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HomeMy WebLinkAbout11-09-12 (2)J g 1505611188 REV-1500 Ex(oz-n)IFII '{A7 OFFICIAL USE ONLY Pennsylvania PA Department of Revenue "18*'"°""'"""" County Cotle Vear File Number Bureau of lndivitlual Taxes INHERITANCE TAX RETURN PoBOxzeoeot 21 12 0643 Harrisburg, PA 1]128-0801 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Binh MMDDYYYY 24 2012 OS 28 1934 Decedent's Las[ Name Gardner (If Applicable) Enter Surviving Spouse's Information Below Suffix Decedent's Frst Name Beryl MI Spouse's Last Name Suffix Spouse's Rrst Name MI Gardner Elizabeth S Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 058 30 0404 REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Retum D 2. Supplemernal Retum D 3. l3emainder Retum (Date of Death Prior to 12-13-82) D 4. Limited Estate D 4a. Future Irnerest Compromise (date of O 5. Iederal Estate Tax Return Required death after 12-12-t32) ~ 6. Decedent Died Tes[ate O 7. Decedem Mairnained a Living Tmst 8. Total Number of Safe Deposit Boxes (Attach Copy of Wilq (Attach Copy of Trust) O 9. Litigation Proceeds Recf:ived D 10. Spousal Poverty Credit (Date of Death O 11. I?lection to Tax under Sec. 9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT -This sec on must be completed. All Correspondence antl Confldentlal Tax Inhrrmatlon Should be Directed to: Narne DaNime Telephone Number Elyse E• Rogers, Esquire 717 612 X801 ~~= G 'u Rrst Line of Address Saidis, Sullivan 8 Rogers Second Line of Address 635 North 12th Street City or Post Office Lemoyne correspondent's a-man addrl~s: erogers(WSSr-aaorneys.com Under penalties of perjury, I declare tAta[ I have exam inetl this return, includ ing accompanying sc hetlu las an tl statements, and to the best of my knowled ge and belief, it is true, correct and complete. Dec l~ration of the preparer other than personal representative is based on all information of which preparer hoe any knowledge. Side 1 1505611188 1505611188 State ZIP Code PA 17043 SJ l;; ' "p~ ~n `'._. 1 r C/: tp C'~-. CX_ 'V Oc_: .u. ~= n..l nr W CJ DATE FILED ~7 .-x~-r r ~ C: i <.~ `r_J '- ~, =c~ . n-, t~ '~ J ~~ YLCXAL VJC VrlllxlrvNl rVr11Yl VrvL1 Rev-1500 IX (FI) Decedent's Name: B e r~/ 1 C G a r d n e r RECAPITULATION 15D5611288 1. Real Estate (Schedule A) ......................................... 1. 2. Stocks and Bonds (Schedule B)......••~~~~~••~~~~~~~~~~~~~~~~~~~~~ 2. 3. Closely Held Corporatioh, Partnership or Sole-Proprietorship (Schedule C) ...... 3. 4. Mortgages and Notes RAceivable (Schedule D) ......................... 4. 5. Cash, Bank Deposits ar{d Miscellaneous Personal Property (Schedule E) ....... 5. 6. Jointly Owned Property(Schedule F) l~ Separate Billing Requested ...... 6. 7. Irner-Vivos Transfers & (Miscellaneous Non-Probate Property (Schedule G) D Separate Billing Requested ...... 7. 8. Total Gross Assets (to~al Lines 1 through 7) ............................ 8. D•DO 363,886.29 O•DO O.OD 58,617.85 O•DD 195,334.11 617,838.25 9. Funeral Expenses and Administrative Costs (Schedule H) .................. 9. 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ............. 10 11. Total Deduedons (totah Lines 9 and 10) .............................. 11 12. Net Value of Estate (Like 8 minus Line 11) ................. • .......... • 12. 13, Chartable and GovemrneMal Bequests/Sec 9113 Trusts for which an election to tax has n'~t been made (Schedule J) ....................... 13. 1a. Net Value Subject to lax (Line 12 minus Line 13) ....................... 14. D•DD O•DO D•DD 617,838.25 O•DD 617,838.25 NSTRUCTIONS FOR APPLICABLE RATES TAX CALCULATION - SEE 15. I Amount of Line 14 taxa le at the spousal tax rate, or 1 116 transfers under Sec. 91 ' 617 838.25 (a)(t2)X.o0 .. , 1s. 16. Anwunt of Line 14 taxable D • D D at lineal rate X .045 16. 17. Amount of Line 14 taxable ' D • D D at sibling rate X .12 17. 18. Anwunt of Line 14 taxable D • D D at collateral rate X .15 ~ 18. 19. TAX DUE ...................... ............................. . 19. 20. FILL IN THE OVAL IF ~'OU ARE REQUESTING A REFUND OF AN OVERPAYMENT side 2 15D56111288 Deceden's Social Security Number 15D5611288 D•DO D•DD D•DD D•DD D•OD 0 Rev-1500 IX (FI) Page 3 IlnruAnnYc Cmm~lofP OrlffrAC4[ Flle Number 21 12 0643 DECEDENTS NAME Beryl C. Gardner STREET ADDRESS 37 Kitszell Drive CITY STATE ZIP Carlisle PA 17015 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Paymerns A. Prior Paymerns 0.00 B. Discourn 0.00 Total Credits (A + B) 3. Irnerest a. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. FIII In oval on Page 2, Line 201to request a refund. 5. It Line 1 + Line 3 is greater than) Line 2, enter the difference. This is the TAX DUE. (1) 0.00 c2> o.oo (3) 0.00 (4) (s> 0.00 (Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did tlecedern make ~ transfer and: Yes No a. retain the use or in c~ome of the property transferred .................................... . ^ b. retain the right to besignate who shall use the property transferred or its income ............... . ^ c. retain a reversiona ry interest .................................................. . ^ d. receive the promi se for life of either paymerns, benefits or care? .......................... . Q 2. If death occurred aft r Dec. 12, 1982, did decedent transfer property whhin one year of death without ree ving adequate consideration? ...................................... . ^ 3. Did decedent own ar h "in tmst for' orpayable-upon-death bank account or security at his or her death? . . ^ 4. Did decedent own ar h individual retirement account, annuity or other non-probate property, which contains a ben eficiary designation? ............................................ . ® ^ IF THE ANSWER TO ANY OF THE ~4BOVE 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, 194 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 peroern [72 P.S. sect. 9116(a)(1.1) i)]. For dates of death on or after Jan. 1, 1 ~95, 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. Sect. 9116(al(1.1 )(ii)]. The statue does not exempt a transfer to a surviving spouse from tax, and the statutory requiremerns 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, 2 0: • The tax rate imposed on the net vat a of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parern, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. Sect. 9118(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. sect. s11s(a)(1p. • 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. Sect. 9116(a)(1.3)]. A sibling is defined under Section 9102, as n individual who has at leas[ one parent in common with the decedent, whether by blootl or adoption. REV -1503 E%t (0-~33) SCHEDULE B COMMONW EALTH OF PENNSYLVANIA STOCKS & BONDS INH ERITANCE TA% RETURN RESID ENT DECEDENT ESTATE OF FILE NUMBER Beryl C. Gardner 21 12 0643 All probertY lolnUy-owned wBh 10 Allegheny County