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Home My WebLink About04-1022Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of William A. Cornell also known as , Deceased Social Security No. 181-18-4185 (COMPLETE "A" OR "B" BELOW:) A. Probate and Grant of Letters and aver that Petitioner(s) is/are the executor named in the Last Will of the Decedent, dated October 17, 2001 and codicil(s) dated Except as follows. Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: NONE B. Grant of Letters of Administration Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence (COMPLETE IN ALL CASES:) Attach additional sheets if necessary Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 65 Glenn Road, Wormleysburq, PA 17043 (Wormleysburq Boro) Decedent, then 80 years of age, died October 9, 2004, at 65 Glenn Road, Wormleysburq, PA 17043 Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property ...................................... $ 130,000.00 (If not domiciled in PA) Personal property in Pennsylvania ........................ $ (If not domiciled in PA) Personal property in County .................................. $ Value of real estate in Pennsylvania ........................................................ $ 227,150.00 Total ........................................................................... $ 357,150.00 Real Estate situated as follows: Y2 tenants by the entireties interest in 65 Glenn Road, Wormleysburg, Pennsylvania 17043($199,190.00); Y= tenants by the entireties interest in 222 South Front Street, WormleysburR, Pennsylvania ($157,090.00); and ~/~ tenants by the entireties interest in 218 South Front Street, WormleysburR, Pennsylvania ($49,010 00) Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: I ~7/'~"Z~ Signa~~ Typed or printed name and residence Beth L. Cornell 6105 Summit Pointe Drive Harrisburg, PA 17111 Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above'named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. ~ -',- ' S;vorn to and affirmed and subscribed before me this ; ' -' day of 2OO4 DECREE OF REGISTER Estate of William A. Cornell Deceased No.:?l' ("q- }(i,' ~)''~ also kno~vn as Social Security No: 181-18-4185 Date of Death: October 9, 2004 AND NOW, ,2004, in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters [] Testamentary [] of Administration are hereby granted to Beth L. Cornell in the above estate and that the instrument(s), if any, dated described in the Petition be admitted to probate and flied of record as the last Will of Decedent. FEES Letters ........................... Short Certificate(s) (~5)... Renunciation ( ) ............ Affidavit ( ) .................. Extra Pages (lz) ........... Codicil ........................... JCP Fee ........................ Inventory & Tax Forms... Other ........................... TOTAL ................ s.¢©5 s 13500 $ $ s3g. oo $ $ $ $ $ Register of Wills ,.2, ', ~. , Attorney: I.D. No: Address: Telephone: Elizabeth d. Goldstei~ 73779 415 Fallowfield Rd. Suite 301 Camp Hill, PA 17011 ~ 1 ~-612-5803 FILED: DATE 148899 1 OMMONWEALTH OF PENNSYLVANIA ' DEPARTMENT OF HEALTH - VITAL RECORDS CERTIFICATE OF DEATH Male ~ 181-- 18 4185 ~ Octoberg, 2004 Dr. William A. Cornell 80 ~ Oct 29, 1923 Cumberland Wormleysburg 65 Oienn Road Wormleysbur9, Pa 17043 Leslie Hall Comell William A Cornell, Jr 65 Glen Road Oct 14 2004 Cumberland ,o~,,.,,,"~ ,ru[~ ~N'~,,,,',"~3[..,l,,,,,t.~, Wormleysburg OF WILLIAM A. CORNELL I, WILLIAM A. CORNELL, of the Borough of Wormleysburg, Cumberland County, Pennsylvania, do make, publish and declare this to be my Last Will and Testament, hereby revoking ali Wills and Codicils by me :at any time made. ITEM I: I direct that all inheritance and estate taxes becoming due by reason of my death, ;vhether payable by my estate or by any recipient of any property, shall be paid by the Executor out of the residue of my estate, as an expense and cost of administration of my estate. The Executor shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. ITEM II: I direct the Executor to pay the expenses of my last illness and funeral expenses from the residue of my estate as an expense and cost of administration of my estate. ITEM III: I may leave a written list in my safe deposit box or elsewhere disposing of certain items of my tangible personal property. The Executor shall dispose of items of my personal property as specified in the written list. If no written list is found in my safe deposit box or elsewhere and properly identified by the Executor within thirty (30) days after the probate of my Will, it shall be presumed that there is no list; any subsequently discovered list shall be ignored. Page ITEM IV: If I die before my wife, LAURA W. CORNELL, I give to her all of my household furniture and furnishings, books, pictures, jewelry, silverware, automobiles, wearing apparel and ali other articles of household or personal use or adornment and all policies of insurance thereon not identified in the written list mentioned in ITEM III. If I do not die before my wife, I make this gift to my children, BETH L. CORNELL and WILLIAM A. CORNELL, JR., to be divided between them as they shall agree. ITEM V: I give one hundred (100) shares of my PNC common stock to SIGMA TAU GAMMA FOUNDATION, Warrensburg, Missouri. ITEM VI: I give the residue of my estate, not disposed of in the preceding portions of this Will, as follo~vs: (a) To my daughter, BETH L. CORNELL, as Trustee, IN TRUST, to be administered and distributed as provided in ITEM VII, a fraction of my residuary estate. The numerator shall be a sum equal to the largest amount that can pass free of Federal estate tax under my Will by reason of the applicable credit amount and the state death tax credit (provided that the use of this credit does not require an increase in state death taxes) allowable to my estate but no other credit and after taking account of dispositions under other items of this Will and property passing outside of this Will which do not qualify for the marital or charitable deduction and after taking account of charges to principal that are not allowed as deductions in computing my Federal estate tax. The denominator shall be the value of my residuary estate. For purposes of establishing this fraction, the values Page finally fixed in the Federal estate tax proceeding relating to my estate shall be used. I recognize that the numerator of such fraction may be zero (0), in which case no property shall pass to this Trust. ~ also recognize that the numerator may be affected by the action of the Executor in exercising certain tax elections. (b) The balance of my residuary estate shall be paid to my wife, LAURA W. CORNELL, if she survives me. If she does not survive me, this portion of my estate shall be added to the Trust funded pursuant to subsection (a) and shall be administered and distributed as provided in ITEM VII. ITEM VII: the Trust established by ITEM VI (a): The following provisions shall apply to (a) This Trust shall be known as The Cornell Family Credit Trust. (b) The Trustee shall pay to or for the benefit of my wife, LAURA W. CORNELL, all of the net income of this Trust in convenient installments, but not less frequently than annually. (c) The Trustee shall also pay to my wife so much of the principal of this Trust as may be necessary in the discretion of the Trustee for the proper support, maintenance and medical care of my ~vife. Page 3 (d) Upon the death of my wife, the Trustee shall divide the principal into as many equal parts as there are then living children of mine and then deceased children of ~nine represented by then living issue. The Trustee shall pay one share to each living child, and shall pay one share to the issue of each deceased child, per stirpes. It is my desire, in distributing the assets of this trust to my children, to allocate my real estate located at 65 Glen Road, Wormleysburg, Pennsylvania, to my daughter, BETH L. CORNELL, and to allocate my real estate located at 222 South Front Street, Wormleysburg, Pennsylvania, to my son, WILLIAM A. CORNELL, JR. ITEM VIII: No part of the income or principal of any Trust created by this Will shall be subject to attachment, levy or seizure by any creditor, spouse, assignee or trustee or receiver in bankruptcy of any beneficiary prior to his or her actual receipt of income or principal distributed. The Trustee shall pay the net income and the principal to the beneficiaries specified by me, as their interests may appear, without regard to any attempted anticipation, pledging or assignment, and without regard to any claim or attempted levy, attachment, seizure or other process against the beneficiary. ~TEM IX: The Executor and the Trustee shall each possess the following powers, each of which may be exercised without court approval and in a fiduciary capacity only: (a) To retain any investments I have at my death, including specifically those consisting of stock of any bank even if I have named that bank as the Executor or Trustee. Page 4 ~ (b) To vary investments, and to invest in bonds, stocks, notes, real estate mortgages or other securities or in other property, real or personal, without being restricted to so-called "legal investments", and without being limited by any statute or rule of law regarding investments by fiduciaries. (c) In order to divide the principal of a Trust or for any other purpose, including final distributions, the Executor and Trustee are authorized to divide and distribute personal property and real property, partly or wholly in kind, and to allocate specific assets among beneficiaries and Trusts so long as the total market value of each share is not affected by the division, distribution or allocation in kind. The Executor and Trustee are each authorized to make, join in and consummate partitions of lands, voluntarily