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HomeMy WebLinkAbout03-0554PETITION FOR PROBATE and GRANT OF LETTERS Estate of William J. LiDsett also known as No. To: , Deceased Social Security No. 205454405 The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut Or in the last will of the above decedent, dated April 28. 2005 and codicil(s) dated Register of Wills for the County of Cumberlan~ Commonwealth of Pennsylvania in the named (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decedent was domiciled at death in Cumberland County, Pennsylvania, with hi~ last family or principal residence at 343 North 19th Street. Camp Hilt, pA. 17011 (list st~eet~ number and municipality) Decedent, then 85 years of age, died 6/25/2003 at Camp Hill, Cumberland County, Pennsvlvania Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never ajudicated incompetent: Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: None 50.000.00 WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant ofl~tters testament, r~ thereon. /~ [I /? (testamentary; administration c.t.a.; adminislration d.b.n.c.t.a_) /Yw/~../[/~ ~"~ 2901 Butler Street ~' / '-~' ~ ~ IV~.,~ /~//T .... ~ ~ /1 ~' ~r~'~'r MarnsDurq PA 17103 ~ Robert J. kips~g~t OATH OF PERSONAL REPRESENTATIVE COMMONNVEALTH OF PENNSYLVANIA COUNTY OF Cumberlandf SS The petitioner(s) above-named swear(s) or afl'win(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as~ersonal represen- tative(s) of the above decedent petitioner(s)will well and tmly~.~. '.~ef)th~e es,_~/t~6~..__a..~,ording to law. Sworn to or affir~!~ed ,and subscribed bg~'ore me this ~ day of | // Estate of William J. Lipsett ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS ANDNOW ~--'L3.~,l, ~__9, c~OO ~ , in considerafion of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated 4/28/2003 described therein be admitted to probate and filed of record as the last will of William J. LiDsett and Letters Testamentary are hereby granted to Robert J. Lipsett FEES Probate, Letters, Etc ......... $ ~5 C3. -- Short Certificates {6 ) ...... $ i ~. '- Renunciation ............ ~-'c_.P $ ~ '~' -- TOTAL $ l~<~,- Filed .-.~ ~L\.~ .~., .' .~..~ ........ Register of Wills Marielle F. Hazen, Esquire 68003 ATTORNEY (Sup. Ct. I.D. No.) 2000 Linolestown Road, Suite 303 Harrisb~lrq PA 17110 ADDRESS 717-540-4332 PHONE LAST WILL AND TESTAMENT OF WILLIAM J. LIPSETT I, WILLIAM J. LIPSETT, of Cumberland County, Pennsylvania, declare this to be my Last Will and Testament. I revoke all other Wills and Codicils that I may have 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 practicable 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 claim reimbursement for any such taxes which become payable as the result of any property over which I have the power of appointment. Article III I give, devise and bequeath in accordance with any memorandum which 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. Article IV All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, I give, devise and bequeath in equal shares to my children, ROBERT J. LIPSETT, JEANNE LIPSETT BELL, and WILLIAM J. LIPSETT, per stirpes. In the event any of my children predecease me, I give, devise and bequeath his or her share to his or her issue, per stirpes. Article V I nominate, constitute, and appoint my son, ROBERT J. LIPSETT, as Executor of my Last Will and Testament. In the event of the renunciation, death, or inability to act, for any reason whatsoever of my Executor, I nominate, constitute and appoim my daughter, JEANNE LIPSETT BELL as successor Executrix of my Last Will and Testament. I direct that my Executor or successor Executrix be permitted to serve without bond and 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 Executor and successor Executrix shall receive reasonable compensation for services rendered to my estate. -2- Article VI In addition to the powers conferred by law, I authorize my Executor and successor Executrix, 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 fight arising from the ownership of investments, (e) to compromise claims without court approval and without consent of any beneficiary, (f) to file any federal income tax remm 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, and to determine the value of any such property, (h) to employ any attorney, investment advisor, or other agent deemed necessary by my Executor; and 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 time of my death, and 0) to receive reasonable compensation in accordance with their standard schedule of fees in effect while their services are performed. -3- Will and Testament, on IN WITNESS WHEREOF, I, WILLIAM J. LIPSETT, hereby set my hand to this my Last ~ ~7ot~/ 2003, at Harrisburg, Pennsylvania. ~ , In our presence, the above-named WILLIAM J. LIPSETT signed this and declared this to be his Last Will and Testament, and now at his request, in his presence, and in the presence of each other, we sign as witnesses. Address -4- I, WILLIAM J. LIPSETT, Testator, who signed the foregoing instrument, having been duly qualified according to law, acknowledge that I signed and executed this instrument as my Will, and that I signed it willingly as my free and voluntary act for the purposes therein expressed· Swom to or affirmed and acknowledged before me by WILLIAM J. LIPSETT, the Testator, on L/-~ 8 ,2003. ,(ot qbli - Notarial Seal _ Ct~ of Hat. Iaaa, Dauphin County My C~mmi~ion Expirea Sept. 23, 2006 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 execute this instrument as his Will; that he signed and executed it willingly as his free and voluntary 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 witnesses, on q-O~ ,2003. ~ ~,~otary Public~ ~ ' ~ IMariol Notarial Seal [ · le E liazen, Notary Public ..Cit~ of ltartisburg, Dauphin County My ~ommission Expires Sept. 23, 2006 -5- 0 0 0 I- i- Name of Decedent: William J. LiDsett Date of Death: 6/2,5/?0Q;~ Register of Wills Cumberland County, Pennsylvania CERTIFICATION OF NOTICE UNDER RULE 5.6(a) ORIGINA Will No. 2003-00554 Admin. No. 21-03-0554 To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on · Name Address Jeanne M. Bell William J. Lipsett 52 Warrington Drive g~h~t~r NY 1,~1~ 590 Kalla Drive Harri~Pur~ PA 171g~) Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: Date: L~ F: ~. ~:i ~ [,_,.!~.,r,r,~ ~-R .....Capacity: Signature Marlelle F. Hazen, Esquire Name: Law Office of Marielle F. Hazen Address: 2000 Linolestown Road. Suite 303 Harrisbum PA 17110 Telephone(717) 5404332 X Personal Representative Counsel for Personal Representative IN RE: WILLIAM J. LIPSETT Deceased : IN THE COURT OF COMMON PLEAS : OF CUMBERLAND COUNTY, : PENNSYLVANIA : ORPHANS' COURT DIVISION : : NO. 2003-00554 NOTICE OF ELECTION AGAINST DECEDENT'S WILL TO THE CLERK OF THE ORPHANS' COURT DIVISION OF CUMBERLAND COUNTY, AND ROBERT J. LIPSETT, EXECUTOR OF THE ESTATE OF WILLIAM J. LIPSETT, DECEASED: NOW, this ~-] ¢ day of ~~/Sg'/~ ., 2003, in accordance with the provisions of Chapter 22 of the Probate Estate and Fiduciaries Code, I, Robert J. Lipsett, Successor Co-Agent under Power of Attorney dated September 25, 2003 (a copy of said Power of Attorney attached hereto as Exhibit "A") for Charlotte K. Lipsett, widow of WILLIAM J. LIPSETT, deceased, do hereby elect on behalf of Charlotte K. Lipsett to take against the Last Will and Testament of her husband, WILLIAM J. LIPSETT, who died June 25, 2003, and against all of the conveyances of WILLIAM J. LIPSETT falling within the scope of 20 Pa. C.S. Section 2203 and I hereby claim Charlotte K. Lipsett's elective share of such estate and conveyances. Date: / for ROBERT ~~LIP T~T,A~ent Charlotte K. Lipsett COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN SS: ON THIS, the ~i day of ~_~ p~. ,2003, before me a Notary Public for the Commonwealth of Pennsylvania, personally appeared ROBERT J. LIPSETT, Power of Attorney for Charlotte K. Lipsett, known to me to be the person whose name is subscribed to the within Notice of Election Against Decedent's Will and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. Not~y Public' blcn~ri~l Seal Marielle F. Hazen, Nota~. Public City of Harrisburg, Dauphin County My Conunisslon Expires Sept. 23, 2006 2 0 c~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DEC, EDEN'PS NAME (LAST, FIRST, AND MIDDLE'INITIAl .ipsett, William J. DATE OF DEATH (MM-DD-Year) 06/25/2003 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Lipsett, Charlotte K. ORIGINAL REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DATE OF BIRTH (MM-DD-Year) 10/25/1917 OFFICIAL USE ONLY FILE NUMBER 2 1 -0 3 0 5 5 4 COUNTYCODE YEAR --~ NUM~ SOCIAL SECURITY NUMBER 2 0 5- 0 5-4 4 0 5 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOQALSECURITYNUMBER [] 1. Original Retum D4. Limited Estate r~'l 6. Decedent Died Testate (~ copy o~w~ O 9. Litigation Proceeds Received ['-1 2. Supplemental Retum O4a. Future Interest Compromise (da~ of ~ aaer 12-12-82) O7. Decedent Maintained a Living Trust (A~ch copy of T~t) r-'l 10. Spousal Poverty Credit Cae o~ ~ 12-31-91 axl 1-1-95) D3. RemainderRetem (daleofdealhp~o~t~12-13-82) O5. Federal Estate Tax Return Required __ 8. Total Number of Safe Deposit Boxes Oll. Election tefax under Sec. 9113(A) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME Marielle F. Hazen~ Esq. FIRM NAME (If ~oplical~) Law Office of Marielle F. Hazen TELEPHONE NUMBER 717-540-4332 COMPLETE MAILING ADDRESS 2000 Linglestown Road Suite 303 Harrisburg PA 17110 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Coq)oration, Par'me,hip or Sole-Pmprietomhip (3) 4. Mo~ages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. JoinUy Owned Properly (StiPule F) (6) O Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Properly (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of E~tale (Line 8 minus Line 11) 13. Charitable and Govemmental Bequests/Sec 9113 Trusts for ~hich an elec~n to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Une 12 minus Line 13) 31 ~277.01 76~715.27 54~598.03 OFFICIAL USE ONLY (8) (11) (12) 10,134.77 2~622.04 162~590.31 12~756.81 149~833.50 (13) (14) 149r833.50 SEE IN,~¥~UCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or tmnsfm under Sec. 9116 (a)(1.2) 16. Amount of Une 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibting rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. 