PA Indl Dev 5% Interest on above bond accrued as of decedent's death DESCRIPTION _ 1 Advisors Disc Mfr UT 469 NavellierlDial Income 2 Advisors Disc 1rr UT 510 Corp Tr NavellierlDial Hich Income Opportunity 3 Advisors Disc ~"r UT 642 Advisors CP Tr Navellier Dial High Income Opportunity 4 Advisors Disciplined Trust ADT 493 Advisors Corp Tr Strat Ser 6 5 Advisors Disciplined Trust UT 608 Act Navel/Dial High Income Opportunity PT 25 6 Blackrock Stra~egic Income Oppty Port Inv A 7 Pimco Inv Gra~e Corp Bd CI D 8 Pimco Short T~rm Fund CI D 9 Pimco Unconstrained Tax Managed Bond D 11 Bucks Cnty Ph1 Wtr &Swr Auth 4.75% Interest on abolI ve bond accrued as of decedent's death 12 Cheltenham TWp PA Sch Dist 3.45% Interest on 13 East Stroul Interest on ab 14 Hempfield PA Interest on ab 15 Lancaster PA Interest on ab Total from col bond accrued as of decedent's death PA Area Sch Dist 5% bond accrued as of decedent's death I Dist Lancaster County 3.5% bond accrued as of decedent's death a Swr Auth 5% bond accrued as of decedent's death cation Schedule(s) 9,647.50 10, 061.80 9,663.80 10,358.30 9, 721.40 14,662.50 10,631.90 20,957.09 25,769.62 10,289.00 198.61 10,886.50 149.10 10,548.00 165.79 10,811.50 31.94 10,495.00 154.58 10,281.50 240.28 178,160.58 TOTAL (Also erner on line 2, Recapitulation) I 363,886.29 (It more space is needed, insert additional sheets of the same size) Page 2 Estate of: Beryl C. Gardner 21 12 0643 Schedule B -Stocks and Bonds Item Value at Date Number Description of Death 16 Northeastern `York PA Sch Dist 5% 10,773.00 Interest on ab¢ve bond accrued as of decedent's death 240.28 17 Pennsylvania convention Center 6% 25,026.00 Interest on ab~ ve bond accrued as of decedent's death 76.67 18 II Pennsylvania I $t for Future Issues 4.25% due 3/1/25 10,635.00 ~ Interest on ab ve bond accrued as of decedent's death 103.75 19 Pennsylvania ~t for Future Issues 4.5% due 1/1/24 10,625.50 Interest on ab~ ve bond accrued as of decedent's death 27.15 20 Pennsylvania ~t Higher Edl 5% 10,088.00 Interest on ab~ ve bond accrued as of decedent's death 137.50 21 Pennsylvania LL pt Tpk 5% 10,753.50 Interest on ab~ ve bond accrued as of decedent's death 156.94 22 Pennsylvania ~t Univ 4% 5,657.75 Interest on ab~ ve bond accrued as of decedent's death 12.78 23 Philadelphia P b, Water & Waste 5% 11,048.50 Interest on ab ~ve bond accrued as of decedent's death 198.61 24 Port St Lucie f ~LA Lease Rev 5.423% 5,400.50 Interest on ab ~ve bond accrued as of decedent's death 17.32 25 Puerto Rico P ~b Bldg 11,543.50 26 Scranton PA ~ ch Dist 3.904% 5,074.75 Interest on ab ve bond accrued as of decedent's death 93.80 27 Bank of Ameril ~a NA 2% 10,081.50 %merest on ab ~ve bond accrued as of decedent's death 25.75 TOTAL (Carr forward to main schedule) ...... 127,798.05 Page 3 Estate of: Beryl C. Gardner 21 12 0643 Schedule B -Stocks and Bonds Item Value at Date Number Descri tion of Death 28 CIT Bank N A .45% 20,672.60 29 General Elec Qap Corp 5.625% Interest on abcyve bond accrued as of decedent's death 30 Wachovia Cori FLT 2016 Notes due 10/15/16 31 Wells Fargo B$nk VAR 2017 Due 8120117 'TOTAL. (Carr forward to main schedule) ..... . III 5,800.50 111.72 9,228.01 14,549.70 50,362.53 REV-1508 EXai11-10) pennsylvania OEh~P~M, N, pl'NEY.+.NGE INH EFITANCE TA% RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF: FILE NUMBER: Rervl C C,ardner ' 21 12 0643 Inclu a the proceeds of litigation and the date the proceeds were received by the estate. All pr perty )olntly owned with right of survivorship must be disclosed on Schedule F. ITEM '. VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Charles Schw~b Money Market Account 3605-2447 58,617.85 Per Schwab v luation I I IIII~ i i I I i i I i I ~. TOTAL (Also erner on line 5, Recapitulation) 58,617.65 If more space is needed, insert additional sheets of the same size REV-1510 E%108-0g) ~;' pennsylvania R~td pIVAPIMEMOFNIYINJF INH ERITANCE TAX RETURN RI:SID ENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Beryl C. Gardner 21 12 0643 This schstlale must be com leted and tiled if the answarto any of questions lihrough4on page three of the REV-~t5oo is yes. ITEM NUM DESCRIPT INCLUDE NAME OFTRANSF DATE OF TRANSFER. ATTA ON OF PROPERTY REE, RELATIONSHIP TO DECEDENTa HOOPV OF GEED FOR REAL ESTATE DATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST E%CLUSON (IF APPLICABLE) TAXABLE VALUE 1 Mass Mutual Annuity ~IContract Re501021190 195,334.11 100 195,334.11 Owner/Annuitant: D~'cedent Joint Annuitant: Dece ent's surviving spouse, Elizabeth Gardner !, Per 9/5/2012 letter ', i i i i i i i ~I ~I TOTAL (Also enter on Line 7, Recapitulation) 195,334.11 If more space is needed, use additional sheets of paper of the same si~:e. REV -1513 EX+101-/0) r'i~ pennsylvani~ SCHEDULE J if7 ~,,,~N,~E~,~,w.~fRl,t INHERITANCE TAX RETURN BENEFICIARIES RESIOENTDECED ENT ESTATE OF: FILE NUMBER: Beryl C. Gardner 21 12 0643 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NuMeE NAME AND AD RESS OF PERSONS RECEIVING PROPERTY Do Not Ust Trus s OF ESTATE T TAXABLE DISTRIBUTI NS [Include outright spousal distributions, and '~, transfers under Sec. 9116(x)(1.2).] Elizabeth S. Gardn@r Surviving spouse 617,838.25 37 Kitszell Drive Carlisle, PA 17015'. i iil it I I I I ENTEfl DOLLAR AMOUNT FOR^ISTRIBUTIONSBHOWN ABOVE ON LINES I5 TH ROUG H 180E REV-1500 COVER $H EET, AS APPROPRIATE. Tt NON-TAXABLE DISTRI UTIONS: A. SPOUSAL DISTRIB TIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: i I B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: I TOTAL OF PART II - ENTE TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. If more space is needed, use additional sheets of paper of the same size. WILL I~ BERYL C. GARDNER, revoke all my prior wills and codicils and declare this to be my will. Last Expenses. I direct the payment from my estate of t e expenses of my last illness and i'uneral. S COND: Tangible Articles. I A. I bequeath all my articles of personal and household u~e and ornament, including jewelry, clothing, furniture a d furnishings, automobiles and similar tangible property, t gether with all insurance thereon, to my wife, Elizabeth S Gardner, if she survives me. If she does not survive me, I bequeath all such property and insurance to my children wh survive me, to be divided as they may agree or, in the absence of agreement, as the executor may think fair. T IRD: Residue. I devise and bequeath all the rest of my estat real and personal, including any property over which I mayhave power of appointment, to the 'trustee of the Revocable I~1`surance Trust Agreement signed by me earlier today, wherein my ~ife, Elizabeth S. Gardner, is named the trustee, to be added toll and become a part of the principal of the trusts created the$eby. . Taxes. The executor shall pay, from the principal o~ my residuary estate, all estate, :inheritance