HomeMy WebLinkAbout12-10-12J 1505611185
REV-1500 EX (02-11)(FI)
PA Department of Revenue OFFICIAL USE ONLY
Bureau of lndivitlual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN 21 12 0370
Harrisburg, PA 1T1ze-osot RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYV Date Of Birth MMDDYYVV
Decedent's Last Name Suffix Decedent's First Name MI
MOHLER GOLDIE
E
(If Applicable) Eller Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
- - REGISTER OF WILLS
FILL IN APPROPRIATE BOXES BELOW
® 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (Date of Death
^ 4
Limited Estate
^
4
F Prior to 12-13-82)
^
. a.
uture Interest Compromise (date of 5. Federal Estate Tax Retu rn Required
®
6
Decedent Died Testate
® death after 12-12-82)
7
D
~
.
(Attach Copy of Will) .
ecedent Maintained a Living Trust
(Attach Copy of Trust.) 8. Total Number of Safe D eposit Boxes
^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credit (Date of Death ^ 11. Election to Taz under Sec. 9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
CRAIG A- HATCH, ESQ• 717 ~31-960E~ ~
z
~CIS'~R OF WIyS,USE L'C7
O !_ O
First Line of Address ~ ""I ~
1013 MUMMA ROAD o
"
u' "'
`~
_
; ca ~~>
Second Line of Address "~ `'' .~ T -rl ~
SUITE 100 `' ~.zi ~. ~= ii
City or Post Office State ZIP Code -`t ~~ ~ DATE FµEO ~ O
LEMOYNE
PA 17043 [„J
Correspondent•se-mail address: C•HATCHaGATESLAWFIRM•COM
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, antl to the best of my knowledge and belief,
it is true, correct antl complete. Declaration of preparer other than the personal representative is based on ail information of which preparer has any knowledge.
NEVIN W• MOHLER, EXECUTOR
487 SAN REMO PLACE LEWISBERRY,;PA 17339
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE / DATE
CRAIG A• HATCH, ESQ• __ a 7 7~
ADDRESS
1013 MUMMA ROAD, SUITE 100 LEMOYNE, PA 17043
1505611185
Side 1
OM464] 3.000
1505611185
HA
J 1505611285
REV-1500 EX (FI)
Decedent's Social Security Number
Decedent's Name MOH R 0 D T F
RECAPITULATION
1. Real Estate (Schedule A) 1 Q • a Q
2. Stocks and Bonds (Schedule B) . .. .. 2 O • O Q
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) 3
, O • 3 a
4. Mortgages and Notes Receivable (Schedule D) 4
O • a 0
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) 5 ~ • 00
6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested 8 9 , 4 58.87
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ~ Separate Billing Requested 7. 4 3 4 , 516 • 3 5
8. Total Gross Assets (total Lines 1 through 7) .. 8 4 43 , 975 • 2 2
9. Funeral Expenses and Administrative Costs (Schedule H). g. 18 , 553.59
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) 10 ~ • ~ ~
11. Total Deductions (total Lines 9 and 10), 11 18 , 553.59
12. Net value of Estate (Line 8 minus Line 11) 12
13.
Charitable and Governmental Bequests/Sec 9113 Trusts for which .
. 4 2 5 , 421 • 63
an election to tax has not been made (Schedule J) , 13 ~ •
14. Net Value Subject to Tax (Line 12 minus Line 13) , 14. 42 S , 4 21 6 3
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers un~er Sec. 9116
(a)(1.2)X.0- Q.~~ 15. ~.0~
16. Amount of Line 14 t xable
at linealratex
o4~
.
425,421.64 1s. 19,143.97
17. Amount of Line 14 taxable
at sibling rate X .12 Q . Q ~ 17. ~ . 00
18. Amount of Line 14 taxable
at collateral rate X.15 ~ • ~~ 18. 0.00
19. TAX DUE,,,,,,,,,,,,,,,,,,, 19. 19,143.97
20. FILL IN THE BO% IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
155611285 1505611285
OMd648 3.400
REV-1500 EX (FO Page 3
Decedent's Comnleta nddro~~•
File Number
~y y~ u~ru
DECEDENTS NAME
MOHL R OLD E E
STREET ADDRESS
C R A
cITY
STATE
ZIP
LEMOYNE PA 17043-
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. CreditslPayments
A. Prior Payments 2 ~ ~r ~ ~ ,
B. Discount q S 7 , IJ
3. Interest
(3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in box on Page 2, Line 20 to request a refund. (4)
5. If line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
(1) 19,143.97
Total Credils(A+g) (2) 21,457.20
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 ........ O ^
.
b. retain the right to designate who shall use the property transferred or its income . . . . 0 ^
c. retain a reversionary interest . . . . . . . . . . . . . . . . . . . . . ^
d. receive the promise for life of either payments, benefits or care? . . . . . . . . . ^
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? . . . . . . . . . . . . . . . . . . ^
3. Did decedent own an "in trust for" or payable-upon-death bank account or security at his or her death? ® ^
4. Did decedent own an individual retirement account, annuity, or other non-probate property
which
,
contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . ® ^
,313.
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent [72 P.S.§9116 (a) (1.1) (i)].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers [o or for the use of [he surviving spouse is 0 percent
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an
adaptive parent or a stepparent of the child is 0 percent (72 P.S. §9116(a)(1.2)].
• The [ax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in [72 P.S. §9116(a)(1 )].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined,
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
e M46]1 2(100
REV-509 EX«(01-10)
Pennsylvania SCHEDULE F
BEPxR`MENi OF REVENGE
INHEaITANCE Tnx aErunN JOINTLY OWNED PROPERTY
RESIDENT pEDEDENT
ESTATE OF. FILE NUMBER:
Goldie B. Mohler 21 12 0370
If an asset became joi~dy owned within one year of the decedent's tlate of death, tt must be reported on Schedule G
- SUfNNMG JOINT TB~141Jf(SI NAh£jS) Aq)FESS RELATgNSHIP TO DECmETR
A Mohler, Nevin W 487 Saa Remo Place, Lewiaberry, P
17339 Son
JOINTLY OWNED PROPERTY:
fI~
NLfi9E32 lErrER
soR ~owr
tENANi BATE
M40E
JqM
twos xntiE OF ri~xnSxcwC~sa u.~nNO~a ~nccouxr nureere av si~nuR
.avwcxuweexnnncn oeeo rox~oinnv xe~oxru es.n
OAATE OF OFAT~'I
VALUE OFASSET r aF
OC{,fppn'S
INrER6T oATEOFOFnnf
VALUE OF
DEC®BJPS rJrEF~ST
1 A 9/28/1977 M&T Hank checkiag accouat 18,917.74 50.0000 9,458.87
TOTAL (Also enter on Line 6, Recapitulation) 5 9 , 4 58.87
9wa6AE z ooc If more space is needed, use additional sheets of paper of the same size.
REV-1510 EX ~ (08-09)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
SCHEDULE G
INTER-VIVOS TRANSFERS AND
MISC. NON-PROBATE PROPERTY
Goldie E. Mohler 21 12 0370
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
ITEM
NUMBE DESCRIPTION OFPROPERTY
irc~werr~wune orr~ranrvsrEaEE. reeia nErnnonswa ro oecaoEUr Arvo
~oAre of ranraFea nnACHnrgar of rive oeEO w6aEnr ESrare.
DATE OF DEATH
VALUE OF ASSET
%OF DECD'S
INTEREST
EXCLUSION
iF napuCAeLE
TAXABLE
VALUE
t~ Real Estate located at 904
Walnut Street, Lemoyne, Lemoyne
Borough, Cumberland County, PA,
Tax Parcel No. 12-21-0267-211.
Deed dated May 31, 2009:
Goldie E. Mohler to Goldie B.
Mohler, Trustee of The Mohler
Family Irrevocable Trust dated
May 31, 2009, recorded June 12,
2009 at Cumberland County
Recorder of Deeds, Instrument
No. 200919923; County assessed
value. 245,300.00 100.0000 0.00 245,300.00
2 Wells Fargo individual
inveetmeataccount #5969-8520,
Registration: Goldie 8. Mohler
TOD to Larry Mohler 50$ and
Nevin Mohler 50$; account
opened 10/3/2002. 189,216.35 100.0000 0.00 189,216.35
TOTAL (Also enter on line 7, Recapitulation) $
I! more space is nestled, usa atltlitional sheets of paper of the same size.
9W46AF 2.000
REV-1511 EX~ (10-09)
Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
FILE
Decedent's debts must be reported on Schedule I
ITEM
NUMBER DESCRIPTION
AMOUNT
A. FUNERAL EXPENSES:
~, Parthemore Funeral Home 11,233.64
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
City State ZIP
Year(s) Commission Paid:
2. Attorney Fees:
3. Family Exemption: (If decedent's address is notthe same as claimant's, attach explanation.)
Claimant
Sheet Address
City State ZIP
Relationship of Claimant to Decedent
4. probate Fees:
5. Accountant Fees:
6. Tax Return Preparer Fees:
7.
