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HomeMy WebLinkAbout07-12-11 (3)1505610140 REV-1500 EX (°'.'°' OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 1 1 D D 8 3 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 2 0 4 3 0 7 4 3 3 0 1 1 1 2 0 1 1 1 2 0 8 1 9 3 8 Decedent's Last Name Suffix Decedent's First Name MI P O G U E J U D I T H E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) ^X 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number H E A T H E R D R O Y E R E S Q 7 1 7 2 4 2 ~ 3 ~0 1 {y ~~ ryry.• ~ ./ "r.~...~5 <~Lr ""!n REGISTER S USE OALY :~ ~ ~ r'~"- rte" ~ ~ ~ First line of address ~ ~ ~ ,~ ("r1 ..... f ;, 4 4 3 1 N F R O N T S T R E E T ``~c7Q i~. 4 =~ Second line of address I~~ ~~ --~°4 '°r C7 fi DATE FILED - ~ City or Post Office State ZIP Code ~_ ; ~ ~ H A R R I S B U R G P A 171 1 0 Correspondent's a-mail address: H R O Y E R a S A S L L P• C O M Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF RSON 12ESPONSIBLE FOR FILING RETURN ~ DATE ~ _~_ ~ n f DRESS ~(,~ ~: ~. G'/3 rah ~ sc.~n-x.~2 ~/z- -~/I~CFk4n~~-~~ ~42G /~ 1 ~7cS ,S~~Q SIGNA,TI~RE OF PR~PA THER THAN REPRESENTATIVE BATE i ~ E USE ORIGINAL FORM OJVLY 1505610140 Side 1 1505610140 J ~~ J REV-1500 EX decedent's Name: JUDITH E• P O G U E Decedent's Social Security Number 2 0 4 3 0 7 4 3 3 RECAPITULATION 1. Real Estate (Schedule A) ........................................... 1. ~ . 0 0 2. Stocks and Bonds (Schedule B) ...................................... 2. • 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. • 4. Mortgages and Notes Receivable (Schedule D) .......................... 4. • 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 4 4 8 0 . 0 2 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested ....... 6. 3 8 6 . 1 8 7. Inter-Vivos Transfers 8~ Miscellaneous Non-Probate Property (Schedule G) ^X Separate Billing Requested ....... 7. 2 8 1 7 7 7. 7 9 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 2 8 6 6 4 3 . 9 9 9. Funeral Expenses and Administrative Costs (Schedule H) ............ ...... 9. 1 6 0 3 6 . 4 2 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ....... ...... 10. 8 2 8 . 6 1 11. Total Deductions (total Lines 9 and 10) ......................... ...... 11. 1 6 8 6 5. 0 3 12. Net Value of Estate (Line 8 minus Line 11) ...................... ...... 12. 2 6 9 7 7 8 . 9 6 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. 2 6 9 7 7 8 . 9 6 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0 0 0 0 15. 16. Amount of Line 14 taxable at lineal rate X .0 ~ 0 ~ 16. 17. Amount of Line 14 taxable at sibling rate X .12 0 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 ~ 0 0 18. 19. TAX DUE ...................... ....................... .. ..... .. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610240 0. 0 0 0. 0 0 0. 0 0 o. 0 0 o. 0 0 L 1505610240 1505610240 J REV-1500 EX Page 3 File Number Decedent's Complete Address: 21 11 oos_3 DECEDENT'S NAME JUDITH E. POGUE STREET ADDRESS 15 CORAL DRIVE CITY 'STATE ~I ZIP CARLISLE PA ] 7013 Tax Payments and Credits: ~. Tax Due (Page 2, Line 19) 2. Credits/Payments A, Prior Payments B. Discount 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, 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. Total Credits (A + B) (2) (3) (4) (5) 0.00 0.00 0.00 0.00 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; ...................................................................... ^ Q b. retain the right to designate who shall use the property transferred or its income; ............................... ^ Q c. retain a reversionary interest; or ................................................................................................ ^ ^X d. receive the promise for life of either payments, benefits or care? ....................................................... ^ Q 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ^ Q 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? .................................................................................................. 