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HomeMy WebLinkAbout12-13-11----~ RSV-1500EX(o,-10) 1505610143 PA Department of Revenue pennsy vania OFFICIAL USE ONLY Bureau of Individual Taxes DEPARTMENTOiREVENl1E County Code Year File Number PoBOx.2sosol INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 10 0 0 9 8 9 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 174 20 9845 08 23 2010 07 23 1927 Decedent's Last Name Suffnt Decedent's First Name PATTERSON MI JAMES H (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name PATTERSON MI PHYLLIS Y Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (date of death prior to 12-13-82) ^ 4. Limited Estate ^ qa Future Interest Compromise ^ (date of death after t2-t2-t32) 5. Federal Estate Tax Return Required ® 6. Decedent PY of W hate ^ 7 Decedent Maintained a Living Trust Attach Co (Attach Copy of Trust) ___ 8. Total Number of Safe Deposit Boxes ^ 9. Litigation Proceeds Received ^ 1 p. Spousal Poverty CredB (date of death between 12-3t- 1 and t-1-95) ^ 11.Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name SCOTT M DINNER ESQ Daytime Telephone Number 717 761 5800 First line of address 3117 CHESTNUT STREET Second line of address City or Post Office State ZIP Code CAMP HILL PA 17011 ~~ REGISTER OF WI SE OIt~1.Y _L~-~ _ _. ., c,.', '~%c ~- - ,- - DATE FILED C -,, ~'~; ~__. .-~ Correspondent's a-mail address: d i n n e r~ I O C a I n e t. C O m Under penalties of perjury, I declare that I have examined this return including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than Ttie personal representative is based on all information of which preparer has any knowledge. SIG jTURE OF PERSON RESPONSIBLE FOR FILI RETURN ~ J~~ /J~ ~ ~ i ~ i > DATE Phyllis Yocum Patterson / °~ ~ U ` 522 Wilson Lane -Apt. #2116 ,Mechanicsburg, PA 17055 f DATE Scott M Dinner Esq D~~ 1 2 2Q11 3117 Chestnut Street, Camp Hill, PA 17011 Side 1 X505610143 1505610143 ~ ~~` ~'~' J REV-1500 EX 1505610243 ~eae~rSNama: PATTERSON, JAMES HOWARD RECAPITULATION 1. Real Estate (Schedule A) ........................................................................................... 1. 2. Stocks and Bonds (Schedule B) ................................................................................. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .............. 3. 4. Mortgages ~ Notes Receivable (Schedule D) ............................................................ 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) .................... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ SeparateBillingRequested .............. 7_ $. Total Gross Assets (total Lines 1-7) ........................................................................ g. 9. Funeral Expenses & Administrative Costs (Schedule H) ............................................ 9. 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ................................... 10. 11. Total Deductions (total Lines 9 & 10) ................ ....................................................... 11. 12. Net Value of Estate (Line 8 minus Line 11) .............................................................. 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .................................................... 13_ 14. Net Value Subject to Tax (Line 12 minus Line 13) ................................................... 14 Decedent's Social Security Number 174 20 9845 494,480.00 2,029,980.70 2,524,460.70 0.00 2,524,460.70 2,524,460.70 0.00 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2)X .00 15. 16. Amount of Line 14 taxable at lineal rate X .045 16. 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 1 g. 19. Tax Due ............................................................................................................... ...... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505610243 1505610243 0.00 ._1 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 - 10 - 00989 DECEDENT'S NAME Patterson, James Howard STREET ADDRESS - 5225 W[Ison Lane -Apt. # 2116 CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credds/Payments A. Prior Payments B. Discount 3. Interest Total Credits (A + B) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. Make Check Payable to: REGISTER OF VNILLS, AGENT. (1) 0.00 (2) 0.00 (3) 0.0 0 (4) (5) 0.0~ PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :..................................................................................... ^ b. retain the right to designate who shall use the property transferred or its income :......................................... ^ c. retain a reversionary interest; or ..................................................................................................................... _ ~^x d. receive the promise for life of either payments, benefits or care? .................................................................. ~ LxJ 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? ............... ~ x^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which ~ 1 contains a beneficiary designation? ........................................................................................................................ L^J ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0 percent [72 P.S. §9116 (a) (1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)j. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption M COMMONWEALTH OF PENNSYLVANIA INHERfTANCE TAX RETURN RESIDENiDECEDENT SCHEDULE A REAL ESTATE ESTATE OF Patterson, James Howard All real property owned sole)yy or as a tenant in common must be reported at fair market at which property would be excFianged between a willing buyer and a willing seller, neither being reasonable knowledge of the relevant facts. Real property which is jointly-owned with right schedule F. ITEM NUMBER 3 4 5 Include a FILE NUMBER 21 - 10 - 00989 value. Fair market value is defined as the price compelled to buy or sell, both having of survivorship must be disclosed on Attach a copy of the settlement sheet if the property has been sold. copy of the deed showing decedent's interest if owned as tenant in common. DESCRIPTION 75 acres of unimproved farm/timberland located in Lack Township, Juniata County, Pennsylvania [PIN: 6-16-2j 38.89 acres of unimproved farmltimberiand located in Beale Township, Juniata County, Pennsylvania [PIN: 1-6-2j. 50.84 acres of unimproved farm/timberland located in Lack Township, Juniata County, Pennsylvania [PIN: 6-20-19]. an undivided one-half interest of 400 acres located in Lack Township, Juniata County, Pennsylvania [PIN: 6-9,4]. Note: the value of each of the above tracts of land is based upon the standing [unharvested] timber thereon at date of death as well as an estimated per acre value of $2,000. [except for the tract listed as Item #4 which was valued at $1,000.lacre due to a significant portion of such tract being mountainous] as per discussions with a local consulting forester familiar with these properties. Decedent's surviving spouse disclaimed her interest in these timberland tracts [see attached Disclaimer] and they are part of The Patterson Family Trust, the total value of which is indicated on Schedule J, part II. TOTAL (Also enter on Line 1, Recapitulation) VALUE AT DATE OF DEATH 158, 800.00 98, 000.00 137, 680.00 100, 000.00 494,480.00 SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Patterson, James Howard FILE NUMBER _-_____ _ ___ ___ _ _ 21 - 10 - 00989 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER -- -- - -- DESCRIPTION _ - - UNIT VALUE ---------- VALUE AT DATE OF DEATH 1 _ ~ MorganStanley SmithBarney Active Assets Account 688-056340-020 (see attached Client Statement]. 