HomeMy WebLinkAbout04-03-14 __ _
� 1505610101
REV-1500 EX`�'_'�, °.:
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania
Bureau of Individual Taxes �""�'"`"' County�Code Year • File Numbe���
pINHERITANCE TAX RETURN n / fl /
PO BOX 28o6oi / 2
Harrisburg PA 1�128-0601 RESIDENT DECEDENT Q r�
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
07/25/2013 09/21/1942
DecedenYs Last Name Suffix DecedenYs First Name MI
OBERHOLSER KARL M
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
OBERHOLSER CONSTANCE L
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
202-36-6715 REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� 1.Original Return O 2.Supplemental Return O 3. Remainder Return(date of death
priorto 12-13-82)
p 4.Limited Estate O 4a.Future Interest Compromise(date of p 5. Federai Estate Tax Return Required
death after 12-12-82)
� 6. Decedent Died Testate O 7.Decedent Maintained a Living Trust � 8. Total Number of Safe Deposit Boxes ,
(Attach Copy of Will) (Attach Copy of Trust) o
R
O 9. Litigation Proceeds Received O 10.Spousal Poverty Credit(date of death O 11. E�tion to tax undg"Sec.�1�� �
between 12-31-91 and 1-1-95) (nGdc ch.O) ITI n, ;
�?—fr7 l9.—;
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONfIDENTIAL TAX INFORM N�OULD BE�CTE�O,�
Name Daytimet191 o�Num er --{ C7�'
� x,. r' � r�+
Andrew H. Shaw, Esquire (717)�3�1� w � �
cn �, a
R�eTS Q @�jWIL SE�`F-q
Q C �"� �'
� � r rrn
First line of address � --1 � � Q
200 S. Spring Garden St �' � �
Second line of address
Suite 11
City or Post Office State ZIP Code DATE FILED
Carlisle PA 17013
CorrespondenYs e-mail address: afiCll'@W d�aShaWIaW.COfII _
Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RE,SPO�BL�E F RJ�RETU�AI �� �9 DATE
l �J .�.f�,�i�l��, i^J �- 3/ - /�/
•L�tia,l
ADDRESS
112 Sholly Drive, Mecha � rg, PA 17055
SIGNATURE EPA R T A REPRESENTATIVE DATE /
ADDRESS
200 S. Spring Garden Street, Suite 11, Carlisle, PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
� 15�5610101 1505610101 J
�
� 1505610105
REV-1500 EX DecedenYs Social Security Number
�ecedenrs Name: Karl M. Oberholser � 199-32-1935 � �Y_
RECAPITULATION ._
1. Real Estate(Schedule A). ...... . .. . .. ..... .. .. . ... .. ..... .. .. . .. .... . 1.
0.00
2. Stocks and Bonds(Schedule B) . .. . ... ....... ...... .. ..... .. .. .. . ..... 2. ,
0.00 ;
.�_�e.. .��... . ...�.,.....��_.�.��
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) ..... 3. , 0.00 ;
4. Mort a es and Notes Receivable Schedule D 4. �.00
9 9 ( ) .. ......... .. .... .... ...... ���. ����_. �.,.� ��.� _......�_ a.,.._��.
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E).... .. . 5. 0.00 ,
6. Jointly Owned Property(Schedule F) O Separate Billing Requested .... ... 6. , 0.00 ;
�.._��. . .....�._m�.._m..m._�. __�.. �.�_�
7. Inter-�vos Transfers&Miscellaneous Non-Probate Property �
(Schedule G) O Separate Billing Requested........ 7. 107,710.21 ;
8. Total Gross Assets(total Lines 1 through 7).. . ....... .. .......... .. .. ... 8. , 107,710.21 ;
9. Funeral Expenses and Administrative Costs(Schedule H).. ........... . ..... 9. !, 753.50 i
10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule I) . .. .. .. .. ..... 10. ' 0.00 ',
11. Total Deductions(total Lines 9 and 10)..... .... ..... .. ............... .. 11. 753.50 ',
12. Net Value of Estate(Line 8 minus Line 11) . .......... .......... .. ....... 12. ' 106,956.71 ',
13. Charitabte and Governmental Bequests/Sec 9113 Trusts for which ��' �� ���� ������������ ����
an election to tax has not been made(Schedule J) .. ....... .. . .. .. .. ...... 13. i 0.00 ;
14. Net Value Subject to Tax(Line 12 minus Line 13) ...... ...... ........... . 14. ' 106,956.71 ',
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
_ . -- -- --- -� _.. _ ..__ _.r -. . ___ _._ -_ ___-__
transfers under Sec.9116 �� �� �� ���� � :
(a)(1.2)x.0 00 m� 106,956.71 ' �5.i 0.00
16. Amount of Line 14 taxable �������� �� ��� ������� � .���������y����� ��H����0.00 �
at lineal rate X.0�� ° 0.00 � 16.;
