HomeMy WebLinkAbout08-07-13 (2) I
J 15QS610b43
REV-15Q0 °"o,_,o, '��'
PA Depattmairt M Revenue y��r�y� OFFICIAL USE ONLY
Bureauof�ndlvidueiTaces �+•��e•e �rcoae r,er r��.w�
�o aoXZa�� iNHERITANCE TAX RETURN 71 13 0383
Hartislwrg.PA 1772&U607 RESIQEN7'DECEDENT
ENTER DECEbENT MFORMATION 9ELdW
Sxiai Securily Number Date of Death Date of Birth
03 01 2013 0? O5 1921
c��ceaa,rg t.�5e Na� sutroc oaCeaenrs F��st rvarna nni
MAINS PAiTI,2NE R
(If AppOpble)E�rcer SurvlNng Spousa's Info'maUon Bslow
Spouse's Laat Name Sutfix Spousa's Frst Name D,N
Spousa'8 Social Seau&y Number
THIS RETURN MUST BE FII.Ed IN DUPLJCATE WITH THE
REGISTER OF WILLS
r-iu.w r�aROawnre ovus e�.ow
O t.OriginaiHaWm � 2. SuppiemtlrtalReWm � 9. RemafrMerReWm(tlahadtleaUi
ptarEo 12-t382)
� 4. LinftedFetale � 4aFuaaakmsatCwmP�w b. FeEe�EEla6eTalRehxnReq�f2d
(dBHdEmHtriafl2-i2ffiy ❑
� e. (��afji�wu�j ❑ 7. (nuemcap)'ainmq'��T`"� � d Tula�NumUvafSakDepoait8aces
t_� 9.l.i8gatlm Procexh Recehmtl � tQ�� 1 7 ena#-+-es] �' �p 11.�S�.OtaMer SeC.e1f3(P.)
CORRESPONDENT-TH19 SEGi1QM1 NUST BE GOYPLE7EL1_ALl CQRRESPONO@iCE At�t:OtiFOENitAt7AX�#flRYAT10N SNOtND 8E DIREGSEb TQ:
Name [)aytlme Telephone Nunhu
RICAARD L WEBHER JR BSQIII 717 �32 ?3$� xr
C ``` �% �'s�
y r��.''r�
RE�F�OF YMILt�_�JSE a�
R7 7:: �' . .. [.-vx
Fl�ikwbd'add� � "` ri -,.7 „�; `:k�
126 EAST RING S'PR�ET n {n ,r` " _
iv c, �
r� �-, `, -�c� -� "r?
Seeand Nne ot addr�s c? c�, �., � ..,,
c;� L= � �7
. , :X'! � ��x
� DASE `s3 �
Cky a Post Office Stats 21P Coda -
SHIPPENSBIIRG pA 17257
ComaaporWerR'armailaddress: �ebb��CDWeiglelSSOCIat@S.GOm
UMa' apa}sy.IdedarsMlhave�nY�lfhbrtum.in���puryhga�ules&M_ amlb9»1�oimylmqMed9ea`Mbefi�.
N ia �antl mn�4e OM3ara8an atpfepseratlrcrtlian the peisonai taP���a is based on�I inMrmaUan awhkh prepaer hac arry qqxiedge.
OFPER$ON P FlUflC+HETikNt oA7E
,/�i .tean M.wetzet 1 �j//.te/3
nqryeESS '7
V
118 Walnut Avenue,Wayoa,PA 19087
SICaWIiUfiEflFPREPAREROTHERTft4NREPRE A7NE �
'�� �. � --� Rtchard L.Webber,Jr.Esquire e� �'�! ?
naoRess
92&East King Street,Shippensburg,PA 17257
Side 1
� b5�5610143 15Q5610143 ,,,� �
�
PA Inheritance Tax Return
Signature of Additiona! Fidnciaties
ESTATE OF FILE Nt1AABER
Mains,Pauline K. 21-13-0383
undv Penapks�pe�wY,I dxlare that 1 hava eacamined this tetum,ir�dudin9 au�pa�yin9 schedul�and stat�neMS,and to tfie bast W
rtry knowkdge end belief,ft is Ove.corred and complete.De aratlon M preparer Wher than the parsona!repreaerRative is basad a�ak
infortna#ion of wiiicFr preparer has any knowledge.
Signature#2 �
Name Robsrt A Nahn
Address7 124z 9rtdae Saset
Addres$2
���g� �P Horbsdats A 18431
n�t� $ i zs�.�
� 15D561Q243
�v=��oc
n�aene�8 s�aar se«�x�.
��'•� Mains, P8U1lnelC.
r�ciw�TUUnoM _ � _` - -- --
t. Reat Estate{Schedub A}....................................................................................... 1.
2. Stadcs and Bonda(SchMule 8).....................................°...................................... 2.
3. Cbsely HeM Cprpolation,Partnmship or Sole�Proprietotahip(Sdteduk C)......... 3.
4. Martgages&NcteB ReaivW�te{Sehbdule D}........................................................ 4.
5. Caa�h,8ank Depoefts&M6scellaneous Personal Pioperty{SrhedWe E)............... 5. 44 j 219. 69
s. aomnr awn�d Ropeny tsu+aame� �1 saae«rs�e e�Heau�............ s.
7. IMar VNas Trartstas&h�eneousn�ro�Property
(scneau�e�) �! s�ar�e anmg Raauesced_.......�.. 7. T7�O5d. 93
8. ram Ciross Aasu ftotat tines 1-7}..................................................................... g. 121,270. 62
_ ___---- �- �.
9. Funaal E�enees 6 Administrative Cos4s(SChe�k H}....................................... 8. 7,065.30
18. De4b af DaoedeeR Mort9age I.iab�tles.&L'rens(Scheduk 1).............................. 10. 1,99Q.03
�t. row deauen+o�(�au un�e a to�................................................��---.._........ �1. 9,055.33
12. Nd Valw M Esdte Nne$minus Line 71).......................................................... 12. 112,215.2 9
t3. �sr�aWeandGovemmeirtal8equesWSec9113Tnistsforwhidi
an olettion to tmc t�as nat bxn made(Schadule.q............................................... 73.
14. Net Valw Subj�ct w Tnc(Line 12 minus Line 13)............................................... 14. 112,215.29
TAX CDMWITATiON-5EE INSTRUCTIONS FOR APPLICA6LE RA7ES �i
75- Amount�Line 14 Lxsbb
mt the spousN tax rafe,or
tnnsfers ander Sec.9116
{a�(iz)X.00 t5. 0.00
i6. Amountoflinet4ta�ble 112 215.29 ts. 5,049. 69
at lirre�l rafe X .045 �
17. AmouM of Line 14 taxa4b
�,��X,2 o_ao ,�. a.00
i8. A+nount cf Line!4 taxabb
atcalafeialrateX.15 O.QO t$. Q. 00
�s. Tmc oue................_................................................................................................ ta. 5,049. 69
za. F�.�n�E ovu.�vou,u�r�auES�c r�r�FUNO+�xu av�nvr�r. �
Side 2
� 1505610243 150561�243 �
REV-1500 EJC Payps S FlNr Numbsr 21-13-0383
DecadeeY#Compiste Addr+ess:
�c.��rs ww�
N�i�pr,Pauline K.
STREETAdDRESS � --- �— — -- ------°---
7ltidge I,.ane
CITV --- ------ —.—.— .—..—. i— STATE ZIP .—�
�� PA 1�241
Ta�c Payme�Ks and Crodits:
t. Ta�c Otre{Pe�2,line 19} (i) 5.049.69
2. CfeditslPeyrt�enta
A PriorPaymeMs 2,900.�
B. Disoou�t 152.63
---- Total Gedits(A +B) (2) 3,052.63
3. IMeres[ (3)
4. tf line 2 is greater tlren L"me 1+Line 3�er�rthe d'dferer�ce. This is tlxs OVERPAYYEtiT. (4)
Chxk bwc+on Piys 2 LMe�to�s�upt a roftu�d ` �.—
5. tf Lv�e 1+Line 3 is groaterth�I.ine 2,entbrHte dtlierence. This is tl�a TAX DUE. (5) 1,997.06
Make Ghedc Payabls ta: REGISTER OF 1MLLS,AGENT.
