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Home My WebLink About02-1104PETITION FOR PROBATE and GRANT OF LETTER4 Estate of Maragret T. Campbell also known as 2 21- 3 0- 7 g Deceased Social Security No. The petition of the undersigned respectfully represents that: in the Your petitioner(s), who is/are 18 years of age or older an the executrix in the last will of the above decedent, dated 1~~ ~ named and codicil(s) dated _A~ct~Gt- 1 g' , 19 (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland h er last family or principal residence at 2 0 6 Todd C i r c l e C Car l i s l e 1vaPAa, with (list street, number and muncipality) Decendent, then 9 2 _ years of age, diedNovember 21 , 2 0 0 2 at_ Carlisle Re Tonal Medical Center ,19 , Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.} All personal property $ _ 4 4 , 0 0 0. 0 0 (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentarv theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) U b .•. ~~ ~~ Ann C. Cla c b ~.0 141 North Middlesex Rd ~a arliclP~ PA~170~'3 ~4. ~° c op OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY QF CUP1.BEi~LAND No. 21-02-1104 To: 1 ss The petitioner(s) above-named swear(s) or 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 represen- tative(s) of the above decedent petitioner(s) will well/and truly administer the estate according to law. Sworn to or affirmed and subscribed C--~ C ~~ yL~~~ ~ before m this 3rd day of nn ~ ~ Z ayc b ~• l~ecem er, 19 ~~! ccJ~' ~ ~~~~~„ y, , Register Register of wWills for e County of Cumber~'and Commonwealth of Pennsylvania A .~. No. 21-oz-llo4 Estate of Margaret T. Campbell Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW DECEMBER 5 - . `.~___ _.-._._._._ ~'~_2~2. in :, tJCSlQerati0!t C ' `~'~.'. t`.t",t';i,F' ,i:: the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated August 1 8, 1 993 described therein be admitted to probate and filed of record as the last will of Mar aret T Campbell and Letters TPGtamPnt^rv are hereby granted to Ann C. Claycomb Register o FEES Probate, Letters, Etc. ......... ~ 80.00 Short Certificates( ) .......... ~ 3~0_~ x-pages. Renunciation ................ ~ ' JCP ~ 10.00 TOTAL ~ 129.00 Filed ..... D~~~~B>;~t .5 , . 2Q02.......... . / ATTOR;~lEY (Sup. Q. LD. No.) T for P, Andrews, Esq., 15641 78 West Pomfret Street ADDRESS Carlisle, PA 17013 (717) 243-012 PHONE I•his is to v~rti!v ghat the: into.lnatic~n her; given is correctly co*~ied t31o an ociinal c~rtificr~te of cjeatiz ~li,~ iii=~c1 r~~l;~ ~~~IC :as LOcz)t ~Zc,ISU~a'-. ~ hC 6fi~717::_~~ Cc~iClfK~iTC ~~'lll ~~Z ~OrIVaI(~E'CI CO Che ~.1°C' ~:iia~ ~eCC~1'QS ~)triCe El~r }?Ci-1l, ,,le'!:C i`~'I.;i;. WAFiNIN~: It is iiiegal to duplicate this c~~p~T by photostat or pf~otogra~i~. X704050 H, OS.: W Re.. ?187 TINT ENT NK J N0V__~ 5_2002 ) r COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • 4tTAl RECORDS CERTIFICATE OF DEATH STRE FILE NUMBER NAME OF DECEDENT IFwm. Mdaa. Laml SE% $OCIAL SECURITY NUMBER DRE OF DEATH,MaIel. Day.'WI +• Mar rat T. Campbell F ,. ,. 221 - 30 - 7482 a. 11/21/2002 AGE Ilam Bw"'mYl UNDER t YEM UNDER, DAY DATE OF BIRTH BIRTHPLACE (C,ry xwl PUCE OF DERH ICnecA only are __ ,.e,r,yn,cl,ay p+ply, Paal ' MomlM I Days /burs MYwlaf 'Manor, Oay. hvl SbhpFdfgn Caunttyl HOSPITAL: OTHER: 92 10 T N 9 5 1 Y,,. / / renton , 9 J ,,pa,;a,,, ~ ERrOIApsIMa u DDA C ,~ ^ ~ ~ M COUNTY OF DERH CRY, BORO. TWP OF DEATN FACILRY NAME pl na xlm•AAwn, yne mrM and numbed VMS OECEDEM OF HISPANIC ORIGIN? RACE -Ammon Mahn B4KR Wnae aC , , . . - Cumberland Carlisle Boro. Carlisle Regional Medical Center "° ~ y" ~ "++• w«eYaaMn IS°°"''' + • R ae. ANsxerl, Pwne Rkan, ria Whlte b. f ' DECEOEM . 10. $USUAL OCCUPRgN KIND OF BUSINESS/INDUSTRY YNS DECEDENT EVER IN DECEDENT'S EDUCRION MMITAL STRUS•MSrrietl ,G"y Meq a e«M data CUrvaqq mom U.S. ARMED FORCES? n SURVIVING SPOUSE ah t N Ynpeey a rrerMMly aN; h na ua reMrea l X ~ S , I wYe. 9^'e mYCn nrnel EMBnenhrylSecondary ra ^ Na C~? M - Homemaker ~,~, Her own hone , • ,:. ,,. „~ „s. 3 , "'" ,. Widowed - ' . OECEDENT S MAILING ADDRESS ryrM,Clty/bwn. STSS, Z4 COae1 DECEDENT'S 1!. PA ACTUAL ne. sh,. ae na^ Ya.. tlec.dr%Xred 206 Todd. Circle IRSE„~~ro,y ~e.<.tl«+ ~ ,. PA 1 013 °n°"°r"°" ,Tb. Ctnnberland °""'""'"? "°•°'<'°"'""'^° ntl (~.alrl.c,lrXmiha Carlisle FRNER'$ NAME IFirm, MCOe. Lam) . <avAOrb MOTHER'S NAME (rem, MAde, Hagen Spnrnel ,.. Wilbur Ha es Ta for „ Margaret - Hoffman INFORMANT'SNAME [rybrvr~q ' INFORMANT S MAILING ADORE ISbem. CXy Sws. Zp~o.~ 20a. Ann C. Cla canb 141 N. Midc~esex~d. Carlisle PA 17013 , , xae METHOD OF DISPOSITNN! I~I OREOaDISPOSITION PLaE ~F'OSITION-NameaCeme,ery. Crematory IOC.VgN•CMlTpfn, Shle. 79 Coh remriien^ Rerrrofrhorll S,ueJa - Drrrion^ 01Mr "__ _. . „~ ^ 1,b 12/06/2002 „Mead of Christiana Cemete Newark, DE 31GNRURE OFF SERVICE LN:ENSE PER,~ACTINO AS SUCH LICENSE NUMBER NAME ANDADORESS Of FAGUTY ttd ~ '" •~ ~ ,_,- FD 012633 L ~kving Brothers Funeral Hoene Carlisle PA 17013 , , Cpnpaew~l7e-e only.Irn tendyMq anybMd 4nowhdpe,h accurrsd aliM Nae. hh rKlda<. coaled. S E Plrysitiarl nelMbbh al lirM O/tlsama ISibneNre i ) /, 1 LICEN NUMBER DATE SMaHED • army nl.. d ann. J IM°"^. Dw. ~~ I / / I S 3 n ' x,~ ~ 2 U 1-~.~ ~ / 1 „< ab. ' ` N /~ Z. t o L acme 2418 rMr MC'olnPlelseW TIME OF DEATN DATE R U EO,D4 (Manor, Day,,barl VMS CASE REFERRED TO MEDICAL EXAMINERICORONER? pwson ale Prornralcea hanl. ~ (p z S N. ^ z.. M. n. ~ Z I G 2 ~ __ 27. PART L• Lhl ~Y err G a ~ •~ ~C<mpbcallorr when uegeB the halo. Do na aMN IM moo.01 oyinp, loco tl CiroieC q rospintory irrM, 9ntt# ar MN hilWa. I Appoaimah PART N: OIIISF yylill<aly tonpypm<onpbayrp y y.ay, DN , 'IOI MUgi^9 in Xr pWeny:q eMr Alen n PART 1. I orrri antl M.BI meF[MATE C/1118E (Foal r.::,'"~ 'AJIa~ ~lJa,~''hnR 5^-~.~~ 3ow~ c>5,i1ru~'. ... DUE tO IOR AS A CONSEQUENCE OFI: SeOYeaiaal' Y eerlrlbm D. NMlc badMq b.rel,ea;na OVE TOIOR ASA LONSEOUENCE OFl: 1 crave. Ear UNDEMYMq talAE Dh ; rra+rFwy c. l ea nsrstl ew"s DUE TO,OR AS A CONSEQUENCE OFl: - .erwrp w tleer) lAST e. I • WAS AN AUTOPSY PEi1FORMEOY WERE AUTOPSY FINDINGS AVAKABLE PRIOR 70 MANNER OF DEATH DATE OF INJURY TIME OF INJURY INJURY R WORKt DESCRIBE HOW INJURY OCCURRED. (Manor. DM Karl COMPLETKJFI Of CAVSE OF DERV? ~E-~ ^ Ne1Wr p1~ Homi<be . A«ihM^\ PerldAry In.eslge,pn ^ YM ^ No ^ qe ^ Ne~ `M ^ No ^ Suicide ^ Celad nol W OmarmmW ^ ,b0. M. PUCE OFINJURY -N tgny hrm m.M lacp oXka O 2aa. 3M. ,~- , , . y, L CRgN ISbew. Ccy/TOwrl, Srrel buadkrp, el<. 15pecM1 ]Oe. CERTNRER ICne JI pYy oral ,Of. 