1 469,807.44 Note: these assets were held solely by decedent and are part of The Patterson Family Trust, the total value of which is indicated on Schedule J , part II 2 MorganStanley SmithBamey Active Assets Account 1 508 446 80 688-060718-020 [see attached Client Statement]. , . Note: these assets were jointly owned with decedent's spouse who disclaimed them [see attached Disclaimer] and are part of The Patterson Family Trust, the total value of which is indicated on Schedule J, part II 3 MorganStanley SmithBarney Active Assets Account 688-056286-020 [see attached Client Statement]. 1 1,051,726.46 ~ Note: these assets were jointly owned with decedent's spouse who disclaimed them [see attached Disclaimer] and are part of The Patterson i i Family Trust, the total value of which is indicated on Schedule J, part II TOTAL (Also enter on line 2, Recapitulation) 2,029,980.70 LAST `i~'ILL O>N ~T_arVIES ~-TOWARD PATTERSON i I I, ,Tames inward Patfi'ers~~n, preC~ntly of 320 Pinewood Drive, Shirerr~anstown - .ower Alien Ar_n,:x, Curri}~erland Coanty, P;:rinsylvania, declare this to be my Last Will hereby voicing all Wills and Codicils previously made by me. I declare that 1 am married to Ph;~•Ilis Yocum Patterson and that all references in this = i i il[ tc `my Wile' are references to her. i I declare I have tlu•ee children now living: my daughter, Terri Sue Patterson, resentiy S 1 years cld and residi~~g i_~ La.r?sclale, Pennsylvania; my son., Robert J. P y 4~9 ;ears old ar~d resici.n~~ i n f2os~~-eat, CTeorgia, and my son, James Kirk ently ~5 years old and residing in I~il.lscurg, IJennsylvania. All references in this ~'JVill to `mv Ja•ani .'~~. nyia3~nrr I~,~ 171?).7L1-nl)li children' i:,clude only tl~ie above named i,~dividuals. AI2Tli~LE I Payment ~f Det~tslEk~;:nses: I direct the payment of my legally enforceable dehts I and i:he expenses of n'ry lasi illness and far.eral, fi-o:n my residuar;- estat: as soon after! my death a.s :nay be ~o~~,-enier;. C~ r--- ~•l ~~ ...(7 J _ `~ ` ~ f~- ' ' i'il `' -. _.' ~ ;, ~ ,` r] _._7 . ,7 ., ~~.a t (~ _~ r ~~J -"Y;) r~~ rte; .- ;:_ ., ~--, -~- ARTICLE II Personal Pro erty sand ~Ioa~sehol~l Effects: I give certain items of my household ings and tangible personal property to my friends and family in accordance with the terms of written memorandum which I have prepared. I bequeath any such property not disposed of by ich memorandum, or all of such propert}~ if the memorandum is not located or received by my ersonal Representative, to n-~y ~7~ife. Further, should my Wife fail to survive me and no such is found, then my Personal Representati~~~e shall distribute my personal property and effects to my children, in shares of substantially equal value as determined by my Representative. If the written memorandum referred to ir: this ARTICLE II is not located or received my Personal Representative within sixty (60) days after taking office as such, after and upon the of a reasonable search. for such memorand~~m, the Personal Representative shall be held less for distributing such propert;~ as hereinbefore provided. II~TiCLE III Establishment of Credit Smelter Trnst: I give to my Wife and to my daughter, Terri S. Patterson, as Co-Trtstees, in Trust (the "Credit Shelter Trust"), in addition to all assets received directly by the Co-Trustees that are excludable from my gross taxable estate for Federal estate tax purposes, assets of a total valr:e equal to the largest amount, if any, that can pass free of 5~v~t ~I' ~"'e'rr Federal estate taa b ~ reason of the unified c~ . ~ '~ t' ~ ~~.~~~~~.~ ~,t .~,. 