and other deathtaxes, including interest and pena:Lties thereon, imposed upo~ all property passing under my wil:1. FIFTH: Powers. In addition to a17_ other powers granted to der by law, the executor shall have the following powers to e>ercise without court approval: A. To retain and invest in al]_ forms of property without be rg confined to legal investments anct without regard for the pri~ciple of diversification; B. To borrow money, mortgaginc~ real property and pledging pe~sonal property as security; C. To lease real property without restriction as to time and to repair, alter, improve, exchange or give options with respec~ to real property; ~~ D. To sell real and personal property at public or private ale for cash and/or credit; 'i E. To carry investments in bearer form or in the name of a nominee; F. To distribute hereunder in cash or in kind, or partly i~ each; i G. To compromise claims; ~~, H. To exercise any election or privilege given by the fede~al or other tax laws, including, without limiting the foregoing, ~oinder with my surviving wife in filing income tax returns, co~sent on gift tax returns to have any gift made by her considered ~s made in part by me for gift tax purposes, payment of any port~on of income or gift tax due under such returns, 2 election of the alternate valuation for federal estate tax purposes, al',location of generation skipping transfer tax exemptions, land election to claim deductions for death tax or for income tax pjurposes; and to make or not make equitable adjustment for the exercise or non-exercise of any such election or privilege; I. To compromise and pay death taxes on all interests, p'iresent and future; J. To buy investments at a premium or discount; K. To determine whether any receipt or shall be allocated to principal or income, or partly to each; I L. To join in any corporate action, reorganization or voting trust plan, to deposit securities under agreements ~nd pay assessments, to subscribe for stock and bond privileges,to give proxies, to grant, obtain or exercise options, anc~ generally to exercise all rights of security holders; ', I M. To borrow from and to sell real and personal property to~the trustee of my trust mentioned earlier herein; 'i N. To disclaim all or any part of any interest in any prop~rty which I may have or to which I or my estate may be or becom~ entitled; 3 O. To distribute directly to t:he individual beneficiary',any part of my estate otherwise distributable to a trustee for !that beneficiary if the beneficiary would be entitled to immediate distribution from the trustee. s~XTH: Election of Marital Deduction. The executor may, in herll,sole discretion, elect to have a specific portion or all of the ~arital Trust under the Insurance Trust Agreement signed by m~ earlier today qualify for the federal estate tax marital ded~ction in my estate if such property could qualify by making the election. The executor's decision concerning the election of ''all, part, or none of the federal estate tax marital deduction potentially available to my estate shall be conclusive upon all pa~ties affected by such decision, and she shall not be liable to a~yone for the effects of her decision. In exercising this discretion, I suggest, but do not direct, that the executor consider the benefits and eventual costs of def erring taxation until my wife's death, possible increase or decrease in values during my wife's lifetime, the foreseeable and relative needs of the beneficiiaries, and any other factors that the executor may deem relevant. It is my purpose in so providing that the executor shall have the option of having deducted from my gross estate subject to federal estate tax so much or so little of the marital deducction allowed by the Internal Revenue Code as she may, in her ~ole discretion, deem best. I direct that my will be 4 so interpretied and that the powers herein conferred on her shall be exercised) in conformity with my said purpose. and intention. SEIbENTH: Administration and Interpretation. A. The interests of the beneficiaries in income and principal shall not be subject to anticipation or to voluntary or involuntary alienation as long as they are in the hands of the executor. B. All executors and all beneficiaries not referred to by name are for convenience ref erred to in this will in the feminine singular. II C. I am married to Elizabeth S. Gardner. All references il~n this will to my wife are intended to mean her. I have three ghildren, Beth G. Aucoin, Sharon L. Gardner and Laura G. Leistra.Illil All references in this will to my child or children are intended to mean one or more of them. References to my issue are intended to mean my children and their descendants. D. Any employee benefits payable to the executor shall not b~ liable for or used for the payment: of or lent for the purpose of paying any taxes, liabilities, ciebts or any other claims or charges against my estate. I' E. If my wife and I die simultaneously or under such c it ;shall be tances that the order of our deaths cannot be proven, presumed that my wife survived me. 5 F. No executor shall be required to enter bond in any jurisdiction. G. If a beneficiary or the Trustee of a trust under my Revocable Insurance Trust Agreement mentioned earlier exercises an election or power to withdraw or distribute the whole amount of any trust before that trust has been completely funded, the executor may, if the Trustee approves, make distribution directly to the beneficiary. EI HTH: Appointment of Executors. I name my wife, Elizabeth S. Gardner, as executor of my will. If she shall fail to qualify o~ cease to act, I name my daughter Beth G. Aucoin as executor. I~ she shall fail to qualify or cease to act as 6 executor, I name my daughter Sharon L. Gardner as executor, or, if she shall fail to qualify or cease to act, :C name my daughter Laura G. Lelstra as executor. INf WITNESS WHEREOF, I have hereunto :>et my hand and seal this ~„~C~ day of ~NY~~ 1993. -~~ (SEAL) l~ ii`~~ ~ ' ~ - G, ~9 ~D,ti B=bl Signed, sea ed, published and declared by Beryl. C. Gardner, the testator ab ve named, as and for his will, in t:he presence of us who, at his request, in his presence, and in tYie presence of each other, all eing present at the same time, have: hereunto subscribed ur names as witnesses. II -.