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HomeMy WebLinkAbout09-20-12J 15056101Q1 REV-1500 Eltf°'-'°' 4`1 OFFICIAL USE ONLY PA Department of Revenue pennsylvartia " ~" County Code Year File Number Bureau of Individual Taxes PO BOX 28D60i Harrisburg. PA 17t28-o6ox INHERITANCE TAX RETURN ~ RESIDENT DECEDENT Ld~ 1 .~_.. L.. _ _ . Date of Birth LL'' MMDDYYYY -l Decedent's Fi~s°t~N;ame yy~~ MI C ~ -la L Spouse's Last Name yi~+ Suffix Spouse's~Fi^r{sit N}ameg~}!~~•~g ~ MI Spouse's social security Number ; THIS RETURN MUST BE FILED IN DUPLICATE WITH THE I I ' REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW I~ 1. Original Return O 2. Supplemental Return t~ 4. Limited Estate O 4a. Future Interest Compromise (date of death after 12-12-82) O 3. Remainder Return (date of death error to 1243-82) O 5. Federal Estate Tax Retum Required O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Bozes (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received p 10. Spousal Poverty Credit (date of tleath O t1. Election to tax under Sec. 9113(A) be(ween 12-3Y-9t and 1-1-95) ~' (Attach Sch. O) CORRESPONDENT- THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND COt1FIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO Name Daytime Telephone Numher _ First line of address Second line of address ~~ Q ~' [~~ ~f4 -n S 9 $ C~ F n J City or Post Office ______._.. Stata ..-___._ I ZIP Code DATE FILED a ~~ "`g Correspondent's if (s free, rgrreG and SIGNATURE OF.PE SIGNATURE Nu LEA E USE ORIGINAL FO Side 1 L 15U561U101 d this return, inGUding accompanying s~ other than the personal representative ~~Qflht\ n 1 ~I ENTATIVE P is based on all information of which preparer has DATE DATE 10- y-rf ~~I-,d N ~ i1 ~ `T"~. `7 RM ONLY 1505610101 and belief, J REV-15a0 E% Page 3 Flie Number Decedent's Complete Address: DECEDENT'S NAME ___ Cocoy_- ~' _~r~d~.fSr7('1 -- STREET ADDRESS --- 5 z z. 5 .-_VJ ~~Sor. /`a T~_t? _~ 30-1 - _. CITY ~ i ' STATE I ~~P Merc.~a~~,f_s~~~ PA Fuss Tax Payments and Credits: 1. Taz Due (Page 2, Line t9) 2. CreditslPayments A. Pdor Payments B. Discount Total Credits (A + 8) (2) 3. Interest (3) 4. If Lirle 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 5. ff Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) ~ ~j ~ ~D_] , Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :................................................................................... ....... ^ ,~ b, retain the right to designate who sha(I use the property transferred or its income : ...................................... ...... ^ c, retain a reversionary interest; or .................................................................................................................... ...... ^ d, receive the promise for I'rfe of either payments, benefits or care? ................................................................ ...... ^ 2. If death occurred attar Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ........................................................................................................ ...... ^ I'~ 3. Did decedent own an "in trust for" orpayable-upon-death bank account or security at his or her death? ........ ...... ^ 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? .................................................................................................................. ...... ^ ®- IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FlLE IT AS PART OF THE RETURN For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)). The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a fax 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 j72 P.S. §9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1500 EX Decedent's Name: 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 and Notes Receivable (Schedule D) ......................... .. 