5 ~ed.t ~,znder sc:c ion :.010 of the Internal Revenue Code); `''~° ~° ''~~'. ~' ` ~ ~'%~ ~ grid any other cre«its available for Federal estate tax purposes except (1) the state death tax credit tq I~;; I,a 7i ih.l-,;;iU~ 4 f E -3- he extent that use would require an increase in the amount of state death taxes paid and (2) the it for tax on prior transfers to the extent that credit arises from transfers to me from individuals rho die after me. Such latter amount shall be reduced by the value for Federal estate tax purposes f any gifts which do not qualify for the marital or charitable deduction made by me under this Will otherwise, and further reduced by an amount equal to the sum of all charges to principal, except taxes (since I direct hereafter that such death taxes be paid from this Credit Shelter i'rust), are not deducted in computing my Federal estate tax. In no event shall the dollar value of the s passing to this Credit Shelter Trust exceed $2,000,000. (not including those assets that may disclaimed by my Wife as hereinafter provided in ARTICLE V or as otherwise disclaimed by I recognize that depending upon the amount of bequests under my Will, my testamentary dispositions, the amount of state death. taxes and administration expenses, and factors, this Credit Shelter Trust might he ron-existent or might consume all estate assets, so that no assets may remain to pass outright to my Wife pursuant to the residuary gift under the isions of ARTICLE ~' hereafter hI2TICLE IV Distributia~u oI'the C:•edit Shelter Tru6~t: A. The assets of the Credit shelter 'Trust shall be held and distributed on the ~~~a~t~ 1~. ~enaeer .~.;~:;,. , ,. ,.n following terns during tine lifetime :~f my Wile: -4- 1. Irncume and F~-ire~pal I~istrib utions: The Trustees shall pay and distribute to my Wife or for her benefit the entire income therefrom, which payments shall he made to her periodically, but not less frequently than quarterly. In addition, the Trustees shall from time to time pay to my Wife, or shall apply directly for her benefit, as much of the principal of this Credit Shelter Trust as the Trustees may consider necessary or advisable for her health, education, support cr maintenance (or airy combination of them). 2. >Powec- ~f ~~+'ithdrawal: In any taxable year of the trust, my Wife shat! have the right to withdraw the greater of $5,000 or 5% of the principal of this Credit Sheller Trust valued as of the date such request for withdrawal is received by the Trustees. The value of the principal is to he conclusively determined by the Co-Trustee other than any Wife. The right of withdrawal shall be exercised only in wri~,ing and delivered to the Trustees and the right of withdrawal wall not be cumulative. B. Upon the deatr~ of m~; Wife or at my death if she shall have predeceased me, then e Trustees shall distribute the balanca of the Credit Shelter Trust to my children, per stirpes. If at y tirr~e any beneficiarry entitled to receive principal f om the Credit Shelter Trust estate pursuant this subparagraph B. is a minor or an incompetent or a person whom the Trustee(s) deem unable handle the funds prcporl~• o.r ~h~:eiy ifpaid u.irectly to the beneficiary; the Trustee(s) in their di::cretion may make payrneiits ir: ar~v _~:~ ~~r i:~or, of t11e following ways: 1. To the natural juardian or legally appointed gaardiar, of the person or estate of the beneficiary; 2. By making expen~~~tures directly for the care, support, maintenance, or education of the benef ciar}°: a: ~ra~i~ ,~. ~nnnnrr ~rv c~i„,,:: ~,~ ~;,.,,, 3. To any per~or• or ~~rgani~ation furnishing care, support, maintenance, or c`""',~ `I~'~,''"-°I ~ educatiar_ far tl~e renefi~: iarF~. ~~i 1717) 761_(~RUD I~;.