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Home My WebLink About05-24-13 __ _ __ ._ __ _ _ _ l� t � f 1505610143 ��•J REV-1500 Ex�02_,,, . OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number _ Bureau of Individual Taxes ��TMEMOFREVEMIE PO BoxzBOSO� INHERITANCE TAX RETURN 21 12 00861 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 07 31 2012 04 18 1923 DecedenYs Last Name Suffix DecedenYs First Name MI MECK MARY E (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 1. Original Retum � 2. Supplemental Return � 3. Remainder Return(Date of Death Prior to 12-13-82) � 4. Limited Estate � 4a.Future IMerest Compromise �I 5. Federal Estate Tax Return Required (date of death afler 12-12-82) � 6 Decedent Died Testate � 7� �qttach Co a�of T�a Living Trust _1 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) PY ) � 9. Litigation Proceeds Received � 10.��e�P2v31 y,Cr di2(Da95�f Death CI ��,Election to tax under Sec.9113(A) 9 T (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATIOPI$J-IOULD BE DIRECTED T�: Name Daytl'Me Telephori�:Ylumb�r� JOIiN F MECK ESQ 4$2�566 -�.91� � R�OI�'jF�OF WtQLS l}&E{t3NLY --.,. G!> First Line of Address �"- ,--, �� --� �` 600 GRANT STREET 44TH F ` �` ��` � :. .... _ „ Second Line of Address "'- � � ,.,:� ;;:a . -J '^� DATE FIIED City or Post Office State ZIP Code PITTSBURGA PA 15219 Correspondent�s e-ma�i address: lmeck@eckertseamans.com Under penalties of perjury,I declare that i have examined this retum,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 preparer has any knowledge. SIGNAT E OF PERSON RESPONSIBLE fOR FILING RETURN DATE Barbara M Kei er S — �/�o?Dl �3 A 428 Swamp Road, Morgantown, PA 19543 SIGNATURE OF PREP RER OTHER T N R RESENTATIVE DATE ! John F Meck Esq. v- ) .- 3 ADDRESS 600 Grant Street,44th Floor, Pittsburgh, PA 15219 Side 1 � 15D5610143 150561D143 � J �� . /; __ __ . _. _ Tll l� . . J 150561D243 REV-1500 EX Decedent's Social Security Number DecedenYsName: M@CIC� Mary E RECAPITULATION 1. Real Estate(Schedule A)....................................................................................... �. 199, 600 . 00 2. Stocks and Bonds(Schedule B)............................................................................. 2. 3 9O ,557 . 8 9 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. J 103 ,572 . 65 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers&Miscellaneous -Probate Property (Schedule G) � Separate Billing Requested............ 7. 342 , 434 . 94 g. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 1 , 036, 165 . 48 - -- 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 13 , 37 9. 90 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10. 5 , 413 . 11 11. Total Deductions(total Lines 9 and 10)................................................................ ��. 1 S , 7 93 _ O 1 12. Net Value of Estate(Line 8 minus Line 11).......................................................... �2. 1, �17 , 372 _ 47 �3. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been made(Schedule J)............................................... 13. 14. Net Value Subject to Tax(Line 12 minus Line 13)............................................... 14. 1, 017 , 3 7 2 . 4 7 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 15 O . �� (a)(1.2)X.00 16. Amount of Line 14 taxable 1�017 , 372 _ 47 �6. 45 , 781 . 7 6 at lineal rate X .045 17. Amount of Line 14 taxable at sibling rate X.12 � . 0 0 17. � . �� 18. Amount of Line 14 taxabie at collateral rate X.15 � . �� 18. � . �� 19. TAX DUE................................................................................................................ 19. 4 'rJ � 7 81 . 7 6 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. � Side 2 � 15D5610243 1505610243 � 1� REV-1500 EX Page 3 File Number 21-12-00861 DecedenYs Complete Address: DECEDENT'S NAME Meck, Mary E __ _ STREET ADDRESS 290Q Lincoln Street CITY STATE ZIP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 45,781.76 2. Credits/Payments A. Prior Payments 39,900.00 B. Discount 2,100.00 Total Credits(A +B) (2) 42,000.00 3. Interest (3) _ _ 4.65_ 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2,Line 20 to request a refund 5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 3,7$6.4� Make Check Pa able to: REGISTER OF WILLS, AGENT. �ll� 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:............................................................................... ❑ 0 b. retain the right to designate who shall use the property transferred or its income:.................................. ❑ � c. retain a reversionary interest;or............................................................................................................... ❑ ❑x d. receive the promise for life of either payments,benefits or care?............................................................ ❑ � 2. if death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.................................................................................................................... ❑ � 3. Did decedent own an"in trust fo�' or payable upon death bank account or security at his or her death?....... �x ❑ 4. Did decedent own an individual retirement account,annuity,or other non-probate property which containsa 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 January 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(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,ari 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 decedenYs lineal beneficiaries is 4.5 percent,except as noted in [72 P.S. §9116(a)(1)j- . The tax rate imposed on the net value of transfers to or for the use of the decedenYs 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. . _ _ _ �a�� . , Rev-1502 EX+(01-10) SCHEDULE A pennsylvania REAL ESTATE DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIOENT DECEDENT ESTATE OF FILE NUMBER Meck, Ma E 21-12-00861 All real property owned solely or as a tenant in common must be repoRed at fair market value.Fair market value is defined as the price at which properiy would be exchanged between a willing buyer and a willing seller,neither being wmpelled to buy or sell,both having reasonable knowledge of the relevant facts. Real property that is jantly-owned with right of survivorship must be disclosed on schedule F. Attach a copy of the settlement sheet if the property has been sold Include a copy of the deed showing decedent's interest if owned as tenant in common. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 2900 Lincoln St.,Camp Hill, PA 17011 -PIN 01-20-1852-188;a two story brick detached 199,600.00 dwelling;value per Cumberland County, PA assessment TOTAL(Also enter on Line 1, Recapitulation) 199,600.00 (If more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule A(Rev.01-10� r�� . � Rev-7503 EX+(6-98) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSVLVANIA INHERITANCE TAX RETURN RESIDENTOECEDENT ESTATE OF FILE NUMBER Meck, Ma E 21-12-00861 All propeRy joinUyowned with right of survivorship must be disclosed on Schedule F. ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH Amerinrise Ba�ic Brokeraae ONE Acct No.45133 consisting of items 1 thru 7: 1 230 shares of Anadarko Petroleum Corp. 69.44 15,971.20 2 4,000 shares of Chamber Street Properties 10. 40,000.00 3 400 shares of Chevron 109.58 43,832.00 4 25 shares of Enzon Pharmaceuticals Inc 6.63 165.75 5 400 shares of Sector Spdr Tr Shs Ben 35.63 14,252.00 6 400 shares of Union Pacific Corp 122.61 49,044.00 7 5,725.69 shares of Wells Asset Alloc-A 12.4900038 71,513.89 8 951.218 shares of First Investors Tax Exempt Fund A 10.2899966 9,788.03 Accrued dividend on Item 8 through date of death 32.15 9 8,145.476 shares of Liberty All Star Equity Fund 4.595 37,428.46 10 2,052.551 shares of Vanguard/Wellesley Income Fund 24.3099977 49,897.51 11 Series HH Bond#M5552637HH-$1,000 face amount 1,000.00 Accrued interest on Item 11 through date of death 897.74 12 Series HH Bond#M5552638HH-$1,000 face amount 1,000.00 Total of Continuation Schedules See attached a es TOTAL(Also enter on Line 2, Recapitulation) 390,557.89 (If more space is needed,additional pages of the same size) Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule B(Rev.6-98) rn� Rev-7503 EX+(6-98) SCHEDULE B STOCKS � BONDS continued COMMONWEALTH OF PENNSVLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Meck, Mary E 21-12-00861 VALUE AT DATE NUM ER UMBER DESCRIPTION UNIT VALUE j OF DEATH Accrued interest on Item 12 through date of death 897.74 73 Series HH Bond#M5552639HH-$1,000 face amount 1,000.00 Accrued interest on Item 13 through date of death 897.74 14 Series HH Bond#M5552640HH-$1,000 face amount 1,000.00 Accrued interest on Item 14 through date of death 897.74 15 Series HH Bond#M5552641 HH -$1,000 face amount 7,000.00 Accrued interest on Item 15 through date of death 897.74 16 Series HH Bond#M5552642HH-$1,000 face amount 1,000.00 Accrued interest on ttem 16 through date of death 897.74 17 Series HH Bond#V1095418HH-$5,000 face amount 5,000.00 Accrued interest on Item 17 through date of death 4,423.00 18 Series HH Bond#V1095419HH-$5,000 face amount 5,000.00 Accrued interest on Item 18 through date of death 4,423.10 19 Series HH Bond#V1095420HH-$5,000 face amount 5,000.00 Accrued interest on Item 19 through date of death 4,423.04 20 Series HH Bond#V1103543HH-$5,000 