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Home My WebLink About11-27-13 (2) � 1505610101 �� IX(ot-io) � OFFICIAL USE ONLY PA Dcpartment of Revenue P�YE�� County Code Year File Number DEVMTMENTOPIIEVENUE . . Bureau of Individual Taxes INHERITANCE TA�C RETURN PO BOX 28o6oi O Q , � � Harrisbu ,PA 1�12&0601 RESIDENT DECEDENT � � 3 ENTE.R DECEDENT INFORMA'#ION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY � �� D l l :� D 6 0 7=�/ 4 � DecedenYs Last Name � Suffix Decedent's First Name MI � L 1S � (If Appflcable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI � o L a � Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL iN APPROPRIATE OVALS BELOW � 1.Original Retum p 2.Supplemental Return O 3. Remainder Retum Edate of death prior to 12-13-82) ; p 4.Limited Estate p 4a.Future Interest Compromise(date of p 5. Federal Estate Tax Retum Required death after 12-12-82) � ^6.Decedent Died Testate p 7.Decedent Maintained a Living Trust � 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9.Litigation Proceeds Received O 10.Spousal Poverty Credit(date of death O 11. Election to tax under Sec.9113(A) . between 12-31-91 and 1-1-95) (Attach Sch.O) - CORRESPONDENT- TH�S SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMIkTION SHOULD BE DIRECTED T0: I�ame - Daytime Telephone Number �� s H / L � S / ! I'� 7 � ,.:.. �. . �G� FER OF U�O. �,Y . � � � � �!i � � �,, �-�- � —i +� First line of address �,, � � -.� � -��, � . � C �. n u s o � � � a ,�, � � Second line of address p � � � "' � �: � �." � rc�n � �v � �� City or Post Office State Z!P Code � DA ED� �.. n�w C JcSbul2 / 0 5 �173 � : Corres ndent s e-mail'_address: �Pi��s 3 4 � � ce� C�CmmCast'�e�' Under penalties of perjury,I declare that I have examined this retum,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATU F S RESPONSIB LING RETURN DATE X ri �� ADDRESS CL� ��D �. 'gRO� �,olo I�Sbury ��-, tY�echQ,,r,;esbar'� P�} �7�.S•s SIGNATUR PREP ER O ER TH f PRE , ATIV�„�� DATE ///� x � ADDRESS CH g.�.L� . S�1��'LL�S �� Q• (o C'Jvt,lS,Cr v�ay��c 4,4��C�5 i�l�� S�S^ PLEASE USE ORIGINAL FORM ONLY Side 1 � 1505610101 15�561�101 � � F 1505610105 REV-1500 EX • Decedent's Social Security Number ✓ RECAPITULATION 1. Real Estate(Schedule A). .. ...... ...... ,,,,••,,•,,... .:. 1. I 2. Stocks and Bonds(Schedule B) ................. ............ .......... 2. ,^f _!J Tcf` T+'7J_' 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3. .}J i 4. Mortgages and Notes Receivable(Schedule D)..... .... .. ........ A,,Oj 5. Cash,Sank Deposits and Miscellaneous Personal Property(Schedule E). ...... 5. J a �570 V•`D f cl�. 6. Jointly Owned Property(Schedule F) p Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property - - (Schedule G) p Separate Billing Requested.... .... 7. IJ la f- J 9 ). ........ .. ..... . ✓✓-� , iJ 8. Total Gross Assets(total Lines 1 through 7 8. 'Li ,l'i Q`` i6; 1Z1 9. Funeral Expenses and Administrative Costs(Schedule H)... ....... ....... .. 9. LL i ±i�f3� d•I 10. Debts of Decedent,Mortgage'Liabilities,and Liens(Schedule 1). .... ... ... ... 10. i� L 1'I��;��J. � J 11. �� / 3 ' (total ) ... .. .... .... ... .... `S 9 -- -il 12. Net Vallue of Estate(L ne 8 minus Line 11) .... ... . .... .... .... ... .... ... 12. UUL-11 _g%� 8J of �3i� 13• an Charitable an election t tl Governmental ax has not be Bequests/Sec made(Schedule J) rusts for which 13. 1 I 1 JI I Q 14. Net Value Subject to Tax(Line 12 minus Line 13) . . ... .... .... .... ... .... 14. a OJ I b III a•�3 _E TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATESo(� 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(1.2)X.0 115 �� _ ----4444--4iil`"• r. 16. Amount of Line 14 taxable at lineal rate X.0-q5 16. 16. x 6 2J� ,.�� 17. Amount of Line 14 taxable at sibling rate X.12 J J , ,J+ 17. 18. Amount of Line 14 taxable at collateral rate X.15 �� `� 0 18 19. TAX DUE . ... .... ... ... ...... .... .,. .... . .... ....... .... .... ........ . 