118,086.18 X OO (15) 31,747.32 x .045 (16) X .12 (17) x .15 (18) (19) 1 ~428.63 1,428.63 ,Decetlent's Complete Address: STREET ADDRESS 343 N. 19th Street Camp Hill Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 1.357.20 71.43 ISTATE PA Izip 17011 (1) 1,428.63 Total Credits ( A + B + C ) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page I Une 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 1,428.63 0.00 0.00 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 fight 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 December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?. .............................................................................................. [] [] 3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a benefidary 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. =.a. [ne pe~ona],~q:~t,aave,}a, ioaseo o~ afl ~ m~=n ~ n~ ~y K~, SIGNATURE ~ PE~N RESP~B[E FOR ~G ~ ~ UEN DATE 2901 Butler ~ ~ Harrisburg PA 17103 S N*TU.E D TE ~DRfiSS ' 2000 Hn~o~to~n Road, Suito 303 Hardsbur,cj PA 17110 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. {}9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 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 twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 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 benefidaries is 4.5%, 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 siblinos is 12% I72 P,S. 69116(a)(1.3)1. A siblin(] is defined, under Section 9102. as an COMMONWEALTH OF PENNSYLVANIA INHERiTANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS,& MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER LiDsett. William J. Z1 0;~ Include the proceeds of litigation and the date the proceeds were received by the e~tate. All property jointly-owned Mth the right of survivorshi ITEM NUMBER DESCRIPTION Check payable to William J. Lipsett distributed funds from annuity Ck. #05580304 1991 Ford Tarus donated to charity Army retirement check TOTAL (Also enter on line 5, Recapitulatio~ 0~4 must be disclosed on Schedule F. VALUE AT DATE OF DEATH 30,343.84 0.00 933.17 $ 31,277.01 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER LiDsett. William ~1, If an assst was made joint within one year of the decedest's date of death, it must be reposed on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Robert J. Lipsett Son B Chadotte K. Lipsett C 2901 Butler Street Harrisburg, PA 17103 c/o 2901 Butler Street Harrisburg, PA 17103 Spouse JOINTLY-OWNED PROPERTY: ~ i i ~ DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Inc~ ~ of ~ancial ins~ and ~k ~t nu~ ~ simil~ idenffying ~. Attach DATE OF DEATH DEC[TS VALUE OF NUMBER TENANT JOINT deed fo~ joinUy-helU real estate. VALUE OF ASSET INTEREST DECEDENT'S INTERE~ 1. A. 6/2003 !Certificate of Deposit 16,000.00 100. 16,000.0( M&T Bank Acct. No. 98216414 2. A. 6/2003 Checking Account 8,600.78 100. 8,600.7[ Citizens Bank Acct. No. 610067-72~1 3. B. Checking A~unt 8,764.49 50. 4,392.2,~ Citizens Bank Acct. No. 610068-529-2 4. iA. 6/2003 Checking A~unt 4,500.00 100. 4,500.0C M&T Bank Acct. No. 5. B. Annuity (Transamerica Life & Annuity) 86,444.47 50. 43,222.2~1 Acct. No. 27304514 Beneficiary: Charlotte K. Lipsett (spouse) TOTAL (Also enter on line 6, Recapitulation) $ 76.715.27 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER Liosett. William J. 21 This schedule must be completed and filed ifl~e answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET ~s ~es. DESCRIPTION OF PROPERTY % OF ITEM INCLUOE ~E N~ME OF THE TRANSF~ THEIR RI~ATIONSHIP TO DECEDENT AND THE DATE OF TRANSE~[~ DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUf NUMBER A~,C~ A COPY OF THE BEuED FOR REN. ESTATE. VALUE OF ASSET INTEREST ~ ~,,~uc,~ 1. Annuity (Monumental Life Insurance Co.) 54,598.03 100. 54,598.0: Acct. No. 010ON222183 Beneficiary: Charlotte K. Lipsett (spouse) 0.0( TOTAL (Also enter on line 7. Recadtulationl $ REV-1511EX COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN HESIDENI I~CEDENI SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF LiDsett. William J, Debts of decedent must be reported on Schedule I. FILE NUMBER 21 03 0554 ITEM NUMBER DESCRIPTION AMOUNT 1. 2. 3. FUNERAL EXPENSES: Resurrection Cemetery Stephenson's Flowers Myers-Hamer Funeral Home ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Robert J. Lipsett Social Security Number(s) / EIN Number of Personal ReprasentalJve(s) Street Address 2901 Butler Street 202-36-7388 Cily Hardsbur,cj Slate PA Year(s) Commission Paid: Attorney Fees Law Office of Madelle F. Hazen Family Exemption: (If decedent's address is notre same as claimant's, attach explanation) Claimant ~p 17103 Street Ad~rass C~ State Zip Relationship of Claimant to Decedent Probate Fees Cumberland County Register of Wills Probate Fees and Tax Retum Filing Fee Accountant's Fees Tax Return Preparers Fees Advertising Fees: The Sentinel 675.00 212.00 7,007.50 2,000.00 145.00 95.27 TOTAL (Also enter on line 9, Recapitulation) $ 10r134.77 ~ ;~=V-1512 EX + (1-97) COIvlMONWEALTH OF PENNSYLVANIA ;NHERJTANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER Liesett. William J. Include unreimbursed medical expenses. 21 03 05,54 ITEM NUMBER DESCRIPTION AMOUNT 1. 350.00 10. 11. 12. 13. 14. 15. Sylvia Kutchman June Rent Penn Waste Inc. Trash removal bill PA American Water Co. Water bill Comcast Cablevision Cable bill PP&L electric bill AT&T Phone bill Verizon )hone bill I'he Patriot News newspaper bill Reclaimation of Army Retirement check PP&L Electric electric bill Comcast Cablevision final cable bill Sylvia Kutchman July rent AT&T phone bill Verizon finalphone bill PP&L Electricbill 50.74 17.04 39.64 143.00 37.52 20.09 3.85 933.17 143.00 39.64 43.31 24.63 163.00 TOTAL (Also enter on line 10, Recapitulation) ; $ i 2,622.04 (If more space is needed, insert additional sheets of the same size) · Continuation of REV-1500 Inheritance Tax Return Resident Decedent Lipsett, William J. 21 03 Paqe 1 Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens 0554 ITEM NUMBER DESCRIPTION AMOUNT 16. 16.53 17. 18. 19. PA Amedcan Water water bill AT&T final phone bill PA Amedcan Water final water bil PP&L final electdc bill 3.07 3.02 240.79 SUBTOTAL SCHEDULE I 263.41 GRAND TOTAL SCHEDULE I $ 2,622.04 REV_1513.{=X + COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF LiDsett. ¥ ;illiaq'l d, NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [i,~9~(~a)~l.~)]usaldist~butions, and ffansfers under Robert J. Lipsett 2901 Butler Street Harrisburg, PA 17103 Jeanne M. Bell 52 Wardngton Drive Rochester, NY 14618 William J. Lipsett 590 Kalla Drive Harrisburg, PA 17109 Charlotte K. Lipsett c/o 2901 Butler Street Harrisburg, PA 17103 FILE NUMBER 21 03 RELATIONSHIP TO DECEDENT Son Daughter Son Spouse Do Not List Trustee(s) 0554 AMOUNT ORSHARE OF ESTATE 2/9 of residue 2/9 of residue 2/9 of residue 1/3 elective share (If mnm TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS NON-TAXABLE DISTRIBUTIONS: A, SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET LAST WILL AND TESTAMENT OF WILLIAM J. LIPSETT I, WILLIAM J. LIPSETT, of Cumberland County, Pennsylvania, declare this to be my Last Will and Testament. I revoke all other Wills and Codicils that I may have 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 practicable 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 claim reimbursement for any such taxes which become payable as the result of any property over which I have the power of appointment. Article III I give, devise and bequeath in accordance with any memorandum which 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. Article IV All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, I give, devise and bequeath in equal shares to my children, ROBERT J. LIPSETT, JEANNE LIPSETT BELL, and WILLIAM J. LIPSETT, per stirpes. In the event any of my children predecease me, I give, devise and bequeath his or her share to his or her issue, per stirpes. Article V I nominate, constitute, and appoint my son, ROBERT J. LIPSETT, as Executor of my Last Will and Testament. In the event of the renunciation, death, or inability to act, for any reason whatsoever of my Executor, I nominate, constitute and appoint my daughter, JEANNE LIPSETT BELL as successor Executrix of my Last Will and Testament. I direct that my Executor or successor Executrix be permitted to serve without bond and 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 Executor and successor Executrix shall receive reasonable compensation for services rendered to my estate. -2- Article VI In addition to the powers conferred by law, I authorize my Executor and successor Executrix, 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 and without consent of any beneficiary, (f) to file any federal income tax return for any year for which I have not filed such return prior to my death, to make distributions in cash or in kind, or in both, and to determine the value of any (g) such property, (h) to employ any attorney, investment advisor, or other agent deemed necessary by my Executor; and 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 time of my death, and 0) to receive reasonable compensation in accordance with their standard schedule of fees in effect while their services are performed. -3- Will and Testament, on IN WITNESS WHEREOF, I, WILLIAM J. LIPSETT, hereby set my hand to this my Last ,L~C,~Le.~ ,2003, at Harrisburg, Pennsylvania. ( In our presence, the above-named WILLIAM J. LIPSETT signed this and declared this to be his Last Will and Testament, and now at his request, in his presence, and in the presence of each other, we sign as witnesses. Address -4- I, WILLIAM J. LIPSETT, Testator, who signed the foregoing instrument, having been duly qualified according to law, acknowledge that I signed and executed 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 WILLIAM J. LIPSETT, the Testator, on /--] 'o0 8 ,2003. WILLIAM J. LII~/E'~'I~ '{/ / Notarial ,%al I Markflle E Haz~n, No~. Public City of Harrialmrg. Dauphin County My C~mmi$$ion Expires ~pt. 23, 2006 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 execute this instrument as his Will; that he signed and executed it willingly as his free and voluntary 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. Swom to or affirmed and subscribed to before me witnesses, on q - ~ 8 ,2003. Notary Public' Notarial Seal _Mmielle E Haven. Notary Public City of Harrisburg, Dauphin County My Commission Expires Sept. 23. 2006 IN RE: WILLIAM J. LIPSETT Deceased : IN THE COURT OF COMMON PLEAS : OF CUMBERLAND COUNTY, : PENNSYLVANIA : ORPHANS' COURT DIVISION : NO. 2003-00554 NOTICE OF ELECTION AGAINST DECEDENT'S WILL TO THE CLERK OF THE ORPHANS' COURT DIVISION OF CUMBERLAND COUNTY, AND ROBERT J. LIPSETT, EXECUTOR OF THE ESTATE OF WILLIAM J. LIPSETT, DECEASED: NOW, this ,~-J ~ day of ~'~9~7'6']nt587~ ., 2003, in accordance with the provisions of Chapter 22 of the Probate Estate and Fiduciaries Code, I, Robert J. Lipsett, Successor Co-Agent under Power of Attorney dated September 25, 2003 (a copy of said Power of Attorney attached hereto as Exhibit "A") for Charlotte K. Lipsett, widow of WILLIAM LIPSETT, deceased, do hereby elect on behalf of Charlotte K. Lipsett to take against the Last Will and Testament of her husband, WILLIAM J. LIPSETT, who died June 25, 2003, and against all of the conveyances of WILLIAM J. LIPSETT falling within the scope of 20 Pa. C.S. Section 2203 and I hereby claim Charlotte K. Lipsett's elective share of such estate and conveyances. Date: Charlotte K. Lipsett COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN SS: ONTHIS, the ~1 dayof ,_~~. ,2003, before me a Notary Public for the Commonwealth of Pennsylvania, personally appeared ROBERT J. LIPSETT, Power of Attorney for Charlotte K. Lipsett, known to me to be the person whose name is subscribed to the within Notice of Election Against Decedent's Will and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. No~ri~l S~I Maricllc E Haz~n. Nou?~. Public City of Harrisburg, Dauphin Coun~ My ~ssi~ Expi~s Se~. 