face amount 5,000.00 Copyright(c)2002 form software only The Lackner Group,Inc. Fortn PA-1500 Schedule B(Rev.6-93", _ _ _ __ _ EIII� • Rev-1503 EX+(6-98) SCHEDULE B STOCKS 8� BONDS continued COMMONWEALTH OF PENNSVLVANIA INHERITANCE TAX RETURN RES�DENT DECEDENT ESTATE OF FILE NUMBER Meck, Mary E 21-12-00861 ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH Accrued interest on Item 20 through date of death 4,488.70 21 Series HH Bond#V1703544HH -$5,000 face amount 5,000.00 Accrued interest on Item 27 through date of death 4,488.62 TOTAL(Also enter on Line 2, Recapitulation) 390,557.89 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B(Rev.6-93J _ ___ _ _ �0�A Rev-1508 EX+�11-10) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, 8� MISC. DEPARTMENTOFREVENUE pERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Meck, Mary E 21-12-00861 _ Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointlyowned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Cash-held in Ameriprise Basic Brokerage ONE Financial Acct No.45133 4,377.74 2 PNC Bank Interest Checking Acct.2432 2,960.93 3 PNC Bank Premium Money Market Acct. No. 2541 79,600.97 4 U.S.Treasury -2011 Form 1040 overpayment,applied to 2012 80.00 5 2003 Buick LeSabre-VIN: 1G4HP52K134124913;value per Kelley Blue Book 4,860.00 6 Household goods-approximate value 10,000.00 7 Commonwealth Annuity Life Ins Policy#0905242-cash value; owned by father, Robert G. 1,329.56 Meck; insured is Barbara M. Hillman(Keiper) 8 Erie Insurance Exchange-car insurance refund; policy No.Q060100262 362.00 9 Misc refunds 61.45 TOTAL(Also enter on Line 5, Recapitulation) 103,572.65 (If more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule E(Rev. 11-1G1 ___ _ _ _ _ _ l� Rev-1510 EX+(08-09� SCHEDULE G pennsylvania lNTER-VIVOS TRANSFERS AND DEPARTMENT OF REVENUE MISC. NON-PROBATE PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Meck, Mary E 21-12-00861 This schedule must be completed and filed'rf the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE NUMBER THE DA E OF TRANSFERSATTACFi A CO Y OF THE DEIED�OR REAL ESTATE. VALUE OF ASSET �NTEREST (IF APPLICABLE) VALUE 1 Ameriprise Brokerage Acct No.44133-transfer on 17,098.41 17,098.41 death, payable to daughter, Barbara M. Keiper 2 RiverSource Adv Fixed Annuity-No.7419-payable to 49,149.91 49,149.91 daughter, Barbara M. Keiper 3 RiverSource Adv Fixed Annuity-No. 7545-payable to 52,627.75 52,627.75 daughter, Barbara M. Keiper 4 RiverSource Fixed Annuity-Rollover IRA-No. 9517- 24,176.02 24,176.02 payable to daughter, Barbara M. Keiper 5 RVS Fixed Annuity-No.9516-payable to daughter, 36,922.55 36,922.55 Barbara M. Keiper 6 RVS Fixed Annuity-No.9759-payable to daughter, 50,247.15 50,247.15 Barbara M. Keiper 7 RVS Fixed Annuity-No.9807 -payable to daughter, 26,935.55 26,935.55 Barbara M. Keiper 8 Strategic Portfolio Srvc Adv One Acct No.84133- 85,277.60 85,277.60 transfer on death, payable to daughter, Barbara M. Keiper TOTAL(Also enter on Line 7, Recapitulation) 342,434.94 (If more space is needed,additional pages of the same size) Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule G(Rev.08-09) . __ _ EIII� . . REV-1511 EX+(�0-09) pennsylvania SCHEDULE H DEPARTMENTOFREVENUE FUNERAL EXPENSES AND RESIDENTDEC ENT URN ADMINISTRATIVE COSTS ESTATE OF FI�E NUMBER Meck, Mary E 21-12-00861 DecedenYs debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT ER q, FUNERAL EXPENSES: See continuation schedule(s) attached 1,839.82 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio Year(s)Commission Paid Waived 2. Attornev's Fees ECKERT SEAMANS CHERIN 8� MELLOTT, LLC 6,001.40 3. Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation) Claimant Street Address City State Zio Relationshio of Claimant to Decedent 4. Probate Fees 832.02 See continuation schedule(s)attached 5. AccountanYs Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 4,706.66 See continuation schedule(s)attached TOTAL(Also enter on line 9, Recapitulation) 13,379.90 Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev. 10-09) _ _ _ _ __ _ __ �0�1 . SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Meck, Mary E 21-12-00861 ITEM AMOUNT NUMBER DESCRIPTION F�neral Ex�enses 1 Auer Cremation Service-memory folders and books 233.20 2 Auer Cremation Service-obituary and balance 386.72 3 Church of God Home, Inc.