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p Side 2 1505610105 1505610105 J COMMONWEALTH OF PENNSYLVANIA REV-1162 EX01-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 - HARRISBURG,PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 017871 BROWN CLIFFORD R 206 ASBURY DRIVE MECHANICSBURG, PA 17055 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- fold 101 $8,550.00 ESTATE INFORMATION: SSN: FILE NUMBER: 2113-0544 DECEDENT NAME: BROWN LOUISE B DATE OF PAYMENT: 07/12/2013 POSTMARK DATE: 07/11/2013 COUNTY: CUMBERLAND DATE OF DEATH: 04/15/2013 TOTAL AMOUNT PAID: $8,550.00 REMARKS: RECEIPT TO ATTY CHECK# 101 INITIALS: WZ SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS TAXPAYER REV-1500 EX Page 3 File Number 2,1^ Decedent's Complete Address: DECEDENT'S NAME I.pUIsr 13, l3�pWnl STREETADDRESS 01 06 45:6ut-y 1>421Vr CITY M6CHA1VjC58uPG STATE IP 17DSS- Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 1 .7, (�6Qf, g 7 2. Credits/Payments p ��• DD A.Prior Payments p. B.Discount L/ 0•00 Total Credits(A+B) (2) C/ DOD• �� 3. Interest (3) 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2,Line 20 to request a refund. (4) 0 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) ' .3, 6 6 9.9 7 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred:.......................................................................................... El N b. retain the right to designate who shall use the property transferred or its income;............................................ El c. retain a reversionary interest;or.......................................................................................................................... ❑ d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ 2. If death occurred after Dec. 12, 1982,did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................................. El 3. Did decedent own an"in trust for"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 designation? ........................................................................................................................ ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after 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 does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, 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 decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S.§9116(1.2)[72 P.S.§9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's 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. r � REV 1503 EX+(6-98) SCMEDVLE B COMN�NWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT - ESTATE OF FILE NUMBER �-au!S F 3. ��ou�� 2 i- i,� _.S-yy All property jointly-owned wtth right of survivorship must be disclosed on Scheduk F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ,. �I �hax�s e�' Common �f a�k eP lY��'L��c h; ti f3L.�� low �3l0•0► � �7�,8�" �: 2 = �ve. ��b.43 � �6s.03 � �5l.G 1r��Na�jorl �1�GJ �t�tjK�J _. �• R �C W�a l� /Yl an4 e n►�nt �. �/o. 3�t-b-39G�. . 9 , l � . CiX°.0 ✓�t�iN�hon3 MtA� Ca�Ca�4�ion Shts! cf.�'�e.ar, c�g3� Z7•Z• �i7 � TOTAL(Also enter on line 2,Recapitulation) s a y y, 331, �O (If more space is needed,insert additional sheets of the same size) anc� Weather a�mes Grc�as l�.�s��e 3 Scr�� '�ickr �tebi3� I tvtor� FI'k3T1c:e Yahoo Originals CNBC °..-----..,� � _........_........_..............._.._.._.................._.._..................._._...._......_.._.....__._......_......_............__.........._.... s��trl�a�ir�.�r.r.;Y �t�'i�Yets AAai) .Nov t 5,2013.6:5TAM E3T-US Markets opsn in 33 mins , r.wr .v.....,u..uuvcay »v.�v Rv � p� Iii � r` �. . - ��f �. , _,, . : �. ��r :�� . ;� : :..... .._................_....._... .._..._.. � � -E,..MW�,lOINMfKfltO �....i._....................................._.. M@�f@,�f1C.(MET�-NYSE �'Follow ; Add to Portfalio: Li(t* �6 _. ........._ 51.�� Nov 14,4:02PM EST 1 Pre-Market:51.39 0.00(0.00°�6)8:41AM EST-Nasdaq Real Time Price Hfstorical Prices c�H��,.s�:�µ�""��'� ; S�Date Range Daiy sartwte: :�pr,��:� �i� �oi3��'Eg.J�1,20�0 �weekN End Dab �! . �; 15�� 2013 : ��y �� , ... �...,_v �Dividends Oniy �P�t!C��.. First�Previaus�Next�Last € Prices � � f Date Open High Low � Close Volume Adj Close' Apr 15,2013 36.61 36. 36.01 36.04 9,408,600 35.39 * pric:e adju dlvide�ds and splits. . . � First�Previous(Next�Last �oo,��d ta Sp�a�� 34.�4 + 3b.o1 - c�, CuRency in USD. ��.SS� 2 = 3��43 � 2l � �b=5y o,� s ��r ,�{q� �� .f �#� i h � z�`� k��^. . ;.%:'`.�:. ..'i � o:iY . �•s�R�� ' �i��:..._:. ' �� ).4k:Aw '�'7r>1°:i_ r�; � �; ��C '�e�l�k� ��rta � �e�� . s � �'�"' \� ' 4 . ��,� \� �vv��. ,�,� � � .� ,,�,. � �� „ . �'� �� n°,3�:�.a�""" � Account Workbook P�e� �� 3!1-�6a 10 Buenced Orowth Pendtnp Bal 1,461.Z0 7ob1 A�t Valw 2�3,7T3 � CSl 03 07 2 po�tfoNo Ysl �7Ts IYffiS LOUISL 8 BROWN 9ws�p 7RAAXX MM��alsrto� 1,461.Z0 Furxk M►otteble 1,4d1.Z0 400 ABOWlY ORtVL Home 7i7Rd�-�67T Fed Cell N�CHANiCa8UR0 PA 170.55•4303 : ' • 1.� �n Oue 4�4 . 9 ' S __ , L � , . 1 1 � N3 ANIA , 6 �� t 84T.11 7 ..�,_ 4 .? � N A , � � � .Os ' - ---_�.