'CEI,TIF/NID PHY8IGAN IPnymcw CerMyyry Ci.M a tleam enan andnr awmaan nas prmolwlcm Deem an0 campHad Xem 2,1 SIGNR AND TITLE CE IER TO ore bM a my Mnerbtlge, hsN aaumtl Due b me <eeeefsl and manner p slalb ..................................................... V . l(bV\~ ~V ~.. „b `J '-ROMOUNCIND ANO CERTIFYB,D PHYSICIAN IPbysKyn Dam arorwunc Te Ble b.riri Moo uq deem and cendyrrgroaw,aa haml m Metl e haN d B LICENSE NUMBER ORE SKiNEDIMann, Day. Yar, -TrR~ o lb 2La l6 <uW 2 .. - y g , oeewre ri ,e aer, hb, antlp,acr, and tlw to n,. weeels) end manner n flaletl ....................... ^ 1 Z ,1<. „ /~1V NAME AND ADDRESS Of PERSON WHO COMPLETED CAUSE aF DERV 'lIEDICAI E%AMINER/CORONER On tRe baNa bt a%aminatlon arMlon inreatigatbn, in my opinion, death o«urred at the time date arM place and due lo,Re ca d (""^~ ~PeM< P, a~ A N ~„~,,, ~ r -~ 1 ~'1 "' , , , use(s) an ^ manner as statW ..................................................................... ,,.. .. REGISTMR'S $IGNRURE ANO M . ~'~ W~~yt. ,2. Z ~oh~ aw C~PLyji. n Z A. FGa c~ DATE FILED IMOmn. Day, lest ~ n. .. ,.. ov l ~5 ~ooa. /-0~ - //o LAST WILL AND TESTAMENT OF MARGARET T. CAMPBELL I, MARGARET T. CAMPBELL, of New Castle County and State of Delaware, do hereby make, publish and declare the following to be my Last Will and Testament, hereby revoking and making null and void any and all Wills and Codicils at any time heretofore made by me. ITEM I: I direct that any legally binding debts (not including mortgages on real estate) and funeral expenses be paid as soon after my death as convenient and that all legacy, succession, transfer, inheritance, estate and other similar taxes be paid from my residuary estate as an administration expense. ITEM II: I aive and bequeath certain articles of my tangible personal property in accordance with a Letter of Memorandum which I may have left with my Will or among my important papers. To the extent that said Letter of Memorandum does not exist or does not adequately dispose of all items of tangible personal property then I give and bequeath the same unto my daughters, ANN C. CLAYCOMB and ELLEN C. CHAMPLIN, with the hope and expectation that they will make an equitable division thereof between themselves. ITEM III: I devise any real estate or interest in real estate which I may own at the time of my death unto my daughters, AN"l C. CLAYCCME and ELLEPI C. CHA.'K~'LIN, in eq~.:al shares, as tenants in common, if living, otherwise unto their issue, per stirpes. ITEM IV: I give, devise and bequeath all of the rest, residue and remainder of my estate, whatsoever the same may be at the time of my death, and including any property over which I may have the right to exercise any power or powers of appointment, unto the Trustee of that Trust Agreement entered l ) t'~_--. ~ti y. ~ into by me on the ~ day ~~~ u'~: ~ , A.D., of ~ :~`fy~i 1993, as the same may have been amended from time to time. -,^~' G ~ It is my direction that no part of the property delivered to i the Trustee shall be considered or administered as a separate testamentary trust. ITEM V: I nominate and appoint my daughter, ANN C. CLAYCOMB, Executrix of my Last Will and Testament. In the event that my daughter, ANN C. CLAYCOMB, shall have predeceased me or be unwilling or unable to act as Executrix then I nominate and appoint my daughter, ELLEN C. CHAMPLIN, Executrix of my Will. I direct that neither o I f the aforementioned persons shall be required to give bond with surety before receiving ~ letters testamentary thereon. ! ITEM VI: I authorize and empower my Executrix as follows: 1. To sell, without the order of any court, either at public or private sale, at such price and upon such terms and conditions as she may deem proper, any or all of the real property constituting a part of my estate, and to transfer and deliver the same to the purchaser or purchasers thereof, without liability on the part of the purchaser or purchasers as to the application of the purchase money. 2. To retai~~ any and all stocks, .bends; roteG securities and other property constituting my estate at the time of my death, and in her sole discretion, to pay any legacy and to make any division or distribution of my estate 2 in cash or in kind, or partly in cash and partly in kind, and to make reasonable and equitable valuations and apportionments of the property to be so divided and distributed. 3. To use administration expenses as deductions for estate tax purposes or income tax purposes and to use date of death values or optional values for estate tax purposes, regardless of the effect thereof on any of the interest under this Will. IN WITNESS WHEREOF, I, MARGARET T. CAMPBELL, have hereunto set my hand and seal, this day of ~' C~v SZ , A.D., 1993. ~J~u'~- ~ ~C ~ ~~r~ ~ ~~~1 ^ ( SEAL) MARG ET T. CAMP ELL Signed, sealed, published and declared by the said MARGARET T. CAMPBELL, as her Last Will and Testament, in the presence of us, who at her request, in her presence and in the presence of one another have hereunto subscribed our names as witnesses. C` *R ~~ 3 STATE OF DELAWARE ) . SS. NEW CASTLE COUNTY ) BEFORE ME, the Subscriber, on this day personally appeared, MARGARET T. CAMPBELL, ;~_~ ~-~,~..,~~ ~~~/a--~-k'"`' and ~` ~ ~ v ~, ~:~--~= ~ : ~ - .~=~~'~--~- , known to me to be the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument and, all of these persons being by me first duly sworn, MARGARET T. CAMPBELL declared to me and to the witnesses in my presence that the instrument is her Last Will and Testament and that she had willingly signed or directed another to sign for her and that she executed it as her free and voluntary act for the purposes therein expressed; and each of the witnesses stated to me, in the presence and hearing of the Testatrix that such person signed the Will as witness and that to the best of such person's knowledge the Testatrix was eighteen years of age or over, of sound mind and under no constraint or undue influence . ~~r -.~. ~ MARGARET T . CAMPBELL ~.. ~;' ~ /' ,, SUBSCRIBED, SWORN AND ACKNOWLEDGED before me by MARGARET T. CAMPBELL, the Testatrix, subscribed and sworn before me by ~~-~-~...,---x----~/`~~~-and `.. -~~£---~-- ~G.~r _ `1 witnesses, this ~ ~ ~ day of ~~"~~ '~ } ~ , A.D., 1993. _ 'M ~ ^n~ - NOTARY PUBLIC 4 CERTIFICATION OF NOTICE UNDER RULES 5 6(a) Name of Decedent: Margaret T. Campbell Date of Death: November 21, 2002 Will No: 21-02-1104 To the Register: I certify that notice of beneficial interest 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 9, 2002: Ann C. Claycomb, Successor Trustee 141 North Middlesex Road Carlisle, PA 17013 Mrs. Ellen C. Champlin 2454 22nd Avenue San Francisco, CA 94116-2435 Ann C. Claycomb, Trustee 141 North Middlesex Road Carlisle, PA 17013 Notice has now been given to all persons entitle~eto un~yld5?. ,~a) except: No exceptions. Date: December 9, 2002 "1~aylor P. Andrews, Esquire 78 West Pomfret Street Carlisle, PA 17013 Phone: 717-243-0123 Capacity: Counsel for personal representatives NOTICE OF BENEFICIAL INTEREST IN ESTATE BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYLVANIA IN RE: Estate of Margaret T. Campbell, deceased, No. 21-02-1104 TO: Ann C. Claycomb, Trustee 141 North Middlesex Road Carlisle, PA 17013 Please take notice of the death of decedent and the grant of letters to the personal representatives named below. You may have a beneficial interest in the estate as follows: that the residue of the estate is given to the trust of which you are successor trustee. Name of decedent: Last Known Address Margaret T. Campbell 206 Todd Circle Carlisle, PA 17013 Date of Death: November 21, 2002 Place of Death: Carlisle Regional Medical Center County of Grant of Original Letters: Cumberland Decedent died testate. A copy of the will is attached. Names, addresses, and telephone numbers of all personal representatives appointed: Ann C. Claycomb 141 North Middlesex