23, 2~ 2 DURABLE POWER OF ATTORNEY FOR CHARI~OTTE K. LIPSETT Prepared by: Jan L. Brown & Associates 845 Sir Thomas Court, Suite 12 Harrisburg, PA 17109 (717) 541-$$50 NOTICE THE PURPOSE OF THIS POWER OF ATTORNEY IS TO GIVE THE PERSON YOU DESIGNATE (YOUR "AGENT") BROAD POWERS TO HANDLE YOUR PROPERTY, WHICH MAY INCLUDE POWERS TO SELL OR OTHERWISE DISPOSE OF ANY REAL OR PERSONAL PROPERTY WITHOUT ADVANCE NOTICE TO YOU OR APPROVAL BY YOU. THIS POWER OF ATTORNEY DOES NOT IMPOSE A DUTY ON YOUR AGENT TO EXERCISE GRANTED POWERS, BUT WHEN POWERS ARE EXERCISED, YOUR AGENT MUST USE DUE CARE TO ACT FOR YOUR BENEFIT AND IN ACCORDANCE WITH THIS POWER OF ATTORNEY. YOUR AGENT MAY EXERCISE THE POWERS GIVEN HERE THROUGHOUT YOUR LIFETIME, EVEN AFTER YOU BECOME INCAPACITATED, UNLESS YOU EXPRESSLY LIMIT THE DURATION OF THESE POWERS OR YOU REVOKE THESE POWERS OR A COURT ACTING ON YOUR BEHALF TERMINATES YOUR AGENT'S AUTHORITY. YOUR AGENT MUST KEEP YOUR FUNDS SEPARATE FROM YOUR AGENT'S FUNDS. A COURT CAN TAKE AWAY THE POWERS OF YOUR AGENT IF IT FINDS YOUR AGENT IS NOT ACTING PROPERLY. THE POWERS AND DUTIES OF AN AGENT UNDER A POWER OF ATTORNEY ARE EXPLAINED MORE FULLY IN 20 PA. C.S. CH. 56. 1F THERE IS ANYTHING ABOUT THIS FORM THAT YOU DO NOT UNDERSTAND, YOU SHOULD ASK A LAWYER OF YOUR OWN CHOOSING TO EXPLAIN IT TO YOU. I HAVE READ OR HAD EXPLAINED TO ME THIS NOTICE AND I UNDERSTAND ITS CONTENTS. PRINCIPAL DATE ACKNOWLEDGMENT i.,_ ' ower o omey and am the person identified as the agent for the principal. I hereby acknowledge that in the absence of a specific provision to the contrary in the Power of Attorney or in 20 Pa. C.S. when I act as agent. I shall exercise the powers for the benefit o£the principal. I shall keep the assets of the principal separate from my assets. I shall exercise reasonable caution and prudence. I shall keep a full and accurate record of all actions, receipts and disbursements on behalf of the principal. Agent ACKNOWLEDGMENT ' I,~/]//~/~. ~ / ?~'~P~ , have read the attached Power of Attomey and am the person identified as the agent for the principal. I hereby acknowledge that in the absence of a specific provision to the contrary in the Power of Attorney or in 20 Pa. C.S. when I act as agent. I shall exercise, the powers for the benefit of the principal. I shall keep the assets of the principal separate from my assets. I shall exercise reasonable caution and prudence. I shall keep a full and accurate record of all actions, receipts and disbursements on behalf of the principal. ~ent ~/~/ ' / Date ACKNOWLEDGMENT I, , have read the attached Power of Attorney and am the person identified as the agent for the principal. I hereby acknowledge that in the absence of a specific provision to the contrary in the Power of Attorney or in 20 Pa. C.S. when I act as agent. I shall exercise the powers for the benefit of the principal. I shall keep the assets of the principal separate from my assets. I shall exercise reasonable caution and prudence. I shall keep a full and accurate record of all actions, receipts and disbursements on behalf of the principal. Agent Date ACKNOWLEDGMENT I, ~~J' /'Poe~'~, have read the attached Power of A~omey and am the person identified as the agent for the principal. I hereby acknowledge that in the absence of a specific provision to the contrary in the Power of Attorney or in 20 Pa. C.S. when I act as agent. I shall exercise the powers for the benefit of the principal. I shall keep the assets of the principal separate from my assets. I shall exercise reasonable caution and prudence. I shall keep a full and accurate record of all actions, receipts and disbursements on behalf of the principal. Agent f~/ v - Date DURABLE POWER OF ATTORNEY FOR CHARLOTTE K. LIPSETT I, CHARLOTTE K. LIPSETT, of Cumberland County, Pennsylvania, hereby revoke any and all prior Powers of Attorney and hereby appoint my husband, WILLIAM J. LIPSETT, of Cumberland County, Pennsylvania, to act as my Agent (hereinafter referred to as "my "Agent") for me and in my name and place to transact all my business and to manage all my property and affairs as completely as I myself might do if personally present, including but not limited to, exercising the following powers contained in this document. In the event of WILLIAM J. LIPSETT's death or if he is unwilling or unable to serve, I hereby nominate and appoint my three children: JEANNE M. BELL, of Rochester, New York; WILLIAM J. LIPSETT, of Harrisburg, Pennsylvania; and ROBERT J, LIPSETT, of Harrisburg, Pennsylvania, to act jointly and/or individually as my Co- Agents with all the powers set forth below. Possession of this original Power of Attorney by my daughter, JEANNE M. BELL and/or my son, WILLIAM J. LIPSETT and/or my son, ROBERT J. LIPSETT shall be conclusive evidence that my husband, WILLIAM J. LIPSETT is unable to serve or to continue serving as my Power of Attorney and/or Agent. 1. Execution of Contracts. To enter into, perform, modify, extend, cancel, compromise, enforce, or otherwise act with respect to any contract of any sort whatsoever -- including but not limited to, leases and mortgages -- and to pay any money or to transfer title and possession to any real or personal property that may be required to be paid or transferred by any contract or in the performance of any obligation entered into or incurred by me or on my behalf. 2. Investments. To invest in all forms of real and personal property without any restriction whatsoever as to the kind of investment, including, but not limited to, United States Treasury Bonds which are redeemable at par in payment of federal estate taxes. 3. Registration of Property. To hold property unregistered or in the name ora nominee. 4. Personal Property. To buy or sell securities; to buy or sell at public or private sale for cash or credit or partly for each, exchange, pledge, lease, give or acquire options for sales or exchanges or leases, or by any other means whatsoever to acquire, dispose of, repair, alter or manage tangible or intangible personal property or any interest therein, and, without limitation, with respect to any securities, to comply with any securities laws or regulations, to execute indemnity agreements, to purchase insurance and to pay commissions or discounts required by any underwriting. 5. Real Property. To buy or sell at public or private sale for cash or credit or partly for each, exchange, mortgage, encumber, lease for any period of time, give or acquire options for sales, purchases, exchanges or leases, dedicate, or by any other means whatsoever, to acquire or dispose of real property or any interest therein; to partition and subdivide real property; to manage real property; to repair, alter, erect, or tear down any structure or part thereof; and to file such plans, applications, or other documents in connection therewith and do such other acts as may be requested by any government or other authority having or purporting to have jurisdiction. 6. Securities. To vote in person or by proxy at any meeting, to join in any merger, reorganization, voting-trust plan or other concerted action of security holders, to make payments in connection therewith, and in general to exercise all fights of a security holder. 7. Insurance. To procure, alter, extend or cancel insurance against any and all risks affecting property and persons, and against liability, damage or claim of any sort. 8. Designate Beneliciaries. To make or change any designation of beneficiary or to make or change any distribution option for any qualified retirement plan, IRA, annuity, insurance policy or other program for which I am entitled to so do. 9. Loans. To borrow money in such amounts for such periods and upon such terms as my agent shall deem proper and to secure any loan by the mortgage or pledge of any property, and I specifically authorize my agent to borrow money and to pledge property as collateral for the purpose of purchasing United States Treasury Bonds which are redeemable at par in payment of federal estate taxes. 10. Bank Accounts. To sign checks, drafts and other instruments or otherwise make withdrawals from any checking, savings, transaction or other deposit account in my name, and to endorse checks payable to me and receive the proceeds thereof in cash or otherwise; to open and close checking, savings, transaction or other deposit accounts in my name; to purchase and redeem savings certificates, certificates of deposit or similar instruments in my name; to exercise and deliver receipts for any funds withdrawn or certificates redeemed; and to do all acts regarding any checking account, savings account, savings certificate, certificate of deposit, or similar instrument which I now have or may hereafter acquire, the same as I could do if personally present. Any f'mancial institution may continue to rely on this power of attorney until it receives written notice fi.om me that this power of attorney is revoked or actual notice of my death and shall be indemnified and held harmless by me and my estate, personal representatives and heirs against any liability or loss, including lawyers' fees, costs of suit and claims of third parties, which it might incur by relying on this power after termination or revocation but before it receives such notice, or any time because of wrongful acts, omissions or representations of my agent with respect to transactions covered by this power of attorney. My agent shall be subject to whatever bank rules and regulations I would be subject to. 11. Individual Retirement Account. To request and receive distributions fi.om any of my individual Retirement Accounts; to give instructions for the purchase and sale of securities in those accounts; to execute on my behalf any powers of attorney or, other instruments needed for those purposes; and to endorse notes, check, drafts and bills of exchange, and to make contributions to those accounts. -2- 12. Safe Deposit Boxes. To have access to and control over the contents of any safe deposit box rented by me, to rent safe deposit boxes in my name, to close out and execute and deliver receipts for safe deposit boxes in my name, and to do all acts regarding any safe deposit boxes in my name, which I now have or may hereafter acquire, the same as I could do if personally present; provided that my agent shall not deposit or keep in any such safe deposit box any property in which my agent has a personal interest. Any financial institution may continue to rely on this power of attorney until it receives written notice from me that this power of attorney is revoked or actual notice of my death and shall be indemnified and held harmless by me and my estate, personal representatives and heirs against any liability or loss, including lawyers' fees, costs of suit and claims of third parties, which it might incur by relying on this power after termination or revocation but before it receives such notice, or at any time because of wrongful acts, omissions or representations of my agent with respect to transactions covered by this power of attorney. My agent shall be subject to whatever bank rules and regulations I would be subject to. 13. Receipts and Approval of Accounts. To receive payment of any kind, including a bequest, devise, gift or other transfer of real or personal property to me in my own right or as a fiduciary for another, and to give full receipt and acquittance therefore, or a refunding bond therefore, to approve accounts of any business, estate, trust, partnership or other transaction whatsoever in which I may have any interest of any nature whatsoever, and to enter into any compromise and release in regard thereto. 