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Home My WebLink About09-12-11COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: FULTON BANK PO BOX 7989 LANCASTER, PA 17604 -- fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: ssN: 202-20-3589 FILE NUMBER: 2110-1267 DECEDENT NAME: MYERS VIRGINIA D DATE OF PAYMENT: 09/ 12/201 1 POSTMARK DATE: 09/09/201 1 COUNTY: CUMBERLAND DATE OF DEATH: 12/ 14/2010 REV-1162 EX~11-96) NO. CD 014953 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 54,730.07 TOTAL AMOUNT PAID: REMARKS: 54,730.07 CHECK# 1 135270 INITIALS: HEA SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS EX (01-10) REV-1500 PA Department of Revenue Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 1 7 1 28-0601 1505610148 OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN 21 10 12 6 7 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth 202-20-3589 12142010 Decedent's Last Name Suffix MYERS (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix MYERS Spouse's Social Security Number M M DDYYYY 0206192], Decedent's First Name M I VIRGINIA D Spouse's First Name M I GEORGE F THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 184-],2-2683 REGISTER OF WILLS FILL IN APPROPRIATE BOXES 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 ® 6. Decedent Died Testate ® death after 12-12-82) 7. Decedent Maintained a Living Trust ~ 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 THOMAS W SHIELDS, VP 717-291,-2726 ~- First line of address FULTON BANK, NA Second line of address P•0• BOX 3215 City or Post Office LANCASTER State ZIP Code PA 1760432],5 REGISTER OF tlp FUSE ONLY..,.: _ - 4.. ~3 I ,. ~ _ {_..~ 7 r .., ~ - ,1 __( 1 . ~ ......_i _ +_ .~ - , DATE FILED ' Correspondent'se-mail address: TSHIELDSa1FULTONFINANCIALADVISORS-COM --r ~~ ;_~, ._._- __ ,, _... - . _ A ! ~ --~ _. ~. ~_~ ,~ Under penalties of perjury, I declare that I have examined this return, inGuding accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE F FILING RETURN DATE FULTON BANK, NA BY : "s~.~,.__ 9/9/201], ADDRESS P-0• BOX 3215 LANCASTER, PA ],7604-3215 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 1505610148 9M46474.000 1505610148 J Estate of Virginia D. Myers Executors (Page 1) Name Fulton Bank, NA Address P.O. Box 3215 202-20-3589 Lancaster, PA 17604-3215 Tax ID 23-1928421 J 1505610248 REV-1500 EX Decedent's Social Security Number 202-20-3589 Decedents Name: M Y E R S V I R~ T N T A _ D RECAPITULATION 1. Real Estate (Schedule A) , 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. 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested 6_ 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested 7. 8. Total Gross Assets (total Lines 1 through 7) 8 Side 2 9. Funeral Expenses and Administrative Costs (Schedule H) , _ _ , 9 3 D , 3 7 7.8 6 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) 10 8 , 2 7 4.3 6 11. Total Deductions (total Lines 9 and 10) , 11 _ 3 8 , 6 5 2.2 2 12. Net Value of Estate (Line 8 minus Line 11) . 12. 9 6 4 , 4 4 9.2 8 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) , , 13 0 • ^ 0 14. Net Value Subject to Tax (Line 12 minus Line 13) , 14. 9 6 4 , 4 4 9.2 8 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers un~er Sec. 9116 (a)(1.2) x .o - 6 4 , 014.9 7 15. 16. Amount of Line 14 t xable 0 4~ at lineal rate x . 9 0 0, 4 3 4.31 16. 17. Amount of Line 14 taxable at sibling rate X .12 0 • 0 0 17 18. Amount of Line 14 taxable at collateral rate X .15 0 . 0 0 18. 19. TAX DUE 19. 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 1505610248 1505610248 •00 0.00 0.00 0.00 9, 405.89 0.00 993,695.61 1,003,],01.50 0.00 40,519.54 0.00 0.00 40, 519.54 a J 9M4648 4.000 REV-1500 EX Page 3 Decedent's Cmm~lPtP ~4rirlracc~ File Number '~, ,n ,ter ~ .vu y~LJ ~ DECEDENTS NAME MY S VIRGINIA D STREET ADDRESS CITY MECHANICSBURG STATE PA ZI P 7055- Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments 3 4, 0 0 0. 0 0 B. Discount 1, 7 8 9.4 ? 3. Interest (1> _ 40, 5],9.54 Total Credits (A + B) (2) 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. 35, 789.47 (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) _ 4 , 7 3 0 • 0 7 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 July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent (72 P.S.§9116 (a) (1.1) (i)]. For dates of death on or after 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, 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 REV-1508 EX + (8-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS & M~S(i. INHERITANCE TAX RETURN RESIDENT DECEDENT , PERSONAL PROPERTY ESTATE OF FILE NUMBER Virginia D. Myers 21 10 1267 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Cash 0.65 Found in Among Jewelry 2 Cash 89.06 Found in Wallet 3 Coins 102.60 Appraised Value See Copy of Thomas Schell Appraisal Sheet 4 Fulton Bank Checking Account #3623-25184 7,216.99 5 Fulton Bank Savings Account #3220-95196 100.19 Interest accrued to 12/14/2010 0.01 See copy of Fulton Bank Letter 6 Jewelry 1,436.15 Appraised Value See copies of The Store and Windham Jewelers Appraisals for item 6. 7 Stamps 1.76 Sale Proceeds 8 Alert Pharmacy Services, Inc 99.43 Credit Balance Refund 9 Delaware Group Treas Resvs Ltdtrm Dvrin I Mutual Fund (As Quoted By Nasdaq) CIISIP: 245912506 19.54 Mutual Fund Fee Rebate 10 Europacific Growth Fd Shs C1 F-2 Mutual Fund (As Quoted By Nasdaq) CIISIP: 29875E100 12.36 Mutual Fund Fee Rebate 11 Federated Mun Secs Income Tr Pa Mun Incur A Mutual Fund (As Quoted By Nasdaq) CIISIP: 313923708 3.85 Mutual Fund Fee Rebate Total from continuation schedules• 323.30 TOTAL Also enter on line 5 Reca itulation $ 9 , 4 0 5 . 8 9 3W46AD 1.000 (If more space is needed, insert additional sheets of the same size) Estate of: Virginia D. Myers 21 10 1267 Schedule E (Page 2) Item Value at Date No. Description of Death 12 Managers Fds Pimco Bd Fd Mutual Fund (As Quoted By Nasdaq) CIISIP: 561717638 90.77 Mutual Fund Fee Rebate 13 McReeson AWP Consumer Cash Payor Class Settlement Fund 100.00 Class Action Suit Settlement 14 Price T Rowe Growth Stk Fd Inc Com Mutual Fund (As Quoted By Nasdaq) CIISIP: 741479109 11.18 Mutual Fund Fee Rebate 15 Rowe T Price Short Term Bd Fd Com Mutual Fund (As Quoted By Nasdaq) CIISIP: 77957P105 121.35 Mutual Fund Fee Rebate Total (Carry forward to main schedule) 323.30 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 Virginia D. Myers 21 10 1267 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 NUMBS DESCRIPTION OF PROPERTY HJCLLOETHENAMEOFTHETRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE p4TE of TRANSFER ATTACHACOPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST EXCLUSION IF APPLICABLE TAXABLE VALUE ~~ Virginia D Myers Revocable Estate Trust dated June 18, 1991 and amended April 18, 2008 with Fulton Bank as Trustee. See copy of trust document. Assets are listed below 1 through 20. 