P�EASE ANSINER 7HE FOLLOWING QUESTIONS BY PLACING AN°'X"IN 7'HE APPROPRiATE BLOCKS
t. Oid dmoedarrt make a Uan�vfer and: Yas No
a. retain fhe we or inCanb W the PropedY transferred:............................_..._......_---.............._.._.,.._._.... �
b. r�in the rigM to detignete wha shall use the property trensferrod a its incane:..................................
c. rdairt a reversia�srY ioW�or............................................................................................................... x
d. tecaivetl�cpromwe���AekherpayrnarNS�beMfitaarGere?...._....................................
..................
z. n a�aan oaw.ea artar oer�mn�r�z, �sez,aia aecea�,c o-.r,�re��eny,�one ye��r ee�n,�wa � �]
racauhrB ade4uata eanaWeralion9.................................................................................................................... x
3. Did decrdeM awn an'Sn hust ior or psyabb upon death bank acauM or aecurt4y ak his or her daalh?....... � []
4. Did decedsrd rn�m m Ir�vlduel Retirement AxooM,annuiry�w othx non-probete propeAy which
�s a�'des(9�8tid�?.................................................................................................................. � ��
IF THE ANSWER Tp ANY OF Tl1E 1180VE QUEStiON3IS YES,YdU YUST CO�tETE SCFiEDUtE 6 AND FR.E R AS PART OF THE I�TURN.
Fa datea af death on or eRer July t.1994 and bafom Jert.t,1995,tl�tax t8te Ynpcsed rn�tlte t�va�e�transiets to w for the t�of tlrp surviuirg
spouse is 3 perceM[72 P.S.§9116(a)(1.7){�].
Fordates of detlh on qr alter Jmuary 1, 1996,tire teac rate impaeed on Ihe nd vplue ot transkns W or fcr fM use M tl�e wrviuing spouere is 0 peroeM
j72 P.S.§9it8(s)(t.t){�}I- The staWte+bes rwt�xxMnpt a ttan8(er to a�rviving apouse irrnn tax�and the ataWtary roquirernnMS for disclosuie M
asflets and flOng a tau retum are aSW applicabk aven If tlro surviving mpousa is tlre adY 6�ieiery-
Fa daMs of deafh on or aRer July 1,20W:
. 7he fa�c`ate im on Me net value of tranmfars hdn a deceased chYd 27 of ages or ya�nger at deaM to or for tl�e�me ef a nahrcaP perdrt,an
ate �gq
eaape�ve a a�ortne cnad is o peroeM pz a.s.§s��s(a�� .�zj
.'ihe t�c r�!�npaed on the nM vWua oFtranskrs to arfarthe use of the decedaM's 6neai beneflaaries is 4.5 peroent,�zxce{#as nded in
72 P.S.§9176 1.2)[72 P.S.§9718(a)(1?].
. The t�rate inposad on tl`e net vslue M tronafers to or for the uae et the decedeM's s�ings ts 12 perca�t[!2 P.S.§81 t6{a)i1.3). A
a�ng Fs defined under Se�stian 9i02.as an individuai who fias at kaax one parent in cammon wilh the deeedenL whqMbr by b�or adopHon.
IW-16MIX�16Ae)
scHEOU� E
CASH, BANK DEPOSITS, 8�MISC.
�K�����
PERSONI0.L Pi20PERTY
M�9iR'FNCETNtPEitFN
pO�BlTO�EO@ft'
ESTA7E OF FN.E NUMBER
Mains,Pau1Ms K. 21-13-0383
n,a�e.rbponW orIiqp�1�m�au.ar.+,.aao.sa.w.e�.c:�a ua..�
AMMnPrNk�Y��tlnryR[d�Nrad�mutM mMp84F.
R�/ VALUE AT DATE
�R DESCRIPTION OF OEATH
1 ACNB Bank CerUticate of Dbposit#172578 2,214.26
2 AGNB 8ank Certlficate�Depasit fl"t�2578-Accrued iMerest to D.O.D. 0.8U
3 Idealife Insurance Comparryr 154.62
4 PSERS ��•�
5 Spirlt iMrysieian Servlce 3-�
6 Sun America Yarlable Mnuliy Aceount MP37A0018182 41,826•�5
TOTAL(Also errtK an Line 5,Recapi#ulatlon? 44.219.69
tx mae a�ne q neeaea.aaai5oa�a�vagae aure esme atre)
Copy�igM{e}2b02 fam saRwa�e only The larXnar C,roup,Ina Farm PMibW Schadub E(Rev.6�89)
x«•u�o oc«�s w�
� scHEau� +�
INTER-VIVt3s TRANSFERS &
MiBC. NON-PROBATE PROPERTY
ca�ax�Kn+ceveK�axvuM
M@li��NGETA%PETUW
PEfIEMfpF�ABlf'
E37ATE OF FiLE NUMBER
Nlatns,Pauline K Zt-i3-0SB3
1i:setl�eOWS mustbemrtqkktl anafloe ameanwerm ryuro+���araq��onme.eva�ae siae arus REV-tsoo covEa SMEt7 isyr.
� ��ar�+oF aaa�RTr oa�oF oenn� x oF o��o�s IXa„a,o„ rnnnei.e
NUMBER ����En.'�r�t,ticEtt�t�rr� �PTr�oa°E�� VAL�OFASSET ��'�� �'�E� VALUE
'1 ACNBDankC�erfHicabeaFDepoaRiFt58tf7 7,422.32 7,422.32
2 ACNB Bar�k CerNflcate of Deposit#t681'tT-Accrued 74.88 79.89
interestto D.O.D.
3 ACNB Bsnk Carlifieste of Deposk#168184 7.232.43 7.282.45
4 ACNB Bank CsrtlRcate of Dapoak i1758184•Acenued 40.42 �0.42
in6erest m d.0.8.
5 ACNB BaMc Certlticate af Oep�asit#1$842t 7,579.3t 7,579.31
6 ACNB Bank Cerdflcale M Deposi!�180421 0.68 0.68
7 AGNB Bank CerMica6a ot Deposit N162357 B,T83.44 g.7$3.4{
S ACNB Bank CertllicaEs of Deposft AN62567-Acuved 3.09 3.Q8
interast to OA.d.
9 ACN9 8mk C+�iiflca�e af 8epasit#16Z5H2 6.413.$B B.413.68
1Q ACNB Bank Certl/ica6e of Dapos(t�F1$2582-Accrued 27.74 27.74
interestto d.O.D.
11 ACNB Em�nk GdrtlflcaEe bt Depask Op980206 B.979.12 6.879.12
12 ACN6 Bonk Certiflcate aF DeposK�i.7S80206-Acerued 5.67 6.61
i�t ta d.O.D.
13 ACNB Bank Certlflcabe of Depasft�t3990204 6.�+16.68 6.746.86
14 ACNB Bank Certlflcatls arf De�pa�sit�M3990249-Acerued i4.55 14.55
lnterestto d.O.D.
Tohl of CwKinwflon Sct�edule ���
TOTAL tAtsa emer an LFne 7.RecaPrtulation) 77.050.83
Qr mae apece b naedea.atldl6onal pagee Mttia same aize)
copyrigra tc}2002 t«m sonwarc ony Iho tacknar 6roup,Ina Fartn PA-i600 SchedWe 6(Rev.6913?
RswY670IXt(&Y)
scH�ou� 6
INTER YIYOS i'RANSFEi2S 8
MISC. N�N-PROBATE PROPERTY
COI�Iaxx6latNaFOBNmvNa�
»��*�� coMinued
�r�
ES7ATE OF FlLE NUAIBER
Mains,PauUns K. 21-igfiggg
�7EM DESCWPTION#PROPERTY ow�aF oEnrri x oF o��as ��,�,o„ Tnxne�.e
ar nursxc� n�enxeu ro �� ,uw
NUMBER .ATT�ACOWOF7�tIE�{DEEQFOR�PE+Y.�ESfA7E. VAL�OFASSET ��� (����C+iBLE) VALUE
15 ACNB Bank CerUfkate of Dsposit f1389Q210 2.668.39 2,668.39
16 AClIB 8sitk CeAlfrea�e�Deposit�138903t0-Accrued 2.17 2.17
inter�esC to 0.d.D.
17 ACNB Bank CerNNcate af Depask�M3980850 6,749.81 6,T44.81
18 ACNB Battk Cart�Mcabe oF ClepasN f19990650-Accrued 7�.87 14.87
��co o.a.o.
18 ACNB 8ank CMiflca�of Gaposit -Aearued 3.978.68 3,970.68
in6etqst M O.p.0.
20 ACNB Bank CartllicaEe of DepoaittM3990928-Accwed 2.06 y08
intersstto D.O.D.