~ 171%) 761-o11i1; -5- The Trustee(s) ;hall not be required to see the application of any funds paid or applied in any ~f the aforementioned ways and ~lre receipt of the payee shall be fiill acquittance to the Tnistee(s). C. In the event tha_ one or both of my co-Trustees named in ARTICLE III are enable to serve, then I appoint my sons, Robert J. Patterson and James Kirk Patterson, to serve (in he order named) in their place. If no named. Trustees can serve, then I appoint Manufacturers and ['radars Trust Company (M&T Flank} and its successors, to serve as successor Trustee of this ~redit Shelter Trust. ARTICLE V Resid~rar}- Estatea If my Wife survives me, then I give the rest, residue and remainder of my estate outrivlrt ?.o my ~~,n~'ife, free of all trusts. In the event my Wife does not survive me, the assets shall be added to and be held and distributed in accordance with the terms of my Credit Shelter Trust pursuant to ARTICLE IV. Furthermore, if my Wife disclaims all or any part of her interest in this residuary gift, such disclaimed property shall be added to and be held and j %.l`iuilitit.c:d an £icCOrciarrcc' ~^."rill ill:, ier:_J Cf file Credrt Shelter ~: r'uJt. 1F ,•;;, t for any aso„ he Crecli+. i Shelter Trust shall not have been created or shall have been exhausted, such property shall be held and distributed on the same ternrs set forth for the Credit Shelter Trust pur •»»± + yTICLE IV. 4 ARTICLE VI i .S~m~ta ~7. D~~u3a~ ~ 1~.~„r„~~; ~; 'L..,,, i ~~ ~ ~ % ~~~~~~~-~~~~ ~ t,,~,.~ Prateetion fi~am Inrpr•as-idence: No interest of any beneficiary under this ! ~,•~ ~;1>> ~~,~i_s~i~~7 ,_ ~,;,, ;,,~_;,,,,~ Wilt or any codicil heroto shall ~~° sui?jeCt to ariiicic:ution or vohrntary or involuntary alienation. -5- ~4I?TICLE VII Personal IZ_e~es~n.t_ztive.: I norr~inate and appoint my Wife to serve as my Personal ve of this Will. In the event of the death, resignation, renunciation or inability to act of Wife, then I appoint my daughter, Terl-i S. Patterson, my son, Robert J. Patterson. and my son, amen Kirk Patterson, to ser~•e (iIl the order named} as my successor Personal Representative. ARTICLE VIII Fidueiary's Perforananee and Powers: No fiduciary under this Will shall be wired to give bond or other securiiy for the faithful performance of the fiduciary's duties. Any such fiduciary shall have the following powers, in addition to those given by law 1. Te retain ary property, per_ding distribution hereunder, to invest in or purchase ar,,y property vdithol~t restriction to legal investments for fiduciaries, to distribute propel-ty in kind, to disclaim any interest in property, and to sell any property at public or private sale; 2. To hold shares of stock or other securities in nominee registration form, including that of a clearing corporation or depository, nr in book entry l~rn~ ,- •,~=ire istarcc' or in s~ICh other form as will pass b}' delivery; 3. To engage n i:.igati~n and coliprolTlise, arbitrate or ab~ndol~ claims; 4. To make distributions in c:zsh, yr in kind at current values, or partly in each, a11ocG.t=:ng s^ecifc assets to particular distributee on a non-prcrata basis, and for such purposes to make reasonable determinations of current values; 5. Te make el~°.;tions, declswns, concessions and set~lements in .~ratt : ~. ~ir¢~nas -~,,,,,,,,, ,,, , ,,,, ecnnection ~~-it11 a'_i Inco111e, estate, inheritance, gift or other tax returns :, i ! - ~'~:~,~~.