1 Patriot Newa, publication of estate notice
2 Cumberland Law Journal, publication of estate notice
Total from continuation schedules .
swasac zoos
TOTAL (Also enter on Line 9, Recapit
If more space is needed, use additional sheets of paper of the same size.
4,000.00
358.50
116.45
75.00
2,770.00
Eetate of: Goldie E. Mohler
Schedule H Part 7 (Page 2)
3 Gingrich memorials, grave marker
21 12 0370
1,325.00
4 Rolling Green Cemetery, grave opening 1,445.00
Total (Carry forward to main schedule) 2,770.00
REV-1513 EX+(01-10)
Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF:
SCHEDULE J
BENEFICIARIES
FILE NUMBER•
Goidie E. Mohler 21 1 2 0370
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal disMbutions and transfers under
Sec. 9116 (a) (1.2).]
1. Nevis N. Mohler
487 San Remo Place
Lewiaberry, PA 17339
50~ of Residue: 212,710.62 Bon 212,710.82
2 Larry R. Mohler
156 Gloucheater Drive
Medina, OH 44256
50~ of Residue: 212,710.82 Soa 212,710.82
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH t 8 OF REV-1500 COVER SHEET, AS APP ROPRIATE.
[[ NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR W HICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 0.00
9W46AI 2.000 ...••°• r "° ~° ~"•°"°°. °'° auu^~~^a~ oneem m PaPrn o~ uie same srze.
LAW OFFICES OF
GATES, HALBRUNER, HATCH & GUISE, P.C.
1013 MUMMA ROAD • SUITE 100 • LEMOYNE, PENNSYLVAN IA 17043
(717) 731-9600 • FAX: (717) 731-9627
LOW ELL R. GATES, LL. M.
LL. M. in Taxation CORRESPONDENCE ADDRESS: BRANCH OFFICE:
Aleo AtlmiKetl tc Massachusetts Bar Lemo ne Office
Y 3 WEST MONUMENT SQUARE, SUITE 304
MARK E. NALSRUNER WEB SITE: LEWIS70WN, PA 1]044
CRAIG A. HATCH, CELA www.GateSLawFirm.com P1]) 245-8909
Cartifietl as an Elder Law Attorney Dy STACEY L. NACE
the National Elder Lew Fountlation ParelegaVORice Manager
CLIFTON R. GUISE
Also Atlmide0 to practice Cebre the
Aprl] 12, 2012 TRACT L. SEPKOVIC
Perelegel
U.S. Patent & Tratlamark OBice TRACT L. HILFERDING
Parelegal
M&T Bank
1200 Market Street #23
Lemoyne, PA 17043
RE: Estate of Goldie E.14iohler
Date of Death: 03/09/12
Social Security Number: 144-12-3229
Dear Sir/Madam:
Please be advised that on March 9, 2012, Goldie E. Mohler passed away. Our firm has been to
retained handle the administration by Nevin W. Mohler, who was appointed as Executor of the estate on
March 27, 2012. I am writing to request infonnation about any accounts the decedent may have owned
jointly, individually or in trust with your bank. For death tax purposes, we would appreciate your providing
us with the following information for each account:
1. The exact title of the account;
2. The name(s) of any joint owner(s);
3. The date the account was established and/or made joint;
4. If applicable, the name(s) of any designated beneficiary;
5. If there was a change of ownership or registration of the account within one year prior to the
date of death, please provide: (a) date of change, and (b) title of account prior to change;
6. The balance as of March 9, 2012;
7. The interest earned from January 1, 2012, to the date of death;
8. If there was a credit or loan account, please provide the balance owed at the date of death.
A authorization form is enclosed for your records. If you have any questions or need any additional
information, please do not hesitate to contact Attorney Craig A. Hatch or myself. Thank you for your
assistance in this matter.
Sincerely,
~~~~Q~
Stacey L. N ce,
Paralegal
Enclosure
cc: Nevin W. Mohler, Executor
"x~.~~ ~irM~~Y10~
Prepared by and Return ta:
Craig A. Hatch, Esq.
Gates, Halbruner & Hach, PC
1013 Mumma Road, Suite 1100
Lemoyne, PA 17043
TAX PARCEL NO. 12-21-0267-21 I
BOROUGH OF LEMOYNE
DEED
THIS DEED is made the day of May, in the year two thousand nine (2009).
BETWEEN GOLDIE E. MOHLER, widow, now of68 North Ninth Street, Lemoyne, Cumberland County,
Pennsylvania, 17043, party of [he first part, GRANTOR,
AND
GOLDIE E. MOHLER, now of 68 North Ninth Street, Lemoyne, Cumberland County, Pennsylvania,
17043, NEVIN W. MOHLER and KAREN S. MOHLER, now of 487 San Remo Place, Lewisberry, York
County, Pennsylvania, 17339, and LARRY K. MOHLER and CONNIE M. MOHLER, now of 156
Glouchester Drive, Medina, Medina County, Ohio, 44256, Trustees of THE MOHLER FAMILY
IRREVOCABLE TRUST, parties of the second part, GRANTEES.
WITNESSETH, that said pally ofthe first part, for and in consideration of the sum of One ($1.00) Dollar,
lawful money of the United States of America, well and truly paid by the said parties of the second part to
the said party of the first part, at or before the sealing and delivery of these presents, the receipt whereof is
hereby acknowledged, have hereby granted, bargained, sold, aliened, enfeoffed, released, conveyed and
confirmed, and by these presents does grant, bargain, sell, alien, enfeoff, release, convey and confirm unto
the said parties of the second part, their heirs, successors and assigns,
ALL THOSE CERTAIN lots of ground situate in the Borough of Lemoyne, formerly East Pennsboro
Township, Cumberland County, Pennsylvania, more particularly bounded and described as follows, to wit:
ON the North by Walnut Street, on the East by Washington Avenue (now Ninth Street), on the South by Lot
No. I I on a Plan of Lots hereinafter mentioned, and on the West by a fifteen (15) foot alley, containing fifty-
[hree and one tenth (53.1) feet in front on Washington Avenue (now Ninth Street), and extending back an
even width one hundred and forty (140) feet to the aforementioned fifteen (15) foot alley. Being Lots Nos.
12 And 13 on the Plan of Lots of Dapp Tract, said Plan recorded in the Recorder's Office in and for
Cumberland County in Plan Book No. 1, page l5.
`~
HAVING THEREON erected atwo-story frame apartment building No. 68 Ninth Street, Lemoyne,
Pennsylvania.
BEING the same premises which George S. Campbell and Mary M. Campbell, by deed dated July 10, 1951,
and recorded in the Recorder of Deeds Office in and for Cumberland County, Pennsylvania, in Deed Book
T, Volume 14, Page 238, granted and conveyed unto Gail W. Mohler and his wife, Goldie E. Mohler. Gail
W. Mohler departed this life, thereby vesting complete title under operation of law to Goldie E. Mohler.
THIS IS A TRANSFER FOR NOMINAL CONSIDERATION TO TRUSTEES OF AN ORDINARY
TRUST WHERE THE TRANSFER OF THE SAME PROPERTY WOULD BE EXEMPT IF THE
TRANSFER WAS MADE DIItECTLY FROM THE GRANTORS TO ALL OF THE POSSIBLE
BENEFICIARIES THAT ARE ENTITLED TO RECEIVE THE PROPERTY OR PROCEEDS FROM
THE SALE OF THE PROPERTY UNDER THE TRUST AND IS THEREFORE EXEMPT FROM
THE PAYMENT OF REALTY TRANSFER TAX.
TOGETHER with all and singular the buildings and improvements, ways, streets, alleys, driveways,
passages, waters, watercourses, rights, liberties, privileges, hereditaments and appurtenances, whatsoever
unto the hereby granted premises belonging, or in any wise appertaining, and the reversions and remainders,
rents, issues, and profits thereof; and all the estate, right, title, interest, property, claim, and demand
whatsoever of the said Grantor, as well at law as in equity, of, in, and to the same.
TO HAVE AND TO HOLD, the said lot or piece of ground above-described, with all and singular the
buildings and improvements thereon erected, hereditaments and premises hereby granted, or mentioned and
intended so to be, with the appurtenances, unto the said Grantees, their heirs and assigns, to and for the only
proper use and behoof of the said Grantees, their heirs and assigns forever.
AND the said Grantor, for herself, her heirs, executors and administrators, does covenant, promise and agree,
to and with the said Grantees, their heirs and assigns, by these presents, that she, the said Grantor, and her
heirs, all and singular the hereditaments and premises hereby granted or mentioned and intended so to be,
with the appurtenances, unto the said Grantees, their heirs and assigns, against them, the said Grantor, and
her heirs, and against all and every person and persons whomsoever lawfully claiming or to claim the same
or any part thereof, by, from or under him, her, them or any of them, shall and will; subject as aforesaid,
SPECIALLY WARRANT AND FOREVER DEFEND.
IN WITNESS WHEREOF, the said party of the first part has hereunto set her hand and seal, the day and
year first above-written.
