HomeMy WebLinkAbout07-31-13 (2) J 1505610140
REV-1500 EX (02-11)(FI)
PA DepaRment of Revenue OFFICIAL USE oNLY
Bureau of Individual Taxes County Code Year File Number
ao sox 2eoso� INHERITANCE TAX RETURN 2 1 1 3 0 7 7 0
Harrisbura PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMODVm' Date of Birth MMDDYYVY
0 7 2 9 2 0 1 1 0 1 1 6 1 9 2 5
DecedenPs Last Name Suffix DecedenCs Firsl Name MI
D E R I C K G I L B E R T N
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
D E R I C K B L A N C H E M
Spouse's Social Security Number
1 8 7 1 8 4 3 3 1 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
Q 1. Original Return � 2. Supplemental Return � 3. Ramainder Return(Date of Death
Priorto 12-13-82)
� 4.Limited Estate � 4a. Future Interest Compromise(date of � 5. Federal Estate Tax Return Required
death after 12-12-82)
❑X 6. Decedenl Died Testate � 7. Decedent Maintainad a Living Trust � 8.Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
� 9. Litigation Proceeds Received � 10. Spousal Poverty Credit(Date of Death � 11.Election to Tax under Sec.9113(A)
Between 1231-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT•THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
B E N J A M I N J B U T L E R 7 1 7 2 3 6 1 4 8 5
� REGISTER OF_WILLS USE ONLY �
> �
�_ -� �;�
=':: �� � ,
First Line of Address ' �- '� �
1.�., . - ... C7
` >
(��; � — :— ::'. :::0
1 0 0 7 M U M M A R 0 A D = - �.,� - ="
�-. . `_��
Sewnd Line of Address ��� -� '-'
- :. : r:,: ..7
S U I T E 1 � 1 -'; ' �
City or Post Office State ZIP Code _�_.__��FILED��_
� _.�; �. .. .... �t7
L E M 0 Y N E P A 1 7 0 4 3� �, � o
-,� -Y�
CorrespondenPs e-mail address: LAWYERS(�n,BUTLERLAWFIRM.COM
Untler penaltles of perjury,I declare that I have examinetl this return,including aaompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correcl and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIG URE OF PE SON ESPONSIBLE F FI RET N DATE
ADDRES
2604 PA HURCH ROAD HARRISBURG PA 17110
SIGNATURE P OT ER N ENTATIVE DAT�_3p_ / ,3
ADDRE
1D07 MUMMA ROAD, SUITE 101 LEMOYNE PA 17043
PLEASE USE ORIGINAL FORM ONLY
Side 1 �
� 1505610140 1505610140 ��
� �v`
� �„�
� � ���
��� l �
o� ��� �
�
. �
�
� 15�5610240
REV-1500 EX(FI) DecedenYs Social Securiry Number
oeceeenesName: GILBERT N • DERICK
RECAPITUTATION
1. Real Estale(Schedule A) . . . . .. .. .. . .. . .. . . . .. . .. .. . . . . . .. . . . . . . . . . . 1. '
2. Stocks and Bonds(Schedule 8) . . .. . .. .. .. ... .. . . . . . . . . . . . . . .. . . . . . .. Z. 3 4 6 8 . 8 5
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . .. . . 3. •
4. Mortgages and Notes Receivable(Schedule D) . . .. . .. . . . . . . . . .. .. . .. . . . . 4. •
5. Cash, Bank Deposits and Miscellaneous Pereonal Property(Schedule E). . . . . . . 5. 7 7 � � , 5 9
6. Jointly Owned Proparty(Schedule F) ❑ Separate Billing Requested . . . ... . 6. •
7. Inter-Vivos Transfers&Miscellaneous N -Probate Property
(Schedule G) � Separale Billing Requested . .. . . . . 7. .