-escort fee and transporation 69.00 4 Memorial service-Sound system,soloist, pianist 110.00 5 Pastor Mike Nelson-memorial service 150.00 6 Royer's Flowers 172.76 7 Swatara Church of God-reception food 718.14 H-A 1,839.82 Probate Fees 8 Cumberland Co. Law Journal -estate advertising 75.00 9 Cumberland Co Register of Wills-probate fee($510 plus$15 filing fee) 525.00 10 The Sentinal-estate advertising 232.02 H-B4 832.a2 Other Administrative Costs 11 Barbara Keiper-AugustlSept-estate expense reimbursement 274.89 12 Debra May-housekeeping;assistance with cleaning out residence 65.00 Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98} _ . . fRl'� , . SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Meck, Mary E 21-12-00861 ITEM NUMBER DESCRIPTION AMOUNT 13 Ehrlich-services at 2900 Lincoln Street,Camp Hill 166.43 14 Lawn Doctor of Camp Hill-yard work-September and October,2012 55.78 75 Leffler Energy-furnace service plan 314.00 16 PNC Estate Acct No. 2432-service charge 20.00 17 PNC Estate Acct No. 2432-check images in statement fee 3.00 18 PNC Estate Acct No.2432-check images in statement fee 3.00 19 PNC Estate Acct No. 2432-check images in statement fee 3.00 20 Tom Keiper-repair gutter guards 53.77 21 Tom Nye-yardwork 35.00 22 Tom Nye-yardwork 35.00 23 Tom Nye-yardwork 35.00 24 Tom Nye-yardwork 165.00 25 Tom Nye-yardwork 35.00 26 Tom Nye-yardwork 8�gutter cleaning 45.00 27 Utilities-Electric-service at 2900 Lincoln St.,Camp Hill, PA 91.00 28 Utilities-Electric-service at 2900 Lincoln St.,Camp Hill, PA 56.00 29 Utilities-Electric-service at 2900 Lincoln St.,Camp Hill, PA 91.00 Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-�18) _ __ _ _ - ��fA . , SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Meck, Mary E 21-12-00861 . ITEM NUMBER DESCRIPTION AMOUNT 30 Utilities-Electric-service at 2900 Lincoln St.,Camp Hiil, PA 91.00 31 Utilities-Electric-service at 2900 Lincoln St.,Camp Hill, PA 92.74 32 Utilities-Electric-service at 2900 Lincoln St.,Camp Hill, PA-final 92.74 33 Utilities-Leffler Energy-service at 2900 Lincoln St.,Camp Hill, PA 581.57 34 Utilities-Leffler Energy-service at 2900 Lincoln St.,Camp Hill, PA 250.00 35 Utilities-Leffler Energy-service at 2900 Lincoln St.,Camp Hill, PA 250.00 36 Utilities-Leffler Energy-service at 2900 Lincoln St.,Camp Hill, PA 250.00 37 Utilities-Leffler Energy-service at 2900 Lincoln St.,Camp Hill, PA-final 176.84 38 Utilities-Penn American Water-service at 2900 Lincoln St.,Camp Hill, PA 25.79 39 Utilities-Penn American Water-service at 2900 Lincoln St.,Camp Hill, PA 43.19 40 Utilities-Penn American Water-service at 2900 Lincoln St.,Camp Hill, PA 36.74 41 Utilities-Penn American Water-service at 2900 Lincoln St.,Camp Hill, PA 44.17 42 Utilities-Penn American Water-service at 2900 Lincoln St.,Camp Hill, PA 36.02 43 Utilities-Penn American Water-service at 2900 Lincoln St.,Camp Hill, PA-final 84.92 44 Utilities-Penn Waste Inc.-service at 2900 Lincoln St.,Camp Hill, PA 45.75 45 Utilities-Penn Waste Inc.-service at 2900 Lincoln St.,Camp Hill, PA 41.55 46 Utilities-Penn Waste Inc. -service at 2900 Lincoln St.,Camp Hill, PA-final 41.55 Copyright(c)2002 form software only The Lackner Group,Ina Form PA-1500 Schedule H(Rev.6-u8) ___ _ _ __ _ _ ��I� . SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Meck, Mary E 21-12-00861 _ ITEM NUMBER DESCRIPTION AMOUNT 47 Utilities-Sewage-service at 2900 Lincoln St.,Camp Hill, PA 170.50 48 Utilities-Sewage-service at 2900 Lincoln St.,Camp Hill, PA 170.00 49 Utilities-Sewage-service at 2900 Lincoln St.,Camp Hill, PA-final 165.00 50 Utilities-Verizon-service at 2900 Lincoln St.,Camp Hill, PA 72.41 51 Utilities-Verizon-service at 2900 Lincoln St.,Camp Hill, PA 72.66 52 Utilities-Verizon-service at 2900 Lincoln St.,Camp Hill, PA 72.66 53 Utilities-Verizon-service at 2900 Lincoln St.,Camp Hill, PA 72.66 54 Utilities-Verizon-service at 2900 Lincoln St.,Camp Hill, PA 71.40 55 Utilities-Verizon-service at 2900 Lincoln St.,Camp Hill, PA-final 107.93 H-B7 4,706.66 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98) _ _ �1f1 . , Rev-7512 EX+(12-08) SCHEDULE 1 pennsylvania DEBTS OF DECEDENT, DEPARTMENTOFREVENUE MORTGAGE LIABILITIES AND LIENS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Meck, Mary E 21-12-00861 _ 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 1 Miscellaneous checks clearing post-death-Tom Nye-yardwork,$35;Swatara Church of 200.00 God-offering,$100; Debra May-housekeeping,$65. 2 Pa Dept of Revenue-2012 Form PA-40 tax due 115.00 3 U.S.Treasury -2012 Form 1040-tax due 3,754.00 4 Utilities-Electric-service at 2900 Lincoln St.,Camp Hill, PA 56.00 5 Utilities-Leffler Energy-service at 2900 Lincoln St.,Camp Hill, PA 581.57 6 Utilities-Penn American Water-service at 2900 Lincoln St.,Camp Hill, PA 57.73 7 Utilities-Verizon-service at 2900 Lincoln St.,Camp Hill, PA 72.34 8 West Shore Emergency Medical Services-ambulance transport 576.47 TOTAL(Also enter on Line 10, Recapitulation) 5,413.11 (If more space is needed,additional pages of the same size) Copyright(c)2008 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-08 i _ _ _ _ ra� �r F REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Meck, Ma E 21-12-00861 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (y�/ards) ($$$) I� TAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec.9116 a 1.2 . 