or involuntarily, including giving of mutual deeds, or other obligations, with as wide powers as an individual owner in fee simple. (d) To sell either at public or private sale real and personal property severally or in conjunction with other persons, and to consummate sale(s) by deed(s) or other instrument(s) to the purchaser(s), conveying a fee simple title. No purchaser shall be obligated to see to the application of the purchase money or to make inquiry into the validity of any sale(s). The Executor and Trustee are authorized to execute, acknowledge and deliver deeds, assignments, options or other writings as necessary or convenient to any of the power conferred upon the Executor and Trustee. (e) To mortgage real estate, and to make leases of real estate. Page (i) To borrow money fi'om any person, including the Executor or Trustee, to pay indebtedness of mine or of my estate, expenses of administration or inheritance, legacy, estate and other taxes, and to assign and pledge assets of my estate or any Trust established by this Will. (g) To pay all costs, taxes, expenses and charges in connection with the administration of my estate or any Trust established under this Will. If any death taxes are payable with respect to my estate, these taxes shall be paid from "The Cornell Family Credit Trust". (h) To make distributions of income and of principal to the proper beneficiaries, during the administration of my estate, with or without court order, in such manner and in such amounts as the Executor deems prudent and appropriate. (i) To vote shares of stock which form a part of my estate or any Trust established under this Will, and to exercise all the powers incident to the ownership of stock. (j) To unite with other owners of property similar to property in my estate to carry out plans for the reorganization of any company whose securities form a part of my estate. (k) To disclaim any interest in property which would devolve to me or my estate by whatever means, including but not limited to the following means: as beneficiary under a will, as an appointee under Page 6 ~/,~"r~.~ the exercise of a power of appointment, as a person entitled to take by intestacy, as a donee of an inter vivos transfer, and as a donee under a third-party beneficiary contract. (1) To prepare, execute and file tax returns of any type required by applicable law, and to make all tax elections authorized by (m) To employ custodians of property, investment or business advisors, accountants and attorneys as the Executor or Trustee deems appropriate, and to compensate these persons from assets of my estate or trust, without affecting the compensation to which the Executor and Trustee are entitled. (n) To divide any Trust created in this Will into two or more separate Trusts so that inclusion ratio for purposes of the generation- skipping transfer tax shall be either zero or one, in order that an election under Section 2652(a)(3) of the Internal Revenue Code may be made with respect to one of the separate Trusts, or for any other reason. (o) To allocate administrative expenses to income or to principal, as the Executor or Trustee deems appropriate. However, no allocation to income shall be made if the effect of the allocation is to cause a reduction in the amount of any estate tax marital deduction or estate tax charitable deduction. Page 7 (p) To do all other acts in their judgment necessary or desirable for the proper and advantageous management, investment and distribution of the estate and Trusts established under this Will. ITEM X: The Trustee is authorized to distribute principal and/or income in any one or more of the following ways if the Trustee, in the sole discretion of the Trustee, considers the beneficiary unable to apply distributions to the beneficiary's own best interests, or if the beneficiary is under a legal disability: (a) Directly to the beneficiary; (b) To the Trustee, or to another person selected by the Trustee, as custodian under the Pennsylvania Uniform Transfers to Minors Act as to a beneficiary under the age of twenty-one (21) years; (c) To a relative of the beneficiary, to be expended by that relative for the benefit of the beneficiary; or (d) By directly applying distributions for the benefit of the beneficiary. ITEM XI: The Trustee, on an annual basis, shall provide each income beneficiary who has attained the age of eighteen (18) years, and the Guardian of the person of any income beneficiary who has not attained the age of eighteen (18) years, statements showing transactions each Trust established for the benefit of that beneficiary. The beneficiary, or the Guardian of the person of such beneficiary, may waive this right to receive an annual accounting. The Page Trustee may, at any time, settle any account, or questions concerning the administration of any Trust established under this Will, by agreement with the then current income beneficiaries of the Trust, if legally competent, or if not legally competent, with the Guardian of the person of the beneficiary, the legally competent spouse of the beneficiary, or the oldest legally competent relative of the beneficiary who would take a portion of the estate of the beneficiary were the beneficiary to die at that time intestate under the laws of the Commonwealth of Pennsylvania. Any settlement made in accordance with this Item shall bind all persons who have an interest in the Trust, and shall constitute a release and discharge of the Trustee with respect to transactions specified in the settlement. ITEM XII: In the absence of actual knowledge of a breach of trust, or information concerning possible breach of trust that would cause a reasonable person to inquire, a successor Trustee is under no duty to examine the accounts and records of a predecessor Trustee, or to inquire into the acts or omissions of the predecessor, and is not liable for any failure to seek redress for any act or omission of the predecessor. The successor Trustee shall have responsibility only for property which is actually delivered to him or her by the predecessor and shall have all of the powers conferred upon a Trustee hereunder. ITEM XIII: Should my wife, LAURA W. CORNELL, by Will or Agreement of Trust, establish Trusts similar to the Trusts I have established for the benefit of my issue, the Trustee of each Trust created in this Will shall have the right to merge it with the similar Trust created by my wife for the same beneficiaries. If merged, the Trustee shall operate the merged Trusts as a single Trust. Page 9 ITEM XIV: Any person who has died within thirty (30) days of my death, or under such circumstances that the order of our deaths cannot be established by proof, shall be deemed to have predeceased me. Any person (other than myself) who has died at the same time as any beneficiary under this Will, or in a common disaster with that beneficiary, or under such circumstances that the order of deaths cannot be established by proof, shall be deemed to have predeceased that beneficiary. ITEM XV: to Executors and Trustees: I make the following provisions with respect (a) I appoint my daughter, BETH L. CORNELL, to be the Executrix (herein referred to as "Executor") and Trustee. (b) In the event that my daughter is unable or refuses to serve as Executor or Trustee, my son, WILLIAM A. CORNELL, JR., shall serve as Executor, or Trustee, or both. (c) The Executor and Trustee shall have the right to receive reasonable compensation for services rendered. (d) The Trustee shall not be liable or accountable for any loss that may result from the good faith exercise of the authority granted in this Will. (e) The Executor and Trustee are specifically relieved fi'om the duty of filing bond or entering security. Page 10 ~kJ/~r.~ IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, consisting of this and the preceding ten (10) pages, at the end of each page of which I have also set my initials for greater security and better / identification this day of ~;~c-~ ~q , 20 WILLIAM A. CORNELL We, the undersigned, hereby certify that the tbregoing Will was signed, sealed, published and declared by the above-named Testator as and for his Last Will and Testament, in the presence of us, who, at his request and in his presence and in the presence of each other, have hereunto set our hands and seals the day and year first above written, and we certify that at the time of the execution thereof, the said Testator was of sound and disposing mind and memory. ~,~j_~j~7~,.~.~~~_~ (SEAL) Residing at ~ ~///~,~ ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA ) ) SS: COUNTY OF ) I, WILLIAM A. CORNELL, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. WILLIAM A. CORNELL Sworn to and subscribed before me this ¥~z~:~ day of ,2oo . · Notary Public NOTARIAL SEAL Mv Commission Expires: PATRICIA D OLYARNIK, Notary Public ~ Hampden Twp,, Cumberland County My Oommission Expires August 27, 2005 (SEAL) AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) ) SS: COUNTY OF ~.~[~ou,xc,k, ) the T. -~\ ~ ~ ~tnesses whose names are signed to the attached or r~regoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testator, WILLIAM A. CORNELL, sign and execute the instrument as his Last Will and Testament; that Testator signed willingly and that he executed said Will as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as Witnesses; and that to the best of our knowledge the Testator was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. Witness Sworn to and subscribed before me this \~;tzk day of Notary Public ~ I NOTARIAL SEAL My Commission Expires: PATRICIA D OLYARN K, Notary Public Hampden Twp Cumberland County My Commission Expires August 27, 2005 (SEAL) :23;658 I CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: William A. Cornel1 Date of Death: October 9, 2004 WillNo. 