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5. 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. 7. Inter-Vivos Transfers 8 Miscellaneous Nan-Probate Property (Schedule G) O Separate Billing Requested...... .. 7. 8. Total Gross Assets (total Lines 1 through 7) ........................... .. 8. 9. Funeral Expenses and Administrative Costs (Schedule H) ................ ... 9. 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ........... ... 10. 11. Total Deductions (total Lines 9 and 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 lax has not been made (Schedule J) ..................... ... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ................... ..... 14. TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 la)11.2) X .0_ 15. 16. Amount of Line 14 t xable at lineal rate X .0 ~ t6. 17. Amount of Line 14 taxable at sibling rate X .12 17 18. Amount of Line 14 taxable at collateral rate X .15 18 19. TAX DUE ......................................................... 19. Decedent's Social Security Number 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 1505610105 O Side 2 1505610105 1505610105 ,J REV-1503 EX+ (8-88) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER 2D\\ - ~o~ob`~ All property jointly-owned with right of survivorship must be disclosed on Schedule F. (I( more space is needed, insen atlditional sheets of the same size) HEV 15oe E%.IY9)1 SCHEDULE E COMMONWEALTHOF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHRESI~ENi0ECE0EN7 RN PERSONAL PROPERTY FILE Include the proceeds of lifigalion and the date the proceeds were received by fhe estate. All property joiMty-owned with the right of survivorship must be disclosetl on Schedule F. " °°' VALUE AT DATE NUMBER DESCRIPTION OF DEATH t7 Or~~~~ (>. C., L~ d ~-~: c:~ ~ c~ ~ v r.1L~~ C,o- 5 ~ 35%~,I~• tog V~l • 3 ~-1 TOTAL (Also enter on line 5, Recapitulation) I S \ l7 N~{ Z ~ ~ I (If more space is needed, insert additional sheets o(ihe same REV-1511 EX+(10-O6) P SCHEDULE H FUNERAL EXPENSES & COMMONWEALTH OE PENNSYLVANIA INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. g. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions C \ - /~ "~-~'~ .'3,,,_h G '2___( `JC7l~ presentative(s) s~ Name of Personal R e ~ ~ (~ (~ ~ ~ ~ ( ~ a3 ~ Street Address ~\~~ ~ ``~a~'~- _ __ .- _ r~ State~~ Zip - ~~ ~ ~ ~1 City ~ C' Cx~~~L~`. n Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant -_ - Street Address City _ State Zip _ __, ___ Relationship of Claimant to Decedent //--~~ ~ ~ ~ ~ 5 V 4. Probate Fees ' °Z ~ ~ U ~ ~~ 5. Accountant s Fees 6. Tax Return Preparer's Fees ~ ~ S (~ , U ~. a.o~~ ~~~5 >~z~ TOTAL (Also enter on line fl, Recapitulation) $ \ ~j ~ S Jr • ~~ (If more space is needed, insert additional sheets of the same size) REV-1573 EX+ (9-00) COMMONWEALTH OP PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF NUMBER ,. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] ~~,~ ~1~d~~~~~ 3~0 ~ ~ F c oc~k~ ~ n, T VJ FILE NUMBER Do Not TO DECEDENT UNT OR SHARE OF ESTATE goo go ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE i. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (It more space is needed, insed additional sheets of the same size) Carol Anderson Valuation of Edward Jones acct Value at 1/13/2011 DOD Cash 6,917.34 New Mexico St Hosp 25000 104.751 26,187.75 Wayne St Univ 25000 98.317 24,579.25 South Carolina Jobs 20000 87,818 17,563.60 Pennsylvania St TPK 30000 92.537 27,761.10 Owen 1 roberts Sch Dist 20000 96.561 19,312.20 Washington St Health Care Facs 25000 104.847 26,211.75 Mahoning Cnty Ohio Career 5000 85.706 4,285.30 San Jose California Airport 20000 82.669 16,533.80 Hesperia Michigan Cmnty Schs 25000 97.342 24,335.50 Paml Beach County Florida 35000 95.968 33,588.80 Van Kampen Investment Grade 86 847.85 