50,000 Par California Pa Area Sch Dist Ref Go Bd Mat: 02/01/2011 3.5$ Financial Times Interactive Data CIISIP: 130532GH1 50,173.50 100.0000 0.00 50,173.50 Interest accrued to 12/14/2010 646.53 100.0000 646.53 2 3,852.933 Shares Delaware Group Treas Resvs Ltdtrm Dvrin I Mutual Fund (As Quoted By Nasdaq) CIISIP: 245912506 34,252.57 100.0000 0.00 34,252.57 3 285.647 Shares Europacific Growth Fd Shs C1 F-2 Mutual Fund (As Quoted By Nasdaq) CIISIP: 29875E100 11,945.76 100.0000 0.00 11,945.76 4 50,000 Par Exeter Twp Pa Sch Dist Sch Dist Mat: 05/15/2013 3.7~ Financial Times Interactive Data CIISIP: 302024JR6 52,572.00 100.0000 0.00 52,572.00 Interest accrued to 12/14/2010 149.03 100.0000 149.03 5 25,000 Par Federal Farm Cr Bks Global Mat: 09/19/2012 3.6$ Government/Agency (Dealer Quotations) CIISIP: 31331GCC1 26,285.16 100.0000 0.00 26,285.16 Total from continuation sched les 817,671.06 TOTAL (Also enter on line 7, Recapitulation) $ 3,695.61 If more space is needed, use additional sheets of paper of the same size. 9W46AF 2.000 Estate of: Virginia D. Myers Schedule G (Page 2) Item DOD Value No. Description of Asset $ Interest Exclusion Interest accrued to 12/14/2010 212.50 100.0000 6 1,089.96 Shares Federated Mun Secs Income Tr Pa Mun Incur A Mutual Fund (As Quoted By Nasdaq) CIISIP: 313923708 11,161.19 100.0000 7 Federated Prime Oblig MMF #396 Invested Principal Cash CIISIP: 60934N708 26,121.76 100.0000 8 27,089.692 Shares Federated Total Return Sers Totl Ret Instl Mutual Fund (As Quoted By Nasdaq) CIISIP: 31428Q101 299,882.89 100.0000 9 651 IInits Fulton Financial Advisors Common Stock Fd CIISIP: 999327901 38,104.70 100.0000 10 5,244 Shares Fulton Financial Advisors Value Stock Fd CIISIP: 999328008 41,149.11 100.0000 11 273.525 Shares Gabelli Equity Ser Fds Inc Sm Cap Grwth I Mutual Fund (As Quoted By Nasdaq) CIISIP: 362397830 9,277.97 100.0000 12 1,014.843 Shares Goldman Sachs Tr Lrg Cp Val Ins Mutual Fund (As Quoted By Nasdaq) CIISIP: 38142Y773 11,843.22 100.0000 13 206.36 Shares Harbor Fd Intl Fd Instl Mutual Fund (As Quoted By Nasdaq) CIISIP: 411511306 12,528.12 100.0000 14 300 Shares Hershey Co Com New York Stock Exchange CIISIP: 427866108 14,217.00 100.0000 Total (Carry forward to main schedule) 21 10 1267 Taxable Value 212.50 0.00 11,161.19 0.00 26,121.76 0.00 299,882.89 0.00 38,104.70 0.00 41,149.11 0.00 9,277,97 0.00 11,843.22 0.00 12,528.12 0.00 14,217.00 464,498.46 Estate of: Virginia D. Myers Schedule G (Page 3) Item DOD Value No. Description of Asset $ Interest Exclusion Dividend accrued on 12/14/2010 96.00 100.0000 15 7,508.071 Shares Managers Fds Pimco Bd Fd Mutual Fund (As Quoted By Nasdaq) CIISIP: 561717638 81,387.49 100.0000 16 305.414 Shares Price T Rowe Growth Stk Fd Inc Com Mutual Fund (As Quoted By Nasdaq) CIISIP: 741479109 9,797.68 100.0000 Dividend accrued on 12/14/2010 5.19 100.0000 17 301.334 Shares Principal Fds Inc Intl Emgmkt Inst Mutual Fund (As Quoted By Nasdaq) CIISIP: 74253Q804 7,925.08 100.0000 18 1,159.042 Shares Principal Fds Inc Mc Bld Fd Intl Mutual Fund (As Quoted By Nasdaq) CIISIP: 74253Q747 15,473.21 100.0000 19 33,994.122 Shares Rowe T Price Short Term Bd Fd Com Mutual Fund (As Quoted By Nasdaq) CIISIP: 77957P105 164,531.55 100.0000 20 500 Shares Verizon Conununications Inc Com New York Stock Exchange CIISIP: 92343V104 17,185.00 100.0000 21 Fulton Bank IRA Certificate of Deposit #225-1906098 2,173.31 100.0000 Payable IIpon Death to George F. Myers Interest accrued to 12/14/2010 65.09 100.0000 22 David Erde Cash Gifts 8/12/10 $9,000 11/15/10 $1,000 10,000.00 100.0000 23 Sally Erde Cash Gifts 3/15/10 $1,000 6/30/10 $3,000 8/12/10 $10,000 14,000.00 100.0000 21 ,10 1267 Taxable Value 96.00 0.00 81,387.49 0.00 9,797.68 5.19 0.00 7,925.08 0.00 15,473.21 0.00 0.00 0.00 3,000.00 3,000.00 164,531.55 17,185.00 2,173.31 65.09 7,000.00 11,000.00 Total (Carry forward to main schedule) 316,639.60 Estate of: Virginia D. Myers Item No. Description 24 George Myers, Jr Cash Gifts 3/10/10 $1,000 4/21/10 $500 6/30/10 $3,000 8/12/10 $10,000 25 Rit Monroe Myers Cash Gifts 8/12/10 $9,000 11/15/10 $1,000 26 Roland Stock Cash Gifts 3/15/10 $500 6/30/10 $1,500 8/12/10 $9,000 11/15/10 $1,000 27 Melissa Stock Cash Gifts 1/4/10 $33 3/15/10 $500 6/30/10 $1,500 8/12/10 $10,000 21 10 1267 Schedule G (Page 4) DOD Value Taxable of Asset $ Interest Exclusion Value 14,500.00 100.0000 3,000.00 11,500.00 10,000.00 100.0000 3,000.00 7,000.00 12,000.00 100.0000 3,000.00 9,000.00 12,033.00 100.0000 3,000.00 9,033.00 Total (Carry forward to main schedule) 36,533.00 REV-1511 EX+ (10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS is ~ A i t ~r FILE NUMBER Vircrinia D. Mvers 2110 1267 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION A. FUNERAL EXPENSES: ~. Musselman Funeral Home, Inc Funeral Expense Total from continuation schedules . B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) Fulton Bank NA Street Address One Penn Square City Lancaster State PA ZIP 17602 Year(s) Commission Paid: 2. Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant George F Myers Street Address 222 Messiah Circle City Mechanicsburg State PA ZIP 17 0 5 5 Relationship of Claimant to Decedent SPOIISE 4. Probate Fees: 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. 1 Cumberland Law Journal Estate Notice 2 EVP Systems, Inc Asset Valuation Fee Total from continuation schedules . TOTAL (Also enter on Line 9, Recapitulation) swasAC z.ooo If more space is needed, use additional sheets of paper of the same size. AMOUNT 5,595.12 3,310.00 7,500.00 7,500.00 3,500.00 127.50 75.00 26.35 2,743.89 $ 30,377.86 Estate of: Virginia D. Myers 21 10 1267 Schedule H Part 1 (Page 2) Item No. Description Amount 2 Gingrich Memorials Grave Marker 3,310.00 Total (Carry forward to main schedule) 3,310.00 Estate of: Virginia D. Myers Schedule H Part 7 (Page 2) 3 Melissa Stock Funeral Luncheon Reimbursement 4 Patriot News Estate Notice 5 Register of Wills Cumberland County Disclaimer Filing Fee 6 The Store Jewelry Appraisal Fee 7 The Store Jewelry Appraisal Fee 8 Waggoner, Frutiger & Daub, LLP 2010 Income Tax Preparation Fee 21 10 1267 1,552.00 171.89 20.00 60.00 15.00 925.00 Total (Carry forward to main schedule) 2,743.89 REV-1512 EX + (12-OS) pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT , INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Virg inia D. Myers 21 10 1267 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE 1 OF DEATH ' Fulton Bank Checking Account #3623-25184 Debts Prior to Death and Deducted Thereto: IInited Insurance Premium 216.50 2 Fulton Bank, NA Monthly Trustee Fee 720.47 3 Johnson Duffie Estate Planning Services 425.00 4 Messiah Village Retirement Community Fee for December 3,619.10 5 Messiah Village Home Care, LLC Nursing Care 152.00 6 PA Dept of Reveunue 2010 4th Qtr Personal Estimate 390.00 7 PA Dept of Reveunue 2010 State Income Tax Due 2,703.00 8 Verizon Telephone Service 48.29 TOTAL Also enter on Line 10, Reca itulatio~ I $ 8 2 7 4 3 6 swasnH 2.00o If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (01-10) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES i D . M ers NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (InGude outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] Virginia D Myers Trust FBO George F Myers Life Estate: Virginia D Myers Trust FBO George F Myers Remainder Estate: George F. Myers ,222 Messiah Circle Mechanicsburg, PA 17055 Fulton Bank IRA Certificate of Deposit #225-1906098 Inventory Value: 2,173.31 Accrued: 65.09 FILE NUMBER: 21 10 1267 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE I Trust ITrust Surviving Spouse I I ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPF ;OPRIATI=. 