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HomeMy WebLinkAbout09-22-111500 ~(o,_,°) -"', REV- PA Department of Revenue Bureau of individual Taxes ~M,~,Y,~a, PO BOX.280801 Harrisburg, Pq f 7128~Of INH CWTGn r..-....._-__ _ ri ..~.~.cn t mrvKMAT10N BELOW -~'- SocialSecurity Number Date of Death 188 20 8660 12 23 2010 Decedent's Last Name EDGIN (If Applicable) Enter Surviving Spouse's information Below Spouse's Last Name EDGIN Spouse's Social Security Number 15D561D143 OFFICIAL USE ONLY County Code Year File Number 'ANCE TAX RETURN 21 11 0039 )ENT DECEDENT Date of Birth 08 17 1926 Suffer Decedent's First Name ARTHUR MI F Suffix Spouse's First Name JULIA Mi R THIS RETURN MUST BE FILED IN DUPLICATE WITH THE FILL IN APPROPRIATE OVALS BELOW REGISTER OF WILLS 1. Original Return ^ 2. Supplemental Return ^ 4. Limited Estate ^ ~ Future (merest Compromise Deceder# Di d (date of death aRer 12-122) e Testate 8. (Attach Copy of will) ^ 7. (Ari Mantamed a Living Trust M( TT oP ^ 9. Litigation Proceeds Received NSf) Y C 10. ~ ?1rri rardtt !data of death 9i a W f 1 95) CORRESPONDENT . Tragic cerr.,......__ ~ ~ __ ^ 3. Remainder Return (date of death prior t0 12-13-82) ^ 5. Federal Estate Tax Return Required 8. Total Number or Safe Depoatt gp,~$ 11. Election to tax under Sec, 9113(A) (Attach Sch. O) Name - ""' m~°' °C ~VMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: MARIELLE F HAZEN ESQ Daytime Telephone Number 717 540 4332 First Ilne of address 2000 LINGI+ESTOWN ROAD Second Ilrte of address SUITE 202 City or Post Office HARRISBURG Correspondent's e-mail address: i I lruinr .e..eu:.._ _. _ _ it is Eve, cimect ei REGISTER Ot'-w~LL3 USE ONLY - r ~ ,... - ,.~ ,_~ ~~T., `~~ .. _ ~~ r'..: State ZIP Code TEyFILED PA ,~ ~ `, nave examined this return, ir>cluding acopmpanying schedules and statements, and to the best of my kna n of preparer other than the personal representative is based on all information of which t FILING RETURN Preparer has any Curtis A. Ed~lin 2000 Lin lestown Road, Ha l.__ 15D5610143 D1027 Marielle F Hazen, Esq. PA Side 1 DATE 15D5610143 belie(, n PA Inheritance Tax Return Signature of Additional Fiduciaries ESTATE OF Edgin, Arthur F FILE NUMBER Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and stat m0039and to t my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on information of which preparer has any knowledge. he best of all Signature #2 ~ o ,~ . _ Name Dia Address 1 415 Address2 City, State, Zip epic Date ~-uk 15D561D243 REV-1500 EX oeceaer,rs Name Ed9jn, Arthur F --- Decedent's Social Security Number ----- --- RECAPITULATION ------------------------------------_-_-- 18 8 2 0 8 6 6 0 ------ 1. Real Estate (Schedule A) ........................... -- ------- ------------------ ............................................................ 1. 2. Stocks and Bonds (Schedule B) ............................ ................................................. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ......... 3 4. Mortgages & Notes Receivable (Schedule D) ........... ............................................. 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 6. Jointly Owned Property (Schedule F r- Separate Billin 7 R I 357,607.72 g . equested............ 6. nter-Vivos Transfers & Miscellaneous f~or~-Probate Property (Schedule G) ~_~ Separate Billing Requested ............ 7' 8. Total Gross Assets (total Lines 1-7)........... .............. 10 2 ~ 1 ~ 9 • 69 ............... 9. Funeral Expenses & Administrative Costs (Schedule H)....... .. 4 5 9 ~ 7 ~- 7 • 41 ............................. s. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ..... 25,202.01 ......................... 10. 11. Total Deductions (total Lines 9 & 10) ............................... 400.20 .................................... 11. 12. Net Value of Estate (Line 8 minus Line 11) 25 , 602 .21 .......................................................... 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 12. an election to tax has not been made (Sched l 434 ~ 115.2 0 u e J) ............................................... 18 14. Net Value Subject to Tax (Line 12 minus Line 13).......... ...... ..................... _ - - ........ TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES ---- --------- 15. Amount of Line 14 taxabl 4 3 4 ~ 115 • 2O -------------------------- e at the spousal tax rate, or -- transfers under Sec. 9116 (a)(1.z) x .o0 341, 0 05.95 15. 16. Amount of Line 14 taxabl e at lineal rate X .045 93 , 10 9.2 5 17. Amount of Line 14 ta bl 16' 0 • O 0 xa e at sibling rate X .12 4 ,18 9.92 18. Amount of Line 14 taxable ~ ~ ~ ~ 17 ~ ~ ~ at collateral rate X .15 ' x.00 18. 19. Tax Due ................................ ~ . 0 0 .................................................................................. 19. 4,189.92 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT . L 15D561D243 Side 2 15D561D243 J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME __ Edgin, Arthur F STREET ADDRESS _ 123 Oriole Dr. ---------- CITY Carlisle Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 0.00 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box 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. Make Check Payable t©: REGISTER OF WILLS, AGENT. 0.00 (3) (4) ------ -- (5) ______ 4,189.92 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE AppR 1. Did decedent make a transfer and: OPRIATE BLOCKS a• retain the use or income of the property transferred :...................... _ ................................... e I~ b• retain the right to designate who shall use the property transferred or its income :.............................. r~ No c. retain a reversionary interest; or .........:..................................., ............................................................ ~ ~l x d. receive the promise for life of either payments, benefits or care... r x ...................................................... ~J 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without _ ~X _~ receiving adequate consideration? .................................................................................................................... 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?....... l ~-~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate r ~-J ~l contains a beneficiary designation?..........., LXJ ~ ~ ...... ~ _ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES YOU MUST COMPLETE SCHEDULE G ANtD FILE I .. ...........TASPxI ~1 -- --- - ART 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 pouse is 3 percent [72 P.S. §9116 (a) (1.1) (i For dates of death on or after January 1, 1995)]the tax rate imposed on the net value of transfers to or for the for the use of the surviving [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statuto re uir assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. use of the surviving spouse is 0 percent For dates of death on or after July 1, 2000: ry q ements for disclosure of • 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 u adoptive parent, or a stepparent of the child is 0 percent [72 P.S. 72 P.S. §9116 1.2) [72 P.S. . 