1 Jarrett S. Hillman Grandson 25,000.00 6 Willow Drive Easton, PA 18045 2 Barbara M. Keiper Daughter 992,372.47 428 Swamp Road Morgantown, PA 19543 Tota I 1,017,372.47 Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet,as a ro riate. NON-TAXABLE DISTRIBUTIONS: II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright(c)2010 form software onfy The Lackner Group,Ina Form PA-1500 Schedule J(Rev.01-101 . _ �If 1'� _ -, . LAST WILL AND TESTAMENT OF MARY E. MECK I, MARY E. MECK, of the Borough of Camp Hill, County of Cumberland, and Commonwealth of Pennsylvania, declare this to be my Last Will, and revoke any Will previously made by me. 1. Debts and Expenses I direct that all my debts which are not barred, funeral expenses and deductible pledges be fully paid as soon as conveniently may be after my decease. 2. Tangib�le Personal Property I give all my tangible personal property to my daughter, BARBARA M. KEIPER. If my daughter, BARBARA M. KEIPER, fails to survive me, then I give my tangible personal property to my grandson, JARRETT S. HILLMAN. 3. Cash Bequest I give $25,000 to my grandson, JARRETT S. HILLMAN, if he survives me. 4. Distribution of Balance of My Estate I give the residue of my estate to my daughter, BARBARA M. KEIPER. If my daughter, BARBARA M. KEIPER, fails to survive me, then I give the residue of my estate to be held in trust for the benefit of my grandson, JARRETT S. HILLMAN, under Paragraph 5 below; but if my grandson, JARRETT S. HILLMAN, fails to survive me then the residue shall be distributed to his then ]iving issue, per stirpes and not per capita. In the absence of any such issue, the residue shall be distributed to the SWATARA CHURCH OF GOD, 81l Keckler Road, Harrisburg, Pennsylvania 17111. Distribution hereunder shall be subject, however, to the provisions of paragraph 6 if at that time any such distributee (other than my grandson} has not then attained 30 years of age. 5. Trust for Grandso� If my grandson, JARRETT S. HILLMAN, is entitled to receive a share of my estate, the same shall be set aside and retained in a separate trust for his benefit by the Trustee hereinafter named. The Trustee may pay to my grandson, JARRETT S. HILLMAN, or use and expend for his benefit all or such portion of the received and earned income as well as the principal of this trust estate as the Trustee, in his absolute discretion, deems advisable to provide for the health, education, maintenance, and support of that beneficiary, taking into account to the extent the Trustee deems proper, any independent means available to the beneficiary of which the Trustee �!1456163.1} ___ _ . _ _ _. 6111� _y F has knowledge. In addition the Trustee shall also be authorized, in his sole discretion, to distribute from the principal of the trust to or for the benefit of my grandson, JARRETT S. HILLMAN, to assist him with (a)the purchase of a residence for himself; (b)the establishment of a business or professional practice, if such business or profession is considered a good risk by the Trustee; and (c) reasonable wedding expenses. Any income not paid or applied as aforesaid shall be added to principal. The Trustee shall distribute to my grandson, JARRETT S. HILLMAN, all or such amounts of the principal of the trust estate as my grandson, JARRETT S. HILLMAN, in his absolute discretion, shall from time to time direct in writing delivered during his lifetime to the Trustee. In no event, however, shall the aggregate sum of such withdrawals by him for any one calendar year exceed the greater of the sum of $5,000, or if my grandson, JARRETT S. HILLMAN, is living on the last day of December of such year, 5% of the market value of the principal on that day. This annual right of withdrawal shall not be cumulative. Upon the death of my grandson, JARRETT S. HILLMAN, the trust shall be distributed to his then living issue, per stirpes and not per capita. In the absense of any such issue, the trust shall be distributed to the SWATARA CHURCH OF GOD, 811 Keckler Road, Harrisburg, Pennsylvania 17111. Distribution hereunder shall be subject, however, to the provisions of Paragraph 6 if at that time any such distributee has not then attained 30 years of age. 6. Young Beneficiary Trust If any beneficiary has not then attained 30 years of age at a time he or she is entitled to