Road 717-249-5846 Carlisle, PA 17013 Names, addresses, and telephone numbers of all counsel: Taylor P. Andrews, Esq. 78 West Pomfret Street Andrews & Johnson Carlisle, PA 17013 Additional information may be obtained from the Date: December 9, 2002 717-243-0123 __~~. Taylor P. Andrews, Esquire 78 West Pomfret Street Carlisle, PA 17013 Phone: 717-243-0123 Capacity: Counsel for personal representatives NOTICE OF BENEFICIAL INTEREST IN ESTATE BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYLVANIA IN RE: Estate of Margaret T. Campbell, deceased, No. 21-OZ-1104 T0: Ann C. Claycomb, Trustee 141 North Middlesex Road ~r C~-r~isle, PA 17013 ~' il~`~ease take notice of the death of decedent and the grant of letters to the personal representatives ~'`~~" f ~blii~v: You ma have a beneficial interest in the estate as foil Y ows: that the residue of the estate is given to the trust of which you are successor trustee. Name of decedent: Margaret T. Campbell Last Known Address: 206 Todd Circle Carlisle, PA 17013 Date of Death: November 21, 2002 Place of Death: Carlisle Regional Medical Center County of Grant of Original Letters: Cumberland Decedent died testate. A copy of the will is attached. Names, addresses, and telephone numbers of all personal representatives appointed: Ann C. Claycomb 141 North Middlesex Road 717-249-5846 Carlisle, PA 17013 Names, addresses, and telephone numbers of all counsel: Taylor P. Andrews, Esq. 78 West Pomfret Street 717-243-0123 Andrews & Johnson Carlisle, PA 17013 Additional information may be obtained from Date: December 9, 2002 Taylor P. Andrews, Esquire 78 West Pomfret Street Carlisle, PA 17013 Phone: 717-243-0123 Capacity: Counsel for personal representatives NOTICE OF BENEFICIAL INTEREST IN ESTATE BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYLVANIA IN RE: Estate of Margaret T. Campbell, deceased, No. 21-02-1104 T0: Mrs. Ellen C. Champlin 2454 22°d Avenue San Francisco, CA 94116-2435 Please take notice of the death of decedent and the grant of letters to the personal representatives named below. This notice is provided to you as a child of the deceased. Name of decedent: Margaret T. Campbell Last Known Address: 206 Todd Circle Carlisle, PA 17013 Date of Death: November 21, 2002 Place of Death: Carlisle Regional Medical Center County of Grant of Original Letters: Cumberland Decedent died testate. A copy of the will is attached. Names, addresses, and telephone numbers of all personal representatives appointed: Ann C. Claycomb 141 North Middlesex Road 717-249-5846 Carlisle, PA 17013 Names, addresses, and telephone numbers of all counsel: Taylor P. Andrews, Esq. 78 West Pomfret Street 717-243-0123 Andrews & Johnson Carlisle, PA 17013 Additional information may be obtained from the Date: December 9, 2002 Taylor P. Andrews, Esquire 78 West Pomfret Street Carlisle, PA 17013 Phone: 717-243-0123 Capacity: Counsel for personal representatives COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX111-96) NO. CD 002394 ANDREWS TAYLOR P ESQUIRE 78 W POMFRET STREET CARLISLE, PA 17013 ACN ASSESSMENT AMOUNT CONTROL NUMBER ------- fold ESTATE INFORMATION: ssrv: 221-30-482 FILE NUMBER: 2102-1 104 DECEDENT NAME: CAMPBELL MARGARET T DATE OF PAYMENT: 04/04/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 1 1 /21 /2002 101 ~ S 1 1,500.00 TOTAL AMOUNT PAID: REMARKS: TAYLOR P ANDREWS ESQUIRE SEAL CHECK# 13 INITIALS: JA RECEIVED BY: DONNA M. OTTO S 1 1, 500.00 DEPUTY REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 002906 CLAYCOMB ANN C 141 NORTH MIDDLESEX ROAD CARLISLE, PA 17013 foltl ESTATE INFORMATION: ssN: 221-3o-74s2 FILE NUMBER: 2102-1 104 DECEDENT NAME: CAMPBELL MARGARET T DATE OF PAYMENT: 08/ 1 5/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 11/21/2002 REMARKS: CHECK#120 SEAL ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ S 1, 949.38 TOTAL AMOUNT PAID: INITIALS: VZ RECEIVED BY: DONNA M. OTTO REV-1162 EX~11-96) S 1,949.38 DEPUTY REGISTER OF WILLS REGISTER OF WILLS OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA REV-1500 FILE NUMBER DEPARTMENT OF REVENUE DEPT. INHERITANCE 280601 HARRISBURG, PA 17128-0601 TAX RETURN RESIDENT DECEDENT 21 - 02 - 1104 COUNTY CODE YEAR NUMBER I- DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Z Campbell, Margaret 1. 221-30-7482 w DATE OF DEATH (MM-DD-YY) DATE OF BIRTH (MM-DD-YY) THIS MUST BE FILED IN DUPLICATE Cl W 11/21/2002 9/5/1910 WITH THE REGISTER OF WILLS U w (IF APPLICABLE) SURVIVING SPOUSE'S NAME SOCIAL SECURITY NUMBER Cl I w txJ 1. Original Return D 2. Supplemental Return o 3. Remainder Return "" ~!:::cn :=J 4. Limited Estate D 4a. Future interest Compromise o 5. Fed. Est. Tax Return Req'd 0"''' w"-O IOO ~ 6. Decedent Died Testate [i] 7. Decedent had Living Trust 0 o"'~ 8. Total number of SOB's "-[[J - "- I 9. Lit'g'tion Proceeds Rec'd n10. Spousal Poverty Credit n 11. Election to tax wi Sec. 9113(A) "" f- t!lIIl$l!cjj&N!1<<i!i@j~:iil!!_itUeWijiji$~i!iI!IeiiiM\jlilmlfil\ll!i!i'tmt\'tMili!W&iMA'tJ$Jiil1IlPWitltimiI z NAME: COMPLETE MAILING ADDRESS: w 0 z Taylor P. Andrews, Esq. 0 "- FIRM NAME: Taylor P. Andrews, Esq. <f) w Andrews & Johnson Andrews & Johnson a:: '" TELEPHONE NUMBER 78 W. Pomfret St. 0 0 717 243-0123 Carlisle, PA 17013 1. Real Estate (Schedule A) (1) $.Q, 00 OFFICIAL USE ONLY 2. Stocks and Bonds (Schedule 8) (2) ~.OO C' 3.Closely Held Corporation, Partnership or Sole.Prop. (3) . 4. Mortgages & Notes Receivable (Schedule 0) (4) $0.00 Z 5. Cash, Bank Deposits & Misc. Personal Prop.(Sch.E) (5) $44,248.90 c.: 0 ;:: 6. Jointly Owned Property (Schedule F) (6) $0.00 ~ .n :3 D Separate Billing Requested :J 7, lnter.Vivos Transfers & Misc. Non-Propate Prop. (7) $268,887.66 l- ii: 8. Total Gross Assets (totall\nes 1-7) (8) $313,13.6.56 <( 9. Funeral Expenses & Administration Costs (Sch H) (9) $10,676.38 _I u W 10. Debts of Decedent, Mortgage liabilities, & Liens (10) $3,585.06 ll: 11 . Total Deductions (total lines 9& 1 0) (11) $14,261.44 12. Net Value of Estate (Line 8 minus Line 11) (12) $298,875.12 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (13) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) $298,875.12 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z 15. Amnt of Line 14 taxable at the spousal rate, 0 i= or transfers under Sec.9116(a)(1.2) x.O_ (15) $0.00 <t f- 16. Amount of Line 14 taxable at lineal rate $298,875.12 $13,449.38 ::> x.045 (16) 0. :E 17. Amount of Une 14 taxable at sibling rate $0 x.12 (17) $0.00 0 (J 18. Amount of Line 14 taxable at collateral rate $0 ><.15 (18) $0.00 >< "" 1 9. Tax Due (19) $13,449.38 f- 20 n CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ,-.,..,...-......,. ...........,.., ..........,..w. ;.:.:.,.". ........,.. ........................................,.: ........,. .................. .........,...... .......................,. ...................... ".,'., ........w.w.,.. .,..,.,.:w.....w..., .............w...... .....,..............._..w.. ......,...."....,. . I /1- I C iJ' - i 7_ "':::":::::'::':':::::::::'::::::::::::::::::::::::::::',:i",~!!!iH;,l\l1Rl$i:r&1i!lllW~$!A!$i:g~n\iii#tg!l,Rliil$J!!!lliMIH~!ii:i'lNPJ:!lalml!@,;Jil.l!il'a$!';::::!::::' "".' ,::,.,.., .',:",:,:,::,~<::;:<::::<::::<:::::::: ............,....w...............,...... ......