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, exc se of a natural parent, an §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 ept as noted in sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether b §9116 (a) (1.3)]. A y blood or adoption. File Number 21-11-0039 STATE ~ ZIP __ PA ~ 17013 (1) Total Credits (A + g) (2) 4,189.92 Rev-1508 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONWEALTH OF PENNSYLVANIA PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE n~ Arthur F FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. I L7 -11-0039 All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE 1 Chase Card Services -refund OF DEATH 2 Mid Penn Bank Certificate of Deposit Acct. #309002187 1.246.11 3 Mid Penn Bank Certificate of Deposit Acct. #309002646 68,428.94 4 Mid Penn Bank Certificate of Deposit Acct. #309002964 65 777 23 5 Mid Penn Bank Checking Acct. #9019019 51,297.69 6 Susquehanna Bank Certificate of Deposit Acct. #401200001998 56,671.65 114,186.10 TOTAL (Also enter on Line 5, Recapitulation- 357,607.72 Copyright (c) 2002 form software only The LacknerpGroupn Inced, additional pages of the same size) Form Pq_1500 Schedule E (Rev. 6-98) Rev-1510 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE Of SCHEDULE G INTER-VIVOS TRANSFERS 8~ MISC. NON-PROBATE PROPERTY Arthur F FILE NUMBER I ~~ ... ~~~ ~c;neaule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-150(1 COVER SHEET Is yeV VJy ITEM DESCRIPTION OF PROPERTY NUMBER THE DATE OF TEROgNSFER.SATTgCFi q CO YEOF TIHOE DEED OR REAL ESTATE 1 Morgan Stanley -IRA Acct. #604-000442-045 - Beneficiaries are decedents children, Curtis Edgin and Diane Miller in equal shares. 2 Mid Penn Bank Certificate of Deposit Acct. #309003054 -Burial Reserve paid to Heath Funeral Home TOTAL (Also enter on Line 7, Recapitulation) Copyright (c) 2002 form software only The (Lackne pGroupn Inced, additional pages of the same size) DATE OF DEATH % OF DECD'S VALUE OF ASSET wrERESr IIF APP~~CAeNE) TAXABLE VALUE 93,109.25 100.000% 93,109.25 9,000.44 100.000% 9,000.44 102,109.69 Form PA-1500 Schedule G (Rev. 6-98) REV•1151 EX+(10-06) t~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ITEM N MBE A. Edgin, Arthur F FILE NUMBER 7~1 A A ni..... Debts of decedent must be reported on Sch ,-VVJ' DESCRIPTION FUNERAL EXPENSES: See continuation schedule(s) attached AMOUNT 10,163.02 B• ADMINISTRATIVE COSTS: 1 ~ Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio Year(sl Commission paid 2. Attorney's Fees Hazen Elder Law 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zio Relationship of Claimant to Decedent 4• I Probate Fees Register of Wills 14,300.00 381.50 5~ Accountant's Fees 6. Tax Return Preparer's Fees ~- Other Administrative Costs See continuation schedule(s) attached 357.49 TOTAL (Also enter on line 9, Recapitulation) 25,202.01 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF Edgin, Arthur F FILE NUMBER 7.~ A I - ~ ~ -vvo5 ITEM NUMBER DESCRIPTION Funeral xn ncpS 1 Funeral meal 2 Funeral service -pastor, pianist, program 3 Heath Funeral Home -paid by Mid Penn CD acct. #309003954 burial reserve account; balance paid from estate funds Other Admini trative ['r,~+~ 4 Cumberland Law Journal -estate notice 5 Hazen Elder Law -disbursements 6 The Sentinel -estate notice Copyright (c) 2002 form software only The Lackner Group, Inc. H-A H-B7 AMOUNT 922.00 170.00 9, 071.02 10,163.02 75.00 6.47 276.02 35 47 9 Form pq_~500 Schedule H (Rev. 6-98) Rev-1512 EX+ (12-08) SCHEDULE 1 - DEBTS OF DECEDENT, COMMONWEALTHOFPENNSYLVANIA MORTGAGE LIABILITIES, & LIENS INHERITANCE TAX RETURN RESIDEN"f DECEDENT ESTATE OF Ed in, Arthur F FILE NUMBER 21-11-0039 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 ~ Family Home Medical -medical equipment rental fee OF DEATH 2 Holy Spirit Hospital -medical 50.85 3 Pinnacle Health Med Svcs -Harrisburg Hospital stay 188 19 4 Quantum Ima In 53.86 9~ 9 -medical 5 Richard P. Pacynski, MD -hospital care 73.32 33.98 TOTAL (Also enter on Line 10, Recapitulation) (If more space is needed, additional pages of the same size) 400.20 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 12-08) REV-1513 EX+ (11-08) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Ed in, Arthur F NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY [• TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 a 1.2 1 Testaments Su Edgin ry pport Trust F/B/O Julia R. 2 Deerfield Drive Easthampton, MA 01027 2 Testamentary SNT f/b/o Julia R. Edgin 2 Deerfield Dr. Easthampton, MA 01027 FILE NUMBER RELATIONSHIP TO 21-11-0039 DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) Trust f/b/o spouse Spousal deduction share 47,685.76 Trust f/b/o spouse I Residue of I Estate 293,320.19 ~~ ~«~ ~viiar amounts for distributions shown above on lines 15 throw h 18 on Rev 1500 cov~easheet, as a I riate. NON-TAXABLE DISTRIBUTIONS: 341,005.95 II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TA,Y IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS Copyright (c) 2009 form software only ThelLackneNGroup~InAc6. E 13 OF REV-1 Form PA-1500 Schedule J (Rev. 11-08) REGISTER OF WILLS CUMBERLAND COUNTY PENNSYLVANIA CERTIFICATE OF GRANT OF LETTERS No . 2011- 00039 PA No . 21- 11- 0039 Estate Of : ARTHUR FEDG/N /First, Midd/e, LasU Late Of : NORTH M/DDLETON TOWNSHIP CUMBERLAND COUNTY Deceased Social Securi ty No : 188-20--8660 WHEREAS, on the 10th day of January 2011 an instrument dated November 30th 2010 was admitted to probate as the last will of ARTHUR F EDGIN /First, Midd/e, Last) late of NORTHM/DDLETON TOWNSH/P, CUMBERLAND County, who died on the 23rd day of December 2010 and WHEREAS, a true copy of the will as THEREFORE I Probated i~~ annexed hereto. GLENDA EARNER STRA SBA UGH for CUMBERLAND Count ~ RE'9'i s ter of Wi 11 s in and y, in the Commonwealth of Pennsylvania, hereby certify that I have this da y gran ted Letters TESTAM, ENTARY to: CURT/S A EDG/N and D/ANE L M/LEER who have du_Zy qualified as EXECUTOR(R/Xl and have agreed to administer the estate according ro law, all of whi fully appears of record in m ~ ch y offi ce a t CUMBERLAND COUNTY COURT HOUSE, CARL/SEE, PENNSYL VAN/A. IN TESTIMONY WHEREOF, I have hereunto set m of my office on the 10th day of January 2011 ~' har.