SIGNED, SEALED AND DELIVERED
IN THE PRESENCE OF
yJ y, ~ yj i
GOLDIE E. MOHLER
COMMONWEALTH OF PENNSYLVANIA
/~,l . , i
couNTYOF ~cc~'I~~LCL(,"~~~C~,~(,C'_~'
On this, the day of May, 2009, before me, a Notary Public for the Commonwealth of
Pennsylvania, the undersigned officer, personally appeared GOLDIE E. MOHLER, known to me (or
satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged
that she executed the same for the purpose therein contained.
CN WITNESS WHEREOF, I hereunto set my hand and official sea
COMMONWEALTH OF PENNSYLVANIA s ~.~`._~~_-~
Notarial Seal ~~~~
Ted L Wacker, Notary Pudic ~
Lemoyne l3oro, Cumberland Courtly "-'"Notar P
My CormnissionE~iresJan.20,2011 = Y is
Member, Pennsylvania Associatbn of Notarlee ,.~'~ My C. mission Expires:
CN;RTIFICATE OF RESH)ENCE
1 hereby certify that the present residence
of the Grantees herein is as follows:
Nevin W. and Karen S. Mohler
487 San Remo Place
Lewisbery, PA 17339
..
ROBERT P. ZIEGLER
RECORDER OF DEEDS
CUMBERLAND COUNTY
1 COURTHOUSE SQUARE
CARLISLE, PA 17013
717-240-6370
Instrument Number - 200919923
Recorded On 6/12/2009 At 12:23:09 PM
* Instrument Type -DEED
Invoice Number - 45880 User H) - RAK
* Grantor - MOHLER, GOLDIE E
* Grantee - MOHLER, GOLDIE E
* Customer -GATES & ASSOCIATES
* FEES
STATE WRIT TAX $0.50
STATE JCS/ACCESS TO $10.00
JUSTICE
RECORDING FEES - $13.50
RECORDER OF DEEDS
PARCEL CERTIFICATION $10.00
FEES
AFFORDABLE HOUSING $11.50
COUNTY ARCHIVES FEE $2.00
ROD ARCHIVES FEE $3.00
WEST SHORE SCHOOL $0.00
DISTRICT
LEMOYNE BOROUGH $0.00
TOTAL PAID $50.50
I Certify this to be recorded
in Cumberland County PA
<~ °a cuye~ ,o
or /~ ~. ~/
° ° RECORDER O D EDS
-._
*rto
* Total Pages - 5
Certification Page
DO NOT DETACH
This page is now part
of this legal document.
* -Information denoted by an asterisk may change during
the verification process and may not be reflected on this page.
II I~ Ilfl IItII IIII
TAXUIG AUTHORITY: WEST SHORE SCHOOL OL4TRX:T
TAX YEAR: 2012-13 REAL ESTATE 7AX NOTICE LEMOYNE BOROUGH
PAYABLE FAITH A. NN:OLA, TIC 1111) 781-7186 PROPERTY ID
To: 610 HERMAN AVENUE surtE 4 12210267211
LEMOYNE, PA 17067-ttN ASSESSED VALUE
246.300
TA% SCHOOL HOMESTEAD EXCLUSION
x,666
9.30 ~ DA
RATE ON ORBEFORE FAQ a1E FARMSTEAD EXCLUSION
AFTER WILL DA
REBATE 2.157.42 BY 09Po1/2012 2,15TA2 0
FACE 2,201.45 EY 11/0112012 45 ENT
PENALTY 2,421.50 AFTERII/01/2012 ~ :80 ' ~V~~i®
~~ 716
L pp
®(\
Tp:, MOHLER FAMILY IRREVOCABLE ST
w GO NEVIN R KAREN MOHLER , ,n n 7 nnA7 -
~
487 SAN REMO PLACE
LEWISBERY PA 17339 ..- J :~ _ _ ._
\ I•' f3 > S
FOR: 88 N NINTH STREET
BaL DATE - oTAtlrmlz BILL #040459
OELINOUENT ERiS ARE NRNED OVER TO TAX CLAIM ON iTO12012 TAXPAYER'S COPY
JULY 2012
PENNSYLVANIA DEPARTMENT OF REVENUE
REALTY TRANSFER TAX
COMMON LEVEL RATIO (CLR)
REAL ESTATE VALUATION FACTORS
FOR
CUMBERLAND COUNTY
The following real estate valuation factors are based on sales data compiled by the State Tax
Equalization Board. These factors are the mathematical reciprocals of the actual common level
ratios. For Pennsylvania Realty Transfer Tax purposes, these factors are applicable for
documents accepted for the periods indicated below. The date of acceptance of a document is
rebuttably presumed to be its date of execution, that is, the date specified in the body of the
document as the date of the instrument. 61 Pa. Code § 91.102
ACCEPTANCE
DATE CLR
FACTOR ACCEPTANCE
DATE CLR
FACTOR
FROM TO FROM TO
7-2-1986 6-30-1987 9.52 7-1-2006 6-30-2007 1.14
7-1-1987 6-30-1988 10.00 7-1-2007 6-30-2008 1.22
7-1-1988 6-30-1989 10.53 7-1-2008 6-30-2009 1.26
7-]-1989 6-30-1990 11.11 7-1-2009 6-30-2010 1.26
7-1-1990 6-30-1991 12.05 7-1-2010 12-31-2011 L25
7-1-1991 6-30-1992 12.35 3 1-1-2011 6-30-2011 ].00
7-1-1992 6-30-1993 12.50 3 7-1-2011 6-30-2012 1.00
7-1-1993 6-30-1994 12.82 7-1-2012 6-30-2013 1.00
7-1-1994 6-30-1995 13.33
7-1-1995 6-30-1996 13.70
7-1-1996 6-30-1997 14.29
7-1-1997 6-30-1998 14.29
7-1-1998 6-30-1999 14.71
7-1-1999 6-30-2000 15.15
7-1-2000 12-31-2000 15.63
(1) 1-1-2001 6-30-2001 1.00
(L) 7-1-2001 6-30-2002 1.00
7-I-2002 6-30-2003 1.01
7-1-2003 6-30-2004 I.OS
7-1-2004 12-31-2004 1.11
(2 1-1-2005 6-30-2005 1.00
(2 7-1-2005 6-30-2006 1.00
(1) Adjusted by the Department of Revenue to reflect an assessment base change effective January I, 2001.
(2) Adjusted by the Department of Revenue to reflect an assessment base change effective January I, 2005.
(3) Adjusted by the Department of Revenue to reflect an assessment base change effective January 1, 201 I.
~~~~~~si
JUN 0 8 2012
BY:
June 7, 2012
Gates, Halbruner, Hatch & Guise, PC
1013 Mumma Rd Ste 100
Lemoyne PA 17043
RE: Estate of Goldie E Mohler
Dear Ms. ~ Jace:
Wells Fargo Advisors, LLC
Three Lemoyne Drive
Lemoyne, PA 17043
Te1:I17-761-7344
Fax: 717-975-8426
Toll Free: 800-468-8685
Please be advised that Goldie E Mohler maintained an individual investment
account #5969-8520 at Wells Fargo Advisors at the time of her death on March 9,
2012.
Registration: Goldie E Mohler
TOD registration
Opened: 10/03/2002
Beneficiary: Larry ,Mohler 50%
Nevin Mohler 50%
This account contained the following investments:
12,578.616 W/F Hi Yld Bd Fd CI C (EKHCX)
6,722.689 W/F Div Incm Bldr CI C (EKSCX)
2,228.164 W/F Wlth Bldr Eq Port (WBGIX)
Nationwide Platnm Annuity
Money Market Bal
c.94985D 186 $39,245.29
c.94985D327 $39,260.51
c.94975G421 $24,866.31
$82,094.66
3, 749.58
$189,216.35
The amount of income earned in this account from January 1, 2012 thru Mrs.
Mohler's DOD is $649.06.
Respectfully,
~~~ Cif ~~~
Shelly A. Weibley
Senior Registered Client Associa+e
Member FINFA/SIPC
THE INFORMATION CONTAINED HEREIN HAS BEEN OBTAINED FROM
SOURCES 9ELIEVED RELIABLE BUT NOT NECESSARILY COMPLETE AND
CANNOT BE GUARANTEED. THIS REPORT IS NOT THE OFFICIAL RECORD OF
YOUR ACCOUNT. YOUR WELLS FARGO ADVISORS CLIENT STATEMENT IS
THE OFFICIAL RECORD OF YOUR ACCOUNT
a.
=~~ ~ a~ A Family Tradition Of Caring®
PARTHEMORE Funeral Home & Cremation Services, Inc.
1303 Bridge Street
?.O. Box 431
vew Cumberland, PA 17070
717) 774-7721
Fax) 774-5546.
vww.partltemore.com
filbert W. Parthemore,
'ounder
filbert J. Parthemore,
tupervisor
'~tephen K. Parthemore,
'A'SP
truce R. Parthemore,
ie-Need Coordinator, CPC
rofessional Memberships:
(FDA • PFDA
~CFDA•CCFDA
J
7ve Rule Yau Knmv,.
he People You Trust
Mr. Nevin W. Mohler
487 San Remo Place 3/13/2012
Lewisberry, PA 17339
For the Service of Goldie E. Mohler
We sincerely appreciate the cenSdence you have placed in us and will coutimie W assist you in every way
we can. Please feel tree to contact us if you have any questions in regard to this statemwt The following
is an itemized statement of the services, facilities, automotive equipment and merchandise ffiat yon selected
when making the f®eral attangements.