- .......... Ad Decedent's ComPlete dress: STREET ADDRESS 206 Todd Circle CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due 2 Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discounts $11,500.00 Total Credits (A+B+C) 3. Interest/Penalty if applicable D, Interest E. Penalty 4. TolallnteresUPenlalty (D+E) if Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT Check box on Page 1 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. A, Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCe DUE. Make Check to: REGISTER OF AGENT (1) (2) (3) (4) (5) (5A) (56) $13,449.38 $11,500.00 $0.00 $1,949.38 $1,949.38 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X"IN THE APPROPRIATE BLOCKS Did decedent make a transfer and yes no a retain the use or income of the property transferred: b retain the right to designate who shall use the property transerred or its income c retain a reversionary interest: or d retain the promise for life of either payments or care? 2 If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? 3 Did decedellt OWlI an "in tr\.lst fa!" or payable upon death bank account or security at his or her death? 4 Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary disignatlon? EJ EJ o o o o o o o EJ EJ EJ EJ EJ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete ADDRESS ADDRESS DATE DATE ~? For dates of death on or after July 1, 1994 and belore January 1, 1995, Ihe tax rate imposed on the net value 01 transfers to or fer the use oflhe surviving spouse is 3% [72P,S Sec. 9116(a)(1.1)(I)J For d..tes of death on or after January i, 1995, the tax rate imposed on the nelvalue oftransfers to or for the use 01 the surviving spouse is 0% [72 P,S, See 9116(a)(1.1)(ii)J The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements lor disclosure of assets and liling a tax return are still applicabie even if the surviving spouse is the Grlly beneficiary For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deseased child twenty.one years of age or younger at death to or for the use 01 a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S, Sec. 9116(a)(1 ,2)] The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4,5%, except as noted in 72 P,S. Sec, 9116(1.2) [72 P.S, See 9116(a)(1) Tile tax lme imposed on me net value 01 transfers to or for the use of the decedenfs siblings is 12% [72 PS, Sec9116(a)(1 ,3)J 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 SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANIOUS PERSONAL PROPERTY ESTATE OF FILE NUMBER Campbell, Margaret T (All property jointly-owned with Right of Survivorship must be disclosed on Schedule F) ITEM DESCRIPTION NUMBER 21-02-1104 VALUE AT DATE OF DEATH M&T Bank cking account 2679008330 $2,358.90 2 Orrstown Bank account 143000052 accrued interest $12,844.26 $2.71 3 1987 Dodge Aries - sold in arms length transaction for $1,000.00 4 Refund of security deposit from uec Home $28,043.03 TOTAL (also on line 5, Recapitulation) $44,248.90 rt;1 MBtlBank Manufacturers and Traders Trus1 Company, 1100 Wehrle Drive, P.O. Box 767, Buffalo. NY 14240~0767 January 16, 2003 RE: Estate Search The Estate of: Date of Death (D.O.D.) MARGARET T CAMPBELL 11/21/2002 To Whom It May Coucern: Identified below is the account information requested. 1. M&T Bank accounts in which the decedent's name appears: Account Type Acconnt Number Account Title Opening Branch D.O.D. Accrued Interest Balances (Includes Accr. Int.) $2358.90 $.00 CHK 2679008330 MARGARETTCAMPBELL 4319 C/O ANN CLAYCOMB POA 2. Loans, Mortgages, or other obligations.titled in the decedent's name Account Number Amount Owed Account Description NO Safe Deposit Box titled in the Decedent's name existed at our office. If you have any questions about the information provided, please contact our Records Department at (716) 635-4010 or 1-800-724- 2440 outside of the Buffalo, NY calling area. Thank you. Sincerely, M&T BANK CORPORATION BY: ~I1A ~ ~--4 ~ -' Authorized Signature DATE: , -I & - CJ '3 ~ ORRSTOWN BANK TO: Andrews & Johnson Attorneys-at-Law 78 West Pomfret Street Carlisle, PA 17013 FROM: ORRSTOWN BANK P.O. BOX 250 SHIPPENSBURG PA 17257-0250 RE: ESTATE OF Margaret T Campbell DATE OF DEATH: November 21,2002 DECEASED IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD, ON THE ABOVE DATE, THE FOLLOWING ACCOUNTS WITH ORRSTOWN BANK: (1) CHECKING ACCOUNTS DATE OF DEATH ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPLE & ACCRUED INTEREST 143000052 Margaret T Campbell 10/30/02 12,844.26 2.71 SAVINGS ACCOUNT DATE OF DEATH ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPLE & ACCRUED INTEREST (3) CERTIFICATES OF DEPOSIT DATE OF DEATH ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPLE & ACCRUED INTEREST Date: 6/23/03 By: Timothea Customer Service Operator P.O. BOX 250 SHIPPENSBURG, PA 17257 TEL. (717) 532-6114 SCHEDULE G T ANSFERS ESTATE OF FILE NUMBER Campbell, Margaret T. 21-02-1104 This schedule to be completed aud filed if the answer of the question on the reverse of the cover is yes. ITEM DESCRIPTION EXCLUSION TOTAL VALUE DECD.% DOLLAR VALUE NUMBER OF ASSET !NT OF DECD. INT 1 Revocable Trust dated August 1, 1993 $268,887.66 100% $268,887.66 See attached for detail: TOTAL (also on line 7, Recapitulation) $268,887.66 MargaretT. Campbell Estate 000: 11-21-02 FIN: 02-6156823 Valuation of Trust Account at Merrill Lynch as of ODD I nvestmenl: DuPont DO DuPont Pfd Cum Ser B Exxon Mobil PP&L Pfd Stk SBC Communications Inc. Verizon Communications Merrill Lynch Prime Fund U.S. Treasury Note Merrill Lynch Money Market No of shares 1579 432 1599 180 859 368 999 500 Hiah 44.2 85 35.4 44.09 27.93 40.89 7.82 108 Low 42.04 84.25 34.86 44.09 26.12 38.76 7.82 107.938 Mean 43.12 84.625 35.13 44.09 27.025 39.825 7.82 107.969 Value $68,086.48 $36,558.00 $56,172.87 $7,936.20 $23,214.48 $14,655.60 $7,812.18 $53,984.50 $467.35 $268,887.66 REVOCABI.R TRUST AGRERMENT iVJ T c. " _ THIS..,.!rl<UST AGl<EEMENT is made this \ 'C c::: day of ~-..J(j-..J >" , A.D., 1993, by and between MARGARET T. CAMPBELL, hereinafter referred to herein as the "Grantor II and MARGARET T. CAMPBELL, hereinafter referred to as IITrustee". ~: The Grantor hereby transfers to the Trustee the property listed in Schedule A annexed hereto, IN TRUST, for the fOllowing purposes: (a) To pay income to the Grantor in convenient installments at least quarter-annually; (b) To pay to the Grantor, at any time or times during Grantor's life, such sums from or any part or all of the principal as Grantor may request in a written instrument delivered to t?e Trustee; (c} To pay to the Grantor, at any time or times during Grantor's life, such sums from or any part or all of the principal as the Trustee may, in Trustee's discretion, determine to be reasonably necessary for Grantor's support, maintenance, comfort or other benefit, or to meet the costs of any illness or accident which may effect Grantor; (d) Upon the death of the Grantor, to pay the then remaining principal, if any, as the Grantor may appoint in favor of Grantor's estate or in favor of others, such power tQ be exercisable tor Grantor in a Will in which Grantor expressly refers to this power; (e) If