruments, deeds, or other documents as may be
deemed necessary or proper, including the following powers, all of which may be exercised
without order of or report to any Court:
(1) To sell, exchange or otherwise dispose of any property at any time held or
acquired hereunder, at public or private sale, for cash or on terms, without advertisement,
including the right to lease for any term notwithstanding the period of the Estate, and to
grant options, including any option for a period beyond the duration of the Estate.
(2) To invest all monies in such stocks, bonds, securities, mortgages, notes,
choses in action, real estate or improvements thereon, and any other property as the
Executor may deem best, without regard to any law now or hereafter enforced limiting
investments of fiduciaries.
(3) To retain for investment any property deposited with the Executor hereunder.
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LAST WILL AND TESTAMENT
OF
DAISY B. JACKSON
PAGE 4
(4) To vote in person or by proxy any corporate stock or other security and to
agree to or take any other action in regard to any reorganization, merger, consolidation,
liquidation, bankruptcy or other procedure or proceedings affecting any stock, bond, note
or other security.
(5) To use attorneys, real estate brokers, accountants and other agents, if such
employment is deemed necessary or desirable, and to pay reasonable compensation for
their services.
(6) To compromise, settle or adjust any claim or demand by or against the Estate
and to agree to any rescission or modification of any contract or agreement affecting the
Estate.
(7) To renew any indebtedness, as well as to borrow money, and to secure the
same by mortgaging, pledging or conveying any property of the Estate.
(8) To retain and carry on any business in which the Estate may acquire an
interest, to acquire additional interest in any such business, to agree to the liquidation in
kind of any corporation in which the Estate may have an interest and to carry on the
business thereof, to join with other owners in adopting any form of management for any
business or property in which the Estate may have an interest, to become or remain a
partner, general or limited, in regard to any such business or property and to hold the
stock or other securities as an investment, and to employ agents and confer on them
authority to manage and operate the business, property or corporation, without liability for
the acts of such agent or for any loss, liability or indebtedness of such business if the
management is selected or retained with reasonable care.
(9) To register any stock, bond or other security in the name of a nominee,
without the addition of words indicating that such security is held in a fiduciary capacity,
but accurate records shall be maintained showing that such security is a Estate asset and
the Executor shall be responsible for the acts of such nominee.
(B) Whenever the Executor is directed to distribute any Estate assets in fee simple to a
G~~ .~
LAST WILL AND TESTAMENT
OF
DAISY B. JACKSON
PAGE 5
person who is then under twenty-one (21) years of age, the Executor shall be authorized to hold
such property in Trust for such person until he/she becomes twenty-one (21) years of age, and in
the meantime shall use such part of the income and the principal of the Estate as the Executor may
deem necessary to provide for the proper support and education of such person. If such person
should die before becoming twenty-one (21) years of age, the property then remaining in trust
shall be distributed to the personal representative of such person's estate.
(C) In malting distributions from the Estate to or for the benefit of any minor or other
person under a legal disability, the Executor need not require the appointment of a guardian, but
shall be authorized to pay or deliver the same to the custodian of such person, to pay or deliver
the same to such person without the intervention of a guardian, to pay or deliver the same to a
legal guardian of such person if one has already been appointed, or to use the same for the benefit
of such person.
(D) In the disbursement of the Estate and any division into separate trusts or shares,
the Executor shall be authorized to make the distribution and division in money or in kind, or
both, regardless of the basis for income tax purposes of any property distributed or divided in
kind, and the distribution and division made and the values established by the Executor shall be
binding and conclusive on all persons taking hereunder. The Executor may in making such
distribution or division allot undivided interests in the same property to several trusts or shares.
(E) The Executor shall be authorized to lend or borrow, including the right to lend to
or borrow from any trusts which I or my husband may have established during life or by will at an
adequate rate of interest and with adequate security, and upon such terms and conditions as the
Executor shall deem fair and equitable.
(F) The Executor shall be authorized to sell or purchase at the fair market value as
determined by the Executor, any property to or from any trust created by me or my husband
during life or by Will, even though the same person or corporation may be acting as Executor of
my estate or as Trustee of any of my other trusts.
(G)
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The Executor shall have discretion to determine whether items should be charged
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LAST WILL AND TESTAMENT
OF
DAISY B. JACKSON
PAGE 6
or credited to income or principal or allocated between income and principal as the Executor may
deem equitable and fair under all the circumstances, including the power to amortize or fail to
amortize any part or all of any premium or discount, to treat any part or all of the profit resulting
from the maturity or sale of any asset, whether purchased at a premium or at a discount, as
income or principal or apportion the same between income and principal, to apportion the sales
price of any asset between income and principal, to treat any dividend or other distribution of any
investment as income or principal, or apportion the same between income and principal, to charge
any expense against income or principal or apportion the same, and to provide or fail to provide a
reasonable reserve against depreciation or obsolescence on any assets subject to depreciation or
obsolescence, all as the Executor may reasonably deem equitable and just under all the
circumstances. If the Executor does not exercise the above discretionary power, the cash or
accrual allocation shall be in accordance with Chapter 81 of Title 20 of the Pennsylvania
Consolidated Statutes, or the corresponding provisions of subsequent state law.
(H) If at any time the total fair market value of the assets of any trust established or to
be established hereunder is so small that the corporate Trustee's annual fee for administering the
trust would be the minimum annual fee set forth in the Trustee's regularly published fee schedule
then, in effect, the Trustee in its discretion shall be authorized to terminate such trust or to decide
not to establish such trust, and in such event the property then held in or to be distributed to such
trust shall be distributed to the persons who are then or would be entitled to the income of such
trust. If the amount of income to be received by such persons is to be determined in the discretion
of the Trustee, then the Trustee shall distribute the property among such of the persons to whom
the Trustee is authorized to distribute income, and in such proportions, as the Trustee in its
discretion shall determine.