61,776.57 814,362.56 2,238.40 II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I ~ 0 0 0 swasAi z.ooo If more space is needed, use additional sheets of paper of the same size. Estate of: Virginia D. Myers Schedule J Part 1 (Page 2) Item No. Description 4 Sally M. Erde 11 Alling Drive Gray, ME 04039 General Bequests: 10,000.00 Sally Erde Cash Gifts 3/15/10 $1,000 6/30/10 $3,000 8/12/10 $10,000 Inventory Value: 11,000.00 Jewelry Inventory Value: 389.00 Coins Inventory Value: 29.70 5 George F. Myers, Jr 1 Rupert Street tiVaterville, ME 04901 General Bequests: 10,000.00 George Myers, Jr Cash Gifts 3/10/10 $1,000 4/21/10 $500 6/30/10 $3,000 8/12/10 $10,000 Inventory Value: 11,500.00 Jewelry Inventory Value: 915.25 Coins Inventory Value: 72.90 Relation Daughter Son 21 10 1267 Amount 21,418.70 22,488.15 Estate of: Virginia D. Myers 21 10 1267 Schedule J Part 1 (Page 3) Item No. Description Relation Amount 6 Melissa M. Stock 701 Green Acres Street Mechanicsburg, PA 17055 General Bequests: 10,000.00 Melissa Stock Cash Gifts 1/4/10 $33 3/15/10 $500 6/30/10 $1,500 8/12/10 $10,000 Inventory Value: 9,033.00 Jewelry Inventory Value: 131.90 Daughter 19,164.90 7 David Erde David Erde Cash Gifts 8/12/10 $9,000 11/15/10 $1,000 Inventory Value: 7,000.00 Grandson 7,000.00 8 Kit Monroe Myers Kit Monroe Myers Cash Gifts 8/12/10 $9,000 11/15/10 $1,000 Inventory Value: 7,000.00 Granddaughter 7 000.00 9 Roland Stock Roland Stock Cash Gifts 3/15/10 $500 6/30/10 $1,500 8/12/10 $9,000 11/15/10 $1,000 Inventory Value: 9,000.00 Son-in-law 9,000.00 REV-1514 EX+ (4-09) Pennsylvania DEPARTMENT OF REVENUE Bureau of Individual Taxes PO Box 280601 Harrisburg PA 1 7128-06 0 1 ESTATE OF SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN (CHECK BOX 4 ON REV-1500 COVER SHEET) FILE NUMBER Vir4'inia D. Myers 21101267 This schedule should be used for all single-life, joint or successive life estate and term-certain calculations. For dates of death prior to 5-1-89, actuarial factors for single-life calculations can be obtained from the Department of Revenue. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99, and in Aleph Volume for dates of death from 5-1-99 and thereafter. Indicate below the type of instrument that created the future interest below and attach a copy of it to the tax return. ^ Will X^ Intervivos Deed of Trust ^ Other NAME OF LIFE TENANT DATE OF BIRTH NEAREST AGE AT TERM OF YEARS DATE OF DEATH LIFE ESTATE IS PAYABLE F Myers 03/15/1920 X Life or Term of Years Life or ~ ~ Term of Years Life or ~ ~ Term of Years Life or ~ Term of Years Life or ~ ~ Term of Years 1. Value of fund from which life estate is payable $ 8 7 6 ,13 9.13 2. Actuarial factor per ap ro riate table . . . . .. . .. . .. . . .. . . . . . . . 0.07051 Interest table rate - ~ 3.5% ^ 6% •^ 10% X^ Variable Rate 1.80000% 3. Value of life estate (Line 1 multiplied by Line 2) ... _ . . _ . . _ _ $ 61, 776.57 NAME OF LIFE ANNUITANT DATE OF BIRTH NEAREST AGE AT TERM OF YEARS DATE OF DEATH ANNUITY IS PAYABLE Life or ~ ~ Term of Years Life or ~ Term of Years Life or _~ Term of Years ' I I Life or ~ ~ Term of Years 1. Value of fund from which annuity is payable 0.00 2. Check appropriate block below and enter corresponding•number ... ~ ~ ~ ~ ~ ~ ~ ~ $ ............ 0.000 Frequency of payout -~ Weekly (52) Bi-weekly (26 Monthly (12) ^ Quarterly (4) ^Serni-annually (2) Annually (1) Other ( ) p 3. Amount of payout per period . . . . . . . . $ 0.00 4. Aggregate annual payment, Line 2 multiplied by Line 3 ~ ~ ~ ~ 0.00 ................ 5. Annuity Factor (see instructions) Interest table rate -~ 3 1 /2 % ^ 6% ~ 10% ~ Variable Rate 0.0 0 0 0 0 % 0.0 0 0 0 0 6. Adjustment Factor (See instructions.) . . . . _ 0.00000 ...... ....... 7. Value of annuity - If using 3.5%, 6%, or 10%, or if variable rate and period. payout is at end of period, calculation is: Line 4 x Line 5 x Line 6 . _ _ _ _ $ 0.00 If using variable rate and period payout is at beginning of period, calculation is: (Line4xLineSxLine6)+Line3...____$ 0.00 NOTE The values of the funds that create the above future interests must be reported as part of the estate assets on Schedules A through G of the tax return. The resulting life or annuity interest should be reported at the appropriate tax rate on Lines 13 and 15 through 18 of the return. If more space is needed, use additional sheets of the same size. SW46AJ 1.010 REV-1649 EX+ (698) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE O ELECTION UNDER SEC. 9113(A) (SPOUSAL DISTRIBUTIONS) ESTATE OF FILE NUMBER Virginia D. Myers 21 10 1267 Do not complete this schedule unless the estate is making the election to tax assets under Section 9113(A) of the Inheritance 8 Estate Tax Act If the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust. This election applies to the Virginia D Myers TW Georcre F Trust (marital, residual, A, B, By-pass, Unified Credit, etc.) If a trust or similar arrangement meets the requirements of Section 9113(A), and: The trust or similar arrangement is listed in Schedule O, and The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule 0, then the transferor's personal representative may specifically identify the trust (all or a fractional portion or percentage) to be included in the election to have such trust or sim- ilar property treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property is included as a taxable transfer on Schedule O, the personal representative shall be considered to have made the election only as to a fraction of the trust or similar arrangement. The numerator of this fraction is equal to the amount of the trust or similar arrangement included as a taxable asset on Schedule 0. The denominator is equal to the total value of the trust or similar arrangement. PARTA Enter the description and value of all interests, both taxable and non-taxable, regardless of location, which pass to the decedent's surviving spouse under a Section 9113(A) trust or similar arrangement. ter more space rs neeoed, insert additional sheets of the same size) 3W46E2 2.000 yl-_Fl~a-o~-`~_ ~-ss y/~ ~~o~ /~ ~ 1 / v~` Last Will and Testament OF VIRGIl~tIA D. MYERS I, VIRGINIA D. MYERS, of Mechanicsburg, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void an}~ and all Wills or Codicils at any time heretofore made by me. ARTICLE I DEBTS I direct the payment of all my legal debts and the expenses of my lest illness and funeral from my Estate as soon after my death as conveniently may be done. ARTICLE II TANGIBLE PERSONAL PROPERTY I give and bequeath my household furniture and furnishings, books, pictures, jewelry, automobiles, wearing apparel and all other articles of household or personal use or adornment, together with any existing insurance thereon unto my husband, GEORGE F'. MYERS, provided he survives me. If my husband, GEORGE F. MYERS, predeceases me, I give and bequeath such articles of personalty to those persons I have listed in a written memorandum, which I intend to place with this, my Last Will and Testament. If no such memorandum is located or received by my Personal Representative within sixty (60) days after taking office as such, after conducting a In the event that My Revocable Trust is not in effect, I give, devise and bequeath the rest, residue and remainder of my Estate unto my Personal Representative under this Will as Trustee (without bond) to hold, administer and distribute the same as a Trust under Will the provisions of which shall be identical with those of the My Revocable Trust which provisions are incorporated herein by reference. ARTICLE IV POV4'ERS OP PERSONAL REPRESENTATIVE AND TRUSTEE My Personal Representative and Trustee shall have the following powers in addition to those vested in them by law and by other provisions of my Will applicable to all property, whether principal or income, including property held for minors, exercisable without court approval and effective until actual distribution of all property: A. To have full authority to deal with any business interest as freely as I might in my lifetime. B. To make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as they may determine. C. To retain any or all of the assets of my estate, real or personal, without restriction to investments authorized. fir Pennsylvania fiduciaries, as they deem proper, ~vitho~at regard to any principle of diversification or risk. D. To invest in all forms of property without restriction to investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to any principle of diversification or risk. 3 IN WITNESS EREOF, I have hereunto set my hand and seal to this, my Last Will ~j~ ~ ~ and Testament, this ~r~ day of ~~ ~~ , 2008. _ ., ~~ ~ ~ Z~ ~ (SEAL) VIRG IA D. MYER Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will. and.. Testament, in the presence of us, who at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses. .