~~:: ,-, ~, and the payrnert of such takes. witl~our. obligation to adjust the `~"""' "''- ~,`` ""' ~ d;stribl:~uve share• of ir.CO'31e or prillclpal Of a any person affected thereby; -7- ~. To borl•~~w money from any person including any fiduciary acting Hereunder, ;::nd to mortgage or pledge any real or personal property; 7. To manage, control, repair and improve all Estate property; 8. To p~ocu+~~ and carry at she expense of the Estate, insurance of the kinds, fangs and amounts deemed advisable by my Personal Representa~ive to protect the Estate against any hazard; 9. T;; Prr,r <«!' arly atto~-r~~y, ;nvestment adviser. accountant. broker, tax speciali:a or a,~y :ether agerZt deemed necessary iIi the discretion ofn;y Personal Represc_tati~;e; anal to pay from the Estate reasonable compensation for all services performed by any of them. ARTICLE X Death Taxes: 11~i}~ Persolal Representative gild Trustees shall pay all estate, itance ar~d othex death taxo; cb?.It r;,~i including any generation skipping tax imposed on a skip), together with interest and penalties, which shall be payable with respect to property or nterests SUbJ pct to taxation by mason of my death and whether passing under my Will or any icil, or other~~ise, incltldu~g-jointly hel;i and :,Hier nc>n-testamentary property. l~~y Personal epresentative and Trustees s~~leli p~~y :ale ;ur_~e out of the principal of the Credit Shelter Trust tap;?ortlC:)CitCrtt.,~l;iV tU t~z' t`:•:`°rlt t:lP ~.,redlt ~:leltr i rliSt iS lnslliflCl:,nt or unless my Wlfe eases t,ie sl~ali any such f~ayrn~;~rlts ~,e made from my residuary estate. AHT'><CLE Xl fyf~~~ E~:en~s~t ~'r© 3erc is ~vo ~,rope1-ty received by my Personal Representative and . ~.it oi~nr.~ vi. _~,u,.~ I ,,-i,-,•,,,,;,,,~, ~,,,,~ ~~rustees which is exeript frol~i 1=ed~.ral estate tax that may be assessed against my estate shall be i '~•~ "~'' %~~'-~~~~~"~ available for }he payment o_'de:lt, iiiheritarsce arld zstate tars or penalties and interest. or r~~ ~;~.~~ ~r~~i_suo:~ r ~ adlninistration expenses in the settl;;ment OI n1v P,State. ~ -8- A1!~TIC'LE XII Canea~Y~rent ~~'ills: >~~y Wife and I are executing wills at approximately the same in which each of us is the prima. h;,nefici~?_ry of the will of the other. These wills are not ecuted because of any agreement bet~~~een my Wife and myself. Either will may be revoked at time at the sole discretion of the nlak~.r tit roof. ARTICLE XIII Invalidi ~: If any pro~~ision of this Will or of any Codicil hereto is held to be five, invalid or iiie~al, it is my ir;tejition that all of the remaining hereof shall continue to be operative and effective so far as it is possible and reasonable. end of page 8~ 5~©7~ ~. ~~~~~ . i i'I ~~ ~~,7.--,~~.x; -9- lid w'IiTNESS '~~'~~ElZ1=.~~', 1 have subscribed hereunto and caused this my Last ill, consisting of tern (10) type~,~;rittei~ pages, inc'.uding this attestation clause, to be executed, and published this 30th day cif October, 2007, at Camp Hill, Pennsylvania. TN~SS~~S: ,l"~.,~ II /"" ~,1 ~~oz~t a~. ~~~~~s >~i ~ r,,..~,,,~:~ >~~~,., ~~ i'' ,'" ' '~. ~_-_-. ,. _) ,, -~- ~ ~~ f` .!!times Howard Patters~nn Residing at_ 71 5 2nd Street New Cumberland, Pennsylvania 111 Sholly Drive Residing at __ __ Mechanicsburg, Pennsylvania 111 Sholly Dr_ivF Residi;~g at . Mechanicsburg, Pe; ;. _.,ii. -10- ACK~*+C}~~v'I,EDOMENT AND AFFIDAVIT OMMON~VEALTII OI' PE°~i:~TS~'I_,VANIA: LINTY OT CUMI3EIaLAND We, James Hc~~•ard Patterson, Timothy A. Kline, Pamela J. Dinner and Scott M. mer, the Testator and the wit,e}~e~., respectively, whew names are signed to the foregoing :rumens ,being duly gaali;:red aLCOrdii~g to lay^,~, d,a hereby declare to the undersigned authority the 1.ostator signed and :;x-~ca~,;ri ~}I~ ins~cument as his Last Will, that he had signed willingly, that he executed it as his r'.ee and voiuntar.,~ act for the purposes therein expressed, that each of witnesses, in the presence and hearint; of the Testator signed the Will as witnesses and that to best cf the witnesses' kncwle:dg~, tree Testator `alas at the time eighteen or more years of age, of ld 1?'iil7d 211d ~w'r:(ier no ~OntrdlIlt ~C l.iPdue II2t2Lt~nCe. DES: r. ~ ~~r~wr~ ~ 4ti , ;' James Howard Patterson nn this, the,~I.ia~; ofC;,_•tJOer, ^c_s ~ r - .