�_ � N 4 �°�,��= � ��l ��«7��? � �. ,. n a .. J :a .. .. .. � . .. , Y �. o • �, � , , � � � ; o �.✓ .. '�l Q 9 !^ � � ` .. ^ ;� t.'^ 1: � g � n �- on �� _�r _. ... . �.. � �i � a f � G • �,� . � j � sn� . � r �✓ c� ' �C" . ° t, =;;- 'i �� S � 1' }.: O i !. �/ L:. � 7 (�? � 1 p n 1 1/ � i � `%h ' , . / o f� �l �. �«�w��•..oww..w��w br��«��.�a�n�o�w�..a�o�.�a wouen aec wo.�nMw,.�.mw,a�Won o1ReC WpNr NUrM�b.LLC,a�.�eK NY�'C„a s�pphm�n{q(MOn�n�ppod bl►1►a�+�11u PApN in�W!�oblNn�d IFa��ouroea we eOMkNt(�bul m nat pu�h�d, �'�� 6£Zb-bZt (L6L) �uawa6eu¢W y�leaM J6Li Wd 15�Z0 LO-��O-£lOZ RE{h1508IX+(1-Y� , SCHEDULE E COMMOMNEALTHOFPENNSYLVANIA CASH, BANK DEPOSITS, &MISC. "'�';""�T��" PERSONAL PROPERTY � ESTATE OF FILE NUMBER Lot,t,lsE '�3, Bnn�Jn� �i-�,�-�yy Indut�the prooeeds of litigation and the dafie tl�e prooeeds were received by the estate.Ap property jointly-owned with the�ight of sunivorship must be disclaed on 8chedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. � �L�1+►� C�t�'•k� IQ�VGrSo�►rcG �.or1g Tctn�► Co►r'G sur, f��rsp� o0 �' RG�'r,n�1 GhtCk� �yU''Sou�a lo� Tt+�► Ceu� �n5�tr- f�oo.00 k TOTAL(Also e.nter on line 5,Recapitulation) s ,� T S�• �� (If more space is needed,insert additionai sheets of the s�ne size) REV-1510 EX+(08-09) �► pennsylvania- SCHEDULE G .. DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DKEDENT • ESTATE Of FILE NUMBER �.ou.iSL= �8. �3RocJ� 2�- �3-S'�� This schedule must be completed and filed if the answer to any of questions i through 4 on page three of the RE11-1500 is yes. �M DESCRIP;TION OF PROPERTY DATE OF DEATH 96 OF DECD'S D(CLUSION TAXABLE INWIDE TNE NAME OF THE TRMlS�2EE,THQR R9JITIONSHtP TO DEC�ENT AND NUMBER nre a►�oF�.�rrr,va�corr oFn�o�v r�r�u.�sr��. VALUE OF ASSEf INTEREST � V�iLUE i. TRI� �'. Nv. .�11- 639`l a,f RBC Weat� hfl ct�a�� P�► fi L'l��r�l R. �re c�rn h ks b a�l 1 a s. Sz 1 oax -��- �xS.Sz � - TOTAL(Also enter on Line 7,Recapitulation) $ � 2 5.S� If more space is needed,use additional sheets of paper of the same size. , , REV 1511 EXt(10-06) . SCNEDULE i�l coMMOr�wEa,.ni o�PErvNSnvannn FUNERAL EXPENSES& INHERITANCE TAX RETURN ADMIN�STRATIVE COSTS RESIDENT DECEDENT ESTA'�E OF ��s E B. $RO GtJ,A� FILE NUMBER �yy �1-13— Debts of decedeM must be reported on Schedu{e L ITEM NUMBER DESCRIPTION ��T A. FUNERAL EXPENSES: 1. �a.�anc.c d�� r G� bsa�- �o!/�n9w �rtn�,r�.l Ho/►1� 7 93. Z 7 �. �'un�•-a I �►�ner c�F PeiPP�'' m;11 �e�'aurant '`a 7a.o0 ISCG Tu/1 E�I 6 i•I� Q�'I d rY1�.M 0 dt.�/�t.I'1��. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions -- Name of Personal Representative(s) C��r�d IZ. ��pw h �Q'�y�� Street Address �� /��►r y �Dr�Ve . City ��qr1►CS�urA � State pA Zip �?D5� � Year(s)Commission Paid: 2. Attomey Fees �.+n4;r� � • O��G�� i �qG' Z� 3. Family Exempfion:(If decedenYs address is not�he same as daimant's,attach explanation) Gaimant ND ON�' /S /Y!r4/�//VG �� CL��/11 /VDNE Street Address ��y Shate . rp Relationship of Ciaimant to Decedent 4. Probate Fees ptl in� ►'iS� 5�+vrt �:¢i'7�� i h �� .�� , a , � 5. AcxountanYs Fees � . ►►�,� w�l, �.s�,� .f d.fi, p,�p�o�' to��, 3So.� 6. Tax Retum Preparer's Fees PA' ��• �• I'¢d�verf'i si i h Car/;s�e �Ln f i ne� � f "9 . I 4 7,o!v �- �dvert�si in �li,n�bu,land ��w ,To�r��/ � '`7�S:o� "� 9. ,�d��fi oN./ pr�o,Gat� �ee ��ajOr 4� • • /�, Fi��n f�;sclaimer � lQ �S�'tx o� �v��l�S '` .00 � � s ��• /�e;n,bKrstrncn�s � G�b�s.E. Sh��lds � �r p1,�l��opies, Po�� onJ d�s�. �.a�l�� e�• (ts�in�.� (�ste�,�':�.�be�� 3•�•�� TOTAL(Also eAter on line 9,Recapitulation) S �� 3 ZL�� b 3 (If more space is needed,insert additional sheets of the same size) I � f � �. s� �r. .�.___._�_.._.. .._____. � �S� o F L,au1 sF._t3. 8,�ow�J�__._-_.__.__ .___.__. .___�it,F�o.Z/�/�'—�y.�.� � . _._.__ �-_��.1a1.�.J� e,�tc�.-��.� l�i! ,��=��,' �. �...____-Y-- . .��Cl�aa,,� . ______.�.___.__��. �.__ �._.____�______ _____ ___�_..� -- - -_.__.__ _ ��0 9 eq �_�.__..�..._� _ �•� �3 .__�._.�..�_ ��_ _ _ _._. o f�.3p - � __ _ ____�,CL�..._--_�- __.___: _____. __ .�______ .. _9��_ ___...___.�. ___._.�.______._._______ ___,._____._�._______.__.___._.______._�, _________.� ___ �;-_--__.. ___..___�__ s ____�.�...._.�.__�_____ �___._.�.w..�_________._______�.._.____.___._______�._.__�..