Terms Due Date Account#
Net 30 4/12/2012 2012020.0
Description Amount
SERVICES & MERCAANDISE
Traditioml Fmeral Service - 6,395.00
On Freedom's Wings Stationery Set
- - 165.00
Solid Oek Casket
- ~ 2,795.00
12 Gauge Standard Steel Vault 1,345.00
Total Services and Merchandise 10,700.00
CASH ADVANCE ITEMS
Death Notice, Harrisburg Patriot - 342.64
15 Cerfdred Copies of Death CertiScate 90.00
Handresser 40.00
Clergy Honorarium 175.00
Honor Guard. _ _ 100.00
Total Cash Advances - ~ ~ 747.64 -
immediate Pay Discotmt - Thank you! _ ~ - -214.00
Total al l,zs3.6a
Payments/Credits so.oo
Balance Due s11,233.64
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RECEIPT FOR PAYMENT
GLENDA FARNER STRASBAUGH
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
MOHLER GOLDIE M
Estate File No.: 2012-00370
Paid By Remarks: NEVIN MOHLER
CJ
-------------------
Fee/Tax Description
PETITION LTRS TEST
WILL
SHORT CERTIFICATE
JCS FEE
AUTOMATION FEE
CODICIL
Check# 1635
Total Received.........
Receipt Date: 3/27/2012
Receipt Time: 15:13:49
Receipt No.: 1069280
Receipt Distribution -----
Payment Amount Payee Name
260.00 CUMBERLAND COUNTY GENERAL FUN
15.00 CUMBERLAND COUNTY GENERAL FUN
40.00 CUMBERLAND COUNTY GENERAL FUN
23.50 BUREAU OF RECEIPTS & CNTR M.D
5.00 CUMBERLAND COUNTY GENERAL FUN
15.00
---------------- CUMBERLAND COUNTY GENERAL FUN
$358.50
$358.50
CUMBERLAND LAW JOURNAL
32 SOUTH BEDFORD STREET
CARLISLE, PA 17013
Tele: (717)249-3186 Faz:(717)249-2883
May 4, 2012
Cumberland Law Journal is published every Friday by the Cumberland County
Bar Association and is designated by the Court of Common Pleas as the official legal
publication for Cumberland County and the legal newspaper for publication of legal
notices.
TO: Craig A. Hatch, Esquire.
RE: Goldie E. Mohler Estate
Legal advertisements must be received by Friday Noon. All legal advertising
must be paid in advance. Make all checks payable to: Cumberland Law Journal.
Advertisement inserted on the following dates:
April 20, April 27, and May 4, 2012
Advertising Cost $ 75.00
Proof of Publication $ 0.00
Second Proof Request $ 0.00
Payment received $ 0 .00
Total Amount Due $ 75.00
Payment received by
• •
~~~ MEMORIALS Since 1921
5243 Simpson Ferry Road, Mechanicsburg, PA 17050
(717) 766-5622 • Fax (717) 766-8007
www. gingrichmemotials.com
SOLD TO:
2-
Drawing Drawing Sent to Cust. Approved
Found. By Found. Ordered
Vendor Ack.#
Grave Position Verified Cremation
Date of Order
Cemetery
Cemetery Location
Phone Cell Center Over Graves Sec./Lot #
Email Approx. Date of Completion
Lettering
Location on Cemetery
^ VasQ < ^ Photo ^ Other
Agreement: A 50% depose a required ro commencement of work. CO$T$:
Agree to pay stated balance upon erection regardless of labor troubles or shipments or any other good reasons. This order or Memorial $
contract cannot be cancelled by customer uMess agreetl by both parties. The article herein mentioned shall remain the property of _.__ _
James R. Gingrich Memorials until paid in full and they reserve the right to remove the same is not paid as stated. FOIJndatlOn $ _
I agree to carefully proofread all names and dates for accurecy antl accept full responsibility for any errors or omissions. THERE
Cemete
Fees
$
WILL BE AN ADDITIONAL CHARGE FOR ANY LETTERING ADDED TO THIS MEMORIAL AFTER ERECTED ON THE ry
CEMETERY. ' _ „ $ ..
1 further agree to pay the balance stated for the work performed untler this contract within thirty (30) days of receipt of the final
invoice and former agree that interest shell accrue at the rate of orre antl onefiati percent (1 %z f) per momh on the unpaid balance _ _~___ $
~wetl to James R. Gingrich Memoriak not paid within thiny (30) days of the invoice date. In adtlition thereto, 1 agree if it becomes
cessary for James R. Gingrich ro institute legal proceeding to collect any Funtls tlue from me for my account being pest due thirty ~- $
,JO) days, to pay aN-coon costs and.attomeys fees incurretl by James R. Gingrich Memorials to collect the same.
TOTAL ;;, $
Dealer
DEPOSIT
~ $
Customer _ Balance Due $ __ ~ _ -'
T
(I turner agree mat the above names, spelling, and dates are correct) Upon Completion
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to
LAW OFFICES
RUPP AND MEIKLE
A PROFESSIONAL C~OR~P gpTION
THE WAGNER BUILDING -SUITE 303
365 NORTH 21ST STREET
CAMP HILL, PA 17011
LAST WILL AND TE TAM T
OF
GOLDIE E. MOHLER
I, GOLDIE E. MOHLER, of 904 Walnut Street, Lemoyne, Cumberland County,
Pennsylvania, 17043, being of sound and disposing mind and memory, do hereby make, publish and
declaze this for and as my Last Will and Testament hereby revoking any and all Wills or Codicils
by me at any time heretofore made.
ITEM I - I am a widow, and I have two (2) sons, NEVIN W. MOHLER and
LARRY K. MOHLER, both of whom are man•ied.
ITEM II - I give, devise and bequeath all of my property, real, personal and
mixed, one-half (%2) to my son, NEVIN W. MOHLER, and one-half (''/z) to my son, LARRY K.
MOHLER. I have complete confidence that my Executor will honor any written instructions that
I may leave with regard to my tangible personal property.
,,
ITEM III - Ifmy son, NEV1N W. MOHLER, predeceases me, his shaze shall be divided
into three (3) parts: one-third (~/a) to his widow KAREN; one-third (~/a) to my Trustee, hereinafter
named, IN TRUST for my grandson NEIL; and, one-third (~/a) to my Trustee, hereinafter named, IN
TRUST for my grandson KEITH.
ITEM IV - The above Trusts shall be sepazate and discrete, and my Trustee shall
hold, invest and reinvest the assets thereof and after payment of the all of the expenses necessary or
incidental thereto shall in his sole discretion pay over the income to each respective Trust beneficiary
or pay part or all of the income and\or principal for each respective beneficiary's medical care,
education, including college and technical school, support and maintenance. Any respective trust
income not expended shall be added to the principal of each respective Trust.
ITEM V - One-half ('/~) of the principal of each respective Trust and any
respective income accumulated to that time shall be paid to each respective beneficiary when each
respective beneficiary attains the age of twenty-two (22) years and the remainder of the principal
and any income accumulated after the first distribution shall be paid to each respective beneficiary
when he attains the age of twenty-seven (27) years at which time each respective Trust shall
terminate.
,~
2
ITEM VI - If my son, LARRY K. MOHLER, predeceases me, his shaze shall be
divided into three (3) parts: one-third (~/a) to his widow CONNIE; and, two-thirds (v3) to my son,
NEVIN.
ITEM V - Wherever I have granted my Trustee the discretionary power to make
payments from the income or principal of my Trust, no Trustee who is a potential recipient of such
a payment may exercise his or her discretion in his or her own favor.
ITEM VI - (1) I name as my Executor, my son, NEVIN W. MOHLER. In the
event that my son, NEVIN, predeceases me or declines to serve as Executor, I name as my Successor
Executor, my son, LARRY K. MOHLER.
(2) I name as my Trustee, my son, LARRY K. MOHLER.
(3) My Executor and Trustee shall receive reasonable
compensation. "Reasonable Compensation" shall be determined in accordance with Pennsylvania
Statutory and Case Law.
(4) The situs of the Trusts created herein shall be Cumberland
County, Pennsylvania.
,,
3
ITEM VII - (1) I give to any Executor and to any Trustee named in this Will
or any Codicil hereto or to any substitute Executor or Trustee all of the powers now applicable by
law to fiduciaries in the Commonwealth of Pennsylvania and in particulaz, through the Pennsylvania
Probate, Estates and Fiduciaries Code, as effective and as in effect on the date hereof, during the
administration and until the completion of the distribution of my estate, and until the termination of
all trusts created in this Will or any Codicil hereto and until the completion of the distribution of the
assets of such trusts.