2i A+CNB Bank Esteem Checking Account i'I77014 14,313.61 14.313.67
22 ACNB Brnk Esteem Cheetde�Aeeoant tFf77040- 0.35 0.3$
Atxeued irrterest ta D.O.D.
TOTA!U1�O en6er on L�7,#2ecapiWtationi 77,050.93
CapyrigM(e)2002 fo�m soflxrsre prtiy The Ladvwr Group,Inc. Form PM1b00 Scheduk 6{Rev.Cr98)
REV•116iFX�C70.06�
scHEnu�E H
� ,,,„„ FUNERAL EXPENSES�
ADINIIVISTRATIYE Ct?STS
ESTATE OF FILE NUMBER
Nkiira,Paaline K. 2t-1S�03B3
DeMs of decedent mwt be reporta!on ScF�edule I.
ITEM DESCI2IP'f10PI AMOUNT
J�, FUNERAL EXPENSES:
See continuatiam schedufe(sy attached �15.9b
B. AOiNNISTRATiVE t�sTS:
1. Persanai Rep�eterdetiYe's Cammissiam
Neme ot Personal Re�esenfative(8)
SheekAddreas
City u'tate Zfn
Y�rfs)Commission oaid
z. Anomev's r-�s Weigie 8 Assacf�ss,P.C. 8,�1.00
3. FamBy Emmptiam: (tf de�Cs addmas is not tlie same es daimarA'a,altach e�ryfianatian)
ClaimaM
$treetXddress
CiIY Stste ZiD
Re�ationsfiio of Ctaimant W DecedaM
4. Piobnte Feaa 143.50
5. Acmur�YS Fees
6. Ta�c ReWm Props�ar's Fees
7. Otl�et Administrative Cosb 2DS.8S
See coMinuadon schedule(s)attached
TOTAL(Also eriter an line 8.Recapitulatlon) 7,066.3G
CapyrigM(c)2009 form softxrero only Tha Laclmer C,roup,(na Form PM7800 5cfr.MUla H(Rav.10-08)
SCHEDUl.E H
FUNERA! EXFENSES AND ADMINISTRATIVE G05T5
continued
ESTATE OF F�E F�lMBER
AIlains,PauRne K 21-13-0383
�M
NUMBER �SCRIPTtOtV AMOUNT
FY!!�
� Eby Grae�te Works 200.�
2 Fw�era!M�1 80.77
3 Fanbral M�1•Pntsbyterian Waman 10�.06
4 Lisa's Floral Shop 2i 1.3Q
6 Tree for cametery 178.88
H-/l 715.95
Aihsr AdministratNa Casis
6 Cumbedand Coutrty Register of VMills-flp�fae tor i�ihu�ce ta�r retum 15.00
7 C�an6eHand Law Joumal-legal advertltemsnt 75.�
8 U.S.Rosml$erviar-stamps 27.6Q
9 VaNay Ttmes-Star-iegat adverfisameM 98.26
H-B7 206.85
Copydght tcj 2002 form soltwam ordy Tho Ladcner Group.ine. Fomr PA-1500 ScMduk H(Rev.698?
Rev-1N=IXt(17fi!}
SGHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LiABil.iT1ES, 8r LIENS
uo�rioNxeFUTM ac PFxenvua�
N�tl1'iN�TAI(WEi{.MN
I�UBlYO[Y�pBl�
ESTATE OF FILE Nt�ABER
Mafns,Pauline K. 21-t3�Sgg
RepartA�WY 6emM.i kYtlM�MeMrrt Mab drlh 61e rwnlnW upW�f tlr dW dtleWL�w�pu�M wdlal a�+rra
N�R oescai�n� Y"o o��.�i,TM'�
1 Garikie Physietan Services �g,g�
2 CarrWryt3nk 58.10
3 Cetttury tink 5.08
4 Cum6eMand lioodwiN Ftre arnd Raaate(EMS) 69.88
5 Cireen Ridge VfllagdPrssbyEeHan Homes i,nt�a.sa
8 PPL ElecMc i$�,$1
7 Presby6erian Homes,(nc. 14.SQ
8 Preabytsrian Hom�,Mc.-phone bN! 14.50
4 U�Nbd 8tatea Treasury-2012 7au 648.00
TBTAL(Aiso enMr on i,ine 10,Recapkulatlon) 1,990.08
� (If mwe aP�la needM.atldNbnal�Mtlio eame aiae)
CopSRigM(c}20pg fam soRware ony Tha tacknar Group,Ina Forrn PA-1600 Schedub I(Rev.12-08?
pEV-0671E][+(it-0/) �
SCHEDULE J
`Oi���'��Y"'�" BENEFICIARIES
ESTA7E OF FILE NUMBER
1Aaies.Pauiirls K. 21-13�0363
�E����� REIATIONSHIP TO SHARE OF ESTATE �ESTATE
NtNNBER PERSONt5i RECENIN�PROi�ERTY �CEDENT (yy�ys) (SSS)
I. Taxaaf.E asrw�unaNS �8,"r"ym�a' °�
under Sac.911 a 1.2
Mains Famiiy t.lving Tnist DaugMer As per paragraph
da.�n M.Wetsei,Trustee 5 of WiII
116 Walnut Ava�ue
WsMyne,PA i8087
roau
Erfierdpiar artwurrtat tor ' slrawn Wwm on tines 15 drco h 18 on Rev 15W oover s w
NCNd-TAXABLE �
II. A.SpOUSA1.DISTRIBUF1pMS UNOER SECTiON 9113 POR WHlCH AN ELECTIQM TO TAX IS tiOT TA�W
B.CHARtTABtE AND t3flVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II-EN1ER TOTAL NON-TAXABLE DISiFtIBUTIONS ON LINE 73 OF REV-150U C01lER SHE
CapyrigM(e)2009 fortn aoRwaare ony The Ledv�er Qroup.Ina Form PM15U0 Sdredub J(ROV.11-08)
��Nn
LAST WILL �iND TESTAMENT
OF
PAULINE K. MAIN5
I,Pauline K Mains,of 7 Ridge Lane,Nevwille,Curnberland County,Pennsylvania,being
of sound and disposing mind,rnemory and understanding, do make, publish and declare tlus to be
my Last Will and Testament, hereby revoking and making void all previous Wills and Codicils
heretofore made by me.
1
I arder anfl direct my personal representativa hereinafter named to pay all of my just debts,
funeral expenses and expenses invalved or connected with the adrninistrarion of my estate as soon
afrer my death as is reasonably possible. However,my personal representative need not accalerate
and pay those w�rnatured obligations which, in his,her ar its opinion, it might be proper and more
advantageous to retain or renew and pay as they became due and payabie. If I da not own a burial
plot or a grava marker at the time of my fleath,I authorize my personal representative,in his,her or
its sale discretion,to purchase a burial plot and to erect a suitable grave marker at my grave,and ta
expend suxns fram my estate for this purpose.
2
No intarest of any beneficiary ofmy astate, either in incorne or in principal,shall be snbject
to anticipation or pledge, assignrnent,sale or transfer in any manner,nox shall any beneficiary have
the power in any manner ta chazge or enoumber his interest either in income or principal,nar shall
the interest of any beneficiary be liable or subject in any manner whiie in the possessian of my
personal represantative for the liability of such beneficiary.
z
, �
LAST WTLL AND TESTAMENT OF PAULINE K. MAINS
3
All federal,estate and other death taacas that may be assessed as a consequence af my death,
whether or not the assets pass under this Will, shall be paid frorn the residuary estate of my probate
estate just as if they were rny debts,and nane af thase talcss shall be chazged against any beneficiary
or joint owner.
4
Tf there is a separate writing signed by rne and in existence at the time af my death, then I
give and devise the iterns of tangible personal properiy listed in the sepazate writing to the persons
narned therein. T give and devise ali of my tangible personal property, other than those items
contained in my separate writing, if any, including my personal effects and automobiles, to my
chiidren,JEAN MAINS WETZEL, NfARGARET M.McCARTER and GLENN D. MAINS,
III and ROBERT ALAN MAINS.
5
I give, devise and bequaath the rest, residue and remainder of my estate together with all
insuranca prooeeds thereon of whatsaever nature and wheresoever situate in equal shares ta the
acring TRITSTEE af the M.AtNS FAMILY LIVING TRUST, created by myself and my late
husband prior hereto,to tie aclministered and distributed pursuant to the terms of the said Trust.