72,915.10 293,274.15 Greg Williams Financial Advisor 513 S Union Street Traverse City, M149684 Fax Sheet F;dwardJones ~! - g c:S~.r,~.v Qv~dp~~ 717-~95~ -47~r 7 DATE TO FAX NUMBER 3 Greg Wtlllams (877) 222-3792 NUMBEA OF PAGES FROM FAJ( NUMBER includng Cover sh¢et For your information. Here are the documents we discussed. Please sign and return to our office. Please call me about the following documents. Here is some information relating to your investment. Please review. As you requested. ^ Diversification issue. Call me. ^ We should discuss this. Following is important account information. Please check it for accuracy, complete if required, sign where indicated, and return. Please complete the fallowing and fax back to our office at (s77) 222-3792 Please sign and fax back to our office at (877) 222-3792 Please call our office with any questions. Phone: (231) 933.0881 Toll Free: ($00)288-9558 The information contained in this facsimile message is intended only for the use of the intlividual or entity to which it is addressed and may contain information that is legally privileged and/or confidential. If the reader of this message is not the intended recipient or the employee or agent responsible for delivering the message io the intended recipient, you are hereby notified that any dissemination, distribution, or copying of this communication is strictly prohibited. !f you have received this communication in error, please notify us immediately by telephone, Thank You. E0/T0 39t1d 53NOP Q?JtiMQ3 Z6LEZZZLLBT GE~EZ LiOZ/80/60 Date Printed: 08-Sep-2011 Financial Advisor: Greg Williams Phone:231-933-0881 Page 1 of 1 Historical Pricing Symbol bescrlptlon/fypa 93978EY63 WASHINGTON ST HEALTH CARE FAC3 2008 D Closing (unadjusted) 946303QN7 WAYNE ST UNIV MICH UNIV REVS 2008 Closing (unadjusted) 428074EP9 HESPERIA MICH CMNTY SCHS BDS Closing (unadjusted) 56005LBY6 MAHONING CNTY OHIO CAREER & 20096 Closing (unadjusted) 921166681 VAN KAMPEN INVT GRADE MUN TR UT 101 Closing (unadjusted) Edward ones Date 13-Jan-2011 13-Jan-2011 13-Jan-2011 13-Jdn-2011 13,)en-2011 Value 104.8470 U5D ~ ~V 25, OOG 98.3170 USD ~ ~ s 5, DOD 97.3420 USD ~~ ~5, DO(7 85.7060 USD~~ ,S, v~ 847.8500 USD / 2(~ UNITS This report Is provtled by Edwartl Jones. The report was calculated using third party information. This report is not Intended to replace ofnckN documenm earn as oonfkmations anNor anccunt statements that shcuW be retained for tax purposes. Past perfomwnee is no guaramss of tukure reaUKa. Edward Jones does not provide tax or legal advtca.You shook! coneutt your tax altl/Or legal advisor fur your particular alNaeon. The historical mst basis inbmrapon famished herein ('Informatiol') is for use by customer ("you`) only and is eased on the purchase and sale vdonnation provkled. While Etlward Jones believes that the urtormdtlon was obgined Nom reliable twurces. Edward Jones Wes nok gueramse the arxurracy or otxnpleteness of the Information arW Is furnishing the Information to you on an "ae-ie• beets. EDWARD JONES MAKES NO WARRANTY OF ANY KIND. EXPRESS OR IMPIJ EA. WfTH RESPECT TO THE MERCHANTABILITY, FlTNE55, CONDITION, USE OR APPROPRIATENESS OF THE INFORMATION. Edwertl Jones Ie supplying the Information on the basis that the Information will be used by Wu for Your own use antl nenetk and not ror resale w other transfer to, or use by or for the benefit of, any other parson or amity. E0/Z0 39tid S3NOP Q21tiNQ3 ZBLEZZZLL81 6E:EZ SiOZ/80/60 Date Printetl: 09--Sep-2011 Financial Advisor: Greg Williams Phone: 231-933-0881 Page 1 of 1 Historical Pricing Symbol t347370kY7 890890JW3 696543JZ1 709221QY4 7961360W0 83703ELD5 [1e»r:rlptlon/Type NEW MEXICO ST HOSP EQUIP LN CO 2008 A Closing (unatljusted) OWEN J ROBERTS SCH DIST PA 2008 . Closing (unadjusted) PALM BEACH CNTY FLA PUB IMPT R REV BDS Closing (unadjusted] PENNSYLVANIA ST TPK COMMN OIL 2003 C Closing (unatljusted) SAN JOSE CALIF ARPT REV 2007A Closing (unadjusted) SOUTH CAROLINAJOBS-ECONOMIC D REV BDS Closing (unadjusted) 13-Jan-2011 Edward Jones Date 13-Jan-2011 13-Jan-2011 13-Jaft-2011 13-Jan-2011 13-Jan-2011 Value 104.7510 USD ~'~yS, ofKJ 96.5610 USD (-~ 2G, GG'v 95.9880 USD ~~ 3 S,vG~ 92.5370 USO /x,30, v0© 82.8690 USD/ '~ 2tirO~V 87.8180 USD ~$ 20, CGU This report is provided by EcAVard Jones. me report was calculated uainp thNxt party infomlatlon. This report Is not intended l0 replace oifklal doarrmente such as conflrmafxau ardor account etatemanffi that should be retained for ffix purposes. Past peAorrnaaee is no guirrarrtaa of tutur0 teWlta. Edward Jones dce9 not provide leX ar legal adults, You should oonsutt your tax and/or legal advisor Mr your part'roular' slNation.l'he historical cost basis irrMrmadon tumiahed herein ('Infonnadon') is for use by custaner ('you') only antl b based at the purchase and sale irrbrmatbn provided. YJhse Edward Jones believes that the hformation was obtained from rollable sources, Etlward Jones does not guarantee the accuracy or completeness of the Infonnati«r and Is turnisbinp Cra Information b YoU on an 'ae-is' balls. EDWARp JONfiS MAKES NO WARRANTY OF ANY KIND, EXPRESS OR IMPLJm, WfT}{ RESPECT TOTHE MERCHANTABILITY, FlTNE55, (+'ONpITION, U5E OR APPROPRIATENE59 OF THE INFORMATION. Etlwafd Jonas Is supplying the Inormation On the basis that the Information will be used tyy You for Your own use and bent and not for resale or other transfer to, or use by or Tor the benefry of, any other person or entity E8/E0 3B4'd 53NOC 112iCM03 Z6LEZ2;ZLL81 bE:EZ LTOZ/60/60 ®y ~ Z C > O o c' W ^ Z `wVY W W f7 2 f 7qR M „'~ E u '~~ d a ~ `o ~ v O 00 C 3 N a S, E Rid ~ g r r T r ~a ~ c R ~~~ a C Q ~ W ~ c ~g ~_~~ ~~ > cp () N N ~a a=te Ngm o = ~ OOC '12 U ~ vu~g .~ o ~ m $~ ~ ~ Q~ ~ Cf N ~ § ~ ~ ~ ~ e ~' S3 ~ ~ ~ ' ~ ~ , n ~ ~ ~ ~ ~~ p~ { ~ -qj O 1` p~ m { O 1~ ~ L ~ ~ ~ ~ n a q O ~ ~ ~ ~ ~ ~~ ~; N F I~ I~I~I I~ I»I~ I~ I~~ ICI ~,~ $ ~~~~ x ~ M F O o i°i ~ ~ IO ~ r ~i .e ~g i3 g6T i `~$S[ O j~ S V O W A 7 C '' V R m C - g I ,~ ~ m ~ ~ ~ ~ m ~ ~ ~ A= ~ ~ 1 ~ y ~ ~ G z ~ ' s %* c $ ~w ~ ~ ~ ~ ~ ~. ~ ~ N ~ ~' ~ ~ ~ ~ m N O ~' ~ ~ ~ ~ ~ '~'~ ~, g ~p N "') g in ,~ ~~~ ~ ~~~ ~ ~ ~ ~ ~. ~ _ ~ ~ ~ ~ ~ ~~ ~ ~ T $ $ s ~ ~ ~ ~ ~ ~ ~ ~ $ ~ ~ ~ ~~ ~ ~ ~qj p p a T ~~ p~= O,~ N O p~ ~~~ g ~~ ~~ ~~~, $ ~N ~~z ~ ~~ ~ ~ yp ~ _ x ~ ~ ~ ?~ ~ a~ ~~ ~3 ~5~u}a ~,,, ~' i W~ ~ '.~Z p~~ ~~~~ 2 W~~~i W~~~W~~~ +W 4 0a0~~ ~tg~Z Wei} W ~ red's ~i ~a ZT ~'Y ~ ~ ~~ C r ..i ' ~ W p~ . F ~ ~, ~n~ Wp., FD ~ U ~~ r <~ rN„~ 4pu u~~ ~ z~o~3~p s R i W N W N z 4 f a Y Y W C ;p~p O ~ 3? n a R~ ~ 1 1 1 y ~ ' ` ~. O! r~ pM ga ~~ I N r' N T 1 i Q~ }}d !~ QQ g$ gS. $ t'- I~*q 14 Q r rQ$~~ T ~~ ~. ~ a ~ y~ C ~ T ~N' a6 ~ S, ~~ $~ ~~ ~~ s g m ~ w ~' ~~ ~U ~ _wrwQ€ w a ~~ ; ~~? W ~ I~ ~~OUq~~4 a N r m t ~ ~ j N i t ~~~~, ~~~o~ 2 ~~ H ~ m ~ e w N 1~ O I I o ~ a m ^W $.~~~~~ i~'~~ E g d0.` ~ v r ~ O d7 0 r R wQQ ~y W O z :~ , ~~~"~~`g` (~ ~ ~y N M i 1 ~' o a~ c T E E m y $ a~ z ;o~c ~ c~~ P''C> ~~ Z m C ~ r ~ G IW/1 acE~ a ~m`~E $ a'm Y m ...ri. ~ ~ ~ ~ N •~ ~~~ O ~ ~~E- ~as~:~m n~ ~ ~ ~ ~ ~~ Ef ~:~~ Yc c ~ia a0Z 3N ~$D~~ R~~z '-vS`~>~ c ~ ~ ~' '~_~~~ ~~~~~ E ~ ~ ~ o m~'E~$ ~m~~~ r~~ ~oE~, W . ~~}W~ $~'~~~ ;ES~t `~~~g m mNm T ~ ~ J T m°p'EQ ~`o ~~ ~id$Sc'' ~ ~ ~ ~ N ~ N l0 ~d ~ W ~7~~ ^ ~.W m~~~ C Z' E~mmS ~~ g~~~~ u'i f` ~ C 0 O O ~C m`` ~I~ 8 5 ~i~ ~~ l~ z s 'S ~ F ` tl! C °. °z $~ O ~ z ~~ 8 a O a ~. c N REGISTER OF WILLS CUMBERLAND COUNTY PENNSYLVANIA CERTIFICATE OF GRANT OF LETTERS No . PA No . 