(2) If there be any property located outside the Commonwealth
of Pennsylvania, in which I may have an interest at the time of my death, which cannot be
conveniently administered as provided herein, then I authorize, but do not require, my Executors to
appoint a bank or trust company with trust powers, to administer such property according to the
terms of this Will.
(3) My Executors and Trustees are authorized and empowered to
retain, either permanently or for such period of time as my Executors or Trustees may determine,
any assets, including the capital stock of any closely held corporation, which at any time shall come
into possession of my Executors and Trustees as a part of any Trust created herein, whether such
assets aze or aze not of the chazacter approved or authorized by law for investment by fiduciaries and
whether such assets do or do not represent an overconcentration in one investment.
.'~
4
ITEM VIII - No interest of any beneficiary under this Will, any Codicil hereto, or
any trust created herein shall be subject to anticipation or to voluntary or involuntary alienation.
ITEM IX - All estate, inheritance, succession and other death taxes imposed or
payable by reason of my death and interest and penalties thereon with respect to all property
comprising my gross estate for death tax purposes, whether or not such property passes under this
Will, shall be paid out of the residue of my estate, as if such taxes were expenses of administration,
without apportionment or right of reimbursement. I authorize my Executors and Trustees to pay all
such taxes at such time or times as deemed advisable.
ITEM X - Wherever I have authorized my Trustee to pay income or principal to
a person under the age of twenty-one (21) years, my Trustee may in his sole discretion make such
payment to a custodian pazent or guazdian of such person or to an adult person with whom such
person resides. The receipt for such payment executed by the custodian parent, guardian or other
person to whom the income or principal is paid shall be a complete discharge of my Trustee from
liability with respect to such payment.
5
ITEM XI - Wherever my Trustee is directed or authorized to pay income or
principal to any persori, he shall also be authorized in his sole discretion to apply the income or
principal for the use of such person.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~[ _ day of
1997.
l ~ ~~ (SEAL)
-OLDIE E. MOHLER
Witnesses:
V4
r .tom-lrG'~~~G~' l~
residing at
residing at
6
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF c c h B~~ ~l+NP
ss.
WE, GOLDIE E. MOHLER, N P Y ~ r-1 l . (~ ~~, ~ ,- and
~a,1 Rb C~nso,~_, the Testatrix and the witnesses, respectively, whose names aze
signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the
undersigned authority that the Testatrix signed and executed the instrument as her Last Will and
Testament and that she had signed willingly (or willingly directed another to sign for her), and that
she executed it as her free and voluntary act for the purposes therein expressed, and that each of the
witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and to the best of
his or her knowledge the Testatrix was at that time eighteen (18) yeazs of age or older, of sound
mind, and under no constraint or undue influence.
,~~ ~~>~.
GOLDIE E. MOHL R, Testatrix
Subscribed, sworn to, and acknowledged before me by GOLDIE E. MOHLER, the Testatrix, and
subscribed and sworn to before me by ~-{ cr brrT G tR , ~ and
al oj~(' _ nwYYS.o~ ,witnesses, this day of ~~~ ~-} , 14^7.
/ ~ -
Notary Public
~,,
•~OMM4 !AL
tMN~I a rRLLR, M~ hEMe
C~ MA M Cw~led t., M
~ Cw~~ la~i+r SNe. 71, IOW
CODICIL TO THE WILL OF GOLDIE E. MOHLER
I, Goldie E. Mohler, of Lemoyne, Cumberland County, Pennsylvania, declaze this to be sole
codicil to my last will dated August 4, 1997.
I hereby revoke ITEM II of my will in its entirety and substitute the following in its place:
ITEM II: I give, devise and bequeath to my son, NEVIN W. MOHLER, a sum equal
to the cash value of an annuity issued by Aetna Life Insurance Company
on August 28, 1979 bearing contract number 4000159, which annuity was
replaced by an annuity issued by Nationwide Insurance Company on May 1,
2001 bearing contract number 015566581(collectively, the "Annuity"), that
I gave to my son, LARRY K. MOHLER, on August 28,1979. The date of my
death shall be the date used to determine the cash value ofthe Annuity. I have
complete confidence that my Executor will honor any written instructions
that I may leave with regard to my tangible personal property.
2. Anew ITEM III should be added to my will as follows:
ITEM III: I give, devise and bequeath all of the rest, residue and remainder of my estate
of whatsoever nature and wheresoever situate, one-half to my son, NEVIN
W. MOHLER, and one-half to my son, LARRY K. MOHLER.
3. Anew ITEM N should be added to my will as follows:
ITEM N: The original ITEMS III through XI ofmy will should be renumbered ITEMS
V through XI11.
4. In all other respects, I hereby ratify, confirm and republish my last will dated August 4, 1997,
together with this sole codicil, as and for my last will.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this a~day ofAugust, 2001.
~` ~ ~~~ ,~~AL~
OLD1E E. MOHLER
Witnesses:
~~~
residing at ~ c~7 1F~` t~i)2Cd~~ ~ `I (~
residing at ~~~ / IV ~ 7 ,S ~ ~2 vHrp /~/ / ~ l d .
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
WE, GOLDIE E. MOHLER,
AND
the Testatrix and the witnesses, respectively, whose names
are signed to the attached or foregoing instrument, being first duly sworn, do hereby declaze to the
undersigned authority that the Testatrix signed and executed the instrument as a codicil to her Last
Will and Testament and that she had signed willingly (or willingly directed another to sign for her),
and that she executed it as her free and voluntary act for the purposes therein expressed, and that
each of the witnesses, in the presence and hearing of the Testatrix, signed the Codiciall as witness
and to the best of his or her knowledge the Testatrix was at the time eighteen (18) years of age or
older, of sound mind, and under no constraint or undue influence.
t ,
GOLDIE~~E. MOHLER, Testatrix
~ ~Y,Oi~o1~ ~,~
Wi 3-'~
~._
Witness
Subscribed, sworn to, and acknowledged before me by GOLDIE E. MOHLER, the Testatrix,
and subscribed and sworn to before me by S QIP ~ Ur<~S and
~~~ ~, h ~oW ~r S n X ,witnesses, this ~ day of u , 2001.
My commission expires:
f
Notary Public
G+~~n d-
Printed Nam of Notary Publi'
Notarial Seal
Wendy H. Cooper, Notary Public
Hartisburg, 8a hin County
My Commisslon Expires Dec. 8, 2004
THE
MOHLER FAMILY
IRREVOCABLE TRUST
THIS TRUST AGREEMENT is executed in triplicate on this day of May, 2009, by
and between GOLDIE E. MOHLER now or formerly of 68 North Ninth Street, Lemoyne,
Cumberland County, Pennsylvania 17043 (hereinafter called "Settlor") and GOLDIE E. MOHLER
now or formerly of 68 North Ninth Street, Lemoyne, Cumberland County, Pennsylvania 17043 ,
NEV1N W. MOHLER and KAREN S. MOHI.ER, now of487 San Remo Place, Lewisberry, York
County, Pennsylvania 17339, and LARRY K. MOHLER and CONNIE M. MOHLER, now of
156 Glouchester Drive, Medina, Medina County, Ohio, 44256, (hereinafter called "Trustees" or "Co-
Trustees").
ARTICLE I. TRUST ESTATE
1.01. Initial Principal. Settlor, desiring to establish an irrevocable trust, does hereby
irrevocably transfer, assign and deliver to the Trustees and their successors, and assigns the assets
listed on Schedule A, attached hereto and made a part hereof. As further evidence of such
assignment, the Settlor has executed or will execute or cause to be executed such other instruments
as maybe required for the purposes of completing the assignment or transfer of title to such property
to the Trustees. The Trustees accept such transfer and assignment to themselves as Trustees, and
undertake to hold, manage, invest and reinvest the assets of this Trust, and to distribute the income
and principal of the Trust in accordance with the provisions of this Agreement.
1.02. Additional PrincinaL The Settlor and any other person or persons, with the consent
of the Trustees, shall have the right at any time to make additions to the corpus of this Trust or any
share thereof hereby established. All such additions shall be held, governed, and distributed by the
Trustees in accordance with the tenns and conditions of this Agreement. The Trustee, in its sole
discretion, may require, as a prerequisite to accepting property, that the transferring party provide
evidence satisfactory to the Trustee that (i) the property is not contaminated by any hazazdous or
toxic materials or substances; and (ii) the property is not being used and has never been used for any
activities directly or indirectly involving the generation, use, treatment, storage, disposal, release or
discharge of any hazardous or toxic materials or substances.
1.03. Disclaimer. The Trustee shall have the right to disclaim, in whole or in part, prior
to its acceptance by the Trustee, any interests in property for any reason, including but not limited
to a concern that such property could cause potential liability under any federal, state, or local
environmental law.
ARTICLE II. IRREVOCABILITY OF TRUST
2.01. Irrevocability. Settlor has been advised of the consequences of an irrevocable trust
and hereby declares that this Trust shall be irrevocable and shall not be altered, amended, revoked,
or terminated by Settlor or any other person or persons.