~ -~ t~, ~. c~~ Witness W~~f ss ` '- 329961 COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF CUMBERLAND . On this, the 1~~day of A ~ , 2008, before me, the undersi ned officer, personally appeared Edmund G. Myers, Attorney I.D. #20558, known to me (or satisfactorily proven) to be a member of the bar of the highest court of Pennsylvania and certified that he was personally present when the foregoing acknowledgement and affidavit was signed by the Testatrix and the witnesses. IN WITNESS WHEREOF, I hereunto set my hand and official seal. l.~-~x ~' otary P is COMMOiV~J`'E1~LTH OF I~F!~1NSYt_`JAE JIA NOTARIAL ~~EAL GAIL. J. ILaAH0t~1EY, Notary Public Lemoyne Coro., C!~mberian~ County ~Jiy Comm~ssior, Expires Feb. i ~, 2Q10 7 y~-~~la-af-~ ~5s a~ ~~ 0 9 Cod Codicil to Last Will and Testament OF VIRGINIA D. MYERS __ I, VIRGINIA D. MYERS, of Mechanicsburg, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this to be the~sole Codicil to my Last Will and Testament dated April 18, 2008. Item 1. 1 hereby revoke Article lI, TANGIBLE PERSONAL PROPERTY, and in lieu thereof provide as follows: ARTICLE II TANGIBLE PERSONAL PROPERTY i dispose of my tangible personal properly, ir:ciuding furniture, fui:~rishir:gs, books, jewelry, pictures, my automobile and all other articles of household or personal use or adornment as follows: A. I give and bequeath my piano unto my daughter, SALLY M. ERDE; B. I give and bequeath such of the remaining items of m~,~ furniture to my son, GF,ORGE F. MYERS, JR. as he may elect; and C. I give and bequeath my books, photographs and other personal memorabilia, together with any and all of the rerriainder of the items described in this Article unto my children who survive me, to be divided .~~- u~ ACKNOWLEDGMENT AND AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND . ss. jj We, VIRGINIA D. MYERS, i C~''V~ ~,- ~` Vt and "Q~ ~~' ~ ~ ~1,~t'v`~ the Testatrix and the witne - ~ sses; respectively, 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 the Sole Codicil to her Last Will and that she had signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the' witnesses, in the presence and hearing of the Testatrix, signed the Codicil as witness and that to the best of his/her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. 4` _,_: ~t._ ` -~ _ y t~t~-tom •~ ~-•=~ . 1 J / .~, i VIRGINIA D. MYERS ~. Witness ,` ~~ __ Witness Subscribed, sworn to and acknowledged before me by VIRGINIA I). MYERS, Testatrix, and subscribed and sworn to before me by ~~~.~.e ~. C7, t,~ and ~R-t'3 ~ ~~'+~ ~-~ ,witnesses, this ~' da of ~a -~~. Y , 2009. ~~\ 1 i Edmund G. Mye Attorney I.D. #205 5 8 . ~-1 ~/ ~~- 0 ~ q •. .-• ~S. ~~~~~qq1 REVOCABLE ESTATE TRIIST ON this ~~-- day of , 1991, I, VIRGI~IZA D. MYERS, of Gamp Hill, Cumberland County, Pennsylvania, as BETTLOR, by this deed of trust with FIILTON BANK, a Pennsylvania Banking Corporation (Corporate Trustee) and GEORGE P. MYERS {individual Trustee) of Camp Hill, Cumberland County, Pennsylvania, as TRUSTEES, have transferred or will transfer certain property to the Trustees. I direct that the trust property or the proceeds of insurance policies, together with whatever additional property is given to the trust by me or by any other person, shall be held by the trustees on the following trusts: section 1. While I am alive: A. The trustees shall pay to me whatever income or principal I request from time to time. B. If I become disabled in any way, the trustees shall apply income or principal directly for my benefit or for the benefit of any person I am legally obligated to support. If a guardian is appointed by a court for me, the trustees shall pay over the principal and undistributed income of the trust to the guardian. Section 2. Diapositive Provisions after my death: On my death, the trustees shall distribute the then remaining principal, together with all income accrued and unpaid to the date of my death, combined with any other assets, which by my East Will and Testament dated ~t~~-(,~ , 19 a~ , have been delivered or paid to trustees in accordance therewith, as follows: 1 2' A. If my husband, GEORGE F. MYERS, predeceases me, I authorize my trustees to distribute to the Executor of my Estate any funds necessary to pay and discharge any administrative expenses, taxes or any other debt or liability of my estate or which may be necessary to be paid to my Executor in order to conclude administration of my estate. All remaining principal and income not expended in accordance with the foregoing shall, upon my death, be distributed unto my then-living issue, per stirpes, by representation, at which time this Trust shall terminate. B. If my husband, GEORGE F. MYERS, is living at the time of my death, I direct that my trustees shall distribute the then-remaining principal and any income accumulated thereon, combined with any other assets, which by my Last Will and Testament dated ~/Lce, l~ , 1991, have been delivered or paid over to trustees in accordance herewith: 1. If the federal estate tax due because of my death will be reduced by making this gift for his benefit, I direct that my trustees retain, in TRUST, (to be known as Trust A) however, for my husband's' benefit, the least amount (based upon the values as finally determined for federal estate tax purposes) as shall be needed for the federal estate tax unlimited marital deduction to reduce the federal estate tax to the lowest possible figure after full use of all other deductions and credits allowable in calculating the federal estate tax, except that such amount shall be calculated without regard to the augmenting of my taxable estate by reason of generation-skipping transfers and without regard for any credit for state death taxes that would not otherwise be payable. Accordingly, I direct that: a. If the marital deduction or any similar benefit is allowable with respect to any property, including property held by entireties, which my husband has received prior to my death or at my death will receive otherwise than pursuant to this Subparagraph 1, the value of such property shall be taken into - -- -J 3 consideration in calculating the size of the gift under this Subparagraph 1. b. No property ineligible for the marital deduction or any similar benefit shall be distributed to this Trust A for my husband, GEORGE F. MYERS. c. Either cash investments or both ma}r be allocated to this Trust A. d. Any property allocated under this Subparagraph 1 in kind shall be valued at the value at which it is finally included fn my gross estate for federal estate tax purposes, provided that the aggregate market value thereof