21- 1 1- 0069 Estate Of: CAROLLANDERSON /FNar, MkW, Leal Late Of: LOWERALLfNTOWNSH/P CUMBERLAND COUNTY Deceased Social Security No: 502-12-4653 WHEREAS, on the 18th day of January 2011 an instrument dated February 17th 2006 was admitted to probate as the last will of CAROL L ANDERSON (ixu. MkUY. 4srl late of LOWER ALLEN TOWNSHIP, CUMBERLAND County, who died on the 13th day of January 2011 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, GLENDA EARNER STRASBA UGH Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: STEPHEN ANDERSON who has duly qualified as EXECUTOR(R/XJ and has agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 18th day of January 2011. **NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) ,AST OIILL AND TESTAMENT I, Carol L. Anderson, of Lower Allen Township (Mechanicsburg) Cumberland County, Pennsylvania, declare this to be my will, hereby revoking all prior wills and codicils. 8'iRST: I give all of my estate to my son, Stephen C. Anderson of Franklin, Tennessee. SECOND: if my son shall not survive me as set forth above, I give my estate to my son's wife, Karen Anderson of Franklin, Tennessee. I acknowledge that I have another living son, David P. Anderson of Harrisburg, Pennsylvania. I have intentionally excluded him as a beneficiary for several reasons, probably the most important of which is the fact that he maintains no contact with me despite knowing my whereabouts. THIRD: My executor and his successors shall have the following powers in addition to those given by law to be exercised by them in their absolute discretion, which powers shall be applicable to all property held by them, effective without the order of any court and until the actual distribution of all such property: A. To retain any investments at discretion including stock of any corporate fiduciary hereunder or of a holding company controlling it; B. To invest and reinvest at discretion without restriction to so-callad "legal investments" with the specific right to invest in common and preferred stocks and in such common trust, diversified, money market and mutual funds as they deem appropriate; C. To sell, to grant options for the sale of, or otherwise convert any real or personal property or interest, at public or private sale, for such prices, at such time, in such manner and upon such terms as they may think proper, and to execute and deliver good and sufficient conveyances, assignments and transfers without liability of any purchaser to see to the application of the purchase money; D. To borrow money and to secure its repayment by mortgage of real or personal property, pledge of investments or otherwise, without liability on the part of the lenders to see to the application thereof; E. To compromise claims by or against my estate or any trust created in my Will; F. To make distributions in cash or kind, or partly in each; G. To register investments in the name of a nominee or to hold the same unregistered in such form that they will pass by delivery; H. To join in any recapitalization, merger, reorganization or voting trust plan affecting investments, to deposit securities under agreement, to subscribe for stock and bond privileges, and generally. to exercise all rights of security holders; I. To manage, operate, repair, alter or improve real estate or other property, and to lease real estate and other property upon such terms and for such period as my executor and 2 trustee deem advisable even for more than five years and beyond the duration of any trust; J. To deduct administration expenses upon either the estate tax return or fiduciary income tax return, with or without adjustment as between principal and income, as my executor shall determine; K. To join with my spouse and Pile any income tax or gift tax returns that may be due on my behalf and to pay so much of such taxes as my executor may deem appropriate and to consent to any gifts made by my spouse being treated as having been made one-half by me; L. To associate with them in the absence of a corporate