~ Address, rn~ ~; ~ e ~ ~ CS f`i ~ ~. i G O ~ p `P C`c ~ ~ ~ /~ i '' ~ Address, I'~ I~ ~I i 7 I STATE OF ~~~~`A' Y~ ~ 0.Y1~ ' / -+- S S . COUNTY OF ~-~! ~ (l 1 \ Wei, Beryl C. Gardner, ~~ ~ `~~ ` ~~F ~ and the testator and the witnesses, V~k-ic~1fl ~. ~r~C~Y\e~~~~~~ , respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersignedauthority that the testator, in they presence and hearing of k~oth witnesses, signed and executed the instrument as his last will, that he signed willingly, that he executed it as his free anc~ voluntary act for the purposes the>rein expressed, that each o~ the witnesses, in the presence anti hearing of the testator anc~ the other witness, signed the wil]_ as witness and that to theibest of our knowledge the testator was at the time eighteen ye~rs of age or older, of sound mind and under no constraint ~r undue influence. ~_`~~ ~ (' ~J _______ ~`~ / l) Bery C. Gardner 1 ~ II ` itnes s i ~ '~ cribed, sworn to and acknowledgec9 before m`e by the above named testator and subscribed and sworn to before me by the above named Ili witnesses this ~, ~~~ day of JeG„l~~ ~~.r , 1993 . i Notary Pu~b1lic 'I (VI y u,7~n n~- ~,S-~-cw~-- ~~,~a rem Q t r~.L-+ I , ~ B GABDNEC.CI F. 1l_/lU!9_ REVOCABLE INSURANCE TRUST AGREEMENT I, ',BERYL C. GARDNER, o£ Rock Hall, Maryland, make this agreement with my wife, ELIZABETH S. GARDNER, who, with any other trustee who hall qualify, is the Trustee in this agreement. FIE~ST: Funding. The Trustee shall collect the proceeds of the life insurance policies listed o:n the annexed schedule, which Z am about to make payable to hear, shall invest and reinvestl~,the same and any other property received by her, shall collect the income and after payment o£ all proper costs and expenses 1, shall pay the net income and the principal as later set forth. SE~I:OND: Marital Trust. If my wife, Elizabeth S. Gardner, sur~rives me, the Trustee shall hold as a separate trust, called the Marital Trust, a share of the principal received by the Trustee,lwhich share shall be calculated as directed later in this agreeme~t, to pay the income and principal as follows. A. The Trustee shall pay the income to my wife for her life. ', B. The Trustee shall pay to my wife so much of the principal) as the Trustee may from time to time consider desirable for her health and maintenance in her accustomed manner of giving. 6 GAIPUN bi..ka M, iL Gtl'Y_` C. The Trustee shall pay to my ~Nife the entire principal if 'its current value shall not exceed $100,000. and if the Trustee slhall determine such payment to be i:n her best interest and shall determine that it is too small for effective administratign. !-~`~ ~~,~~~~~"~' ~' D. ' The Trustee shall pay to my wife so much of ~ .~ ~ t •,i Ac,.i i ~? _ the principals as she may from time to time request by written notice to th~ Trustee, but not exceeding for any calendar year $5,OD0. or fijve percent of the value of the principal of the Marital Trust{ at the end of such year, whichever is larger. Each such notice ~ust be received by the Trustee by the end of the year for which payment is requested. Payments for a calendar year shall b@ completed not more than thirty days after the end of the year.' E. Upon my wife's death, the Trustee shall pay from the pri~hcipal the amount, if any, by which all death taxes and administration expenses payable with respect. to her death shall be increased by reason of the inclusion in her estate, for the purposes~'~,of such taxes and expenses, of any part of the principal of'this Trust, such payment to be made upon certification by her personal representative of the sum due. F. Upon my wife's death, subjects to any payments required by nth( preceding paragraph, the Trustee shall add the 2 BG AHUN hf:.ti~H IULU/Y_ balance of principal to the Non-marital Trust, to be held and distributed as if originally a part of it. THIRD: Non-marital Trust. The Trustee shall hold all property other than that held under the provisions of the Marital Trust as a separate trust, called the Non-marital Trust, to pay the income and principal as follows. A. If my wife survives me, 1. The Trustee shall pay the income to her for her lifej; 2. The Trustee shall pay t.o her so much of the principalR as the Trustee may from time to time consider desirable fob her health and maintenance in her accustomed manner of living, blot only after exhaustion of the Marital Trust; 3. The Trustee shall pay t.o her the entire principal if'its current value shall not exceed $100,000. and if the Trustee !shall determine such payment to be i.n her and her estate's beslt interest and shall determine that it is too small for effectivie administration; ~~ ~4y? After exhaustion of the Marital Trust, ~~,~~~'~ the Trusteelshall pay to her so much of the principal as she may from time to time request by written notice to t:he Trustee, but not exceeding for any calendar year $5,000. or rive percent of the value of, the principal of the Non-marital Trust at the end of such year, v~hichever is larger. Each such notice must be 3 6GARDNER.RTH 12/28/93 received by the Trustee by the end of the year for which payment is requested. Payments for a calendar year shall be completed not more than thirty days after the end of the year; 5. The Trustee shall pay to her so much of the principal as she may from time to time request by written notice to th~ Trustee, but not exceeding an amount which, if a part of her state for federal estate tax purposes, assuming her death at the ',time of such request, would cause her estate to pay federal estate tax or increased federal estate tax. For the purpose of this paragraph, the Trustee may accept as accurate the statement of,her assets and liabilities which shall accompany such requests shall assume administration expenses in her estate of ten perce~t of her gross testamentary estate, and shall not take. into consideration any marital deduction or charitable deduction wh~ch might be claimed in determining federal estate tax in her estate. B. shall not survive principal in~o as mine'then lij~ing, issue then living issue then l~ving this paragra~h to Upon my wife's death, or upon my death if she me, the Trustee shall divide the balance of many equal parts as there are (1) children of (2) children of mine then deceased leaving and (3) children of mine them deceased without who have exercised their powers given later in direct the payment of their trusts after their 4 BGpRDNEE.P.Tk 12/28/97 deaths, and slhall hold each of such parts as a separate trust as follows. 1. The Trustee shall pay to each child the income from her trust as long as any part of the income or principal regains undistributed. 2. The Trustee shall pay to each child, or apply for he1~ benefit, so much of the principal of her trust as the Trustee ~ay from time to time consider desirable for her education an~ health and for her maintenance in his accustomed manner of living. 3. The Trustee shall pay to each child so much of the principal of her trust as she may from time to time request by written notice to the Trustee. 4. The Trustee shall pay to each child the entire principal of her trust if its value shall not exceed $50,000. and ', if the Trustee shall determine such payment to be in her best int~rest and shall determine that it is too small for effective adl~inistration. 