or to the extent to which the Grantor fails effectively to exercise the power granted to Grantor in subarticle Cd) above, to dispose of principal, if any, remaining on Grantor's death as provided in Article THIRD. SECOND: Upon the Grantor's death, the Trustee shall pay to the Grantor's estate an amount equal to the trust's fair share, determined as provided below, of all estate, inheritance and other death taxes (including any interest thereon and penalties with respect thereto), federal estate and other, imposed by reason of the Grantor's death in respect of property held by the trust or otherwise. The trust's fair share of such taxes shall be determined by the executors or administrators for each tax separately and, for each tax, shall be the proportion of the tax which the value of the property held by the trust in respect to which the tax is imposed bears to the value of all property in respect to which the tax is imposed. A tax shall not be considered imposed in respect to property to the extent of any deduction, credit, exemption or exclusion allowed in respect to such property. The determination by the executors or administrators of the amount payable under this Article shall be final, and the Trustee shall pay such sums without making inquiry into their accuracy. Upon making payment of the amounts determined, the Trustee shall be discharged from any liability with respect to such payments and from further accountability therefor. Such payment shall be made out of the principal of the trust. TIllIill : At the death of the Grantor, MARGARET T. CAMPBELL, the balance of the property held in trust shall be distributed by the Trustee as follows: (a) The sum of TWENTY-FIVE THOUSAND DOLLARS ($2S,OOO.OO), each, unto those of Grantor's sons-in-law who shall have survived Grantor, on condition that Grantor'S son-in-law and Grantor's daughter were legally married at the death of Grantor, and living together as husband and wife; (b) After the distributions set forth in (a) herein, Grantor directs that the rest, residue and remainder of the trust estate shall be distributed unto Grantor's daughters, ANN' C. CLAYCOMB and ELLEN C. CHAMPLIN, in equal shares, if living, otherwise unto their issue, per stirpes. FOURTH: If, under the terms of other provisions of this trust, any money or other property is required to be distributed to a person who is a minor or who is otherwise under a disability (such as incompetency), such money or other property shall not be, distributed, but instead shall be held by the Trustee, IN TRUST, for the following purposes: (a) During the period of minority or other disability, the 'l'rustee shall pay to the minor or other person under a disability any part or all of the income or principal as Trustee may, in Trustee's discretion, determine to be reasonably necessary for such person's support, maintenance, education, or health or to meet the costs of any illness or accident affecting such person; (b) Durinq the period of minority or other disability, the Trustee may accumulate any part of the income not disposed of pursuant to subarticle (a) of this Article, or they may add such income to principal; {c) Upon the termination of minority or the other disability, the Trustee shall pay all remaining property to the person whose minority or disability has terminated, or in the event such person has died before attaining majority or without termination of the disability, the Trustee shall distribute such property to such person's estate. rI..F:rH= Any property which the Trustee is authorized to pay to a person who is a minor or otherwise under a disability, may, in the discretion of the Trustee, be paid for the benefit of such person to a guardian or to another individual who is not under a disability with whom the minor or otherwise disabled person resides. If the Trustee obtains a receipt for any payment made in accordance with this provision, such receipt shall fully diSCharge them from liability with respect to such payment and from further accountability therefor. ~: Whenever the 'Trustee is directed or authorized to make payments to a person, the Trustee is authorized, in Trustee's discretion, to apply such payments to or for the use of such person. SEVENTH~ Any income, which has been accumulated by the Trustee for the benefit of a specified person may be paid to such person at any time prior to the termination of the trust which earned the income and shall be paid to such person upon such termination. In the event that such person dies prior to the 2 termination of such trust, any such accumulated income shall be paid to his or her estate. EIGHTH: Whenever the Trustee is given the discretionary power to make payments from the principal of a trust, no Trustee, who is a potential recipient of such a payment, may exercise his or her discretion in his or her own favor. No payment of discretionary principal shall be made to anyone other than the Grantor herein, MARGARET T. CAMPBELL, during the life of the Grantor. 1lllITH.: The Trustee, in exercising any discretionary powers given under any provision of this Trust, need not take into consideration any other assets or inco~e owned by or available to the person to whom a discretionary payment is under consideration, except that the Trustee shall be prohibited from making any payments in reimbursement to any governmental entity which may have incurred expense for the benefit of a beneficiary, and the Trustee shall not pay any obligation of a beneficiary which obligatipn is otherwise payable by any governmental entity or pursuant to any governmental program of reimbursement or payment. It is the Grantor's primary purpose in creating the trusts provided for in this agreement to benefit the beneficiaries of the income and not to preserve the principal for the benefit of the remaindermen; this purpose shall be carried out in determining any questions which may arise between the interests of the beneficiaries of the income and the interests of the beneficiaries of the remainders. ~: The word "issue" as used in this agreement (1) shall mean issue per stirpes and (ii) shall include those born under the date at this agreement. The word "minor" as used in this agreement shall mean a person under the age of majority in the jurisdiction in which such person is domiciled, and the word "minority" shall mean that periOd before such person attains the age of majority. The words "Trustee" and "Trustees" apply to and include not only the Trustee named herein to act in the first instance, but also otherwise specifically provided, any additional or successor Trustee. The word "discretion" means 11501e exclusive and unrestricted discretionl' Unless the context otherwise requires, the masculine shall be deemed to include the feminine and neuter, and the use of the singUlar and plural be interchangeable. ELEVENTH: Witl10ut limiting tile autl10rity wl1iel1 the Trustee would otherwise have pursuant to law or pursuant to other provisions of this agreement, they are hereby vested with the following discretionary powers which they shall have until the final distribution of all assets in their hands: (a) To retain for as long a periOd of time