8. Total Gross Assets(total Lines 1 through 7) . .. . .. . .. .. . .. . . . . . . . . . . . . . 8. . 1 1 1 6 9 . 4 4
9. Funeral Expenses and Administrative Costs(Schedule H) . . . .. . . . . . . . .. . .. . 9� 1 3 8 . 5 �
10. Debts of Decadent,Mortgage Liabilities,and Liens(Schedule I) . . . . . . . . . . . . . 10. •
�7, ToWI Deductlons(total Lines 9 and 10) . ... . .. . .. . .. .. . . . . . . . .. . . . . . . . 11. 1 3 8 . 5 0 �
12. Net Value of EsWte(Line 8 minus Line 11) . . . . . . . . .. . . . .. . . . . . . . . . .. . . 12. 1 1 0 3 0 . 9 4
13. .Charitable and Governmental 8equests/Sec 9113 Trusts for which
an�election to tax has not been made(Schedule J) . . . . . . . . .. . . . . . . .. . . . . 13. •
1a. Net Value Subjeet to 7ax(Line 12 minus Line 13) . . .. .. . . . . . . . .. . . .. . . . 14. 1 1 � 3 0 . 9 4
TAX CALCULATION-SEE INSTRUCTIONS FOR APPlICABLE RATES �
75. Amount of Line 14 taxable
at the spousal tax rete,or
transfers under Sec.9116
(a)(�z)x.000 1 1 0 3 0 . 9 4 i5. 0 . 0 0
16. Amount of Line 14 taxable �
at lineal rate X.0 0 . 0 � 76. � . � 0
17. Amount of Line 14 taxable
at sibling rate X.12 � • � Q 17. � . � � �
18. Amount of Line 14 taxable
at wllateral rate X.15 0 . � 0 �g, 0 . 0 �
19. TAX DUE . . . . .. . . . . . . . .. . . .. . .. . . . . . . . . . . . . .. . . . . . . . . . . . . . . .. . . 19. O . O �
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REPUND OF AN OVERPAYMENT �
Side 2
� 150561�240 _ 15056.10240 � _
REV-1500 EX(FI) Page 3 Flie Number
DecedenYs Complete Address: Zi i3 0��0
DECEDENTSNAME
GILBERT N.DERICK
STREETADDRESS �
132 Carol Lane
CIN STATE 21P
Enola PA 17025
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 0.00
2. CreditslPayments
A.Prior Payments
B.Discount
Total Credits(A+B) (p) 0.00
3. Interest
(3)
4. If Line 2 is greater than Line 1+�ne 3,enter the d'rfference.This is the OVERPAYMENL
Fill in oval on Page 2,Line 20 W request a rePond. (4) 0.00
5. If Line 1 +Line 3 is greffier than Line 2,enter the diflerence.This is the TAX DUE. (5) 0.00
Make check payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedenl make a transfer and: Yes No
a. retain the use or income of the property transferred ...................................................................... ❑ �
b. retain the right to designffie who shall use the property transferred a its income ............................... ❑ ❑x
c. retain a reversionary interest :.................................................................................................... ❑ �
d. receive the promise for life of either payments,benefits or care7 ....................................................... ❑ X❑
2. If death occurred after December 12,1982,did decedent iransfer property within one year of death
without receiving adequate consideration7 ....................................................................................... ❑ ❑X
3. Did decedent own an"in Wst for or payable-upondeath bank account or security at his or her dealh7 ......... ❑ ❑x
4. Did decedent own an individual retlrement account,annuily or other non-probate property,which
contains a beneficiary designaUon?.................................................................................................. ❑ �
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
� :°,
For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent p2 P.S. §9116(a)(1.1)(i)].
For dates of death on or after Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S.§9116(a)(1.1)(ii)].The statute dces not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
filing a tax return are s611 applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an
adoptive parent or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)].
• The tax rate imposed on the net value of transfers to or for the use of the decedenPs lineal beneficiaries is 4.5 percent,except as noted in n2 P.s.gs��s�a��ip.