0 ^ 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 July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse 3 percent [72 P.S. §9116 (a) (1.1) (i)]. 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. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, undE Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood ar adoption. REV-1508 EX + (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, 8c MASC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER JUDITH E. POGUE 21 11 0083 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PERSONAL PROPERTY & HOUSEHOLD FURNISHINGS 3,500.00 2. MEDICARE REFUND 245.00 3. COMCAST AND HIGHMARK REFUND 289.02 4. PROCEEDS FROM SALE OF DAYBED, DRESSER, MEAT SLICER, SOFA TABLE AND 215.00 END TABLES 5. REFUND HOMEOWNERS INSURANCE PREMIUM 86.00 6. CENTRAL PA TEAMSTERS PENSION FUND -FINAL PAYMENT 145.00 TOTAL (Also enter on line 5, Recapitulation) I $ 4 480.02 (If more space is needed, insert additional sheets of the same size) REV-1509 EX+ (01-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF: FILE NUMBER: JUDITH E. POGUE 21 11 0083 If an asset was made jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A. JANICE A. MONISMITH B C. JOINTLY-OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE C)F DEATH VALUE OF ASSET % OF DECEDENT'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A, 04/09/09 SUSQUEHANNA BANK CHECKING ACCOUNT NO. 502.64 50. 251.32 1506598009 2. A. 04/09/09 SUSQUEHANNA BANK SAVINGS ACCOUNT NO. 29.67 50. 14.84 1512608720 3. A. 04/09/09 SUSQUEHANNA BANK ALL PURPOSE CLUB ACCOUNT 240.03 50. 120.02 NO. 1506598028 11 CORAL DRIVE DAUGHTER CARLISLE, PA 17013 *******SEPERATE BILLING REQUESTED*****'**** TOTAL (Also enter on Line 6, Recapitulation) I $ 386.18 If more space is needed, use additional sheets of paper of the same size. PENNSYLVANIA INHERITANCE TAX INFt1RMATIQN NQTICE BUREAU OF INDTYIDUAL TAXES A N D Fo Box 2aa6nl TAXPAYER RESPCINSE IiARRIS8UR0 PA 17128-D601 RFY^Y 545 E% AFP i46-QH) JANICE A MONISMITH 15 CORAL DR CARLISLE PA I7g13 EST. OF JUDITH E POGUE 5SN 2q4-30-7433 DATE OF DEATH 01-II-2011 COUNTY DAUPHIN REMIT PAYMENT AND FARMS Tp: REGISTER GF WILLS FRONT AND MARKET ROOM Iq3 HARRISBURG PA 1710I TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST [~ CERTIF. SUS QUE WAN NA .BANK provided the Department with the information below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-nosed decedent, you were a joint ownerlbeneficiary of this account. If you #eeI the information is incorrect, please obtain written correction from the financial institution, attach a copy to this forb and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of Pennsylvania. Flease call f7I7? 787-832'I with questions. COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. I50b598009 Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due PART CHECK flNE aLOCK QNLY Date 04-q9-2009 Established ~ 502.64 X 5q.000 $ 251.32 ~( . 