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HomeMy WebLinkAbout11-30-12-J REV-1500Ex(°'-'°' PA Department of Revenue penns(y vania Bureau of Individual Taxes oerannrx.or nevraer Po Box.2sosol INI Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death 19 2012 Decedent's Last Name Suffix CULLEY (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Social Security Number 1505610143 OFFICIAL USE ONLY County Cotle Vear File Number TAX RETURN 21 12 0 0 3 0 2 )ECEDENT Date of Birth O1 Ob 1964 Decedent's First Name MI DEBBIE p~ Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® i. Original Reurn ^ 2. Supplemental Retum ^ 4. Limited Estate ^ 4a. Future Interest Compromise (tlete of death after 72-12-a2) ® g Decetlent Died TaNete ^ ~ Dacetlent Mainleinetl a Living Trust (Attach Copy of Wily (Attach Copy of Trust) ^ 9. Litigation Proceeds Received ^ 10. Spousal poverty Cretlit{data of tleath between 1231-91 antl -1-95) ^ 3. Remaintler Retum (date of death prior to 12-13-a2) ^ 5. Federal Estate Tax Return Required 0 e. Total Number of Safe Deposit Boxes ^ 11.Election to tax untler Sec. 8t 13(A) (Attach Sch. 0) ~--> CORRESPONDENT -THIS SECTION MUST BE COMPLETED:~ALL CORRESPONDENCE AND CONFIDENTIAL TAX INF Ot/~T ON SHOITL~" BE Name Daytime p~bne Nur1~r ~ THOMAS P GACKI 717 .~pi~ f~QO~0 ~ First Ifne of address 213 MARKET STREET Second line of address 8TH FLOOR City or Post Office HARRISBURG Correspondent's a-mail address: Under penal8es of cedurv. I declare that i8'R OFAWLLS USE Cpl .1(7 O C O ~ ~. g'1 ~ --i rv ~ rn a cn rn o tV ~t State PA ki@eckertseamans.com ZIP Code 17101 s antl on all DATE FILED preparer TO: ~VCr r Karen C. Culley ~ ~ a2l~ ~~ ADD SS 1 West Sherid Avenue, New Castle, PA' 16105 51 RE OF P R OTHER THAN REPRESENTATIVE GATE Thomas P Gacki I I /Z ~ / ~ `~ n„~R~„ 213 Market Street, Harrisburg, PA 17101 Side 1 L, 1505610143 1505610143 J 1505610243 REV-1500 EX Decetlent's Social Security Number oeoeaeors Name: CULLEY, DEBBIE A. --- _ -__ RECAPITULATION -- - - - - _ --- 1. Real Estate (Schedule A) ................................................................................. ......... 1. 1 6 9, 0 0 0. 0 0 2. Stocks and Bonds (Schedule B) ....................................................................... ........ 2. 1 2, 9 9 5. 5 5 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. 2 4 , 3 3 4 . 0 5 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .......... ... 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested .......... ... 7_ 1 9 , 4 6 8 . 0 3 8. Total Gross Assets (total Lines 1-7) ................................................................ ....... 8. -- 2 2 5, 7 9 7. 6 3 9. Funeral Expenses & Administrative Costs (Schedule H) ................................... ...... 9. _ __ - -_ - - 3 4 , 1 2 5 . 1 5 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ........................... ..... 10. 1 5 , 3 7 5.14 11. Total Deductions (total Lines 9& 10) ............................................................... .......11, 4 9, 5 0 0. 2 9 12. Net Value of Estate (Line 8 minus Line 11) ...................................................... ....... [2. 1 7 6 , 2 9 7 . 3 4 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. 1 7 6 , 2 9 7 . 3 4 - -- -- TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES - _ _ 15. Amount of Line i4 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .00 15. 16. Amount of Line 14 taxable at linealratex .045 174,000.58 16. 7,830.03 17. Amount of Line 14 taxable at sibling rate X .12 2, 2 9 6. 7 6 77. 2 7 5.61 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. Tax Due .............................................................................................................. .....19. 8 , 10 5 . 6 4 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 1505610243 1505610243 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 - 12 - 00302 Culley, Debbie A. STREETADDRESS -- -- --- - 1710 Wyndham Road - ___- - _- - - __ CITY - --------- STATE - iZIP ~- Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments 10,000.00 __ __ -- B. Discount 405.28 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5. If Line i + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (1) 8,105.84 Total Credits (A + B) (2) 10,405.28 (3) 0.00 (a) 2,299.64 (5) 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 :..................... r,: ~ x 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?.......... ~-~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .....................................................................................................................