fiduciary, an investment advisor, accountant, custodian and other agents and to compensate them out of principal or income or both as my executor or trustee shall determine, such compensation to be a reduction of the compensation of my executor or trustee; M. To associate with them at any time, in their absolute discretion and of their choice, a corporate fiduciary which shall have the same powers as my executor or trustee, such designation by my executor or trustee and acceptance by a corporate fiduciary to be in writing; N. To delegate to a corporate fiduciary the exercise of any powers, with the same effect as if the executor or trustee delegating such power had joined in the exercise of such power; and to revoke any such power, provided, however, that ttie revocation of 3 any such delegation shall be in writing delivered to and accepted by the corporate fiduciary; O. To exercise any stock options which they may receive, including my stock from any source as my executor or trustee may deem necessary for the exercise of such options; and to pledge assets as my executor or trustee deems appropriate for this purpose; P. To do all other acts and things necessary or appropriate in the management, administration and distribution of my estate or trust, including incorporation of my estate. SOL1R'PH: No interest in income or principal shall be assignable by a beneficiary or available to anyone having a claim against a beneficiary before actual payment to the beneficiary. FIPTH: All estate, inheritance and other death taxes, together with interest and penalties thereon, payable with respect to property or interests passing under my Will or any codicil thereto shall be paid out of the principal of my residuary estate without apportionment. SIRTB: I appoint my son, Stephen C. Anderson of Franklin, Tennessee as executor of my estate. I further direct that my executor shall not be required to furnish security in any jurisdiction. SEVSLiTH: Words used in the singular may be read to include the plural or the plural may be read as the singular. Similarly, the 4 masculine form may be read to include the feminine and neuter; the feminine may be read to include the masculine and neuter; and the neuter may be read to include the masculine and. feminine. I have signed this Will this ~~' day of ~~ ~<~-c.- f_-.v- 2006. CAROL L. ANDER$ODi, TiBTA R Signed by Carol L. Anderaon, the testatrix, as her Will, in the presence of us, who, at her request, in her presence, and in the presence of each other, have signed our names as witnesses. 5 co~s~wEALTe os or co~sRLAND ss: We, Carol L. Anderson, the testatrix and undersigned witnesses to the Wi11, the attached or foregoing instrument, who have signed the instrument, having been qualified according to law do depose and say: a.) that I, the testatrix, do hereby acknowledge that I signed the instrument as my Will, that I signed it willingly and as my free and voluntary act for the purposes therein expressed; and b.) that we, the witnesses, were present and saw the testatrix sign the instrument as her Last Will, that she signed it willingly and executed ft as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the Will as a witness and that to the best of our knowledge the testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence. Sworn and Cc ~ , (SEAL) subscribed CAROL L. ANDERSON, STA 2006. NOTAR IC My aoaissioa expires: A NNSYLV/WW ~ Fi~YMMO.Deupl#iCaeb NyCtitniMon E~6M,Msis 11, 20Q/ NMnber, Pw~a~MA~ 1lanelNpi Of NoYAa before me this l I~ day of ~ Pennsylvania DEPARTMENT OF REVENUE BUREAU OF INOIVIOUAL TAXES Telephone February 17, 2011 STEPHEN ANDERSON P O BOX 429 FRANKLIN TN 37065-0429 (717) 787-6201 Re: Estate of t:arol L Anderson File Number N/A Social Security 502-12-4653 BNY MELLON ^ Capitol Stock ^ Registered Bond ®A