21-04-1022 Admin. No. To the Register: I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on December 22, 2004 : Name Address Beth L. Cornell 6105 Summit Pointe Drive, Harrisburg, PA 17111 Beth L. Cornell, as Guardian for Laura W. Cornell 6105 Snmmit Pointe Drive, Harrisburg, PA 17111 Beth L. Cornell, as Trustee for the Trust created under the Last Will and Testament of William A. Cornell 6105 Summit Pointe Drive, Harrisburg, PA 17111 William A. Cornell, Jr. 65 Glen Road, Wormlevsburg, PA 17043 Sigma Tau Gamma Foundation, P. O. Box 373, Warrensburg, Missouri 64093 Notice has now been given to all persons entitled thereto under Rule 5.6(a). Date: Dec. 22, 2004 Sxgnature Elizabeth J. Goldstein, Esquire Name 415 Fallowfield Road, Suite 301 Camp Hill, PA 17011 Address .l.~Jnoo S,NVt4dI::tO (717) 612'5803 Telephone 8~ :~ ~ld ~8 33~]]0~apacity: Personal Representative X Counsel for Personal Representative HEATH L. ALLEN N. DAVID RAHAL CHARLES W. RUBENDALL II ROBERT L. WELDON EUGENE E. PEPINSKY. ..JR. .JOHN H. ENOS m GARY E. FRENCH DONNA S. WELDON BRADFORD DORRANCE .JEFFREY S. STOKES ROBERT R. CHURCH STEPHEN L. GROSE R. SCOTT SHEARER ELYSE E. ROGERS CRAIG A. LONG YEAR .JOHN A. FEICHTEL DONALD M. LEWIS:m BRIDGET M. WHITLEY ELIZABETH .J. GOLDSTEIN STEPHANIE KLEINFELTER BRADLEY A. WALKER KEEFER WOOD ALLEN & RAHAL, LLP ATTORNEYS AT LAW 415 FALLOWFIELD ROAD, SUITE 301 CAMP HILL. PA 17011-4906 ESTABLISHED IN 1878 OF COUNSEL: SAMUEL C. HARRY PHONE 717-612-5800 FAX 717-612-5805 HARRISBURG OFFICE: 210 WALNUT STREET HARRISBURG. PA 17101 EIN No. 23-0716135 www.keeferwood.com PHONE 717-255-8000 July 13, 2005 717 -612-5803 egoldstein@keeferwood.com ViA CE.RTIFIE.IJ MAILBE7'l1.RN .RECEIPT .REtlUESTE.IJ Cumberland County Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 o *~ f:o-o '-":::r:o ::U-~r- 0::: 2; rn .,;~;o")~ ,-joo os;!" ':J --- , :0 .-,---1 >- '" = = ~ L c:: r- -~ ~T~ o C) 5 rn CJ ~~!~ F'i ._ rn .RE: Estate o/WilliomA. Cornell File #lJ.l-lJOM-.lOlJlJ Dear Sir/Madam: ,&- ." ::J: ~ CJ1 W ':""");-J T'.1 Enclosed herewith for filing please find the following: 1. Pennsylvania Inheritance Tax Return (filed in duplicate;) 2. Inventory; 3. Check in the amount of $30.00 in payment of your filing fee. Kindly acknowledge receipt of these documents by time-stamping the enclosed copy of this letter and returning it to our office. Thank you. .- waw Enclosure Sincerely yours, KEEFER WOOD ALLEN & RAHAL, LLP By [4M lJ~' Elizabeth J. Goldstein cc: Beth Cornell (w/o enclosure) Register of Wills of York County, Pennsylvania INVENTORY Estate of William A. Cornell No. 21-04-1022 also known 8S Date of Death 10/09/2004 Deceased Social Security No. 181-18-4185 Personal Representative(a) of the above Eats , deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value a8 of the date of the Decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to uneworn falsification to authorities. Name of Attorney: Personal Representative: LD. No.: Elizabeth J. Goldstein tf~~Ld 1 AJ,Jo1..... 73779 Beth L. Cornell Address 415 Fallowfield Road. Suite 301 Camp Hill, P A 170 II Dated: ~i CD ",n 0 :IJ .- ~ m :.2U) ^ ~ ;::,c , ::0 ::9--1 -"~" Telephone 717-612'5803 DESCRlPI'lON I. Book Contr act $12,836.00 2. PSECU IRA $ 1,395.22 3. Smith Barney IRA $37,905.00 4. Dodge Van 5. Two (2) $75 U.S. Treasury Bonds EE Series $16,000.00 $126.54 Total $68,262.76 (Attach Additional Sheela IfNece8lJ8ry) ~ <=> <=> "" c...... c:: r- - -0 :x ~ "" c..:> ::IJ ::r:J ::Q rTl ....0 J Go --- ::D ~O r'"m ':;00 (~O "n-Tl ~.-n ~.~ h=i ("/)0 --rt NOTE: The Memorandum of real eetate outeide the Commonwealth of Penneylvania may. at the election of tbe penonal repreeentative, include the value of each item, but 8uch liguree ehould not be extended into the total of the Inventory. F_RW.,(D....phiDCOUnty)-~_9192 11927_1 WILLIAM A. CORNELL Social Security #181-18-4185 Attachment The decedent held a safety deposit box as tenants in the entirety with his wife. The contents of the box are now owned by his wife, and hence are not inventoried with the Pennsylvania Inheritance Tax Return. REV.1SOOiXl6-OOl COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESJDENT DECEDENT I- Z W C W (.) W C DECEDENTS NAME (lAST, FIRST. AND MIDDLE INITIAL) Cornell, William A. DATE OF DEATH (MM.DD-YEAR) 10/09/2004 FILE NUMBER 21 04 1022 DATE OF BIRTH (MM.DD.YEAR) 10/29/2004 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (lAST, FIRST, AND MIDDLE INrrlAL) Cornell, Laura W. W 0- ~:!!;CI) ,,0:'" w"" ",00 ,,0:'" .... .. .. ~ 1. OriginolRetum o 4. Umited Estate 06. Decedent DiedTestate(Allacl'l~dWil) o 9. Litigation Proceeds Received o 2. Sup~emental Retum o 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a UvingTrust(Allachco~ofTRlSI) D 10. Spousal Poverty Credit (daI& of death belw8en 12-31-91 and 1-1-95) o 3. Remainder Retum ldate of duth prior~ 12-13-a2) o 5. Federal Estate Tax Retum Required 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A)_",,~ -- -- COUN1'Y CODE YEAR ----- HUMBER SOCIAL SECURITY NUMBER 181-18-4185 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURrrY NUMBER 210-22-3303 I- Z W C Z o .. ., w 0: 0: o " ~II.. COMPLETE MAILING ADDRESS 415 Fallowfield Road, Suite 301 Camp Hill, PA 17011 50,587.26 x.O_ (15) x.O_ (18) x .12 (17) x .15 (18) (19) NAME Elizabeth J. Goldstein FIRM NAME ('_I Keefer, Wood, Allen & Rahal, LLP TELEPHONE NUMBER (717) 612-5803 z o ~ ::l l- ii: <( (.) w a::: 1. Re~ Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgagas & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate BiI~ng Requested 7. Inter-VIVOS Transfers & Miscellaneous Non-Probate Property (Schedule G Of L) (1) (2) (3) (4) (5) (6) (7) 8. Total Gross Assets (total Unes 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Deceden~ Mortgage liabilities, & liens (Schedule 1) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has no1 been made (Schedule J) (9) (10) 14. Net Value Subject to Tax (Une 12 minus Une 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o !C( .- ::l 0.. == o (.) ~ 15. Amount of Une 14 taxable at the spousal tax rate, Of transfers under Sec. 9116 (0)(1.2) 16. Amount of Une 14 taxable at lineal rate 17. Amount of Line 141axab1e at sibling rate 18. Amount of Line 141axable at collateral rate 19. Tax Due 20.0 . ::: " :;':'.{B":m!iflE., CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0.00 126.54 0.00 0.00 28,836.00 l'"~-"-(:':'~:';:iL~ri:~'~~t;~"S' '~';;' Co U"t ::.I)~q S::o c- ...',)1,;--;.. COI c:: <::. ,-' ''11 g . C.'.") ::::J :0. :_~ t.::J :.- f-,',n, . ~05:D .. -'.) 0 .,- /< C") 0 880 -0 :T\ -n ......'") -n :x ."'- .'1 oe :"~': c5 ;::s I):l;= rn j2 c..n C'"'8 <.:> 0.00 39,300.22 (8) 16,955.96 593.00 (11) (12) (13) 68,262.76 17,548.96 50,713.80 0.00 (14) 0.00 0.00 ~1l\!i1!l$1tlIt)~E$~'RECHECIIilMl\TH,<< . Decedent's Complete Address: STREET ADDRESS 65 Glen Road CITY Wormleysburg I STATE PA I ZIP 17043 Tax Payments and Credits: 1. Tax Due (P.age 1 Line 19) 2. CredlmIPaymen\ll A. Spousal Poverty CredIt B. Prior Paymenls C. Discount (1) -0- -0- Total Cledlts (A+ B .. C ) (2) 3. ifIIsrestIPenaIty If appflC8ble O.inlBIest E. Penally -0- Total b,te.1lSlIPtonally (D" E) . (3) 4. If Une 2 is.QllBlar1han Line 1 .. Une 3,enter!he dlIl8l1l1lC11. This is !he OVERPAYMENT. Chock bax DIl PJge 1 Line 20 1II18lj118Sl. NIund. (4) 5. If Uno 1 .. Line 3 is ~1I>an Line.2. enter !he dI1Iorence. This is lhe TAX DIlE. A. EnIar the illlarast on !he lax due. (5) (SA) B. Enlarthe ltIlaI of Line 5" SA. 1lS illlhe IlAI.AIICE DIlE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN'''X'' IN THE APPROPRIATE BLOCKS 1. Did dec8donl ..... a lnInsf8r and: Yes No a. _Ihe use or income af1he prnperIy1ransfemld;---..-.--.-....:...:...... __.._..__......_. 0 Qg b. .1IlIain Ihe JighllD ......"atnho shaB use 1he property _nod or ils Inalme; .__..._.._...._.......... 0 Qg c. _.I8\IIlISion8Iymtsmst;ar_____.____.__,-_.____..___.._.._....._ 0 [il d, receiw!he pIOIlIise for life of _ paymenls, bensfiIs or care? ._..__..__..___....___............._ 0 [!i 2. If death 0CCllIl1lIi aIIer Oocamber 12, 1982, diI decadenI transIar plDperty wlIhinone year at dealh wihlut I1IC8iYing adequaIe ccmsiIeration? ___.._.__...____.__.__._._..__....._....._ 0 [!i 3. Die! decaclei1t.lWn an "In 1rust lor" or payable upon dealh bank account or secul1ly at hill or ber death? _...._ 0 [!i 4. Did decadent 0lIll an Individual RetirementAccount, annuity, or o1her nan-probale ptOperty wlIich . conIains a beneIiciary designation? --..:__....__.......____.___..._..._.lD 0 IFTlIE AIlSWER TO ANY OF lIlE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND ALE IT AS PARr OF THE RETURN. l.Ir*"""dJ*jwy,ld8cllJtthlt ,__...... ......~_ ...--,L......_...... and'Gh btIl.Gtflt/knDwlIldgBand b8IIIt.1l is true, comctlnd canpIIIte. =~~~~=u~_. 7/f/oo AllllRESS 6105 Summit Pointe Drive, Harrisburg, PA 17111 S~1UREOFPREP7'~1~~' ADDRESS Keefer Wood Allen & Rahal, LLP, 415 Fa1lowfie1d Road, Suite 301, Caup Hill, PA 17011. DATE 1-8'- oS For dat." of death OIl or aItBr July 1, 1994 and before JarwaJy 1, 19l15, Ihe tax rate imposed on the net value at tnmsfers 11> or tor Ihe use of the lIllfYiving spo"," is 3% [72 P.s. ~116 (a) (1.1) (i)J. . For dales of death on or afIBr January 1, 1995, Ihe tax IlIle imposed on the net wille of transfers 11> or for the use ...... (\ ~ f'\ 5 (~(1.1) iij The _ does not exemol . bansfer 11> . SUlVivin9 spouse from tax, .nd the S1aIutDry requi_ lor lliscIosure \ \ \\ V ~ ,licalHo even i the SllViving spouse is the only beneflciaJy. . For dales of death on llf a1\er July 1, 2lloo. The lax rate imposed on the net value of bansfels from a deceased child twenty-one years of age Dr younger at dea J 1\,. rr ioptile pacem, or a stepparent of the child is 0% [72 P.S. 59116(.X1.2)J. . ""~\ The lax rete imposed on the net value ofllll1sfers to or for the use oflhe de<:edent's lineal beneficiaries is 4.5%, except ;(aX1)]. The lax Jate imposed on Ihe net value of transfl!1S 10 or for !he use of the decedent's siblings is 12% [72 P.S. 9911 n gJ02, as ~ individual wlIo has at least one parent in common with the decedent, whether by blooDllf adoption. .. . REV-15113 EX' (6-98) '. COMMONV\IEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Cornell, William A. FILE NUMBER 21-04-1022 All property jolntly-owned wfth right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION $75 Face Value United States Treasury Bond Series EE Fair Market Value=$63.27 $75 Face Value Untted Stales Treasury Bond Series EE Fair Market Value=$63.27 VALUE AT DATE OF DEATH 2 63.27 63.27 TOTAL (Also enter on line 2, Rec.paul"lion) $ {If more space is needed. insert additional sheets of the same size} 126.54 ~ ;~~-"'~~ w .'