5. After the death of each child before final distribution of the principal of her trust, the Trustee shall pay th~ balance of principal to such one or more of my issue (not including such child) and the spouses of any of my issue (inclining the surviving spouse of such child or of any other issue ~f mine), the interest of any spouse. being limited to 5 BuARDNEf..R7 C, 12/28/43 income, in swch proportions, in such manner and for such estates as the child shall at any time before or after my and my wife's deaths appoint by specific reference in his will to this power; and in default of such appointment, or to the extent that it shall be ineffectual, ', a. If there is any issue of the child then living,~lthe Trustee shall pay the balance of principal to her then liv'}ng issue, per stirpes; or, b. If there is no issue of the child then living,~ithe Trustee shall pay the balance of principal to my then living ~ssue, per stirpes; Pr~vided, however, that any part payable to any person for whom at ikhat time the Trustee is holding a part of this Non- marital Trus$ shall be added to that part for administration and distribution+ 6. The Trustee shall pay the principal of each trust f~r the issue of a deceased child of mine to such issue, per si~irpes. FOIRTH: Disclaimer. If my wife survives me, but she or her personal representative or other qualified person disclaims an~ portion of the Marital Trust, the disclaimed portion shall pass to the Non-marital Trust to be held and distributed ~n accordance with its provisions (as if my wife were living for a~ long as she actually lives). 6 B GARDNER.P.1k 12i 2II/93 FIFTH: Youth Trust. Principal payable to any beneficiary, 'other than a child of mine, who has not reached the age of twenty-one years (hereinafter called a "Youth") shall be held by the Trustee. As much of it and of the income from it as the Trustee ~ay from time to time consider desirable for the Youth's eduction, health and maintenance shall be paid to her parent or gu~rdian, to the person with whom she resides or to her if permittedby law, or shall be applied directly for such purposes. Ar}y income not so paid or applied shall be accumulated and added tol!iprincipal. The unexpended principal and income shall be paid to her upon her reaching the age of twenty-one years or, upon her earlier death, directly to those persons related by brood or adoption to me who would be entitled to her estate under and in the proportions among such persons provided by, the inte~tate law of the Commonwealth of Pennsylvania in effect at the date of this agreement if it were effective upon her death anc~ if the persons so related to me were the only persons so e~titled; provided, however, that any principal and income payable to any person for whom at that time the Trustee is holding a pat of the Non-marital Trust shall be added to that part for adm'~nistration and distribution. SIXTH: Marital Trust Technical Provisions. A. The Marital Trust shall be composed of a Fractional share, if any, of the principal received by the 7 BGARD N:iR.RTP. 12/28/93 Trustee. The denominator of that fraction shall. be the value of the principal received by the Trustee. The numerator shall be the minimum amount which, when added to the net value of all other assets which shall qualify for the marital deduction for federal estate tax purposes, will, after taking into account all credits and ¢ther deductions claimed by and allowed to my estate for federal estate tax purposes (but only to the. extent that the amount, if any, of all death taxes will not be increased thereby), result in no federal estate tax, or if that is not possible, the smallest amount of federal estate tax possible. B. In making the computations necessary to determine the fractional share of principal comprising the Marital Trust, 1. The net value of all assets, after deducting encumbrances, as finally determined fos federal estate tax purposes shall control; and 2. It shall be assumed that my personal representative will elect to qualify the Marital Trust for the federal esta~e tax marital deduction to the greatest extent possible, whither or not she so elects. C. In allocating assets held under this agreement to',the Marital Trust, 8 BGARDN ER .P.ik 12i 28/93 1. That Trust shall be neither favored nor disfavored, ahd the fair market value at the timE=_ of allocation of each such asset shall control; 2. Any fluctuation in the value of such assets pending such allocation shall be equitably and ratably apportioned; and 3. That Trust shall consist solely of property which would qualify for the federal estate tax marital deduction if ,the deduction were elected. D. My personal representative m<3y, in her sole discretion, ellect to have a specific portion or all of the Marital Trusty qualify for the federal estate tax marital deduction in ~y estate if such property could qualify by making the election., Any portion of the Marital Trust as to which such election is made and the remaining portion of then Marital Trust may be held als separate trusts for purposes of administration, investment anld distribution if the Trustee, in hf=_r sole discretion, ei,lects to do so. E. It is my purpose in creating the Marital Trust that my', personal representative shall have the option of having deductled from my gross estate subject to federal estate tax so much olr so little of the marital deduction allowed by the Internal Reveinue Code as she may, in her sole discretion, deem best. It is 7ny intention that it shall produce 7°or my wife 9 BGARDNEF..RTP 1Z/28/93 during her lifetime such income as is consistent with the value and preservation of the principal. I direct that. this agreement shall be so imterpreted and that the powers herein conferred on the Trustee shall be exercised in conformity with. my said purpose and intention; F. The Marital Trust shall be composed of such assets as sha d be appropriate to carry out my said purpose and intention. I~ the principal shall at any time consist of property whic~ is not likely to become income producing during my wife's life, the may by written instrument lodged with the Trustee compel her to render the trust productive in such manner as the Trusted shall consider advisable, consistent with my said purpose and intention. SEV~NTH: Early Termination. Irrespective of any other part of this agreement, every trust hereunder shall terminate not later than one day before the limit, if any, imposed by the applicable statute or rule of law requiring vesting of ownership and limiting the duration of trusts, commonly known as the Rule Against Perpetuities. Upon such termination, the: Trustee shall pay the balance of principal and income to the persons then entitled to receive income, in proportion to their income interests. 