~ ~_i 3. Did decedent own an "in trust for' or payable upon death bank account or security at his or her death?......... J ~x ~ 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 FILE IT AS PART OF THE RETUR ~h 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) tii)]. 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 reiiurn 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 benefciaries is 4.5 percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. • sibingXa defined under Sehctiont9102eas an~ndividtua~who has at least oneepardenttin common withf he d cedet, wh§ethes by)tilood or adoption. COMMONWEALTH OF PENN6YLVANIA INHERITANCE TA% RETNRN RESIDENT DECEDENT SCHEDULE A REAL ESTATE _. --..- c.____ -_ ESTATE OF Culley, Debble A. FILE NUMBER 21 - 12 - 00302 All real property owned solely or as a tenant in common must be reported at fair. market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having sch dulel Fknowledge of the relevant facts. Real property which is jointlyowned with right of survivorship must be disclosed on Attach a copy of the settlement sheet if the roe has been sold. Include a copy of the deed showin decedent's interest if owned as tenant in common. - __._ -__. __.. _ _ _ _ _9 ITEM -- --__ NUMBER DESCRIPTION ~ VALUE AT DATE OF DEATH __ 1 1710 Wyndham Road, Camp Hill, PA--Sale Price 169 000.00 TOTAL (Also enter on Line 1, Recapitulation) I 169,000.00 COMMONN£ALTH OF PENNSYLVANIA INHERITANCE Tq%RENRN RESIDENT DELEOENT __. _. _ -. ESTATE OF Culley, Debbie A. SCHEDULE B STOCKS 8L BONDS FILE NUMBER 21 - 12 - 00302 All property jointly-owned with right of survivorship must be disclosed on Schedule F. _ _ --r -. --- - _ __ _ __ ITEM -_-- - - NUMBER DESCRIPTION - - _- _ -- - -- -- _- -- _ _ - - 1 Edward Jones Brokerage Account -_ UNIT VALUE VALUE AT DATE OF DEATH -_ - _. _ 12,995.55 --- _- _ - TOTAL (Also enter on line 2, Recapitulation) 12 995.55 SCHEDULE E CASH, BANK DEPOSITS, & MISC. `DMM°NWEA~T"°`RE"NSVLVANIA PERSONAL PROPERTY INHERITANCE TPX RETURN ' RESIDENT DECEDENT ESTATE OF CUlley, pebble /~. FILE NUMBER 21 - 12 - 00302 _- __ . _- Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER ___ 1 2 3 4 5 6 7 8 9 10 11 12 13 Final Pay Check Toyota Camry--sale price Miscellaneous personal property Income Tax Refund Verizon Credit State Farm Carlnsurance Refund Credit Card refunds Refund of county taxes at settlement Refund of school taxes at settlement Refund of sewer at settlement Refund of trash at settlement Real estate tax escrow refund Comcast Refund DESCRIPTION __ __ _ -- - TOTAL (Also enter on Line 5, Recapitulation) VALUE AT DATE OF DEATH 10,176.00 7,600.00 2,500.00 2,053.57 9.60 129.58 47.22 212.13 1,285.22 2.39 2.35 307.04 8.95 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDUpL~sE G INTER-VIVOS TRANSFERS C{ RESIDENT DECEDENT __ __ MISC. NON-PROBATE PROPERTY ~_ -- _ _ -- - -- ESTATE OF Culley, Debbie A. __ i FILE NUMBER 21 - 12 - 00302 __ This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. - - _ -_ - ITEM NUMBER DESCRIPTION OFPROPERTV Inclutle the name o(the transferee, their relationship to decatlent ~ DATE OF DEATH VALUE OF ASSET DECDFS EXCLUSION TAXAB LE VALUE . entl the tlale of transfer. Attach a copy o(tha tleetl for real estate _ - - ~ INTEREST (IF APPLICABLE) 1 P __ -- PA State Deferred Com ensation account--Mother K C ll B f --.._ 7,z7z.2a - _ 100% ~- - _ -- 0.00 - - -- 7,272.24 aren U e ene lCa Y rY 2 PA State Deferred Compensation account--Brother 2,296.76 100% 0.00 2 296 76 Scott B. Culley Beneficiary ' , . 3 PSECU Checking 8103947613-S4--Information ssas.o5 100% 0.00 5 989 05 Notice attached--made joint with mother Karen Culley ' , . within one year of death i 4 PSECU Savings 8103947613-S1--Information Notice sso9.9a 100% 0.00 3 909.98 attached--made joint with mother Karen Culley within , one year of death I I _. _- __- _- TOTAL I _ __ _ _ (Also enter on line 7, Recapitulation) 19,468.03 p', ~SpCwF'EDU_E HG~ COMMONWEALTH OF PENNSYLVANIA rM~ ~ ~ ~ `^ INHERITANCE TPX RETURN A11~I1\~QTpI1'RLIC /~/~'TC RESIDENT OECEOENT i ~Y/I~~rw~lrlYlrrYCVWiJ __ _ _ _ _ _ ESTATE OF Culley, Debbie A. FILE NUMBER - 21 - 12 - 00302 Debts of decedent must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION ~ AMOUNT _.