receive a share of my estate or income or principal of a trust created hereunder, the same shall be set aside and retained in a separate trust for his or her benefit by the Trustee hereinafter named. The Trustee may pay to that beneficiary or use and expend for his or her benefit all or such portion of the received and earned income as well as the principal of this trust estate as the Trustee, in his absolute discretion, deems advisable to provide for the health, education, maintenance, and support of that beneficiary, taking into account to the extent the Trustee deems proper, any independent means available to the beneficiary of which the Trustee has knowledge. Any income not paid or applied as aforesaid shall be added to principal. At any time after the beneficiary has attained 30 years of age, the Trustee shall distribute to that beneficiary such portion or portions of the principal of his or her trust as that beneficiary shall from time to time direct in writing. In no event, however, shall the aggregate sum of such withdrawals prior to that beneficiary's having attained years of age, valued at the date of the withdrawal, exceed one-half of the value of the principal of that beneficiary's trust estate at its inception. Any principal of a trust for a beneficiary hereunder who dies before the full termination of his or her trust shall be distributed to such person or persons who would have been entitled to receive the same as the heirs at law of the beneficiary under the laws of the Commonwealth of Pennsylvania as though he or she had died at that time the owner thereof, unmarried, intestate, and domiciled in that Commonwealth excluding, however, any person who is not related to me. Distribution hereunder shall also be subject, however, to the provisions of this Paragraph 6 if at {J 1456163.1} 2 . _ _ _ _ __ _ Pnl'1 r� • that time, any such distributee has not then attained 30 years of age. If more than one trust is held hereunder for the same beneficiary, the Trustee may, in his absolute discretion, combine them into a single trust. Notwithstanding the foregoing, the Trustee may accelerate from age to an earlier age the termination of a trust for any particular beneficiary hereunder if, in the absolute discretion of the Trustee, the size of the trust is deemed too small to warrant continued retention in trust. In that case, distribution may be made to that beneficiary or to a Custodian appointed for his or her benefit as hereinafter provided. 7. Technical Provisions The following technical provisions shall prevail in the administration of my estate and trusts hereunder where applicable: 7.1. Beneficially Interested Fiduciary [rrespective of any contrary provision herein or any discretion granted by law, no Trustee acting hereunder shall have or enjoy any power or authority in that capacity, if the existence, exercise, lapse or disclaimer of such power or authority may be deemed to be or cause the trust or any part thereof to be a taxable transfer by the Trustee for Federal Estate Tax, Gift Tax, or Generation-Skipping Tax purposes. In any such case, the power and discretion shall be vested exclusively in the other Trustee or Trustees, if any, then acting hereunder not also thus similarly disqualified. If all of the current Trustees are thus disqualified, that specific power and discretion shall be vested exclusively in the next succeeding Trustee or Trustees hereinafter designated or provided for not also disqualified. In the absence thereof, such specific power and discretion shall be vested exclusively in any Special Trustee appointed by me or the court for that specific limited purpose. 7.2. Stock Dividends In any trust hereunder, corporate distributions in shares of the distributing corporation, however described or designated by that corporation, shall be deemed principal. 7.3. Spendthrift Clause The interests of the beneficiaries in principal and income of my estate and any trust created herein shall be free from anticipation, assignment, pledge, or obligations of those beneficiaries and shall not be subject to any execution or attachment until actually distributed. This shall not preclude (i) a personal exercise by a beneficiary of a right of withdrawal granted hereunder, if any, (ii) a disclaimer by a beneficiary, in whole or in part, of any interest in income or principal hereunder, or (iii) a setoff against such interest of any indebtedness of the beneficiary to me, my estate or any trust described herein. {J1456163.1} 3 _ �o � � �. 