�_--- RECEIPT FOR PAYMENT - ------------------- ------------------- GLENDA FARNER STRASBAUGH Receipt Date: 5/10 2013 Cumberland County - Register Of Wills Rece�pt Time: 13 : 7:52 One Courthouse Square Receipt No. : 1074166 Carlisle, PA 17613 BROWN LOUISE B Estate File No. : 2013-00544 Paid By Remarks: ATTY CHARLES E SHIELDS III WZ ---------------------�--- Receipt Distribution , ------------------------ Fee/Tax Description Payment Amount Payee Name PETITION LTRS TEST 90 .00 CUMBERLAND COUNTY GENERAL FUN� WILL 15 .00 CUMBERLAND COUNTY GENERAL FUN SHORT CERTIFICATE 25. 00 CUMBERLAND COUNTY GENERAL FUN JCS FEE 23 .50 BUREAU OF RECEIPTS & CNTR M.D AUTOMATION FEE 5 .00 CUMBERLAND COUNTY GENER.AL FUN INH TAX RETURN � 15 . 00 CUMBERliAND COUNTY GENER.AL FUN INVENTORY 15 .00 CUMBERLAND� COUNTY GENER�L FUN Check# 1883 $188 .50 ; � Total Received. . . . . . . . . $188 .50 s - �� m�'�>. t4. ��- � '� �� '~ � - �� . aka,.� i � � � j r�� - f +��I��'��1 ��1r�-�� '#v� �� H�:.� � " � k �, ° :��' � ' � =-�n�I..Ha�ling�r ,�� `,�a� �s�� ' ,,, ��#�. �c�,�� ,� � -' -�rb��J 4#�1` �' S� * � s-, r� ` � x �� 4 ,r � - p A.N}� � � �g tt t f � k �Y _ !. 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RESIDENT DECEDENT ESTATE OF FILE NUMBER l.at�I5�" 8. �R.�w� ,2 I- �3-SS�� Report debts incurted by the decedent prior to death which rsmained unpaid as of the date of death�including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Cr'C�Lx - �t�any �h�c�ma �35�. 3.S' � .�. i¢q/•1i�ioilal 4S�c p�Lm u�`a,� �son1 �vS.{� � $�rtn �/i�/l �(� �•316 �° r -�- CCD?X- �Bc�i.�a �ar�t� ��i�. f�9 . y `y R TOTAL(Also enter on line 10,Recapitulation) s V��. itd (If more space is needed,insert additional sheets of the same size) . � REV-t513 EX+(11-08) . � pennsylvania SCHEDULE � DEPARTMENT OF REVENUE INHERITANCE TAX RETURN . BENEFICIARIES � RESIDENT DECEDENT � ESTATE pF , FILE NUMBER �du�sEB.��owa �i-,3-s'y� � � RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEMNG PROPERTY Do Not List Trust (s) OF ESTAT� I TAXABLE DISTRIBUTIONS[Include outright spousa)distributions and transfers under Sec.2116(a)(1.2).] ' � 1. C 1:f�r� R l3 rot�tl , , , S�Oousa Li�t ihtCnesf l�cs a� /�sbNr �r,rc, �I�c.�han�csbu ,.1�i4 . . . � �t7o3's` . c�,s�.�1a•n�e d (see d:scla i M� a�a�hed� -- o — . a. T��y �. �� I0632. Nar poon N�11, Cv�u,mb�a� �hD �1oyy sG►� yoZ �� tCCt�cn�"ed � rr,�si d ue 1�'' . �s e/a;tne r �. �� n n t��fr . da ht�.�' . y `� Yx of �ccelcr�t�r,1 02 opfr �Iden �r,y� res�d uc c�' : p S�a,�-}, A�b� 1'on Tw�., P� I g�� d;s�J��m�r-. � . ENTER DULtAR AMOUMTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. II NON TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 2113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN 1. . B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS I. TOTAL OF PART II—ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed,insert additional sheets of the same size. f •. . : - � . � . LAST AND TESTAMENr OF E B.BRQWN � I,LOUISE B.BROWN,of t6e Bomough of Mechanicsburg,(�mberland County, pennsylvania,declaYe this�o be my last Will,heaeby re�rolong all p�iar wills and c�odicls. �,T: 'Ihe expenses of my last illness and funeral shall be p�d iroan my estate. ��: I hereby give a�d boqueath,absoluuly and in fee simple,to my spouse,CI.IFFORD R BROWN,�my nou�no�a�a��a��,booa�,�, jewelry,silveawarc,suLomoblles,weazing aPP�'el and aIl other articks of household ar pasonal use a�adommeat,Pro�vidod that if mY spouse dies befaa�ee tl�tLirtietb(30t6)day f�llowing the day of my death,this gift shall lapst ar be divesood and I make said boquast�my 9on,TERRY R BROWN,and my daughtcr SUE A.PETRY,or,in the cvcnt eid�r ar both�them pz�clocxase me, d�eir issue,Per s�rpes,living at the t�me of my death,t�be dividod among them as tlxy shall agrce. If thty cannot agree for any reason,then these it�ems shall be sold at pablic auctLOn,my issuc bcing peanitted to bid upon such items widaut spocific paarission of the conR cvea though thCy might be a fiducimy at the time. � My Facocuoo�shall rq�sent any minor child in any divis�ion af such p�+opetty and shall deliver to the prxson standing in the place af a par�t to such m�no�,without bond.s�eh portion of the mino�r's shai+e as my F�cecutor,afoe�r considering the minar's wishes,d�odns appropria�e aad shall scll the balanoe aad pay the pr0000ds�o my Tnutoes�be raainod foc the mino�under Itan SE:1�:NTH h�reof. �p; Slyould I so dasire,I will mak+e a se�s o� specific bequats to spocific individuals on a plain piax of p�pe,z to be signod and dated by me and to be inserooci with ihis,my Last Will a�Testament �; 1he gift to my spouse u►this Ite�m is inux�ed m give my estate the marital d�oductian effaxive undcr the InLenoal Revtnue C�ode�rod�oe Fod+t�al estate tax, Any provisivns