15 $ 37.70 TAXPAYER RESPON To ensure proper credit to the account, two copies of tl~is notice must accompany payment to 'the Register of Wills. Make check payable to "Register of Wills. Agent". NOTE: If t;ax paymen#s are made within three months of tl~e decedent's date of death: deduct a 5 i~ercent discount on the tax due. Any Inheritance Tax due will became delinquent nine months after the date of death. ~FJ4~L.DRE 'I'{1 RESPOND Wilt R~StILT IN AN OFFICIAL TAB A~SS~.SSM~NT i A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, ar check box. "A" and return this notice to the Register of Wi11s and an official assessment will 6e issued by the PA Department of Revenue. 8. Q The above asse# has been ar will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the estate representative. C. The shave infara~a ion is incorrect and/or debts and deductions were paid. Complete PART ~ andlar PART ~ below. PART _, If indicating a different ~x rave , ~p7.easeTstate ~ ~ ~~ ~ ~' --- ~~~~~~AL ~~~ {~~~~ ~ ~A~ 2 ^ relationship to decede nt: ~ ~ ~- - ~' - ~ ~` ~ ~ PA DEPARTMENT QF ~~v~r~~~ TAX RE TURN - COMPUTATION OF TAX DN JOiNT/TRUST ACCOUNTS f'AD ..LINE 1. Date Established 1 _ _ ~~ ~; ~ 2. Account Balance. 2 $ ,. ~""~~.-~ c., ~ ~.f~ 2 3. Percent Taxable 3 ~ ~,~~,' • ~.~~~ 3 4. Amount Subject to Tax 4 ~ ~~ ~~ + --~ ~, !~ 5. Debts and Deductions 5 ~ ~~ ~ b. Amount Taxable b ~ r^ c'""~ ~~+ ~.. V:~.=~tl ~ 7. T a x R a t e 7 X ~~~` , ~._, ~ ~.--~ -~ 8. Tax Due 8 ~ ~ ~ ~ ..,~~ } 8 Under penalties of perjury, I declare that the facts I have reported above are true, correct and .~'~..,~-~ complete to the best of my knowledge and belief. ~QM~ { 3 '"~~ WORK ( ) ,~ r TAXPAYER SIGNATURE TELEPHONE NUMBER 11 TES FILE hID. 22 ACN 11114841 DATE'. q3-q4-20II PART DEBTS AND DEDUCTIONS CLAIMED a DATE PAID PAYEE DESCRIPTION AMOUNT PAID ~~'t1t1S~~Vr~n1~ `- ~ `, BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX C~EPARTME~IT OF REVENUE .INHERITANCE TAX DIVx5I0N APPRAISEMENT, ALLOWANCE OR DISALLOWANCE .... Pa Box 2s G6 U1 OF DEDUCTIONS., ANI) ASSESSMENT OF TAX ON REV-1548 CX AFP (I2-xd) ttARRxSBURG FA i712a-~6(-1 JOINTLY HELD OR TRUST ASSETS DATE 05-30-2011 ESTATE OF POGUE JUDITH E DATE OF DEATH 01-11-201 FILE NUMBER 22 11-©258 COUNTY DAUPHIN SSN/DC 204-30-7433 JANICE A MONISMITH ACN 11114841 15 CORAL DR AppEAL BY DA'TE:OT-29-2011 C A R L I S L E P A 17 013 ("See revs rse side u,n der Oh jectivtx s) Amount Remitted C MAKE CHECK PAYABLE AND REMIT PAYMENT T0; REGISTER OF WILL~- FRONT .AND MARKET ROOM 103 HARRISBURG PA 1.7101 CUT ALONG THIS LINE i'~' RETAIN LOWER PORTION FOR YOUR RECORDS #"' _.. . REY-1548 EX AFP t12-103 _ ,._ ----------------..__---____-- NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 05-3Q-2'011 ESTATE OF:POGUE JUDITH E DATE DF DEATH:O1-11-2011 FILE NO.: 22 11-0258 S.S/D.C. NO.; 204-30-7433 COUNTY: DAt1PHiN ACN: 11114841 TAX RETURN WAS: CX~ ACCEPTED AS FILED C } CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION; SUSQUEHANNA BANK ACCQUN'T NE}.; 15055980.09 TYPE OF ACCOUNT: ( )SAVINGS C ~ CHECKING C )TRUST { )TIME CERTIFICATE DATE ESTABLISHED 04-09-2009 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax. Rate Tax Due TAX CREDITS: 502.64 X 0.500 251..32 - .00 251..32 x ,045 11,31 NOTE: TO ENSURE PROPER CREDIT TO YOUR` ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WIThi YOUR TAX PAYMENT TO THE REGISTER O~ WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR. MIONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." - PAYMENT DATE _ - RECEIPT NUMBER. ---- DISCOUNT C+°~ INTEREST/PEN PAID C-3 -...~~ _ AMOUNT PAID 03-09-2(111 DAO1266$ .57 1.1.31 TOTAL TAX PAYMENT 11.88. BALANCE OF TAX DUE .57CR INTEREST AND PEN. - .DO TOTAL UUE .5TCR TF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULA7TON OF ADDITIONAL INTEREST. IF TOTAL. DUE IS REFLECTED AS A "'CREBIT"' CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR I~{STRUCTIONS. REV-1510 EX+ (08-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER JUDITH E. POGUE 21 11 0083 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. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET °o OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1. SUN LIFE FINANCIAL IRA ANNUITY NO. 12-1250-171806 195,586.46 100.00 195,586.46 ***SEPERATE BILLING REQUESTED**** 25% -Janice A. Monismith -Daughter 25% -Kristin A. Brown -Daughter 0.00 25% -David J. Pogue -Son 10% -Jeffrey E. Keath -Grandson 5% -Cody E. Woollett -Grandson 5% -Emily A. Brown -Granddaughter 5% -Noah A. Brown -Great Grandson 2. LINCOLN FINANCIAL ANNUITY N0.924473096 86,191.33 100.00 86,191.33 ***SEPERATE BILLING REQUESTED*** 25% -Janice A. Monismith -Daughter 25% -Kristin A. Brown -Daughter 25% -David J. Pogue -Son 10% -Jeffrey E. Keath -Grandson 5% -Cody E. Woollett -Grandson 5% -Emily A. Brown -Granddaughter 5% -Noah A. Brown -Great Grandson TOTAL (Also enter on Line 7, Recapitulation) I $ 281,777.79 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+ (10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER JUDITH E. POGUE 21 11 0083 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. JESSE H. GEIGLE FUNERAL HOME 12,252.57 B 2. 3. 4 5. 6. 7, 8. 9. 10. ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State Year(s) Commission Paid: Attorney Fees: SMIGEL, ANDERSON & SACKS, LLP 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 Probate Fees: REGISTER OF WILLS 345.50 Accountant Fees: Tax Retum Preparer Fees: PP&L -ELECTRIC BILL 183.69 SHIPLEY OIL 223.63 HARMONY ESTATES -LOT RENT 385.00 UHAUL TRUCK RENTAL 113.53 ZIP 2,532.50 TOTAL (Also enter on Line 9, Recapitulation) I $ 16,036.42 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ (12-08) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER ESTATE OF JUDITH E. POGUE 21 11 0083 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. VALUE AT DATE ITEM DESCRIPTION OF DEATH NUMBER 64.50 1. NORTHSIDE VETERINARY 2. CENTURYLINK -FINAL TELEPHONE BILL 39.11 3. IRS - 2010 PERSONAL INCOME TAX 725.00 TOTAL (Also enter on Line 10, Recapitulation) I $ 828.61 If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (01-10) pennsylvania ~ SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: TT TTITTN F. P(l(TT TF. 21 11 0083 RELATIONSHIP' TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. JANICE A. MONISMITH Lineal 11 CORAL DRIVE CARLISLE, PA 17013 2. DAVID J. POGUE Lineal 1201 SCENERY DRIVE MECHANICBURG, PA 17050 3. KRISTIN A. BROWN Lineal 228 NORTH RACE STREET MIDDLETOWN, PA 17057 4. CODY WOOLLETT Lineal 61 W. MAIN STREET, P.O. BOX 56 NEW KINGSTOWN, PA 17072 5. EMILY BROWN Lineal 124 1 /2 EAST HIGH STREET HUMMELSTOWN, PA 17036 6. JEFFREY E. KEATH Lineal 201 DENISON DRIVE DAUPHIN, PA 17018 7. NOAH A. R. BROWN Lineal 124 1/2 EAST HIGH STREET HUMMELSTOWN, PA 17036 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. , II. NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. 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, use additional sheets of paper of the same size. REGISTER t~F IlV[LLS CU~IItBERLAND Ct~UNTY PENNSYLVANIA CERTIFICATE OF GRANT QF LETTERS No . 201.1- 0D483 ~'A No . 21- 1 ? - 0083 Estate Of ; JUUITH E P"C'GUE _ ;First, Middle, Last/ Late Of : N~R7H MlL7DL ETON i~a WNSHlP CUlVIB;ERLA NL3 CQ UNT Y .Deceased Social Securi ~y No: 204-30-7433 ~tlHEREAS, o.n the 19th day of ~.Tanuary 20II an inst3-ume.nt dated Tune- 2uth 2009 was admitted to probate as the last w.