(I) Except as otherwise provided in this Will, when the authority and power under this
Will is vested in two (2) or more Executors or Trustees, the authority and powers are to be held
jointly by the Executors or Trustees, respectively. A majority of the Executors or Trustees may
exercise any authority or power granted under this Will or granted by law, and may act under this
Will. Any attempt by one such Executor or Trustee to act under this Will on other than
ministerial acts shall be void. The action of one such Executor or Trustee under this Will may be
validated by a subsequent ratification of the act by a majority of the Executors or Trustees.
LAST WILL AND TESTAMENT
OF
DAISY B. JACKSON
PAGE 7
SEVENTH: Rights and Liabilities of Executor.
(A) No bond or other security shall be required of any Executor.
(B) This instrument always shall be construed in favor of the validity of any act or
omission by any Executor, and any Executor shall not be liable for any act or omission except in
the case of gross negligence, bad faith or fraud. Specifically, in assessing the propriety of any
investment, the overall performance of the entire Estate shall be taken into account.
(C) Each Executor shall be entitled to receive reasonable compensation for services
actually rendered to my estate, in an amount the Executor normally and customarily charges for
performing similar services during the time which he/she performs the services.
EIGHTH: Spendthrift Provision. No beneficiary shall have the power to anticipate,
encumber or transfer his or her interest in the estate in any manner other than by the valid exercise
of a power of appointment. No part of the estate shall be liable for or charged with any debts,
contracts, liabilities or torts of a beneficiary or subject to seizure or other process by any creditor
of a beneficiary.
NINTH: Tax Elections.
(A) In determining the estate, inheritance and income tax liability relating to my Estate,
the Executor's decision as to all available tax elections shall be conclusive on all concerned. If the
Executor joins with my husband in filing income tax returns, or consenting for gift tax purposes to
having gifts made by either of us during my life considered as having been made one-half by each
of us, any resulting liability shall be borne by my Estate and my husband in such proportions as
they may agree. In accordance with IRC Section 2632(a) and without regard to whether a
Federal estate tax return is actually filed, my Executor shall allocate so much of the Federal
Generation Skipping Transfer (GST) exemption amount as will fully exempt any generation
skipping transfer which may occur under this Will.
(B) The Executor may, in its discretion, determine the date as of which my gross estate
shall be valued for the purpose of determining the applicable tax payable by reason of my death.
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(C) The Executor may, in its discretion, decide whether all or any part of certain
deductions shall be taken as income tax deductions (even though they may equal or exceed the
taxable income of my estate and whether or not claimed or of benefit on my estate's income tax
return) or as estate tax deductions when a choice is available; and in the event that all or any part
of such deductions are taken as income tax deductions, no adjustment of income and principal
accounts in my estate shall be made as a result of such decisions.
TENTH: Definitions and General Provisions.
Survival. Any beneficiary who dies within sixty (60) days after my death shall be
considered not to have survived me.
Captions. The captions set forth in this Will at the beginning of the various
articles hereof are for convenience of reference only and shall not be deemed to define or limit the
provisions hereof or to affect in any way their construction and application.
(C) Children. As used in this Will, the words "child" and "children" shall include
persons who are legally adopted and the issue of said persons, whether born in or out of wedlock,
so long as any person born out of wedlock is acknowledged in a written instrument executed by
the one of their natural parents who is a descendant of mine to be the child of said descendant.
The word "issue" shall include descendants of all generations including adopted persons. A
posthumous child shall be considered as living at the death of his parent. The birth to me or the
adoption by me of a child or children subsequent to the execution of this Will. shall not operate to
revoke this Will. Except for discretionary distributions which may be made unequally among a
group of persons and distributions pursuant to a valid exercise of a power of appointment, in
making a distribution to the children of any person, the property to be distributed shall be divided
into as many shares as there are living children of the person and deceased children of the person
who left children who are then living. Each living child shall take one share and the share of each
deceased child shall be divided among his then-living descendants in the same manner.
(D) Code. Unless otherwise stated, all references in my Will to section and chapter
numbers are to those of the Internal Revenue Code of 1986, as amended, or the corresponding
provisions of any subsequent federal tax laws applicable to my estate.
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LAST WILL AND TESTAMENT
OF
DAISY B. JACKSON
PAGE 9
(E) Other terms. The use of any gender includes the other genders, and the use of
either the singular or the plural includes the other.
(F) Powers of Appointment are Exercised. By this Will I exercise any and all
Powers of Appointment which I possess at the time of my death.
IN WITNESS WHEREOF, I, DAISY B. JACKSON, the Testatrix, have to this my
Last Will and Testament, typewritten on ten (10) pages, including the Acknowledgment and
Affidavit, set my hand and seal thi~~~day of June, 2002.
DAISY B ACKSO
Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will and
Testament, in the presence of us, who have hereunto subscribed our names at her request, as
witnesses hereto, in the presence of the said Testatrix, and in the presence of each other. Each of
us further declares that he or she believes the Testatrix to be of sound mind and memory. The
preceding instrument consists of this and nine (9) other consecutively numbered typewritten pages
including the Acknowledgment and Affidavit.
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ACKNOWLEDGMENT AND AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
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COUNTY OF CUMBERLAND
The Testatrix and the witnesses whose names are signed and subscribed to the attached or
foregoing instrument, being first duly sworn and qualified according to law, do hereby
acknowledge, depose and say to the undersigned authority, that the Testatrix signed and executed
the instrument as her Last Will in the presence of the witnesses; that she signed it willingly or
willingly directed another to sign it for her; that she executed it as her free and voluntary act for
the purposes therein expressed; that each of the witnesses were present and saw the Testatrix sign
and execute the instrument as her Last Will; that each subscribing witness in the hearing and sight
of the Testatrix signed the will as witnesses; and that to the best of their knowledge the Testatrix
was at that time eighteen years of age or older, of sound mind and under no constraint or undue
influence.