• The tax rate imposed on the net value of transfers to or for the use of the decedenPs siblings is 12 percent(72 P.S. §9116(a)(1.3)].A sibling is defined,
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
REV-1503 EX+(8-72)
pennsylvania SCHEDULE B
�EPARTMENT OF REVENUE
INHERITANCETAXRETURN STOCKS & BONDS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
GILBERT N.DERICK 21 13 0770
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. 85.00 shazes MetI.ife,Inc.(ME'I)�$40.81 3,468.85
� TOTAL(Also enter on Line 2,Recapitulation) S 3 468.85
If more space is neaded,insert additional shaets of the same size
REV-1508 EX+(OB-12)
pennsylvania SCHEDULE E
OEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCETAXRETURN pERSONAL PROPERTY
RESIDENT DECEOENT �
ESTATE OF: FILE NUMBER:
GILBERT N.DERICK 21 13 0770
Include tha proceeds of litigation and the date the proceeds were received by the estate.
All property Jointly owned wlth rleht of survivorship must be dlselosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Highmazk-Refund 200.59
2. 2002 Ford Ranger 7,500.00
value based on sale
� TOTAL(Also enter on Line 5,Recapitulation) ; 7 700.59
If more space is needed,use additional sheets of paper of the same size.
REV-1511 ER+(1p-09)
pennsylvania SCHEDULE H
DEPAF2TMENT OF REVENUE FUNERAL EXPENSES AND
iNr+ewrnucer,ixaEruaN ADMINISTRATNE COSTS
RESIDENTDECEDENT
ESTATE OF FILE NUMBER
GILBERT N.DERICK 21 13 0770
DecedeM's debta must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
L
B. ADMINISTRATIVE COSTS:
t. Personal Representative Commissions:
Name(s)ot Personal Representebve(s)
SUeet Address
Cily State ZIP
Year(s)Commission Pab:
p. Aqomey Fees:
3, Femity Exemption:pf decadenYs address is not the same as daimanYs,attach explanatlon.)
Claimant
St2et Address �
City State ZIP
Relationshlp of Clalmant lo Decedent
4. Probate Fees: (�ncludes additional probate of$30.00) 138.50
5 Aarountant Feas:
6. Taz Retum Preparer Fees:
7.
TOTAL(Also enter on Une 9,Recapitulation) S 138.50
If more spece is rreeded,use additional shee�of paper of the same s¢e.
REV-1513 E%�(01-10)
pennsylvania SCHEDULE J
�EPARI7AENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
GILBERT N.DERICK 21 13 0770
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not L(st Trustee(e) OF ESTATE
I TAXABLE DISTRIBUTIONS (Indude ouUightspou;I,distributions and Nansfers under
Sec.91 f6(a)(1.2.
i. Blanche M.Derick(DOD:4/18/13),c/o Sherry Lynn Sallada,Exec Spousal 11,030.94
2604 Paxton Church Road
Harrisburg,PA 17110
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
n. NON-TAXABLE DISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FORWHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
»
1.
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. 5
It more space is needed,use additional sheets of paper of ihe same size.
L� ST 1llt1LL � ND T£ ST � 16I � NT
0 �'
� IL � � �T N. D � � ICK
I, GILBERT N. DERICK, of Enola, Cumberland County, Pennsylvania, being.pf
sound and disposing mind, memory, and understanding, do hereby make, publish, and declaze
this to be my Last Will and Testament and hereby revoke all other Wills and Codicils, if any,
that I have made.
FII2ST: I give and devise all of my personal jewelry, guns, hunting and fishing
equipment to my grandson, CORY A. SALLADA, of Harrisburg, Pennsylvania, so long as he
� shall sutvive me by thirty (30) days.
� SECOND: I give, devise, and bequeath all the rest, residue, and remainder of my
� Estate, of whatever nature and wherever situate, to my beloved wife, BLANCHE M.
DERICK, so long as she survives me by thirty (30) days.
` THII2D: Should my wife fail to survive me by thirty (30) days or shouid she for
�'
� an reason fail to take under this m Last Will and Testament, then I
y , y give, devise, and
bequeath all the rest, residue, and remainder of my Estate, of whatever nahue and wherever
situate, to my daughter, SHERRY LYNN SALLADA, of Harrisburg, Pennsylvania, so long as
she shali survive me by thirty (30) days.