-.- _- A. 1 Myers Harner Funeral Home 3,406.00 2 I Urn 258.00 3 Cunningham Funeral Home 816.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions ', Name of Personal Representative(s) Street Address '~ City State Zip Year(s) Commission paid 2. ~, Attorney's Fees Eckert Seamans 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 4. Probate Fees Register of Wills probate fee 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 ,Sharon Newcomer--Car Inspection and battery 3,000.00 377.50 182.00 TOTAL (Also enter on line 9, Recapitulation) 34,125.15 Schedule H Funeral Ems & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ~ ^~ VlJ6Cf RESIDENT DECEDENT _. ESTATE OF Culley, Debbie A. FILE NUMBER -.._ - 21 - 12 - 00302 2 Home Depot--Paint for House , 251.27 3 Home Depot--Paint for House 141 80 4 'Home Depot--Paint for House 18.23 5 Home Depot--Paint for House 32.13 6 PPL 57.32 7 ,Ace Hardware--switch covers i 13.70 8 i Gary Brightbill--Repairs and painting of house ! 1,000.00 9 ,Gary Brightbill--Refinish Hardwood floor 1,000.00 10 Gary Brightbill--painting/electrical work 1,000.00 11 Sears--new stovetop for house ' 352.44 12 Target--lamp shade 26.52 13 UGI--gas bill 114.00 14 Comcast--tv and phone 137.05 15 Comcast--tv and phone 125.06 16 JC Penney--Area Rug for home 32.86 17 PPL 35.88 18 Water Bill 37.53 19 Water Bill 22 92 20 Ritter's Hardware--door bell 39.73 Page 2 of Schedule H St~ied~e HH C r~- ------~ COMMONWEALTH OF PENNSYLVANIA ~ T INHERITANCE TAX RETURN ~ ~C~TB~ RESIDENT DECEDENT ~_ ESTATE OF Culley, Debbie A. FILE NUMBER i 21 - 12 - 00302 21 Bank fee ~ 4.00 22 UGI 114.00 23 PPL 29.92 24 I Grass cutting 125.00 25 UGI 114.00 26 Gary Brightbill--Front door work 247.00 27 'Water 13.79 28 PPL 23.64 29 UGI 82.00 30 Sewer/Refuse 108.95 31 'Water 15.70 32 PPL 24.37 33 Grass Cutting 100.00 34 UGI 82.00 35 Water 18.45 36 PPL 55.66 37 'Grass Cutting 125.00 38 Seller Assist at closing 5,800.00 39 ~ Realtor commission at closing 10,142.00 Page 3 of Schedule H Sdteck~le H Funeral F~er>ses & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TA%RETURN ~y `.~/~~y y Acinlnistr-ativle WO{Sc~orttirttred RESIDENT DECEDENT ESTATE OF Culley, Debbie A. -- _ -- 40 -- _ 'Deed Preparation - -- - - 41 Wire fee at closing 42 Tax certification 43 ;Transfer Tax 44 Electrical Repairs 45 Radon mitigation 46 Home Warranty 47 I Masonry repairs 48 Shingle repairs, repair trim 49 Final Electric 50 'Final Gas 51 Final Water FILE NUMBER ~1 - 12 - 00302 -- _- - -- -- 125.00 20.00 10.00 1,690.00 279.00 850.00 365.00 750.00 105.00 115.17 82.22 30.34 Page 4 of Schedule H i SCHEDULEI DEBTS OF DECEDENT, MORTGAGE COM NRERITANCE TA%RETURNVANIA LIABILITIES, & LIENS RESIDENT pE0E0ENT i __-- ____ __ _ _ __ -_-.. r-._._ -.. - __-- _..._-._ -._.__. FILE NUMBER ESTATE OF Culley, Debbie A. 121 - 12 - 00302 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM NUMBER ___ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Chase Credit Card payment Citibank credit card payment Comcast Bill PPL Bill Mortgage payment due Mortgage payment due Mortgage payment due Mortgage payment due Mortgage payment due UGI Bill First Merit Bank--furnace loan First Merit Bank--furnace loan First Merit Bank--furnace loan First Merit Bank--furnace loan First Merit Bank--furnace loan Welis Fargo--Window loan DESCRIPTION AMOUNT 248.78 400.35 146.68 70.68 703.50 703.50 703.50 703.50 703.50 114.00 100.00 100.00 100.00 100.00 100.00 218.31 _- TOTAL (Also enter on Line 10, Recapitulation) 15,375.14 SCHEDULEI DEBTS OF DECED~+ENpT, MORTGAGE COMMONN£ALTH OF PENNSYLVANIA LIABILITIES ° LIENS INHERITANCE Tq%RETURN ~ ' RESIDENT DECEDENT continued -_ ,._ ESTATE OF cUlley, Debbie A. FILE NUMBER 21 - 12 - 00302 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM --- - - - - NUMBER DESCRIPTION AMOUNT 17 Wells Fargo--Window loan 218.31 18 Card Master services bill 125.08 19 Water Bill 49.24 20 i, Comcast 99.43 21 j PA Revenue Income tax due 8.00 22 Cumberland County local tax due 15.00 23 I QVC final payment due 90.16 24 Cit Card final payment due ' 7.93 25 ~ Lower Allen Township 108.95 26 National Rehab Equipment--saline 5.10 27 Wells Fargo--final payment for Window loan 6,584.42 28 First Merit Bank--pay off of furnace loan 2,847.22 Page 2 of Schedule I REV.1617 E%+111.08) SCHEDULE) COMMONWEALTH OF RENNSVLVANIA INHERITANCE TA% RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF Culley, Debbie A. RELATIONSHIP TO NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT RECEIVING PROPERTY Do NOt Llat Trvatealst I, TAXABLE DISTRIBUTIONS[include outright spousal distributions and transfers under Sec. X116 (a) (1.2)] 1 I Scott B. Culley Brother 1 West Sheridan Avenue New Castle, PA 16105 2 Karen G Culley .Mother 1 West Sheridan Avenue New Castle, PA 16105 3 _l _ _.