on the date of allocation (plus the value as finally determined for federal estate tax purposes of all other property qualifying for the marital deduction) is at least equal to the dollar value of the marital deduction as finally determined for federal estate tax purposes. e. My husband, GEORGE F. MYERS, shall be paid the entire income from the principal in such periodic installments as the trustees shall find convenient, but at least as often as quarter--annually. f. My husband, GEORGE F. MYERS, is hereby given a power to appoint by Will to his estate or to others, in such manner and for such estates as he may appoint, exercisable only by specific' reference by him alone and in all events over the principal of this Trust. g. As much of the principal of this Trust as the trustees may from time to time find in the exercise ~f its sole discretion shall be reasonably required for the support, maintenance and medical care of my husband, as nearly as may be in the style to which he has been accustomed during his lifetime with Settlor shall be paid to him or else applied directly for his benefit by the trustees. h. In addition to the above provisions, my husband, GEORGE F. MYERS, shall have the power to withdraw such amounts from 4 principal as he shall desire from time to time including the entire exhaustion of principal. i. If my husband, GEORGE F. MYERS, shall fail, either wholly or in part, to exercise effectively the power of appointment created in the preceding Section h, the unappointed principal shall be added to, and thereafter treated as a part of, the Trust estate passing under Paragraph B, Subparagraph 2 hereof, provided that the trustees shall first deduct and pay to the personal representative of my husband's estate an amount equal to the increase in federal and state death taxes and any increased administration expenses which his estate will have to pay because of the inclusion of the principal of this Trust in his estate for tax or administration purposes. j. If any provision of this Trust shall result in depriving my estate of the marital deduction for federal estate tax purposes, such provision is hereby revoked and this Trust shall be read as if any portion thereof inconsistent with the allowance of the marital deduction for federal estate tax purposes is null and' void. 2. The balance of the then-remaining principal, income accumulated thereon, any other assets which, by my Last Will and Testament, have been delivered or paid to trustees, I direct what my trustees retain in TRUST (to be known as Trust B), for the following uses and purposes: a. To pay the net income therefrom to GEORGE F. MYERS for and during his lifetime, in such periodic installments as my trustees shall find convenient, but at least as often as quarter annually. b. After taking into account his other readily available assets and sources of income and support, as much of the principal of this Trust as the Corporate Trustee in its sole discretion may think advisable for the support, maintenance and medical care of my husband, GEORGE F. MYERS, shall either be paid to him or else applied directly for his benefit by the trustees, it being 5 Settlor's intention to invade this Trust B only if such other sources are inadequate for such purpose. c. My trustees may apply the net income of this Trust for the support of GEORGE F. MYERS, should he by reason of age, illness or other cause in the opinion of the trustees be incapable of disbursing it. d. Upon the death of GEORGE F. MYERS, the then--remaining principal and any undistributed income thereon shall be distributed unto the beneficiaries, and in the amounts and for the purposes set forth in Section 2, Paragraph A. 3. In the event that my husband, GEORGE F. MYERS, survives me, I authorize my trustees to distribute to the Executor of my estate any funds necessar}• to pay and discharge any administrative expenses, taxes and any other debt or liability of my estate or which may be necessary to be paid to my Executor in order to conclude administration of my estate, however, such funds shall be allocable to or chargeable only against the assets or property which fund Trust B. C. In the event that any beneficiary shall not have reached the aqe of twenty-five (25) years at the time for distribution of his or her share, I give, devise and bequeath such share unto FULTON BANK, IN SEPARATE TRUST, to hold, manage, invest and reinvest the share so received, and the accumulation of income thereon, and to use and apply the income and principal, or so much thereof as, in trustee's discretion, may be necessary or appropriate for such beneficiary's support and education (including college education, both graduate and undergraduate, and vocational training) without regard to his or her ability to provide for such support or education or to make payment for these purposes, without further responsibility, to such beneficiary or to any person taking care of such beneficiary. When such beneficiary shall reach the age of twenty--f ive ( 25 ) years, trustee shall distribute one-half of the then remaining principal and any income accumulated thereon unto the beneficiary, and when such 6 beneficiary shall reach the age of thirty (30) years, trustee shall distribute the then-remaining principal and any income accumulated thereon unto such beneficiary absolutely, and the Trust as to that beneficiary shall terminate. In the event any beneficiary dies before receiving his or her final distribution hereunder, such beneficiary's Tr+~st shall terminate and the balance of principal and income shall be paid over to my then-living issue per stirpes by representation. 1. During the time any portion of my Estate remains in Trust, the same shall not be subject to attachment, levy or seizure by any creditor, spouse, assignee or trustee or receiver in bankruptcy of any beneficiary prior to his or her actual receipt thereof . The trustee shall pay over income and principal as hereinbefore determined to the parties designated, as their interest may appear, without regard to any attempted anticipation, pledge or assignment by any beneficiary, and without regard to any claim thereto or attempted levy, attachment, seizure or other process, provided that i.f any such levy or seizure, or other process, shall be authorized by law or specific order of any Court having jurisdiction, trustee shall note be liable to any beneficiary for violation hereof by reason of the same. , 2. If at any time during the continuance of any Trust creates hereunder, the trustee in its sole and absolute discretion determines that the size of any individual Trust account has become so small as to bF impractical to continue to hold in Trust and uneconomical to continue tC administer as a Trust, then in such circumstances, ache trustee may without further authorization distribute the balance of the principal and income it such Trust account to the beneficiary then-entitled to the income therefrom, and upon such distribution the trustee shall be released from further obligation with respect to that account and shall not be subject to and claim from any person who may have had a future interest in such Trust account had it been continued in Trust. ~i D. Should Settlor and GEORGE F. MYERS die under such circumstances that it is difficult or impossible to determine who died first, the Settlor should be deemed to have predeceased GEORGE F. MXERS. Section 3. In the administration of the trust herein during my lifetime: a. Before actual payment to a beneficiary, ro interest in income or principal shall be assignable by, or available to anybody having a claim against, the beneficiary. B. The trustees may make authorized distributions to beneficiaries in cash or in kind. C. The trustees at any time may terminate the trust if the value thereof is less than twenty thousand dollars or does not warrant the cost of continuing said share in trust or if its administration would be otherwise impractical. On such termination, the trustees shall pay the principal and any accumulated income of the trust to me. Section !.