~d and affixed the seal T A ~ ~~ 1 Register of ills r Depuiy * *NOTE* * ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) LAST WILL AND TESTAMENT cn ,~ `- z~ -, OF ~ .~ ~ "~ .a. c~ _ ~~ I` - t r-,, _~~ ~. ~ _: ARTHUR F. EDGIN I ` ~~ '~ ,, __ .-- - - ;,;~ - -, -;, I, ARTHUR F. EDGIN, now domiciled in Cumberland County, Pennsylvania, declare this to be my Last Will and Testament. I revoke all other wills and codicils that I ma hav y e previously made. Article I My just debts and expenses of my last illness, funeral, and administration of my estate shall be paid by my Executor from the principal of my residuary estate as soon as racticabl P e after my death. Article II All inheritance, estate, and succession taxes (including interest and penalties thereon, but not including any generation skipping tax) payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate without reimbursement from any person. This provision is not a waiver of any right which my Executor has to clai m reimbursement for any such taxes which become payable as the result of any propert over Y which I have the power of appointment. Article III I give, devise and bequeath my tangible personal property in accordance with any memorandum I have handwritten or signed, located with my will or with my valuable papers and found within :30 days of the probate of my will. Gifts may only be to persons who survive me or to organizations which exist at my death, and if there is a conflict, the memorandum having the latest date shall govern. To the extent no such memorandum is Found, or all of my tangible personal property is not disposed of pursuant thereto, my tangible; personal property shall be added to my residuary estate and pass under Articles IV and V hereoiF: Article ITS If my spouse, JULIA R. EDGIN, survives me by one hundred seventy (170) days, I give, devise and bequeath to my spouse cash, securities or other property of my estate having a value equal to the amount, if any, that my spouse would be entitled to receive if she exercised her elective share rights as set forth in section 2201 et seq. of the Pennsylvania Probate, Estates and Fiduciaries Code (the "PEF Code"); provided, however, that this bequest shall be reduced to the extent my spouse has waived the right to elect under PEF Code section 2207 or forfeited the right to elect under PEF Code section 2208. In computing the amount of this bequest, it shall be assumed that my spouse has elected under PEF Code section 2204(c) to retain all beneficial interests in property that she would otherwise be required to disclaim if she exercised her elective share rights. Provided my spouse survives me for one hundred seventy (170) days and she has not waived or forfeited her elective share rights, it is my intention, that as ;~ result of my death, she receive property having a value equal to (but not more than) that which she would receive if she were to exercise her elective share rights. My Executor shall have the sole discretion to select the assets which shall constitute this bequest. If my spouse does not survive me by one hundred seventy (170) days, or in the event my spouse (or her legal representative) disclaims any portion of this bequest, this bequest, or the disclaimed portion thereof, shall be distributed as part of my residuary estate. 2 This bequest shall be distributed, in trust, to my hereinafter-named Trustee to be held, administered and distributed as follows: •A• To expend and apply so much of the net income and. so much of the principal of the Trust as the Trustee shall consider advisable for the support, health, and care of JULIA R. EDGIN, for the remainder of her lifetime. B. In the event of JULIA R. EDGIN's death, the trust shall terminate, and the remaining principal and accumulated income of the trust shall be equally divided and distributed to my children, CURTIS A. EDGIN, of Easthampton, Massachusetts, and DIANE L. MILLER, of Elliottsburg, Pennsylvania, per stirpes. D• I hereby appoint my son, CURTIS A. EDGIN, as Trustee of any Trust(s) created in this Will for the benefit of my spouse. In the event of the renunciation, death, or inabilit to Y act, for any reason whatsoever of CURTIS A. EDGIN, I nominate, constitute and appoint my daughter, DIANE L. MILLER, successor Trustee of any Trust(s) created in this Will for the benefit of my spouse. E• In order to carry out the purposes of the Trust established by this Will for the benefit of JULIA R. EDGIN, the Trustee, in addition to all other powers granted by this Will or bylaw, shall have the following powers over the Trust estate, subject to any limitations s ecified P elsewhere in this Will: (a) to retain in the form received and/or to sell either .at public or private sale, any real estate or personal property except that which I specifically bequeath herein; (b) to manage real estate; (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification; (d) to exercise any option or right arising from the ownf;rship of investments; 3 (e) to compromise claims without court approval and without consent of any beneficiary; (~ to file fiduciary/income tax returns and pay the tax due for any year for which such a return is required; (g) to make distributions in cash or in kind, or in both, and to determine the value of any such property; (h) to employ any attorney, investment advisor, or other agent deemed necessary by my Executor; to pay from my estate reasonable compensation for all their services; (i) to conduct alone or with others, any business in which I am engaged in or have an interest in at the time of my death; and (1) to receive reasonable compensation in accordance with the standard schedule of fees in effect while their services are performed. Article [~ All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, I give, devise and bequeath as follows: A• If my spouse survives my death by thirty (30) days, then I give, devise and bequeath the rest and residue of my estate to a Third Party Special Needs Trust for the benefit of my spouse to be administered in accordance with the terms of Article VI hereof. B• If my spouse fails to survive my death by thirty (30) days, then I give, devise and bequeath the rest and residue of my estate in EQUAL shares to my children, CURTIS A. EDGIN and DIANE L. MILLER, per stirpes. 4 Article YI The share of my estate that is set aside for JULIA R. EDGIN shall be held by my Trustee,. CURTIS A. EDGIN, or his successor(s), in trust for JULIA R. EDGIN's benefit in a Third-Party Special Needs Trust in accordance with the following provisions. I hereb nominate Y and appoint my son, CURTIS A. EDGIN, as Trustee of the Third!