FOURTH: Should my daughter fail to survive me by thirty (30) days, then I give,
devise, and bequeath all the rest, residue, and remainder of my Estate, of whatever nature and
wherever situate, to my grandson, CORY A. SALLADA, so long as he shall survive me by
thirty (30) days. Should my grandson fail to survive me by thirry (30) days, but be represented
by children then living, these children shall take, per stirpes, the share to which my grandson
would have been entitled if then living.
FIFTH: Should my grandson not have attained the age of twenry-five (25) yeazs
at the time of my death, I direct that my Estate as given to my grandson in part FOURTH of
this, my Last Will and Testament, be given to my Trustee, hereinafter named, in trust for the
following uses and purposes and upon the following terms:
A. The net income of the Trust shall be paid to and be applied for my
grandson's caze, maintenance, education, or support at such times as my Trustee shall
determine in his absolute discretion. Should the income from this Trust be insufficient to
provide adequate maintenance, education, or support, my Trustee, in his sole discretion, may
invade the principal for this purpose.
J B. In the administration of the Trust, the Trustee shall have the following
� powers, deemed to be supplementary to and not exclusive of, the general powers of trustees
pursuant to law and including all powers necessary to cazry the same into effect, all of which
shall be exercised in a fiduciary capacity:
� 1. To hold any or all of the Trust Fstate in the form received.
2. To sell at public or private sale, to mortgage, pledge, or hypothecate
or to exchange or lease (including lease for a period extending beyond the term of this Trust),
any stocks, notes, securities, real estate, minerais, and other trust property, upon such terms,
cash or credit, or both, as he may deem advisable.
3. To invest and reinvest the Trust Estate in investments limited to real
or personal properry, minerals, royalties, and leaseholds.
4. To construct, add to, repair, or demolish (in whole or in part) any
improvements upon any Trust property.
5. To participate in any reorganization, consolidation, merger, or
dissolution of any corporation, the stocks, bonds, or other securiries of which may be held at
any time as part of the Trust Estate and to receive and continue to hold any property which
may be ailocated or distributed to it by reason of participation in any such reorganization,
merger, or dissolution.
6. To make or hold investments or any part of the Trust Estate in
common or undivided interests with other persons, corporations, or trusts.
7. To demand, receive, receipt for, sue for, and collect any and all
�� rights, money, properties, or claims, to which this Trust may be entitled, and to compromise,
settle, azbitrate, or abandon any ciaim or demand in favor of or against this Trust.
2 8. To borrow funds for trris Trust in such amounts and for such
�
purposes as he shall deem for the best interest of tlus Trust and the beneficiary thereof, and to
purchase property on the credit of this Trust, and, in connection with such bonowing or such
� purchase, to execute and deliver promissory notes or other evidences of indebtedness of this
Trust and to mortgage or pledge all or any part of the Trust Estate to secure payment of such
indebtedness, and to repay such indebtedness out of the Trust Estate.
9. To employ agents, legal counsel, brokers, and assistants, and to pay
their fees and expenses as he may deem necessary or advisable to carry out the provisions of
this Trust.
10. To vote in person or by proxy any shares of stock which may form
part of this Trust.
_ _ _ _
11. To lend money to any person or persons upon such terms, but with
adequate interest and security, as he may deem advisable for the best interests of this Trust.
12. To elect, appoint, and remove d'uectors of any corporation, the
stock of which shall constitute Trust properry, and to act as a d'uector and officer of any such
corporation.
13. Generally, and without limitation by any specific enumeration
herein, to manage, control, operate, reconvert, invest, reinVest, sell, exchange, lease,
mortgage, pledge, pool, or otherwise encumber and deal with the properry of this Trust, for
and in behalf of this Trust and the beneficiary thereof, to the same extent and with the same
powers that any individual would have in respect to his own properry and funds.