~ Any fiduciary appointed in this trust may exercise the powers given by law and those given by this trust, and in addition thereto and without any order of court and in the discretion of such fiduciary, may sell all or any trust property, real or personal, at public or private sale, for cash or credit, and may execute deed or bills of sale. Such fiduciary may also invest and reinvest in any property without restriction to legal investments, including any common trust fund maintained by a fiduciary and~~ including stock in or obligations of a f fiduciary, and also vote securities, in person or by proxy, including stock in a fiduciary and in such connection', delegate discre-tionary powers, and also compromise or abandon claims. section 5. The situs of the trust shall be Cumberland County, Pennsylvania, and questions about the validity, construction and administration of the trust shall be determined in accordance with the law of Pennsylvania. 8 Section 6. A. I reserve the right to revoke or amend this trust in whole or i~ part at any time and from time to time by written instrument delivered tc the trustees when I am living. B. The duties, powers and liabilities of the trustees shall not be changed by amendment without the written consent of the trustees. C. The trustees shall deliver as directed, absolutely and free o1 trust, any policies or other property withdrawn by revocation. Section ?. Concerning fiduciaries: A. No fiduciary shall be required to give or enter into any bond or security in any jurisdiction. B. The corporate fiduciary shall be compensated periodically in accordance with the schedule of compensation of the fiduciary currently in effect when the services are performed. C. The trustees may make court accountings, but the approval of an account by the interested beneficiary shall be a full discharge of the trustees. D. In the event the Individual Trustee dies, :becomes incapacitated, resigns or ceases to so act, I direct that the Corporate Trustee shall continue to so serve without the appointment of a successor individual trustee. I further direct that the Individual Trustee shall not have any duty, obligation or right, in the administration of this trust, to exercise any discretion with respect to payments of principal or income under the provisions set forth in Section 2 hereof, such discretion to be exercised solely and entirely by my corporate trustee. Morecver, I direct that the. Individual Trustee shall not participate in decisions regarding payments td~ me, or for my benefit, set forth in Section 1 or Section 3 hereof. In no, event shall the status of the Individual Trustee as such be deemed or interpreted in such way that the Individual Trustee shall have the right to ._ , 91 _ v+ ~ ": ~ • i i exercise any discretion with respect to an distributions which are to be made in the exercise of corporate trustees' discretion exclusively. IN WITNESS WHEREOF, Settlor and Individual Trustee have hereunto set their hands and seals, and the Corporate Trustee has executed this instrument and caused its Corporate Sea 1 to be affixed hereto on the day and year first above written, with intent to be legally bound hereby. SIGNED, SEALED and DELIVERED in the presence of Witness ATTEST: _.~. ? •~., .. t ' . ~~' ~" ~~ '~,~. Title y ~~ i , ,.~;. ~ vs+ ~ ~"' .• :. --i :rte ('SEAL) ~, _- •~• ~ .• . j~.~ SIGNED, SEALED and DELIVERED in the presence of SETTLOR: -- o -1 .~ EAL ) Virgins D. Myers ' FULTON BANK BY : - ~^- Title ' '~"~ ( SEAL) George My rs .. _ _ 10 COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND On this the %y~~ day of , 1991, before me, the undersigned officer, personally appeared the within named settlor known to me (or satisfactorily proven) to be the person whose name he/she subscribed to the within deed of trust and acknowledged that he/she executed the same for the purposes therein contained. ... . ~ >> . ~i ~N WITNESS WHEREOF, I have hereunto set nay hand and sc_`~'1 ~~ ~~ r ~~' ~~' r v `~ r ~~~ .}~ Ali. ~~ ~ ~_r ~ .~Lt r• ~~~~ otary Public ' -:; NOTARIAL. SEAL GINA M ALOISIO, Nafary public ~Iliamsport, tycoming County, Pa. My Commission Expires Oec. 28, 1992 I ----- _. , 1 1 Trustees hereby acknowledge receipt of the property described in this Schedule "A": 1 41F112-O1-9 it y- ~ g• d~ AMENDMENT TO REVOCABLE ESTATE TRUST A~r,~rr, THIS AMENDMENT TO REVOCABLE ESTATE TRUST is made this ~g~- day of ~ , 2008, between VIRGINIA D. MYERS, Mechanicsburg, Pennsylvania ("Settlor") and FULTOI\' FINANCIAL ADVISORS, N.A. (formerly Fulton Bank} and GEORGE F. MYERS, (`'Trustees"). BACKGROU~tD A. Settlor and Trustees executed a Revocable Estate Trust on June 18, 1991 ("Trust"). B. The parties wish to amend the Trust and to set forth their understandings in writing. NOW, THEREFORE, in consideration of the mutual promises and covenants set forth herein, the parties, with intent to be legally bound hereby, covenant and agree as follows: 1. Background. The background is incorporated herein. ?. Section 2: Diapositive Provisions after my Death:. Section 2: Diapositive Provisions after my Death: is hereby deleted and the following substituted therefor: Section 2: Diapositive Provisions after my Death: Upon my death, I direct my Trustee to distribute all net income and principal of the Trust, together w7th all property distributable to the Trustee as a result of my death, as follows: A. Distributions to Personal Representative. The Trustee shall pay and distribute from the Trust to the personal representative of my estate, or in the Trustee's discretion, pay directl}•, without seeking reimbursement from any person; such sums as may be required by the personal representative to pay legal debts, expenses payable on account of my death, whether arising with respect to assets passing under this Trust or otherwise. All death, succession and transfer taxes may, in Trustee's discretion, be paid from the assets of the Trust to the personal representative for satisfaction thereof in Trustee's discretion. In making such determinations, Trustee may rely upon written instructions of the personal representative of my estate. Such payment(s) shall not require reimbursement or adjustment of accounts of the Trust or of the shares that beneficiaries shall be entitled to receive in income and/or principal. B. Distribution to Beneficiaries. After payment of such sums as may be required under the foregoing paragraph, I direct my Trustee to distribute the sum of TEI~' THOUSAND {$10,000.00) DOLLARS unto each one of my children, MELISSA M. STOCK, SALLY M. ERDE and GEORGE F. MYERS, JR., who survives me, and to distribute the balance of principal and net income unto my husband, GEORGE F. MYERS, provided he survives me (and I direct that for purposes of this distribution that he shall be deemed to have survived me unless it appears unmistakably that he predeceased me} and further subject to the provisions of Paragraph