- -- FILE NUMBER 21 - 12 - 00302 SHARE OF ESTATE AMOUNT OF ESTATE (Words) ~ ($$$) Deferred Compensation Beneficiary Designation 100% residue, joint property, beneficiary designation Enter dollar amounts for distributions shown above on lines i5 through 18 on Rev 1500 cover sheet, as appropriate. II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEgT 0.00 CONFORN~ED COPY WILL OF DEBBIE A. CULLEY I, DEBBIE A. CULLEY, of Cumberland County, Pennsylvania, make this my Last Will, hereby revoking any and all former Wills or Codicils made by me. ARTICLE ONE Payment of Last Expenses I direct my Personal Representative to pay the expenses of my last illness and my funeral expenses as soon as maybe convenient after my death. ARTICLE TWO Tan¢ible Personal Property I give my automobiles, household and personal effects, and other tangible personal property of like nature (not including cash or securities), together with any existing insurance thereon, as I may have provided in a memorandum kept with the original of this Will, or to the extent not so provided, to my mother, KAREN C. CULLEY, provided she is living on the thirty-fu•st (31s`) day after my death. Any such property not so distributed shall be sold and the proceeds added to my residuazy estate and pass under Article Three hereof. ARTICLE THREE Residue Section 1. I give all the residue of my estate remaining after application of Article Two to my mother, KAREN C. CULLEY, provided she survives me by thirty (30) days. If KAREN C. CULLEY does not survive me by thirty (30) days, I give all the residue of my estate to my brother, SCOTT B. CULLEY. Section 2. Ultimate Distribution of Certain Reversions. In the event that any portion of my residue originally distributed by Section 1 of this Article Three reverts to my estate, then such assets should be distributed to such persons who would have been entitled thereto if I had died at that time intestate, unmarried, without children surviving, and domiciled in the Commonwealth of Pennsylvania. ~ rA46106'7.1 ~ ARTICLE FOUR Personal Representative I appoint my mother, KAREN C. CULLEY, as my Personal Representative under this Will. My said Personal Representative, or any successor Personal Representative, shall have the authority, in his or her sole discretion, to appoint another individual or bank as an additional or successor Personal Representative, or to renounce his of her appointment in favor of another individual or a bank. If my above-named Personal Representative is unable or unwilling to act or to continue to act as my Personal Representative under this Will, I appoint my brother, SCOTT B. CULLEY, as successor Personal Representative. In addition to the powers conferred by law, my Personal Representative shall have the following discretionary powers, exercisable without the need to obtain court approval: Section 1. Power to Retain Assets. To retain as part of my estate any property received hereunder, without any duty of diversification. Section 2. Power to Invest. To invest and reinvest the principal of my estate in such stocks, bonds, mortgages, securities or other property, real or personal, without being limited to the classes of securities or investments in which fiduciaries aze by law authorized to invest funds. Section 3. Power to Deal With Assets. To sell, exchange, lease, encumber, option or otherwise dispose of all or any portion of my estate, real or personal in such manner and upon such terms and conditions as aze deemed advisable, and to make, execute and deliver any documents necessary to effectuate any powers herein granted. Section 4. Tax Powers. In connection with the making and filing of all income tax, estate, inheritance and other death tax, gift tax and other tax returns and the paying of such taxes, to make