~.ll of JUDI TH F POGUE (Fiisf, MiddlQ Casty Late of NDRTH MJi]DLE"7'ON TOWNSfHIF', CUMBERLAND County, who died on the ~.1 th day of ~Tanuary 2 03 I and, TnTHEREAS, a true copy of the will as probated is an.~3exed hereto. WHEREFORE, I, GLENDA EARNER STj4ASBAUGh+ Register of Wi 11 s in anci+ for CUMBERLAND C'oun ty, in the Commonwealth of Penns.yl van i a, hereby certify that I have this. -day granted Letters TESTAit/'El1lTARY to: JANICE A MQNlSMlTH and DA V!fl J POGUE who have duty goal if~ed as EXECUTOR{RlX) and have agreed to administer the estate .according to I aw, all of which fully appears of record in my office at CUMBERLAND ~CC~UNTY CDURT HOUSE, CARLISLE, PENNSYL VA111lA. IN TESTIMONY WHEREOF, I have hereunto set my ha,~d and of-fixed the seal. o.f my office on the r9tfi day of January to r ~. t~ag(star Qf rlls -•-, ~+` ~x ~r ,~ 4 ';: ,~ t ~'.~~ err: ~Ar~L ~ lsl:~ t;,~. l .G`B,riut y * *NOTE* * ALL NAMES ABpVE APPEAR (~'.£RSZ', MII~D.~,E, LA.SP) 1 ~2?1-I -il4vilt/HDWtmc GlZ4/04 10:03 AM LAST WILL :AND 'T'ESTAMENT a>~ JUDITH E. PDGUE ... 5 _ ... . ~ <4~ ~ , ;3 ,_~f .. lJTli 6-~ t E',', 4 t F Y: ~ 1 RR I, JUDITH E. POGUE, presently of Cumberland County, Pennsy:[vania, declare this to be my Last Will and Testament hereby revoking .all 'Wills: and Codicils prE:viously made by me. MARITAL STATUS I declare that I am a widow. CHII..DREN I have. three (3} children, now living, whose names and dates of birth are as follows: JANiCE A. MUNISMITH born Idavember t 1, 1463 KRISTIN A. BROWN born. March 25, 1965 DAVID J. POGUE born. September t, 1967 All references in thus -Will to my children include only the children n~nned above. PERSONAI. P~tQPERTY ARTICLE I .~. gi~Te all of xn}~ hQ~sseh~ld furnishings anal tangible personal property to my children, rc be divided among them. as they are able to agree... If they are unable to agree, then I direct m}~ Co- Executors to sell all of my household furnishings and tangible personal property and add the proceeds to my residuary estate. If, however, I leave a merilorandum 5ettug forth directions as to the distribution of certain items, I direct. that my Co-Executors take into account any such dire~;tions and make every effort. to distribute such property in kind consistent therewith.. RESIDUE ARTICLE LI I direct that the rest, residue and remainder-of my estate be divided and distributed as follo~fs: A. One third (113} to my daughter, JANICE A, MfJNISMITH, presently of Carlisle, Pennsylvania. If my daughter, JANICE A. MONISMI7'H, fails to survive rrre, then I direct that. her one third ('1/3} share of my residuary estate shalt( be distributed to her son, Ct~DY WUC}LLETT, presently of I~'ew I~ingstourn, Penns°Ivania. B. One third (I/3) io my daughter, KRISTIN A. I3R0-W~N, presently of Carlisle, Pennsylvania. If my daughter, KRIS'T'IN A. BRCl'U~N, fails to survive me, then I direct that her one third (1/3} share ofrny residuary estate shall b~e d:istributed to her daughter, :EMILY A. BRU~'~'N, presently of Iviiddletown, Perlnsy[vania, C. One third (113} to my son,. DAVID J. POGUE, preser~tiy of Mechanicsburg, Pennsylvania. If my son, DAVID J. PUGUE, fails to survive rne, then I direct that .his one third (,.113} share of my residuary estate shall be distributed to mfr Page 2 of 9 Pages daughter, JANICE A. MQNISM~TII, arid. my daughter, KRISTIN A. BRClVVN, in equal shares. CU-EXECUTORS ARTICLE III A. Appointment. I appoint. my daughter, JAN~YCE' A.. M+DNISMITH, and my son., DAVID J. P(~GUE, to act.Jointly as the Co-Executors af`this Will. In the-event of the death, resignation, renunciation. or inability to act of JANIC'E A. MUNISMITH or DAVID J. POGUE in that. capacity, then