14. Compromise and Arbitration of Claims. To compromise or arbitrate any claim in which I may be in any manner interested, and for that purpose to enter into agreement to compromise or arbitrate, and either through counsel or otherwise to carry on such compromise or arbitration and perform or enforce any award entered in arbitration. 15. Institution and Defense Claims. To institute, prosecute, defend, compromise, or otherwise dispose of, and to appear for me in, any proceedings at law or in equity or otherwise before any tribunal for the enforcement or for the defense of any claim, either alone or in conjunction with other persons, relating to me or to any property of mine or any other person (including the authority to sue if this power of attorney is not honored), and to retain, discharge and substitute counsel and authorize appearance of such counsel to be entered for me in any such action or proceeding. 16. Taxes. To prepare, execute and file in my name and on my behalf any return, report, protest, application for correction of assessed valuation of real or other property, appeal, brief, claim for refund or petition including petition to the United States Tax Court in connection with any tax imposed or purported to be imposed by any government, authority or agency, or claimed, levied or assessed by any government, authority or agency and to pay any such tax and to obtain any extension of time for any of the foregoing; to execute waivers of restrictions on the assessment and collection of deficiency in any tax; to execute closing agreements and all other documents, instruments and papers relating to any tax liability of mine of any sort; to institute and carry on either through counsel or otherwise any proceeding in connection with contesting any such tax or to recover any tax paid, or -3- to resist any claim for additional tax or any proposed assessment or levy thereof, and to enter into any agreements or stipulations for compromise or other adjustment or disposition of any tax. 17. Bonds. To purchase for me United States of America Treasury Bonds of the kind which are redeemable at par in payment of federal estate taxes; to borrow money and obtain credit in my name from any source for such purpose, to make, execute, endorse and deliver promissory notes, drafts, agreements or other obligations for such bonds and, as security therefore, to pledge, mortgage and assign any stocks, bonds, securities, insurance values and other properties, real or personal, in which I may have an interest, and to arrange for the safekeeping and custody of any such Treasury Bonds. 18. Disclaimer. To execute, deliver and file or record disclaimers of any part or all of any property, power or interest passing to or for me under any will, deed or trust or otherwise; and to direct my spouse's executor to elect to qualify or to elect not to qualify for the marital deduction any portion or all ora marital deduction trust created for me by my spouse. 19. SpousalElection To release or disclaim any interest in property on behalf of me (the Principal). I direct my Agent to disclaim any and all interest in any and all property if it impacts or delays my eligibility for private and public benefits, including state, local, and federal benefits; specifically, I direct my Agent(s) to refuse to take or claim a spousal election if it will impact or delay the receiving or eligibility of medical assistance benefits. I specifically direct my Agent to refuse to claim an election share in such a situation, and I consider refusing to take or claim a spousal election a part of my estate planning, and it is my wish and reflects my intentions regarding my estate planning and my directions of my estate to refuse to take or claim the elective share if it impacts or delays my eligibility for any private or public benefits. 20. Etnplol, ment o.f Others. To employ accountants, attorneys-at-law, investment counsel, custodians, agents, servants, and others, and to delegate to them, to remove them, and to pay them such remuneration as my agents shall deem proper. 21. Execution of Documents. To execute, deliver, file for record, cancel, modify, endorse, acquire or dispose of any instrument including, but not limited to, stock and bond powers, vehicle registrations, financing statements and related filing documents, reports of any sort to any government, authority or agency, as required or permitted by law, deeds with or without covenants or warranties, and any other document appropriate for carrying out any of the foregoing powers. 22. G~ft Making Powers. To make gifts, as set forth below, either outright or in trust or, in the case of minors, in accordance with the Uniform Gifts to Minors Act and, for gifts made in trust, to persons, including my Agent, as original or successor trustees. This power includes the right to make additions to an existing trust and does not require my Agent to treat the donees equally or proportionately and may entirely exclude one or more permissible donees. The pattern followed on the occasion of any such gift (or gifts) need not be followed on the occasion of any other gift (or -4- gifts). The gifts shall be restricted to: my spouse; my lineal descendants; any trust(s) for my benefit and/or for my spouse's benefit and/or for my lineal descendent(s)' benefit; and any organization described in IRC Section 501(c)(3). My Agent and the donee of the gift shall be responsible as equity and justice may require to the extent that a gift made by my Agent is inconsistent with my directions and planning of my probable intent with respect to the disposition of my estate. The ability of my Agent to make gifts of my property shall be limited by and shall only be made in conformity with my prenuptial agreement, if any such agreement exists. I specifically direct my Agent to make gifts to any and all persons listed in the above paragraph who he/she deem appropriate, and further direct my Agent to make transfers including gifts in order to hasten and facilitate my eligibility for public and private benefits, including medical assistance, so to allow me and/or my spouse or any family member to receive state, local, and federal benefits at the early possible time/date. Further, I consider transfers and gifting in order to obtain such benefits to be in accordance with my estate planning, and I direct such action to be taken to obtain said benefits for me. Any and all transfers and gifts are not inconsistent with my estate planning and in fact reflect my intention and direction with respect to the disposition of my estate. Specifically, I do not restrict or limit the amount of money or assets to be transferred and gifted, and direct the funds available for such gifts or transfers include Principal and income. 23. Governmental Benefits. To exercise complete dominion and control over any and all social security, veteran, county, state and federal benefits to which I may now or hereafter be entitled. 24. Healthcare Decisions. To consent, refuse or withdraw consent to any and all types of medical care, treatment, surgical procedures, diagnostic procedures, medication, blood and blood products, and the use of mechanical or other procedures that affect any bodily function, including, but not limited to, artificial respiration, nutritional support and hydration, kidney dialysis and cardiopulmonary resuscitation; And to have access to medical records and information, including psychiatric records, to the same extent that I am entitled to, including the right to disclose the contents to others; And to authorize, or refuse to authorize, any medication or procedure intended to relieve pain, even though such use may lead to physical damage, addiction or hasten the moment of (but not intentionally cause) my death. 25. Placement in an Institution. To take charge of my person in case of illness or disability of any kind; to authorize my admission to a medical, nursing, residential or similar facility, and to enter into agreements for my care; and to remove and place me in such institutions or places -5- as my agent may deem best for my personal care, comfort, benefit and safety after giving consideration to any wishes I have previously expressed on this subject. 26. Create a Trust. To execute a deed of trust, designating one or more persons (including my Agent) as original or successor trustee(s) and to transfer to the trust any or all property owned by me as my Agents may decide. The income and principal of the trust may, but need not, be distributed to me or to the guardian of my estate, or be applied for my benefit, and upon my death, any remaining principal or unexpended income of the trust may, but need not, be distributed to my estate. Furthermore, this trust or deed of trust may be amenable or revocable at any time by me or my Agents, or the trust or deed of trust may be irrevocable by me or my Agent. The establishment and funding ora Trust, either revocable or irrevocable, is not inconsistent with my estate planning, and in fact reflects my intention and direction with respect to the disposition of my estate. 27. Fund the Trust. To add at any time, any or all of the property owned by me to trust in existence for my benefit when this power was created. The income and the principal of the trust may.. but need not, be distributable to me or to the guardian of my estate or be applied for my benefit during my lifetime and upon my death any remaining principal and unexpended income of the trust, may, but need not, be distributed to my estate. The establishment and funding of a Trust, either revocable or irrevocable, is not inconsistent with my estate planning, and in fact reflects my intention and direction with respect to the disposition of my estate. 28. Guardianship. Pursuant to Pennsylvania Consolidated Statute Title 20, Section 5604 (c) (2) or the corresponding provisions of any subsequent state law, if incapacity proceedings of my person are hereafter commenced, I hereby nominate, constitute and appoint the herein-described Agent as the guardian of my estate and my person. If and in the event that my Agent predeceases me, or does not complete the duties of my true and lawful Agent, then and in such event, I nominate, constitute and appoint the herein-described Successor Agents as the guardian(s) of my estate and my person. 29. Substitution. My Agent shall have full power of substitution and revocation, and such substitution or revocation may relate to, or be limited to, any one or more or all of the foregoing acts or powers, or be limited as to time or in such other respect as my Agent shall deem proper. 30. General. To do all things which my agent shall deem proper in order to carry out any of the foregoing enumerated powers, which shall be construed in the broadest possible manner. However, in no event shall this power of attorney be exercised in favor of my agent, anyone he or she has the obligation to support, my agent's estate, my agent's creditors or the creditors of his or her estate, unless specifically provided in this power of attorney. The descriptive headings of this general power of attorney are inserted for convenience only and shall not be deemed to affect the meaning or construction of any of the provision hereof or to limit in any way the construction thereof in the broadest possible manner. -6- 31. Liability. Any person who is given instructions by my Agent in accordance with the terms of the Power of Attorney shall comply with the instructions. Any person who without reasonable cause fails to comply with these instructions shall be subject to civil liability for any damages resulting from non-compliance. Reasonable cause under this subsection shall include, but shall not be limited to, a good faith report having been made by the third party to the local protective services agency regarding abuse, neglect, exploitation, or abandonment. However, I consider qualifying for medical assistance benefits to be prudent planning. Any actions taken to hasten and facilitate my eligibility for medical assistance shall not be challenged by a third party, including the local protective services agency. 