such elections, decisions, concessions and settlements, including extensions of time for the payment of any Federal estate taxes or other taxes due, as may be deemed proper, without liability to any person thereby affected, and without the necessity of making compensating adjustments. Section 5. Power to Distribute in Kind. To make distributions of my estate in cash, in kind, or partly in cash and partly in kind; and to make non-pro rata distributions in kind without consideration of the income tax basis of the assets distributed. Section 6. Advance Distributions. To make advance distributions in an estimated amount to fund the respective Trusts established under my Revocable Trust. Section 7. Allocation of Generation-Skinpine Exemption. I expressly authorize my Personal Representative to allocate, pursuant to Section 2631(a) of the Internal Revenue Code of 1986, as amended, any unused Federal generation-skipping transfer tax exemption which may be available as of the date of my death to any property with respect to -2- which I am the transferor for generation-skipping tax purposes, whether or not such property passes under this Will or otherwise and whether or not such property was transferred during my lifetime or by reason of my death; provided, however, that it is my desire, but not my direction, that my Personal Representative allocate said exemption in the following order of priority: (a) to all direct skips other than any direct skips resulting from a disclaimer; and (b) to property distributed to the Family Trust established under Article Three of my Revocable Trust, unless my Personal Representative shall determine otherwise for good reason. My Personal Representative also shall be authorized to exclude any property with respect to which I am the transferor from any such allocation of such exemption. My Personal Representative shall be authorized to make any election relating to the allocation of such exemption. Any such allocation or election made by my Personal Representative shall be made without the necessity of obtaining court approval and shall be binding on the transferee of any inter vivos generation- skipping transfer I may have made and on all persons interested in my estate or in any trust established or to be established therefrom. Any good faith exercise, partial exercise or failure to exercise the authority granted to my Personal Representative hereunder shall not be subject to complaint or appeal by any party, and I hereby indemnify my Personal Representative against any and all such claims and costs (including attorneys' fees) associated therewith. Section 8. Business Powers. My Personal Representative may carry on any business owned and operated by me or my estate as a sole proprietorship or any business conducted by a limited or general partnership of which I or my estate was a partner for whatever period of time my Personal Representative may deem advisable, and to that end my Personal Representative shall have the power to do any and all things deemed necessary or appropriate, including the power to pay any negative cash flow, the power to incorporate any such business or hold the stock as an investment, the power to bonow and pledge assets held in trust as security for such borrowing, the power to liquidate or sell any such business or such interests therein at public or private sale and at such times and upon such terms as my Personal Representative deems advisable, and the power to employ agents to manage and operate such business without liability for the actions of any such agents, or for any loss, liability, or indebtedness of such business, if the management is selected or retained with reasonable caze. Section 9. Real Estate and Proceeds. I do not wish to have the value of my estate reduced by the forced sale of any real estate which I may own at my death. I therefore authorize my Personal Representative to retain such real estate until such time as it can be sold for its fair mazket value and, if necessary in order to provide funds for the payment of any debts, expenses, estate taxes, inheritance taxes, transfer taxes and other taxes of a similaz nature payable by reason of my death, I authorize my Personal Representative to borrow money and for that purpose to mortgage any such real estate and to execute and deliver all notes, bonds, mortgages, and