D hereafter. If my husband predeceases me, I direct the Trustee to distribute the balance of the principal and net income unto my then-living issue, per stirpes. C. Further Trusts: Beneficiary Under the Age of 27. Should any person entitled to a distribution of a share of the Trust not have reached the age of twenty-seven (27} years at the time for distribution to him or her, I direct Trustee to hold such distribution, ICI SEPARATE TRUST. and to manage, invest and reinvest the share(s) so received, and to use and apply the income and principal, or so much thereof, as in Trustee's discretion. may be necessary or appropriate for such beneficiary's support and education (including college education, graduate and under graduate and vocational training), taking into account such beneficiary's other resources or to make payment for these purposes, without further responsibility, to such beneficiary or to any person taking care of such beneficiary. Trustee shall distribute one-third (1/3) of the then remaining principal and any income accumulated thereon unto such beneficiary when such beneficiary shall reach the age of twent}~-one (21) years and shall thereafter pay the net income therefrom unto him or her. When such beneficiary attains the age of twenty-four {24) years, Trustee shall distribute one-half of then remaining principal and any income accumulated thereon and the balance of the principal and any income accumulated thereon when such beneficiary reaches the age of twenty-seven {27}, and the Trust as to that beneficiary shall terminate. If, at the time of funding of any SEPARATE TRUST described above, the beneficiary has already reached an age at which a principal distribution is scheduled to be made, Trustee shall distribute that portion of the principai and net accumulated income unto such beneficiary immediately. If a beneficiary dies before receiving his or her final distribution, Trustee shall distribute to or in Trust for one or more persons or organizations -other than such beneficiary's estate; his or her creditors, or the creditors of his or her estate - as said beneficiary may appoint by a Will containing a specific exercise of this power. In the absence of the exercise of such limited power of appointment, Trustee shall distribute the same unto such beneficiary's then-living issue, per stirpes. D. Disclaimer. If any person .otherwise entitled to take hereunder (or such person's legal representative) files a written disclaimer, in whole or in part, with respect to any provision of this Trust, as amended, with my Personal Representative within the period allowed by Section 2518 of the Internal Revenue Code, such person (i) shall be treated as having predeceased me for purposes of holding or distributing the disclaimed shaze, and {ii) shall not participate in any decision to pay or apply the income or principal of the disclaimed share to or for the benefit of any person hereunder, but such person shall not be treated as having predeceased me for purposes of holding, distributing or participating in any such decision under any provision to which the disclaimer does not extend. In the event my husband, GEORGE F. MYERS, .files such a written disclaimer, in whole or in part, with respect to any property or interest otherw7se distributable to him pursuant to this Section 2, Paragraph B, such property or interest so disclaimed shall be held by to my Trustee, IN TRUST, to hold, manage, invest and reinvest the same under the following terms and conditions: A. To pay the net income therefrom at least as often as quarter- annually unto my husband, GEORGE F. MYERS, for and during his lifetime. B. As much of the principal of this Trust as my Trustee in its sole discretion may from time to time think advisable for my husband's health, maintenance, and support to maintain him in the station of life to which he is accustomed at my death, or during his illness or emergency, shall be either paid to him or else applied directly for his benefit by my Trustee after taking into account other assets and sources of income available to hire. C. Trustee may apply the net income of this Trust for the support of my husband, GEORGE F. MYERS, should he by reason of age, 41 4 51 illness or any other cause in the opinion of my Trustee be incapable of disbursing it. D. t;pon the death of my husband, GEORGE F. MYERS, I direct my Trustee to distribute the balance of the principal and net income unto my then-living issue, per stirpes. 3. Resignation of George F. Myers as Trustee. The parties agree that George F. dyers shall no longer serve as Trustee. 4. Ratification. In ail other respects, the Trust is hereby ratified and confirmed, except as otherwise expressly amended herein. IN WITNESS WHEREOF, Settlor and Trustees have caused this Amendment to be duly executed on the day and year first above written. Witness: SETTLOR: ~/ T V~ii-t~-.~,,,~-~ ~ I'Lt~ Y-~ (SEAL) Virgini .Myers ' Witness: TRUSTEES: ~~ Fulton Finarscial Advisors, N.A.. ~% ~ ';~ By: ~ ~ ~ t _~ Title ~~ (SEAL) George F. Myers :329965v2 5 VIRGINIA D. MYERS ESTATE COIN LIST ~ o°i ~ 1. (1) Gettysburg Commemorative c ;~,~-~~~ 2. (1) 1963 Liberty Half Dollar 3 . (1) 1944 Liberty Half Dollar 4. (5) 1964 Silver Quarters 5 . (1) 1952 Silver Quarter ~ j 6. (1) .1960 Silver Quarter ~~ 7. (1) 1963 Silver Quarter 8. (5) 1964 Silver Dimes 8 ~ 3~~i ~cc~. ~ Z2 G, ~ ~3 9. (1) 1960 Silver Dime 10. (1) 1961 Silver Dime 11. (1) 1953 Silver Dime ~~~ 12. (1) 1977 Canadian Commemorative Coin a° ~ ~ 13 . (1) 1965 Canadian Dollar Dated: 3 3 j ~D ~ o~• •~(~~we~ ~epuew j uol~~ j aye ~o ~agway~ •~~Q j ~agway~ •y~N '~ueg uol~n j wo~•~uequo~~n~ t~'NOllfl~'008' L .IOSSaao.Id uoi~~uz~I,~uo~ ~ipa.~~ .~~o~J •~ ~ngsor .~~~ `~ja.zaauis •9 £~Z-I 6Z CL t L) ~~ auz ~a~~uoa off. aa.>~ taa~ as~atd `suoi~sanb .Iau~o ~u~ an~u nod ~I •uosuana~s auoog ina~ .IOC ~unoaa~ s~uin~s ~ uo ~y~tin .zapun u~ipo~.sn~ ost~ si s~a~y~ •Q ~iuI~.ITn ~~~ pasinp~ aq as~aid ~ei~~auaq acp se pa~sii s.ca~y~ •3 a~.zoa~ jinn auolE aw~eu .~aq ui pai~iZ -~ Zi/i/t~ 00/i/b 88/i/b %OZ•9 60'S9$ I£•£LI`Z$ 860906i-SZZ nirxnidin~ x~no z~ox u~ao ~i~x iui ~~»dzdg #Q~ ~~~ H,Lt~~(I 30 ~Zda s.~a~y~ •3 a~.IOa~ u~inn ~t~utof ptau `uau~aq a.~ous ~sam a~ ~~ L8/8/S pauadp 08Z# xog ~isodaQ a~~s auot~ auz~u .Iau uT pat}t~ `LO/0 t/6 pauado `66'91 Z`L$ aau~t~q u~~ap ~o a~~Q ~8 t SZ-£Z9£# ~ui~aau~ auot~ aureu .zau ul pal~i~ `98/LI/9 Pauado `~sa.~a~ui Pan.~aa~ t 0'0$ sntd 6 t '00 t $ aau~i~q u~~ap ~o a~~Q 96 t S6-OZZ£# s~utn~s :u~~ap ~o a~up auk ~~ uado azann s~unoaa~ ~utnnotto~ auk ~~u~ paslnp~ aq asuatd `~uapaaap auk ~o auz~u auk ui paut~~ureuz s~unoaa~ auk ~utu.Iaauoa ~.Imbul ~uaaa.~ .~no~ o~ asuodsa~ uI 0 t OZ `'b t .IaquzaaaQ pas~aaap `s~a~y~ •Q ~iui~.Itn :~ DJi~t+'~ +1Sit93~.~~7 :: ~.:: Iz~#f^ ~y- .. EJ~'t,fi`'t} ~l.' •~ ~ ,• - E .: ar l~~y'a Lkt~,~c~~ ~~~1 s~ r1~,ejt]yS~~rs ~~ ~'_~c4;,t~iE`9eiy= ' ~ i ~ ~.lal ~o I ! ~ v~s?~if :1~jt'~w~i3;i~ s~(~ ~uttls~~~n~ ~u~q ~~l •~(~ ~ ? ;~• ~~ ~f;~a~ .~:~t s~ I~~ 'fir .~s~ c# ~t%~&tt;? u~ ~~~ ss~.tgsrt~ ~ .sew ~ s~ pays~wr~ a ~~~u~ sill 1t1t1N341~N0~ `~uatp • sy~ .reaQ ~09L t ~v'd `.Ia~.s~au~7 686E xog 'O•d ari/nbs uuad aup sal~a~~.i~S u~t~a~c1 ~uouuat~ t t OZ `8 I ~n~f w5'JNINNIJ38 3H1 1Sflf SI JNIN31SIl ~~\\11I //~~~ Estate Appraisals C~~!