6
I nominate,eonstitute and appoint my daughter, lVIARGARET 14IAINS MeCARTER, as
executr� of this my Last Will and Testament. Tn the event my daughter is deceased, unabte ar
unwilling to serve or sha11 cease to serve for any reasan whatsoever,then I nominate,constitute and
appoint my son GLENN D. iVIATNS, iII, as personal representative af this my Last Wi11 and
Testament. If he is unable ta serve,I then appoint JEAN MAIN3 VYETZEL and ROBERT ALAlY
2
LAST WII,L AND TESTA.NIENT t7F PAULINE K. TvIAINS
MATNS as Ca-Executors. T direct That my parsonal representative sha21 not be required to give or
post bond for the faithful performance af 2us, her or its duties in this or any other jurisdictian.
7
I grant my personal representative the following powers in addition ta and not in limitation
of such powers as my personal representative shall hoid by Iaw:
(a} To retain a11 praperty reeeived including the stock of any corporate fidnciary acting
hereunder,provided such property remains productive.
(b} Ta jpin in any carporation, partnership,recapitalization, merger, reorganization or
vating trust ptan; ta delegate authority with respect thereto; ta deposi#inveshnents
under agreements and pay assessments; and generally ta exercise all rights of
investors, including but not limitad to, the voting o£shazes.
(c) Ta managa,operate,repazr,zmprove,martgage or lease on any terms any real estate
heId or owned by my estate.
(d} Ta operate any business that I may own at my death.
(e) Ta invest any funds af my estate zn any stocks, bonds, notes ar other securities or
praperty, real or personal, without regazd to the principle of diversification or any
other statute ar generat rule of taw in his,her ar its absalute discration, it being my
intention to give my personal reprasentative the braadest investmant powers possible,
providing sach investments do not unnecessarilypreventtheprompt settlement ofmy
estate.
(f j To sell or othettivise dispase of any property,real or personal,tangibie or intangible,
at any tirne forming a part of my estate in any manner and on such terms and
conditians as my persanal representative shall see fit in his, her, or its absolute
discretion.
3
LAST WILL AND TB3TAMENT C1F PAULINE I{. TvIAINS
(g) To bonow maney for the payment of ta7ces ar for any other proper purposes in the
administrarion of my estate,and to mortgage or pledge astate asseis as security.
(h} Ta oompramise claims without court approval including, but not limited to, any
controversies with the United States of America ar the Cammanwea3th of
Pennsylvania concerning estate and inheritance taa;es on any interests that may pass
under this my Las#WiII and Testament.
(i} Ta distribnte in cash ar in kind upon any divzsian ar disficiburion af my estate.
(j) To undertake any and all acts deemed necessary and proper by my parsanal
represezrtative for the praper, advantageous and prompf management of tha
sattlement of my estate.
(k) In general, ta exercise all powers in the rnanagement of my estate which any
individuat coutd exercisa in the management of similar properi;y awned in his own
right, upon snch terms and conditians as to him, her or it may seem best and ta
execute and deliver all insmiments and to do all acts which he, she or it deems
necessary or proper to carry aut the pwposes pf this,my Last Will and Testarnent.
8
Whenever the context af this Wi12 requires, the following rules of canstruatian or
interpretation shall be used:
(a} Gender. T'he masculine gender includes the femuune or neuter, and the singulaz
number includes the plurai.
(b) PennsylvaniaLaw. My Will shall be construed according to and govemed by tha laws
af the State of Pennsytvania.
(e) Severahility. If any portion of my Wili is heid to be void or unenfore�ab2e,then ali
remaining portions of my Will shall continue to be carried into effect.
4
LAST WILL AND TE3TAMENfi pF PAULINE K. MAINS
TN WITNESS WHEREOF,T have heraunto set rny hand to this rny Last Will and Testament
this r}����day of iUt�l��r'" _, 2040.
WITNESS:
'"7/t.,✓ 2 c..f'r ..� � ���,t,,y,�,,,
-µ����� auline � Mains � •
��f��f��l
ACKNCiWLEDGMENT
COivIlVIONWEALTH OF PENNSYLVANIfi. .
: SS.
COUIVTY OF CUMBERLAND .
I, Panline K Mains, the testatria whose nazne is signed to the attached or faregoing
instrument,having been duly quali�ied accarding ta law, da hereby acknawledga that I signed and
executed the instrument as rny Last Will and Testament; that I signed it willingly, and that T signed
it as my free and voluntary act for the purposes therein expressed.
� � !
Pau me am ��'�--
Sworn or affirmed and acknowledged before me by Pauliue K Mains, the testatrix, thi's
�'� day of rt�. �_ 244ff.
G�./�'-�_
�������
��da�"t��t�
� utember,Penr�svmm�l�naaoraana7art�bmnes
� + .
LAST WII.L AND TESTAMENT bF PAULINE K. MAINS
AFFIDAVTT
CC7MM4N'WEALTH OF PENNSY'LVANi�i .
: SS.
Ct}UNTY C7F CUNTBERLA.ND .
WE, {'^��G�tr7s� �-'�n/'E�a�r��f, and (.�r.t t.s1.�. +.. � 1`a� ,the
witnesses whose names are attached ta the faregoing dacument,being duly quaiified according ta
Iaw,do depase and say that we were present and saw testatrix sign and execute the instrument as
her Last WiIl and Testament, #hat she signed witlingly and that she executed it as her free and
voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and
sight of the testatrix signed the Last Will and Testament as witnesses and that to the best of our
knowiedge the testatrix was at the time 18 or more yeazs of age, of sound mind and under no
constraint or undue influence.
'�/`�i' � w../ti�'�,L_.,''1
�
� + C.
Sworn or affirmed and subscribed before me by���G� ,L. (�t,�¢bbe�,,lr. and
! ]Q.,�}i`uC'- G--• 1 � Q--- this�day af �'zw�z-c_... , 2000.
���
.��.. � -�11�.z.�u.�.,_
��"�'�,�
►n�,c�,�o„'�,�.g;'°�S
Member,PennsNvamn naRwiat�on m rl�aHes
FOTh¢Foi�eFFbm DoeelW�lktt473-tpkmwill.a�pd
6
- �
- TiiE M,SA�IS FAMii.Y - -
• [.IYR�IG TttU57 AGREFINENf ..
2he udrrsRs[�ed._GhEt�•t D. bIAiNS>JR.a�rd PAUL11�K.A{XINS, as Gr.vctars,
for ard in caaideration of tf�e muural cowenants contai�d here"a�, haeby transfecs to
GLEA8�1 U..MAI6lS..7R and PAULWE K. [�iAtNS.as 7cvstees,ail of wr righi,fi.Ue and �
int�aest in and w tt�e PropettY identified and described on Sciiedde A�attached.iwsem
�d u�a part he�e.of:toSe'Uier with st�ch ot7�praperty transferred to ar Znstees by
� us or any otlier permn. which shall 6e known as ar uust rstate and held upun tAe .
followi�„terms: �
AR77C7.E T '
N:��e: 7Atis q�mertit. as from time ta time amended.a�vl the trvst created
irseee�lar�y be des�mted the'NltiNS PAMRY LFX�iG 7RUSi''.
- - � � AltTICI.E Q
A�etins D�ra�g Grantoca' Lifet� pEring as joicst Zifetmes and the
lifetime af tl�e aa�vivor of the two oY us;, wr Tnstees sha.0 hold ard p�anage a.t� trust �
estate and sha}! pay ta or fa� au'6erefit all ihe rnet aimme therefra�t and sa murly af
t#c prmci[+ai thaeof as eii3r.r ot us�a.it from time w time direc[wr Tns2ees. In lieu
!of s�ch �fiiection, ar upa�.khe serio�rs illness ar i�ompe�teix-.e of eiiher of us, our �
.T�tsEces s6att pay Eo or�for am bgiefit att oL ihe net v�cnme of air tnr:.t estate,and, co
� the eatent�ecessary,w much of the priricipal theren[as may 6e requ'v�eJ,in tlee apinion
� o#aa Tnc:tzas,to�wae ata i�eaith,mae4t�acice aed r t.b mmfort x.d s�qywrt.