-"'" W t't\ ,..M 0' W m ....IV> 00 ", w ~ 00 ,--:;)~ ""'.. V> ;~~. Q\ 0- ,'.J: ~,...~ /'Tl 0' ,':c; ~ ....~ ru ... ,Q.......: :; , /'Tl ... : c......= ~ , /'Tl rf) ~ G)" ~ ......., . (.:): CI , r.:l . G:).~ ,....;: ',caoCt! ~ ......., \a; ! N;i , r \CK: : N;i r """ = "" U.U , J) "" ~'.r J) 0 U)_ IX _-; 0 '<!l '" , , r.:l ..... ~ -6..- U1 ...~ - -Q,.~- U1 rf) II. <<( r u.. c r CJ CJ :::.::: :::.::: ~ ~ ,." ru ,." ,." - - we ,J; C'- w<t we: ~'" ,J; C'- II t't\ I cJ] t't\ cJ] "" ~ 1 111 "" ~I 111 0 0 ,.. .... t1-,., C'- ,.. ..... t1-.,s C'- ... 1 1 IT' ... I .." IT' "'0' J1 0 ,..00 Jf 0 c ..0..0 0 C[ -0..0 ~ 0 ~ 11\..0 CL 11\..0 :::,!.:cI .....,..,. ,." ~,....,.. WOo WC/' 20 ' 20 a '" HI' 0::1..,. I~ 000 000 'UtO 11 ...I UIO ...I ..: 0 lIoI 0 ,..I C 0 ..... C .0 W (l) C/' .0 W (l) 0. 0 .. N '% '" E ... - N % '" E ... .. ,.. e:Cl:;) <<( N C'- ,.. IXC:;) C N ['- I "" OllCC ... 0 0 I "" OIX= ... 0 0 u VI ...I 0 0 U V') ...I 0 ..0 %> ...I 0 ..0 %> ~ 0 0 N www ... 0 0 N ww'w ... 0 0 %..1...1 :I: ... IT' %...t..l :I: ... IT' 0 :;)(l)E ... 0 <:) ;:)(l)E ... C/' ., ar; ... 0 C/' ., '" "" 0 ... "'0 '" C/' ... ''''0 '" q-. 0 .,..0:1: 0 ... 0 .,..0:31 0 = 0 0 0 ~ ~ .. _""'f"."'- Savings Bond Calculator Page 1 of 1 110/2004 ~ 1:1l'~~1 CALCU Savinc Value As Of Bund Info Series IEEBond~s .' Denomination Serial Number Issue Date $175 JI Results K97567132EE 04/1993 EE K97567133EE 04/1993 EE $75 $37.50 75 37.50 $25.77 $63.27 25.77 63.27 Interest Rate 2.69% 2.69% YTD Inl S3.1~ Nen Final Accrual Maturity 04/2005 0412023 0412005 04/2023 # Bonds 2 Total Price $75.00 Total Interest $51.54 Total Value $126.54 Serial Number Issue Date Series Issue Denom Price Interest Value Leqelld lJ..t.s4 - Note Description NI Not Issued NE Not Eligible for Payment P5 Includes 3-month interest penalty MA Matured and Not Earning Interest Please rate this service. (Please print and/or save this page before submitting your survey) Service Excellent Good Fair Poor Savings Bond Calculator r r r r "~I~ ~;i',:"",",,-, ",' ~""'h "" '.t~;;: [,;,~ ," .'"".,', http://wwws.publicdebt.treas.govIBC/SBCPrice 7/8/2005 . RE'/"508 EX, (&98) . . COMMONWEALTH OF PENNSYLVANIA INHERlTANCETAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Willaim A Cornell FILE NUMBER 21-04-1022 Include the proceeds of litigation and the date the proceeds were received by the estate. All property lolnlly-owned wlUt right of lurvlVOfShlp muat be dilClosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1998 Dodge Ram custom handicapped van 16,000.00 Contract between William A. Cornell and Penns Valley Publishers, Inc. for back II 12,836.00 royalties. An explanation of the valuation is attached. . TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 28,836.00 WILLIAM A. CORNELL Social Security #181-18"4185 Attachment to Schedule E Dr. Cornell wrote a book on the history of Pennsylvania. The attached contract governs the relationship between Dr. Cornell and the publisher of this book. The royalty payments for the last three years were as follows: 2002 2003 2004 $2,152 $3,110 $3,456 The royalty payments are paid annually. The owner of the contract is responsible for up-dating the book, or assigning the contract to someone who will update the book. The book is updated at least every five years. The person completing the revisions must be paid the market rate, and this rate is surely equal to or more than the yearly royalties. Hence, at the point the book needs to be revised, the owner of the contract has two choices. It can keep the contract and hire someone to revise the book. Under this scenario, the royalties will be fully depleted by the payments needed for the person up-dating the book. Second, the owner of the contract can assign the contract to the person doing the up-dating. As the royalties are equal to or less than the market rate to complete these up-dates, the owner ofthe contract could only assign the contract for a diminimis price. Therefore, the book contract will have no value at the point the book needs to be revised. The average royalty payment for the years 2002 to 2004 is $2,906. The present value of 5 yearly payments of $2,906, using the IRS annual mid-term rate for May 2005 (4.28%), is $12,836. Back-up for these calculations are attached. ;@M-/() (!Htfu.rd- I' ~ Tli1S AG1lF.ZMEN'! , made the I' day of,.l t:L-:C::~ ,.. 1984, BETWEEN Penns Valley Publishers, Inc., of Harrisburg, PexmsylvmU.a, hereinafter called "Publisher" and Will:l.am A. Cornell of Lemoyne, Pennsylvania, hereinafter called "Author". WITNESSETH WHEREAS the Author has submitted the manuscript of a book tentatively entitled llNliERS'IANDING PENNSYLVANIA CIVICS. \o7Il17.IlF.A!': the Publisher is agreeable to publishing said book on the terms and conditions hereinafter set forth; NOW THEREFORE. in consideration of the sum of One Dollar ($1.00) each to the other in hand paid, the receipt whereof is hereby acknowledged, and of the agreements and covenants thereinafter set forth, it is mutually agreed and covenanted as follows: 1. The Publisher shall, as soon as practicable, .at its own expense, proceed to print and publish the said book: UNDERSTANDING PENNSYLVANIA CIVICS, in such style as to paper. type. binding, etc., as promote the sale of the books to the best of its ability and shall at all times keep the market fully supplied with sufficient copies of the book for purchase. 2. The Au1:hor shall promptly revise and correct all proofsheets submitted by the Publisher and shall prepare a suitable preface, index. table of contents, and shall o1:herwise consult with 1:he Publisher on such matters as would pertain to revising and upgrading the q\1&lity and educational value of the book. . 3. The PubU.sher shall pay to the Author a royalty of ten (10) percent of 1:he net retail price at which the book is sold on each copy of the book which shall be sold. 4. The Publisher shall render to the Author an annual statement on or before January 15. of each year which accurately identifies the preceding year's sales of all copies of the book and shall, by January 31, provide the Author with a royalty payment eq\1&l to ten (10) percent of the net re1:ail price for that preceding year. 5. The Publisher agrees to pay the Author three hundred dollars ($300.00) for indexing each edition of any book the Author is asked to index. 6. The Publisher agrees not to publish any book in competition with the works of the Author unless the Author has refused an offer to write the new publication. 7 . The Author agrees that he will not, during the continuance of this Agree_nt without the written consent of the Publisher, write, print, or cause to be published any other ed:ition of the book, UNDERS'IANDING PENNSnVANIA CIVICS, rev:ised, enlarged, abridged, or otherwise, or any book of a character that m:l.ght :interfere with or injure the sale of said books. 8. The Publisher shall cause the said book to be properly and legally copyrighted. 9. The Author warrants that the book :is or:iginal except for such excerpts from copyrighted works as may be included w:ith the perm:iss:ion of the copyright owner, thereof, that :it contain no libelous stat~nts ,and does not infringe upon any copyright of others, and he will indelllIl:ify the PubU.sher against any costs, expenses, and damages arising from any breach of this warranty . 10. The Author shall have the full and complete right to assign his tights and ob ligat:ions under this Agreement, to his heirs. 11. The Publisher shall provide the Author with twenty-five (25) copies of the book each year at no charge. 12. The Author agrees to assist in the promotion and sale of the books. 13. The Publisher shall have the right to assign this Agreement and any assignee thereof shall take the same subj ect to all of the privileges and obligations herein contained in favor of or against the Author. 14. The Author may term:l.nate this Agreement if the Publisher shall be adjud:icated bankrupt or shall become insolvent, or shall default in the payment of royalties for six (6) IDOnths after they are due, or sllall otherwise fail to perform substantially the agreements in its part. In the event of this Agreement being terminated, any copies of the book remaining in stock shall become the property of the Author at fair valuation. IN WITNESS WHEREOF, The party of the first part has caused the Agreement to be assigned by its corporate officers and its C01lllllQIl corporate seal affixed hereto, and the party of the second part have hereunto set his hand and seal the day and year first above written. PARTY OF THE FIRST PART: PENNS VALLEY PUllLISHERS, by Attest: 9-,..;,~ A ,<::2. iJ " . ~ S etary PARTY OF THE SECOND PART 4 ' (~'. -- .. by ..' ..l:~i.L(,-~,,~ u' L~_.A_Lll.