32. Third Party Immuni.tv. Any person who acts in good faith, reliance on my Power of Attorney shall incur no liability as a result of acting in accordance with the instructions of my Agent. 33. Compensation and Reimbursement for Expenses. The Agent shall be entitled to reasonable compensation based on the actual responsibilities assumed and performed. My Agent shall also be entitled to reimbursement for actual expenses advanced on behalf of the Principal and to reasonable expenses incurred in connection with the performance of my Agent's duty. 34. Ratification. I hereby ratify and confirm all that my agent or the substitute or substitutes therefore shall lawfully do or cause to be done by virtue hereof. 35. Reliance b.v Others. This power of attorney shall continue in force and may be accepted and relied upon by anyone to whom it is presented despite my purported revocation of this power, the age of this power, the issuance ora court decree declaring my incompetency or my death, until written notice of such event is received by such person. 36. Ef_fectofMyDisabilit),. This power of attorney shall not be affected by my disability or incapacity. 37. Waivers and Directions. Initials by Principal is reinforcing his/her interest on the following issues, responsibilities, and undertaking by Agent on Principal's behalf: 1. ~ ~ ~I specifically and expressly waive any requirements in effect now Initials and in the future to have my assets kept separate from my Attorney- in-Fact and/or Agent's assets. Initials I specifically and expressly waive any requirements in effect now and in the future to require my Attorney-in-Fact and/or Agent to keep a full and accurate record of all activities, receipts, and disbursements my Attorney-in-Fact and/or Agent has made on behalf of me (the Principal). -7- ~I specifically and expressly waive the requirement in effect now and Initials in the future that my Attorney-in-Fact and/or Agent is to file an accounting of his or her action with any office or agency in the county or state, or elsewhere. Initials I specifically and expressly direct my Attorney-in-Fact and/or Agent take all and any legal and all financial action that would assist in my receiving local, state, federal, private, and public benefits. 38. Severabili~. Should any of the provisions of this document be for any reason declared invalid, such invalidity shall not affect any of the other provisions of this document and powers, and all invalid provisions or powers shall be wholly disregarded in interpreting this document. ,2002. CHARLOTTE I~. L/I~TT IFitnesses: -8- COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN SS: On ,2002, before me a Notary Public for the Commonwealth of Pennsylvania, personally appeared CHARLOTTE K. LIPSETT, known to me to be the person whose name is subscribed to the within instrument and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. _ NOTARIAL SEAL _ JESSICk A. HOLLAND, NOTARY PUBLIC CITY OF HARRISBURG, DAUPHIN COUNTY MY COMMISSION EXPIRES MARCH 4, 2006 -9- COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003050 HAZEN MARIELLE F ESQUIRE $45 SIR THOMAS COURT HARRISBURG, PA 17109 ........ fold ESTATE INFORMATION: SSN: 205-0§-4405 FILE NUMBER: 2103-0554 DECEDENT NAME: LIPSETT WILLIAM J DATE OF PAYMENT: 09/23/2003 POSTMARK DATE: 09/22/2003 COUNTY: CUMBERLAND DATE OF DEATH: 06/25/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $1,357.20 TOTAL AMOUNT PAID: $1,357.20 REMARKS: ROBERT J LIPSETT C/O MARIELLE HAZEN ESQUIRE SEAL CHECK# 606 INITIALS: VZ RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS ORIGINAL Cumberland County, Pennsylvania Register of Wills INVENTORY Estate of Lipsett, William J. also known as , Deceased No. 21 03 0554 Date of Death 6/25/2003 Social Security No. 205054405 Personal Representative(s) of the above Estate, deceased, vedfy that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/VVe verify that the statements made in this inventory are true and correct. I/VVe understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unswom falsification to authorities. Name of Attorney: I.D. No.: Marielle F. Hazen~ Esq. 68003 Address: 2000 Lin,qlestown Road Harrisbur,q Telephone: 717-540-4332 PA 17110 Personal Representative: Robert J. Lipsett~ Executor Dated Description Cash, Bank Deposits, & Misc. Personal Property Check payable to William J. Lipsett distributed funds from annuity Ck. #05580304 1991 Ford Taros donated to chadty (Attach Additional Sheets if necessary) Total Value 30,343.84 0.00 30,343.84 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. RW-4 ~lle F. Hazen ~n Road ,17110 ~ills , Courthouse ~ Square 17013 DURABLE POWER OF ATTORNEY FOR CHARI,OTTE K. LIPSETT Prepared by: Jan L. Brown & Associates 845 Sir Thomas Court, Suite 12 Harrisburg, PA 17109 (717) 541-5550 NOTICE THE PURPOSE OF THIS POWER OF ATTORNEY IS TO GIVE THE PERSON YOU DESIGNATE (YOUR "AGENT") BROAD POWERS TO HANDLE YOUR PROPERTY, WHICH MAY INCLUDE POWERS TO SELL OR OTHERWISE DISPOSE OF ANY REAL OR PERSONAL PROPERTY WITHOUT ADVANCE NOTICE TO YOU OR APPROVAL BY YOU. THIS POWER OF ATTORNEY DOES NOT IMPOSE A DUTY ON YOUR AGENT TO EXERCISE GRANTED POWERS, BUT WHEN POWERS ARE EXERCISED, YOUR AGENT MUST USE DUE CARE TO ACT FOR YOUR BENEFIT AND IN ACCORDANCE WITH THIS POWER OF ATTORNEY. YOUR AGENT MAY EXERCISE THE POWERS GIVEN HERE THROUGHOUT YOUR LIFETIME, EVEN AFTER YOU BECOME INCAPACITATED, UNLESS YOU EXPRESSLY LIMIT THE DURATION OF THESE POWERS OR YOU REVOKE THESE POWERS OR A COURT ACTING ON YOUR BEHALF TERMINATES YOUR AGENT'S AUTHORITY. YOUR AGENT MUST KEEP YOUR FUNDS SEPARATE FROM YOUR AGENT'S FUNDS. A COURT CAN TAKE AWAY THE POWERS OF YOUR AGENT IF IT FINDS YOUR AGENT IS NOT ACTING PROPERLY. THE POWERS AND DUTIES OF AN AGENT UNDER A POWER OF ATTORNEY ARE EXPLAINED MORE FULLY IN 20 PA. C.S. CH. 56. IF THERE IS ANYTHING ABOUT THIS FORM THAT YOU DO NOT UNDERSTAND, YOU SHOULD ASK A LAWYER OF YOUR OWN CHOOSING TO EXPLAIN IT TO YOU. I HAVE READ OR HAD EXPLAINED TO ME THIS NOTICE AND I UNDERSTAND ITS CONTENTS. PRINCIPAL DATE ACKNOWLEDGMENT I, ~ t~ e_ e read the attached Power of Attorney and am the person identified as the g principal. I hereby acknowledge that in the absence of a specific provision to the contrary in the Power of Attorney or in 20 Pa. C.S. when I act as agent. I shall exercise the powers for the benefit of the principal. I shall keep the assets of the principal separate from my assets. I shall exercise reasonable caution and prudence. I shall keep a full and accurate record of all actions, receipts and disbursements on behalf of the principal. ~gent ~' - ACKNOWLEDGMENT I,~.~ JJ.~ff, r~' ff~-"-~,~,~?,,gt? ~P~ , have read the attached Power of Attomey and am the person identified as the agent for th~ principal. I hereby acknowledge that in the absence of a specific provision to the contrary in the Power of Attorney or in 20 Pa. C.S. when I act as agent. I shall exercise the powers for the benefit of the principal. I shall keep the assets of the principal separate from my assets. I shall exercise reasonable caution and prudence. I shall keep a full and accurate record of all actions, receipts and disbursements on behalf of the principal. Date ACKNOWLEDGMENT I, , have read the attached Power of Attorney and am the person identified as the agent for the principal. I hereby acknowledge that in the absence of a specific provision to the contrary in the Power of Attorney or in 20 Pa. C.S. when I act as agent. I shall exercise the powers for the benefit of the principal. I shall keep the assets of the principal separate from my assets. I shall exercise reasonable caution and prudence. I shall keep a full and accurate record of all actions, receipts and disbursements on behalf of the principal. Agent Date ACKNOWLEDGMENT person identified as the agent for the principal. I hereby acknowledge that in the absence of a specific provision to the contrary in the Power of Attorney or in 20 Pa. C.S. when I act as agent. I shall exercise the powers for the benefit of the principal. I shall keep the assets of the principal separate from my assets. I shall exercise reasonable caution and prudence. I shall keep a full and accurate record of all actions, receipts and disbursements on behalf of the principal. Agent Date DURABLE POWER OF ATTORNEY FOR CHARLOTTE K. LIPSETT I, CHARLOTTE K. LIPSETT, of Cumberland County, Pennsylvania, hereby revoke any and all prior Powers of Attorney and hereby appoint my husband, WILLIAM J. LIPSETT, of Cumberland County, Pennsylvania, to act as my Agent (hereinafter referred to as "my "Agent") for me and in my name and place to transact all my business and to manage all my property and affairs as completely as I myself might do if personally present, including but not limited to, exercising the following powers contained in this document. In the event of WILLIAM J. LIPSETT's death or if he is unwilling or unable to serve, I hereby nominate and appoint my three children: JEANNE M. BELL, of Rochester, New York; WILLIAM J. LIPSETT, of Harrisburg, Pennsylvania; and ROBERT J. LIPSETT, of Harrisburg, Pennsylvania, to act jointly and/or individually as my Co- Agents with all the powers set forth below. Possession of this original Power of Attorney by my daughter, JEANNE M. BELL and/or my son, WILLIAM J. LIPSETT and/or my son, ROBERT J. LIPSETT shall be conclusive evidence that my husband, WILLIAM J. LIPSETT is unable to serve or to continue serving as my Power of Attorney and/or Agent. 1. Execution o. fContracts. To enter into, perform, modify, extend, cancel, compromise, enforce, or otherwise act with respect to any contract of any sort whatsoever -- including but not limited to, leases and mortgages -- and to pay any money or to transfer title and possession to any real or personal property that may be required to be paid or transferred by any contract or in the performance of any obligation entered into or incurred by me or on my behalf. 2. Investments. To invest in all forms of real and personal property without any restriction whatsoever as to the kind of investment, including, but not limited to, United States Treasury Bonds which are redeemable at par in payment of federal estate taxes. 3. Registration of Proper_tv. To hold property unregistered or in the name ora nominee. 4. Personal Property. To buy or sell securities; to buy or sell at public or private sale for cash or credit or partly for each, exchange, pledge, lease, give or acquire options for sales or exchanges or leases, or by any other means whatsoever to acquire, dispose of, repair, alter or manage tangible or intangible personal property or any interest therein, and, without limitation, with respect to any securities, to comply with any securities laws or regulations, to execute indemnity agreements, to purchase insurance and to pay commissions or discounts required by any underwriting. 