. ARTICLE lll . �
17uties Upm G�caoYOts'Deatlr Upon the death of the wrvivor af us,our Trustees
st�all take the folbwing actims; � 3
- (a3 Dislributiocs ta Grantor's FsEate. Ois� Ynrstees sha12 disu�ute from a� `-
lnat estate to the pasce�a! represerttative nf tfie iazt decaased Craertar� estate, as
promptly as is nonva�ieni �apun Me written reqt�est of the perso�l representative
appoented tuyder tbe tast �cteased Grant�TS �st wilt,� sz�ctf �un or rs�.t7ns as may be
rc�uested by�the persa�al represenwti�ve with which to pay debis, [une;al eapenses,
. �tm�istration expet�ses aod esUte:inheritan�e ard s�scesinn tazes ciue and PaYabM bY
� such dec:eased Grantor's estate: The pewsw�at representative reed rot appty all ar afry
part of the assess in ttee deceased Grantor's probaYe estare for wcie purposes, cwr reed
- the peswriat represenia6ve seek omn�ibution fran any pintSy hetd property or ott+er
Ixop�erty taxabte in #ie decea.aed Grantor4-escate tor�sucF�p¢pases. Cha Trus'[ees ace
authorized to es[imate and a�t asitle or deliva to fhe permtttt ceguesenta2ive a ta�c azd
_ expetse f�a�d fa' tF�e p�rposes set fc� in tltis paragrapiti, io enaG(e wr Trustees to
estabiis6 tM1e separafe viRt fur�Twreimafter descriGed as saon as mnveniently possible. .
(b) Taz Retu�� If a d�ra*,ed Gr:uitoNs estate is mt prW�ated, nr. if a
pert.rvyal represaiYatire fai a decease�f t;rantce"� estate is `at a�apointeel, aur Tru&tees
� shati�prepare az�d f0e, or catae to be prepared'arni filed,the federal esEate tax reucn far
- -ti�e dece,ast.d f;raa�tar's esiaYe azd such ot}ier�ettKns as may be s�Erssary�and shail PaY
_ sex�h taxes as may be d�ard pay�te try ttis or ku�r estate,together wiih aII of his or her
- debts and Lux,raf e�q�, Our TruStees sha[I Ae Euliy protec[er1 in paYug sw;fi debts,
ezpc�aes and taxes.
_ _ AR7'�L£N
Farai DatrHr�tiws (Ipm the deaffi of the 13st Eving Granta-,and aftar having
set aside 11re amnunis referenced in ARTICLE QI adrve,aur 7rustees�ai!distribuie oe�c
r�nmg hust estate, »equal shares>io air e�xitdren,xith itse cFrklren of a Geceased
chiki of ncrs tak�per stirpes.
(a} Mipr Ba�eficiary_ Natwithstandu� rlie faregoing, i[ any benefidarg
entitled to a dtstribution is�[kr this AgFeeicent has rot thets attai�ed the age of tweniy-
me (21} ypars, a� Trusiees ace dtrected tb cmtimac Fwiding the pra��ty whicfi awM
atherwise be disirilwted to sarh miawr bm�r.iaz�y in trust Our 7nsiees shall pay iran
' the ret income U�'efrom, togetha with stsh QrindpaF wcns as wr Tceatees may
deterenine oecessarya to e��ee su:h benefidary's IceaFth. cducaiion ard reasarable
. wpport acd mainten�nce. My income not d�stributed to tlie f�e£�ciary d�n'ing, a�ry .
' fiscal year of the tna:t shal.l be atk,ied to princigaL L)pa� the henefic"wy aEtaini� the
� age oF twenty-cx�e {21) pcvs ar soa�a� dyi� the icnst shaQ ter�ninate � to s�:h
beeefgiarq a[d aa Trustees shali Aistri{wte ai1 0# ttre temainifg pnncipat and oet
, i�rcorne therefrwn to the be��eficiarY, free from fiatlu�' trus[ or limitation, ar to his ar
Iws estate it the bereficisry is roi thas liva�g.
� (G} gp�dprifL Cl�mce. No§�rinc�.rat or��e paya6ie or to iaectwne payable
here�rd�r shall be s�ject to m�ticipativn ar assigmneat hY�Y Lw�ficiary thereaf,ar to
� attachment by or to t'he interferenrz a control oE any creditar of aery such JxreficiarY,
a' io cl3sns ior atimmY � ��P«'=+ and m WoPeTtY sdait be taken or reack�vl by any .
legat ar equitaWe process in sa2isfact[on af any d�t or liability of any beneficiary prior
. to its afit�l receip[ 6y the 6eneficiary. F�¢thermore,uur Tnsstees are prohibiked Lcom
makinffi azey PaYments in reirsdreasement xa aoy gerrernnteicta3 srtity ariiich may tsave
Z
aicaured any e�a�sc #or the benefit of a tieneficiary hereu�, �d wr 7n.stees shall
rot pay a/ry obligatim of a beneficiaz�y, u�hicA adtigatim is otheiroaise payabie by anq
. ga�e�nun�Nai ent7ty oc pcir�nt to any governnenta! prugram of rei�¢:r�nent or
PaYme*it• - � -- . - .
{c) Beaefi�ax�y Capacity. Ff any 6eneficiary eEig�ie�to receive net incaoe or
principa! distri�hutiats es exder a legal �'aabiliry, ar in the apinian. of oie Trustees is �
incapabie of praq.rly mattaging his or tier CxwKial aCfairs, our irustees may issake
�disiriCu[ic�s iiere�nder�directty tn the beneficiary, co a�ly aQpass�ced guaedia+i of d�e
persm oc prope:rty of the bel�eficiary,a to a wsYatian sdected by wr Trrctees for the
be��efir.iary tnder a Uniform Tr:arsfers to Muracs Act, a may otheraise e�end the
amourts W be distriMfied f� the benefit of tlte be�oeficiary in such nra�ner as aur
Tnatees de:.ecn adv's�;bie. .
nanci.E v
?nrstee Powec� O�a- Tnstees shall have tM followiog powers wi�tts respect 20
U�e trusts ard trust slw�es created herein in a�i.tion to tlio�ganied by law: .
(a} GenecaL Cku TreMees shai! ha� every ri�t in respec_-C to hotding aud
maziaging t+ea tcust �L3te. rnay bo�revw msd tmd ma�ey; maiY esecute any cmtract in
re5pe.cL to propecty caistiNt'a�g a part of aa tcwt �tatq may sell pr��y on any
t�ms ar Tcus[ees deem prupeq may make mry investa�tit our Rnstees deem ceasw�abie
, witFrout reference to fegal I"unitatiay may retain or d�ose of, urvest ar reinvest in,arty
praQerip 6rcAid'inp,convnai stacks,prefesred storS.s,bauis,aptions,camnon tn�st funds
and ntha property� reat ar perso�v�i, torr�gn ar dom�tic, (mctuding partial inurests� .
. sich as life estates�tezm ar remaind�intarests}witinut reg,ud m ordoary principles of
�.versiYication a cwicentration or oVier limitatims upoct investments; n�ay invesi 'si
owney_mar&et ar,.caa�ts, muhat f�nets acd vade m marg"� may trade in se�irities of
any nah¢�e, i�lud�g puts, calls,straddies acd oUws opYtot�s,cod�ed ard u�overeA, an
nrarSin>and maY INecl$e:any securities S�etd by brokecs as ses:m'ity for laa�atui advarices;, ,
" osay fnid�uopertp in mm6iee naoze,with or wittnut designation as Trustees;may rnake
�sfr�etiians in property or in cash; may employ agents and attorneys; may empluy
affiiiaxes ta provide 'vrvestme�t aMiwrp services and rnaY pay reawnaWe compensation
therefor; may settie dainrs ar deaiards by any meats availa6le; and may receive
ad�t➢wul Pcoperry at any xime Fr«a any sauce To abnittistes as a purtion of a�trust
estaie..