ARTICLE III. LIFE INSURANCE POLICIES
3.01. General Provisions. If any insurance policies aze transferred into this Trust, the
Trustees shall be vested with all right, title, and interest in and to the transferred policies of
insurance, and are authorized and empowered to exercise and enjoy, for the purposes of the Trust
herein created and as absolute owners of such policies of insurance, all the options, benefits, rights
and privileges under such policies, including the right to borrow upon and to pledge them for a loan
or loans. The Trustees take all rights, title, and interest in and to the above-stated insurance policies
subject to any prior split-dollar life insurance agreement and assignments, which may be in effect
at the time of transfer. The insurance companies which have issued policies are hereby authorized
and directed to recognize the Trustees as absolute owners of such policies of insurance and as fully
entitled to all options, rights, privileges, and interests under such policies, and any receipts, releases,
and other instruments executed by the Trustees in connection with such policies shall be binding
upon all persons interested in this Trust. The Settlor hereby relinquishes all rights, title, interest and
powers in such policies of insurance which Settlor may own and which rights, title, interest and
powers are not assignable, and will, at the request of the Trustees, execute all other instruments
reasonably required to effectuate this relinquishment.
3.02. Payment of Premiums. The Trustees shall be under no obligation to pay the
premiums which may become due and payable under the provisions ofany policy of insurance which
may be transferred or assigned to this Trust, or to make certain that such premiums are paid by the
transferor of such policy, or to notify any persons of the nonpayment of such premiums, and the
Trustees shall be under no responsibility or liability of any kind incase such premiums are not paid,
except the Trustees shall apply any dividends received on such policies to the payment of premiums
thereon. Upon notice at any time during the continuance of this Trust that the premiums due upon
such policies are in default, or that premiums which will become due will not be paid, either by the
transferor or by any other person, the Trustees, within their sole discretion, may apply any cash
values attributable to such policy to the purchase of paid-up insurance or of extended insurance, or
may borrow upon such policy for the payment of premiums due thereon, or may accept the cash
values of such policy upon the policy's forfeiture. In the event that the Trustees receive the cash
value of such policy upon its forfeiture for nonpayment of premiums, the amount received shall be
added to the corpus of this Trust, and shall be administered according to the terms of this Agreement.
Ifthe insured under such policies of insurance, becomes totally and permanently disabled within the
meaning of any policies and because thereof the payment of premiums, or any of them, shall during
the pendency of such disability, be waived, the Trustees, upon receipt of such knowledge, shall
promptly notify the insurance company which has issued such policies, and shall take any and all
steps necessary to make such waiver of premium provision effective.
3.03. Duties of Trustees With ReEard to Life Insurance PoBcies. The Trustees shall be
under no obligation or duty whatever except with respect to the safekeeping of such policies of
insurance and the duty to receive such sums as may be paid to them, in accordance with the
requirements of this Trust, by the companies issuing such policies, and to hold, manage and disburse
such proceeds subject to the terms of this Agreement. Upon the death of the insured, the Trustees
shall make reasonable efforts to carry out the provisions of this Agreement, including the
maintenance or defense of any suit, provided, however, the Trustees shall be under no duty to
maintain or enter into any litigation unless its expenses, including counsel fees and costs, have been
advanced or guaranteed in an amount and in a manner reasonably satisfactory to the Trustees. The
Trustees may repay any advances made by them or reimburse themselves for any such fees and costs
from any corpus or income of this Trust.
ARTICLE IV. TRUST DISTRIBUTIONS
4.01. Trust Principal. The entire corpus of this Trust, including the assets initially
transferred to this Trust, subsequent additions to this Trust, and the proceeds of any sale, exchange
or investment of such Trust assets, shall be used for the purposes herein contained.
4.02. Income Distribution. During the Settlor's lifetime, the Trustees shall distribute all
of the net income of the trust to, or for the benefit of, GOLDIE E. MOHLER. The Trustees shall
make no distributions of principal to GOLDIE E. MOHLER. Upon the admission of GOLDIE E.
MOHLER to a long term care facility for a period of time in excess of four (4) yeazs from the date
of this Trust, the Trustee shall cease the distribution of income and shall accumulate the income to
the principal of the Trust.
4.03. Principal Distributions. Upon the death of the Settlor, the Trust shall terminate.
Upon termination, the remaining trust estate shall be divided into sepazate and equal shazes and one
such share shall be distributed to each ofthe Settlor's children, NEV1N W. MOHLER and LARRY
IC. MOHLER. If either of the Settlor's children predecease the termination of this Trust, the
predeceased child's share shall be distributed to the spouse of the predeceased child, provided that
the spouse of the predeceased child has not remazried at the time of distribution. If any of the
Settlor's children predecease the termination of this Trust without a surviving spouse or if the
predeceased child's spouse has remarried, then the predeceased child's shaze shall be distributed to
the issue of the predeceased child, per stirpes. If any of Settlor's children predecease the termination
of this Trust without a surviving spouse or surviving issue, then such predeceased child's shaze shall
be distributed to the other child of the Settlor, with the terms of such distribution being the same as
the direct distribution to that child.
4.04. General Power of Appointment. Settlor's children, KEVIN W. MOHI.ER and
LARRY I{. MOHLER, aze hereby granted the general power to appoint some or all of the principal
of this Trust to themselves, in such proportions and upon such terms (intrust, outright gifts, or in any
3
other manner) as they jointly deem advisable. This power shall not be exercisable under their Wills.
If Settlor's children fail, either in whole or in part, to exercise this general power of appointment
herein granted, the unappointed principal shall continue in trust and shall be administered according
to the terms of this Trust. Upon the death, resignation, removal or incapacity of Settlor's children,
1VEVIN W. MOHLER and LARRY K. MOHI.ER the survivor ofthem shall exercise the general
power of appointment under this provision. Prior to the exercise of the General Power of
Appointment by KEVIN W. MOHLER and LARRY K. MOHLER, or either ofthem KEVIN
W. MOHLER and LARRY IC. MOIIL,ER shall provide a written notice of the intent to exercise
this power to the then-current Trustees. The Trustees shall inform the Settlor of the intent to exercise
this General Power of Appointment. For a period of ten (10) days, the Settlor may veto the proposed
exercise of the General Power of Appointment. After the ten (10) day period expires, the proposed
exercise of the General Power of Appointment shall take effect unless the Trustees have received
written veto from the Settlor. This Power shall terminate upon the death of the Settlor.
ARTICLE V. POWERS OF TRUSTEES
5.01. General Powers. In addition to such other powers and duties as may have been
granted elsewhere in this Trust, but subject to any limitations contained elsewhere in this Trust, the
Trustees shall have the following powers and duties:
A. In the management, caze and disposition of this Trust, the Trustees shall have the power
to do all things and to execute such deeds, instruments, and other documents as may be deemed
necessary and proper, including the following powers, all of which maybe exercised without order
of or report to any court:
(1) To sell, exchange, or otherwise dispose of any property, real, personal or
mixed, wheresoever located, at any time held or acquired hereunder, at public or
private sale, for cash or on terms as may be determined by the Trustees, without
advertisement, including the right to lease for any term notwithstanding the period
of the Trust, and to grant options, including an option for a period beyond the
duration of the Trust.
(2) To invest all monies in such stocks, bonds, securities, investment
companies or trust shazes, mortgages, notes, chows in action, real estate,
improvements thereon, and other property as the Trustees may deem best, without
regard to any law now or hereafter in force limiting investments of fiduciazies..
(3) To retain for investment any property deposited with the Trustees
hereunder.
(4) To vote in person or by proxy any corporate stock or other security and
to agree to or take any other action in regazd to any reorganization, merger,
consolidation, liquidation, bankruptcy or other procedure or proceedings affecting
any stock, bond, note or other security held by this Trust.
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(5) To use lawyers, real estate brokers, accountants and any other agents, if
such employment is deemed necessary or desirable, and to pay reasonable
compensation for their services.
(6) To compromise, settle or adjust any claim or demand by or against the
Trust and to agree to any rescission or modification of any contact or agreement
affecting the Trust.
(7) To renew any indebtedness, as well as to borrow money, and to secure
the same by mortgaging, pledging or conveying any property of the Trust, including
the power to borrow from the Trustees (in the Trustees' individual capacity) at a
reasonable rate of interest.
(8) To retain any business interest transfeaed to the trustee, as shazeholder,
security holder, creditor, partner or otherwise, for any period of time whatsoever,
even though the interest may constitute all or a large portion of the trust principal; to
comply with the provisions of any agreement restricting transfer of the interest; to
participate in the conduct of the related business or rely upon others to do so, and to
take or delegate to others discretionary power to take any action with respect to its
management and affairs which an individual could take as outright owner of the
business or the business interest, including the voting of stock (by sepazate trust or
otherwise regardless of whether that separate trust will extend for a term within or
beyond the term of the trust) and the determination of all questions of policy; to
execute and amend partnership agreements; to participate in any incorporation,
reorganization, merger, consolidation, sale of assets, recapitalization, liquidation or
dissolution of the business, or any change in its nature, or in any buy-sell, stock
restriction, or stock redemption agreements; to invest in additional stock or securities
of, or make secured, unsecured, or subordinated loans to, the business with trust
funds; to take all appropriate actions to prevent identify, or respond to actual or
threatened violations of any environmental law or regulation thereunder; to elect or
employ with compensation, as directors, officers, employees, or agents of the
business, any persons, including a trustee of any trust held under this instrument, or
any director, officer, employee, or agent of a corporate trustee of any trust held under
this instrument, without adversely affecting the compensation to which that trustee
would otherwise be entitled; to rely upon reports of certified public accountants as
to the operations and financial condition of the business, without independent
investigation; to deal with and act for the business in any capacity (including in the
case of a corporate trustee any banking or trust capacity and the loaning of money out
of the trustee's own funds) and to be compensated therefor; and to sell or liquidate
the business or any interest in the business.