as they may consider advisable or proper any property which may at any time be in their hands; e~change without consider extension security; (b) To sell at public or private sale or to any property which may at any time be in their hands, application to court, on any terms Which they may advisable or proper, including terms involving an of credit tor any period of time and with or without 3 (c) To invest in or otherwise acquire any property, without being bound by any provisions of law restricting investments by trustees, including but not limited to common and preferred stocks, secured obligations, mutual and common funds, other securities, mortgages, and interests and options in any of the foregoing; (d) To acquire and retain property without regard to any principles of diversification; (e) To acquire, exercise, sell or abandon conversion, subscription and other rights and options in connection with secur i ties or any other property, and to grant options for any period of time; (f) To operate, repair, alter, improve, insure, grant options upon, mortgage, partition, or lease for any period of time any real property or interest in real property which at any time forms part of any trust herein created; (g) To ~employ and pay investments advisors, accountants, attorneys, bookkeepers, clerks, stenographers and other assistants; (h) To borrow money for any purpose, including but not limited to the payment of taxes, this power to include the power to borrow from income for the benefit of principal or from principal for the benefit of income, with or without interest, and to pledge or mortgage property as security for money borrowed; person, including (1) To corporation, a beneficiary lend money or other property partnership, trust or other hereunder; to any entity, (j) To make any division or distribution hereunder in kind or in cash or partly in each; (k) To determine in case of reasonable doubt on their part, whether any property coming into their hands constitute income or principal, and whether any payment or expenditure made by them shall be charged to income or to principal, but any distribution by a corporation or association made to the Trustee in the shares of the distributing corporation or association, whether in the form of a stock split or stock dividend, shall be allocated wholly to principal; (1) To place the assets of the trust or any part of them in one or more bank, brokerage, custodian or other accounts with any banks, trust companies, or stock brokerage firms, and to pay the cost of maintaining such accounts; (m) To maintain bank, brokerage, custodian and other accounts under the title MARGARET T. CAMPBELL TRUST or in the name of the Trustees or any of them, followed by the words uAccount No. 11 or by the word "Special"; (n) To keep property of the trust in any convenient place of safekeeping, without limitation, provided that such property is at all times earmarked as being the property of the trust; 4 (0) To delegate to anyone of the Trustees, or to others, any nondiscretionary power, including but not limited to the power, singly or with others, to sign checks, withdrawal slips, instructions for the receipt of securities or other property, and instructions for the payment or receipt of money, and the power, singly or with others, to have access to any safe deposit box or other place where property of any trust created pursuant to this agreement is deposited. TWELFTH: No Trustee shall be required to furnish any bond, undertaking or other security for the faithful discharge of his duties as Trustee, nor shall any Trustee be required to file any interim account of his proceedings in any court in any jurisdiction in which he may be called upon to act. No Trustee shall be responsible or liable for the manner in which any discretion is exercised pursuant hereto, or tor any misinterpretation of this agreement, or for any act or omission of any other Trustee, or, unless his conduct amounts to fraud or willful misconduct, for any act or omission of his own. THIRTEENTH: Any person, including the Grantor, may, at any time and fro~ time to time, add additional property by will or otherwise to the trust, providing such property is acceptable to the Trustee. Any property so added shall become a part of the trust estate and be subject in all respects to the terms and conditions of this agreement. FOURTEENTH: Any statement sent by registered mail or delivered by any Trustee to, or any release to a Trustee signed by any beneficiary who is living and of full age and sound mind, or any statement so sent or delivered to, or any release signed on behalf of any beneficiary by the executor or administrator of any beneficiary if the beneficiary is not living, or a parent, guardian or committee of a beneficiary who is living but not of full age and sound mind, shall conclusively discharge the Trustee from any and every claim and demand of any such beneficiary with re.spect to any matter contained in such statement or release, except with respect to any matters in such statement as to which written objection is made to and received by the Trustee rendering the statement within sixty days after the statement has been delivered. Any such release, if given with respect to all matters relating to the trust and the administration thereof, with or without a formal or informal accounting or the rendition of any statement, shall conclusively discharge such Trustee from all claims of the beneficiary by whom or on whose behalf the release was signed, and from all claims of the then living descendants of such beneficiary having no interest in the trust conflicting with that of such beneficiary, and from all claims of such beneficiary'S unborn iasue, with respect to all matters re.lating to the trust or the a.dministration thereof, including claims which were not disclosed to or not known by such beneficiary or the person signing the release on such beneficiaryts behalf. FIFTEENTH: A Trustee may resign by executing and acknowledging a written resignation and delivering it to an acting Trustee, if there is a Trustee acting, or if not the Grantor if Grantor is then living, or if not to the then income beneficiary of the trust. SIXTEENTH: If any Trustee ceases to act, the successor trustee or trustees shall be permitted to act singly or jointly, 5 provided, however, that no discretionary payments of principal are pi:lyable to any Trustee other than Grantor during Grantor's lifetime. The Grantor shall have power to remove any Trustee and to designate additional Trustees or successors Trustee. Any designation shall be revocable at any time prior to the qualification of the person so designated. After the death of the Grantor, the Trustee or Trustees acting from time to time shall have the power to designate additional Trustees to serve with them or suooessor TrUstees to serve upon the occurrence of a further vacancy if the successors named herein or designated as provided herein are unable to act. The powers provided for by this paragraph shall include the power to designate different Trustees for different trusts created herein. The Trustee acting from time to time snall have the power to delixer