I appoint my daughter, :KRISTIN A. BROWi~t, as the Co-Executor of this. Will. to serve in his or her place and stead. B. Bond. No bond or other security shall be required of any Co-Executor appointed in this Will. C. C©tnpensation. The Co-.Executors. shall_receive reasonable compensation for their servicesperformed as determined by the Court in which this Will is admitted to probate. CO-EXECUTQR PfJ'V~ERS ARTICLE IV I give my Co-Executors in addition to ..and not in limitation of the powers given b~T law or by other provisions of this V~'ill, the following powers with respect to settlement of my estate, to be Page. 3 of ~ Pages exercised from time to time in the discretion of my Co-Executors without. further order or license of the Register of Wills or of any court: A. investments. To retain any property, pending. dista•ibuton hereunder, to invest in or purchase any property without restriction to legal investments for fiduciaries, to compromise claims, and to sell. any property at public or private salt:; $. Seeurities. To hold shares of stock or other securities in nominee registration form, including that of a clearing corporation or depository, or in book entry form or unregistered or in such other farm. as will. pass by delivery ; C. Litigation. To engage in litigation. and compromise„ arbitrate or abandon claims; D. Distributions. To make distributions in cash or in kind at current values, or partly in each, allocating specific assets to particular distrbbutees on a non-pro rata basis, and for such purposes to make. reasonable determinations of current values; E. Tax Returns. To make elections, decisions,. concessions and settlements in connection with. all income, estate, inheritance, gift or other tax retunr~s and the payment of such taxes, without obligation to adjust the distributive share of inc;o~me ar principal of any person affected thereb~f; F. Loans.. To pay off any loans I may have Taken a€;ainst any life insurance policies owned by me that remain unpaid at the time of my death; Page 4 of 9 Pages G. Burr©win~ and Eneumberin~. To borrow money from any person including. any fiduciar~T acting hereunder, and to mortgage. or pledge any real or personal property; H. Pra~erty l1!Ianagement. To manage,, control, repair and improve all real and personal property, L Insurance. To procure and carry- at the expense of'the estate, insurance. of the kinds, forms and amounts deemed advisable by the Co-Executor , to protect the estate and the Co-Executors against any hazard; J. Empioyment of Attornevsz .Advisors and Other L~_g~Il,,,~,,tS. To employ any attorney, investment adviser, accountant, broker, tax specialist or .any other agent. deemed necessary in the discretion of the Co-Executors; and to pay from the estate reasonable compensation for all. services performed by any of them; ~. Business Operation. To conduct alone or with. others rtny business in which. l am engaged or in which I have an .interest at my death, with all the powers of any owner with respect thereto, including. the power to delegate. discretionary duties to others, to invest other property held. hereunder in such business. and to organize a partnership or corporation to carry on such business; ~.. Ge, nerai. To do all the acts,. to take all the proc~ed:ings, and to exercise all the rights, powers and. privileges which an absolute o~~vner of the= property would have, subject al~~a~s to the discharge of their fiduciary obligations. The enumeration of certain powers in this Will shall nat limit the general or implied. powers of the Co-Executors.. The Page 5 of 9 Pages