__ - William A. Cornell Present Value of an Annuity 511612005 Annual Amount Received: Effective Interest Rate: Number of Years: $2,906 4.280% 5 Present Value of Receipts: $12,836 Actual Amount Received: $14,530 Mid Term AFRs (...) TAX PAGE Pillsbury Winthrop Shaw Pitimanuo Mid Term AFRs (Term More Than 3 Years and 9 Years or Less) I Compounding Period I BI Semi- II Quarterly II Monthly I Annual May 200S 14.28% 18 I 4.22% 114.20% 1 Rev.Rul. 2005- 27 April 200S 14.09% 181 4.03% 114.02% 1 Rev.Rul. 2005- 21 March 200S 13.83% 1813.77% 113.76% 1 Rev.Rul. 2005- .u February 200S 13.83% II 3.79% II 3.77% II 3.76% I Rev.Rul. 2005-8 Last updated April 26, 2005 Current AFRs Short Term I Long Term j Adiusted I 7520 Mav 2005 Revenue Ruling a http://tax.pillsburywinthrop.comlafr/midAFR.shtml Page I of 1 'i/1 fi/?On<; R:"'-1510 EX+ (6-98* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF William A. Comell FILE NUMBER 21-04-1022 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV.1500 COVER SHEET is yes. DESCRIPTION OF PROPERlY ITEM INClUDE THE NAME OFTHE TRANSfEREE. THSR RELATIONStiP TO DECEDENT AND OATE OF DEATH % OF DECO'S EXCLUSION TAXABLE NUMBER 'fHEt>>.1EOflRAMSfel ATW;tI~COPYOFl'rlE.DEa)FOR RCN. ESJ.I(I'E. VALUE OF ASSET INTEREST lIFAPPUCAElLE\ VALUE 1. Smith Barney IRA; spouse is beneficial)' 37,905.00 100 37,905.00 2. PSECU IRA; spouse is beneficial)' 1,395.22 100 1,395.22 TOTAL (A150 enter on line 7 Recapitulation) $ 39,300.22 (If more space is needed, insert additional sheets of tt\e same size) SMITH BARNEY..... cltlgroupJ February 22, 2005 patricia D. Olyarnik Keefer Wood Allen and Rahal LLP 415 Fallowfield Rd., Suite 301 Camp Hill PA 17011-4906 Re: Estate of William A. Cornell Date of death: 10/09/04 Dear patricia: As you requesting the following are values in the IRA account we held for William A. Cornell as of 10/9104: Amount Description Price Value 15.940 Bank Deposit Program 1. 00 15.94 143.227 Bristol Myers Squibb Co 23.29 3335.60 408.087 ChevronTexaco Corp 55.112 22490.49 297.140 Exe10n Corp 37.83 11240.80 11 . 000 Zimmer Holdings 74.83 823.13 TOTAL 37905.96 Should you require additional information please let us know. (Z::~ns Business Development Assoc. to The Forman Group at Smith Barney Inc. Idak The information herein has been obtained from sources we believe to be reliable, but do not guarantee its accuracy or completeness. Citigroup Global Markets lne. 11 North 3rd Street. 2nd Floor Harrisburg. PA 17101 Tel7l7780 1700 Fax 717 233 1090 Toll Free 800 2371700 PSECItP the financial link", December 24, 2004 Account # 0181184185 PATRICIA D OLYARNlK C/O KEEFER WOOD ALLEN & RAHAL LLP 415 FALLOWFlELD RD SillTE 301 CAMP HILL, PA 17011-4906 Dear MS OLYARNlK: The following is the status of WILLIAM A CORNELL's account with PSECU as of the date of death. Joint Owner's Name Date of Death Date of Birth LAURA W CORNELL, JOINT TENANT W/ROS 1O.Q9.2004 11.28.1923 Share Description Open date Balance Accrued Dividend 801 Regular Shares 04.12.1991 $ 3,063.73 $ 0.50 804 Checking 1,579.51 0.07 S 50 60 Month IRA Cemfic~te 09.01.2003 1,394.21 1.01 858 24 Month Certificate 04.10.1998 2,745.61 1.22 864 60 Month Certificate 09.06.2002 12,999.12 12.31 The Non-IRA dividend earned from January 1, 2004 through the date of death was $534.24; the IRA dividend earned was $35.08. The decedent had no loans with us. We do not have safe deposit boxes for our members. If you have any questions, please call 234-8484 in Harrisburg or our toll-free number, (800) 237-7328. At the menu prompt, enter 6 and then extension 2227. Sincerely, Cf~ Meacie Fairf Member Service Representative Finance Support Unit PENNSYLVANIA STATE EMPLOYEES CREDIT UNION Main Address: 1 Credit Union Place, Harrisburg, PA 17110-2990. (717) 234-8484. (BOO) 237-7328 Mailing Address: P.O. Box 67013, Harrisburg, PA 17106-7013. (717) 777-2100 (TOO) . (800) 472-1967 (TOO) Web Address: www.psecu.com Savings federally Insured up to $100,000 by the National Credit Union Administration. REV~5"EX+('~99~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIOENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF William A. Cornell FILE NUMBER 21-04-1022 Debts of docedont mUlt be reportod on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: Myers Funderal Home Catering Additional Myers Funeral Home charges Viewing expenses I 7,404.00 693.00 798.48 129.00 B. ADMINISTRATIVE COSTS: 1. PeBOnaJ Representative's Commissions Name of Personal Repmsonla\iVe(s) Social Security Number(I)/EIN N.-r of PolSO!\Ol Repmsonlative(s) Siroot Address City ,State Zip Year(s) Commission Paid: Z, Attomoy Foes 3,815.71 3. Family Exemption: (If decedenrs address is not the same as claimant's, attach explanation) 3,500.00 Claimant Laura W. Cornell Siroot Address 65 Glen Road City Wormleysburg Relationship of Claimant to Decedent Wife 4. P_F..I 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Estate advertising Slale PA ,Zip 17043 486.00 129.77 TOTAL (Also enter on line 9, Recapitulation) $ (It more space is needed, insert additional sheets 01 the same size) 16,955.96 REV-1512EX+t12.(3) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE UABIUTlES, & UENS ESTATE OF William A. Comell FILE NUMBER 21-04-1022 ITEM NUMBER 1. Report debts Incurred by the decedent prior to death which remained unpaid as of tbe date of death, including unreimbursed medical expenses. VALUE AT DATE DESCRIPTION OF DEATH Visa #4301 731500308; joint with Laura W. Cornell (Total = $1,186) 593.00 TOTAL (Also enler on line 10. Recapitulation) $ (11 more space is needed, insert additional sheets 01 the same size) 593.00 REV-1513EX+(0<Xl) .- COMMONWEALTH OF PENNSYLVANIA IllHERlTANCE lAX RElURN RESDENT OECEDENT SCHEDULE .. BENEFICIARIES EST ATE OF William A. Cornell FILE NUMBER 21-04-1022 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERlY Do Not list Trusteels) OF ESlATE I TAXABLE DISlRIBUTIONS pnclude outright spousal distributions, and transr... undar Sec. 9116 (a) (1.2)1 Laura W. Cornell Wife 39,300.22 65 Glen Road Wonnleysburg, PA 17043 .. ENTER DOLLAR AMOUNTS FOR DISlRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE. ON REV-1500 COVER SHEEl IT NON-1AXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE Marital trust under Item VI of the decedent;s Will. The estate has chosen not to tax this 17,287.04 trust in the estate of William A. Cornell. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEEl $ 17,287.04 (If more ~ce is needed, insert additional snaets of the se.me size} HlO'igO.'i REV 9!H6 This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. , WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 p 1066,7618 No, "Iu~ IUR"" .,illl ~c~~ar~ (9C'li)1RA) / ~ ;! ~ f Date COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VirAL RECORDS CERTIFICATE OF DEATH [lATE()F'DE;;:TH'W;;;~hD~;-'Y""'l 4 October 9, 2004 "'" -- Caunli_. ~umberland ~? 17cl.1il :;"~=OI MOTHE:R'S NAME (f"'. MiOcM. M-. Sur'\iIII....l 1'. June Henderson INFOt-lflAANT'S """!LING ADDRESS {S-. C~ylTown, StaIlI. ZJp CO(leI - - 201>. 65 Glenn Road Wormteysburg, Pa. 17043 PlACE Of DISPOSITION- N_ of C8ITI8Irioy. C.emlll"'l LOCATION. C~yllU\..;;---:S;~I;;Z-';:' coo~-' OI:Olhe'Place 21c lndiantowii Gap National Jo.. -. III PlACEOfINJURY-Al-.Iarm,_,f-=lay,o/lIQo bo-.g,olo(SpooIy) 2111. -. 21. 30.. CERllF1ERtChldlonly_) .~:~..::fof'":~~=~.=l=~s~~.~~.~.~d.~.~.~.~.~~ .Pr..o~~:r:.:"'~PHY.=~..-:"~~':::~~~":(:a~~~~...__. .:':..~~~~In_""'''''lhoc:c'''''''all''''llme,d''''an''PI.u,.ndd'''lo_UU'''I(.J_ ...........aaAMad... '" rtPl.'lPRINT " PlR..ANENT ElLACKINK NAME OF DECEOEHT {First. _. llalJ , AGE jla51&rthclayl '" Dr. William A. Cornell , Male 8IRTHP~ACE lC'lyand PlA E SIat801:FOI:..gnCounlly) AI- Bfairsville, -D 1. k. FACILITY NAME (~OOI "Sl~UIion, giv.. ....eetlllld runberl Slale~ Pa. 80 Y" .. COUNTVOF OEATH m. Cumber1and .. 65 Glen Road DlECEOENrS USUAL OCCUPATION lGfoolOnllar__==r "'-~""'wnrer 1,.. 1110. r'<::,-EOEN1"'S- MAILING ADDRESS ($lrHI. Cilyll........, SIIIIlI. ZlpCodsl 65 Glenn Road Wormleysburg, Pa. 17043 W"-S DEC(OENl EVER IN USARMEOFORCES? Ye.~ NaD " 17b. .. f_'1I1ER'5NAME(Fnl.........,tllSll .. INfORUANT'SNAME ITypeJPmll Leslie Hall Cornell William A. Cornell, Jr. N. . MtlHOD OF OtSPOSllION 11 Bu..... 00 CremallOl'l DRefllOVlIllrnmSlalS 0 ~~'~~"U" L.J OIho<(Spacily) SIGNAl FUNE.R vie '" e " 8 8 o o DAlE OF INJURY ~,Do.,.Y"'1 C I"~"m carI/fyIog pl1i,,,,,,,,,,,"<>lav_illhmaofdealhto ccMyUlu,;eal<lea1tl "~m.24-2l;,,\U",l>ro~by p~,>oo,"'tIOf-'lor'OlJI'ICM<Ioalh N. iIi. 21. PAIn I: E....'...._.......,.................,_._~c.-...._~. O"_.n.........._..dy..",.""h...."'ko.o:.....ploo."'oy.......o.hodl.........Io_. '-,......._<....00__ \..$ DUflO(OR ACONSEQUENCEOf) ;;~'l''''f1haiyl<S.l~ona ,f~"'1 lea<J>ng 'oomme<liate ".","'tnlell.lllDERlYING CAUSE I[~'u"'" OI:..-v Uh,III.IlooI<>J","",~s 'o"ull..... oo_n I lAST I I. IlUETO(ORASACONSECllIENCEOFI DUl!ro{ONAlA~lOFI ~RE AUTOPSY FlNPING8 MANNER OF OEATH AVA1LAUPR/ORTO IXI 0 CONPl.U","OF Oillse ..- - OfDEAlI1~ ..-. 0 P-.glrwe.ligalioo 0 VMO NO(XJ '"0 "IKI -- 0 ClIIIkIootba<lelerQ'...... 0 :i z STATEF1U:NUolBfR SOCIAl SECURITY NUMBER 161- 16 - 4165 , "",""",,~.IKI ~~ID RACE-Amer<:anlncll"'lBlaocl<.WhlLe.elC jSpecdjl " White MARITALSlATUS-MlIrriecl. _~.'IYidowed. ......,-, Married SURVIVING SPOUSE <....1.,....".......,...... Laura Weigle l1c.0 Ye.._tveOin Worml eys-b-urg- ___I*p ~,- 21G. Annvilic, Pennsylvania 17003 NAME ANI) ADDRESS OF fACILITY Uc. Myers Funeral Home, Inc. 37 East Main SlIeet Mechanicsburg, Pa, 17055 liCENSE NUMBER lJ~it'SI(;tllf)-'-- iM'."'''',[)''1 Y""<I ,,,,~WsI'133U... 'k Ocr '1 20_ WAS CASE REFERRED TO A MEDICAL EMMINER';{.;OHONlR~ 2'. ynO t~" l.g] ; AppIo........ .int.......lIlbalween :""""'-"""'-~ PART'; QlIIa, si(JrollC<01Il u~"!oIlon. C""lr~,,,I,og lo<Jeal~. tK~ not N'ulhng"'u.. """,>,IY'lg wu,e\l',..n,nPART I TtMEOFINJlIflY INJURY AT'A'C)R>;? r.ESCF!I~ HoW-INJURY l;ccufm~o ^'" c nOI) Last Will and T est:ament: OF WILLIAM A. CORNELL -.,,- 'J W (;.. v:;. ITEM I: I direct that all inheritance and estate taxes becoming due by reason of my death, whether payable by my estate or by any recipient of any property, shall be paid by the Executor out of the residue of my estate, as an expense and cost of administration of my estate. The Executor shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. ITEM II: I direct the Executor to pay th~ expenses of my last illness and funeral expenses from the residue of my estate as an expense and cost of administration of my estate. ITEM III: I may leave a written list in my safe deposit box or elsewhere disposing of certain items of my tangible personal property. The Executor shall dispose of items of my personal property as specified in the written list. !fno written list is found in my safe deposit box or elsewhere and properly identified by the Executor within thirty (30) days after the probate of my Will, it shall be presumed that there is no list; any subsequently discovered list shall be ignored. Page 1 W~ ITEM IV: If I die before my wife, LAURA W. CORNELL, I give to her all of my household furniture and furnishings, books, pictures, jewelry, silverware, automobiles, wearing apparel and all other articles of household or personal use or adornment and all policies of insurance thereon not identified in the written list mentioned in ITEM III. If I do not die before my wife, I make this gift to my children, BETH L. CORNELL and WILLIAM A. CORNELL, JR., to be divided between them as they shall agree. ITEM V: I give one hundred (100) shares of my PNC common stock to SIGMA TAU GAMMA FOUNDATION, Warrensburg, Missouri. ITEM Vl: I give the residue of my estate, not disposed of in the preceding portions of this Will, as follows: (a) To my daughter, BETH L. CORNELL, as Trustee, IN TRUST, to be administered and distributed as provided in ITEM VlI, a fraction of my residuary estate. The numerator shall be a sum equal to the largest amount that can pass free of Federal estate tax under my Will by reason of the applicable credit amount and the state death tax credit (provided that the use of this credit does not require an increase in state death taxes) allowable to my estate but no other credit and after taking account of dispositions under other items of this Will and property passing outside of this Will which do not qualify for the marital or charitable deduction and after taking account of charges to principal that are not allowed as deductions in computing my Federal estate tax. The denominator shall be the value of my residuary estate. For purposes of establishing this fraction, the values Page 2 WfrC- finally :fixed in the Federal estate tax proceeding relating to my estate shall be used. I recognize that the numerator of such fraction may be zero (0), in which case no property shall pass to this Trust. I also recognize that the numerator may be affected by the action of the Executor in exercising certain tax elections. (b) The balance of my residuary estate shall be paid to my wife, LAURA W. CORNELL, if she survives me. If she does not survive me, this portion of my estate shall be added to the Trust funded pursuant to subsection (a) and shall be administered and distributed as provided in ITEM VII. ITEM VII: the Trust established by ITEM VI (a): The following provisions shall apply to (a) This Trust shall be known as The Cornell Family Credit Trust. (b) The Trustee shall pay to or for the benefit of my wife, LAURA W. CORNELL, all of the net income of this Trust in convenient installments, but not less frequently than annually. (c) The Trustee shall also pay to my wife so much of the principal of this Trust as may be necessary in the discretion of the Trustee for the proper support, maintenance and medical care of my wife. Page 3 W~ (d) Upon the death of my wife, the Trustee shall divide the principal into as many equal parts as there are then living children of mine and then deceased children of mine represented by then living issue. The Trustee shall pay one share to each living child, and shall pay one share to the issue of each deceased child, per stirpes. It is my desire, in distributing the assets ofthis trust to my children, to allocate my real estate located at 65 Glen Road, W ormleysburg, Pennsylvania, to my daughter, BETH L. CORNELL, and to allocate my real estate located at 222 South Front Street, Wormleysburg, Pennsylvania, to my son, WILLIAM A. CORNELL, JR. ITEM VIII: No part of the income or principal of any Trust created by this Will shall be subject to attachment, levy or seizure by any creditor, spouse, assignee or trustee or receiver in bankruptcy of any beneficiary prior to his or her actual receipt of income or principal distributed. The Trustee shall pay the net income and the principal to the beneficiaries specified by me, as their interests may appear, without regard to any attempted anticipation, pledging or assignment, and without regard to any claim or attempted levy, attachment, seizure or other process against the beneficiary. ITEM IX: The Executor and the Trustee shall each possess the following powers, each of which may be exercised without court approval and in a fiduciary capacity only: (a) To retain any investments I have at my death, including specifically those consisting of stock of any bank even if I have named that bank as the Executor or Trustee. Page 4 IN\-t:.. (b) To vary investments, and to invest in bonds, stocks, notes, real estate mortgages or other securities or in other property, real or personal, without being restricted to so-called "legal investments", and without being limited by any statute or rule oflaw regarding investments by fiduciaries. (c) In order to divide the principal of a Trust or for any other purpose, including final distributions, the Executor and Trustee are authorized todivide and distribute personal property and real property, partly or wholly in kind, and to allocate specific assets among beneficiaries and Trusts so long as the total market value of each share is not affected by the division, distribution or allocation in kind. The Executor and Trustee are each authorized to make, join in and consummate partitions oflands, voluntarily or involuntarily, including giving of mutual deeds, or other obligations, with as wide powers as an individual owner in fee simple. (d) To sell either at public or private sale real and personal property severally or in conjunction with other persons, and to consummate sale(s) by deed(s) or other instrument(s) to the purchaser(s), conveying a fee simple title. No purchaser shall be obligated to see to the application ofthe purchase money or to make inquiry into the validity of any sale(s). The Executor and Trustee are authorized to execute, acknowledge and deliver deeds, assignments, options or other writings as necessary or convenient to any of the power conferred upon the Executor and Trustee. (e) To mortgage real estate, and to make leases of real estate. Page 5 LV .A-C- (f) To borrow money from any person, including the Executor or Trustee, to pay indebtedness of mine or of my estate, expenses of administration or inheritance, legacy, estate and other taxes, and to assign and pledge assets of my estate or any Trust established by this Will. (g) To pay all costs, taxes, expenses and charges in connection with the administration of my estate or any Trust established under this Will. If any death taxes are payable with respect to my estate, these taxes shall be paid from "The Cornell Family Credit Trust". (h) To make distributions of income and of principal to the proper beneficiaries, during the administration of my estate, with or without court order, in such manner and in such amounts as the Executor deems prudent and appropriate. (i) To vote shares of stock which form a part of my estate or any Trust established under this Will, and to exercise all the powers incident to the ownership of stock. (j) To unite with other owners of property similar to property in my estate to carry out plans for the reorganization of any company whose securities form a part of my estate. (k) To disclaim any interest in property which would devolve to me or my estate by whatever means, including but not limited to the following means: as beneficiary under a will, as an appointee under Page 6 Wkc...... the exercise of a power of appointment, as a person entitled to take by intestacy, as a donee of an inter vivos transfer, and as a donee under a third-party beneficiary contract. (1) To prepare, execute and file tax returns of any type required by applicable law, and to make all tax elections authorized by law. (m) To employ custodians of property, investment or business advisors, accountants and attorneys as the Executor or Trustee deems appropriate, and to compensate these persons from assets of my estate or trust, without affecting the compensation to which the Executor and Trustee are entitled. (n) To divide any Trust created in this Will into two or more separate Trusts so that inclusion ratio for purposes of the generation- skipping transfer tax shall be either zero or one, in order that an election under Section 2652(a)(3) of the Internal Revenue Code may be made with respect to one ofthe separate Trusts, or for any other reason. (0) To allocate administrative expenses to income or to principal, as the Executor or Trustee deems appropriate. However, no allocation to income shall be made if the effect of the allocation is to cause a reduction in the amount of any estate tax marital deduction or estate tax charitable deduction. Page 7 w~ Trustee may, at any time, settle any account, or questions concerning the administration of any Trust established under this Will, by agreement with the then current income beneficiaries of the Trust, if legally competent, or if not legally competent, with the Guardian ofthe person of the beneficiary, the legally competent spouse of the beneficiary, or the oldest legally competent relative of the beneficiary who would take a portion of the estate of the beneficiary