~~~••• Coins and Jewelry ,~,~~ Qualr_~ty jet~elry and Diamonds lJ JEWELRYJ~IST VIRGINIA D. MYERS ESTATE 1. lOk ESEMCO yellow gold flower pin with five (S) small garnets surrounding one (1) larger center garnet TOTAL VALUE Dated: April 20, 2011 ~75.0~ ~~ Barry Killian l5 West Chestnut Street, P.O. Box 1495 ~ Lancaster, PA 17608-1495 • (717) 393-2699 • Fax (717) 393-2715 ~~... ~~t'nZi~ ~ ~~\~~t) ~/i~j E9 Estate Appraisals Coins and Jewelry Quali_ y~eze~elry and l~iamor~ds JEWELRYLIST VIRGINIA D. MYERS ESTATE 1. Silver Cross Necklace with red, green and turquoise collared stones. ~6,qc~ Dated: August Z3 201I l.5 West Chestnut Street, P.O. Box 1495 • Lancaster, PA 17608-1495 • (717) 393-x'.699 • Fax (717) 393-2715 ~~~~ ~~ Estate Appraisals Coins and Jewelry QZIQII-fyJ~ze~elr`y- and Diamonds VIRGINIA D. MYERS ESTATE JEWELRY LIST 1. Yellow Goldtone Charm Bracelet with 14 yellow gold charms $ 310.00 2. Sterling Silver Bangle Bracelet engraved with saying "Where There's Hope There's Help" 20.00 3. 925 Italy Rope Necklace 2.50 4. Vendome Yellow Gold Plated Necklace n/v 5. Amber Beaded Necklace with Asian Pendant n/v 6. Yellow Gold Filled A.W.W. Co. Waltham, Mass Pocket Watch , Engraved with a "B" 50.00 7. R Tenn Sweden Silver Cross 1.00 8. Yellow Gold Filled Etched Bangle Bracelet 5.00 9. 14k Yellow Gold Bangle Bracelet engraved with saying "My Wife My Love" 227.50 10. Monet Yellow Goldtone Chain Necklace 1.00 11. Sterling Silver Necklace 12.25 12. White Cameo Pin with Yellow Goldtone Border (Broken) 2.00 13. Silvertone "Believe" Pin with 5 small crystal-like stones and 4 stars n/v 14. Liechtenstein Silvertone Circular Pin w/ Flowers 1.00 15. 1/20 Gold Filled 4-Stone Scarab Pin 2.00 15 West Chestnut Street, P.O. Box 1495 • Lancaster, PA 17608-1495 • (717) 393-2699 • Fax (717) 393-2715 16. Silvertone Bracelet with "Don't Fence Me In" Charm 1.00 17. 12k Yellow Gold Filled Charm Bracelet with 9 yellow gold Charms 268.00 18. Long Yellow Goldtone Chain with Miscellaneous Beads (Costume) n/v 19. Sterling Silver Military Bracelet engraved with name "Lt. Col Ernest A. Dolpke, Jr." 6.00 20. R B Wooden Beaded Earrings with Silvertone Clip n/v Z1. Yellow goldtone 4-Leaf Clover Pin (painted green) with small Crystal like stone in center 1.00 22. Yellow goldtone multi-colored small beaded Necklace n/v 23. 1928 Pearl like Beaded Necklace 2.00 24. Ladies' Bucherer Yellowtone Watch n/v 25. Ladies' Timex Indiglo Watch with black Leather Band n/v 26. Silvertone Men's Cuff Links 3.00 27. Long Silvertone Necklace with Bucherer 17 Jewel Swiss Watch Pendant with crystal like stones surrounding watch 3.00 28. lOk yellow gold Men's Ring missing center stone Scrap Gold 102.00 29. Silvertone Pill Box with Revolutionary Scene 5.00 TOTAL $1,025.25 Dated: `'t ~N ~ WINDHAM JEWELERS ' No. Windham Shopping Ctr. • 765 Roosevelt Trail Ste. 16 Windham, Maine 04062-5365 (207) 892-6700 Customer's nrrlr~r Nn .~_~_ :.,,.: ~ ~ ~ J Name u ... ~, , , __-__t1U Address f Q Phone: - SOLO BY , CASH 0 C.O.D. CHARGE o n~~ ~ ON ACCT. MDSE. RETD. PAID OUT o , 3 ~ ) Ez ~ ~• ~ ~ ~ ~ 1 I I AH claams ;,a~t~, returnee , gdods MUST be accompanied °'ay this. bill. OQ1 7863 Received TAX i3y TOTAL ~ cs-~-z PRINTED IN U.S.A. vrxer~o wrt (~rJl ~~~tAIIKJ SOY I N K ~~~ INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA 1 SS COUNTY OF LANCASTER ) File Number 21-2010-1267 VIRGINIA D. MYERS Personal Representative(s) of the Estate of ed de ose s and say(s) that the items appearing in the following inventory include all of the persono l os to each item of said deceas p ( ) and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that tecedent owned o real estate outside of the inventory represents its fair value as of the date of the decedent s death, and that D Commonwealth of Pennsylvania except that which appears in a memorandum K thN eAd of this inventory. FULTON BAN , I verify that the statements made in this Inven- B Y : ,~ - , tort' are true and correct. I understand that false state- CAR 0 L R. F AH N E S T 0 K, T F ments herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities. EDMUND G. MYERS, ESQUIRE (SuT~reme Court I.D. No.) 20558 Attorney -- (Name) PA 17043 Address) JOHNSON, DUFFIE, STEWART & WEIDNER, 301 MARKET STRI?ET, LEMOYNE, ( ('T'elephone) (717) 761-4540 DECEDENTS SOC. SEC. N0. DATE OF DEATH LAST RESIDENCE 202-20-3589 DECEMBER 14, 2010 222 Messiah Circle, Mechanicsburg, PA 17055 FIGURES MUST BE TOTALED 9,405.89 PLEASE SEE ATTACHED +...~. ~Jcf~, -~ ~r t i.i ~.._t <....-. ~...__ ~. ,__ ! l1_ ~ ~ ~..._ ~. L 1 ~~.~ _` ~;G., ~~ _ U (Attach additional sheets as needed) TOTAL: 9,405.89 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative include the value of each item, but such figures should not be extended into the total of the Inventory. (See 20 Pa. C.S. ~ 3301(b)) Form RW-09 rev. 10.13.06 Estate of Virginia D. Myers Estate Inventory Valued as of Date of Death Cash and Cash Equivalents $ 89.06 Cash 0.65 Cash 102.60 Coins Fulton Bank Checking Account 7,216.99 #3623-25184 100.19 Fulton Bank Savings Account #3220-95196 0.01 Interest at Date of Death $ '],509.50 Total Cash and Cash Equivalents Miscellaneous $ 99.43 Alert Pharmacy Services, Inc 1,436.15 Jewelry McKeeson AWP Consumer Cash Payor 100.00 Class Settlement Fund 1.76 Stamps 1,637.34 Total Miscellaneous No. of Shares Mutual Funds Delaware Group Treas Resvs Ltdtrm Dvrin I $ 19.54 Mutual Fund (As Quoted By Nasdaq) Europacific Growth Fd Shs Cl F-2 Mutual 12.36 Fund (As Quoted By Nasdaq) Federated Mun Secs Income Tr Pa Mun Incm A Mutual Fund (As Quoted By 3.85 Nasdaq) Managers Fds Pimco Bd Fd Mutual Fund 90.77 (As Quoted By Nasdaq) Price T Rowe Growth Stk Fd Inc Com 11.18 Mutual Fund (As Quoted By Nasdaq) Rowe T Price Short Term Bd Fd Com 121.35 Mutual Fund (As Quoted By Nasdaq) 259.05 Total Mutual Funds ~ 9,405.89 Total Inventory Page 1 (1) CLERMi~NT WEALTH STRATEGIES Writer's Direct Dial Number (717) 291-2544 Register of Wills and Clerk of Orphans' Court Cumberland County Courthouse 1 Courthouse Square, Room 1.02 Carlisle, PA 17013 September 9, 20 ] 1 Re: Estate of Virginia D. Myers, Deceased File No. 21-2010-1267 ~ ~,., ~.~., -~_ `'~. ~__-. C-_'f:. Dear Sir or Madam: Enclosed for filing are the following documents for the above referenced estate: om lete co ies of the PA Inheritance Tax Return and four copies of the first 1, Two c p P page of the Return; and 2. Three copies of the Inventory. ase time stamp all copies and return the four first pages of the PA Inheritance Ple turn and two copies of the Inventory to me in the enclosed self addressed postage- Tax Re paid envelope. Also enclosed is a check, in the amount of $30.00, for the filing of th the ~ lance d PA Inheritance Tax Return and a check, in the amount of $4,7.30 ~07, ressed envelope. an of PA Inheritance Tax due. Please send a receipt in the enclosed s~,lf ad If ou need any additional information, please let me know. Thank you for your Y assistance. ,., Q. ~.._ Sincerely yours, _.~ c~R_ ~~w ~ J , - w ~ ~= T...: t .~ -~ ~ _ ,. ~CLO Enclosures cc: Edmund G. Myers, Esquire Cindy L. Ulena Assistant Estate Account Administrator Clermont Wealth Strategies A Division of Fulton Bank, N.A. One Penn Square, P.O. Box 7989 Lancaster, PA 17604 clermontwealth.com ~ ~- o ~,~o^ •rn Y Oa ~ z w O s~{}~'a N ~~ ~~ O O 9 1® v lei. ~~ W <-- N J d ~ `~s N p0 Q 43tiNC1 0 0 ~ f a~l~dsesu~o~ ileW ~ll~olad N C~ L N V cd N C t a 0 4- O N N O ~ N ~--I L ~ N O ~ r- .C p U +~ O L ~ 'O ~ ~ O ~ RS U dJ M L ~-- N a ctf O r---• ~1-~ ~ t\ r- ~ Q' r-- '~ ~ (~ 3 O ~ U N Q N d O ~ ~ +~ ~ O ~ L S.. rt3 .~ O N ~r +~r +~ O S. i. N N U N ~ •,- •r' 1] O r-- ~ E U s. N ~ rtS fY U r-- U v ~'O~ N,TEOST /~,j~~ /~y® ,41F-s p t ~S~ 4S at 4s oST~C s'ERVIC ~os.~ohi F lei ro~q /a"~ary2p 08 N rti