in this Will which oonfli�ct with or fail of this inteation shail be so , . • . . , . reoonciled ar amplified as w a�cx;amplish this objective. If my spouse,CLIFFORD R BROWN,smvives me,I direct that my Trus�ees, hcreinaftea nam,od,ho1d,IN TRUST,an annount fi+oe�of all tax�es oqual tio tht ma�d�m marital doducdon allowabde to my cstate far Foderal estatc tax puzpos�,itducod by an amount,if anY, neoded m incrcase my taxable esta�e�the l�rgest amount that after allowing far the imified c�it � ana any ochcr crodits available to my es�u,a►;u re�lc in no Foderal est�e ta�c,ar,a pay the na _ invome thea+efr�m not less frequendy than quar�crly�o my spou9e far lifa My spouse shall have pawc�r to appaint all o�any pa�t o�parts of the principal of this Trust m himself o9r a class co�mposed of the issue�myself and my spouse. This pov�rer shall be exercisocl by him aloc�and in all cveuts by s�pocific refarnoc thcr+cw in ht�r Will,ar by dclivery at any tim�ar times during his lifctimc of a written diroction to my Tivstees who shall tharatpon make paymant as he dirocts. My Tn�oc shall pay�hi:s pelsonal n�ntativcs from any unappointod principal the differ�x�e betwcea all t�uces,interest and penalaes which tt�eY must PaY bY reason of . his death and those whi�ch would be payable by the�a if sucb unappainud p�incip�l wrr�e not taxable in his estate and shall add the balance of such unappoicztiod pcincip�il�o mY r�idua�tY Trast. �: I give�devise the res�due of my�state,real and personal, to my Trnstee hemanaf�er named,IN TRUST,as follaws: (a) T6e net inconie t6erefrom shall be paid�o my spouse,Q.IFFORD R BROWN,for life. (b) MY spouse shall have the pawer tn appoint to hims�lf up to tLe gre�tter amount of five pei+ceat(596)�$5,000 aimually from the principal of the�duu3►uust under this Ium. This power of appointiment shall be noncumulative and may be e�cerci.SOd durin$mY spcwse's lifetime only by him 8ivinS t6t Trustx�dirocdon od�r than by his WilL (c) Upon the death of my spouse,�in the ovc�nt mY SP��P�� me,my cstau shall be distribu�od as follows: C) All the�st,residue and remainde�of my estate shall be dividod inm two oqual shares,and one share shall be paid to my son,TERRY R BROWN,and the othGr share s1�all be paid o�my daughur SITE A.PETRY. In the event�ittx�of my afo�+esaid child�n shauld predecease the survivo�of my spouse ac�d me,hisJhGC'share shall be paid m hislht�'s�urviving � . . . iss�e,�t�,or in default of such issue,shall be paid to my rcnnaining child,ar to that child's surviving issue,FgI�t1i�as the case may be. ('ii) If no issne of my cluldctin smvive the surviva of my said spoust and mysel� the rcmaining undistrib�ed principal and ac.cumulated incane shall be divided in�t�w�o equal sha�es and one share shall be paid to my h�irs who waild be cntidod t6ere�o�the In�estate Laws of P+annsylvania in effect at the death of the s�nviv�af mysclf and my spouse;and the othrr share s6all be paid to my spoase's heirs who would be e,ntitled the�e�under the Int�Le Laws of P+e�nsylvania in effect at the death of the survivor of myself and my spouse as if my spous�e hsd thcn died Intcstau. �: T�may usc principal of the aust�mder Itcm FOURTH hc,c+oo�(Marital Doduction Tn�st)only far the benefit of my spou5e. With the � foregoing exception my Trusooe may use principal froan the uust ucdu Itean FIFI'H he�oof (Residuc Ttust)fo�the bene�t of my spouse and issue as that Trustoe d�oems nxes.Sary: (a) To moet the expense of any accident,illness ar o�her cmc18�Y�g any of thes� (b) Far maintenanve,suppart and education('including oollegc and gradua�e school); . (c) To pay funeral cxpenses,inclu�ding the oost of a grave marker and perpewal care of the grave. AnY p�incipal used f�the benefit of my i�e shall be c�rgad as an advanoe�nent from his�her family's share of the uust Fmthe,r,any invasion on behalf of any iss�e caimot exvood the amount that would be allocatod to his or her family's share of such trust Notwithstanding the fa�egoing,the powcr to con�me,invade o�aP�op�ia�e propGrty far the benefit of my spouse a�issue sLall tie limitai by asoertainabk standaid relating to health,odwcation,support ac m�inttnance within the meaning of subparagaraph(a)of Socx�oa 2041(b)(1)of the Int�mal Revenue Code of 1954 ar any similarprnvision which may be in effect at the time of my death so that such po�w�will not oonstitu�c a ge�ral p�w�cr of ap�poinm�a►t � ��r.