Co-Executors shall have all additional powers. that. may now ar hereafter be conferred on the Co-Executors by law or that may be necessary to enable. the Co-Ea~ecutors to administer the provisions of this Will, subject to any limitations specified in this t~1'ill. NQ ALIENA`TIt~N ARTICLE No interest of any benef ciary under. this Vi~ill ar any codicil hereto shall be subject to anticipation or voluntary ar involuntary alienation. NU CONTEST ARTICLE VI if any beneficiary oz remainderrr;tan under this Will in any .manner,. directly or indirectly, contests ar attacks this Will ar any of its pra~~isions, any share ar interest. in my estate given to that contesting beneficiary oar remainderrnan under this Wilt is revoked artd :shall be disposed of in the same manner provided herein. as if that contesting beneficiary or re:manderman had. predeceased ame without issue. Page 6 of 9 Pages LEGALITY 4F ARTICLES. ARTICLE VII If any provision of this Will or of any codicil thereto is held- to be inoperative, invalid.. or illegal, it is my intention that all of the remaining pra~isions thereof shall +~o~~tinue to be fully operative and effective so far as it is p©ssible and reasonable. TAXES ARTYC~.E VIII All estate, inheritance and succession taxes,. together with. any inte~•est and penalties thereon, payable as a result of my death and imposed -with respect to any property, whether or not disposed of by this Will, shall be paid out of the residue of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal and caused this my Last Will and Testament, consisting of nine ~4) typewritten pages, includir.~g this attestation frl clause, to be executed, declared and published this .~ ~ day of ~=~cf~.~' , 2009, at River Chase Office Center,. 443 I North :Front Street, Harrisburg, Pennsylvania. ~- ~'` .._. (SEAL) ~IJDITH E. PQGUF~' ~,: Page 7 of 9 Pages •. i i Signed., sealed, published and deciaxed by the above named JUDY'TH E. POGUE, Testatrix, as and for her Last Will, in the presence of us and each of us, ~v:ho, at her request and in her presence and in the presence of each other,. have hereunto subscribed tux names as witnesses thereto the day and year last above written. a _ ;~„ ,,~, Residing at jC~. ~`~"1. Residing at ~, ,(,.. Residing at } Page 8 of 9 Pages CpMM~N~~4'EALT~I CAF PENNSYL`JANIA SS. CQUNTY' OF DAUPHIN We, JUDITH E. PC~GUE, the Testatrix, and''` ~.. _ _ - ~ ..~'~_ ~t~. ~~~. Q~ and : ,the witnesses, whose names are signed to the attached or foregoing instrument, being first duly sworn, do :hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will, that the Testatrix signed willingly and executed it as her free and voluntary act. four the purposes therein expressed; that each. subscribing witness in the hearing and sight of tl~e Testatrix signed the 'Will. as a witness and. that to the best of his or her knol~vledge the Testa:triK was at that time eighteen (I $} years of age or older, of sound mind and under no constraint: o~~ undue influence. tf _~ .r ~..c-~ f`~ , ~ ~~ ~ J~"DITH ~. PO E ~ , .._._._.. ~, • Y ' .~ Witness ~ Witness ~~.,~.Y1 ,~' - Witness Subscribed,. sworn to and acknowledged before me by JUDTTI P()GUE, the Testatrix, andsubscribed and sworn to before me by ~.. , ~~ ~ ~ ~`~~. ~ and ~,,, , .~'-- ,witnesses, This ;~ ~.fi~' i ~--~- •~ E~ day of ~ ~~ 1 ~~.- , 20}9. r~ ~, ~ ,~ i .- r l Notary PuUlic r My Commission Expires: coMMOC~~r~~t: ~ :~t ~-~~f~a~;~Y~ ~~~:A l~tarisl Seat Gwymne C. Pr~n~b, fVatary Public Susq«af~c~na T~vp., Cauphin Cau~ty ivty Commission E.~cl:,ir~ ~uiy 25, Page ~ of 9 Pages Member, Pertnsytr•~^~~ =:~sori•,ticn ei lYatsrlss