Testatri
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Sworn to or affirmed, subscribed to, and acknowledged, before me by the above-named
Testatrix and witnesses, this ~~'-day of June, 2002.
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THE
JACKSON FAMILY
IRREVOCABLE TRUST
THIS TRUST AGREEMENT is executed in triplicate on this ~a of October 2002
by and between DAISY B. JACKSON, now of 118 Wesley Drive, Mechanicsbui• ,Cumberland
County, Pennsylvania 17055 (hereinafter called "Settlor") and DAISY B. JACKSON, now of 118
Wesley Drive, Mechanicsburg, Cumberland County, Pennsylvania 17055, DENNIS O. JACKSON,
now of 747 Country Club Road, Camp Hill, Cumberland County, Pennsylvania 17011, and
DEANNA G. HASKELL, now of 43984 Clary Court, Ashburn, Virginia 20147 (hereinafter called
Trustees or Co-Trustees ).
ARTICLE I. TRUST ESTATE
1.01. Initial Principal. Settlor, desiring to establish an irrevocable trust, does hereby
in•evocably transfer, assign and deliver to the Trustees and their successors, and assigns the assets
listed on Schedule A, attached hereto and made a part hereof. As further evidence of such
assignment, the Settlor has executed or will execute oi• cause to be executed such other instruments
as may be required for the purposes of completing the assignment or transfer of title to such property
to the Trustees. The Trustees accept such transfer and assignment to themselves as Trustees, and
undertake to hold, manage, invest and reinvest the assets of this Trust, and to distribute the income
and principal of the Trust in accordance with the provisions of this Agreement.
1.02. Additional Principal. The Settlor and any other person or persons, with the consent
of the Trustees, shall have the right at any time to make additions to the corpus of this Trust or any
share thereof hereby established. All such additions shall be held, governed, and distributed b the
Trustees in accordance with the terms and conditions of this Agreement. The Trustee, in its sole
discretion, may 1•equu•e, as a prere9uisite to accepting property, that the transferring party provide
evidence satisfactory to the Trustee that (i) the property is not contaminated by any hazardous or
toxic materials or substances; and (ii) the property is not being used and has never been used foi• any
activities directly or indirectly involving the generation, use, treatment, storage, disposal, release or
discharge of any hazardous or toxic materials oi• substances.
1.03. Disclaimer. The Trustee shall have the right to disclaim, in whole oi• in part, prior
to its acceptance by the Trustee, any interests in property for any reason, including but not limited
to a concern that such property could cause potential liability under any federal, state, or local
environmental law.
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ARTICLE II. IRREVOCABILITY OF TRUST
2.01. Irrevocability. Settlor has been advised of the consequences of an irrevocable trust
and hereby declares that this Trust shall be irrevocable and shall not be altered, amended, revoked,
or terminated by Settlor or any other person or persons.
ARTICLE III. LIFE INSURANCE POLICIES
3.01. General Provisions. If any insurance policies ai•e transferred into this Trust, the
Trustees shall be vested with all right, title, and interest in and to the transferred policies of
insurance, and are authorized and empowered to exercise and enjoy, for the purposes of the Trust
herein created and as absolute owners of such policies of insurance, all the options, benefits, rights
and privileges under such policies, including the right to borrow upon and to pledge them fo1- a loan
or loans. The Trustees take all rights, title, and interest in and to the above-stated insurance policies
subject to any prior split-dollar life insurance agreement and assignments, which may be in effect
at the time of transfer. The insurance companies which have issued policies are hereby authorized
and directed to recognize the Trustees as absolute owners of such policies of insurance and as fully
entitled to all options, rights, privileges, and interests under such policies, and any receipts, releases,
and other instruments executed by the Trustees in connection with such policies shall be binding
upon all persons interested in this Trust. The Settlor hereby relinquishes all rights, title, interest and
powers in such policies of insurance which Settlor may own and which rights, title, interest and
powers are not assignable, and will, at the request of the Trustees, execute all other instruments
reasonably required to effectuate this relinquishment.
3.02. Payment of Premiums. The Trustees shall be under no obligation to pay the
premiums which may become due and payable under the provisions of any policy of insurance which
may be transferred or assigned to this Trust, or to make certain that such premiums are paid by the
transferor of such policy, or to notify any persons of the nonpayment of such premiums, and the
Trustees shall be under no responsibility or liability of any kind in case such premiums are not paid,
except the Trustees shall apply any dividends received on such policies to the payment of premiums
thereon. Upon notice at any time during the continuance of this Trust that the premiums due upon
such policies are in default, or that premiums which will become due will not be paid, either by the
transferor or by any other person, the Trustees, within their sole discretion, may apply any cash
values attributable to such policy to the purchase of paid-up insurance or of extended insurance, or
may borrow upon such policy for the payment of premiums due thereon, oi• may accept the cash
values of such policy upon the policy's forfeiture. In the event that the Trustees receive the cash
value of such policy upon its forfeiture for nonpayment of premiums, the amount received shall be
added to the corpus of this Trust, and shall be administered according to the terms of this Agreement.