10 BGARDNEf:.RTk i2/Z8!9 EIGHTH: Additions to Trust. Any person may from time to time, by deed, will or otherwise, add to the :principal of this trust if the Trustee approves. NINTH: Amendment and Revocation. I reserve the rights to re~oke and amend this agreement in whole or in part, at any time and 'from time to time, by written instrument, other than a will, signed by me and lodged with the Trustee. TENTH: Taxes. To the extent that estate, inheritance dnd other death taxes have not been :paid from my testamentary estate pursuant to a direction in m:y will, the Trustee shah pay, first from the principal of t:he Non-marital Trust and th$n, to the extent that the Non-marital Trust is insufficient,, from that portion, if any, of the ;principal of the Marital Trust which shall not have qualified for the federal estate tax marital deduction, all such taxes, including interest and penalties, imposed upon all property comprising my gross estate for death tax purposes. EL~VENTH: Insurance Policies. With respect to all insurance policies payable to the Trustee hereunder: A. The Trustee shall be under no obligation to pay premiums 'or charges; B. I reserve all rights, option's and powers granted to m~ as the insured, including but not limited to the rights to: ', 11 BGARDN E6.RTh 12i 2~/9S 1. change beneficiaries, 2. borrow thereon, 3. surrender the same, and 4. receive dividends, the cash value and all other sums payable to the insured; C. No issuing company shall be responsible to see to the performance of the trusts under this agreement; D. After my death, the Trustee may exercise all rights, options and powers granted by the issuing company, may settle all d~sputes arising thereunder, and may litigate, but need not lit~gate unless reasonably indemnified. TW~LFTH: Powers. In addition to all other powers granted to her by law, the Trustee shall have the following powers to exercise without court approval: A. To retain and invest in all forms of property (including sock and interests in common trust funds of any corporate trustee or an affiliate or subsidiary of such trustee or of a hold~ng company controlling such trustee) without being confined to legal investments and without regard for the principle of ',diversification; B. To borrow money, mortgaging real property and pledging personal property as security; 12 BGARDN Ek.RTA 12/28/95 C. To lease real property without restriction as to time and to repair, alter, improve, exchange or give options with respect to real property; D. To sell real and personal pr operty at public or private Salle for cash and/or credit; E. To carry investments in bearer form or in the name of a no~inee; F. To distribute hereunder in cash or in kind, or partly ineach at fair market values on the date of distribution;', G. In any division of principal into separate trusts or shajres, and in any distribution of trusts or shares, to allocate to alny trust, share, or beneficiary, property different from the proplerty allocated to another trust, shares, or beneficiary, as the disinterested fiduciary, using fair market values on thel date of division or distribution, deems appropriate; provided, however, that this power :shall not be exercised in ',a manner contrary to any specific a:Llocation of property else here in this instrument or in a manner that renders ineligible al',1 or any part of any gift for any tax deduction; H. To compromise claims; I. To exercise any election or privilege given by the federa'il or other tax laws, including, without limiting the foregoing, election of the alternate valuation for federal estate 13 8GAR0 NER.RTF~, iZ/28/43 tax purposes, allocation of generation skipping transfer tax exemptions, and election to claim deductions for death tax or for income tax purposes; and to make or not make equitable adjustment for the exercise or non-exercise of any such election or privilege; J. To apply principal and income directly for the benefit of any beneficiary entitled thereto by direction of or exercise o~ discretion under this agreement who, in the opinion of the Trustee, may be incapable of properly disbursing the same; K. To compromise and pay death taxes on all interests, present and future; L. To buy investments at a premium or discount; M. To determine whether any receipt or disbursement shall be allocated to principal or :income, or partly to each; N. To join in any corporate action, reorganization or voting trust plan, to deposit :securities under agreements and pay assessments, to subscribe for stock and bond privileges, tp give proxies, to grant, obtain or exercise options, and generally to exercise all rights of security holders; O. To make loans to and buy real and personal property from'', my estate; BGPRDNER. P,Tk i2/28/9~ P. To combine or to divide into separate trusts any or all of'the trusts created herein. Provided, however, that, irrespective of any other part of this agree~ent, so long as the Marital Trust shall continue, she shall note with respect to any portion of it which shall have qualified for~the federal estate tax marital deduction, A. Allocate any receipt or disbursement to principal or ~ncome except as required by law; B. Have the power to borrow money or to mortgage or pledge property; C. Exercise any power conferred upon her herein or by law, except in conformity with the stated purpose and intention in treating such Trust. THIRTEENTH: Administration and Interpretation. A. The interests of the beneficiaries in income and principal', shall not be subject to anticipation or to voluntary or involuntary alienation as long as they are in the hands of the trustee. B. The situs of this trust shall be that state and county which the Trustee shall from time to time select, in her sole discretion. After the Trustee has filed her first account in a court of competent jurisdiction, the situs may not be changed without leave of court. 15 BGARDNE F:.PTF 12/28/43 C. The Trustee and all beneficiaries not referred to by name are for convenience referred to in this agreement in the feminine singular. D. I am married to Elizabeth S. Gardner. All references irr this agreement to my wife are intended to mean her. I have three children, Beth G. Aucoin, Sharon L. Gardner and Laura G. LeiStra. All references in this agreement to my child or children alre intended to mean one or more of them. References to my issue afire intended to mean my children and their descendants. E. In this agreement the words "child," "issue" and words ofl,similar import shall include persons adopted into my line of descent when less than twenty-two years old and their issue (but ndt other persons adopted into my line of descent or their issue)'~and persons related by blood to me even if adopted by other persons. F. In considering the desirability of any discretionary payment of principal, the Trustee may, but is not required to, ',consider the other income, assets and sources of support, to $he extent known to her, of any beneficiary to