� 14. To act freely under all or any of the powers by this agreement given
� to the Trustee in all matters concerning ttris Trust, after forming his judgment based upon all
the circumstances of any particular situation as to the interest of this Trust and the beneficiary
hereunder, without the necessity of obtaining the consent or permission of any person
� interested therein, or the consent or approval of any court, and notwithstanding that he may
also be acting individually, or as trustee of other trusts, or as agent for other persons or
corporations interested in the same matters, or may be interested in connection with the same
matters as stockholder, duector, or otherwise, provided, however, that he shall exercise such
powers at all times in a fiduciary capaciry primarily in the interest of the beneficiary
hereunder.
15. To invest trust funds in interests in any common trust fund or funds
now or hereafter estabiished and being administered by the Trustee solely for the investment of
trustfunds.
C. I specifically d'uect that my Trustee shall not be required to segregate ihe
shares held in Trust in some separate accounts prior to the termination of any Trust created
hereunder. Should the Trust, in the sole opinion of my Trustee, be or become too small to
wanant continuing such fund in trust, or should its administration be or become impractical for
any other reason, my Trustee, in his sole discretion, may deposit the trust monies in a savings
account in a savings institution of the Trustee's choosing, payable to the beneficiary at
majority.
D. If the beneficiary of this trust is the beneficiary of any life insurance
policies, any pension plans, or other contracts, the proceeds of such policy, plan, or conuact
may be added to such trust at the sole discretion of my Trustee. Should my beneficiary be a
minor at the time of my death, I direct that the procceds of such policy, plan, or contract shall
�
be added to such trust and administered in accordance with the terms of the Trust as set forth
herein.
� E. 7'his Trust shall terminate, and the Trustee shall pay the accumulated and
undistributed principal and income then remaining in his hands at termination to my grandson
when my grandson has attained the age of twenty-five (25) years. If my grandson dies prior to
attaining the age of twenty-five (25) years, then the Trust shall terminate upon my grandson's.
death and shall be distributed in accordance with Pazagraph FOURTH, as if no trust had been
created.
SIXTH: All interests of any beneficiary in the income or principal of this Estate,
while undistributed and in the possession of my Executruc and Trustee, even though vested and
distributable, shall not be subject to attachment, execution or sequestration for any debt,
contract, obligation or liability of any beneficiary and, fiuthermore, shall not be subject to
pledge, assignment, conveyance, or anticipadon.
SEVENTH: All inheritance, estate, and succession taxes (including interest and any
penalties thereon) payable by reason of my death shall be paid out of and be charged generally
against the principal of my residuary estate without reimbursement from any person.
EIGHTH: In addirion to all rights and powers conferred by law, I authorize and
empower my Executrix and Trustee and their successors, in their absolute discredon and
without necessity of obtaining court approval:
A. To retain any of the investments composing the principal of this trust in
� the form in wluch the same shall have been delivered to the Trustee whether or not the same be
in the nature and type legal for the investment of trust funds under the laws of the
�
Commonwealth of Pennsylvania, including the stock of any corporate fiduciary acting
�
hereunder.
B. To invest in all forms of property (including, but not by way of
� limitation, real estate, all types of stocks and bonds, and participations in common trust funds),
without being confined to investments prescribed by statute.
C. To buy investments at a premium or discount.
D. To hold property unregistered or in the name of a nominee.
E. To give pro�ries, both ministerial and discretionary.
F. To compromise claims.
G. To join any merger, consolidation, reorganization, voting trust
plan, or any other concerted action of security holders and to delegate discretionary duties with
respectthereto.
H. To lend to, and buy from, my estate.
I. To borrow and to pledge real and personal property as security therefor.
J. To sell at public or private sale for cash or credit or partly for each, to
exchange, or to lease for ariy period of time, any real or personal property, and to give options
for sales, exchanges, or leases.
K. To allocate any properry received or charge incurred to principal or
income or partly to each, without being obliged to apply the usual rules of trust accounting.