-Party Special Needs Trust under this my Last Will and Testament. If CURTIS A. EDGIN is unable or unwillin to serve g , I appoint my daughter, DIANE L. MILLER, as successor Trustee. A. INTENT It is my intention by this trust to create a purely discretionary ;supplemental care fund for the benefit of JULIA R. EDGIN and not to displace financial assistance that may otherwise be available to her. Illustrative of the kinds of supplemental, non-support disbursements that would be appropriate for my Trustee to make from this trust for JULIA R. EDGIN inclu de. sophisticated medical or dental or diagnostic work or treatment for vrhich there are not funds otherwise available, including plastic surgery or other non-necessary mE;dical procedures• rivat ,p e rehabilitative training; dental care; recreation and transportation; differentials in cost betwee n housing and shelter for shared and private rooms in institutional settings; supplemental nur ' smg care and similar care that assistance programs may not otherwise provide; telephone and television service; companions for travel, reading, driving and cultural experiences and a ent p ym s to bang her children or grandchildren for visitation in the event nny Trustee deems that appropriate and reasonable. B. It is important that JULIA R. EDGIN maintain a high level. of human dignity and that her care be humane. If this trust were to be eroded by creditors, subjected to liens o r encumbrances, or cause assistance benefits to be unavailable or terminated, it is likely that the trust corpus would be depleted prior to her death, especially if the cost of care for her would be 5 high. In such event there would be no coverage for emergencies or supplementation to basic needs. The trust provisions contained in this instrument should be interpreted by my Trustee in light of'these concerns and this intent. '~. My Trustee shall pay or apply for the benefit of my wife for her lifetime such amounts from the principal or income, or both, of this trust up to the whole thereof, as the Trustee, in the Trustee's sole and absolute discretion, may from time to time deem necessar or Y advisable for the satisfaction of JULIA R. EDGIN's special non-support needs, if an An Y y income not distributed shall be added annually to principal. As used in this instrument, "special non-support needs" refers to the requisites for maintaining my wiff:'s good health, safety and welfare when, in the discretion of the Trustee, such requisites are riot being provided b an Y Y public agency, office or department of the state where she lives or of the United States, or are not otherwise being provided by other sources of income available to her. Special non-support needs shall include but shall not be limited to the list of suggested non-support items set out in this article. D. In the event that she is unable to maintain and support herself independently, the Trustee may, in the exercise of the Trustee's best judgment and fiduciary duty, seek su ort and PP maintenance for her from all available public and private sources. The Trustee shall take into consideration the applicable resources and limitations of any public assistance program for which she is eligible. In carrying out the provisions ~f this trust, my Trustee shall be mindful of the probable future needs of my wife, but not of the trust remainder beneficiaries. E. No part of the corpus of the trust created by this article shall be used to supplant or replace public assistance benefits of any county, state, federal or other governmental agency that has a legal responsibility to serve persons with disabilities that are the same or similar to those which JULIA R. EDGIN may be experiencing. For purposes of determining my wife's public 6 assistance eligibility, no part of the principal or undistributed income of the trust shall be considered available to her. In the event that the Trustee is required to release principal or income of the trust to or on behalf of JULIA R. EDGIN to pay fc-r benefits or services which such public assistance is otherwise authorized to provide were it not for the existence of this trust, or in the event the Trustee is requested to petition the court or any other administrative agency for the release of trust principal or income for this purpose, the Trustee is authorized to deny such request. My Trustee is authorized, in the Trustee's diiscretion, to take whatever administrative or judicial steps may be necessary to continue the public assistance program eligibility of JULIA R. EDGIN, including obtaining instructions ii-om a court of competent jurisdiction ruling that the trust corpus is not available to the beneficiary for such eligibility purposes. Further, my Trustee should cooperate with the beneficiary';s conservator, guardian, or legal representative to seek support and maintenance for the beneficiary from all available resources, including but not limited to, the Supplemental Social Security Income Program (SSI); the Medicaid Program; and any additional, similar or successor programs; and from any private support sources. Any expense of the Trustee, including reasonable attorney fees, shall be a proper charge to the trust. F. SPENDTHRIFT PROVISIONS No interest in the principal or income of this trust shall be anticipated, assigned or encumbered or shall be subject to any creditor or to any legal process X-rior to the actual receipt by the beneficiary. Furthermore, because this trust is to be conserved. and maintained for the special non-support needs of JULIA R. EDGIN throughout her life, no part of the corpus hereof, neither principal nor undistributed income, shall be construed as part of JULIA R. EDGIN's estate or be subject to the claims of voluntary or involuntary creditors for the provision of care and services, including residential care by any public entity, office, department, or agency 7 of any state or the United States or any governmental agency. Under no circumstances can the beneficiary compel a distribution. G. B_ICIARy_ Unless sooner terminated, the trust created for JULIA R. EDGIN shall terminate upon her death. At that time all remaining trust assets shall be distributed to my children, CURTIS A. EDGIN and DIANE L. MILLER, per stirpes. H:. TRUSTEE'S POWERS Subject to the requirement that my Trustee be prudent, my Trustee shall have full power and authority to manage and control the trust estate and to sell, exchange, lease, rent, assign, transfer and otherwise dispose of any or part thereof upon such terms and conditions as my Trustee may, in my Trustee's discretion, deem proper. My Trustee may invest or reinvest all or any part of the trust estate in such common or preferred stocks, bonds, debentures, mortgages, deeds, deeds of trust, notes and other securities, investments of property, including common trust funds, which my Trustee, in my Trustee's absolute discretion, may select or determine. It rs my express intention that the Trustee shall have full power to invest and reinvest the trust funds as I might do if living, without being restricted to forms of investments which Trustees may be otherwise permitted by law to make, and without any requirements as to diversification of investments. My Trustee may continue to hold in the form in which received, any securities or any property which I might own at the time of my death or which my 'Trustee may at any time acquire hereunder; and may invest any part of the trust funds in property located within or outside of the Commonwealth of Pennsylvania. My Trustee is further authorized to invest in life, annuity, accident, sickness, including disability, and medical insurance on behalf of and for the benefit of the trust beneficiaries. 