Security Asset ^ A Security Account 8065-9509 $2,148.00 Sincerely, II .. LL.,~ Judy Watts Tax Examiner II Inheritance Tax Division Dear Sir: The Department issues this waiver for the following security held in beneficiary format by the decedent. The security will be subject to Pennsylvania inheritance tax. The Department will issue. an information notice to the transferee of the potential Pennsylvania Inheritance tax due for this asset. A copy of this waiver is to be used by you to notify the transfer agent that the reporting requirements of Section 6411 of the Probate Estates and Fiduciaries Code (Title 20, Chapter 64, Pen onso r ,have been satisfied. Aflame of Company: Type of Account: ID Number: Account Balance: Depattment of Revenue I PO Box 2806011 Harrisburg, PA 17128 1717.787.8327 I Ivww.revenue.state.pa.us Free Checking Account Statement PNC 11at,k For the porlod 12l30M010 to 01/27/2011 002507 CAROL L ANDERSON • +°` 5225 WILSON LN APT 304 MECHANICSBURO PA 17055-6663 Check Card/Bankcard POS PIN tmnsadlons 0 Para aervfclo en espaRol, 1.866-HOLA-PNC MoWn51 Please contact us at 1-888-PNC-BANK ~ WAta to: Customer Service PO Box 609 Pittsburgh PA 15230-9738 Visit us at pna.com ® TDD terminal: l-800.531-1640 Pot lrras'big impvbed cloaca only Free Checking Account Summary Carol LAnderson Account number: 50-05795328 Overdraft Protection Provided By: Contact PNC to sotnblbh Ctrerdreft Protection Balance Summary Beglnnlnq Deposits and Checks end other Ending balance other atltlitlons deductions balance 8,38b.39 2,105.00 7,050.1fl 3,440.15 Avsmge monthly Charges balance and lees s,a29.oo 00 Transaction Summary Checks Paid/ withdrawals 9 Total ATM tmrtsacllons Y Check Card POS signed lmnsamlom t) PNG Bank ATM transactions 2 Other Bank ATM tmnsadlon5 0 °'` PNCBANK Primary aecount number: 50-0579-9328 Page 7 of 3 Number o} enclosures: 0 I For 24hour banking, and trnnsadion or " interest rate information, sign on to PNC Bank Online Banking at pnc.com. 'a' For customer service call i-BBB-PNC-BANK Monday - Friday: 7 AM - 10 PM ET Saturday & Sunday: B AM -5 PM ET Activity Detail Deposits and Other Additions Dale Amount Drscripclon 07/09 1,27Fi.00 nirect ncposit • $nf. Scr, US'1'reasut3~ SI2 XXXXX9354n ul/09 810.97 Direct Deposit -Payment Unisys (:otpol3ti Uni01 MdcanON9N4 Ol/09 18.69 nirect Drposit • Payment. lbt)sys Cnrprnmtl Uni62Mdcuu0N9N4 Cheaka and Sutrstituta Checks Check Dale Retamnce number Amount paid number 40fl 64,00 U1,i04 Dabeg75ai1 ~ihere were 3 Deposits and Other Additions rtotaling $2,105.00. Check Date number Amount paid 410 * 8(1.00 O] f20 PN DMLT01-JOB49041-NAO-N NNN NN-002-004201 Refemnca number gR5tu 5daq S Free Checking Account Statement For t!w period 1219 0/2 0 7 0 b O7/27/2017 for 24-hour Information, sign on to PNC Bank Online Banking CAROL L )kNDERSON on pn¢com, Primary axount number: 50-0579-9328 Account number: 5g-(1579-982ES • continued Page 2 of 3 • Gap in check sequence There wore 2 checks listed totaling $740.00. BankinglCheck Card Withdrawals and Purchases Thsre were 2 Banking Machine withdrawals Date Amount Description totaling $000.00. iX/90 500.00 ATM W ithdrowal ~i`LflS Simpson Deny Mechunie.sbnr PA Ol/06 4tW.00 ATTvf Witbc3rnsal 5225 Mechanicsbur PA Online and Electronic Banking Deductions Date Amoent Description 01/14 6,001.18 (w»poratr. ACH (ash CRci) Rebury C.nnun 162 H10 Daily Balance Detail Dale Balance Oate Balance 1`2/90 7,885.93 07/04 9,!)yfi.a!1 01/03 9190.39 Ol /06 9,fi2fi.99 There was t Online or Electronic Banking Dsduction totaling $8,007,78. Date Bala~nce'~"'^\ 01/74 3 rtyq r l 01/20 9,44q.1'r~- rcuva. ~ Mdl \ I ' ` J N ~. Q5 O ~K N '~ T O 0 p1 N ~ CiC v ~ ~ G _ pCAff_ W ~ N to ma ~ N x ~ '00 zo D " a. ~~m Y' y °~ O ~ ~ u ~~ do `' ''~ S~IdE~ ~ m k~~ ....~ L h =fit i~r Ot d3S Z: J. ...~,.,~,„...,..,,e I f... ~~~~n.~'