whom or for whose benefit such payment may be made. G. No trustee who is a beneficiary, or is legally obli~ated to support a beneficiary, shall participate in any power or ', in any discretionary decision from which she or any 16 BGARDN B:.RTA 1L/28/93 person she is legally obligated to support might benefit or relating to her capacity. H. The word "education," as used in this agreement, shall include, but not be limited to, public, private, secondary, college, graduate, vocational, technical and professionaljeducation. I. The corporate trustee shall be entitled to receive compensation for its services in accordance with its standard schedule of compensation in effect from time to time as its services ',are performed. Individual co-trusties serving with the corporate trustee shall be entitled to receive compensation in addition ~o that of the corporate trustee, but the total compensation'Ireceived by all individual co-trustees for a period of service shall equal one-half of the compensation received by the corporate trustee for the same period of service. J. Any employee benefits payable to the Trustee shall not be ',liable for or used for the payment of or lent for the purpose of paying any taxes, liabilities, debts or any other claims or charges against my estate. K. If my wife and I die simultaneously or under such circumstances that the order of our deaths cannot be proven, it shall be presumed that my wife survived me. L. Whenever the Trustee is directed to pay income to or ',for the benefit of one or more persons, without 17 BGARDNEk. RTA i2!2ti,i 9> authority to accumulate income or delay payment, in the absence of any specific direction or persuasive reason for less frequent payment, the Trustee shall pay the income not le:>s often than quarterly; and in no event shall income from the Marital Trust be paid less frequently than annually. M. No trustee shall be required to enter bond in any jurisdiction. N. If a beneficiary or the Trustee exercises any election or power to withdraw or distribute the whole amount of any trust before that trust has been completely j`unded, the Trustee may mike distribution directly to the beneficiary without the formalitylof funding the trust. If assets would be receivable by',the Trustee from sources outside the trusts hereunder, (e',.g. from my executor or from a life insurance company or pe$ision trustee), the Trustee may approve or direct payment directtly to the beneficiary. o_o.lynw~r vVt.r~ FOURTEENTH: Trustees. ~~ d,~~. ~a D.tc `c ~! After my death, Farmers Trust: Bank, of Carlisle, Pennsylvania, shall become a co-trustees when (1) nine months have e~apsed after my death or (2) the Trustee and all beneficiaries',given powers or elections to withdraw or distribute the whole amo)tnt of a trust have given written notice that they do not intendlto exercise that power or election, whichever is earlier. 18 BGARD NEG.R7A 12/28/43 B. If my wife, Elizabeth S. Gardner, shall cease to act as a trustee of any trust hereunder of which none of my daughters is then a trustee, my eldest daughter then willing and able to serve as a trustee shall become eligible so to serve. C. After my death, if none of my daughters is a trustee of the Non-marital Trust, my eldest daughter then willing and able to serve shall become eligible to do so. D. If any of my daughters shall cease to act as a trustee of any trust hereunder, my eldest daughter then willing and able so tq act shall become eligible to do so. E. When any of my daughters becomes eligible to be a trustee hereunder, the corporate trutee (or if none is then serving, any trustee) shall give her written notice of her eligibility. '.Such daughter shall become a trustee upon her filing writteh notice of acceptance with the other trustee or trustees within sixty days after such notice of eligibility. F. At any time, a majority of my wife and children then ',living may, not more often than once in five years, by written notice to the Trustee and all persons then eligible to receive income, discharge the corporate trustee for any reason, including unsatisfactory investment performance, mistakes, lack of attention ~o the trust or its beneficiaries and geographical 19 6GARDNEP..RTA 122G/9 sepa7-ation from the beneficiaries or co-trustees, and appoint another corparate trustee. IN 'WITNESS WHEREOF, I have signed this agreement this ~~~~ day of ~~~/~.~W/t , 1993. Signed, sealed and delivered in the presence of: ~~ :~~ ~, 44 ! ~-~ ~ /: ~'h~-~J~jlr~~ 1~1 ~ L~ rY U ~-, I ,~''~ ` ` v G-~c"~_ (SEAL) Beryl C. Gar ner The Trustee named in the foregoing agreement hereby accepts it arld agrees to its terms. F. Dated: ~°' ~'~ ~' ~-~ _ Elizabeth S. Gardner, Trustee 20 L_ BGARDNE6.R7k 12,'28%93 Schedule of insurance policies referred to in they Revocable Insurance Trutt Agreement of Beryl C. Gardner. Navy Mutual Aid Association No. 38359 B GARDNEf,. RTA 12i 28/9: STATE OF i-'j~~; ,~~ r ~/ I ~ ~~~ SS COUNTY OF i~I~~t On tthis ~~~-h day of J`'CF'''~'~~=r , 1993,, befLOre me, ''_ ~ G 1~ -=~ A ti'•~4-C the subscrabezt, a notary public in and for the G.~~+~+-~+F z-e!„-,~~:~:e~.a, ',personally appeared the above named. Beryl C. Gardner, who 1n due form of law acknowledged the foregoing agreement to lie his act and deed and desired that. the same might be recorded a$ such. WITNJESS my hand and notarial seal the d.ay and year aforesaid. ' Notary Public .(~ e n ~ e -~-E . ~T-h o r,~, ~ S runt ~7~UX ~trJn2.~~cY~ -~~-1 ~u~- Q,L(S{~.cEoJ` ~~ / 9 J~ AIVIENDIvIENT Of REVOCABLE 1NSURAIVCE TRUST AG3ZE'EMENT L BEPnYL C G'ARDhIER, of Carlisle, Pennsyvania, am the Settlor and my wife, ELIZABETI-1~, S. GAPT)NER, is the Trustee of a Revocable insurance Trusi A~neement signed Yly tine on December 39, l 993. Pursuant to the right reserved to me in Article NINTH, 1 hereby amend that trlast agreement in the following manner: ]. Change Para<~raph FOURTEENTH Trustees' A. Substitute Orrstown Banl: ; of Orrstown; Penmsylvania as co-trustee in place of Farmers Trusi Bank of Carlisle, Pennsylvania. IN W~TI~TESS WHEREOF, I have hereunto set my hand and seal this ~ L~~`day of Cia ~_ ~..4~~, I,~002. ~.~ ~_~-. ~' Ir~l~~AL) -zi~~u~ 1, ~- J ! t Bery] C. Gardner /1G-~~------' ~ rl The 7~rust~ aeknowlede 's'receipt of the foregoing amendrneni. i ~ %i i / ~~~ y~ i y~. r.J Date.--------- -~----------- -------- -------T----~------~--------- `Elizabeth S. Gardner CONIIV)ONVJ'EALTI-3 OF PENNSYLVANIA / ~ SS ~~~c;uNTTY OTC/%~a',!J//'/.~_J~ On thje%,~~~day of/~i?'~~1~~~'!?tt02, before me, the unde:rsibmed; a notary public for the Connnonwe~lth of Pennsylvania, personally appeared the above named Bery] C. Gardner, l.~x)vm to me (or satisfactorily proven) to he the person ~nrho sued the foregoing, amendment; who in due f~nn of ]aw ac1:nowledged the amendment to be his act and deed and desired that The san7e might lie recorded as such. ~~ , ~J y~r~-I Notary Public Notarial Seal Olivia A. Reeder, Notary Public Carlisle Uaro, CumberlenC Count}' wry Commission Erpirca Mar. 7. 