8 My Trustee shall not be obligated to undertake litigation fo;r collection of any benefits or assets payable by reason of my death including, but not limited to, such benefits under life insurance policies, employee benefit plans or other contracts, plans or arrangements providing for payment or transfer at death which are payable to my Trustee unless my Trustee is indemnified to my Trustee's satisfaction against any liability and the expense of such litigation. Payment to my Trustee and the receipt of or release by my Trustee shall fully discharge any payor, and no payor need inquire into or take notice of my Will to see to the application of such payment. To the extent that this trust is the beneficiary of a Retiremem` Account, the Trustee shall draw the benefits from the Retirement Account in amounts sufficient to meet the minimum distribution requirements of IRC Section 401(a)(9) and the regulations thereunder (the "Required Minimurr- Distribution"). Notwithstanding any provision of the trust to the contrary, the Required Minimum Distribution shall be applied for the benefit of the person or persons then entitled to receive or have the benefit of the income from this trust, or if there is more than one income beneficiary, the Trustee shall make such distribution to such income beneficiaries in the proportion in which they are beneficiaries or if no proportion is designated in equal shares to such beneficiaries. "Retirement Account" means a plan qualified under IRC Section 401, or an individual retirement arrangement under IRC Section 408, or a Roth IRA under IRC Section 408A, or atax-sheltered annuity under IRC Section 403 or any other benefit subject to the distribution rules of IRC Section 401(a)(9), or the corresponding provisions of any subsequent federal tax law. It is my intention that this trust qualify as a "conduit trust" under IRC Section 401(a)(9) sc- that the trust beneficiaries shall be considered designated beneficiaries for purposes of the minirnum distribution rules, and that distributions may therefores be taken over the trust beneficiary's life expectancy (or the life expectancy of the oldest trust beneficiary). The 9 Retirement Accounts shall not be subject to the claims of any creditor of my estate and they shall not be applied to the payment of my debts, taxes or other claims or charges against my estate unless and until all other assets available for such purposes have been exhausted, and even then only to the minimum extent that would be required under applicable law in the absence of any specific provision on this subject in this Trust. All distributions ;;hall be made in accordance with Artticle VI, Paragraphs A through F of this Third-Party Special Needs Trust. My Trustee shall, in addition to the powers granted above., have all powers otherwise granted under the Pennsylvania Fiduciaries' Powers Act as amended after the date of my Will and after my death. My Trustee shall specifically have the powers to invest in non-income producing assets. I. UNSUPERVISED ADMINISTRATION The trust created by this Will maybe administered by my Trustee free from the control of any court that may otherwise have jurisdiction over my estate. Article VII If any beneficiary has not attained the age of twenty-five (25) years, the share of the beneficiary shall be placed in a separate trust, for the benefit of that beneficiary according to the following terms: A• To expend and apply so much of the net income and so much of the principal of the Trust as the Trustee shall consider advisable for the health, education, support and maintenance of the beneficiary until the beneficiary attains the age of twenty-five (25) years. B. Upon attaining the age of twenty-two (22) years, one-third (1/3) of the principal and accumulated income of the beneficiary's share shall be distributed outright to the beneficiary,. 10 C. Upon attaining the age of twenty-five (25) years, the remaining principal and accumulated income of the beneficiary's share shall be distributed outright to the beneficiary. D. If the beneficiary dies before the entire principal of the Trust has been withdrawn, the remaining principal and accumulated income shall be distributed by my Trustee to the beneficiary's then-living descendants, per stirpes. If the beneficiary dies before the entire principal of the Trust has been withdrawn leaving no surviving issue, the remaining principal and accumulated income shall be distributed to the beneficiary's siblings., per stirpes. I'• No beneficiary or remainderman of this Trust shall have any right to alienate, encumber, or hypothecate his or her interest in the principal or income of the Trust in any manner, nor shall any interest be subject to claims of his or her creditors or liable to attachment, execution, or other processes of law. F• At the time any distribution or distributive share of Trust assets is to be made by the Trustee, if a beneficiary of this Trust is disabled as defined in Section 1614 a 3 of the OO Social Security Act (as determined by the Social Security Administration or by any State-level disability determination agency operating under the auspices of the Social Security Administration), and/or has been determined by a nursing home or State agency to be medically eligible for nursing home care, then said beneficiary shall cease to bey a Trustee of this Trust or any Trust share hereunder and, thereafter, the Trustee shall not make any distributions to said beneficiary that might decrease or eliminate that beneficiary's eligibility for any public benefits based on need, such as, but not limited to, Medicaid or Supplemental Security Income. G. In order to carry out the purposes of the Trust established by this Article VII, the Trustee, in addition to all other powers granted by this Will or by law., shall have the following powers over the Trust estate, subject to any limitations