� ��......� �, �..� ��..�.. ��_._�s.��....._
17. Amount of Line 14 taxable 0.00 I � 0.00 .
at sibiing rate X.12 »• ;
.���_.��m� a._.�.�._ �����..���..
_�,_..J e��.__....�
18. Amount of Line 14 taxable � �m ��
at collateral rate X.15 I 0.00 � �g � 0.00 ;
_�_ -. _ _ __ . _ _.__.. ..
19. TAX DUE ........ .......... ... .. ... .. .... .. .. ... .. .. .. .... . ... 19.� __0.00 �
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT �
Side 2
� 1505610105 1505610],05 �
REV-1500 EX Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Karl M. Oberholser
STREETADDRESS
112 Sholly Drive
C�N STATEPA Z�P17055
Mechanicsburg
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 0.00
2. CreditslPayments 0.00
A.Prior Payments
B.Discount _ 0.00 0.00
------- Total Credits(A+B) (2)
3. Interest 0.00
(3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. 0.00
Fill in oval on Page 2,Line 20 to request a refund. �41
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.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 decedent make a transfer and: Yes No
a. retain the use or income of the property transferred:.......................................................................................... � �
b. retain the right to designate who shall use the property transferred or its income:............................................ ❑ �
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?.............................................................................................................. ❑ 0
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑ 0
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
containsa beneficiary designation? ........................................................................................................................ x❑ ❑
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
flling 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 decedenYs siblings is 12 percent[72 P.S.§9116(a)(1.3)].A sibling is deflned,under
Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
����� 4���� ��� ����������
��
iil�itt��P}?R.�-lUi.uER
�� �d[;'C'e.1.� {�lii.'ry�I`i,.x:�'�Jt�ii'�,i, ()�� �'�3};E'X' �i�.f:11 ��_�",%'�''Ilfii'Ili). L.���riE�crlancl �::��,.z��t�,�,
I�;-:3 i:�;':i'iVc131�%L.}..�(;��;.c�t)���±t�<<.Cl�X3aia ic.�:1.r1C��31S�3�J�1.�1�27IeI11`v'T."}'r L�i.tJ i]�ra I 1'i'u j1Z�� ::il:L?i::�::Y'i�iii i L�°
�?x (�1iS ;:lri?. .� }?�:`J(' E'l.11� C().il�lu�T1C:E': ��I11'� tTUSf ?Tl Iiljr ���fC� �:.?!.!i �7a�'l07'� .�C',i4"� �:rll'�;�i:. i(I ��.:5
cl�:ath ori �he cross for my sins and in His shed blood as an atonerrient for rny soul; aild !.
krat:�;�;b�,faith that because of�-Iis 5acrifice on the cross for me l ha�e�;t�rnal life, dc)i�=re►yy
rY;;�t:t, fl.:s 1�Ti11, hereby revoking all my fc�rnit.r Wzlls and i;ofiic�ls.