(9) To register any stock, bond or other security in the name of a nominee,
without the addition of words indicating that such security is held in a fiduciary
capacity, but accurate records shall be maintained showing that the stock, bond or
5
other security is a trust asset and the Trustees shall be responsible for the acts of the
nominee.
(10) To set aside as a sepazate trust, to be held and administered upon the
same terms as those governing the remaining trust property, any interests in property,
for any reason, including but not limited to a concern that such property could cause
potential liability under any federal, state, or local environmental law.
B. Whenever the Trustees are directed to distribute any trust principal in fee simple to a
person who is then under twenty-one (21) yeazs of age, the Trustees shall be authorized to hold such
property in trust for such person until he becomes twenty-one (21) yeazs of age, and in the meantime
shall use such part of the income and the principal of the trust as the Trustees may deem necessary
to provide for the proper support and education of such person in the standard of living to which he
has become accustomed. If such person should die before becoming twenty-one (21) yeazs of age,
the property then remaining in trust shall be distributed to the personal representative of such
person's estate.
C. In making distributions from the Trust to or for the benefit of any minor or other person
under a legal disability, the Trustees need not require the appointment of a guardian, but shall be
authorized to pay or deliver the distribution to the custodian of such person, to pay or deliver the
distribution to such person without the intervention of a guardian, to pay or deliver the distribution
to the legal guazdian of such person if a guardian has already been appointed, or to use the
distribution for the benefit of such person.
D. In the distribution of the Trust and any division into separate trusts and shares, the
Trustees shall be authorized to make the distribution and division in money or in kind or in both,
regazdless of the basis for income tax purposes of any property distributed or divided in kind, and
the distribution and division made and the values established by the Trustees shall be binding and
conclusive on all persons taking hereunder. The Trustees may in making such distribution or
division allot undivided interests in the same property to several trusts or shazes.
E. If at any time after Settlor's death the total fair mazket value of the assets of any trust
established or to be established hereunder is so small that the corporate Trustee's annual fee for
administering the trust would be equal to or less than the minimum annual fee set forth in the
Trustee's regularly published fee schedule, then the Trustees in their discretion shall be authorized
to terminate such trust or to decide not to establish such trust, and in such event the property then
held in or to be distributed to such trust shall be distributed to the persons who aze then or would be
entitled to the income of such trust. If the amount of income to be received by such persons is to be
determined in the discretion of the Trustees, then the Trustees shall distribute the property among
such of the persons to whom the Trustees aze authorized to distribute income, and in such
proportions, as the Trustees in their discretion shall determine.
F. The Trustees shall be authorized to lend or borrow, including the right to lend to or
borrow from the Settlor's estate, at an adequate rate of interest and with adequate security and upon
such terms and conditions as the Trustees shall deem fair and equitable.
G. The Trustees shall be authorized to sell or purchase, at the fair mazket value as
determined by the Trustees, any property to or from Settlor's estate, the estate of Settlor's spouse, or
any trust created by Settlor or Settlor's spouse during life or by will, even though the same person
or corporation may be acting as executor of Settlor's estate or the estate of Settlor's spouse or as
trustee of any other such trusts and as the Trustee of this Trust.
H. The Trustees shall have discretion to determine whether items should be chazged or
credited to income or principal or allocated between income and principal as the Trustees may deem
equitable and fair under all the circumstances, including the power to amortize or fail to amortize
any part or all of any premium or discount, to treat any part or all of the profit resulting from the
maturity or sale of any asset, whether purchased at a premium or at a discount, as income or principal
or apportion the same between income and principal, to apportion the sales price of any asset
between income and principal, to treat any dividend or other distribution on any investment as
income or principal or to apportion the same between income or principal, to chazge any expense
against income or principal or apportion the same, and to provide or fail to provide a reasonable
reserve against depreciation or obsolescence on any asset subject to depreciation or obsolescence,
all as the Trustees may reasonably deem equitable and just under all of the circumstances.
I. The Trustees are hereby authorized and empowered to purchase such insurance policies
as they deem appropriate.
5.02. Votive by Trustees. When the authority and power under this Trust is vested in two
(2) or more Trustees or Co-Trustees, the authority and power under this Trust or granted by law shall
be vested in, and exercised by, each of the Trustees individually or all of the Trustees jointly, such
that each Trustee may act independently, or the trustees may act jointly, in the administration or
under the terms of the Trust agreement.
5.03. Trustees Power to Deal with Environmental Hazards. The Trustee shall have the
power to use and expend the trust income and principal to (i) conduct environmental assessments,
audits, apd site monitoring to determine compliance with any environmental law or regulation
thereunder; (ii) take all appropriate remedial actionto contain, clean up orremove any environmental
hazazd including a spill, release, discharge or contamination, either on its own accord or in response
to an actual or threatened violation of any environmental law or regulation thereunder; (iii) institute
legal proceedings concerning environmental hazazds or contest or settle legal proceedings brought
by any local, state, or federal agency concerned with environmental compliance, or by a private
litigant; (iv) comply with any local, state or federal agency order or court order directing an
assessment, abatement or cleanup of any environmental hazazds; and (v) employ agents, consultants
and legal counsel to assist or perform the above undertakings or actions. Any expenses intoned by
the trustee under this paragraph may be chazged against income or principal as the trustee shall
determine.
7
ARTICLE VI. SPENDTI3RIPT PROVISION
6.01. General Provision. No beneficiary shall have the power to anticipate, encumber or
transfer his interest in the Trust Estate in any manner other than by the valid exercise of a Power of
Appointment. No part of the Trust Estate shall be liable for or charged with any debts, contracts,
liabilities or torts of a beneficiary or subject to seizure or other process by any creditor of a
beneficiary.
ARTICLE VII. CONSTRUCTION OF TRUST
7.01. Choice of Law. This Trust shall be administered and interpreted in accordance with
the laws of the Commonwealth of Pennsylvania.
7.02. Code. Unless otherwise stated, all references in this Trust to section and chapter
numbers are to those of the Internal Revenue Code of 1986, as amended, or corresponding provisions
of any subsequent federal tax laws applicable to this Trust.
7.03. Other Terms. Unless the context otherwise requires, the use of one or more genders
in the text includes all other genders, and the use of either the singular or the plural in the text
includes both the singular and the plural.
7.04. Caotiona. The captions set forth in this Agreement at the beginning of the various
divisions hereof are for convenience of reference only and shall not be deemed to define or limit the
provisions hereof or to affect in any way their construction and application.
7.05. Situa of Trust. The Trust shall have its legal situs in Cumberland County,
Pennsylvania.
ARTICLE VIII.
COMPENSATION OF TRUSTEES AND
APPOINTMENT OF SUCCESSOR TRUSTEES
8.01. Compensation. The Trustees shall receive as their compensation for the services
performed hereunder that sum of money, based on an hourly charge or percentage rate, which the
Trustees normally and customarily charge for performing similaz services during the time which they
perform these services.
8.02. Removal of Trustees. Settlor may remove the Trustees, or any of them, at any time
or times, with or without cause, upon thirty (30) days written notice given to the current Trustees.
Upon the death of the Settlor, a majority of the current income beneficiaries may remove the
Trustees, or any of them, at any time or times, with or without cause, upon thirty (30) days written
notice given to the current Trustees. Upon the removal of the Trustees, or any of them, a successor
Trustee(s) shall be appointed in accordance with the terms set forth in Pazagraph 8.03.
8.03. Anoointment of Saccesaor Trustees. The Trustees, or any of them, may resign at
any time upon thirty (30) days written notice given to the Settlor if Settlor is living, or in the event
of Settlor's death, upon thirty (30) days written notice given to the current income beneficiary or
beneficiaries (including a beneficiary's natural or legal guardian or legal representative), hereunder.
Upon the death, resignation, removal or incapacity of the Trustees, or any of them, a successor
trustee(s) may be appointed by the Settlor during Settlor's lifetime, or, after Settlor's death, by a
majority of the current income beneficiazies. Notwithstanding the foregoing provisions respecting
the appointment of a successor trustee(s), if and in the event that one Trustee shall die, resign, be
removed, or be adjudicated incompetent, the remaining Trustee shall exercise the powers, and carry
out the duties, of Trustee individually until such time as a successor trustee is appointed. Any
successor trustee(s) shall be a financially sound and competent corporate trustee or issue of the
Settlor. Any successor trustee(s) thus appointed, or, if the corporate trustee shall merge with or be
consolidated with another corporate fiduciary, then such corporate fiduciazy, shall succeed to all the
duties and to all the powers, including discretionary powers, herein granted to the Trustees.