specified elsewhere in this Will: 11 (a) to retain in the form received and/or to sell either at public or private sale, any real estate or personal property except that which I specifically bequeath herein, (b) to manage real estate, (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, (e) to compromise claims without court approval and without consent of any beneficiary, (fl to file fiduciary/income tax returns and pay the tax due for any year for which such a return is required, (g) to make distributions in cash or in kind, or in both, and to determine the value of any such property, (h) to the extent any trust hereunder is the beneficiary of a Retirement Account (as hereinafter defined) my Trustee shall draw the benefits from the Retirement Account in amounts sufficient to meet the minimum distribution requirements of IRC Section 401(a)(9) and the regulations thereunder (the "Required Minimum Distribution"). Notwithstanding any provision of the trust to the contrary, the Required Minimum Distribution shall be paid to or applied for the benefit of the income beneficiary of such trust, or if there is more than one income beneficiary, my Trustee shall make such distribution to such income beneficiaries in the proportion in which they are beneficiaries or if no proportion is designated in equal shares to such beneficiaries. "Retirement Account" means a plan qualified under IRC Section 401, or an individual retirement arrangement under IRC Section 408, or a Roth IRA under IR.C Section 408A, or a tax- sheltered annuity under IRC Section 403 or any other benefit subject to the distribution 12 rules of the IRC Section 401(a)(9), or the corresponding provisions of any subsequent federal tax law. It is my intention that this trust qualify as a "conduit trust" under IRC Section 401(a)(9) so that the trust beneficiaries shall be consi~.dered designated beneficiaries for purposes of the minimum distribution rules, and that distributions may therefore be taken over the trust beneficiary's life expectancy (or the life expectancy of the oldest trust beneficiary). The Retirement Accounts shall not be subject t,o the claims of any creditor of my estate and they shall not be applied to the payment of my debts, taxes or other claims or charges against my estate unless and until all other assets available for such purposes have been exhausted, and even then only to the minimum extent that would be required under applicable law in the absence of any specific provision on this subject in this my Will, (i) to employ any attorney, investment advisor, or other agent deemed necessary by my Trustee; to pay from the trust reasonablf; compensation for all their services, (j) to conduct alone or with others, any business in which I am engaged in or have an interest in at the time of my death, and (k) to receive reasonable compensation in accordance with the standard schedule of fees in effect while their services are performed. H. I hereby appoint my son, CURTIS A. EDGIN, as Trustee of any Trust(s) created in this Article VII. In the event of the renunciation, death, or inability to act, for any reason whatsoever of CURTIS A. EDGIN, I nominate, constitute and appoint my daughter, DIANE L. MILLER, successor Trustee of any Trust(s) created in this Article V1I. Article VIII I nominate, constitute and appoint my children, CURTIS A.. EDGIN and DIANE L. MILLER, as Co-Executors of my Last Will and Testament. I direct that my Co-Executors be 13 permitted to serve without bond. In addition to those powers granted by law, I grant them power to distribute in cash or in kind, in like or in unlike shares, and to file any qualified disclaimer I could have filed if living. My Co-Executors shall receive reasonable compensation for services rendered to my estate. Article IX In addition to the powers conferred by law, I authorize my Co-Executors, in his/her absolute discretion: (a) to retain in the form received and to sell either at public or private sale, any real estate or personal property except that which I specifically bequeath herein, (b) to manage real estate, (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, (e) to compromise claims without court approval acid without consent of any beneficiary, (fl to file any federal income tax return for any year for which I have not filed such return prior to my death, (g) to make distributions in cash or in kind, or in both, a:nd to determine the value of any such property, (h) to employ any attorney, investment advisor, or other agent deemed necessary by my Co-Executors, and to pay from my estate reasonable compensation for all their services, (i) to conduct alone or with others, any business in whi<;h I am engaged in, or have an interest in at time of my death, 14 (j) to disclaim, in whole or in part, any property or interest therein which passed to me or which was created for my benefit, for any reason in the discretion of my Co-Executors, and (k) to receive reasonable compensation in accordance with the standard schedule of fees in effect while their services are performed. IN WITNESS WHEREOF, I, ARTHUR F. EDGIN, hereby set my hand to this my Last Will and Testament, on ~~' ~ G' , 2010, at Harrisburg, Pennsylvania. --~`~-~ ' ~~ J ARTH R F. EDGIN In our presence, the above-named ARTHUR F. EDGIN sighed this and declared this to be his bast Will and Testament and now at his request, in his presence, and in the presence of each other, we sign as witnesses. Name Address ~.. ~< < ~ L p ~'~ ~~ 2000 Lin glestown Rd Suite 202 Harrisbur PA 17110 , g , M c?~-r.e> ~ ~C~Cr~= 2000 Ling lestown Rd Suite 202 Harrisbur PA 17110 , g , 15 I, ARTHUR F. EDGIN, Testator, who signed the foregoing instrument, having been duly qualified according to law, acknowledge that I signed and ex:ecuted this instrument as my Will, and that I signed it willingly as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and Acknowledged before me by ARTHUR F. EDGIN, the Testator on %v ~~? ~: ~-,,6~`~ 3 ~ , 2010. -, J ,~',~ ~ r~~i, `~ , Notary Public 6~y " `Gtr- ARTHUR F. EDGIN COMMONWEALTH OF PENNSYLVANIA Notarial Seal Melissa M. Kain, Notary Public Susquehanna TWp., Dauphin County My Commission expires Au . li 2014 We, the undersigned witnesses who signed the foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the Testator sign and e~cecute this instrument as his Will; that he signed and executed it willingly as h.is free and volunt~ry-act for the purposes therein expressed; that each of us in his sight and hearing signed the `Will as witnesses, and that to the best of our knowledge, that he was at that: time eighteen (18) years or more of age, of sound mind, and under no constraint or undue influence. Sworn to or affirmed and Subscribed to before me by ~~+ CUl ~ M K.2IN and (ti1~lu r~ S' ~ "~~~-nnta witnesses, on /~`~~Je 1-~,(~~~ 3t~ , 2010. Notary Public COMMONWEALTH OF PENNSYLVANIA Notarial Seal Melissa M. Kain, Notary Public Susquehanna T1rvp,, Dauphin County MY commission Expires Au . 