�'1,`�'3�IC,�.E i)?�,r,
���JI�.r iyS
.` �... ,ail i � 7 � i� '�(: ; ,'"C} 3R,�,��'. �z�t�'�t!�.�A'..2��.�. t)`� \,y�:J��,'� «�i
5 � �� E f.}F.;C�1.3l.:�2k,: li Yis� �.�.i'7.�T,'.i3f.i, x E;7 'll;l rC' } , _
�l�'I';11':lt1C•'iTj1tF):Zr�Ci)y�:Z�'i):f�Jlii�i?LLJII;T,S;i%0115+'..�l0if-�;1,at::��(�lt�"L'�rci1C'�!i..':'+i5{"!'?3�.;..,}i:±.lil'.i.. ,
. -
!,:,��.r�� :�<<��.�r:;btlr>s.jti�����e�r� ;�nc� r,eAsai.ai. f.'.�:��:.._A . C..na ._t.,,� c_ ,� ,. .F�.. � T .� , ,.� . ��.�c..� .x.. .t
,�, .�.� i.r , r � •} e.�";�,���
., ( ��ti. ti ) g� .l'V��,. �,`r ! P
/
1 � '1^, t';! .T�TCe�k���SL��� A...r.��ar�•�.�.1l�,' k'Y�.A� ��� �(` ! . . f
tF:;!.it,C3j �: i��!_�i,'��i, t�, �J.ILj�vvit.c' erc-t�, x � i:•d'��71��' , � •,i�ii1: Gi11`'%;\ `
jf " �y �il.f .x..F�.i i.�,%'� �'�.���tt t� ��lr. � � �.:is�:..�'.t.�t ���.i, ct�lSv t.�, �.�. r�.t :,�. ir.ii�li {i••Ji.ii� 1 .iJ.:.�� .:i��
! 't i - � ; �i't • i �'�a ( '1� �).', S '1�S' i'; �t,`;,''' {3.!`� �tr�;.i.t, {'�; C1:I,t: ir;1':+�)i.`a
���J;�, ui,.I�::l. iti:� .s iit�.Tiit 1';3:]t ii ,l, c:2 I'':t! t t. . zCi:r_,. 'o !.?i
.� ct � ��v 7 '� `tY ''' � :.�F� �F 1' � ;j '� � If,-�r �r• ( t t, j""�
±:��sa�;����.�;,� �. ,�,�3cs .:.�: �,�r�s�t:�t.t...�. �xi ,.��E- r_v.� t Ci��.. �c; i.il...3. � nzc..��.n iux_i i ��c;r.�.��a:tei�
L �_ � " ; 4 � ` ��� �-�� r et7�:i;11�±t1�1�E',:)IS�I�)ei:;0t��ll�L't'��erty of ctie n�lure
�•ri�,�n.;i�'i��n�'t�t�.l(:E;7+.ZE'tii,i:ai.:t ; �.:���i .
i'i:.�'C;;7:'.°.,C�t �':� 1.?1 '�lic> T;;i"(3r;L'�?.;�}1 Y�'itl.[}� i?%:V:=:` 11i)�: �?e;E';� Z.�E���.SCfP)i�.��".4 (U:' '_�.IS:.i"l�iLlrit?I1 1?1 S?1C�
�
's1`<,r,;, �E ._.,_,.:^�_..,.._.___.__.. �
" �
memorandum, I bequeath all such property to my children living at my death, to be divided
among them in as nearly equal shares as they agree. Iri the event of irreconcilable
disa�eement among n�y childre►:, they shal!take alternate tua•ns selectin�iridividual items
with rriy oldest child rriaking the first selection. Any items not sa selected shall be sold aiid
the proceeds shall pass as a part of my residuary estate.
§1.� To rhe extent practicable in the Eleci�.tor's solc,tliscretion, I beq�+t:ath
any policies of insuraiice on such property to the bene�iciary entitled to such properi��.
§1.3 I direct that tYie expenses of storing, packing, shipping, insuring and
delivering any such property to the beneficiary erztitled tYzereta shall be paid by the
��;cecutor as an administrative expense of my estate.
ARTICI,E TWO
RESIDUE
§2.1 � cievise a.rid bequeath aIl the r.esidLe of my �state to My Wife, if she
survives me. If she c?oes not survive me, i devise and bequeath all such assets to my issue
Lz.�'D2�.�`dt IT?�� r3eath, pF:Y stil•t��s; '3�'}��: sYaarA o�ans�he_ref�.r.,s'.arv und�r• tt�e ��;e ��.f twenty-ori�:
(�1) ye�rs shal� �i� _�eld in ��� ti�ued �rust :zi accc�r�a��ice x4-ith t�� �+rovisions of Axt�c�c>
Three Ilereof.
�, �'
a ,
.
- �,o� �, ____.___._...�._..__. _...