5. RealProperty. To buy or sell at public or private sale for cash or credit or partly for each, exchange, mortgage, encumber, lease for any period of time, give or acquire options for sales, purchases, exchanges or leases, dedicate, or by any other means whatsoever, to acquire or dispose of real property or any interest therein; to partition and subdivide real property; to manage real property; to repair, alter, erect, or tear down any structure or part thereof; and to file such plans, applications, or other documents in connection therewith and do such other acts as may be requested by any government or other authority having or purporting to have jurisdiction. 6. Securities. To vote in person or by proxy at any meeting, to join in any merger, reorganization, voting-trust plan or other concerted action of security holders, to make payments in connection therewith, and in general to exercise all rights ora security holder. 7. Insurance. To procure, alter, extend or cancel insurance against any and all risks affecting property and persons, and against liability, damage or claim of any sort. 8. Designate Beneficiaries. To make or change any designation of beneficiary or to make or change any distribution option for any qualified retirement plan, IRA, annuity, insurance policy or other program for which I am entitled to so do. 9. Loans. To borrow money in such amounts for such periods and upon such terms as my agent shall deem proper and to secure any loan by the mortgage or pledge of any property, and I specifically authorize my agent to borrow money and to pledge property as collateral for the purpose of purchasing United States Treasury Bonds which are redeemable at par in payment of federal estate taxes. 10. Bank Accounts. To sign checks, drafts and other instruments or otherwise make withdrawals from any checking, savings, transaction or other deposit account in my name, and to endorse checks payable to me and receive the proceeds thereof in cash or otherwise; to open and close checking, savings, transaction or other deposit accounts in my name; to purchase and redeem savings certificates, certificates of deposit or similar instruments in my name; to exercise and deliver receipts for any funds withdrawn or certificates redeemed; and to do all acts regarding any checking account, savings account, savings certificate, certificate of deposit, or similar instrument which I now have or may hereafter acquire, the same as I could do if personally present. Any financial institution may continue to rely on this power of attorney until it receives written notice from me that this power of attorney is revoked or actual notice of my death and shall be indemnified and held harmless by me and my estate, personal representatives and heirs against any liability or loss, including lawyers' fees, costs of suit and claims of third parties, which it might incur by relying on this power after termination or revocation but before it receives such notice, or any time because of wrongful acts, omissions or representations of my agent with respect to transactions covered by this power of attorney. My agent shall be subject to whatever bank rules and regulations I would be subject to. 11. Individual Retirement Accou#t. To request and receive distributions fi.om any ofmy individual Retirement Accounts; to give instructions for the purchase and sale of securities in those accounts; to execute on my behalf any powers of attorney or, other instruments needed for those purposes; and to endorse notes, check, drafts and bills of exchange, and to make contributions to those accounts. -2- 12. Safe Deposit Boxes. To have access to and control over the contents of any safe deposit box rented by me, to rent safe deposit boxes in my name, to close out and execute and deliver receipts for safe deposit boxes in my name, and to do all acts regarding any safe deposit boxes in my name, which I now have or may hereafter acquire, the same as I could do if personally present; provided that my agent shall not deposit or keep in any such safe deposit box any property in which my agent has a personal interest. Any financial institution may continue to rely on this power of attorney until it receives written notice from me that this power of attorney is revoked or actual notice of my death and shall be indemnified and held harmless by me and my estate, personal representatives and heirs against any liability or loss, including lawyers' fees, costs of suit and claims of third parties, which it might incur by relying on this power after termination or revocation but before it receives such notice, or at any time because of wrongful acts, omissions or representations of my agent with respect to transactions covered by this power of attorney. My agent shall be subject to whatever bank rules and regulations I would be subject to. 13. Receipts and/lpproval of/lccount~. To receive payment of any kind, including a bequest, devise, gift or other transfer of real or personal property to me in my own right or as a fiduciary for another, and to give full receipt and acquittance therefore, or a refunding bond therefore, to approve accounts of any business, estate, trust, partnership or other transaction whatsoever in which I may have any interest of any nature whatsoever, and to enter into any compromise and release in regard thereto. 14. Compromise and~4rbitration of Claims. To compromise or arbitrate any claim in which I may be in any manner interested, and for that purpose to enter into agreement to compromise or arbitrate, and either through counsel or otherwise to carry on such compromise or arbitration and perform or enforce any award entered in arbitration. 15. Institution and Defense Claims. To institute, prosecute, defend, compromise, or otherwise dispose of, and to appear for me in, any proceedings at law or in equity or otherwise before any tribunal for the enforcement or for the defense of any claim, either alone or in conjunction with other persons, relating to me or to any property of mine or any other person (including the authority to sue if this power of attorney is not honored), and to retain, discharge and substitute counsel and authorize appearance of such counsel to be entered for me in any such action or proceeding. 16. Taxes. To prepare, execute and file in my name and on my behalf any return, report, protest, application for correction of assessed valuation of real or other property, appeal, brief, claim for refund or petition including petition to the United States Tax Court in connection with any tax imposed or purported to be imposed by any government, authority or agency, or claimed, levied or assessed by any government, authority or agency and to pay any such tax and to obtain any extension of time for any of the foregoing; to execute waivers of restrictions on the assessment and collection of deficiency in any tax; to execute closing agreements and all other documents, instruments and papers relating to any tax liability of mine of any sort; to institute and carry on either through counsel or otherwise any proceeding in connection with contesting any such tax or to recover any tax paid, or -3- to resist any claim for additional tax or any proposed assessment or levy thereof, and to enter into any agreements or stipulations for compromise or other adjustment or disposition of any tax. 17. Bonds. To purchase for me United States of America Treasury Bonds of the kind which are redeemable at par in payment of federal estate taxes; to borrow money and obtain credit in my name from any source for such purpose, to make, execute, endorse and deliver promissory notes, drafts, agreements or other obligations for such bonds and, as security therefore, to pledge, mortgage and assign any stocks, bonds, securities, insurance values and other properties, real or personal, in which I may have an interest, and to arrange for the safekeeping and custody of any such Treasury Bonds. 18. Disclaimer. To execute, deliver and file or record disclaimers of any part or all of any property, power or interest passing to or for me under any will, deed or trust or otherwise; and to direct my spouse's executor to elect to qualify or to elect not to qualify for the marital deduction any portion or all of a marital deduction trust created for me by my spouse. 19. SpousalElection To release or disclaim any interest in property on behalf of me (the Principal). I direct my Agent to disclaim any and all interest in any and all property if it impacts or delays my eligibility for private and public benefits, including state, local, and federal benefits; specifically, I direct my Agent(s) to refuse to take or claim a spousal election if it will impact or delay the receiving or eligibility of medical assistance benefits. I specifically direct my Agent to refuse to claim an election share in such a situation, and I consider refusing to take or claim a spousal election a part of my estate planning, and it is my wish and reflects my intentions regarding my estate planning and my directions of my estate to refuse to take or claim the elective share if it impacts or delays my eligibility for any private or public benefits. 20. Employment o.[ Others. To employ accountants, attorneys-at-law, investment counsel, custodians, agents, servants, and others, and to delegate to them, to remove them, and to pay them such remuneration as my agents shall deem proper. 21. Execution of Documents. To execute, deliver, file for record, cancel, modify, endorse, acquire or dispose of any instrument including, but not limited to, stock and bond powers, vehicle registrations, financing statements and related filing documents, reports of any sort to any government, authority or agency, as required or permitted by law, deeds with or without covenants or warranties, and any other document appropriate for carrying out any of the foregoing powers. 22. G~ft Makin~ Powers. To make gifts, as set forth below, either outright or in trust or, in the case of minors, in accordance with the Uniform Gifts to Minors Act and, for gifts made in trust, to persons, including my Agent, as original or successor trustees. This power includes the right to make additions to an existing trust and does not require my Agent to treat the donees equally or proportionately and may entirely exclude one or more permissible donees. The pattern followed on the occasion of any such gift (or gifts) need not be followed on the occasion of any other gift (or -4- gifts). The gifts shall be restricted to: my spouse; my lineal descendants; any trust(s) for my benefit and/or for my spouse's benefit and/or for my lineal descendent(s)' benefit; and any organization described in IRC Section 501(c)(3). My Agent and the donee of the gift shall be responsible as equity and justice may require to the extent that a gift made by my Agent is inconsistent with my directions and planning of my probable intent with respect to the disposition of my estate. The ability of my Agent to make gifts of my property shall be limited by and shall only be made in conformity with my prenuptial agreement, if any such agreement exists. I specifically direct my Agent to make gifts to any and all persons listed in the above paragraph who he/she deem appropriate, and further direct my Agent to make transfers including gifts in order to hasten and facilitate my eligibility for public and private benefits, including medical assistance, so to allow me and/or my spouse or any family member to receive state, local, and federal benefits at the early possible time/date. Further, I consider transfers and gifting in order to obtain such benefits to be in accordance with my estate planning, and I direct such action to be taken to obtain said benefits for me. Any and all transfers and gifts are not inconsistent with my estate planning and in fact reflect my intention and direction with respect to the disposition of my estate. Specifically, I do not restrict or limit the amount of money or assets to be transferred and gifted, and direct the funds available for such gifts or transfers include Principal and income. 