were the beneficiary to die at that time intestate under the laws ofthe Commonwealth of Pennsylvania. Any settlement made in accordance with this Item shall bind all persons who have an interest in the Trust, and shall constitute a release and discharge of the Trustee with respect to transactions specified in the settlement. ITEM XII: In the absence of actual knowledge of a breach of trust, or information concerning possible breach of trust that would cause a reasonable person to inquire, a successor Trustee is under no duty to examine the accounts and records of a predecessor Trustee, or to inquire into the acts or omissions of the predecessor, and is not liable for any failure to seek redress for any act or omission of the predecessor. The successor Trustee shall have responsibility only for property which is actually delivered to him or her by the predecessor and shall have all of the powers conferred upon a Trustee hereunder. ITEM XIII: Should my wife, LAURA W. CORNELL, by Will or Agreement of Trust, establish Trusts similar to the Trusts I have established for the benefit of my issue, the Trustee of each Trust created in this Will shall have the right to merge it with the similar Trust created by my wife for the same beneficiaries. If merged, the Trustee shall operate the merged Trusts as a single Trust. Page 9 W~ ITEM XIV: Any person who has died within thirty (30) days of my death, or under such circumstances that the order of our deaths cannot be established by proof, shall be deemed to have predeceased me. Any person (other than myself) who has died at the same time as any beneficiary under this Will, or in a common disaster with that beneficiary, or under such circumstances that the order of deaths cannot be established by proof, shall be deemed to have predeceased that beneficiary. ITEM XV: I make the following provisions with respect to Executors and Trustees: (a) I appoint my daughter, BETH L. CORNELL, to be the Executrix (herein referred to as "Executor") and Trustee. (b) In the event that my daughter is unable or refuses to serve as Executor or Trustee, my son, WILLIAM A. CORNELL, JR., shall serve as Executor, or Trustee, or both. (c) The Executor and Trustee shall have the right to receive reasonable compensation for services rendered. (d) The Trustee shall not be liable or accountable for any loss that may result from the good faith exercise of the authority granted in this Will. (e) The Executor and Trustee are specifically relieved from the duty of filing bond or entering security. Page 10 UJ}lL... ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA ) ) SS: COUNTY OF ) I, WILLIAM A. CORNELL, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. qJ/lL-. <^. ~EAL) WILLIAM A. CORNELL Sworn to and subscribed before me this \I.t1-> day of Dcto\rt.- ,200\. ~v.~c Notary Public My Commission Expires: NOTARIAL SEAL PATRICIA D. OlYARNIK, Notary Public Hampden Twp" Cumberllrld County M Commission Expires A us! 'fl, 2005 (SEAL) AFFIDAVIT COMMONW~THOFPENNSYLV~ COUNTY OF ~CA--\J... ) ) SS: ) w., fui:l."t(, ;;./;K~ff ~d C~.lG ~ 4::rl the Witnesses whose names are signed to the attached or egomg instrument, being duly qualified according to law, do depose and say that we were present and saw Testator, WILLIAM A. CORNELL, sign and execute the instrument as his Last Will and Testament; that Testator signed willingly and that he executed said Will as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as Witnesses; and that to the best of our knowledge the Testator was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. ~JJt.~~ Witness Sworn to and subscribed before me this \'\:f:L... day of \)~ ,200\. y~~~ Notary Public NOTARIAL SEAL . PATRICIA D. OL Y ARNIK, Notary PubliC Hampcten Twp., Cumbe!land CounI'li or M eommisSlOII Expires Au , .005 My Commission Expires: (SEAL) :235658 _I " REGISTER OF WILLS CUMBERLAND County, Pennsylvania CERTIFICATE OF GRANT OF LETTERS " ,\ '., U ), ,~r'/"~ '"". ~,'r .'.. "",' \"\..), ,. ,;\",'" ("" \.:, '... -I '~( , -.. ") :: \~ . ~) }:; I,. \ ....',.. ) .~. "'\n "",, '\ -'.\ " No. 2004-01022 PA No. 21-04- 1022 Estate of: CORNELL WILLIAM A (Last, First,Middle) Late Of: WORMLEYSBURG BOROUGH CUMBERLAND COUNTY . ..' i),., ~', ,," . '\ ~ Deceased Social Securi ty No: 181-18-4185 WHEREAS, on the lOth day of November 2004 an instrument dated October 17th 2001 was admitted to probate as the last will of CORNELL WILLIAM A (Last, First. Middle) late of WORMLEYSBURG BOROUGH, CUMBERLAND County, who died on the 9th day of October 2004 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, GLENDA FARNER STRASBAUGH for CUMBERLAND County, in the Commonwealth of certify that I have this day granted Letters TESTAMENTARY to: CORNELL BETH L who has duly qualified as EXECUTOR(RIX) and has agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYL VANIA. Register of wills Pennsylvania, hereby in and IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 10th day of November 2004. ~....... "'L_l-~.h.~ egister 0 Wi/J~ * *NOTE* * ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) 10-18-2005 CORNEL L 10-09-2004 21 04-1022 CUMBERLAND 101 APPEAL DATE: 12-17-2005 ( See reverse side under Objections) Amount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 ~Y!_~~9~~_!~~~_~~~~______~___~g!~!~_~~~g~_~~~!!~~_~~~_!~~~_~g~~~~~__~____________________ REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX WILLIAM A FILE NO. 21 04-1022 ACN 101 DATE 10-18-2005 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE :-->. r- r\ r'-. ,-, .__\ ~.'......., _~ BUREAU OF INDIVIDUALTAx'~s ' , , INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE , NOTICE OF INHERITANCE TAX - · . APPRAISEMENT , ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ". I DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN ELIZABETH J GOLDSTEIN KEEFER ETAL 415 FALLOWFIELD RD 30 CAMP HILL PA 17011 ESTATE OF CORNEL L REV-1547 EX AFP (06-05) WILLIAM A RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) .00 126.54 .00 .00 28.836.00 .00 39,300.22 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 16,955.96 593.00 (11) (12) (13) (14) NOTE: I~ an assessment was issued previously, lines re~lect ~igures that include the total o~ ALL ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 68,262.76 17.548 96 50,713.80 17,287.04 33,426.76 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. ,,'-~'-~. . l+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 33,426.76 X 00 = .00 X 045 = .00 X 12 = .00 X 15 = (19)= · IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .00 .00 .00 .00 .00 ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. ^~ IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE\<J' A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) REV-1470 EX (6-88) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box. 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME William A. Cornell REVIEWED BY Harry Herr SCHEDULE ITEM NO. INHERITANCE TAX EXPLANA TION OF CHANGES EXPLANATION OF CHANGES Adjustments made per systems requirements. ROW FILE NUMBER ACN 2104-1022 101 Page 1 .-J 15056051058 REV-1500 EX (06-05) PA Department of Revenue '*' Bureau of Individual Taxes . PO BOX 280601 Harrisburg, PA 1712~1 ENTER DECEDENT INFORMATION BELOW Social Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICiAl USE ONLY County Code Year File Number 1022 Date of Birth 10/09/2004 10/29/1923 Cornell Decedent's Last Name Suffix Decedent's First Name William MI A (If Applicable) Enter Surviving Spouse's Infonnation Below Last Name Suffix First Name MI W Cornell ~pouse's ~~~~,:~rity _~'::Ir:nber "^mm_ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS , i 210-22-3303 L FILL IN APPROPRIATE OVALS BELOW c::::> 1. Original Return ~ 2. Supplemental Return c::::> 3. Remainder Retum (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required c::::> 4. Limited Estate c::::> ~ c::::> 4a. Future Interest Compromise (date of death after 12-12-82) c::::> 7. Decedent Maintained a Living Trust (Attach Copy of Trust) c::::> 10. Spousal Poverty Credit (date of death c::::> 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. All CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name [)aytir11ElTeIElph()f1Elf\Jumber m 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes ~ Elizabeth J. Goldstein i (717) 724-0266 Finn Name REGISTER OF WILLS USE ONI.Y Elizabeth Goldstein, First line of address 355 North 21 st Street Second line of address State ZIP Code DATE FILED or Post Office ~... '-.-.. 17011 Correspondent's e-mail address:egoldstein@elizabethgoldsteinlaw.com Under penalties of pe~ury, I declare that I have examined this retum, induding accompanying schedules and statements, and to the best of my knowledge and belief, it is true, and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowlEldge. SI OF ROE BlE FOR FILING URN ~ t.. ~~ ADDRESS 65 Glen Road; Wormleysburg, PA 17043 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS 355 North 21st Street, Suite 202; Camp Hill, PA 17011 PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051058 15056051058 ....J ~~ -.J 15056052059 REV-1500 EX Decedent's Name: RECAPITULATION William A Cornell D~ce<:1ent'~So~i~IS~curity f\Junl~~rm ; 181-18-4185 0.00 ... 0.00 0.00 50,000.00 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . . . 9. 0.- 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . . . . . . . . . . . 10. I 11. Total Deductions (total Lines 9 & 10). . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . 11. I 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Govemmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . . . 14. 50,000.00 1. Real estate (Schedule A). ............................................ 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3. 