11 2014 16 J "~ Witness > ,, Witnte ~ _.~ 09/15/2011 16:05 FAa Morgan Stanley ~ 0001/001.0 MorganStanley Facsimile SmithBarney THE GEHMAN/YANDERS GROUP 1550 Pond Road, Suite 202 Allentown, PA 18104 Not for Redistribution by Recipient September 15, 2011 To: Corinne Eggers Woodhouse From: Nanci J. Nlickeison, Sr. Registered CSA Company: Hazelu Elder Law Telephone: 610-398053 or 800-827-9077 Faz: 717-540-4313 Faa: 610-398-6057 Subjecf~ Estate of Arthur F. Edgin - Our Accot>int No_ 604-000442-045 per' Yom' request, please find ola the following pages, the value of the above-refet+enced account as of the date of death that includes the accoutxt number and type, a listing of all activity on the acoot><trt from the date of death to the present, bex>tceficiary designation of the account and a listing of interestldividends earned from January 1, 2010 through Decembeac 23, 2010. If you have any questions regarding the attached, please feel free to call me at the number above. Thank you_ ^ Urgent ^ Confirm Receipt Total pages in<:luding cover sheet: 10 r~-~.ao~ 09/15/2011 1.6:06 FAX Morgan Stanle3~ 0 0002/0010 The Gehmaa Randers Group 1550 Pond Road Suite 202 Allcn[own, PA 18104 direct 610 398 6500 fax Gl0 398 6057 toll :free 800 8Z7 9077 MorganStanley SmithBarney ARTHUR F EDGIN IRA ROLLOVER 123 ORIOLE DR CARLISLE PA 17013-8770 ACCT NO.604-000442-045 Date of Death Values as of 12/23/2010 Unit Holding Security Name Quantity Date Price Value Period stocks /options Long BANK OF AMIERICA CORD 100 12232010 13.14 1,314.00 ADJ 9/13/11 Long BiJCKEYE PARTNERS L P 100 12/232010 66.60 6,660.00 AQJ 9/13/11 Long FRONTIER COMMUNICATIONS CORP 24 12!232010 9.4$ 227.52 ADJ 9113111 Long OLD FAIRPOINT EQUITY INTERESTS 1 12232010 0.02 0.02 ADJ 9113/11 Long VERIZON COMMUNICATIONS 100 12232010 35.36 3,536.00 ADJ 9/13/11 Total Stocks /Options 11,737.54 Corporate Fixed Income FPL GROUP CAP 15 718 3-154 Total Corporate Fixed Income Fracas H. Gehman FII First Vice Pr«ident Financial Advisor Long 200 17123/2010 24.51 4,902.00 ADJ 9!13111 4,902.00 Korth J. Yaaders Nand ). Midcelson vu President Sr Reg'd Clicnt Service Associate Bench Manager Morean Stanlcv Smirk 9arncy LLG Manber SIPG 09/15/2011 16:06 FAX Morgan Stanley 1~j0003/0010 Mutual Funds INVESCO CHARTER A iNVESCO GLOBAL CORE EQUITY A Total Purchased Shares Fund Total INVESCO S8P 500 MlDF.J( A Total Purchased Shares LT Dividend Reinvestment Fund Total INVESCO VALUE A Total Purchased Shares LT Dividend Reinv~estnent Fund Total MS FOCUS GR0INTH FD A Total Purchased Shares LT Dividend Reinveshnent Fund Total Total Mutual Funds Certificates of Deposit ALLY BANK CD 1.050 8-06-12 GOLDMAN SACHS BK 4.550 11-0T-11 11 CAPIIIARK BANK MIDYALE 2.4596 6-03-11 Total Certi~icabes of Deposit 387.271 12/13/2010 f 61.005 12/23/2010 161.005 113.482 12/23/2010 83.897 12/23/201 0 0.935 12!23/2010 0.249 12/2312010 198.563 19.079 12/232010 217.642 412.325 12123/2010 108.456 12/23/2010 520.781 77.556 12/23!2010 13.364 12123/2010 90.92 5,000.00 12/23/2010 10,000.00 12/23/2010 10,000.00 12123/2010 10,000.00 12123/2010 15.97 6,185.99 Long 13.03 2,097.90 Long 13.03 2,097.90 Long 13.53 1,535.41 ADJ 9113/11 Long 13.53 1,135.13 ADJ 9/13/11 Long 13.53 12.65 ADJ 9!13/11 Long 13.53 3.37 ADJ 9/13111 13.53 2,686.56 13.53 258.15 Long 13.53 2,844.71 ADJ 9/13111 12.57 5,182.93 Long 12.57 1,363.29 long 12.57 6,545.22 ADJ 9/13/11 35.84 2,779.61 Long 35.84 478.97 Long 35.84 3,258.58 21,033.40 1.002181 1.033957 1.013519 1.008339 5,010.91 Long 10,331.57 Long 10,135.19 Long 10,083.39 Long 35,569.06 09/15/2011 16:07 FAX Morgan Stanley 0 0004/0010 Cash, Deposits and Money Market Funds MORGAN STANLEY BANK NA 19867.25 GRAND TOTAL Disclaimer.- 12/23/2010 The Barn and bss infomlafiort is provided for iMormatiorral purposes only, is not a substitute 1099 foan {or any other appropriate tax form), arrd should not be used for tax preparatan. Unreaf¢ed gain and bss values are estimates and should be independently verified We recommend that yvu contact your tax advisor to determine the appropriate use of this information. Past performance does not guarantee future returns. Gain and loss information is cakculated based upon urtifam standards and does not aaaount for each individual ctier+t's particular carrcumstanoes such as the existence of hedgfng banzactions or oonshtrobve sales. Although we make every effort to aopust the oust basis for securities' capital changes. s+as do not adjust the cost basis for a!1 events. Contact your Finarraal Advisor for guidarnae on particxdar questions. For accounts with Choice Select p-iring, the oorrmNssions paid on your eligible equity and option praohases aril sales are app,G@d to the Total Cost on a monthly basis. WFtlr respect to estimated gains and k~es for !r"sled equity gptions, we have taken aKo accormrf option prenuums paid or received and, in respect to multjple purchases andrbr sales, calculated cost using an average unit price for aN k7ce positions. We are not responsible for any gain and k)ss information provided by you or another financial institiition; You are responsible for ensuring the accuracy of such irdorrnation. IMretherprovided by you, another finarxaial institution or MSSB, K is y+wrr responsibility to ensure the accuracy of aN of the Estirr-afed Gain end Loss lrrformation. For die-rts wishing fo make versus pun~ase sales that informatan needs fo be oarrmeyed at the time of the sale. UrHess you tell us otherwise, we use frst in first out (FlFQ) accounting. 1.00 19,867.25 93,109.25 Page Re#rfeved Ore 9/15!2011 2:39:18 PM EST 09/15/2011 7L6:08 FAX Morgan Stanley 0007/0010 t.:._, ,JVV ~ L1Jl V1 L+Lblli LVt.uu1GLLW Y C 1 OI 4 Ds wt ~aur7Mmslm....iek.6dr~.•w.4s~w+ert.+i.rvs~stm...cs.+rd/...~..n.-T..~a.l ••~ar•p~rra:~sr~w.so.•w.~~.,~a..~ i+s.e+olR~r~•~..~rr~..aremwvr~~.~e..+..~.. r.irl~~l~.dc..r~r.pq:.•es~: ~ •o... ~.rtrr~.n is.s As .~e..a•~•.r•r..rai.i~r..,trria.e R .,s:~m...•...•y.:.a r.e• p.:oo..•t~ ~ a~ s..ce~..r+'s..~t..s~ o.+~+. d.dl m•~tii errr ~4s s •i.M ~d ~~. ~: i~..ia~ Idoec ~ 1~1im e!'EmrSoag teen: oay..ba rer,6e .bo~e.deemaa ~tar~,o se.deg ~w Aooonae k. omor~r.~..s...yn~r< C ~. 9 httpJrdeas.msdwis.com/sec~ueJDocuments/ClientA.ccountTmage/ClientA.cctimg.aspx?row... 9/15/2021 Morgan St7aley IRA Designation of Benefccary t.rs.+ray..~+.i.frrrr iel6~ a.tii.a.ia+R.~ ~r.l+•~u~ad,i.+.r..•arr.m.c ra~.A.tae lsf~saidrKi[r~.d•~.G.. rt.di[ s~.r.~~-sfdr~w.i.a.~+.~rKU..it.a1aafe~~Iro~r.~s4r~lfa.gw.i.. Om~rdeGwisegrr bae rewei3~ id ieC.