(b? P[�c�at or 6�ou�n�tn determining whett�er receipts or dis&vsements are �
- pr'vXipal or Lv_ome,from titrie to iSme,au'Tnatees shatl be govemeJ by the provisions
3
of the� "v�cume taw of Flari as ii may have 6een�merdtd at tlie ti�o#
c -
detaminaiimi. �
(c} Bad. lf mry law row ar hereafter enacted sl�afi requi�e an Tnstaes to
.post t�and, or Eequn�e jkdicia! suprrvisian of ar taut esEate a�eated tx,rein. tMen we
warve any ucfi r�{eure�nes�i far lwrd ar jtdiciai�.qervisim. �
(d) AdiStiana!pTOpex�ty, 6ta Trusiees may receive additimat piroper[y at any
time f.rucn eiti�;of css,or from any oUier saurce:K'��-'� �IQT VtV05 OC 2C5�3IIICItL3[)'�
an6 y�a�reqei�t shall adm"v�istec the same as a partiore of au uust estate as if it fiad
, «igirelly E�een a part tMreof. - . �
(� CFanns Agaimt Tnutoes. Qr Trustee� m�y settle aury ri"iEfere�ces or
diffiw(ties, and atay claims or demanQs which may at atry time be made by or against
them�Tnestees.ar by ur agair�st oix tnrst esCate, ar any part tlrereof,by canpromise,
co��rsition or arbitratiay as aa Trusues may deem expedtes.t
. (t3 AppGcatia.ot Fu�:. Our Trustx�es sha(1�wt be requ6�ed to st�e to ihe.se
or apptication of any part of the tncome or prircipat of �ur trust estate d�str�6uted in
accorchr�ce with ri�e x�n�s ard praraims of t!�'ss Ag,eeement,and payrtieot so nnade staall
� uoR.p�tety di,ctr�rge ar Tnste�with respect to their dv[y as to such paymenti
� (g} >. 7rustce P�utectioa The gaud feith esaci5e x non-exrscise by aur
-Tnsiees oi powees and d'�scretiwis herein�anted sl�U be cmriusive m atl pers�vt. Rb
1�«WY�g maney oc detiverinC P�apertY to a.e Tn6Eees her�uida st�ai[be requu�ed ar
priviMged to see W fts applicatlon: A cert"sficatbn of as Tcvstees th3t they are actin�
� wmpSiance with tiae t�m.. o# this Agreemee�i sha0 fulty protect aLL persons deali�g
tvith ar Tnstees_
n�cnctE n
sucioesaar rnate� tt��f,��Na�! es�gec or fait a cease w sxve as rn,stee
i
far any reassoiyy'�a�ax�__�son. GLENN L!. AiAItdS ll4 � rwan6rated az�d appomted as
successor co-Trusz�w serve wixh Ure wrvivor ot the two of�s. tt ar son,GLI?NN D.
A4A[t�6, SQ,shali resi�n or fait or cease to serve as wccessor co-Trustee far aoy reasm,t
ihen ois daught�, JEAN MRINS WETZk:L, is naninated and appoinied as wc�cessor ca-�
tl
7nTStee to serve heremrJer. �
(� � dutig of !Suarssor TnLStee. No successac Srsatee shaii be abliged to .
e�cacni� ttie accamu ac aciions of aery previaus Tnatee and ro succe�sor Trustee shaA
be liable fac any act oc aengsim ivttess�the same be doe tn snch successor Trustee's act
or nntissiort My ssr_cessor Tnstee shalt serve wiih alt tlee powas. dCsa'etiarts and
unow�aiities granted to our 7rvstees rere�e6 herein. �
-4
�
. (bj L.istomg of A�.vei.- An}� succe�ox� T�lstee��s8ait be enYEtied xa rety
absolutely upm any sworn retvm listug tE�e assers af my in�st estate delivered xo ttre
- suicceswr Tnscee 6y a pzedecesmr Trustee, �! if an indivi�al Tnatee st�ll die or
ticmme ineo�e�petaii 1Phi� serving as Trusaee Mse.�uidery ivs or t�er �c:cessor Ti°uste.�e
str�t� be �titied' La rciy atao6�tety �pai a swam reNrn made by sur� Tnrsteee's legaf
r�entatine. � � - � �
- (c} iiesT&���/��-Y- A Tntstee may�esign at�e}r time bY f,tya�S Prmr
writi� mtice to t!�6erieFriary or bmeficixies cet wMm the c�arent ircome from our
tn�st esWte ar estates rnay or neesst d�n 6e dstri4eted. If this Agreement does nox
specificalty provi� Eac a iraened wrcessu Tnstee in the arse a 7nrstee caimot or wiII
roi�ve.�then tfie 6enefi�y or 6eneficiacies referenced in the i�nmediatelY i�l;
se�ttence shait,by majarity wte,ap(wint a successur Tf�stee.
(d} Casnpa�satian. Any r-o`porate Tnatee actiag here�ader fi�a51 receive
oo�nper�tion foc the performmanee of irs f�ctims liet-e�mder ui acra�dance wiih its
yctee�hile of fees in effect, from time xo ume, dmring the perind over which iss servires
are prrExmed,and any"aKlividual Trustee shatl 6e entitled to reasonable fee�
� hRTICLL YR
Amendmeni, Reva�ar.`nrc We rr.serve the rigtrt dur'stg ar tifetgnes,by vrrittati.
ins7KmWent detivered to au Trusrcrs and signed by 1wFh af us, to az[te�d or ievoke ihis
Agreen��t in whole�or 'si part. Upon the death of a Grantar, tius tr�af shall becane
arevoca6le.
nitn�vu�
Canstrurtiorc Wha�ever the context of tleis Agreemast re.qcures, U�e fdbw�ng
niles�of ca�tnu:�tim ar interEs�eYatim stki!!6e used:
�� (a) i`.ecder. 2M �riasculi�e getider irciudes ktte femvtv�e or neutere and the
simgular Fnanbr.r ind��des�he pkiral.
�h����Ftaric►a Law. 17ris Agreement is a Fla�i�rnntract ar�d shall be consfrued
accorciing m and gwemed by the iaws of the State of Fbcida.
(c) Be�qef`ru.�- Reterence herein to our childresi stiaE!mean 3EAN f.iA[NS
WETZEL, MARGARET MAtPLS McCARTER, GLEAfN 6.MA[NS, tii, atM R�EftT ALAN
1NA1115_ Refeience tn chikken ur tineat tfesc�xiaiits shall mean children or lireal
descerdants relafed to us 6y ca�sanguinity ard ku persons adopted inio families of our
liESeat desc�ants, whet}rer wd� persans shatl be bom or adopted before ar atter the -
e3[eCUtion of this Rgrecmertt. �
S
. (d} tfisab�fity. The determination as to aa serious IlL�css or inmmpetence as
setereni.�ed in RRT(CtE ll slfail he mada by two ticensa3 physic:wns chosen by o� w`y�
GL.EFIN D.MAINS,IIC_ r
� (e) INu�prs If any decisem un[kr this Agre�meat ia regtired to he enade by a
Oeneficiary undec the age of eightcen(i8}Years, ihen such decLsion shall be ma.de by ihe
parenis or se�vivss�pac�t ot sveh beneF"�ary,and if timre shaii be no s�YViving paernt,
tt�en tM legat guardwn of wrh Uaieficiary. -
� (� Sa..��,:r:�r. [f any purtion of this Agreement is hefd to be vaid or
. ru�enforceab[e. t}� a1t remaining portims o[tlus Rgreert�ent shall contifrie to 6e carried _
into effc�ct. .
(g} F..diratfa�. Refer�ee�ce haein ta educatian shall usctude primary ard
secrnw3az�y esi�r.atim. whether private or 'Publr, arll@ge a,d" posc-3aaccalaueate
educatian, erFxation ai a�ry profeuia�ai school af law,�r�fi�'u�e,dentistry ar the lilce,
vocaT�r�ai x rer�ed'sa!edu�tian,and acry phYsical or s�r'uitual educatlon which is deemed
reasaiable bg wr 2rustees.
(i'a Health. Refecence herein xo MaFth shalt 'vx�ude the enaintenance of
ron�nal medical, denta7, emulional and mentat care, inckid6ig tl�e costs of any lmspital,
dnrp„ rerrsaig and physical therapy care, as wetl as any e�¢p�nses i�curred for equipnrent .
and trave!re{aiecl tt�eta,anef sha[I vxlude the Cosx af any premsttns fur health or ma jor
mesJ"r.al insi.�rance.
IN WITNFSS WHFRECIF, rhis Agree�nent has Uer.n racecuted'ut dupli�-ate this�
day of�uM1C��,3.490. - -
Sigoed,sealed a�M delivered -
ati the yxRS�c�e of: �
- ��__�ts�nt>
L.NN . AIF7S, GRMTLOR
As to nWr �
� ". { y� i
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" PAULINE K.MAIl�6,7'RUSIEE .
As to?n6tee
(
STATE OF FLORIDA - .
COUNLY OF 11ARION
. 1990,�GLE�MJ D A�em was acla�o' �. be� _ -� �9 �y of
dS b1A1N5,7R.as Crarttor ° e
Tnr. /'�
'f._ • /
/ "�tarY Pubiic. i�te of Fbrida at ge �
� MY Commisim E�cpnrs
NO7AR'(PUBIJG,STATE OF F10RDA�
- 6{Y a�uo e�4�.len.22,1992
STATE OF FLORIDA
-COUNTY OF MAR10N
The faregoinS Ag�.'eemeni was adcr�owledged befw me this �`� day of .