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 6. Jointly Owned Property (Schedule F) C> Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) C> Separate Billing Requested.. . . . . .. 7. TAX COMPUTATION. SEE INSTRUCTIONS FOR APPUCABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate. or transfers under Sec. 9116 (a)(1.2) X .0_ 50,000.00 16. Amount of Line 14 taxable at lineal rate X.O_ 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 0.00 15. 16. 17. 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 0.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT c::J L 15056052059 Side 2 15056052059 .-.J Kt:V-1OUU t:X I-'age;j File Number Decedent's Complete Address: 0~f1022-- I DECEDENTS NAME DECEDENTS SOCIAL SECURITY NUMBER William A Cornell 181-18-4185 STREET ADDRESS 65 Glen Road CITY I STATE PA I ZIP Wormleysburg 17043 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 0.00 Total Credits (A + B + C ) (2) 0.00 :3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (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, Une 20 to request a refund. (4) !i. If Line 1 + Une 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A. Enter the interest on the tax due. 6. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (56) 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;.......................................................................................... D ~ b. retain the right to designate who shall use the property transferred or its income; ............................................ D [i) c. retain a reversionary interest; or.......................................................................................................................... D [i] d. receive the promise for life of either payments, benefits or care? ...................................................................... D [i) 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. D [i) 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D [i) 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ ~ D 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 January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse iE, three (3) percent [72 P.S. 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [n P.S. 99116 (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 twenty-one 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 zero (0) percent [72 P.S. 99116(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 four and one-half (4.5) percent, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 99116(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-15G8 EX+ (6-98) *' COMMON\l\iEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISe. PERSONAL PROPERTY ESTATE OF William A. Cornell FILE NUMBER 21-04-1022 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 NUMBER Personal Injury Settlement VALUE AT DATE OF DEATH DESCRIPTION 50,000.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) *' SCHEDULE J BENEFICIARIES COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21-04-1022 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE ESTATE OF William A. Cornell NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distribuUons, and transfers under ...............ww...~~,~11?((lL(1,?)1... ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAl DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE Marital trust Item VI of descendent's Will. The estate has chosen not to tax this in the estate of William A. Cornell. B. CHARITABLE AND GOVERNMENTAl DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space is needed, insert additional sheets of the same size) 50,000.00 50,000.00 Hegister of Wills of Cumberland County, Pennsylvania SUPPLEMENTAL INVENTORY Estate of William A. Cornell No. 21-04-1022 also known as Date of Death 10/09/2004 Deceased Social Security 181-18-4185 No. Beth L. Cornell Personal Representative(s) ofthe above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date ofthe Decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. IfWe verify that the statements made in this Inventory are true and correct. IfWe understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: Elizabeth J. Goldstein Personal Representative: Beth L. Cornell LD. No.: 73779 Address: 65 Glen Road W ormleysburg, P A 17043 Address 355 North 21"t Street, Suite 202 Camp Hill, PA 17011 ~~~ 6/b/lib E ( Date: Telephone 717 -724-0266 DESCRIPTION VALUE 1. Proceeds from personal injury law suit $50,000 TOTAL $50,000 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. 11927_1 L~ ELIZABETH GOLDSTEIN, P.C. 355 NORTH 21sT STREET, SUITE 202 CAMP HILL, PENNSYLVANIA 17011 TELEPHONE: (717) 724-0266 FACSIMILE: (717) 724-0288 May 12, 2006 Glenda Strasbaugh Register of Wills One Courthouse Sq. Carlisle, PA 17013 Re: Estate of William Cornell Dear Ms. Strasbaugh: Please find enclosed: 1. A $30 check for filing a (Supplemental) Inventory and the (Supplemental) Pennsylvania Inheritance Tax Return; 2. 3 Copies of the (Supplemental) Pennsylvania Inheritance Tax Return; and 3. 2 Copies of the (Supplemental) Inventory. Please file the Tax Return and Inventory, and send back to me in the enclosed self-addressed envelope a file-stamped copy of the Tax Returr and Supplemental Inventory. Thank you. Sincerely yours, ELIZABETH GOLDSTEIN, P.C. By: t:4Ld -fiJAiL' Elizabeth Goldstein Enclosure cc: Beth L. Cornell ~ h1 Cumberlano County -. Reg~st:eruur WLLlS-u_u--- One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/14/2006 GOLDSTEIN ELIZABETH JAN KEEFER WOOD ALLEN & RAHAL 415 FALLOWFIELD RD STE 301 CAMP HILL, PA 17011 RE: Estate of CORNELL WILLIAM A File Number: 2004-01022 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 10/09/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) ~ Cumberland County - Re~ister at Wl~~S One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/14/2006 CORNELL BETH L 6105 SUMMIT POINTE DRIVE HARRISBURG, PA 17111 RE: Estate of CORNELL WILLIAM A File Number: 2004-01022 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of wills a Status Report of completed or uncompleted administration. This filing is due by: 10/09/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel ~ ",/111.;. '..__ '-~.~- , , "....... z~~ :<. tiC: \'. 0-..' Co"', u.J .0' W (J C) ( ) 1::.tJ 0.. o N ~ :c. 0- . Register of Wills of Cumberland County STAres RFPORTUNDERRULB 6.12 Name of Decedent: William A. Cornell DatcofDeath: 10-9-2004 EstateNo.: 21-04-1022 Pursuant to Rule 6.12 of the Supmne Comt Orpbma' Court Rules. I report the fonowing with respect to completion of the adminimation of the above.-captioned estate: 1. State whether ,rl1'ft;,,;stration of the estate is complete: Yes m No 0 '2. Iftbe mrwer is No, state whta the personal representative reasonably belj.eves that . the admmflrtra1ion will be campi.: 3: rfthe answer to No. 1 is Yes, state the following: a. Did the personal represc:Dtative file a final account with the Court? Yes 0 No ID . b. The separate Orphans' Court No. (If any) for the personal reprcs=tative's account is: If') \ r- c.....," o ....0 c:::> ~ c. Did the penona1 ~ve state an account informally to the parties in interest? Yes 0 No g] . c. Copies of receipts, releases. joinders and approval of formal or infomJa1 accounts maybe filed with the Clerk of the Orphans' Court and may be -.bed to 1hI1repa11. (' / / n Date: ,O.~-O~ ~~ Sipture Elizabeth Goldstein Name 355 North 21 st St. Suite .202 Address Camp Hill, PA 17011 Telephone No. Capacity: 0 Personal Representative IXl Counsel for personal representative , [) ~ 08-07-2006 CORNELL 10-09-2004 21 04-1022 CUMBERLAND 101 APPEAL DATE: 10-06-2006 ( See reverse side under Objections) Amount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ..... RETAIN LOWER PORTION FOR YOUR RECORDS +- REY:is47-EX-AFP-ioi:osi-NOTicE-OF-iNHERiTANCE-TAX-APPRAisEMENT:-ALLOWANCi-OR--------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX WILLIAM A FILE NO. 21 04-1022 ACN 101 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO lOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE [J'('(',Orrn rn149\i:ft OF INHERITANCE TAX : .' . '."~e.~AJ~"ENT, ALLOWANCE OR DISALLOWANCE OF.DEOUCfIONS AND ASSESSMENT OF TAX 20% \ L} ,r,. II, i I~ . It DATE ESTATE OF DA TE OF DEATH FILE NUMBER COUNTY ACN ELIZABETH J GOLDSTEIN! KEEFER ETAL 355 N 21ST STREET CAMP HILL PA 17011 ESTATE OF CORNELL '* J REV-1547 EX AFP [06-05) WILLIAM A TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED DATE 08-07-2006 NO. 01 RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN 1. R..l Estate (Schedule A) (1) 2. Stocks end Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. HortgageslNotes Receivable (Schedule D) (4) 5. CashlBank Deposits/"isc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets .00 .00 .00 .00 50.000.00 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/A~. CostsIHisc. Expenses (Schedule H) (9) 10. Debts/Hortgage Liabilities/Liens (Schedule I) (10) 11. Total Deductions 12. Net Value of Tax Return 13. Cheritable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax .00 .00 Ul) (2) (3) (4) NOTE: To insure proper credit to your account, subeit the upper portion of this form with your tax paYllBnt. 50,000.00 00 50,000.00 50,000.00 33,426.76 NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Mount of Line 14 at Spousal rate (5) 33,426.76 X 00 = .00 16. AIIount of Line 14 taxable at Lineal/Class A rat. (6) .00 X 045 = .00 17. AIIount of Line 14 at Sibling rate (7) .00 X 12 = .00 18. AIIount of Line 14 taxable at Collateral/Class B rate (8) .00 X 15 = .00 19. Principal Tax Due (9)= .00 TS: + INTEREST/PEN PAID (-) AHOUNT PAID DATE NUMBER TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE · IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .00 .00 .00 .00 ( IF TOTAL DUE IS LESS THAN $1, NO PAY"ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIr' (CR), YOU "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)