~", beLore me, Nancy C. 13reighner, the undersigned ~rcl ~~. ~~nkiner \n u:~r r.~ ul l..m, !~:~. 1717) 7r,7->>I)iir ~f;'icer, person..Illy appeared Scott ?vi. ilirner, i/squire, known to me to he a member of the Bar of he ~tt~:rer,~e Cua.t of Pe.~ns}~':~~~.r.r; aria cc;rtifie? that he tivas personally present when the aJ '-.CK(1Ci~'!'ird~!l'_:TIt ~iiiE r.:Ii:l::.Vlt ~i,~<±S s±~I~Cd ~)`/ l'.:e ~ °StatOI' and WltneSSeS. ~ ~~ (// y i ~~ ~~lt~d't}~ Puollc r~ h1AWC.'Y C ~fil~ `~ C'AMIIII~OROUSN, Cl~~fgM ~ CA11 ~Mt ~'1 ~. ~~ d `° Q~ A Os O n r p D C n o N y ~ g ~- > ° ~ ° o m CD ~"'~ N CAD T ~ ~ ~ ~ ~ ~ ~ O ~ m Qo N j ~ ~ r=+ T -O ° O C ~~ 0 ~ a s Cp N ~ N ~ C 0 C n N d ~ n cn ~ ~' r: ~~ 3 ~, _ L N :n N ~ ~ CD _ ~ ~ Q W ~ m n m ~. ° A Ul Cl~ O O O O O O ~ z N m m ~ N ~ m '-~ C 1A 69 A A '., .p c0 (D ' <0 m W N CJ1 (71 '^ I I I I I I I ~ I ~o'o W~ ~ O ~ ~ ~~ O O O'' O o °a 69 Eq O -~ W A N ~ 000 '^ i l l l l l l~ l ~o~°o~W~ IV O 00 _--: W J '~ O O O O p a ~ ' z ? t0/1 m c ~ r n ~ ° ' c ~ n z vii ~ d V~ C 1 x D ~° ° -1 ~ c ro n o - -i ~ ~ ~ ~ ~ m fD ~ m a ~ n 1+ ~ ~ y a j 2 p rZ m Q 3 C7 ~ n m ^ m ~. chi N 2 ~ ~ ~• [s1 ~ ~ -• o ~N p in a ~' a ~ - D °- 3 p D o ~ `^ " ~ a N `~ -^ ni r ~ '^ z n te-. „ i ~ ~, m r ~ 7 v o ~ ~- m g. ~ m ~D W ° ~ n ~ ~ N (7 p j ° n a ° r: °' ~ ° N N A ? ;d/ fA O W O N co `;~ w Np N ~ . e0 O ~ ~ °cn° i °' O °' I I O I I °' ° Oa N ~ Cn°W O I I I o I O ~ ~ ~tiW {v p ~ O O s? ~~ ~ N'N A A w I I I o';o ~ I l l o l I I I O I I I 0 00' °O o 0 o :z o n 1 m m n z g ~ z m ~ "' -~° a N v 2 m W ,v .H a Z n m v+ 'tn Ui iN ~ O ,yam 0 O ,W °° s O .00 I w N O W od ~ ~ xA N r ~ O ~ T I o ww" ~~ o rn~~ 0 ooa W Z n D Q ~ z ~ m N ~ ~ ~ ~ D m m - ~G T O fD O a D c cn c N w N O_ O N n T O ~ ~~ a o~ _ ~n n I~ N 3 ~ o.. 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' " 3 n ~ ? ~ m yo z ~ r+ m o ~ ~ ~ `° `" N d n ~ ~ z p r-4~ ? ~ ~ ~ ,~ n ~, ~ ° ~ ° ti o ~. m ~ n ~ J ~a $ ~ ~ a ~ ° m m D ~TT1 ~ ~ `O ~ ° ~ t n ~, ~ ~ ~ o` ~ ~ °' = Z m W ~ . ,~. ~ '~ 1 {GI1 I~il ~ ~ 0 C N ° i,; O n 4~ o ~~ n l ~ a ~ ,F, ~ = ~ ° `" ~ 3 'o n °i °i ~ ~ '~ o b i° m m a ° ~ c ~ O ^ ',3 cp m `' '. to ~ N N ~ C d ~ ~ O O C O ~ ~ ~ N C n ~ O • ~ ? j ? d ~ , ~ ;~~. Q N ~ U ~ ~ d Of o p r o m C ~ C ~ °~ ~ ~` n D- v c ~ ~ _ o 0 N o m- `° n ~ m ~ m Q ~ ~ H O ~ m m t ;~ n o ~ ~ o ~~ ~ s _ fD ~ i ao H ~ ~ co ~ N ~ O D r- A 0 n ~ n -a O p C m z -~ m N Z -~ o n C D ~ - N O Z n c o~ C Z N ~~ °z C m 7_ ~ ~ VI ~ ~ ~ ~ Q~ J 025597 M SADTO ID Q ~:. d n N a[ m -~ D ° O ti $c N D r v Z v~; m ~ ~ z ~ T z O j ~ ~ w D ~ ~ 0 rZ c ~ n ~ o z cn ~ z o z< ~ p m~ ` o r z• ~, ~ m r ,-. -1 =~ o D ~ v ~ z T v m m o~ i m O ~ m ~ i ~ ~ y n i o D j ~ O~ C ~ ~' I I n 2 m r O ~ n $ a ~o Q. 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O J Z ~~ q ~ ~ J ~ Z ,, m ~. ~ ~' o; ~ ~ o ~ ~ ~ ~ C'7 N j (11 O ~ O ~ O O O n: m W N Q1 8 N o ~ ~ O l O O O 0 O N t0 N Q7 w N' A A A A O O ~ ~ m m d m m m 'D ~ O O < < a n m m A A w w O O v v Q~ m t Q ~ ~ i j ~ ~ A . N -i c ~ n 1 q ~ 1 .Z7 J ~ ~ Z ~ ~ n o i ~ Nti N ~ a + i ~ ~ n n N a 3 ... D J (Ji D W ~ O 1 O O c S 0 ~ 1 m m U O o: m W ~D Q1 Q~ W O I f ~ ~ ~ ~ I r ; J n • a i v 9 J W ~ > ~ rn~ ~ 'i O' O ' O m ~' O m 01 ~ N ~ A W ~ A A 1 Q ~ \ I ~ :. O O r ~ O m ~ ~.. Z Z N . ~ ' ,^ O s' . n ~ , ~ ~ ' H I~ 1 ~ ~ Z Z C m ~ T o m <V i O O. ~ C 7 ~p ' c i ~ W N O_ O y'C ~~ d Z Z z Z Z Z Z z z Z Z Z Z Z Z H N D D D D D D D' D D D D A D D D ~a rn O N N O 0 0 CP cn m rn O O? A A O O 0 O O N rD O Q1 N O W N O J N N v m -N ~. 