2005 il~rrldeL PonnsyNana As9oolatlon O11JOtarloB 6ARD N2RE-AM ~, :f l~ D. /OS'!4- AMENDMENT of REVOCABLE INSURANCE TRUBT AGREEMENT I, BERYL C. GAP.DNER, of Carlisle, Pennsylvania, am the Settlor and, my wife, ELIZABETH S. GARDNER, is t_he Trustee of a Revocable Ipsurance Trust Agreement signed by me on December 29, 1993. Pursuant to the right reserved to me in P.rticle NINTH, I hereby amend that trust agreement in the following manner: 1', I revoY,e Paragraph SECOND: D. and substitute the following p'gragraph in its place: "D. The Trustee shall pay to my wife so much of the principal as she may from time to time request by written notice to tie trustee." 21. I revo}:e subparagraph 4. of Paragraph THIRD: A. I~' WITNESS WHEREOF, I have hereunto :aet my hand and seal this '', '~~ ~ day of ~~i~~~~-_J.. , 1997. 1 r ~-~ l it ~~'tiK ( l _-1I~'''~!~ ~~ ( SEAL) Beryl C.J Gardner Wl/t s5: GARDN_`R6. Ah4'.: L;~ [;^/e5'~O- The Trustee ac}_nowledges receipt of 'the foregoing amendment. ,~ ,~ r ~. ~ a i~-c--, '' l~ ~ i..,,/,. /'~ Date : ~ ~~~'; ~ ~ ~ r r i !~.~ % ~~:~ -{ ~ .1 >.!~y_ Ls.: -c. ~~ Elizabeth S. Gardner COMMONY~7EALTH',, OF PENNSYLVANIA SS. COUNTY Or - %I On the~_ day of ~-d;l?t'%~ ~~-' 1997, before me, the ,~~ . undersigned,',a notary public for the Commonwealth of Pennsylvanial, personally appeared the above namE=_d Beryl C. Gardner, }cnoMrn to me (or satisfactorily proven) to be the person who signed tQ7e foregoing amendment, who in due :Form of law acknowledged', the amendment to be his act and deed and desired that. the same might be recorded as such. ~~~ Notary ]public .. IVorariai Seal Bohn L Iv9anganello. Notary Public Carlisle 6oro, Cumberland County ~ IJly Commission Erpires Hprll 1;, 2006 ni. ~~,'~~uci r'r:nm;ylvania kssociation cl IVOtaries EXERCISE OF RIGHT TO Vi~ITHDRAW PRINCIPAL BERM C. GARDNER REVOCABLE INSURANCE TRUST AGREEMENT DATED DECEMBER 29, 1993 AS AMENDED BY AMENDMENTS DATED APRIL 12, 1997 AND DECEMBER 12, 2002 Exercise of Right to «%ithdraw Principal made this w~ _ day of ~ ~i„- ~ ~ , 2012, by Elizabelth S. Gardner. Backsrouhd: WHEREAS, Beryl C. Gardner created a P~evocable Insurance Trust Agreement by Agreement of Trust dated December 29, 1993; ViTHEREP~S, Beryl C. Gardner executed a Last Will and Testament, also dated December', 29, 1993, which provided for the residue of his estate to be paid to the Trustee of the Revocable Insurance Trust; ~~i~HEREFIS, Beryl C. Gardner executed two Amendments to the Revocable Insurance Trust Agreement, one on April 12, 1997 and the other on December 12, 2002; WHEREfiS, Beryl C. Gardner died March 24, 2012; WHEREE'~S, all o1'the assets controlled by the Last Will and Testament of Beryl C. Gardner which were made payable to the Revocable Insurance Trust Agreement: are do lie allocated; pursuant to the funding language set forth in the Revocable Insur~,ance Trust Agreement, to the Non-Marital Trust, which is to be administer°ed pursuant to Article THIRD of the Revocable Insurance T1°ust Agreement; Z~'HEREAS, pursuani to the provisions of Article THIRD A.5., Elizabeth S. Gardner sha- have the right to withdraw all of the assets of the Gardner Non- Mari~al Trust. NOS' THEREFORE, intending to be legally bound: 1. Elizabeth S. Gardner does hereby exercise her right to v~~ithdraw all principal from the Gardner Non-Marital Trust; pursuant to th.e power granted her in Article THIP~b A.5 of the Revocable Insurance Trust Agreement. 2. Elizabeth S. Gardner does hereby certify that as of the date of this docwnent, the ajmount which she is withdrawing from the Gardner Non-Marital Trust, v~~hen aggregated with her remaining assets, will not cause her estate to pay federal estate tax or an increased federal estate tax. 3. Elilzabeth S. Gardner, who, as of the date of this document, is the sole Trustee of the Gardner Non-Marital Trust, consents and agrees to the termination of the Gardner ion-Marital Trust. IN WITNi'ESS VirHEREOF, Elizabeth S. Gardner has set her hand and seal the date and year first above written. Vi'itnes~ / ~'; Eliza~}aeth S. Gardner COMMONWEALTH OF PENNSIL~ANIA COUNT7' OF ~.~-I--a~~~~--0~ On this, the ~3`~'' da3~ of "^'~ """`~""" , 2012, before me the undersigned officer, personal]- appeared ELIZABETH S. GARDNER, known to me to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same foi° the purposes therein contained. In witness whereof, I hereunto set my hand and official seals. d Not }~ Public COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL CYNTHIA J RULE, Notary Public Borough of Lemoyne, Cumberland County My Commission Expires February 3, 2018 ~ ' ~ ~ w 0 0 ~ 0 m 0 ~, 0 ~ 0 o _ ~, ~ ~ ~; ~ m ~ N QJ ~ Q N O t0 M ~ ~` '. ~ Q~ O O~ ~A. O '1 Oi W O _ (C .` ~ y~ # +~ M J U ~, ~ N ~ Q) W O' ' z ~ d in W N M m m V ti m m ® .. ' d' a v U ` 1~ ~ o ~ m N r N o . ~ V a m o rn o ~ J N > w ~ ti w PJ; Y C' vi O f LL ~. v. ~- 7 w 07 ~ rl rJ rl ~ i ^+ ~ p~ 'I m O o 0 0 0 0 O '1~~ ~ d 0 W N m o ti 0 © ~ e~ {L # ! 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W "'' ~ a r~+ 2 Q p r p f W Z Z p O ., LL ` N ~ Q W -..,,,, W '~ U N ~ O Q ¢ ~ p > a ~. ~~ ~~ ti~ ~^ ~rv ~ v. u v N u M ~~ d 6 -i 7 ~ f LL "a m N N ar. 0 0 H~- 0 /i X C . ~ C ' ^ ~ C u : "' Z W ~ y ', : `¢ U j 0 ~ w > ', Ul F- ~ Z ~ O V Z C a ~~ d ~n w o x ~ 'A E ~:~ uTi I'a 6 N 'G ~ iry 7 Irv {J i~ v,o a >'',~ L ~ J Y I Q Ui F- N ~ (n z # i ~P n a v O LL Q K V m n Z O C- N u. 0 0 ti i 0 w m of N 0 tR 0 to G m ~ ~ w _ ~ ~ a '" O ~ a' ~ a U_ n ~ /1 = O Z ~ LL O O ~ ¢ } Z ~o0 w 3w = a o> o ~ ~~ acs v i~ ino x x Q U N Q n 0 G ID m N 0 Z F Y z 'w Z O z m N l` N N m m N N m O Z O m =. £ n = e of ~_ e 2 _° ~ '_ d a m ti cc '~ c c a r ~ m a a am W ~ W z Y J ~ c m ~ ~ Q z ~ ~ v ~ ~ R .~ z c C ~ J O y = U ~ U w ry Q m = C ~~ v ` ry y - ti m m w Q N a, ~ C u ~ _ m -s i .~' Massnchusem Ivluwul Lilu Inswunce Com~em and a(I7Laie~ Springrield MA 0111 i-0001 ww,v,utass~rmlunl.coin I-BUOi?R 'OIG MassMutual September ~, 2073 *'*M35E"' SAIDIS, SULLIVAN & ROGERS ATTN: GAYLE D SWINDLER 635 NORTH 12TH STREET STE 400 LEMOYNE PA 17043 Dear Ms. Swind]er: RE: Contract Number(s): RE50 1 021 1 90 Am~uitant: $ery] and Elizabeth Gardner Funds were placed under our Joint and Survivor option to provide a monthly payment of $1,980.13, beginnihrg Aua st 15, 2009 to Beryl and Elizabeth Gardner. According to the tQnns of the contract, payments continued to Mrs. Gardner on May 15, 2012. She will continue to receive monthly installments tlnoughout her lifetime. The commuted value at the time of 1\Qr. Gardner death was $195,334.11. If you have airy questions, please contact me at 1-800-767-1000 ext 21471. Sineea'ely, ,SU~~vt (`l]enr2PJZd Siobhan Demers Associate Claim examiner US1G Policyholddr Services and Claims