1990.bY PAUL(NE K.MAFNS,as Grazttar and az T
� �'�O�Y :¢,State of Florida at Large
MY Commissian Expires:
M6�AFY P�IB�IC.ST,l7E OF RORICt�
�ro����n-22.1932
5558��T�
-7-
. SCHEDULE A
- TO
� 'R�MAINS FAMILY - .
11YING IRUS7 ACRFFUFnTr- .
_ 'Cash"a�the arnowt of One Hmdred Dollars($I00.00).
$
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��
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B 1$ I`�s �
Apri1 12, 2013
Weigle&Associatas P�
Attn: Richard L Webberlr
126 E King St
Shippensburg PA 17257
RE: Estate of Pauline K Mains
Uear Mr.Webber:
The following infarmation is being pmvided as per your request:
Aect.Type Account Na. Balance at Accrued Ownership Date
DA.D. Interest to dpened/Joint
D.O.I?.
Esteem 177444 $14,313.6] $d.34 Mains Family Living Trust IO/24J96
Checking Pauline Malns,TST
Account
Certificate of 158117 $7,422.32 $79.89 Mains Farnily Living Trust 6/28141
Deposit Pauline Mains,TST
Certificate of 158184 $7,232.43 $40.42 Mains Farnily Living Trust t0124t01
Deposit Paulina Mains,TST
, Certificate of 160421 $7,57931 $0.68 Mains Faznily Living Trust 7125102
Deposit Paulina Mains,TST
Certificate of Ib2557 $6,783.44 $3.09 Mains Family Living Trust 3111(43
Deposit Paulina Mains,TST
Certificate of 162582 $6,413.66 $27.74 Ma'rns Farnily Living Trust 6!i 1103
Deposit Pauline Mains,TST
Certificate of I72S78 $2,214.20 $0.$0 Individual 4!3lQ7
Deposit
CeRiftcate of 399020b $6,979.12 $5.61 Mains Family Living Trust 8/]7/49
Deposit Pauline Mains,TST
Certificate of 3940209 $6,746.66 $1455 Mains Family Living Trust 4(20/00
Depasit Pauline Mains,TST
Certificate of 399027d $2,668.39 $2.17 Maitts Family Living Trust 8/15l00
Deposit Pauline Mains,TST
Certificate af 3990550 $6,749.8i $14.87 I4lains Family Living Trust 4l13/99
Deposit Pauline Mains,T`ST
Certifioate of 394092b $3,97d.69 $2.08 Mains Family Living Trust 10/24/00
Deposit Pautine Mains,TST
acnb.com•acnbbusiness.cam•P.O.Box St 28,Gettysburg,PA 17325•Phone 717334.3761 •ToII Free 1.888334.AtN6 i2z62)
�
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A�i r�J
BA � �
Inquiries conceming ACNB Corporation stock information should be directed to the Registrar and Transfer Compan,
at I-800-368-5948. If you need any additional information, please contact me at(717)339-5122.
Sincerely, ' .
1 �
� �
Bazbara J er
ACNB Ba,t�k
Deposit Services Representative II
acnb.com•acnbbusiness.com• P.O.Box 3129,Gettysburg,PA 77325 •Phone 777334.3161 •Toll Free 7.888334.ACN8(2262)
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�inoncial Planning for Families itt Tmnsitton
R'Iai'Ch 7,2{}�3
Jean M. Wetzel
2IS WalnutAvenne
Wayne, PA 19087
RE. Psntine Maias
SunAwerica Variable Annniiy Aceount#P37A0018183 ,
Dear Jeart:
Again I offer my candolences on the passing of your rnother. As we discussed,I have enclosed a
Variabie Annuity Death Claim form The beneficiary of this SuuAmerica Variable Annuity is
the Mains Pamily Living Ttust. The enclosed claim form will need to be signed by the Trustee
of tttis Trust.
Please retwm the ciaim form when exeouted. In addition,please return an original Death
Certificate and a copy of tho executed Mains Family Living Trust document,as well as an
originat let�e�af resignation audlor renunciation signed by your brother Glen zenot�ncing the
right to se�e as Tn�stee in favor of yau. Finally, you ar your attomey wi11 need to obtain a
Ta�cpayer Iclentification Number for the Mains Pamily Living Tnut. Please piovide this nuuiber
ta ma.
As af the date of death of qour mother,March 1,2Q13,the value of the alwve referenced annuity
canriact was$41,826.35. According to SuaPimerica,the cost basis af this contract was
$SS,369.42. As such, the liquidation oEthis cantract will not result in any income that will be
subject to any income ta�e. This annuity contract is a non-qualified variable annuity contract
owned by Pauiine Maias.
You should provide your attorney andlor tax prepazer with a copy of this letter so that.they
wauld have�he relevant inforniation abave ta pregare the P�ansylvania lnheritancc Tax Retum.
Please contaci me ifpou e any questions or o#her issues.
Sixice Iy
�
ego K. ehards�
GIf R/kj
?�6�Sna A�r.nnr.fioitr iM.N�immrlxtns�m.P.4 f7�3fi .� Phone f7171533-$9(iq f Fa�e(7171533�6952 � Webslte GrePpr��RicliartlsLT.f..cun�
RESIDENT STATEMENT FROM
GREEN RIDGE VILLAGE '�
SWAIM HEALTH CENTER Statement Date Due Date ACCOUNT NUMBER u
210 BIG SPRING ROAD 03/31/2013 Upon Receipt 184367GRVIL
NEWVILLE, PA 17241-9486
�1�a76-s25s • ' = ' ' � $1,004.84
AMOUNT PAID $
Piease make check payable to GREEN RIDGE VILLAGE
PAULINE K MAINS Remit To:
Go PAULINE MAINS Presbyterian Homes Inc/Green Rid e/Swaim
7 GREEN RIDGE LANE P O Box 416825 9
NENNILLE, PA 17241 Boston MA 02241-6825
Please detach and retum this portion with your remittance to the address above.
Comments
f vou have anv questians reaardinq your statement please contact the Business Office at(717)776-8256
'.... Date -- `,Description :,��
E?dY� 1�d�� Chargesh, ;;Paymenf�? . ,yBalance„ �,',
'' Units ",.[�"cadlt).
Balance Forward $1,444.00
02/28/13-02/28N 3 Days Away Meal Credit 1 $(39.50) $(39.50)
03/23l13-03131/13 Monthly Fee (9) $(399.66)
TOTAL BALANCE DUE: Q�. `�Ilt�l�3���1� (01�1.3'I g1,004.84
.
a
Department of the Treasury
2{}12 Form 1040-V Internai Revenue Service
What Is Form 1040-V Hpw To Prepare Your Payment
it is a statement you send wtth your check or money s Make yovr check ar money arder payabie to"United
order for any balance due on the"Amount you owe"line States Treasury."po not send cash.
pf your 2072 Form 164�,Farm 1040A,or Farm 1040EZ. •Make sure your name and address appeer on your
. check or money order.
� You can afso pay your texes oNine or by Phone either by a • EMer your daytime phone number and your SSN on
direct tre�sfer from your bar�k actount orby crsdii ar debK your check or money ortler.tf you are fiting a joinY retum, -
card.Paying oMine or by pbone is convenient end sewre enter the SSN shown first on ynur retum.Also enter
and helps make sure we get your payments on fime.For
more infottnatlon,go to www.irs.gav/e-pay. "2012 Form tOdO,""20�2 Fartn�04pA,"or"2012 Form .
1 pa�E1;'whiahever is appropnate.
H6W To FiII In FOPIIt 1d40-V • To help us process your payment,enter khe amounk on
Line 1.Enter your social security number{SSNj.If you are the rigbt side of yaur check like this:$XXX.XX.Do not
. flling a joint retum,enter the SSN shown first on your use dashes or lines(for example, do not enter"$XXX='
retum. or"$XXX bctt40").
I.ine 2. If you are filing a joint return,enter the SSN shown �
secona 4�yo��ret�m. Haw Ta Send tn Yaur 2012 Tax Return,
Line 3.Enter the amount you are paying by check or Payment,and Fortn 1040-V
money oMec • Oetach Form 1040-V along the dotted line.
- Li�e 4.Enter your name(s}and address exadly as st�own • Da not staRle or othe�wise atfads your payment ar Fortn
pn your retum.Please print clearly. 1040-V ta your retum or to each other. Instead,just put
them Ioose in the enveiope.