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O o~ o~ w m N N ';';'m ~ N ^ N r~ ~- a . \Y . i V ~ ~ ^ ' ,) ~ o ~ Zr" ~~ ~ N ~ ~ m Z + ^ ' ~n ~~ m r- N ,;~ ~ m ~ N 'mod N Q Q N N Q vt1 ~ '~ ~ ~~ v .;a ° ~ e ~ J 4 ~ 'r ~ ~; ~ cn '' a 3 W ~' Q tY ~ ~ A A < N.m p a 0 3° ' t f . tk IN RE: . ESTATE OF JAlv1ES HOWARD PAT~I'ERSON a/k/a ,TAMES IT. PATTERSON, deceased LN TIIE COl1RT OF C01411MON PLEAS Cl)ivII3E~RLAND COUNTY, PENNSYLVANIA ORPIIANS' COURT DIVISION No. _z 2010-00989 ti~ ~ ~ _, ~ O -' U - _ ~ 7 -- i ~ _ _ ' :7P_ ~ -~' f~''l I '1 l ~~ (. -.. ~ ~.. L, _ 4J .... . _ ~~ -.CJ _ rv '. .. ~~~~ .~ ~I:-. -- Q n~~scr,ArNrcR 1.) The Decedent died testate on August 23, 2010, sttivived by his Wife, Phyllis Yocum Patterson, (hereinafter the "Disclaimant"). 2.) On September 27, 2010, an instrument dated October 31, 2007, was admitted to probate as Decedent's Last Will (hereinafter the "Will"). 3.) Decedent anal the Disclaimant were joint owners of the following items of intangible personal property (hereinafter the "Disclaimed Assets"): a.) Morgan Stanley Active Assets Account # 688-056286-020. b.) Morgan Stanley Active Assets Accotmt # 688-06071.8-0?0. 4.) Disclaimant irrevocably and unconditionally disclaims and renounces: (i) her survivorship rights with respect to the Disclaimed Assets and (ii) her interest, if any, in Decedent's residuary estate (pursuant to ARTLCLE V of the Will) with respect to such Disclaimed Assets. ~,. ~E.. -2- IN WITNESS WHEREOF, I have subscribed hereunto this 2 8~~y of October, 201.0. Witness: ~~~~, ACKNOWLEDGMENT COMMONWEALTII OF PENNSYLVANIA) COUNTY OF CUMBERLAND ) `~"`r., Phyllis Yocum l~atterson On this, the c~~'~day of October, 2010, before me, Scott Nl. Dinner, the undersigned officer, personally appeared Phyllis Yocum Patterson, known to me to be the person whose name is subscribed to the foregoing Disclaimer, and acknowledged that she executed same for the purposes therein contained. c~~~ Notary Public NOTARIAL SEAL SCOTT M DINNER Notary Publlc CAMP HILL BOROUGH, CUMBERLAND COUNTY My Commission Expires Oct 23.2011 1N RE: IN TIIE COURT OF COMMON PLEAS ESTATC OF JAA~IES 1-[O~VARD 1'AT'irERSON C11~'S~TSERLAND COUN~CY, PENNSYLVANIA a/k/a JAMFS H. NAT"CCRSON, deceased ORPI~.-DNS' COURT' D[VISION N o. ~~~~ n ~> 201 A-00989 ~O . `~ -~- -~ ~ ~' ~ ~ ,. , o ~_._ _ ~ _ - ~ ' f '-i .:' ~ .l _ )L. DI,S'CLAIAIF.K D ~' _ ~-~ c.. ..; 0 1.) The Decedent died testate on August 23, 2010, survived by his Wife, Phyllis Yocum Patterson, (hereinafter the "Disclaimant"). 2.) On September 27, 201.0, an instrument dated October 3 1, 2007, was admitted to probate as Decedent's Last Will (hereinafter the "Will."). 3.) Decedent owned the following parcels of real property located in Juniata County, Pennsylvania (hereinafter the "Timberland Assets"): a.) 75 acres situate in back Township (parcel # 0616002]. b.) 38.89 acres situate in Beale Township [parcel # 0106002]. c.) 50.84 acres situate in Lack Township [parcel # 0620019]. d.) an undivided one-half interest of 400 acres situate in Lack Township [parcel # 0609004]. 4.) Disclaimant irrevocably and unconditionally disclaims and renounces all of her right, title and interest in the Timberland Assets and in Decedent's residuary estate (pursuant to ARTICLE V of the Will) with respect to the Timberland Assets. _. . -2- IN WITNICSS WHEREOF, I have subscribed heret.mto this 2 $t~lay of October, 2010. Witness: ACKNOWLEDGMENT COIVIMONWEALThI OF PENNSYLVANIA) COUNTY OF CUMBERLAND ) ~~~ ~., is Yocum Patterson On this, the~_' day of October, 2010, before me, Scott M. Dinner, the undersigned officer, personally appeared Phyllis Yocum Patterson, known to me to be the person whose name is subscribed to the foregoing Disclaimer, and acknowledged that she executed same for the purposes therein contained. Notary Public NOTARIAL SEAL SCOTT M DINNER Notary Public CAMP HILL BOROUGH, CUMBERLAND COUNTY My Commission Expires Ort 23, 2014