~iiiid•e M1c swr yikr ey *«.crh.r+c~..rs.c.+L r..c. .f diisi~ e*i iy r E~dips swc.p..~eae t as.c~i~/ee s~akRay~ie~kiari~in~rArdr tl sde.Jdur.+K~l •[rrir~~reriewcrrfdds ie ~eiAMsi•! MID PENN BANK February 23, 2011 Hazen Elder Law 2000 Linglestown Rd., Suite 202 Harrisburg, PA 17110 Re: Estate of Arthur F. Edgin Date of Death: 12/23/2010 SSN: XXX-XX-8660 Dear Ms. Woodhouse: In response to your recent letter requesting information on the accounts of Arthur F. Edgin, I have accumulated the necessary data below: Account Name: Arthur F. Edgin or Julia R. Edgin Account #: 1051788 -Checking Account Date Opened: 9/1/1990 Balance DOD: $27002.58 Balance Accrued Interest DOD: $.87 Total DOD Balance: $27003.45 Date Joint Ownership Established: 12/20/2010 Change in Ownership Date: 12/20/2010 Ownership Prior to Change: Arthur & Julia Edgin Revocable Living Trust, Arthur Edgin and Julia Edgin Trustees Ownership Subsequent to Change: Arthur F. Edgin or Julia R. Edgin Balance on Date of Change: 27024.56 Balance Accrued Interest on Date of Change: .69 Total Balance on Date of Change: 27025.25 Account Name: Arthur F. Edgin Account #: 9019019 -Checking Account Date Opened: 11/26/2007 Balance DOD: $56606.31 Balance Accrued Interest DOD: $65.34 Total DOD Balance: $56671.65 Date Joint Ownership Established: N/A Change in Ownership Date: 12/20/2010 Ownership Prior to Change: Arthur & Julia Edgin Revocable Living Trust, Arthur Edgin and Julia Edgin Trustees Ownership Subsequent to Change: Arthur F. Edgin Balance on Date of Change: 65606.31 Balance Accrued Interest on Date of Change: 57.16 349 Union Street, Millersburg, PA 17061 1-866-bHAPPEN • 1-877-9HAPPEN • www.midpennbank.com Member FDIC Total Balance on Date of Change: 65663.47 Account Name: Arthur F. Edgin Account #: 309002187 -Certificate of Deposit Date Opened: 6/20/2008 Balance DOD: $68402.93 Balance Accrued Interest DOD: $26.01 Total DOD Balance: $68428.94 Date Joint Ownership Established: N/A Change in Ownership Date: 12/20/2010 Ownership Prior to Change: Arthur & Julia Edgin Revocable Living Trust, Arthur Edgin and Julia Edgin Trustees Ownership Subsequent to Change: Arthur F. Edgin Balance on Date of Change: 68402.93 Balance Accrued Interest on Date of Change: 6.50 Total Balance on Date of Change: 68409.43 Account Name: Arthur F. Edgin Account #: 309002646 -Certificate of Deposit Date Opened: 9/24/2009 Balance DOD: $65373.03 Balance Accrued Interest DOD: $404.20 Total DOD Balance: $65777.23 Date Joint Ownership Established: N/A Change in Ownership Date: 12/20/2010 Ownership Prior to Change: Arthur & Julia Edgin Revocable Living Trust, Arthur Edgin and Julia Edgin Trustees Ownership Subsequent to Change: Arthur F. Edgin Balance on Date of Change: 65373.03 Balance Accrued Interest on Date of Change: 390.88 Total Balance on Date of Change: 65763.91 Account Name: Arthur F. Edgin Account #: 309002964 -Certificate of Deposit Date Opened: 7/6/2010 Balance DOD: $50859.27 Balance Accrued Interest DOD: $438.42 Total DOD Balance: $51297.69 Date Joint Ownership Established: N/A Change in Ownership Date: 12/20/2010 Ownership Prior to Change: Arthur & Julia Edgin Revocable Living Trust, Arthur Edgin and Julia Edgin Trustees Ownership Subsequent to Change: Arthur F. Edgin Balance on Date of Change: 50859.27 Balance Accrued Interest on Date of Change: 430.73 Total Balance on Date of Change: 51290.00 Account Name: Arthur F. Edgin -Burial Reserve Account #: 309003054 -Certificate of Deposit Total Balance on Date of Change: 65663.47 Account Name: Arthur F. Edgin Account #: 309002187 -Certificate of Deposit Date Opened: 6/20/2008 Balance DOD: $68402.93 Balance Accrued Interest DOD: $26.01 Total DOD Balance: $68428.94 Date Joint Ownership Established: N/A Change in Ownership Date: 12/20/2010 Ownership Prior to Change: Arthur & Julia Edgin Revocable Living Trust, Arthur Edgin and Julia Edgin Trustees Ownership Subsequent to Change: Arthur F. Edgin Balance on Date of Change: 68402.93 Balance Accrued Interest on Date of Change: 6.50 Total Balance on Date of Change: 68409.43 Account Name: Arthur F. Edgin Account #: 309002646 -Certificate of Deposit Date Opened: 9/24/2009 Balance DOD: $65373.03 Balance Accrued Interest DOD: $404.20 Total DOD Balance: $65777.23 Date Joint Ownership Established: N/A Change in Ownership Date: 12/20/2010 Ownership Prior to Change: Arthur & Julia Edgin Revocable Living Trust, Arthur Edgin and Julia Edgin Trustees Ownership Subsequent to Change: Arthur F. Edgin Balance on Date of Change: 65373.03 Balance Accrued Interest on Date of Change: 390.88 Total Balance on Date of Change: 65763.91 Account Name: Arthur F. Edgin Account #: 309002964 -Certificate of Deposit Date Opened: 7/6/2010 Balance DOD: $50859.27 Balance Accrued Interest DOD: $438.42 Total DOD Balance: $51297.69 Date Joint Ownership Established: N/A Change in Ownership Date: 12/20/2010 Ownership Prior to Change: Arthur & Julia Edgin Revocable Living Trust, Arthur Edgin and Julia Edgin Trustees Ownership Subsequent to Change: Arthur F. Edgin Balance on Date of Change: 50859.27 Balance Accrued Interest on Date of Change: 430.73 Total Balance on Date of Change: 51290.00 Account Name: Arthur F. Edgin -Burial Reserve Account #: 309003054 -Certificate of Deposit Date Opened: 12/23/10 Balance DOD: $9000.00 Balance Accrued Interest DOD: $.44 Total DOD Balance: $9000.44 Date Joint Ownership Established: N/A If you have any questions, please contact me at (717) 896-5381. Sincerely, ~~'~ ~C,~1~ Jessica Kerwin Deposit Processing Specialist M~~ 0 1 2011 February 16, 2011 HAZEI~f ELDER LAW ATTN: CORINNE EGGERS WOODHOUSE 2000 LINGLESTOWN RD SUITE 202 HARRISBURG, PA 17110 RE: Arthur F. Edgin Estate EIN: 27-7039714 DOD: 12/23/10 SS#: XXX-XX-8660 ~~sgc~e~c~ln~c~ Susquehanna Bancshares, inc. 26 North Cedar Street P.O. Box 1000 Lititz, PA 17543-7000 Tel 1.800.311.3182 Fax 717.625.4478 To Wi1om It May Concern: In response to your letter of January 25, 2011, here is the above customer account information as of December 23, 2010. Account # 1 Account #2 • Account Title: Arthut F Edgin • Account Type/# CD/401200001998 • Date Opened /Maturity 12/27/06 1127/12 • Interest Rate: 1.98% • Account Balance*: 114,025.28 • Accrued Interest: 160.82 • YTD Interest: 2,121.96 *Account balance does not include accrued interest. Account #3 ® There is no safe deposit box in the name of the decedent. ^ There is a safe deposit box # 0 in the name of the decedent located at the branch name. Julia Edgin was removed as joint owner on this account on 12/16/10. Curtis Edgin was appointed POA for Arthur on 11/30/10. If I can 'be of further assistance, please feel free to call. SincereYy, Dawn M Berrier Deposit Research -Reporting Department Lead 1-717-625-6546 DMB/LJR