L. To exercise any option permitted by law which they believe to be
advantageous &om the viewpoint of overall tax reductions, including, without limitation of the
foregoing, power and authority to claim administration or other expenses either as income tax
� deductions or inheritance or estate tax deductions, without regazd to whether they were paid
� from principal or income and without requiring adjustments between principal and income for
any resuiting effect on income or estate taxes, and a deduction of such expenses for income tax
. purposes shall be given effect in computing the respective shazes of all persons interested in
� my estate or the trusts set forth herein, even though the effect is to increase the share of one
beneficiary or class of beneficiaries hereunder at the expense of another; and to make such
adjustments, if any, between beneficiaries with respect thereto as they deem appropriate in
view of the nature of the transaction and the amounts involved.
M. VJhen permitted under the Internal Revenue laws of the United States, or
of any state, to join with my spouse in ffiing a joint income tax return without requiring my
spouse to indemnify my estate against liability for the tax attributable to my spouse's income,
and to consent to any gifts made by my spouse during my lifetime being treated as having been
mad� one-half by me for the purpose of federal laws relating to gift tax.
N. To distribute in cash or in kind or paztly in each.
The powers granted hereunder shall be exercisable with respect to all real and personal
property, including, but not lunited to, income and principal held for minors or disabled
beneficiazies at any time held by the Trustee and shall continue in full force, even after the
termination of any trust hereunder, until the actual distribution of all properry. All powers,
authorities and discretion granted here shall be in addition to those granted by law and shall be
exercisable without leave of court. However, nothing herein shall be interpreted or construed
to encourage, authorize, empower, or permit the Trustee or Executrix to act or cause anyone
to act in a manner contrary to or inconsistent with accepted standards of portfolio
diversification and risk management.
NINTH: I nominate, constitute, and appoint the following persons:
�
� A. My wife, BLANCHE M. DERICK, as Executrix of this, my Last Will
and Testament. In the event of the renunciation, death, resignation, or inability of my wife to
act for whatever reason in this capacity, then I nominate, constitute, and appoint my daughter,
� SHERRY LYNN SALLADA, as Executrix of this, my Last Will and Testament.
B. My son-in-law, DONALD SALLADA, of Harrisburg, Pennsylvania as
Trustee of the Trust described herein. In the event of the renunciation, death, resignation or
inability of my son-in-law to act for whatever reason in this capacity, then I nominate,
consdtute, and appoint my nephew, BARRY DERICK, of Enola, Pennsylvania as Trustee.
I direct that no representative named above shall be required to post security for the
faithful performance of his/her duties in any jutisdiction insofar as I am able by law to reli�ve
him/her of such obligation. Any of my representatives shall be entifled to reasonable
compensarion for the performance of the duties set forth herein.
_ ___ __ _ .
..,.
IN WTI'NESS WFIEREOF, I have hereunto set my hand and seal tlus 13 day of
5,�,�,� , 2001, on this, the ninth of nine typewritten pages. I have also signed the
left-hand margin of the first eight of these pages for purposes of identification only.
������ ��
GILBERT N. DERICK
SIGNED, PUBLISHED, and DECLARED by the Testator, GILBERT N. DERICK as
tris Last Will and Testament, in the presence of us, who at his request, in lus presence, and in
the presence of each other, have hereunto subscribed our names as witnesses.
tQ�,vw 1t•�J.,�w- A9 4au�vi r.�,) �t..
un.�....r�4cb ar.. �k t i-a s
---v
E,��Ll�CLn , 1.�a� �Uln .�rr.c�o.0 ,,��
`�Ler��r.c�nr.�r,L�..,_� , P�4- � 7aS�
ACKNOWLEDGMENT
Commonwealth of Pennsylvania
County of C�mberland
I, GILBERT N. DERICK, Testator, whose name is signed to the attached instrument,
having been duly qualified according to law, do hereby acl�owledge tUat I signed and executed
the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as
my free and voluntary act for the purposes therein expressed.
��.� � ��
ILBERT N. DERICK
Swom or affirmed to and subscribed before me by GILBERT N. DERICK, the
Testator, this � day of�) 1_�v_. , 2001.