23. GovernmentalBenqflts. To exercise complete dominion and control over any and all social security, veteran, county, state and federal benefits to which I may now or hereafter be entitled. 24. Healthcare Decisions. To consent, refuse or withdraw consent to any and all types of medical care, treatment, surgical procedures, diagnostic procedures, medication, blood and blood products, and the use of mechanical or other procedures that affect any bodily function, including, but not limited to, artificial respiration, nutritional support and hydration, kidney dialysis and cardiopulmonary resuscitation; And to have access to medical records and information, including psychiatric records, to the same extent that I am entitled to, including the fight to disclose the contents to others; And to authorize, or refuse to authorize, any medication or procedure intended to relieve pain, even though such use may lead to physical damage, addiction or hasten the moment of (but not intentionally cause) my death. 25. Placement in an Institution. To take charge of my person in case of illness or disability of any kind; to authorize my admission to a medical, nursing, residential or similar facility, and to enter into agreements for my care; and to remove and place me in such institutions or places -5- as my agent may deem best for my personal care, comfort, benefit and safety after giving consideration to any wishes I have previously expressed on this subject. 26. Create a Trust. To execute a deed of trust, designating one or more persons (including my Agent) as original or successor trustee(s) and to transfer to the trust any or all property owned by me as my Agents may decide. The income and principal of the trust may, but need not, be distributed to me or to the guardian of my estate, or be applied for my benefit, and upon my death, any remaining principal or unexpended income of the trust may, but need not, be distributed to my estate. Furthermore, this trust or deed of trust may be amenable or revocable at any time by me or my Agents, or the trust or deed of trust may be irrevocable by me or my Agent. The establishment and funding ora Trust, either revocable or irrevocable, is not inconsistent with my estate planning, and in fact reflects my intention and direction with respect to the disposition of my estate. 27. Fund the Trust. To add at any time, any or all of the property owned by me to trust in existence for my benefit when this power was created. The income and the principal of the trust may, but need not, be distributable to me or to the guardian of my estate or be applied for my benefit during my lifetime and upon my death any remaining principal and unexpended income of the trust, may, but need not, be distributed to my estate. The establishment and funding of a Trust, either revocable or irrevocable, is not inconsistent with my estate planning, and in fact reflects my intention and direction with respect to the disposition of my estate. 28. Guardianship. Pursuant to Pennsylvania Consolidated Statute Title 20, Section 5604 (c) (2) or the corresponding provisions of any subsequent state law, if incapacity proceedings of my person are hereafter commenced, I hereby nominate, constitute and appoint the herein-described Agent as the guardian of my estate and my person. If and in the event that my Agent predeceases me, or does not complete the duties of my tree and lawful Agent, then and in such event, I nominate, constitute and appoint the herein-described Successor Agents as the guardian(s) of my estate and my person. 29. Substitution. My Agent shall have full power of substitution and revocation, and such substitution or revocation may relate to, or be limited to, any one or more or all of the foregoing acts or powers, or be limited as to time or in such other respect as my Agent shall deem proper. 30. General. To do all things which my agent shall deem proper in order to carry out any of the foregoing enumerated powers, which shall be construed in the broadest possible manner. However, in no event shall this power of attorney be exercised in favor of my agent, anyone he or she has the obligation to support, my agent's estate, my agent's creditors or the creditors of his or her estate, unless specifically provided in this power of attorney. The descriptive headings of this general power of attorney are inserted for convenience only and shall not be deemed to affect the meaning or construction of any of the provision hereof or to limit in any way the construction thereof in the broadest possible manner. -6- 31. Liability. Any person who is given instructions by my Agent in accordance with the terms of the Power of Attorney shall comply with the instructions. Any person who without reasonable cause fails to comply with these instructions shall be subject to civil liability for any damages resulting from non-compliance. Reasonable cause under this subsection shall include, but shall not be limited to, a good faith report having been made by the third party to the local protective services agency regarding abuse, neglect, exploitation, or abandonment. However, I consider qualifying for medical assistance benefits to be prudent planning. Any actions taken to hasten and facilitate my eligibility for medical assistance shall not be challenged by a third party, including the local protective services agency. 32. Third Party lmmunit~. Any person who acts in good faith, reliance on my Power of Attorney shall incur no liability as a result of acting in accordance with the instructions of my Agent. 33. Compensation and Reimbursement.for Expenses. The Agent shall be entitled to reasonable compensation based on the actual responsibilities assumed and performed. My Agent shall also be entitled to reimbursement for actual expenses advanced on behalf of the Principal and to reasonable expenses incurred in connection with the performance of my Agent's duty. 34. Ratification. I hereby ratify and confirm all that my agent or the substitute or substitutes therefore shall lawfully do or cause to be done by virtue hereof. 35. Reliance by Others. This power of attorney shall continue in force and may be accepted and relied upon by anyone to whom it is presented despite my purported revocation of this power, the age of this power, the issuance ora court decree declaring my incompetency or my death, until written notice of such event is received by such person. 36. Effect of My Disability. This power of attorney shall not be affected by my disability or incapacity. 37. Waivers and Directions. Initials by Principal is reinforcing his/her interest on the following issues, responsibilities, and undertaking by ~4gent on Principal's behalf: 1. ~ 7~ ~/I specifically and expressly waive any requirements in effect now Initials and in the future to have my assets kept separate from my Attorney- in-Fact and/or Agent's assets. Initials I specifically and expressly waive any requirements in effect now and in the future to require my Attorney-in-Fact and/or Agent to keep a full and accurate record of all activities, receipts, and disbursements my Attorney-in-Fact and/or Agent has made on behalf of me (the Principal). -7- ~" J/Y' ~°I specifically and expressly waive the requirement in effect now and Initials in the future that my Attorney-in-Fact and/or Agent is to file an accounting of his or her action with any office or agency in the county or state, or elsewhere. Initials I specifically and expressly direct my Attorney-in-Fact and/or Agent take all and any legal and all financial action that would assist in my receiving local, state, federal, private, and public benefits. 38. $oerabilit~. Should any of the provisions of this document be for any reason declared invalid, such invalidity shall not affect any of the other provisions of this document and powers, and all invalid provisions or powers shall be wholly disregarded in interpreting this document. ,2002. CHARLOTTE K. LfP~gTT ~Fitnesses: -8- COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN' On SS: ,2002, before me a Notary Public for the Commonwealth of Pennsylvania, personally appeared CHARLOTTE K. LIPSETT, known to me to be the person whose name is subscribed to the within instrument and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. JESSICA A. HOLLAND, NOTARY PUBLIC CITY OF HARRISBURG, DAUPHIN COUNTY UY COMMISSION EXPIRES MARCH 4, 2006 -9- BUREAU OF INDIVIDUAL TAXES THHERTTAHCE TAX DTVTSXON DEPT. 18060! HARRXSBURG, PA 17118-0601 CONHONHEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSENENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSHENT OF TAX DATE ESTATE OF DATE OF DEATH .FILE NUNBER ,~_. - .~.~ it.. /'COUNTY REV-16,~7 EX &FP COZ-OS) 11-10-2005 LIPSETT WILLIAN J 06-15-2005 21 05-055q CUHBERLAND ACN 101 HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF NILLS CUNBERLAND CO COURT HOUSE CARLISLE, PA 17013 HARIELLE F HAZEN ESQ H F HAZEN LAN OFFICE 2000 LZNGLESTNN RD 50 " HBG PA 17Lio' ~' CUT ALONG THIS LZNE ~ RETAIN LONER PORTZON FOR YOUR RECORDS 4 REV-1547 EX AFP (01-03} NOTZCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLONANCE OR DZSALLONANCE OF DEDUCTZONS AND ASSESSNENT OF TAX ESTATE OF LZPSETT NILLIAH J FILE NO. 21 05-055q ACN 101 DATE 11-10-2005 TAX RETURN NAS: (X) ACCEPTED AS FILED ( } CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Sohedule A) (1) 2. Stocks and Bonds (Schedule B) (2) $. Closely Held S~ock/Par*nership Interest (Schedule C) ($) 4. Hortgeges/No~es Receivable (Schedule D) (4) 5. Cash/Bank Daposits/flisc. Personal Property (Schedule E) (S) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,al Assets APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funeral Expenses/Ada. Costs/Nisc. Expanses (Schedule H) (9) 10. Debts/Nortgage Liabilities/Liens (Schedule 1) (10) 11. To,al Deductions 12. Nat Value of Tax Return O0 O0 O0 O0 51z277.01 76z715 27 5qz598.05 (G) 10,15q.77 NOTE: To insure proper credit to your account, submit the upper portion of this form wi~h your tax payment. 15. 14. NOTE: 162,590.$1 ANOUNT PAID 1,357.20 TOTAL TAX CREDIT BALANCE OF TAX DUEI ZNTEREST AND PEN. TOTAL DUE reflect figures that lnclude the total of ALL returns assessed to date. ASSESSHENT OF TAX: 15. Amount of Line 14 et Spousal rata (15) 118,086.18 X O0 = 16. Asouni of Line lI taxable at Lineal/Class A rate (16) 51,7fi7.