If the insured under such policies of insurance, becomes totally and permanently disabled within the
meaning of any policies and because thereof the payment of premiums, or any of them, shall during
the pendency of such disability, be waived, the Trustees, upon receipt of such knowledge, shall
p1•omptly notify the insurance company which has issued such policies, and shall take any and all
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3.03. Duties of Trustees With Regard to Life Insurance Policies. The Trustees shall be
under no obligation or duty whatever except with respect to the safekeeping of such policies of
insurance and the duty to receive such sums as may be paid to them, in accol•dance with the
requirements of this Trust, by the companies issuing such policies, and to hold, manage and disburse
such proceeds subject to the terms of this Agreement. Upon the death of the insured, the Trustees
shall make reasonable efforts to carry out the provisions of this Agreement, including the
maintenance or defense of any suit, provided, however, the Trustees shall be under no duty to
maintain or enter into any litigation unless its expenses, including counsel fees and costs, have been
advanced oi- guaranteed in an amount and in a manner reasonably satisfactory to the Trustees. The
Trustees may repay any advances made by them or reimburse themselves fo1- any such fees and costs
from any corpus or income of this Trust.
ARTICLE IV. TRUST DISTRIBUTIONS
4.01. Trust Principal. The entire corpus of this Trust, including the assets initially
transferred to this Trust, subsequent additions to this Trust, and the proceeds of any sale, exchange
or investment of such Trust assets, shall be used for the purposes herein contained.
4.02. Income Distribution. During the Settlol•'s lifetime, the Trustees shall distribute all
of the net income of the trust to, or for the benefit of, DAISY B. JACKSON. The Trustees shall
make no distributions of principal to DAISY B. JACKSON. Upon the admission of DAISY B.
JACKSON to a long term care facility for a period of time in excess of thirty (30) days, the Trustee
shall cease the distribution of income and shall accumulate the income to the principal of the Trust.
Upon the discharge of DAISY B. JACKSON to a long term care facility for a period of time in
excess of thirty (30) days, the Trustee shall resume the distribution of income, although all such
accumulated income to that time shall accumulate to and remain a portion of the principal of the
Trust.
4.03. Principal Distributions. Upon the death of the Settlor, the Trust shall terminate.
Upon termination, the remaining trust estate shall be divided into sepal•ate and equal shares and one
such share shall be distributed to each of the Settlor's children, DENNIS O. JACKSON and
DEANNA G. HASKELL. If either of the Settlor's children predecease the termination of this Trust,
the predeceased child's share shall be distributed to the surviving issue of the predeceased child, per
stirpes. If any of Settlor's children predecease the termination of this Trust without surviving issue,
then such predeceased child's share shall be distributed to the other child of the Settlor, with the
terms of such distribution being the same as the direct distribution to that child.
4.04. General Power of Appointment. Settlor's children, DENNIS O. JACKSON and
DEANNA G. HASKELL, are hereby granted the general power to appoint some or all of the
principal of this Trust to themselves, their estates, their creditors, the creditors of their estates, in
such proportions and upon such terms (in trust, outright gifts, or in any other manner) as they jointly
3
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or individually deem advisable. This power shall not be exercisable under their Wills. If Settlor's
children fail, either in whole or in part, to exercise this general power of appointment herein granted,
the unappointed principal shall continue in trust and shall be administered according to the terms of
this Trust. Upon the death, resignation, removal or incapacity of Settlor's childl•en, DENNIS O.
JACKSON and DEANNA G. HASKELL, the survivor of them shall exercise the general power
of appointment under- this provision. Prior to the exercise of the General Powel• of Appointment by
DENNIS O. JACKSON and DEANNA G. HASKELL, or either ofthem, DENNIS O. JACKSON
and DEANNA G. HASKELL shall provide a written notice of the intent to exercise this power to
the then-current Trustees. The Trustees shall inform the Settlor of the intent to exercise this General
Power of Appointment. For a period of ten (10) days, the Settlor may veto the proposed exercise of
the General Power of Appointment. After the ten (10) day period expires, the proposed exercise of
the General Power of Appointment shall take effect unless the Trustees have received written veto
from the Settlor.
ARTICLE V. POWERS OF TRUSTEES
5.01. General Powers. In addition to such other powers and duties as may have been
granted elsewhere in this TI•ust, but subject to any limitations contained elsewhere in this Trust, the
Trustees shall have the following powers and duties:
A. In the management, care and disposition of this Trust, the Trustees shall have the po~~~er
to do all things and to execute such deeds, instruments, and other documents as may be deemed
necessary and proper, including the following powers, all of which may be exercised without order
of or repoz-t to any court:
(1) To sell, exchange, or otherwise dispose of any property, real, personal or
mixed, wheresoever located, at any time held or acquired hereunder, at public or
private sale, for cash or on terms as may be determined by the Trustees, without
advertisement, including the right to lease foi• any term notwithstanding the period
of the Trust, and to grant options, including an option for a period beyond the
du1•ation of the Trust.
(2) To invest all monies in such stocks, bonds, securities, investment
companies OI' tI11St shares, mortgages, notes, choses in action, real estate,
impl•ovements thereon, and othel• property as the Trustees may deem best, without
regard to any law now or hereafter in force limiting investments of fiduciat-ies.
(3) To retain for investment any property deposited with the Trustees
hereunder.
(4) To vote in person or by proxy any corporate stock or other security and
to agree to or take any other action in regard to any reorganization, merger,
consolidation, liquidation, bankruptcy or other procedure or proceedings affecting
4
any stock, bond, note oi- other security held by this Trust.
(S) To use lawyers, real estate brokers, accountants and any other agents, if
such employment is deemed necessary or desirable, and to pay reasonable
compensation for their services.
(6) To compromise, settle or adjust any claim or demand by or against the
Trust and to agree to any rescission or modification of any contact or agreement
affecting the Trust.
(7) To renew any indebtedness, as well as to bor-r•ow money, and to secure
the same by mortgaging, pledging or conveying any property of the Trust, including
the power- to bol-row from the Trustees (in the Trustees' individual capacity) at a
reasonable rate of interest.
(8) To retain any business interest transfei-r•ed to the trustee, as shareholder,
security holder, creditor, partner or otherwise, for any period of time whatsoever,
even though the interest may constitute all or a large portion of the trust principal; to
comply with the provisions of any agreement restricting transfer of the interest; to
participate in the conduct of the related business or• rely upon others to do so, and to
take or delegate to others discretionary power- to take any action with respect to its
management and affairs which an individual could take as outright owner of the
business or• the business interest, including the voting of stock (by separate trust or•
otherwise regardless of whether that separate trust will extend for a team within or
beyond the team of the trust) and the determination of all questions of policy; to
execute and amend partnership agreements; to participate in any incorporation,
reorganization, merger, consolidation, sale of assets, recapitalization, liquidation or
dissolution of the business, or any change in its nature, or in any buy-sell, stock
restriction, or stock redemption agreements; to invest in additional stock or securities
of, or make secured, unsecured, or subordinated loans to, the business with trust
funds; to take all appropriate actions to prevent identify, or respond to actual or
threatened violations of any envu•onmental law or regulation thereunder; to elect or
employ with compensation, as dir•ector•s, officers, employees, or agents of the
business, any persons, including a trustee of any trust held under this instrument, oi•
any director, officer, employee, or agent of a corporate trustee of any trust held under
this instrument, without adversely affecting the compensation to which that trustee
would otherwise be entitled; to rely upon reports of certified public accountants as
to the operations and financial condition of the business, without independent
investigation; to deal with and act for- the business in any capacity (including in the
case of a corporate trustee any banking or trust capacity and the loaning of money out
of the trustee's own funds) and to be compensated therefor-; and to sell or• liquidate
the business or any interest in the business.
(9) To register any stock, bond or other security in the name of a nominee,
5
without the addition of words indicating that such security is held in a fiduciary
capacity, but accurate records shall be maintained showing that the stock, bond or
other security is a trust asset and the Trustees shall be responsible foi• the acts of the
nominee.
(10) To set aside as a separate trust, to be held and administered upon the
same terms as those governing the remaining trust property, any interests in property,
for any reason, including but not limited to a concern that such property could cause
potential liability under any federal, state, or local environmental law.
B. Whenever the Trustees as•e directed to distribute any trust principal in fee simple to a
person who is then under twenty-one (21) years of age, the Trustees shall be authorized to hold such
property in trust for such person until he becomes twenty-one (21) years of age, and in the meantime
shall use such part of the income and the principal of the trust as the Trustees may deem necessary
to provide for the proper support and education of such person in the standard of living to which he
has become accustomed. If such person should die before becoming twenty-one (21) years of age,
the property then remaining in trust shall be distributed to the personal representative of such
person's estate.
C. In making distributions from the Trust to or for the benefit of any minor or other person
under a legal disability, the Trustees need not requiT•e the appointment of a guardian, but shall be
authorized to pay or deliver the distribution to the custodian of such person, to pay or delivel• the
distribution to such person without the intervention of a guardian, to pay or delivel- the distribution
to the legal guardian of such person if a guardian has already been appointed, or to use the
distribution for the benefit of such person.
D. In the distribution of the Trust and any division into separate trusts and shares, the
Trustees shall be authorized to make the distribution and division in money or in kind or in both,
regal•dless of the basis for income tax purposes of any property distributed or divided in kind, and
the distribution and division made and the values established by the Trustees shall be binding and
conclusive on all persons taking hereunder. The Trustees may in making such distribution or
division allot undivided interests in the same properrty to several trusts or shares.
E. If at any time after Settlor's death the total fau• market value of the assets of any trust
established oi• to be established hel•eundel• is so small that the corporate Trustee's annual fee for
administering the trust would be equal to or less than the minimum annual fee set forth in the
Trustee's regularly published fee schedule, then the Trustees in their discretion shall be authorized
to terminate such trust or to decide not to establish such trust, and in such event the property then
held in or to be distributed to such trust shall be distributed to the persons who are then or would be
entitled to the income of such trust. If the amount of income to be received by such persons is to be
determined in the discretion of the Trustees, then the Trustees shall distribute the property among
such of the persons to whom the Trustees as•e authorized to distribute income, and in such
proportions, as the Trustees in their- discretion shall determine.
6
F. The Trustees shall be authorized to lend or borrow, including the right to lend to or
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bon•ow fi•om the Settlor's estate, at an adequate rate of interest and with adequate secut-ity and upon
such terms and conditions as the Trustees shall deem fail- and equitable.
G. The Trustees shall be authorized to sell or purchase, at the fau• market value as
determined by the Trustees, any property to or fi•om Settlor's estate or any trust created by Settlor
dui7ng hfe or by will, even though the same person or corporation may be acting as executor of
Settlor's estate or as t1-ustee of any other such trusts and as the Trustee of this Trust.
H. The Trustees shall have discretion to deteiznine whether items should be charged or
credited to income or principal or allocated between income and principal as the Trustees may deem
equitable and fau• under all the circumstances, including the power to amortize or fail to amortize
any part or all of any premium or discount, to treat any part or all of the profit resulting from the
maturity or sale of any asset, whether purchased at a premium or at a discount, as income or principal
or apportion the same between income and principal, to apportion the sales price of any asset
between income and principal, to treat any dividend or othel• distribution on any investment as
income or principal or to apportion the same between income or principal, to charge any expense
against income or principal or apportion the same, and to provide or fail to provide a reasonable
reserve against depreciation or obsolescence on any asset subject to depreciation or obsolescence,
all as the Trustees may reasonably deem equitable and just under all of the circumstances.