any or allot the assets of the trust to any Trustee or Trustees then acting in any jurisdiction. This power shall include the power to administer separate trusts created herein as separate entities with different Trustees in different jurisdictions. It is the Grantor's intention that if the assets of the trust are delivered to another jurisdiction, they be administered in and subject to the laws of that jurisdiction. Each of the powers granted by this Article shall be exercisable by a written and acknowledged instrument. A designation shall become effective upon the delivery thereof to the person so designated and the qualification ot such person in the manner hereinafter provided. A revocation of a designation shall become effective upon delivery thereof to the person whose designation is revoked, except that a revocation to be effective need not be delivered to such person. A removal shall become effective upon the delivery of the instrument ot removal to the Trustee so removed. Additional and successor Trustees shall be vested with all the discretion, authority, rights and immunities and be subject to all of the duties of Trustee named pursuant to this agreement.. SEVENTEENTH: Any additional or successor Trustee shall qualify by delivering a written and acknowledged acceptance of the trust to an acting Trustee, if there is a Trustee acting, or if not to the Grantor, if Grantor is then living, or if not to the tnen income beneficiary of the trust. EIGHTEENTH: In the event that for whatever reason it is necessary to appoint a successor Trustee because of Grantor's inability to act as Trustee, Grantor appoints as successor Trustee, ANN C. CLAYCOMB, if living, willing and able to act as such otherwise, ELLEN C. CHAMPLIN, as successor Trustee with the same rights and duties as their predecessor. Both ANN C. CLAYCOMB and ELLEN C. CHAMPLIN hereby accept the trust and agree to execute the same to the best of their ability. NINETEENTH: The trust shall be revocable by the Grantor J at any time, and either in whole or in part. The Grantor may, in addition, amend or modify this agreement, at any time, in any way whatever. Any such revocation, amendment or 6 modification shall be made by a written and acknowledged instrument delivered to the acting Trustee. After the death of the Grantor, the trust cannot be revoked or amended, and no part of the income or principal of the trust can be transferred, pledged or otherwise alienated by any beneficiary or become subject to the debts of any beneficiary. TWENTIETH: The provisions of this agreement and the trust created hereunder shall be construed and interpreted in accordance with the laws of the state of Delaware. IN WITNESS WHEREOF, the parties have executed this ~ ~~ay and year first above written. W tness 1 )J1~ pJ:J C:~4" MARG T. CAMPB GRANTOR AND TRUSTEE ~ Witness t2__) C C,{r/'A-JAAt ANN C. CLAYCOMB TRUSTEE ~~ Witness t!~c.~~, ELLEN C. CHAMPLIN . TRUSTEE 7 STATE OF DELAWARE SS. NEW CASTLE COUNTY BE IT REMEMBERED that on this \ 21 k day of A.,::) Cr-J> \ A.D., 1993, personally appeared before me, a Notary Public for the State and County aforesaid, MARGARET T. CAMPBELL, known to me peraonally to be such, and acknowledged this Revocable Trust Agreement to be her act and deed. -----~ NO Y PUBLIC .9t '-. STATE OF PlmN:J:Ui..MUA ~~ COUNTY OF '<'-""~"-~~ BE IT REMEMBERED SS. that on this '\ <6 c::: day of A-.:J &" s.'Z. A.D., 1993, personally appeared before me, a Notary Public for the state and County aforesaid, ANN C. CLAYCOMB, known to me personally to be Guch,and acknowledged \ ~-C day of ~...;:)G';::'S<. A.D. r 1993, personally appeared before me, a Notary pUblic for the state and county aforesaid, ELLEN C. CHAMPLIN, known to this Revocable Trust me personally to be such, and acknowledged Agreement ~r ~nd deed. ..--- ~~ NOTARY PUBLIC 8 SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES ESTATE OF FILE NUMBER Campbell, Margaret T. 21-02-1104 c. (All property joinl]y~owned with Right of Survivorship must be disclosed on Schedule F) ITEM DESCRIPTION AMOUNT NUMBER Funeral Expenses: I Ewing Brothers $6,133.70 2 Cecil Vault & memorial $100.00 3 Pastors, flowers, reception, etc. $1,059.25 Administrative Costs: 1 Personal Representive Commissions Social Security Number of Personal Representative: 2 Attorney fees to Andrews & Johnson $3,000.00 3 Family Exemption Claimant Relationship: Address of Claimant at decedent's death: Street: City: State & Zip 4 Probate Fees to Register of Wills $158.43 Miscellaneous Expenses: 1 income tax preparation $216.00 2 bank service charges $9.00 3 4 5 6 7 8 9 10 TOTAL (also on line 9, Recapitulation) $10,676.38 A B. SCHEDULE 1 DEBTS OF DECEDENT MORTGAGE LIABILITIES AND LIENS ESTATE OF FILE NUMBER Campbell, Margaret T. 21-02-1104 ITEM NUMBER DESCRIPTION AMOUNT Medical bills $989.53 2 Federal income taxes - final year $959.00 3 State income taxes - final year $847.26 4 Utility bills - Sprint $69.40 5 Todd UCC Home $719.87 TOTAL (also on line 10, Recapitulation) $3,585 SCHEDULEJ BENEFICIARIES ESTATE OF FILE NUMBER II Camobe Margaret T 21-02-1104 [TEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE NUMBER OF ESTATE 1 Ann C. Claycomb, 141 N. Middlesex Rd. Daughter 1/2 of residue Carlisle, PA 17013 2 Larry Claycomb, 141 N. Middlesex Rd. Son-in-law $25,000 Carlisle, P A 17013 3 Ellen C. Champlin, 2454 22nd Ave. Daughter 1/2 of residue San Francisco, CA 94116-2435 4 Clarence Champlin, 2454 22nd Ave. Son-in-law $25,000 San Francisco, CA 94116-2435 ITEM NAME AND ADDRESS OF BENEFICIARY NUMBER AMOUNT OR SHARE OF ESTATE B. Charitable and Governmental Bequests: TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (also enter on line 13, Rc(,;apitulation) $0 LAST WILL AND TESTAIIEIIT OF JIARGARET T. CllHPBELL If MARGARET T. CAMPBELL, of New Castle County and state of Delaware, do hereby make, publish and declare the following to be my Last Will and Testament, hereby revoking and making null and void any and all Wills and Codicils at any time heretofore made by me. ITEM I: I direct that any legally binding debts (not including mortgages on real estate) and funeral expenses be paid as soon after my death as convenient and that all legacy, succession, transfer, inheritance, estate and other similar taxes be paid from my residuary estate as an administration expense. ITEM II: I give and bequeath certain articles of my tangible personal property in accordance with a Letter of Memorandum which I may have left with my Will or among my important papers. To the extent that said Letter of Memorandum does not exist or does not adequately dispose of all item.s of tangible personal property then I qive and bequeath the sallle unto my daughters, ANN C. CLAYCOMB and ELLEN C. CHAMPLIN, with the hope and expeotation that they will make an equitable division thereof between themselves. ITEM III: I devise any real estate or interest in real estate which I may own at the time of my death unto my daughters, ANN c. CLAYCOMB and ELLEN C. CHAMPLIN, in equal shares, as tenants in common, iflivinq, otherwise unto their issue, per stirpes. ITEM IV: I give, devise and bequeath all of the rest, residue and remainder of my estate, whatsoever the same may /"}1 0.!JYh Jt>1 be at the time of my death, and including any property over which I may have the right to exercise any power or powers of appointment, unto the Trustee of into by me on the \~c:. that Trust Agreement day of ~~C" ,,:>."