7.4. Post-Death Income Unless otherwise provided, upon the death of any income beneficiary, any income accrued or received by the Trustee subsequent to the last income payment date shall be paid to the person or persons for whose benefit the principal producing such income is continued in trust or to whom such principal is distributed under the terms hereof. 7.5. Allocation of Capital Gains Funds distributed in a discretionary application of principal or in response to an exercise of a right of withdrawal hereunder, if any, shall neither be deemed to nor actually include capital gains realized during the current tax year, except to the extent in the exercise of absolute discretion, the Executrix or Trustee expressly elect to allocate all or a part of such gains thereto. 7.6. Additions to Trusts With the consent of the Trustee, other persons may add to the principal of any trust hereunder by inter vivos transfer, testamentary transfer, or beneficiary designation. 7.7. Adopted and Related Persons References in my Will to children, grandchildren, issue, descendants, heirs, or persons related to others shall be deemed to include, in addition to blood relatives, persons who fall into that relationship solely by reason of adoption, so long as the adoption occurred during the minority of the adoptee. 7.8. Per Stirpes Gifts In any gift hereunder to the issue of any individual, per stirpes, the starting point in allotting shares shall always be the children of such individual, even though all of such children are then deceased, and no distribution at any lower generational level shall be determined on a per capita basis. 7.9. Exoneration In the absence of willful wrongdoing or gross negligence, no Executor or Trustee acting hereunder shall be liable by reason of the exercise of or failure to exercise any power or discretion granted to that Executor or Trustee hereunder or by law. 7.10. Trust Combination The Trustee may, in his absolute discretion, combine any trust created hereunder with any trust containing substantially similar provisions, notwithstanding the fact that the trusts may have been created by separate instruments or by different persons. If necessary to protect possibly different future interests or to facilitate later division of the trust, the assets shall be valued at the time of any such combination and a record made of the proportionate interest of each separate trust in the combined fund. {J1456163.1} 4 __ _ _ _ _ �n� _ w � 8. Fiduciary Powers In the administration of my estate and any trust created under my Will, the Executrix and the Trustee shall have, in addition to and not in limitation of any authority given by law, and without necessity of obtaining the consent of any court, full and complete power and discretion as follows: to accept, retain, and hold in the estate or trusts any of my investments or property without duty to diversify; to invest and reinvest the assets of the estate or trusts in any kind of property, real or personal, or part interest therein, without being restricted to investments which are legal for trust funds; to sell, pledge, exchange, lease for any period of time, or mortgage any real or personal property, and to grant options for the sale, exchange, or lease of the same; to borrow money from themselves or others and pledge or encumber any property of the estate or trusts as security therefor, without liability on the part of the lender to see to the application of such funds; to compromise claims in favor of or against the estate or trusts; to exercise options to subscribe to or purchase securities; to join in, consent to, or oppose any voting trust and any plan of lease, mortgage, merger, consolidation, reorganization, recapitalization, liquidation, foreclosure, or other readjustment of the financial structure of any firm or corporation in which the estate or trusts may have an interest; to deposit securities in a clearing corporation or carry the same in the name of a nominee or in book entry form; to maintain, repair, alter, improve, partition, subdivide, dedicate, and otherwise manage or deal with real estate; to decline to accept, disclaim, release, renounce, or abandon any interest in property and any power; to nominate themselves or another as Custodian under a Uniform Gifts or Transfers to Minors' Act and make transfers of a beneficiary's interest in all or part of the estate or trust to such Custodian to be held for the benefit of such beneficiary until the beneficiary attains 25 years of age; to purchase from my estate and that of my spouse any assets thereof and to make loans to those estates to provide liquidity; to allot different kinds of interests in property to different beneficiaries of my estate or different trusts created hereunder; to retain investment advisors, professional