I. The Trustees at•e hereby authorized and empowered to purchase such insurance policies
as they deem appropriate.
5.02. Voting by Trustees. When the authority and power under this Trust is vested in two
(2) or more Trustees or Co-Trustees, the authority and power under this Trust or granted by law shall
be vested m, and exercised by, each of the Trustees individually or all of the Trustees jointly, such
that each Trustee may act independently, or the trustees may act jointly, in the administl•ation oi-
under the teams of the Trust ag1-eement.
5.03. Trustees Power to Deal with Environmental Hazards. The Trustee shall have the
power to use and expend the trust income and principal to (i) conduct environmental assessments,
audits, and site monitoring to determine compliance with any environmental law o1• regulation
thereunder; (ii) take all appropriate remedial action to contain, clean up or remove any environmental
hazard including a spill, release, discharge or contamination, either on its own accord or in response
to an actual or threatened violation of any environmental law or regulation thereunder; (iii) institute
legal proceedings concerning environmental hazards or contest or settle legal proceedings brought
by any local, state, or federal agency concerned with environmental compliance, or by a private
lrtigant; (iv) comply with any local, state or federal agency order or court order di1•ectin an
assessment, abatement or cleanup of any environmental hazards; and (v) employ agents, consultants
and legal counsel to assist oi• pei•foi~n the above undertakings or actions. Any expenses incun-ed by
the trustee under this paragraph may be charged against income or principal as the trustee shall
determine.
7
ARTICLE VI. SPENDTHI2IFT PROVISION
6.01. General Provision. No beneficiary shall have the power to anticipate, encumber or
transfer his interest in the Trust Estate in any manner other than by the valid exercise of a Power of
Appointment. No part of the Trust Estate shall be liable for or charged with any debts, contracts,
liabilities or torts of a beneficiary or subject to seizure oI- other process by any creditol• of a
beneficiary.
ARTICLE VII. CONSTRUCTION OF TRUST
7.01. Choice of Law. This Trust shall be administered and interpreted in accordance with
the laws of the Commonwealth of Pennsylvania.
7.02. Code. Unless otherwise stated, all references in this Trust to section and chapter
numbers are to those of the Internal Revenue Code of 1986, as amended, or corresponding provisions
of any subsequent federal tax laws applicable to this Trust.
7.03. Other Terms. Unless the context otherwise requires, the use of one or more genders
in the text includes all other genders, and the use of either the singular or the plural in the text
includes both the singular and the plural.
7.04. Captions. The captions set forth in this Agreement at the beginning of the various
divisions hereof are for convenience of reference only and shall not be deemed to define oI- limit the
provisions hereof or to affect in any way their construction and application.
7.05. Situs of Trust. The Trust shall have its legal situs in Cumberland County,
Pennsylvania.
ARTICLE VIII.
COMPENSATION OF TRUSTEES AND
APPOINTMENT OF SUCCESSOR TRUSTEES
8.01. Compensation. The Trustees shall receive as their compensation foI• the services
performed hereunder that sum of money, based on an hourly charge or percentage rate, which the
Trustees normally and customarily charge for performing similar services during the time which they
perform these services.
8.02. Removal of Trustees. Settlor may remove the Trustees, or any of them, at any time
oI• times, with or without cause, upon thirty (30) days written notice given to the cuI•rent Trustees.
Upon the death of the Settlor, a majority of the current income beneficiaries may remove the
Trustees, or any of them, at any time or times, with or without cause, upon thirty (30) days wl7tten
notice given to the current Trustees. Upon the removal of the Trustees, or any of them, a successor
Trustee(s) shall be appointed in accordance with the terms set forth in Paragraph 8.03.
8
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1
8.03. Anyoint~nent of Successor Trustees. The Trustees, or any of them, may resign at
any time upon thirty (30) days written notice given to the Settlor if Settlor is living, or in the event
of Settlor's death, upon thirty (30) days written notice given to the cun•ent income beneficiary or
beneficiaries (including a beneficiary's natural or legal gual•dian or legal representative), hereunder.
Upon the death, resignation, removal 01• incapacity of the Trustees, or any of them, a successor
trustee(s) may be appointed by the Settlor during Settloi•'s lifetime, or, after Settlol•'s death, by a
majority of the cui7•ent income beneficiaries. Notwithstanding the foregoing provisions respecting
the appointment of a successor trustee(s), if and in the event that one Trustee shall die, resign, be
removed, or be ad~uchcated incompetent, the remaining Trustee shall exercise the powers, and carry
out the duties, of Trustee individually until such time as a successor trustee is appointed. Any
successor trustee(s) shall be a financially sound and competent corporate trustee or issue of the
Settlor. Any successor trustee(s) thus appointed, or, if the corporate tt•ustee shall merge with or be
consolidated with anothel• corporate fiduciary, then such corporate fiduciary, shall succeed to all the
duties and to all the powers, including discretionary powers, herein granted to the Trustees.
8.04. Exoneration of Trustee. No Trustee shall be liable for any loss oi- depreciation in
value sustained by the Trust as a result of the Trustee retaining any property upon which there is later
discovered to byhazardous materials or substances requiring remedial action pursuant to any federal,
state, or local environmental law, unless the Trustee contributed to the loss or depreciation in value
through willful default, willful misconduct, or gross negligence.
8.05. Indemnification of Trustee Upon Distribution. Notwithstanding any contl•asy
provision in this Trust Agreement, the Trustee may withhold a distribution to a beneficiary until
receiving from the beneficiary an indemnification an agreement in which the beneficiary agrees to
indemnify the Trustee against any claims filed against the Trustee as an "ownel•" or "operator" undel•
the Comprehensive Envu•onmental Response, Compensation and Liability Act of 1980, as fi•om time
to tune amended, or any regulation thereunder.