/
Notary Publ
r+amnai sw
M.Lopx.NotaY Publ�
�,cx"'°�'�o�c. �r�°,`"�
,�rmywero,ne�oaena�a
AFFIDAVIT
Commonwealth of Pennsylvania
County of Cumberland
We, Debra K. Wallet and Rhor�p` 1�. ►�1,t�� , the witnesses whose names
are signed to the attached instivment, being duly qualified according to law, depose and say
that we were present and saw the Testator sign and execute the instrument
as his Last Will and Testament; that he executed it as his free and voluntary act for the
purposes therein expressed; that each of us in the hearing and sight of the Testator signed the
Will as witnesses; and that, to the best of our knowledge, the'�estator was at that time 18
yeazs of age or older, of sound mind, and under no constraint or undue influence.
�Q.�, K.�..M-
Swom or affirmed to and subscribed before me by�4�_ �, (�)Q��� and
�hpY�dp��D.'h�l.u�,� , witnesses, ttus Ia� day of .�ul�.l , 2001.
Notary Publ
�yy wo�e�sea�
Gmp t�Bao,�Ci�r�d�counb
�,y ComNwo„p�pves oc�.z�;2ooa
, qggociatlp�olNda�ies
._. .. .. ..___ __
MET Historical Prices �Metl.ife,Ina Common Stock Stock-Yahoo! ... http://finance.yahoo.com/q/hp?s=MET&a=06&b=29&c=2011&d=0...
Home Mail Naws Sports Finance Weattier Games Groups Amwers Flickr More
_- � BeNamin Mail
''. HOI.E I--INVESIING NEWS PERSONPLFlNIWCE MYPORTFOWS EXCLUSNES
........- Wetl.JJ t7.2013.3:34PM EPT-U S.�+krkels clme m 28 rrire.
�ov+ 0.01°/.Nastlep 0.2�%
��T�t �^ ��MET 8;
e.r:TraW��Jw_;'_. AM w[ , �/1mMbtAO O
umw�umm��f iw .. .
MetLife,Ma(MET) -Nvse �..� aae eo Ponrouo � u�e �ao'��..
4�.! �7 0.27��..r7s��a� 3:32PMEDT-NeeCeqReelTirroPriw
__
Historieal Priees � c.eNN«ierrrmsror:l . .. , c�J-.-
SetDelaRenBe � �
__ . ___,
�>oeiy
Start DM� �Jul. I29_......,2011........;Ep.Jmt.2m0 C Nbekly
,.._... __ . .............
ErMMta _Jul... I29 i2017.....'',. OMOnfhy
G DIWAenEe Only
� �P�a i
Fint�Prevbua�Natl�Lest
.................. __.._. ....... ..._...._.... .. ......... __....._.... .. . .............._ . . . ........._...._...:
Pticss
Date Opm Hiph Low Close Wlume M�Clwe'
Ju128,20fl � 4070 01.48 40.14 N.21 17,073,000 39.02
•ceae prloe.Qucme r«Eiwerae rin,pFta.
First�Previous�NeM�Leel
�DownloaA to SproaCS�sal
Curtenq in USD.
= �� . � � x
�s-
_
_
'�.. Ad Topka That Might Intereat You...
��' 1.Stocka to Buy Now 6.Beat PaAOrming Stoeks
'. . . .. .. .......... ._.._ .......
Y.Top Divltlentl Stacka � �� 6. Beat Stocks!or 2013
1.The Beat Penny Stxks �7.Beat Stxkn to Buy
��, 4. Penny Stocks to Watch 8.Gaotl Stocka to Invast � ���
Fee:Eeck._ ._.. .... ... _... __. 'e�_..
Gopy�qkb2013 Ya�wo�Mc.N rgM�mervM.Piiwry Poky-IDOUtOVMM�Trrtu W SeNC��CqMW��P�1-Sad Feedwck-Y8h0�1-A8C N0�46 NBiWOfk
1 of 2 7/17/2013 3:32 PM
__ _
_ _ _ . _ _ _ _
_ _ _ _ _
i IGHh�NZK�
Date: 08/23/2011
This Month
Gross payment amount 200 .59
Net payment amount 200 . 59
0362861