- , A.D., entered 1993, as the same lUay have been amended from time to time. It is my direction that no part of the property delivered to the Trustee shall be considered or administered as a separate testamentary trust. ITEM V: I nominate and appoint my daughter, ANN C. CLAYCOMB, Executrix of my Last Will and .Testament. In the event that my daughter, ANN C. CLAYCOMB, shall have predeceased me or be unwilling or unable to act as Executrix then I nominate and appoint my daughter, ELLEN C. CHAMPLIN, Executrix of my will. I direct that neither of the aforementioned persons shall be required to give bond with surety before receiving letters testamentary thereon. ITEM VI: I authorize and empower my Executrix as follows: 1. To sell, without the order of any court, either at public or private sale, at such price and upon such terms and conditions as she may deem proper, any or all of the real property constituting a part of my estatef and to transfer and deliver the same to the purchaser or purchasers thereof, without liability on the part of the purchaser or purchasers as to the application of the purchase money. 2. To r~ta1ri any and all stocks, bonds, notes_ securities and other property constituting ~y estate at the time of my death, and in her sole discretion, to pay any legacy and to make any division or distribution of my estate 2 q in cash or in kind, or partly in cash and partly in kind, and to make reasonable and equitable valuations and apportionments of the property to be so divided and distributed. 3. To use administration expenses as deductions for estate tax purposes or income tax purposes and to use date of death values or optional values for estate tax purposes, regardless of the effect thereof on any of the interest under this Will. IN WITNESS WHEREOF, I, MARGARET -hand and seal, this T. CAMPBELL, have \ '0 c:: day of hereunto set my A --J G.-..;:, s I. , A.D., 1993. /lltl'~,vJ:J {'fU1')U/ MAR ET T. CAMPBELL (SEAL) Signed, sealed, published and declared by the said MARGARET T. CAMPBELL, as her Last Will and Testament, in the presence of us, who at her request, in her presence and in the presence of one another have hereunto subscribed our names as witnesses. of .....::J\~. I , ~z. ~c~//~ of ~ \""'-'-- /J &:>EL. 3 STATE OF DELAWARE 55. NEW CASTLE COUNTY BEFORE ME, the Subscriber, on this day personally ap)?,eared, MARGARET T. CAMPBELL, ~_ . CYlJ", ,,,,,0 , and ~jJee- (~'~ ~~4;~L , known to me to be the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument and, all of these persons being by me first duly sworn, MARGARET T. CAMPBELL declared to me and to the witnesses in my presence that the instrument is her "'Last will and Testament and that she had willingly signed or directed another to sign for her and that she executed it as her free and voluntary act for the purposes therein expressed; and each of the witnesses stated to me, in the presence and hearing of the Testatrix that such person signed the Will as witness and that to the best of such person's knowledge the Testatrix was eiqhteen years of age or over, of sound mind and under no constraint or undue influence. /;;~~,7. (lam,Nd/ MARG . CAMPBEZ:L a~,. C7/J~ .fZ:4-G ~ V SUBSCRIBED, SWORN AND ACKNOWLEDGED before me by MARGARET T. CAMPBELL, before me by a -& witnesses, this ,~-=- the Testatrix~~r;e~ and. sworn ~J?J",.- " and ._~ " y day of ("\..::lc. -.l> Z A.D., 1993. -----::z ~ NOTARY P BLIC 4 /~ add - ~~ COMMONWEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 NOTICE OF INHERITANCE TAX HARRISBURG, PA 17128-0601 APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REY-1547 E% ~FP cai-o3) DATE 09-29-2003 ESTATE OF CAMPBELL MARGARET T DATE OF DEATH 11-21-2002 FILE NUMSER 21 02-1104 _ ~-_ COUNTY CUMBERLAND TAYLOR P ANDREWS ESQ ~ ACN 101 ANDREWS & JOHNSON Anount Remitted 78 W POMFRET ST CARLISLE PA 17013 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ -------------------------------------------------------------------- ----------------------------------- REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF CAMPBELL MARGARET T FILE N0. 21 02-1104 ACN 101 DATE 09-29-2003 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule Al (1) .00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) .00 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion 4. Mortgages/Notes Receivable (Schedule D) (4) .00 of this fora with your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 44,248.9 0 tax payment. 6. Jointly Owned Property (Schedule F) (6) .00 7 Transfers (Schedule G) (7) 268,887.66 . (g) 313,136.56 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 10,676.38 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 3,585.06 (11) ) 4 .261.44 11. Total Deductions 298,875.12 12. Net Value of Tax Return (l2) 00 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule Jl (13) . 298,875.12 14. Net Value of Estate Subject to Tax (14) NOTE: If an assessment was issued previously, lines 14, 15 andior 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 0 0 0 0 . 0 0 15 . Amount of Line 14 at Spousal rate ( l5 ) . = X 298,875.12 X 045. 13,449.38 16 Amount of Line 14 taxable at Lineal/Class A rate (16) . 17 Amount of Line 14 at Sibling rate (17) .00 X 12 .00 . 18 Anount of Line 14 taxable at Collateral/Class B rate (18) •00 X 15 .00 . (l9)= 13,449.38 19. Principal Tax Due AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 04-04-2003 CD002394 .00 11,500.00 08-15-2003 CD002906 .00 1,949.38 TOTAL TAX CREDIT 13,449.38 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN Sl, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) STATUS REPORT UNDER RULE 6.1 ?. Name of Decedent: Date of Death: /i- Z[ ~- Will No.: Zl -- 65) 2- -- ({~ V Admin. No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Com-t Rules, I report the followh~g with respect to completion of the administration of the above-captioned estate: 1. State..~__hether administration of the estate is complete: Yes~ No [--J 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. I2' the answer to No. 1 is Yes, state the followkng: a. Did the personal representative file a final account with the Court? Yes _ No ~ b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal r_r_r_r_~resentative state an account informally to the parties in knterest? Yes ~[~ No [--] c. Copies of receipts, releases, joinders and approval o£formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached tos~'this~F,C,t,0 Date: / Z ¢ Name · ~ Address ~-'---- Telephone No. CK¢acity: [--J Personal Representative "Counsel for personal representative Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 12/01/2004 CLAYCOMB ANN C 141 NORTH MIDDLESEX ROAD CARLISLE, PA 17013 RE: Estate of CAMPBELL MARGARET T File Number: 2002-01104 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. 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 will become delinquent on: 11/21/2004 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Counsel Judge