ARTICLE IX. PERPETUITIES CLAUSE
9.01. General Provision. Notwithstanding anything to the contialy in this Trust, each
disposition the Settlor has made here, legal or equitable, to the extent it can be refel•~•ed in its
postponement of becoming a vested interest to a duration measured by some life ol• lives in being
at the time of Settlor's death is definitely to vest in interest, although not necessarily in possession,
not later that twenty-one (21) years after such lives (and any period of gestation involved); or, to the
extent it cannot be 1•efei~•ed in any such postponement to such lives, is to so vest not later than
twenty-one (21) years from the time of Settlol•'s death.
ARTICLE X.
ACQUISITION OF UNITED STATES TREASURY BONDS
ELIGIBLE FOR TAX PAYMENT; PAYMENT OF TAXES, FUNERAL
EXPENSES, AND EXPENSES OF ADMINISTRATION
9
11
1
10.01. Acquisition of Bonds. The Trustees may, at any time, without the prior approval or
direction of the Settlor and whether or not the Settlor is able to manage Settlor's own affau•s, acquil•e
United States Treasury Bonds selling at a discount, which bonds are redeemable at their paI• value
plus accl•ued interest thereon for the puI-poses of applying the proceeds to the payment of the United
States estate tax on the Settlor's estate; and the Trustees may bon•ow fiom any lender, including
themselves, Wlth Ol' WlthOUt SeCUI'lty, to so acquu•e these bonds.
10.02. Payment of United States Estate Tax by Bond Redemption. The Settlor• diI•ects
that any United States Treasury Bonds which may be redeemed at their par value plus accrued
interest thereon for- the pulTose of applying the proceeds to the payment of the United States estate
tax imposed on the Settlor's estate, and which ar•e held by the Trustees, shall, to the extent of the
amount determined to be required for payment of the estate tax, be distributed to the legal
representative of the Settlor's estate to be used by the legal representative ahead of any other assets
and to the fullest extent possible to pay the estate tax.
10.03. Payment of Death Taxes and Other Estate Settlement Costs. After the Trustees
have complied with paragraph 10.02, above, and ascertained fiom the legal representative that all
such bonds have been redeemed in payment of the United States estate tax, the Trustees shall also
ascertain fiom the legal representative whether the legal representative has sufficient assets to pay
the remaining legacy, succession, inheritance, transfer, estate and other death taxes or duties (except
the additional estate tax imposed by Section 2032(c), or corresponding provisions of the Internal
Revenue Code of 1986 applicable to the Settlor's estate and imposing the tax) levied or assessed
against the Settlol•'s estate (including all interest and penalties thereon), all of which taxes, interest
and penalties aI•e hereafter referred to as the death taxes, interest and penalties. If the legal
representative advises the Trustees that insufficient funds exist to pay all the death taxes, interest and
penalties, the Trustees shall then pay to the legal representative from the trust property, an amount
equal to all the death taxes, interest and penalties in excess of the funds available to the legal
representative for these purposes, which payments are to be made without apportionment.
If the Executor- ofthe Settlol-'s estate, in such Executol•'s sole discretion, shall determine that
appr•opI-iate assets of Settlol•'s estate ar•e not available in sufficient amount to pay (1) the Settlor•'s
funeral expenses, and (2) expenses of administering the Settlor•'s estate, the Trustees shall, upon the
request of the Executol• of the Settlor's estate, contribute fiom the pI-incipal of the tI•ust estate the
amount of such deficiency; and in connection with any such action the Trustees shall I•ely upon the
wI•itten statement of the Executol- of the Settlor•'s estate as to the validity and coI•I•ectness of the
amounts of any such expenses, and shall fiu7lish funds to such Executor- so as to enable such
Executor to discharge the same, or to discharge any part or all thereof itself by making payment
du-ectly to the person entitled or claiming to be entitled to receive payment thereof. No consideration
need be required by the Trustees fiom the Executor of Settlor's estate for any disbursement made by
the Trustees pursuant hereto, nor shall there be any obligation upon such Executor to repay to the
Trustees any of the funds disbul•sed by them heI-eundel•, and all amounts disbul-sed by the Trustees
pursuant to the authority hereby confer-I-ed upon them shall be disbursed without any right in or duty
upon the Trustees to seek or obtain contribution or reimbul•sement from any person or property on
account of such payment. The Trustees shall not be responsible for the application of any funds
10
ii ~•
i
delivered by them to the Executor of the Settloi•'s estate pursuant to the authority herein granted, nor
shall the Trustees be subject to liability to any beneficiary hereundel• on
account of any payment made by them pursuant to the provisions hereof.
IN WITNESS WHEREOF, the Settlor and Trustees have hereunto set their hands and seals
as of the day and year first above written.
WITNESS:
_ _. ~ I
COUNTY OF CUMBERLAND :
On this, the ~~ day of October, 2002, before me, a Notary Public, the undersigned officer,
personally appeared DAISY B. JACKSON, known to me (or satisfactorily proven) to be the person
whose name is subscribed to the within Trust Agreement, and acknowledged that she executed the
same for the purposes therein contained.
~' ~ (SEAL)
DAISY .JACK ~ON, SETTLOR
COMMONWEALTH OF PENNSYLVANIA
SS:
IN WITNESS WHEREOF, I have set my hand and official Seal.
Notary Public
My Commission Expires:
Notarial Seal
Teri L. Walker, Notary Pubiic
Lemoyne Boro, Cumberland County
My Commission Expires Jan. 20, 2003
Member, Pennsylvania Association of NotariP^
11
_.._ ..