• Mail your 2012 tsx return,payment,and Form 104RV fo
the eddress shown pn paye 2 that applies to you.
us+oaow
ecc Fom, 1040-V (2012>
i _ _ _ T _ _ ^ _ _ _ � ♦ Detaeh Here and Mafl Wikh Your Payment and Raturn�_ _ _ _ _ _ _ _ _ _ _
� �' — — .� _ .� _. ._ _. _
. . . . I I� � � ,
� ► uw�ni.�a,a�xwnenmawrqap.ym�rnwre�FO��pqo AmouMyouare�ollars Cents
► Do not Appb tni6 vauchx or yaur p�ymaM W Foim 1040
. ► MakeymuM,e�amamey«derpeyadNmma"unAedstetae7rensury^ p�yliigbychCCk eo
► NhMe your Satial Sewnty Num W�(SSN)on your tlreck w money wtle� or maney order ► 6 9 O .
T,84-36-7232 ioaa
PAULINE K t1AINS
? RID6E LANE Ptl BOX 37008
NEWVILLE PA 17241- HARTFORD CT 06176-0008
184367232 Pt MAIN 30 0 2012Z2 61�
E1040X
LL Department of the Treasury-Internal Revenue Service
Amended U.S. Individual Income Tax Return OMB No. 1545-0074
(Rev.�e' mber2o�2J ►Information about Form 1040X and its separete instructions is at www.irs.gov/form1040x.
7his return is for calendar year 2012 2011 2010 2009
Other year.Enter one:caiendar year or fscal year(month and year ended):
Your first name and initial Last name Your social security number
PAULZNE K MAINS 184-36-7232
If a joint retum,your spouse's first name and initial Last name Spouse's social seeurity no.
Home address(number antl street). If you have a P.O. box,see instruccions. Apt. no. Your phone number
7 RIDGE LANE 717-776-9707
City,town or post offce,state,and ZIP code. If you have a foreign address,also wmplete spaces below(see instPucti6ns).
NEWVILLE PA 17241—
Foreign country name Foreign province/state/county . � Foreign postal code
Amended return filing sWtus.You must cheek one boz even if you are not changing your filing status.
Caution.In general,you cannot change your filing status from joint to separate retums after the due date.
BSingle ' Marned filing jointly , � Married filing separetely � �
Qualifying widow(er) Head of household(if the qualifying person is a child but not your dependent,see instructions.)
A.Origlnal amount B.Net change-
Use Part IIf on the back to explain any changes or as previously amount of increase c.correct
InCOmeandDeduCtiOns adjusted or(decrease)- amount
see instruetions ex lain in Part Itl
1 Adjusted gross income.If net operating loss(NOL)'cartyback is
inGUded,checkhere .......... ...........► Q t 10� 734 . 12, 000 . 22� 734 .
.................
2 Itemized deductions or standard deduction .......................... 2 7, 4 0 0 . 5, 0 8 3. 12, 4 8 3.
3 Subtract line 2 from line 1 ........ ................. 3 3, 3 3 4 . 6, 917 . 10, 2 51 .
...................
4 Exemptions.If ehanging,complete Part I on page 2 and enter the
amountfromline3o ................... a 3, 800 . 3'� 800 .
..................
5 Tauable income. Subtrect line 4 from line 3 .......................... 5 6, 4 51 . 6, 4 51.
Tax Liability
� 6 Tax.Enter method used to figure tax: , � �
TABLES s 648 . 648 .
7 Credits.If generel business credit carryback is included�,check
here ........................................................► � 7
8 Subtract line 7 from line 6. If the resuk is zero or less,enter-0- .... . 8 64 8 . 64 8 .
9 Othertaxes ........................................................ 9
10 Total tax.Add iines e and 9 ........................................ 10 64 8 . 6 4 8 .
Payments
17 Federal income tax withheld and excess social security and tier 1
RRTA tax wkhheld(if changing,see instructions) .................... 11
� 12 Estimated tax payments,including amount applied from prior year's �
return .............................................................. 12
13 Earned income aedit(EIC) ...................
.. 13
14 Refundable credits from Schedule(s) �8812 or M or Fortn(s) �2439
84136 B Sd05 �8801 �BB12(200&2011) 88839 �ggfi3
8885 or OMB!(SPBLI(Yf: .14
15 Total amount paid with request for extension of time to file,tax paid with original 2turn,and additional
taz paid after return was filed ...................
................................................................... . 15
'I6 Total payments.Add lines 11 through 15 ........ ...
. . . . .................................... 16
Refund or Amount You Owe(Note.Allow 8-12 weeks to process Form 1040X.)
77 Overpayment,if any,as shown on original return or as previously adjusted by the IRS.................................. 17
'18 Subtract line 17 from line 16(If less than zero,see instructions)........................................................ 18
�9 Amount you owe.If line 10,column C, is more than line 18,enter the difference ...................................... 19 64 8 .
20 If line 10,column C, is less than line 1 B,enter the difference.This is the amountoverpaid on this return................ 20
27 Amount of line 20 you want refunded to you ......................... .._.... . Z�
..... .. ..... ...... ...
22 Amount of line 20 you want applied to your (enter year): � estimated tax 22 -
.0 � .'.�,3�
Complete and sign�thfs form on Page 2.
For Paperwork Reduction Act Notice,see instructions. Form 1040X(Rev. 12-2012)
BCA
U51040X1
_ _
t2-20t2) PAULINE K MAINS 184-36-7232 Page2
�cemptions
`part only'rf you are:
ng or decreasing the number of exemptions(personal and depentlents)claimed on line 6d of the return you are amending, or
,sing or decreasing the exemption amount for housing individuals displaced by a Midwestern disaster in 2009.
A.Original number
of ezemptions or C.Correct
� amount reported or B.Net change number
See Form 1040 or Form 1040A instructions and Fortn 1040X instructions. as previously or amount
adjusted
23 Yourself and spouse.Caution.If someone can claim you as a
dependent,you cannot claim an exemption for yourself .............. 23
24 Your dependent chiidren who lived with you .......................... 24
25 Your Gepentlent chiltlren who did not live with you tlue to divorce or saparation .......... 25
26 Other dePendents .................................................. 26
27 Total number of ezemptions.Add lines 23 through 26 .........'....... 27
28 Multiply the number of exemptions Gaimed on line 27 by the
exemption amount shown in the instructions for line 28 for the year
you are amending(see instrudions) ................................. 26
29 If you are claiming an exemption amount for housing individuals
displaced by a Midwestern disaster,enter the amount from Form �
8914, 1ine 6 for 2009 ................................................ 29
30 nda lines 2e ana 29.Erner Me resu�t nere anE on�i�a on peae 1 oi this torm .......... 30
31 List ALL dependents(children and others)Gaimed on this amended retum.If more than 4 dependents,see instructions.
� (d) Check box if qualirying
(b) DependenYs social (c) Dependenfs �ild for child tau uedit
(a) First name Last name sewrity number relationship to you
(see instruc[ions)
Presidential Eleetion Cam ai n Fund
Checking below will not increase your taz or reduce your refund.
nCheck here if you did not previously want$3 to go to the fund, but now do.
nCheck here'rf this is a joint return and your spouse did not previously want$3 to go to the fund but now does
Explanation of changes In the space provided below tell us why you are fihng Fortn 1040X.
► Attach any supporting documents and new or changed forms and schedules.
MISSED PENN TREATY NETWORK LTC 2200
MISSED 1099R FROM SUN AMERICA 12000
Sign Here
Remember to keep a copy of this fortn for your recorcls. �
Under penatties of perjury, I declare that i have filed an original retum and that I have ezamined this amended return,including accompanying
schedules and statements,and to the best of my knowledge and belief,this amended retum is true,correct,and complete.Declaration of pxparer
(other than taxpayer)is based on all infortnation about which the preparer has any knowledge.
� ' '
Your signature � Date Spouse's signature. If a joint retum,both must sign. Date
Paid Preparer Use Only
� 03/O1/2013 BIG SPRING SENIOR CENTER
Preparer's signature ' Date Firm's name(or yours'rf self-employed)
91 DOUBLING GAP RD
AARP FOUNDATION TAX-AIDE NEWVILLE PA 17241-
PrinUtype preparefs name � � Firm's address and ZIP code
S 2 S 0 S�8 17 � Check if self-employed
PTW � Phone number EIN
� BCA For forms and publications,visit IRS.gov. usioaoxs Form 1040X(Rev. 12-2012)