$2 X 015 = 17. Amount of Line lq at Sibling rata (17) .00 X 12 = 18. Amount of Line 14 taxable at Collateral/Class B rata (18) . O0 X 15 = 19. Principal Tax Due (19)= TAX CREDITS: PAYflENT R~CE/PT DISCOUNT DATE NUHBER INTEREST/PEN PAID (-) 09-ZZ-Z003 CD003050 71 .R3 .00 .00 1,q28.65 .00 .00 1,q28.65 IF PAID AFTER DATE /NDZCATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 1,~28.65 .00 .00 .00 ( XF TOTAL DUE 'rs LESS THAN $1, NO PAYNENT 'rS RE~UTRED. XF TOTAL DUE 'rS REFLECTED AS A 'CRED'rT' (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SXDE OF THXS FORH FOR XNSTRUCTTONS.) Char/table/Governmental Bequests; Non-eXacted 9115 Trusts (Schedule J) (15) Net Value of Estate Sub~ect to Tax (Il) 1~9,855.50 If an assessment was issued previously, lines Ii, 15 and/or 16, 17, 18 and 19 ~ill 2~612.0~ (11) 12.7~&.81 (12) lq9,855.50 RESERVATION: PURPOSE OF NOT[CE: PAYMENT: REFUND (CA): OBJECTIONS: ADMIN- iSTRATiVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 1Z, 198g -- if any futura interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer inheritance Taxes at the laaful Class S (collateral) rate on any such futura interest. To ~ulfill the requirements of Section ZlqO of the inheritance and Estate Tax Act, Act Z$ of ZOO0. (7Z P.S. Section 91qO). Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side. --Make check or money order payable to: REGISTER OF #ILLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, nay be requested by completing an "Application for Refund of Pennsylvania inheritance and Estate Tax" (RE¥-1315). Applications ara available at the Office of the Register of Hills, any of the g$ Revenue District Offices, or by calling the special gq-hour answering service for fores ordering: 1-BOO-36Z-g050; services for taxpayers with special hearing and / or speaking needs: 1-800-qqT-3OgO (TT Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest} as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 2810Z1, Harrisburg, PA 17198-1021, --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. OR Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. Sea page 5 of the booklet "instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedant's death, a five percent (SI) discount of the tax paid is elloead. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day free the date of death, to the date of payment. Taxes which became delinquent before January l, 198Z bear interest at the rate of six (6Z) percent par annum calculated at e daily rate of .O0016q. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 19SI through 2003 are: Interest Daily Znterest Daily Interest Oaily Year Rata Factor Year Rate Factor Year Rate Factor 198Z ZOZ .O00Sq8 1987 9Z .OOOZq7 1999 7Z .000192 1983 16Z .000q$8 1988-1991 IZZ .000301 ZOO0 aZ .000Z19 198q llZ .000301 1992 9Z .O00Zq7 ZOO1 9Z .O00Zq7 1985 15X .000356 1993-199q 7Z .O0019Z ZOOZ 6Z .O0016q 1986 IOZ .00027q 1995-1998 9Z .000247 2003 5Z .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must ba calculated. STATUS REPORT UNDER RULE 6.12 Name of Decedent · William J. Lins~tt Date of Death: 6125/2003 Will No. 2003-00554 Admin. No. 21-03-0554 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: State whether administration of the estate is complete: Yes X No ~ 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete · 3. If the answer to No. 1 is Yes, state the following: a o account with the Court ? Did the personal representative file a final Yes ~ No X b. The separate Orphans' Court No. (if any ) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest ? Yes X No ~ d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may he attached to this report. Date · t - Signatur~e- ,-- . ~ Marielle F. Hazen. Esa. Name (Please type or print ) 2000 kin§lestown Road, Suite 303 Harrisbur9 PA Address 17110 (717) -5404332 Tel. No. Capacity: Personal Representative Counsel for personal representative FAMILY SETTLEMENT AGREEMENT AND FINAL RELEASE IN THE ESTATE OF WILLIAM J. LIPSETT, DECEASED KNOW ALL MEN BY THESE PRESENTS, that WHEREAS William J. Lipsett, late of Camp Hill, Cumberland County, Pennsylvania, deceased, died testate on June 25, 2003, having first made his Last Will and Testament, which was duly executed April 28, 2003 and is duly recorded in Cumberland County Courthouse, register of Wills, File No. 2003-00554; WHEREAS, the said William J. Lipsett, by the aforesaid Last Will and Testament, named Robert J. Lipsett as Executor of his Last Will and Testament; WHEREAS, Letters Testamentary on thc estate of said decedent were duly issued by the Register of Wills of Cumberland County, and Letters were granted to Robert J. Lipsett, hereina~er called Personal Representative; WHEREAS, Charlotte IC Lipsett, surviving spouse of said decedent, through her Agent, filed a Notice of Election Against Decedent's Will with the Clerk of the Orphans' Court of Cumberland County on September 25, 2003, in which she elected to take a one-third (1/3) share of decedent's estate; WHEREAS, the said Personal Representative has gathered thc assets of the estate of thc said decedent, and the assets consist of personal property to a total value of $31,277.01 as set forth in Exhibit A, which is a statement of account of the said Personal Representative, and which is attached hereto and made a part hereof and marked Exhibit A; WHEREAS, the balance for distribution as shown in the said statement marked Exhibit A has been distributed as herein indicated in accordance with thc terms of thc Last Will and Testament of thc said decedent and pursuant to the Notice of Election; NOW, THEREFORE, KNOW YE, that we, Robert J. Lipsett, Jeanne M. Bell, William J. Lipsett, and Charlotte K. Lipsett by her Agent, Robert J. Lipsett, being the beneficiaries and heirs of the said decedent, and being those persons entitled to inherit under said Last Will and Testament and said Notice of Election, do hereby acknowledge that we have this day had and received from the aforesaid Personal Representative, in full satisfaction and payment, all sum or sums of money, legacies, bequests and devices as are given, devised and bequeathed to us, which amounts we have received this day, and which amounts are set opposite our names in the table and schedule of distribution in said statement attached hereto and marked Exhibit A; AND, we do hereby stipulate that in order to avoid the expense and time involved in the filing of a formal account and schedule of distribution, we agree that no account is necessary, and we do hereby agree that we do consent to distribution being made without the filing of an account and schedule of distribution, the same to be with the same force and effect as if it had been filed and confirmed by the Orphans' Court Division of the Court of Common Pleas, Cumberland County Branch. THEREFORE, we and each of us do hereby remise, release, quit claim and forever discharge the said Personal Representative, Robert & Lipsett, his heirs, executors, administrators and assigns, and Marielle F. Hazen, Esquire, of and from the said estate and from all actions, suits, payment, accounts, reckoning, claims and demands whatsoever for or by reason thereof, or for any other use, matter, cause or thing whatsoever touching upon the estate of the said decedent; and each of us do further hereby covenant and agree that should any liability come due to the estate of the said decedent after the signing of this agreement, each of us do hereby covenant and agree with each other and the aforesaid Personal Representative that we will contribute pro rata our share of the estate to satisfy any and all claims, demands, suits or 2 causes of action which may be successfully prosecuted against the said estate or the aforesaid Personal Representative after the signing, sealing and delivery of this Family Settlement Agreement and Final Release. IN WITNESS WHEREOF, we have hereunto set our hands and seals this~$P'~day of ,2003. l~obert J. ~l~ett ~/ Witness Jeanne M. Bell Witness William J. Lipsett l~harlotteJfit/L~pstt~t, 'by her Agent, Robert J. ~Lipsett, causes of action which may be successfully prosecuted against the said estate or the aforesaid Personal Representative after the signing, sealing and delivery of this Family Settlement Agreement and Final Release. IN WITNESS WHEREOF, we have hereunto set our hands and seals this ('/r~day of "~I[ 0.~ . ,2003. Wimess Robert J. Lipsett Witness Jeanne M. Bell Witness Charlotte K. Lipsett, by her Agent, Robert J. Lipsett, 3 causes of action which may be successfully prosecuted against the said estate or the aforesaid Personal Representative after the signing, sealing and delivery of this Family Settlement Agreement and Final Release. IN WITNESS WHEREOF, we have hereunto set our hands and seals this f day of Wimess Robert J. Lipsett ~ness an~ne M. Bell Wimess William J. Lipsett Wimess Charlotte K. Lipsett, by her Agent, Robert J. Lipsett, COMMONWEALTH OF PENNSYLVANIA ) ) SS.' COUNTY OF ._{~tO_]~h ~/~ ) On this the g;P"'day of , 2003, before me, a Notary Public, the undersigned officer, personally appeared Robert J. Lipsett, known to me or satisfactorily proven to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Pul~l'i'c- "" g ~, c_~- Notarial Seal Ml~lle E Haz~n, Notary Public Cit~ of Harrisburg, Dauphin County_ _ My Commission Expires Sept. 23, 2006 COMMONWEALTH OF PENNSYLVANIA ) )ss: COUNTY OF ) day of c~t ?g~/~2~c.~ , 2003, before me, a Notary On this the Public, the undersigned officer, personally appeared Charlotte K. Lipsett, by her Agent, Robert J. Lipsett, known to me or satisfactorily proven to be the person whose name is subscribed to the within instrument, and acknowledged that Robert J. Lipsett, in his capacity as Agent for Charlotte K. Lipsett, executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. I Notarial Seal Mm'ielle R Hazen, Notary Public City of Harrisburg, Dauphin County My Commission Expires Sept. 23, 2006 COMMONWEALTH OF PENNSYLVANIA ) )ss: ) On this the L~,- day of ~ 0_[f~-~3~f- , 2003, before me, a Notary Public, the undersigned officer, personally appeared William J. Lipsett, known to me or satisfactorily proven to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Notarial Seal Madelle F. Hazen, Notary Public City of Harrisbur~, Dauphin County_ _ My Commission [~xpir~8 Sept. 23, 2006 STATE OF NEW YORK COUNTY OF · ~ O~q (- o ~ On this the ~ day of Public, the undersigned ) ) SS: ) , 2003, before me, a Notary officer, personally appeared Jeanne M. Bell, known to me or satisfactorily proven to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. No~3/Public t Nora, , ' Y~i'k Coma,> 99.~ STATEMENT OF ACCOUNT OF THE ESTATE OF WILLIAM J. LIPSETT PROBATE ASSETS,: (date of death values) Annuity check payable to decedent $30,343.84 1991 Ford Taurus $ 00.00 (donated to charity) Army retirement check $ 933.17 TOTAL $31,277.01 DEBTS AND EXPENSES: Inheritance Tax $1,357.20 Probate Fees $ 160.00 Estate advertising fees: $ 170.27 Funeral Expenses $7,894.50 Attorney Fees $2,000.00 Executor Fees $ 00.00 Debts $2,622.04 TOTAL $14,204.01 NET .AMOUNT AVAILABLE FOR DISTRIBUTION: DISTRIBUTIONS: Name Charlotte K. Lipsett Robert J. Lipsett Jeanne M. Bell William J. Lipsett $17:073.00' Share Actual Distribution* 1/3 elective share $5,691.00 2/9th residue $3,794.00 2/9th residue $3,794.00 2/9th residue $3,794.00 *Actual cash distribution may be increased or decreased based on interest accrued, market value of assets, or presentation of an obligation and/or payment of additional charges. EXHIBIT "A"