The foregoing TI-ust Agreement was delivered, and is hereby accepted, at Lemoyne,
Pennsylvania, on October,~_, 2002.
,_
/
;
WITNESS
,,
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WITNESS
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WITNESS
,'-~ ' ~' %~ .. ~, , ~ ., (SEAL)
DAISY;~,B: JAGI~SON, TRUSTEE
~/~ y~,, .- ~ (SEAL
DENNIS O. JACI~S~ON, TRUSTEE
. ~ _ (SEAL)
,,
DEANNA G. HASKELL, TRUSTEE
12
.~ ~_z _.~
SCHEDULE "A"
SCHEDULE
REFERRED TO IN THE ANNEXED
TRUST AGREEMENT
DATED: OCTOBER <~ , 2002
FROM DAISY B. JACKSON,
SETTLOR
TO DAISY B. JACKSON, DENNIS O. JACKSON and DEANNA G. HASKELL,
TRUSTEES
i
,;
_ =;_
~_
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Property Description:
ALL THAT CERTAIN lot in Plan No. 1, Windsor Pa1•k, Lower Allen Township, Cumberland County,
Pennsylvania, as shown on the survey dated January 31, 1959, by D. P. Raffensperger, R.S., more fully
described as follows:
LOT 31, BLOCK "C" BEGINNING at a point in the southerly side of Wesley Drive, a distance of six
hundred ninety-one and four hundred twenty-five thousandths (691.425) feet East of the Southeast corner
of Windsor Boulevard and Wesley Drive; thence South forty-five (45) degrees seventeen (17) minutes East
along the southerly side of Wesley Drive, a distance of seventy-five and five-thousandths (75.005) feet to
a point; thence South forty-five (45) degrees twenty-two (22) minutes West along the division line between
Lots No. 31 and 32, a distance of one hundred twelve and twenty-seven hundredths (112.27) feet to a point;
thence North forty-four (44) degrees thirty-eight (38) minutes West along the division line between Lots No.
12 and 31, a distance of seventy-five (75) feet to a point; thence North forty-five (45) degrees twenty-two
(22) minutes East along the division line between Lots No. 31 and 30, a distance of one hundred eleven and
forty-tvvo hundredths (111.42) feet to a point in the southerly side of Wesley Drive, the place of
BEGINNING.
HAVING THEREON ERECTED a dwelling house known as No. 118 Wesley Drive.
13
EFORM100472-0900
~,~}~~$A~ Your account was DEBITED for the following reason:
^ Check # posted on encoding error posted to incorrect account
® Closed account 5070094738
^ B h d' t b h
ranc a dustmen (ranc narne~ -_
^ Service charge error
^ Other.
Account Number File ID
5070094738 040
D DAISY B JACKSON
E DEANNA G HASKELL
13 82 FAIRWAY DR
I CAMP HILL, PA 17011-2064
T
AMOUNT $ 3, 049.90
PNC Bank, National Association
FOR BANK USE ONLY
Branch #/Dept. # Date
0000106 04/27/2011
Prepared By (PRINT Name) Authorized By
RYAN BRADY
Customer's Advice of Charge
~~•a ~ ~
ivmg
May 17, 2010
To Whom It May Concern,
Daisy Jackson had a Resident Trust Account with Golden Living. There was
approximately $3,528.70 in her account when she passed away. This account will be
closed on May 20, 201 1.
If you have any questions, please contact me at (717) 763-7361.
Sincerely,
Missie Stuffing
FBOC -Camp Hill
~"/i- 3'7/- 1~u~
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b ;~~
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Golden t_ivingCenter
Camp Hill
46 Erford Road
Camp Hill. PA 17011
t 717 763 7361
f 717 763 7842
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DENNIS 0. JACKSON
82 FAIRWAY DRIVE
CAMP HILL PA 17011
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF PUBLIC WELFARE
BUREAU OF PROGRAM INTEGRITY
DIVISION OF THIRD PARTY LIABILITY
ESTATE RECOVERY PROGRAM
PO BOX 8486
HARRISBURG, PA 17105-8486
May 9, 2011
Re: Daisy Jackson
CIS #: 730201634
SSN: ###-##-3196
Date of Death: 04/22/2011
Dear Mr. Jackson:
Please be advised that the Department of Public Welfare is attempting to
recover the monetary value of any and all eligible assets in the subject
estate. Although the amount in the estate may be considerably less than that
which is owed to the Department, our claim is against the estate, no one
else. Your responsibilities, as the primary next of
kin/administrator/executor, is to advise the Department of any assets in the
estate and to insure that the remaining money, after all funeral and
administrative costs are deducted, is sent to the Department.
The Department of Public Welfare maintains a claim in the amount of
$55,728.20 against the above-mentioned estate. This claim is for restitution
of medical assistance granted on behalf of the decedent for which the Probate
Estate is now responsible to reimburse the Department according to Act 49, 62
P.S. 1412, effective August 15, 1994, as amended by Act 20-95, effective June
30, 1995. Enclosed is the Department's itemized statement of claim.
A portion of this medical expense, namely $12,604.39, was incurred
during the last six months of the decedent's life; therefore, it is a Class 3
claim pursuant to Section 3392 of the Decedents, Estates, and Fiduciaries
Code, 20 Pa. C.S.A. 3392(3). The balance of the claim, namely $43,123.81, is
to be entered as a priority Class 5.1 claim against the estate.
Please acknowledge receipt of this letter and advise when payment may be
expected. If the estate accounting is complete, please provide a copy. If
the estate contains real estate, please provide copies of the deed, the
latest tax assessment and a current appraisal, if available.
Sincerely,
Enclosure
Katie J. East
TPL Program Investigator
717-772-6713
717-772-6553 FAX