�-�� r , � � �: I aPPo�t m3+Trnstoe as Guardisn�o ho�d far minors all p�op�rty payable by law to a gua=dian appointied by my Will and use the same fo�'t6e minor's mainunanve and education,eith�r directly o�bY PaY�t Lo any person 9elcctod�o disburse it,whosc roctipt s�hall be a campkte acquitt�xx thaef� All unexpaidod inc�ome and principal shall be paid to the min�at majority. Foz purposes of this Will,majarity sball be constniod to be whcn the individual attains the age of tweaty-fivc�(2.�Years. �j; No provision of this Will is inua�od to e�rcise any p�wer�appainanent,including any powtr of appoinm�ant gnanoed Lo me bY mY spouse's esta�e planning ar�htr documents. � �; All ta�ces,in�crrst and pcnaldes dit,�+eon paYabk bY rcason of my dcath with respoct m property comPrising mY gi+oss estatic,whed�r ar not � passing under this Will,shall be p�aid fron�the psincipal uf my residuary estate undar Item FIHTH C.1.,provided howcve�,that fiuids of my Tivst crcatod hexcin may be usod m pay ta�ces,interest and penaltics ataibutod m such uust assets. �: No in�st of any b�nGficiary und�r this Will or any cadicil heatm shall bc subjoct tp ant�cipation or voluntary or imroluntary alie�ation,and thc pasonal roocipt o�such beaeficiary shall be t�sufficieat and only discharge a�my Exocutor and Trustee unless otheswise p=+�v�d�ed heiein In��to powe�s given t6un by law,my Execura and Tivs�oe and t�ir suooesso�s and anY Suaidian acting hcramder shall have the � following discnetionary powcrs applicable�all r+eal and personal p�roperty held bY them,tffoctive without voiut oi+der and until actual distribution: (a) To retain all propeacy roeaivod by th�n ineluding the soodc af anY oapas�e fiduciary a�cting haeunder,p�+ovided s�ch P�tY�P�`�e; (b) To urvest in all fams of pivperty widiout resuictiaa Lo invesan�nts authociud to f duciari�s,so long as such invesm�nts ar+e pioducave� (c) To jain in any inca�poration,partr�crshiP,rxaPitalizatiou,mtr'8a. reocganization ar voting avst plan;m delcgat�c authaity with raspect tha+e�o;tio�t invesdments ' � . ��tsk� � � i . . � . . . � . u�drr agrocnne�ts and pay assessments;and gea�erally m exa�cise all rights of uivesoo�s;. (d) To c�ono�rnmisc conn�avessies; (e) To eacchange o�sell for cash,property ar crodit,publicly ar privately,v�to lease,even far a t�m caccoeding five(S�Years or the duration af the uusts hea+eundea,without liabifity on thc pun:ha�rs or kssces to soc tiu applu;�tian of d�vo�nsiclaration,and to give o�ns far the.se purposes without obfigation m r�pu�diate them in fava of a highta offea; (� With respect to my residuary avst u�er Iuan FgTH hereof,to alloc�e it�os of raxipt or disbu�stment betv�xn i�co�me and pri�ip�l as t6�y doem oquitabk ragaidkss o� the chara�cter givea snch iums by law; (g) To apply i�anne ar p�incipal m which au3r bcnefiaiary is cntitlod directly far his ac her maintrnance and suppo�t should th�y doem such bcanefi�ciary inc�pabie of recxiving the same by reason of age,illness ar any infimaity ar i�capacity,ar m pay the sam�� such pesson as they seloct t�disburse it,whose rocxipt shall be a c�omplete aoquivanoe therefor, - without the inteavention of any guaidian: (h) To ba�row monCy,including thc right�o boaow fiom any co�potstc . fid�iary a�cting h�,and mortSage ur plodge as security; (i) To hold investments in the name of a nomino� (j) To distirib�te in cash ar land vr pffitly in each at valuations fi�ced by them: (k) To assume vontinuance of the staws af any bcneficiary wid►r�fennoe m marriage,div�+ce,illness,incaPa�city o�othcr change in the absen�ve of info�rnation deemed reliable without liability far disbursements made on such assvm�ptian; (1) To clect m value my$vss estate far Tockral estate tax purposes as of t6e date�£ my d�ath or as of die alt�mate valuation da�e as allowed far such purposes,and�u claim as inoo�ne tax deductivns expensss that woutid otherwise qualify as estate tax dodiiction aad othGr eloctians allowable under law; , , , . . • , � • (m) Except to the extent necessary in ozd�r that the t�rnst und�r Item FOURIH he�of 9ualifY for d�e marital dod�allowabk imder the Internal Revenue Code,it shall not ba na;essmy to scgrega�e invesmn�nts as belaiging Lo a p�rdcular wst oa�sharc thcaein and all intertsts may be held in undivided farm in a single f�nd frnnn which p�+opationate distrib�t�ons are � made basod on currcnt rca�raisals; (n) To mergc any similar tnist cstablished bY mY spovse where the terms of the same are identical; (o) To make incomc ar principal distributions during the coius�of admini�ration o�my est�e oz uust Grca�ed hes+eu�r; (p) In the event d�at:I am thc bc�acficiary�a qualifiod uznninal interest avst and the same is taxable in my esta�e,I d'a+ect that my Faceeutor shall soelc r�imb�nsd�t fran said uust f�all taxes due by my estate boc�use of the inclt�ion of such trust in my estate,sald comp�utation of taxes due t�be comp�ud by taldng ta�ces owed by my es�e and suc�pr�perty includcd thcrein as ca�ared to the taxes my estate waild owe in the event said pro�rty wa+e not ta�cabl,e ia my e.state;and (c� To undatalae any and all acts d�oemed n�ecessary and pzo�p�r by it fac the proper and advantago�us n�anagement of any trust and the settiement a�my estate. �j,r'j�; No fiduciary who is a baxficiary of my �y trnst creatod in Item FIFTH ha�oof shall paiticipa�e in the exe�+cise of any di�ztio�nary powcr m nsc the principal thGroof for the benefit of any prrson ac�o apportion ac allocate i�m.s o� cliarge vr c,�cdit betw�oen prin�cipal and income of such trust Additionally,no fiduciary named herein shall par�icipate in any discretionary decision to invade ar use tla�princ.�ipal of any trast hrreby cx�eatod far his�lha benefit ar far the bcne�it af hislha'issue and in addition no fiduciary► named�wnd�shall enttr into any r+ociprocal�'ang�t with any ot�r fiduciary�mmloe such discrctionary disuibUtions. No fiduciary named herein shall have aay powGr with regaid�o the a�dminisastion�a tr�st creatod hereundez'if such powa would cause the t�nst m be n�cl�dibl�in his or her estatc fos fcdual e�ate t�u�Purposes. ��Ii� Any person,othe�than mY SPouse, who shaIl have died within thirty(30)days�my death,shall be d�cmcd to have prodooeasod me. � , , . . ' . - - �my spoos�e and i a�s��oo�y,��n ' �ct��r��a�ns cannot be escablished by pmoof,mY spouse shall be decmod t�have s�nvived�. AnY P�� (other than mysel fl who sball have diod at the same tune as any then roc�t of inco�e o�in a . . c�non disast,�r with such beneficiary,os imder such cinumstances t�at it is difficult or imp�ssible to determine who diod first,shall bc docmod m have pcndooeasod I appoint my spouse,C�.IFFORD R. BROWN,as Executrix of and as Tivstoc un�r�is my Will. In the�vent my said spcw�c cannot act ar continue�o aat as F�cecutri�c and/ar Trustee for any reason,I appoint my eon TERRY R BROWN and daughur SLJE A.PETRY,m act in his plaoc. No fid�ciary scting h�eund�r shall be required to post t�ond ac eaur socurity in any jur'isaicd«l. BQ.1�.E�= MY CarPotal�F�iary,if any,shall � receive campensation for thc perfamance af its functions her�under in a�^o°�da°°�with its Schodulc of Fees in effoct fram time�tim�during the period aver which its se�vices ar+e P��- The siws of the ttvsts establistxd hCreundcr shall be oonsidea+ed to be in CY�mbr,�iand County,PrnnsYlvania. IN WTI'NESS WHEREOF,I have hereunto sct my hand and seal ttds�t��y of I:�l.v 1996__,Lo this and thc pTeceding � pages,and I have also placed my initials on each p�c�ding P�ge far bet�idcntific�tion and g�eatcr socurity. � f (SEAL) LO E B.BROWN ' C�iG Q�� i�o� * '�1-- �l��iG;(N � �Q,�,�,j Q./�G� �� .. � . r. , � � . . . " " - SIGNED,SEALED,PiJBLISHED and DECLARID by the abwe-named Tes�r, LOiTISE B.BROWN,as a�fQ his Last Will and Testament,in thc prescncx of ns,wl�at his request,in his presenoe and in the p�+esence of each other,have here.�mto subscribed our names as wimesses. � ��p�w1 � � `��.��n�,�.a , � In Re: Estate of Louise B�Brown : IN THE COURT OF COMMON PLEAS OF a.k.a.Kathryn Louise Brown, : CUMBERLAND COUNTY,PENNSYLVANIA Deceased,Late of Lower Allen . Township,Cumberland County, : DOCKET NO.21-13-0544 Pennsylvania = � • ORPHANS' COUR�'DIVISION,/.�; . : REGISTER OF WILL.� `^�' � w � C"t r_�, t°g3 � �•-� t�1 {,�' U �_.. ::.- ,�"-: °—i :r"Yc i� N �;� tsj DISCLAIMER IN ACCORDANCE WITH 20 Pa.C.S.� �-6�01 :'� �<< �� ... . , . � �� . '� ;..j --�•� _ . _ .,,� �� „i `, :_...: N �+ �y '�` l�e on l. . Louise B.Brown,also known as Kathryn Louise Brown,de�i�arted'sre�rth� � April 15,2013,at Bethany Village Retirement Center,Mechanicsburg,Cumberland C�tnty, , Pennsylvania. � 2, Decedent was survived by her widower,Clifford R.Brown,of 206 Asbury Drive, Mechanicsburg,Cumberland County S Pennsylvania 17055. � 3. Decedent'�probate estate consisted primarily of an account held in her single name at RBC Wealth Management composed of assorted stock and bond funds having a total current date of death value of$293,773.00. Additional small amounts of monies were received as partial refunds and reimbursements on various expense and credit aecounts held by decedent in her name alone. 4. Decedent also owned assorted entireties property,primarily composed of household furnishings and the like,none of which are directly relevant to this disclaimer. 5. The probate estate is subject to the payment of inheritance taxes,costs,fees,.expenses and debts. The said probate estate is well more than sufficient to bear the payment of the same with no danger of insolvency. 6. Decedent's widower is not indigent,necessitous nor impoverished and has sufficient means and property of his own to comfortably maintain himself in the stylz to which he is accustomed. 7. Letters Testamenta�y were duly and properly granted to the said Clifford R.Brown by the Register o_f Wills in and for Cumberland County on the 10 day of May 2013. 8. Under the terms of decedent's duly grobated Last Will and Testament dated the 6`�day of March 1996(a true and correct copy of which is attached hereto and made a part hereo�,most particularly Items FOURT�I and FIFTH af the said Will provide for the ultimate creation of a Credit Shelter Residuary Trust,which,inter alia,holds and administers decedent s probate assets for the benefit of her said widower for and during his natural life,prov.iding for the payment of the net income Page 1 therefrom to hirn,as well as�a limited power of appointment most commonly referred to as a"Five and Five Power." � 9. Item FIFI'H subparagraph(c),et seq•,provides that upon the death of decedent's said widower,the balance and residue then remaining is to be divided into two(2)equal shares and distributed to decedent's two(2)children,to wit:TERRY R.BROWN,currently of 10632 Harpoon Hill,Columbia,Maryland 21044 and SUE A.PETRY,currently of 2008 Elden Drive,South Abington Township,Pennsylvania 18411,both of whom survived and continue to survive decedent. 10. Both of the aforesaid residuary benefciaries are adult individuals and are com os mentis. Both of them have made or are in the process of making arrangements with Mark Snyder of RBC Wealth Management for the holding and/or transfer or the partial holding andlor transfer in kind or in cash of their respective shares or for the outright distribution of their respective shares,as the case . may be. . 11. Clifford R.Brown has accepted no benefits from the aforesaid assets including the said RBC Wealth Management Account,has exercised no dominion over the same,except in his capacity as Executor,and,in the event there have been any automatic credits of any kind or sort made or credited to or for his benefit in said RBC Wealth Management account,he has disgorged or shall disgorge all of the same back into the probate assets from whence they came,to the favo�of the said � two(2) residuary bene�ciaries. 12. Clifford R.Brown,in his capacity as decedent's surviving widower,and in his capacity as life tenant beneficiary of the aforesaid Credit Shelter Residuary Trust provided for in decedent's Last Will and Testament,desires to disclaim any and all of the above referred to probate assets of decedent. The operation of which disclaimer will deem him to be legally dead for the purposes of the distribution provided for in the said Last Will and Testament and result in the distribution of the balance of the same remaining after the payment of all death taxes,costs,fees,expenses and debts unto the said two(2)residuary beneficiaries. NOW THEREFORE,intending to be legally bound hereby,I,Clifford R.Brown,the unremarried widower of Louise B.Brown,also known as Kathryn Louise Brown,do hereby disclaim any and all interest in and to the aforesaid probate assets and any fruits thereof,to which I would otherwise have been entitled under the laws of the Commonwealth of Pennsylvania. I have hereunto set my hand and seal this day of � ,2013. . y j �� -�-d✓ . Wimess CLI ORD R. RO N Witness Page 2 COMMONWEALTH OF PENNSYLVArTIA ) ) SS: COUNTY OF CUMBERLAND ) � On this,the�L�'�day of �� ,2013,before me,the undersigned officer,personally appeared CLIFFORD R.BROWN,who being duly sworn according to law,deposes and says that the foregoing Disclaimer is his act and deed and that he desires the same to be recorded as such. IN WITNESS WHEREOF,I have hereunto set my hand and notarial seal the day and year aforesaid. / ,, . � Notary Public My commission expires: , , , (SEAL) (��NVVEA�fiH t�Pl�NNSYLY�t2A �Io�riai 5e�a► ��,K (;ti�C:�S E.��•� P'E�t�rt�;'iV�p•,a+mbertand GOURtY My C�r:m��une 20,2016 ��t�s�.��F�YI.vANIA ASS�TiON OF NOTARI�S Page 3