ARTICLE THREE
TRt1S1'FC)R BENE�ICIARY UNDER TWENT'Y-FiVL;YFARS OF AGE
��.1 Except.as otherwise may be provideJl iti chis W:11, if any beneficiary is
z>7;tii1�� �o receive a c�istri�tuti��i of��roperty from m� es�ate ox� xr.orr� ariy trust created by
this �%ill a�l� is under t�venry-o�ie (21) years Qf a�e, I cievise arld bequ�ath such property
�c� mv Trust�Q, hPreiri r.�.�ned, or l d'zrect t�i•at s�ach �x�anerty i�e held b�� rx:v Tru�teF� i�i
continued trust, as the case may be, for t'r1e benefit of such beneficiary, in trust, itl
accordance with the follow-ing provisions of this Article Tt�ree:
§3.1.1 VVhile each such beneficiaiy is uridez• eighte�n {18) yc�ars of'
age, the Trustee shall hold, rrianage, u�vest and reinvest trie trust property,
shall c.u;lect the incc�me thereof and sha11 apply r.o or for tf�e'aenefit af sizch
beneficia.ry se much of the net i�ZCOme anc�, ii the��e*ir��+:o�x}c�is insufhcieait,
so much t�f the princip�.i of'tl:e trus�property�as �t<<���'s��ititt}°, in the T.rustef;'�
discretion, sYiall from �.�zr�c t� t:ir:�e deern r.ec�ssarv `�r proper for s,_icf�
beneficiazy's healt;h, mai;ite.ia.nr.e, s�?ppar.t arid co�ii�lete education. ', ��e
Trustee shall anr�ual'v rzcc�:xn>>ti��.S.0�11V l��t]I)C`Ol".C'e nc�t s�clistribute�i ar�d�ztid
the same ta the principal �:�['�t�� trusr. prr,�,ertti.
§3.1.2 r'�f'ter sucx� h,tle�ici�z�y- aitains ��i�hre��;� ;�i�;r y+�ars of age, �Yi�
Trustee shall cunti�z�z� �o �iold, m.trAa�e, i��c��es� �.���! reirivest t�ie trus�
property, shall c��llect tlie incarr�e thereof anci ��iE�ll c�.s�J ibute the net incorrie
in quarter-atiritial irjs�allm�;lts, :�r anore �rc�qUE:17.t.)�' I�the Tr�astee deems it
advasa�i��, to c,r �c�r thr;}��t��#�t- c�.t'�:i�r.,h be��eii�i��r=-.
§3.l .3 In adciiti��rr t.c� thw toi°e;oir�g, a.�'tez �«.c:� t�eneficiary attains
eighteen (18) years uf age, thE,Tr�stee iYia3'C�1SLI'ILJU�F tt; Cfi°Eor the benefit of
such beneficiary so mu�lz s�E' tlie princi�lal of tlif� tr��5t property as the
Trustee, in the'I'rustee's discretian, shall from tir�ie lo tiixxe deem necessary
or proper for such beneficiary's health, niainteriance, support and cornplete
education, including college axid �araduate education, and professiorial,
vocational or technical trair�ing, ar�d to assist suc}i benef ciary with his or her
reasonable wedd�n;expense�, ai3 the purchase of a principal residence arrd
in the establishmcr.t c�f a p7•c�fessxon or �f a busin.ess considered a good risk
by the Trustee, t.�,k.ing iiit�� �::c��;��na o��zez a�a�lable £ua�d�, includiri�; su�:h
beneficiary`s asse�s.
Yas;� '� �.��__.___.___.
§3.?.4 At any time after such beneficiary attains twenty-one (21}years
of age arid p.rior to attaining twenty-five (25) years of'abe, such beneficiary
may withdraw such surns as do not exceecl one-half(l/21 of the market value
of the principal of Yus ar her trust as coristit�ted an liis or Yiet• twenty-�irst
(21st) b�rthday, c►r ii'his or her trust is established �z�� or after his or h�r
twenty-firyt (21 st)birthday, sucl�i sums as do r�ot exceed one-half(1/2) of the
market value of the principai of his or her trust as coristituted on the
establishment thereof.
§3.1.5 At any time after s:.�cn beneficia cy attains twenty-five(25)ye�.rs
of age, such beneficiary may withdraw any or all of the principal of his or her
trust.