8.04. Eaoneration of Trustee. No Trustee shall be liable for any loss or depreciation in
value sustained by the Trust as a result ofthe Trustee retaining any property upon which there is later
discovered to by hazazdous materials or substances requiring remedial action pursuant to any federal,
state, or local environmental law, unless the Trustee contributed to the loss or depreciation in value
through willful default, willful misconduct, or gross negligence.
8.05. Indemnification of Trustee Upon Distribution. Notwithstanding any contrary
provision in this Trust Agreement, the Trustee may withhold a distribution to a beneficiary until
receiving from the beneficiary an indemnification an agreement in which the beneficiary agrees to
indemnify the Trustee against any claims filed against the Trustee as an "owner" or "operator" under
the Comprehensive Environmental Response, Compensation and Liability Act of 1980, as from time
to time amended, or any regulation thereunder.
ARTICLE 1X. PERPETUITIES CLAUSE
9.01. General Provision. Notwithstanding anything to the contrary in this Trust, each
disposition the Settlor has made here, legal or equitable, to the extent it can be referred in its
postponement of becoming a vested interest to a duration measured by some life or lives in being
at the time of Settlor's death is definitely to vest in interest, although not necessarily in possession,
not later that twenty-one (21) yeazs after such lives (and any period of gestation involved); or, to the
extent it cannot be referred in any such postponement to such lives, is to so vest not later than
twenty-one (21) years from the time of Settlor's death.
ARTICLE X.
ACQUISITION OF UNTTED STATES TREASURY BONDS
ELIGIBLE FOR TAX PAYMENT; PAYMENT OF TAXES, FUNERAL
EXPENSES, AND EXPENSES OF ADMINISTRATION
10.01. Acquisition of Bonds. The Trustees may, at any time, without the prior approval or
direction of the Settlor and whether or not the Settlor is able to manage Settlor's own affairs, acquire
United States Treasury Bonds selling at a discount, which bonds are redeemable at their par value
plus accrued interest thereon for the purposes of applying the proceeds to the payment of the United
States estate tax on the Settlor's estate; and the Trustees may borrow from any lender, including
themselves, with or without security, to so acquire these bonds.
10.02. Payment of United States Eatate Taa by Bond Redemption. The Settlor directs
that any United States Treasury Bonds which may be redeemed at their par value plus accrued
interest thereon for the purpose of applying the proceeds to the payment of the United States estate
tax imposed on the Settlor's estate, and which aze held by the Trustees, shall, to the extent of the
amount determined to be required for payment of the estate tax, be distributed to the legal
representative of the Settlor's estate to be used by the legal representative ahead of any other assets
and to the fullest extent possible to pay the estate tax.
10.03. Payment of Death Taws and Other Eatate Settlement Coats. After the Trustees
have complied with pazagraph 10.02, above, and ascertained from the legal representative that all
such bonds have been redeemed in payment of the United States estate tax, the Trustees shall also
ascertain from the legal representative whether the legal representative has sufficient assets to pay
the remaining legacy, succession, inheritance, transfer, estate and other death taxes or duties (except
the additional estate tax imposed by Section 2032(c), or corresponding provisions of the Internal
Revenue Code of 1986 applicable to the Settlor's estate and imposing the tax) levied or assessed
against the Settlor's estate (including all interest and penalties thereon), all of which taxes, interest
and penalties are hereafter referred to as the death taxes, interest and penalties. If the legal
representative advises the Trustees that insufficient funds exist to pay all the death taxes, interest and
penalties, the Trustees shall then pay to the legal representative from the trust property, an amount
equal to all the death taxes, interest and penalties in excess of the funds available to the legal
representative for these purposes, which payments aze to be made without apportionment.
If the Executor of the Settlor's estate, in such Executor's sole discretion, shall determine that
appropriate assets of Settlor's estate aze not available in sufficient amount to pay (1) the Settlor's
funeral expenses, and (2) expenses of administering the Settlor's estate, the Trustees shall, upon the
request of the Executor of the Settlor's estate, contribute from the principal of the trust estate the
amount of such deficiency; and in connection with any such action the Trustees shall rely upon the
written statement of the Executor of the Settlor's estate as to the validity and correctness of the
amounts of any such expenses, and shall furnish funds to such Executor so as to enable such
Executor to discharge the same, or to discharge any part or all thereof itself by making payment
directly to the person entitled or claiming to be entitled to receive payment thereof. No consideration
need be required by the Trustees from the Executor of Settlor's estate for any disbursement made by
the Trustees pursuant hereto, nor shall there be any obligation upon such Executor to repay to the
Trustees any of the funds disbursed by them hereunder, and all amounts disbursed by the Trustees
pursuant to the authority hereby conferred upon them shall be disbursed without any right in or duty
upon the Trustees to seek or obtain contribution or reimbursement from any person or property on
account of such payment. The Trustees shall not be responsible for the application of any funds
10
The foregoing Trust Agreement was delivered, and is hereby accepted, at Lemoyne,
Pennsylvania, on May ~, 2009.
WITNESS
GOLDIE E. MOHI.ER, TRUSTEE
WITNESS
~,F~ ~,~,,~ o~ °~,L~-,~k~a.~o~
WITNESS
WITNESS
-~ wITNESs
NEVIN W. MOHLER,TRUSTEE
(SEAL)
N S. MOHLER TRUSTEE
~,J
LARK K MOHI.ER, TRUSTEE
r. c~YVv~p~, ~l0-~s,~ (SEAL)
CONNIE M. MOHLER, TRUSTEE
12
delivered by them to the Executor of the Settlor's estate pursuant to the authority herein granted, nor
shall the Trustees be subject to liability to any beneficiary hereunder on
account of any payment made by them pursuant to the provisions hereof.
IN WITNESS WHEREOF, the Settlor and Trustees have hereunto set their hands and seals
as of the day and yeaz first above written.
WITNESS:
` C ~~l ~C O ~5EAL)
GOLDIE E. MOHLER, SE TL R
COMMONWEALTH OF PEN~NSYLV,/A~NIA
~~~L.~l'~(f% SS:
COUNTY OF ~~
On this, the ~_ day of May, 2009, before me, a Notary Public, the undersigned officer,
personally appeared GOLDIE E. MOHLER, known to me (or satisfactorily proven) to be the
person whose name is subscribed to the within Trust Agreement, and acknowledged that she
executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I have set my hand and official
COMMONWEALTH OF PENNSYLVANIA
Notarial Seel
Tell L WeNwr, Notary PiA1YC
Lemoyne Born, Cumberland Cathy
MyCornmYdon Ekes Jan. Z0, 2011
Member, Penneylvanle Aseocletion of Notarise
11
SCHEDULE"A"
SCHEDULE
REFERRED TO IN THE ANNEXED
TRUST AGREEMENT
DATED: MAY ~ 2009
FROM GOLDIE E. MOHLER,
SETTLOR
TO GOLDIE E. MOHLER NEVIN W. MOHLER,
KAREN S. MOHLER, LARRY K. MOHLER and CONNIE M. MOHLER,
TRUSTEES
Property Description:
1. Real Estate located 68 North Ninth Street.
13
IHl1`. Milt ~`. L.,.
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, X6.00
P 18161115 _
Certification Number
ue/Print In
~r
Th'ts is to certify that the information here given i(;
correctly copied from an original Certificate of Death
duly fil(;d with me as Local Registrar. The original
certificate will be fixw:uded (o the State Vitai
Accords Offic~f r permanent filing.
~~~`~`~ MA 13 011
~~ ~_~_-
Local 32egistrar Date Issued
COMMON WEALTH OF PENNSV LVANIA • DEPARTMENT OF HEALTH VITAL RECORDS
' l.tK 1 [ra.N s yr s+r.+... state .nc ••v.....~.' os Dea<n (Mn/Dev/Vt) RP`II mot
Date
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Black lnk .
2- Sex 3. Social 3ecurl<y Number
aen:a Laal Nama (First. Mleale. Last. wrnx)
12 - 3229 March 9 a 2012
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Dupoaunn Pmmb No. Or (OY J L
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280801
HARRISBURG. PA 1]128-0601
RECEIVED FROM:
MOHLER NEVIN W
487 SAN REMO PLACE
LEWISBERRY, PA 17339
__-____- lotl
ESTATE INFORMATION:
FILE NUMBER:
DECEDENT NAME:
DATE OF PAYMENT:
~STMARK DATE:
'CpUNTY:
DATE OF DEATH:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
SSN: 144-12-3229
2112-0370
MOHLER GOLDIE E
06/08/2012
06/08/2012
CUMBERLAND
03/09/2012
TOTAL AMOUNT PAID:
REMARKS:
REV-1162 EX(11-961
NO. CD 016081
S 20, 500.00
CHECK#1002
INITIALS: HMW
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
TAXPAYER
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER