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1505610105
REV-1500 EX (02-11) (H) 1!1
tvania OFFICIAL USE ONLY
PA Department of Revenue pennnsyy County Code Year File Number
PO Bureau of Individual Taxes FEE F~L,
BOX28o6o1 INHERITANCE TAX RETURNi
Harrisburg PA 17128-0601 RESIDENT DECEDENT b /
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
208-24-2216 07/25/2012 02/23/1932
Decedent's Last Name Suffix Decedent's First Name MI
Hoover Carolyn L
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Hoover Jr. Harvey E
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
1. Original Return O 2. Supplemental Return O 3. Remainder Return (Date of Death
Prior to 12-13-82)
O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
C§D 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death G@D 11. Election to Tax 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
Robert R. Black, Esq. (717243-3727
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ME TER OF WILDS UWOI&
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First Line of Address ::7 r- N T-41
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36 South Hanover Street c;•
Second Line of Address C:~~ y "r1
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City or Post Office State ZIP Code DATE FILED
Carlisle PA 17013
Correspondent's e-mail address: Rblack@blacklaw.COmcastbix.net
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which prepamr has any knowledge.
NAT E F PERSON RESPONSIBLE FOR ILING RETURN f~T€ s' a
AD S
99 AAqrs R "d, lisle, PA 17015
SIGN T R H t]A REP NTATIVE D E
ADD ESS
36 South Hanover Street, Carlisle, PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610105 1505610105 J
14
1505610205
REV-1500 EX (Fl) Decedent's Social Security Number
Decedents Name: 208-24-2216
RECAPITULATION
1. Real Estate (Schedule A) 1. 0.00
2. Stocks and Bonds (Schedule B) 2. 723,845.23
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) 3.
4. Mortgages and Notes Receivable (Schedule D) 4.
5. Cash, Hank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 43,792.69
6. Jointly Owned Property (Schedule F) O Separate Billing Requested 6.
7. Inter-Vvos Transfers & Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested........ 7. 555,847.20
8. Total Gross Assets (total Lines 1 through 7) 8. 1,323,485.12
9. Funeral Expenses and Administrative Costs (Schedule H) 9. 31,601.64
10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule 1) 10.
11. Total Deductions (total Lines 9 and 10) 11. 31,601.64
12. Net Value of Estate (Line 8 minus Line 11) 12. 1,291,883.48
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) 13. 767,637.43
14. Net Value Subject to Tax (Line 12 minus Line 13) 14. 524,246.05
TAX CALCULATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) x .0_ 524,426.05 15.
16. Amour-,: of Line 14 taxable
at lined rate X .0 _ 16.
17. Amount of Line 14 taxable
at sibling rate X .12 17.
18. Amoun! of Line 14 taxable
at collateral rate X .15 18.
19. TAX DUE .........................................................19.
20. FILL Its THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
1505610205 1505610205
REV-1500 EX (Fl) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Carolyn Hoover a/k/a Carolyn L. Hoover
STREET ADDRESS
99 Alters Road _
CITY STATE ZIP
Carlisle PA 17015
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) (1) 0.00
2. Credits/Payments
A. Prior Payments
B. Discount _
Total Credits ( A + B) (2)
3. Interest
(3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund. (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00
Make check payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred ❑ ■
b. retain the right to designate who shall use the property transferred or its income ❑ 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? ❑ 0
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? ❑
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 to or for the use of the surviving spouse is 0 percent
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an
adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in [72 P.S. §9116(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)]. A sibling is defined,
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1503 EX+ (8-12)
pennsylvania SCHEDULE B
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN STOCKS & BONDS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Hoover, Carolyn a/k/a Carolyn L. 21-12-0873
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
Eaton Vance Acct. 0003330776 - PA Municipal Income Fund Class A (ETPAX) - 4,748.243 shares 43,493.91
9.16 per person
2 WI Services Company - Waddell & Reed. Carolyn Ann Hoover Acct. 26675058. See attached let. 571,297.68
3 Morgan Stanley Smith Barney Acct. 913-107751-101. See attached Itr. and statement 109,053.64
Bank Dep. Program 4,730.49
Hershey Co. 33,928.67
Western Asset High 10,333.60
Agoura Hills Calif Redev 16,855.50
North Sumter Cty. 39,795.00
FHLMC Remic 2,164.48
Federal Home 1,245.90
TOTAL (Also enter on Line 2, Recapitulation) $ 723,845.23
If more space is needed, insert additional sheets of the same size
REV-i5o8 EX+ (08-12)
pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Hoover, Carolyn a/k/a Carolyn L 21-12-0873
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. ACNB Bank - certificate of deposit #158168. See attached letter. Principal $25,000. Interest $24.81 25,024.81
2. ACNB Bank - certificate of deposit #4990520. See attached letter. Principal $11,000. Interest $21.00 11,021.00
3. M&T Bank - checking account #423262. See attached letter 4,607.70
4. Genworth Insurance Co. - premium return long term care 398.38
5. PSERS - pro-rated retirement checking. See attached letter 2,740.80
TOTAL (Also enter on Line 5, Recapitulation) $ 43,792.69
If more space is needed, use additional sheets of paper of the same size,
REV-1510 EX+ (08-09)
--A SCHEDULE G
r pennsylvania
DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Hoover, Carolyn a/k/a Carolyn L. 21-12-0873
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.
DESCRIPTION OF PROPERTY
ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1• Union Central Life Ins. Co. - policy A64000967S-SPDA-TDA Annuity contract 236,341.69 236,341.69
Harvey E Hoover, Jr., beneficiary and husband. See attached letter
2. Union Central Life Ins. Co. - policy A64004981S-SPDA-non qualified 151,113.77 151,113.77
Harvey E Hoover, Jr., beneficiary and husband. See attached letter
3 Bankers Life & Casualty Co. -policy contract 7913333 57,483.93 57,483.93
Harvey E Hoover, Jr., beneficiary and husband. See attached letter
4 Wells Fargo Bank -IRA account XXXXXX8645 69,740.01 69,740.01
Harvey E Hoover, Jr., beneficiary and husband. See attached letter
5 Nationwide Life Ins. Co. - special interest annuity contract 4004A 41,167.80 41,167.80
Harvey E Hoover, Jr., beneficiary and husband. See attached letter
TOTAL (Also enter on Line 7, Recapitulation) $ 555,847.20
If more space is needed, use additional sheets of paper of the same size.
REV-1511 EX+ (10-09)
pennsytvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Hoover, Carolyn a/k/a Carolyn L. 21-12-0873
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Hoffman-Roth Funeral Home - funeral services 9,678.44
2. Cumberland Valley Memorial Gardens - grave opening 1,826.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: 0.00
Name(s) of Personal Representative(s) Harvey E Hoover Jr.
Street Address 99 Alters Road
_
City _ Carlisle......... State PA zip 17015
Year(s) Commission Paid:
2. Attorney fees: 15,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) 3,500.00
Claimant Harvey E. Hoover, Jr.
Street Address 99 Alters Road
City Carlisle State PA zip 17015
Relationship of Claimant to Decedent husband
4. Probate Fees: 597.20
5. Accountant Fees: 500.00
6. Tax Return Preparer Fees:
7. Reserve - filing and account and releases 500.00
TOTAL (Also enter on Line 9, Recapitulation) $ 31,601.64
If more space is needed, use additional sheets of paper of the same size.
REV-1512 EX+ (12-12)
i pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Hoover Carolyn a/k/a Carolyn L. 21-12-0873
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
i. 0.00
TOTAL (Also enter on Line 10, Recapitulation) $ 0.00
If more space is needed, insert additional sheets of the same size.
REV-1513 EX+ (01-10)
ilk pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Hoover, Carolyn a/k/a Carolyn L. 21-12-0873
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 distributions and transfers under
Sec. 9116 (a) (1.2).]
1. Harvey E. Hoover, Jr. spouse 555,847.20
99 Alters Road, Carlisle, PA 17015
IRA's and annuities
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF 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:
1 Credit shelter trust under Item Second of will 767,637.43
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 767,637.43
If more space is needed, use additional sheets of paper of the same size.
REV-1649 EX+ (09-12)
pennsytvania SCHEDULE O
DEPARTMENT OF REVENUE ELECTION UNDER SEC. 9113(A)
INHERITANCE TAXES RETURN
RESIDENT DECEDENT (SPOUSAL TRUSTS)
ESTATE OF FILE NUMBER
Hoover, Carolyn a/k/a Carolyn L. 21-12-0873
PART A - DEFERRING STATEMENT
For all trust assets reportable for Pennsylvania inheritance tax purposes for which a deferral of tax is being elected under
Section 9113(a), the personal representative responsible for filing the return and the trustee(s) of the trust in question hereby
acknowledge the department's Statement of Policy set forth at 61 Pa. Code § 94.3 concerning any potential termination of the
trust under 20 Pa.C.S. § 7710.1 that occurs after the return was filed. Specifically, the signatories recognize each individual's
assumption of liability for inheritance tax consequences that result from any termination of the trust under 20 Pa.C.S. § 7710.1
that occurs after a return has been filed.
1 /'ten
Sigfrature of rson R sponsible for F' ing Return Signature(s) o Trustee(s)
PART B - ELECTION TO TAX AMOUNTS
Complete this section only if making the election to tax available under Section 9113(a) of the Inheritance &
Estate Tax Act.
If the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust. This election
applies to the credit shelter Trust (marital, residual A, B, by pass, unified credit, etc.).
Enter the description and value of all interests for which the Section 9113(a) election is made.
DESCRIPTION VALUE
The assets that comprise the credit shelter trust. All the assets are taxable for Pennsylvania 767,637.43
Tota l 767,637.43
If more space is needed, insert additional sheets of the same size.
COPY
LAST WILL AND TESTAMENT
OF
CAROLYN L. HOOVER
I, CAROLYN L. HOOVER, of West Pennsboro Township, Cumberland County,
Pennsylvania, declare this to be my will, hereby revoking all prior will and codicils.
Distribution of Personal Property
FIRST: I give my personal property to my husband, HARVEY E. HOOVER, JR.,
if he survives me, for a period of thirty (30) days. If he shall not so survive me, I give to my
brother-in-law, John W. Bear, the following personal property: John Deere 40 tractor, John Deere
620 tractor, two (2) wheel cart, grader blade, ladders, welders, drill presses, band saw, bench saw,
lathe and hand tools. I give my household goods and all jewelry to my sister, Barbara Jo Bear, if
she survives me for a period of thirty (30) days. If she does not so survive me, I give said jewelry
to my niece, Amy Jo Abbott and my nephew, Jason R. Bear.
Credit Shelter Trust for Husband
SECOND: I give to my hereinafter named trustee to hold in trust (hereinafter referred
to as "credit shelter trust"), in addition to all assets received directly by trustee that are excludable
from my gross taxable estate for federal estate tax purposes, assets of a total value equal to the
largest amount, if any, that can pass free of federal estate tax by reason of the unified credit and
any other credits available for federal estate purposes except:
(i) the state death tax credit to the extent that use would require an increase in
the amount of state death taxes paid, and
(ii) the credit for tax on prior transfers to the extent that credit arises from
transfers to me from individuals who die after me.
Such latter amount shall be reduced by the value for federal estate tax purposes of any
initials
gifts which do not qualify for the marital or charitable deduction made by me under this will or
otherwise, and further reduced by an amount equal to the sum of all charges to principal, except
death taxes (since I direct hereafter that such death taxes be paid from this trust), that are not
deducted in computing my federal estate tax.
I recognize that depending upon the amount of bequests under my will, my non-
testamentary dispositions, the amount of state death taxes and administration expenses, and other
factors, this trust might be nonexistent or might consume all estate assets, so that no assets may
remain to pass outright to my husband pursuant to the residuary gift.
My executor shall select and distribute to the credit shelter trust, the cash, securities and
other property that shall constitute the credit shelter trust, employing for the purpose of valuation
the adjusted basis of the asset for federal estate tax purposes, provided that the assets distributed
shall be selected in such manner that they shall have an aggregate fair market value fairly
representative of the appreciation or depreciation in the value to the date or dates of distribution
of all assets then available for distribution.
The assets of the credit shelter trust shall be held and distributed on the following terms:
During the lifetime of my husband, HARVEY E. HOOVER, JR., trustee shall pay
and distribute to him or for his benefit the entire net income therefrom, which payments
shall be made to him periodically, but not less frequently than quarterly. In addition,
trustee shall from time to time pay to my husband, or shall apply directly for his benefit, as
much of the principal of this credit shelter trust as my corporate or disinterested trustee
may consider desirable for his health, maintenance and support, after considering all
resources available to him.
My husband shall have the right to withdraw annually the greater of $5,000 or 5
percent of the principal of this credit shelter trust valued at the end of the calendar year in
which the withdrawal is made. The right of withdrawal shall be exercised only in writing
and delivered to the my corporate or disinterested trustee in the lifetime of my husband
_L
2 initials
and the right of withdrawal shall be noncumulative. Upon the death of my husband or at
my death if he shall have predeceased me, the principal of this trust shall become a part of
the residue of my Estate.
Distribution of Residue to Husband
THIRD: If my husband, HARVEY E. HOOVER, JR., survives me for a period of
thirty (30) days, I give the residue of my Estate to him free of all trusts.
Distribution of Residue
FOURTH:
(i) In the event my husband, HARVEY E. HOOVER, JR., does not so survive
me, I give my two farms, namely the Sheaffer farm conveyed to me by deed dated August
17, 1987, and recorded in Cumberland County Deed Book "W", Volume 32, Page 633
and the Weibley farm conveyed to me by deed dated February 23, 1998, and recorded in
Cumberland County Deed Book 172, Page 434 to Barbara Jo Bear and John W. Bear, if
they survive me for a period of thirty (30) days. If they, or either of them, do not so
survive me, I give said farms to my niece, Amy Jo Abbott, and my nephew, Jason R. Bear,
or their issue per stirpes, who survive me for a period of thirty (30) days.
(ii) In the event my husband, HARVEY E. HOOVER, JR., does not so survive
me, I give the residue of my estate to my hereinafter named Trustee to hold in trust to pay
the entire net income therefrom, which payments shall be at least quarterly, in equal shares
to my niece, Amy Jo Abbott, and my nephew, Jason R. Bear, or the survivor thereof for
and during the term of their natural life.
(iii) Upon the death of both my niece, Amy Jo Abbott, and my nephew, Jason
R. Bear, I devise and bequeath the residue of my estate as follows:
(a) Fifty (50%) percent to the Grace United Methodist Church to be held in a
C~ X/-~
3 initials
separate fund known as the Harvey E. Hoover, Jr. and Carolyn L. Hoover
Memorial Fund with interest only payable yearly to said Church for general
operating expenses; and
(b) Fifty (50%) percent to the Milton S. Hershey Medical Center of Penn State
University to be used for general research purposes.
Simultaneous Death
FIFTH: If my husband and I should die under circumstances which render the order
of our deaths uncertain, for the purposes of the residuary marital gift, it shall be conclusively
presumed that my husband survived me.
Minors and Incapacitated Persons
SIXTH: If any income or principal shall be payable to any person who shall be a
minor or who shall be incapacitated for any reason, trustee shall hold such income and principal
during minority or incapacity and shall be entitled to apply such income and principal to the
health, maintenance, support and education of such person during minority or incapacity without
the appointment of any guardian or committee or any authority of court. Trustee shall be entitled
to make direct application or to make application by payment of income and principal to the
parent or other person in charge of such minor or incapacitated person, or to his or her guardian
or to a custodian under the Uniform Transfers to Minors Act. Any remaining income and
principal to which such person shall be entitled shall be paid and distributed to such person upon
the termination of minority or incapacity.
Appointment of Guardian of Estates of Minors
SEVENTH: I appoint my trustee as guardian of the estates of minors with power to
hold all property payable by law to a guardian appointed by my will and to use the same for the
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minor's health, maintenance, support and education, either directly or by payment to any person
selected by my trustee to disburse it whose receipt shall be a complete acquittance. Guardian
may, in discharge of all of the guardian's duties, pay any minor's share deemed impractical of
administration to the parent or other person in charge of the minor or to his or her guardian or to
a custodian for the minor under the Uniform Transfers to Minors Act. My trustee as guardian
shall have the same powers as my trustee and shall serve without bond.
Protection of Beneficiaries (Spendthrift Provisions)
EIGHTH: No interest in income or principal shall be assignable by a beneficiary or
available to anyone having a claim against a beneficiary before actual payment to the beneficiary.
Powers of Executor and Trustee
NINTH: My executor and trustee and their successors shall have the following
powers in addition to those given by law to be exercised by them in their absolute discretion,
which powers shall be applicable to all property held by them, effective without the order of any
court and until the actual distribution of all such property:
A. To retain any investments at discretion including stock of any corporate
fiduciary, or of a holding company controlling it;
B. To invest and reinvest at discretion without restriction to so-called "legal
investments," with the specific right to invest in common and preferred stocks and in such
common trust, diversified, money market and mutual funds as they deem appropriate;
C. To sell, to grant options for the sale of, or otherwise convert any real or
personal property or interest therein, at public or private sale, for such prices, at such time,
in such manner and upon such terms as they may think proper, and to execute and deliver
good and sufficient conveyances, assignments and transfers thereof without liability of any
purchaser to see to the application of the purchase money;
5 initials
D. To borrow money and to secure its repayment by mortgage of real or
personal property, pledge of investments or otherwise, without liability on the part of the
lenders to see to its application;
E. To compromise claims by or against my estate or any trust created by this
will;
F. To make distributions in cash or kind, or partly in each;
G. To register investments in the name of a nominee or to hold the same
unregistered in such form that they will pass by delivery;
H. To join in any recapitalization, merger, reorganization or voting trust plan
affecting investments, to deposit securities under agreement, to subscribe for stock and
bond privileges, and generally to exercise all rights of security holders;
I. To manage, operate, repair, alter or improve real estate or other property,
and to lease real estate and other property upon such terms and for such period as my
executor and trustee deems advisable even for more than five years and beyond the
duration of any trust;
J. To deduct administration expenses upon either the federal estate tax return
or fiduciary income tax return, with or without adjustment between principal and income,
as my corporate or disinterested executor shall determine;
K. To join with my husband and file any income tax or gift tax returns that
may be due on my behalf and to pay so much of such taxes as my corporate or
disinterested executor may deem appropriate and to consent to any gifts made by my
husband being treated as having been made one-half by me;
L. In the absence of a corporate fiduciary, to retain accountants, custodians,
investment advisors and other agents as my executor and trustee shall determine and to
compensate them out of principal or income or both as my executor and trustee shall
determine, such compensation to be a reduction of the compensation of my executor and
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trustee;
M. To disclaim any interest in property without Court approval; and
N. To do all other acts and things necessary or appropriate in the
management, administration and distribution of my estate.
Payment of Death Taxes
TENTH: My executor and trustee shall pay all estate, inheritance and other death
taxes (including the supplemental estate tax on certain qualified plan benefits but not including any
generation skipping tax imposed on a direct skip), together with interest and penalties, which shall
be payable with respect to property or interests subject to taxation by reason of my death and
whether passing under my will or any codicil, or otherwise, including jointly held and other non-
testamentary property. My executor and trustee shall pay the same out of the principal of the
credit shelter trust without apportionment. Only to the extent the credit shelter trust is insufficient
or unless my husband predeceases me shall any such payments be made from my residuary estate.
Appointment of Executor and Trustee
ELEVENTH: I appoint my husband, HARVEY E. HOOVER, JR., Executor of
my will. If my husband, HARVEY E. HOOVER, JR., is unable or unwilling to qualify as
Executor, or having qualified is unable or unwilling to continue to act, I appoint Adams County
National Bank as Executor. I appoint my husband, HARVEY E. HOOVER, JR., and ADAMS
COUNTY NATIONAL BANK and its successors or the survivor of them as trustees. I further
direct that my Executor and my trustees shall not be required to furnish security in any
jurisdiction.
Compensation of Fiduciaries
TWELFTH: My corporate fiduciary shall be compensated as such in accordance with its
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schedule of fees in effect from time to time when such services are rendered.
Interchangeability of Language
THIRTEENTH: Words used in the singular may be read to include the plural or the
plural may be read as the singular. Similarly, the masculine form may be read to include the
feminine and neuter; the feminine may be read to include the masculine and neuter; and the neuter
may be read to include the masculine and feminine.
Headings
FOURTEENTH: The headings used on the various paragraphs of this will are
included for convenience only and shall have no legal significance.
I have signed this will this day of , 2000.
/4-Cr-r, U~eX-
(%AtJN n
Carolyn L. oover
(Witness)
r
L'
(Witness)
ACKNOWLEDGMENT and AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA )
SS.
COUNTY OF CUMBERLAND )
We, Carolyn L. Hoover, the Testatrix in, and0 fi~ . ILJ.LC
8
and
4 - , the witnesses to the last will, the attached or
foregoing instrument, who have signed the instrument, having been duly qualified according to
law do depose and say:
(a) that I, the Testatrix, do hereby acknowledge that I signed and executed the
instrument as my last will, that I signed it willingly and as my free and voluntary act for the
purposes therein expressed; and
(b) that we, the witnesses, were present and saw the Testatrix sign and execute
the instrument as her last will, that she signed it willingly and executed it as her free and
voluntary act for the purposes therein expressed; that each of us in the hearing and sight of
the Testatrix signed the will as a witness and that to the best of our knowledge the
Testatrix was at that time eighteen or more years of age, of sound mind and under no
constraint or undue influence.
Caro L. +Hver
Witness
Witness
c~ C_`t.
(Signature of Officer of,atto*n
(Seal and official capacity of officer or state
of admission of attorney)
Esusan otarial Seat
Guyer, Notary public
o, Cumberland County
n Expires Sept. 41220
03
Member, Pennsylvania Association of Notaries
9
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01 14
WI Services Company
6300 Lamar Avenue
Post Office Box 29217
Shawnee Mission, KS 66201-9217
September 10, 2012 www.waddell.com
Robert R Black
36 S Hanover St
Carlisle PA 17013
RE: 26675058
Carolyn Ann Hoover
Dear Mr. Black:
In response to a request we received from, we are pleased to provide you with the account/fund value
as of July 25, 2012.
FUND SHARES PRICE VALUE
Ivy Small Cap Growth (602) 4586.958 $13.68 $62,749.59
Ivy Science & Technology (608) 5228.418 $31.23 $163,283.49
Ivy Pacific Opportunities (611) 5716.268 $12.30 $70,310.10
Ivy Global Natural Resources (612) 6188.956 $15.20 $94,072.13
Ivy European Opportunities (614) 951.053 $20.97 $19,943.58
Ivy Cundill Global Value (615) 3442.473 $11.01 $37,901.63
Ivy Value (632) 1370.658 $16.26 $22,286.90
Ivy Large Cap Growth (667) 2034.642 $13.68 $27,833.90
Ivy Mid Cap Growth (668) 4408.486 $16.54 $72,916.36
We appreciate the opportunity to be of service. If you have any further questions, do not hesitate to
contact us at 1-888-923-3355.
Sincerely,
Resource Center
Client Services Division
Waddell & Reed Services Co.
a: 9/20/2012 Time: 4:23 I'M TO: LVL L1G\n
u ioncenbal
A UNIFI Company
The Union Central Life Insurance Company
Individual Lire Claims
1876 Waycross Rd / Cincinnati, OH 45240
Toll Free 800.319-6302
September 17, 2012
ROBERT R BLACK Re: A64000967S A64004981S
LANDIS & BLACK Carolyn L. Hoover
36 SOUTH HANOVER STREET
CARLISLE PA 17013
Dear Mr. Black:
In response to your request for information on the above individual please find the following information
concerning your client. She was the owner of the following two policies with our company. She is also
the beneficiary on a third policy A64010848S.
Policy Number Policy Type 07-25-12 Cost Basis Profit
Values
A64000967S SPDA-TDA $236,341.69 0 $236,341.69
A64004981S SPDA-Non-Qualified $151,113.77 $100,000.00 $51,113.77
The beneficiary for the above policies is Harvey E. Hoover Jr. husband of the owner/annuitant, namely
Carolyn L. Hoover.
If you have any questions concerning these contracts please do not hesitate to call me. My toll-free
number is 1-800-319-6302.X52740.
Respectfully,
Earl Ray, FLHC, ACS
Senior Claim Examiner
Individual Life Claims
ecr
cc: Agency 347- Richard J. Johnson
• BANKERS LIFE AND CASUALTY COMPANY
PO Box 1937
Carmel, IN 46082-1937
September 17, 2012
Harvey E Hoover JR
99 Alters Road
Carlisle, PA 17015
Contract Number: 7913333
Carolyn Hoover, deceased
Dear Mr. Hoover:
Below is the breakdown of the death claim payout for the above referenced
contract. You have chosen to transfer your death benefit proceeds to a pending
new business application. You will receive your new policy under separate
cover.
Death Benefit: $ 57,483.93
Less After Death Withdrawal -$0.00
Your Share: $ 57,483.93
Interest @ 0.75% $0.00
Taxable Amount: $ 0.00
Federal Withholding: $ 0.00
Amount Sent to Pending Application $ 57,483.93
Check Amount: $ 0.00
If you have any questions regarding this transfer, please contact our office at
800-654-3072.
Sincerely,
Annuity Claims Department
BANKERS
LIFE AND CASUALTY COMPANY
(800) 621-3724
PO Box 1937
Carmel IN 46082-1937
September 12, 2012
Law Offices Landis & Black
36 South Hanover ST
Carlisle, PA 17013
Policy: 7913333
RE: Carolyn Hoover, deceased
Dear Family of Carolyn Hoover:
Please accept our sincere sympathy on the passing of your loved one.
The primary beneficiary of the policy listed above is Harvey E Hoover JR.
Once the documentation has been received, a Claims Adjuster will review the cases
to determine that all requirements to service your claims have been met. The
Claims Adjuster will then either contact you directly if additional information is
needed or complete the servicing of your claims.
Please contact our Customer Service Department at 1-800-654-3072 by phone or
1-317-817-4431 by fax if you have questions or require additional assistance.
Sincerely,
Annuity Claims Department
b z o x O x o m o rn o x 'Jd d d
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H A
R
Nationwide Financiale
Income Products Service Center
P.O. Box 182928
Columbus, OH 43218-2928
On Your Side®
October 22, 2012
Harvey Hoover Jr.
99 Alters Rd
Carlisle, PA 17015
RE: Estate of Carolyn Hoover
Date of death: 07/25/2012
Contract: 4004A
Dear Mr. Hoover,
This is in response to your inquiry about the date of death value on the above referenced
contract for Carolyn Hoover. The date of death value is $41,167.80.
If you should need any additional information, please contact our office at
1-800-634-5222. Our office hours are 8:00 a.m. to 5:00 p.m. Eastern Time.
Sincerely,
Catherine Jorge-Ratliff
Income Products Service Center
Annuities and life insurance products are issued by Nationwide Life Insurance Company, Columbus, Ohio, a member of Nationwide Financial.
The general distributor is Nationwide Investment Services Corporation, member NASD. In MI only: Nationwide Investment Svcs. Corporation.
Nationwide, the Nationwide framemark, On Your Side and Nationwide Financial are federally registered service marks of Nationwide Mutual Insurance
Company.
Nationwide Financial@
Income Products Service Center
P.O. Box 182928
Columbus, OH 43218-2928
On Your Side®
October 22, 2012
Harvey Hoover Jr.
99 Alters Rd
Carlisle, PA 17015
Re: Contract Number: 4004A
Payee: Carolyn Hoover
Date of Death: 07/25/2012
Dear Mr. Hoover:
We at Nationwide extend our sympathy to the family of Carolyn Hoover.
Our records indicate this contract was an 5 Year Special Interest Only Annuity issued on
November 19, 1999. The proceeds are payable to you as beneficiary in one lump sum
payment.
In order to process the benefits, we will need the following:
• Completed Claimant's Statement
A return envelope is enclosed for your convenience. If you have any questions or need
additional information, please call us toll-free at 1-800-634-5222. Our office hours are
8:00 a.m. to 5:00 p.m. Eastern Time.
Sincerely,
Income Products Service Center
Cmjr
Enclosure
Annuities and life insurance products are issued by Nationwide Life Insurance Company, Columbus, Ohio, a member of Nationwide Financialo.
The general distributor is Nationwide Investment Services Corporation, member NASD. In MI only: Nationwide Investment Svcs. Corporation.
Nationwide, the Nationwide framemark, On Your Side and Nationwide Financial are federally registered service marks of Nationwide Mutual Insurance
Company.
ACNB
BANK
August 29, 2012
Landis & Black
Attn: Robert R Black
36 S Hanover St
Carlisle PA 17013
RE: Estate of Carolyn L Hoover
Dear Mr. Black:
The following information is being provided as per your request:
Acct. Type Account No. Balance at Accrued Ownership Date
D.O.D. Interest to Opened/Joint
D.O.D.
Money 1595148 $171,250.87 $8.45 Jt w/ Harvey E Hoover Jr 10/26/1987
Market
Account
Certificate of 158168 $25,000.00 $24.81 Individual 9/25/01
Deposit
Certificate of 4990520 $11,000.00 $21.00 Individual 3/19/99
Deposit
Save Deposit 803/314 Jt w/ Harvey E Hoover Jr 2/14/69
Box (Newville
Office)
Inquiries concerning ACNB Corporation stock information should be directed to the Registrar and Transfer Company
at 1-800-368-5948. If you need any additional information, please contact me at (717)339-5122.
Sincerely,
Barbara J Warner
ACN13 Bank
Deposit Services Representative II
Cc: ACNB Bank Trust Department
acnb.com • acnbbusiness.com • P.0. Box 3129, Gettysburg, PA 17325 • Phone 717.334.3161 • Toll Free 1.888.334.ACNB (2262)
M&TBank
10. M 499 Mitchell Road, Millsboro, DE 19966 Adjustment Services
Phone 888-502-4349
F ax (302) 934-2955
August 21, 2012
Law Offices
Landis & black
36 South Hanover Street
Carlisle, PA 17013
Re: Estate of Carolyn L. Hoover
Social Security: 208-24-2216
Date of Death: July 25 2012
Dear Sir or Madam:
Per your inquiry on August 14, 2012, please be advised that at the time of death, the above-named decedent had
on deposit with this bank the following:
1. Type of Account Checking Account
Account Number 423262
Ownership (Names ofl Carolyn L. Hoover
Opening Date 0910111967
Balance on Date of Death $4,67.07
Accrued Interest $ .00
Total
$4,607.7
For any additional information on the above accounts, including ownership and any changes, closures and/or reimbursement of funds,
please call the High Street Carlisle at 717-2404536.
We were unable to locate any safe deposit box for the above-mentioned decedent.
This letter does not include any accounts in which the deceased may have been listed as Power of Attorney, Custodian of Uniform Transfers,
Representative Payee, or Trustee under a Written Agreement.
Sincerely,
Valarie Mercer
Adjustment Services
219 North Hanover Street
Carlisle, Pennsylvania 17013
717.243.4511
toll free 1.866.451.4511
fax 717.243.3723
www
FUNERAL HOME & CREMATORY INC. .hoffm anroth.com
infoCa?hoffmarcoth.com
August 27, 2012
Harvey Hoover
99 Alters Road
Carlisle, PA 17015
Statement of Funeral Expenses for: Carolyn Hoover
Date of Death: July 25, 2012 Account Id: 16615-178
PACKAGE:
Traditional Funeral Service
TRADITIONAL FUNERAL SERVICE PACKAGE $ 4,850.00
Sub Total: $ 4,850.00
MERCHANDISE:
Casket: Adirondack $ 2,670.00
Outer Container: Monticello $ 1,620.00
Sub Total: $ 4,290.00
TOTAL FUNERAL HOME CHARGES: $ 9,140.00
CASH ADVANCES:
20 Certified Death Certificates at $ 6.00 each $ 120.00
Newspaper Notice - Sentinel $ 144.44
Clergy $ 100.00
Flowers $ 159.00
Hairdresser $ 40.00
Credit For Clergy $ -100.00
Organist $ 75.00
Sub Total: $ 538.44
Total Funeral Expense: $ 9,678.44
Total Payments Made: $ 9,678.44
Payments Made:
Harvey Hoover Check 01 Aug 15, 2012 9,678.44
Balance: 0.00
Please return this portion with your Remittance.
$ Amount Enclosed
Carolyn Hoover
Service ID#: 16615-178
SERVING OUR COMMUNITY SINCE 1907