other instruments and to perform all acts necessary, proper or convenient in connection therewith, any and all such loans and mortgages to be made in the sole discretion of my Personal Representative and For such amounts and upon such terms as my Personal Representative deems proper. I authorize my Personal Representative, without the necessity of petitioning any court for approval or confirmation, to sell at any time all or part of the real estate in my residuary estate to any one or more of my children or their issue for such price and upon such terms and conditions as all of my surviving children may agree. -3- ARTICLE FIVE Waiver of Bond I direct that no Personal Representative or any other fiduciazy named hereunder shall be required to give bond for the faithful performance of duty in any jurisdiction. ARTICLE SIX Source of Payment of Debts Exaenses and Taxes All estate taxes, inheritance taxes, transfer taxes and other taxes of similaz nature, together with any interest and penalties thereon, payable by reason of my death upon the property constituting my gross estate for death tax purposes, whether or not such property passes under this Will, and all debts, costs of administration and other proper expenses, paid by my Personal Representative shall, except to the extent paid by my Trustees, be paid from the principal of my residuary estate passing under Article Three, without reimbursement from or apportionment among the legatees or devisees or persons having a beneficial interest in any such property. Assets sold by my Personal Representative to make payments hereunder shall be selected, to the extent advisable, so as to minimize the recognition by my estate of gain for income tax purposes. My Personal Representative may enter into such agreement to pay all or any part of the death taxes on any future interest as may be deemed appropriate, and such agreement shall be binding upon all parties in interest. ARTICLE SEVEN Interpretation of Will Section 1. SinQUlaz and Plural: Use of Gender. Whenever used herein, the singulaz shall include the plural, the plural the singulaz and the use of any gender shall be applicable to all genders. Section 2. Definition of Child. Children or Issue. Whenever the terms "child," "children" and "issue" are used herein, such terms shall be interpreted to include adopted children, regardless of the date of adoption, with full effect as if they were the natural children of the adopting pazents. Such terms aze also intended to include persons in gestation at any pertinent time under this Will, provided such persons survive birth by thirty (30) days. Section 3. Captions. The captions of articles and sections of this Will aze for convenience of reference only and shall not affect the interpretation of this Will. -4- Section 4. Govemin2 Law. I hereby declare that I am a domiciliary of the Commonwealth of Pennsylvania and that the succession laws and other applicable laws of the Commonwealth of Pennsylvania shall control the interpretation of this Will and the ownership of any other property passing at the time of my death other than under this Will, and that no succession laws of any other nation or state shall have any applicability to this Will or the ownership of any other property passing at the time of my death other than under this Will. IN WITNESS WHEREOF, I have hereunto set my hand and seal to the original of this Will only this ls` day of November, 2011. Witness DEBBIE A. CULLEY i Witness ~ ~ Signed, sealed, published and declazed by the above-named DEBBIE A. CULLEY, as and for said person's Will in the presence of us and each of us, who, at said person's request, in said person's presence and in the presence of each other, have hereunto subscribed our names as witnesses thereto the day and yeaz last above written. ____ ' 1 Residing at Harrisbur . Pennsylvania Residing at Harrisbur ,Pennsylvania -5- ACKNOWLEDGMENT AND AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) SS: COUNTY OF DAUPHIN ) We, DEBBIE A. CULLEY, Thomas P. Gacki, and Kelley M. O'Brien, the Maker of this Will and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Maker signed and executed the instrument as the Maker's Last Will and that the Maker signed willingly, and that the Maker executed it as the Maker's free and voluntary act for [he purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Maker, signed the Will as witnesses and that to the best of their knowledge the Maker was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Witness ~' ~ ~ 3~ ~~ ,; DEBBIE A. CULLEY SUBSCRIBED, sworn to and acknowledged before me by DEBBIE A. CULLEY, the Maker, and subscribed and sworn to before me by Thomas P. Gacki, and Kelley M .O'Brien, witnesses, this ls` day of November, 2011. Notary lic My Commission Expires: COMMONIIyEgLn { ~ PENNSYLVANIA JuOy M' Cstlenheaq Nolary Pubilc CMy of Hanbbury, Dauphin County My Commbabn ExWree June 18, 2013 Member. PennsYNenle Aeeodetion of Notaries -6- A. Settlement Statement (HUD-1) oya AOnyYa Ne zspzozeE ~: i.®FHA 2.^ftH5 3.Q DOOV. Unina 6. File Number: ]. Loan Number: B. hmNpaP lnsunn4 Case NUmbx'. ' 13TH i5d00BdON N61632S3Yt03 ~ d.~VA S.~COnV. Inc. C. Noh: TM1p fdm b Nmklgl b yre YW a aNMnwrX of atl~e laryymem maN Amewdi Psb le aM by IM aetlkmenl mNMa xa aMw6llema maMeO " ly.e el cote Pa! vNfbe IM tloaieq.IMy an aM1wm Mn KK inldmllimal WrpPeea aM an rw1 gtluEN b W INfY, D. Nerve 6 AMreu of BOrtovrer. E. Name 8 Atltlresa of Se6ee F. Nerve 8 AMmas el LeMer Gregory A. Ndx, Brat ~. Pamimw FsuNaOeNUe Ann Cvpel EVerpyiµ 1059 NOnA 0.tlrerlOn Baea, PM Maiba, PA 1!A]C 1116 Wy>~an ROM. Lace Ha. PA IlDti 301 West BaY Slreal. JxSeWVik GL)1A3 G. 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See attached atldendum for additional information Prerlvuz Masons are obsdete pads pia nuo-1 BUREAU OF INDIVIDUAL TAXES PD BOX 290601 HARRISBURG PA 17129-0691 Pennsylvania DEPARTMENT OF REVENUE REY-]Sf6 E% .YFP (%5 -l l) $ 5,989.05 X 50.000 $ 2,994.53 X .045 g 134.75 KAREN C CULLEY 1 W SHERIDAN AVE NEW CASTLE PA 16105-2562 EST. OF DEBBIE A CULLEY ssx zoo-56-0116 DATE OF DEATH o2-19-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SpUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. PSECU provitled the department with the information below, which was used in calculating the inheritance tax due. Records indicate that at the death of the above-named tlecedent, you were a ,l of nt owner/beneficiary of this account. If y0U are the spOUSe Of the deceased and any amount other than zero is reflected below on the Potential Tax Due line, note no tax may be due, but you must notify the department of your relati onshtp to the deceased by checking Box C to PART 1 below and writing "spouse" in PART 2. if you believe the information is incorrect, please obtain wry tten Correction tram the financial institution, attach a copy to this form and return it to the above adtl ress. Please tall 717-7B7-8327 with questions. COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 81 0 3947 6 1 3-14 Date 10-22-2DU1 To ensure proper credit to the account, two Estab 115hed copies of 4his notice oust accospanx account Balance Percent Taxable Amount Subject to Tax Tax Rate PotentSal Tax Due PART CHECK ONE BLOCK ONLY PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 12-0302 ACN 12145324 DATE 08-16-2012 payeent to the Repisier of Wills. Make check pax able to "Register of Wills. Agent". NOTE: If tax vayments era lade within three months of the tleeedent•s date of death, detluct a 5 percent tliscoun4 on the tax due. Airy inheritance tax tlue will becoee delinquent nine aonths attar the data of death. A. ~ The above info nation and tax due is correct. Resit paym ant io the Repist•r of Wills with two copies of this notice to obtain a discount or avoitl interest, or return this notie• to the Register of Wills antl an official assa ssment will be issuetl bx the PA Oepartmenk of Revenue. B. M Tha above asset has been or will ba repo rtetl and tax paid with the Pennsylvania inheritance iax return J~ filetl by khe estate reOrasantativa. C. ~ The above inf orwe eon is incorrect and/or debks and deductions were paid. Complete PART ~2 and/or PART ~ below. PART If indicating a tlifferent tax rate relationship to doeedent: TAX RETURN - CALCULATION OF TAX ON LINE 1. Dato Estab lishe0 1 JOINT/TRUST ACCOUNTS 2. Account Balance 2 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 >f 5. Debts and Deductions 5 6. Amount Taxable a 7. Tax Rate 7 X e. Tax Due e S PART DEBTS AND DEDUCTIONS CLAIMED Under penaltSes of perjury. I doelare that Lho facts I reported above na ro'/true. eorroet and eompl a Yo th• best of any knowledge and Deli •t. HOME C /a~ 7 ) ~~a - 7 ~~~ ~ivt~ l/.Y (/rJ.I~L-('p /JLIiL WORK ( ) please State ~ ~ / ~ TELEPHONE NUMBER DATE DATE PAID PAYEE DESCRIPTION AMOUNT PAID PENNSYLVANIA INHERITANCE TAXI INFORMATION NOTICE ';FILE ND. z1 12-0302 BUREAU OF INDIVIDUAL TAXES PO BOX 280601 pennsylVania AND ~ACN 12145323 HARRISBURG PA 1nzB-BSB1 DEPABTMExrpfBEVBxuE TAXPAYE R RESPONSE DATE 08-16-2012 REV -I Sf3 EX RFP (OS-11) TYPE OF ACCOUNT EST. OF DEBBIE A CULLEY ® SAVINGS SSN 200-56-0118 ^ CHECKING DATE OF DEATH D2-19-2012 ^ TRUST COUNTY CUMBERLAND ^ cERTiF. REMIT PAYMENT AND FORMS TD: KAREN C CULLEY REGISTER OF WILLS 1 W SHERIDAN AVE 1 COURTHOUSE SQUARE NEW CASTLE PA 16105-2562 CARLISLE PA 17013 PSECU provided the tleDartment with the information below, which was used in calculating the inheri Lance tax due. Records indicate that at the death of the above-named tlecetlent. you were a 7of nt owner/beneficiary Of this account. If you are the spouse of the deceased and any amount other than zero is refiected DeloW on the Potential Tax Due line, note no tax may De due, but you must notify the department of your relationship to the deceased by checking Box C in PART 1 below and wrl ttng "spouse" in PART 2. If you believe the information is incorrect, Dl ease obtain wrf Lien Correction from the financial institution. attach a copy to this form an0 return it to the above atltlress. Please call 717-787-8327 with questions. COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 8103947613-S1 Date 10-22-2001 To ensure proper credit to the account, two Established conies of this notice aunt accoaparo Account Balance Per<enY Taxable Amcunt Sub]e<t to Tax Tax Rate Potential Tax Due $ 3,909.98 X 50.000 $ 1,954.99 X .045 S 87.97 pavaent to the Register of Wills. Make check payable to "Register of Wills. Agent". NDTEv If kax payaents are wade within three aonths of 4ha decedent's data of death. deduct a 5 percent tliseount On the tax due. Am inheritance tax due will beeoaa delinquent nine aonths of kar the date of tleakh. A. ^ The above infonet Son and tax tlua is correct. Resit pevaent to the Register of Wills with two copies of this notice to obtain a discount or avoid iota rest, or return this notice to the Register of Wills antl CHECK an official assassaent will be issued by the PA Depa rtaent of Revenue. ONE BLOCK B. air ~X~ Tha above asset has been or will be report ad and tax Daitl with the Pennsylvania inheritance tax return ONLY Y+ files by the estate representative. C. ^ Tha above info raa ion iz incorrect and/or debts antl tleductions were paid. Coapleta PART 2~ and/or PART ~ below. 7 9 /.2 TELEPHONE NUMBER DATE Under penalties of perjury. I tleclare that the facts I reportetl above ar•'/i rue. co r~rle~t an d~1 ~cj/oq_p lets to th/~e bas/t,,~of mpy7~knowledpe antl belief. HOME C 7E>27 ) ~~ oc ~ 70 S~ ~C /7 .C /1.~ !~ (;fA.f"I /~til_ WORK C ) Eckert Seamans Cherie & Melba, LLC TEL 717 237 6000 ~~~~~ ~ 213 Market Street FAX 717 237 6019 8`" Floor www.eckertseamans.com Hamsburg, PA 17101 ATTORNEYS AT LAW November 27, 2012 Glenda Farner Strasbaugh, Register of Wills & Clerk of the Orphans' Court Cumberland County Courthouse One Courthouse Squaze Carlisle, PA 17013-3387 Re: Estate of Debbie A. Culley No. 21-12-0302 Deaz Ms. Strasbaugh: Thomas P. Gacki 717.237.6093 tgacki@eckertseamans.com Enclosed for filing please find the original and two (2) copies of the Inheritance Tax Return in the above-referenced matter. Also enclosed is our check made payable to "Register of Wills, Agent" in the amount of $15.00 to cover the cost of filing same. Please date-stamp and return one copy of the Return to me in the enclosed self-addressed, stamped envelope Thank you for your courtesy and cooperation in this matter. Please do not hesitate to contact us if you have any questions. Yours truly, ~,, ,,,, / / 0 ' ~ p ~ ~ ~~.1 .1 . y ac~i ~ ? ~ i ~ ~ n Thomas P. Gacki y `i C7 a O ~ ~ U ~ -'' TPG:kmo ~ ~ ti Sri -n -1 n~ r;- m Enclosures n N ti o cc: Kazen C. Culley (w/out enc.) {L0499952.1} RECORDED OFFICE OF N o N REGISTER OF WILLS II ~ N ~ I c ~ 1E1? NUU 30 Pal 12 52 li) ~ Z CLERK C: ~~ ~ ~ ORPHANS'COURi f!\~ ~~ OW48ERlAND CO., PA lll\ o ~ ` N 00 . .~ i. 1 B'JIIdS@BWO'J W ~ ~~ey,~ 63i~aid ~ O U p ~' _ ~ ~ ~ ~a ~~~ ~~ ~a~ ~aF"~w`~ p;a]Ov~o .a W~~U~~ A ~g rdOZ~~a ~SaM dW~~aa-1 =.L°~°o WCW7~~W~ ~ N '"' C7 rx U O U Z z`^ a ~ya¢, h. ~° r- ~ .o ~~. ~^ r.INS