advisors, custodians, and agents and to delegate to them any power or discretion vested in the Executrix and the Trustee; and to distribute the estate or trusts either in cash or in kind. 9. Appointment of Trustees I appoint my son-in-law, THOMAS KEIPER Trustee of the Trusts created under my Will. In the event my son-in-law, THOMAS KEIPER, is unable or unwilling to serve or continue to serve as Trustee and if he has not appointed a successor as hereinafter provided, then I appoint PNC Bank N.A., Trustee to fill that vacancy. An individual Trustee then serving hereunder, whether or not named herein, may appoint in writing his or her successor, such appointment to take effect when the Trustee making it ceases to act. Any such appointment may be revoked or changed prior to its becoming effective. Any Trustee may resign with or without cause. Any Trustee, whether appointed hereunder or by the court or succeeding to a corporate Trustee by reason of inerger or consolidation, shall upon delivery of written acceptance of his, her, or its appointment be empowered to act without necessity of notice, court accounting, or court order. No Trustee appointed hereunder or by the court shall be under any duty to review, audit, or question the actions or accounts of his, her, or its predecessors. {J 145616:3.1} 5 _ _ _ _ rn� �. � Any corporate Trustee shall be entitled to receive annual compensation for its services hereunder in accordance with its schedule in effect when the services are performed, but not in excess of such compensation as would be approved by a court of competent jurisdiction. Any individual Trustee shall be entitled to receive annual compensation reasonable and commensurate with his services rendered, but not in excess of such compensation as would be approved by a court of competent jurisdiction. 10. Appointment of Executors I appoint my daughter, BARBARA M. KEIPER, Executrix of my Will. Should my daughter, BARBARA M. KEIPER, be unable or unwilling to serve or continue to serve, then I appoint my son-in-law, THOMAS KEIPER, Executor to fill that vacancy. I direct that no bond shall be required of any personal representative, trustee, guardian, or custodian named herein or appointed hereunder. IN WITNESS WHEREOF, I have hereunto set my hand and seal the �� `{�/ day of �c��')�y�,, , 2010. {;:.� (SEAL) MARY E. ME Signed, sealed, published and declared by MARY E. MECK as and for her Will in the presence of us, who at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses. '11 ` A °�.�y.�-��f � � Address: Address: \ �j�2.�' ��2�. 1Y.� l��C�� '�`� ��'^�- —` � {J1456163 1} ( _ ._ _ . �A� �,• --. ACKNOWLEDGMENT AND AFFIDAVIT FOR SELF-PROVED WILL COMMONWEALTH OF PENNSYLVANIA ) ,.. , ) ss: COUNTY OF � '!��'�� ) We, � MARY E. MECK, ��;�;i�.�h�41��. ,�t � h� ��'� and �N�jl1 Y�5 ��£�{��1� , the Testatrix and the witnesses, respectively, whose names are signed to the foregoing Last Will, being first duly sworn according to law, do depose and say that the Testatrix signed and executed the foregoing instrument as and for her Last Will, that she signed willingly, that she executed it as her free and voluntary act for the purposes therein expressed, that each of the witnesses, in the presence and hearing of the Testatrix, signed the Last Will as witnesses and that to the best of the knowledge of each of the witnesses the Testatrix was at that time eighteen (l8) years of age or old�r, of sound mind and under no constraint or undue influence. , �� d X�r n �� „�,. MARY E. M ; . '\\ �J ; ----� __.— ,�� 1 ON THIS, the .`' - day of ��,`�G'�(,�'#^;�,[?t�'~ , 2010, before me, a Notary Public, the undersigned officer, personally appeared JOHN F. MECK, PA I.D. 26439 known to me or satisfactorily proven to be a member of the bar of the highest court of the Commonwealth of Pennsylvania and a subscribing witness to the within instrument, and certified that he was personally present when the foregoing acknowledgment and a�fidavit were signed by MARY E. MECK, the "I'estator, an�d �l)n`i�.`t�h`�h i�� , (��l1 r l� and '" i ��C;'��,�;�j �L j��r(� , the witnesses. ---�--- IN WITNESS WHEREOF, I hereunto set my hand and official seal. ; '�,. , r � , . `! �` ��!� ( �' �-{J, ;. � .,1 � �� .�':. �i.�`. Not y ublic� ',� `' � COMMpNWEAI.'PM qF PENNSYLVANlA IVotaria!Seal Kathleen L't?xxnson.Ptotary PubGc City OtPitlsbtxgh�ANe^t�eny Ca�ntY ►uly�n Ex,�es Nov 21,2011 M�mbet,Ppnns�MraniA Ascociation of NotariN+i {J 1456163.1} "] � o M � N � ° M � > w � N '�-� z � � � O � RECOR�:;�n ��=t;C"� p;- w � � �� `7 v i i:i\ �r ' Q � ;_$; EG{�� '�Ik_!..S ,:� � P� N t{7 � ��=�-_p �[i13 I�I�Y 2`! 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