§3.1.6 If such beneficiary clies before the cornplete terniinatic�n ��f nis
ox her trust, the Trustee shall distribu�e tlie propert.y tllen held in trust as
follows:
§3.1,6.1 I� the beneticiar��'s trust is a Nori-t�ST Exempt
`�'rust as defined in §G.2.12 hereiri, tne T�ustee shall distri�ute tYae
propexty then held in t:rust for sL;ch �eneficiaxy to such persons or
entities (includirig the beneficiar}�',; esta.te), iri such amounts ancl
upon such trusts, tern�s and cotiditi�ns as the beneficiary by his or
h�r last W�ii may �.p�oirzt by spe�ific r�ference to this general power
of ap�ointment. r�n}- ��Y•operty not so appoin�rh:a ;:ha�l k�e divided into
shai es f'a.r the t►�n.�fic:iaiy's issue then Iiving,per st:irl�es, or if none,far
rliy= issue t�ieri siviz�g, per st:irpes, and helr.l in continuec� trust in
accurdan�,e wit�� the provisions c�f this Articlr� Three.
�3.��.��2 If ihe beneficia,r��'s t�ust is a GS'I' Exempt Trust
as defir�ed in �6.2.1� herein, the i iu�tee shall di:�tr.i?7ate th�3�ro�e�ty
then held ir. trust for such bene.ficiary to such af rny issue other than
the berieficiaty iri such amounts and upr,ri such triasts, terms and
conditi�ns as the beneficiary by his or her Iast Wi�l may appoint by
specific reference to this special power of appointment. Before
exercisirig such special power of appointment, I request that the
benefic:iary seek counsel regardirig the generation- skipping transfer
tax effects of such exercise. Any pr�perty not sa appointed shal� be
divided ixito shares for the ben��icia��'s then living issue, per stirpes,
or if nc�ne, for my then living issue, per stirpes, �u��ject to being held
in continued trust in accordaxice with trie pro�isions of tYiis Article
Thi�ee.
Page � �
ARTICLE �'OUR
A�'P(�INTME'_VT OF FIT�'J�^,Ir���,IES
§4.1 I appoznt My Wife as Executrix of r�his Will. If she is unable or
unwilling to act or continue to act,for any reason whatsoever, I appoint my sori, UOUGLAS
M. t3BERHOLSE�, as successor Executor. In the evet�t triat tY�y son, D�UiJt.�S N�._
fJBERHOLSER, is unable to serve, I appoix�t m}� claugrite.rs, I.dTA I.,. 013ER.HOLSE�.a.c�ci
CHERYL A UBERHOLSEii, as siiccessar Co-EYec.utors. Al] "GlE'T�I3C;e5 i:t���•�i}� tc; tZ�e
"`Ehecutor" sh�ll mieari my orig�nally a�pointed Executx•;x ��My SLtCCt�;s�LB:t� ��:��:(�x��cutors,
as the case may be.
�4.2 T ap��oint my surviving children as i'7°��stc��.> �;�er�ei;� relF,rred t�as
'`Trustee") of any Txust crea�ec� under this'Wi.11 and a.Iso a��xtaar<��-.;.ras��i'tY�e estates of any
rnin�►i:berieficiaries t�.rider this Will,�,ncluding the proce�c(s of'a��,�s{<..;r�surarice on my liFe
��a��a.�>a�t�such miriors ar�d ariy ocY��r propert_y, rights or claarris ti�rith respect to whi��h I �.m
e�.�;.zt�cd to appolnt a��.�ardian ancl 11ave not otl�erwi5e sl�ecific,ll�r dutie so. The Guardians
Sr?��II r�ave full authc�ii.5'tC, Ur,� sucli ass�:cs, �iiil'21�1;.�1"I�3.�a.7lC� it:c;;raiu, i.��ts}':z]1i2i1CT i.X'it'
!=luardians shall dee�n advisable for the best interests of the minor, including college and
�racivate education, and professional, vocational or technictil c�•zin.ing, �vithout securing
a �'c��.tz� rrr�er.
��
Page 5 —
ARTICLE FIVE
POWERS C)F FIDUCIARIF;S
§5.1 No fiducia�y iinder tYais Will sYiall be z•eqLtired ro gi,» boz�d or other•
security for the faithful performarice o£the fiduciary's duties.
§5.2 �y such fiduciary shall have the following pawers,in additiori to those
�'iVt?I1 b)�1fiW:
§5.2.1 To invest iil, �.ccept and r�ta�r� an� rE:al ar perso;�a� I�rr��_�erty�,
including stock uF a cot��orate �ducia.±�� c?r ?�:� hold�z�ig corYlpari}r, ��ithout
x�estrictzon to legal iti�7�stnlerits;
§�.�.2 To sell, exchange, partitiori or Ieas�for����p�rzoc.i of tiirte�r�y
real or personal property and to give options thet�for. for ��ash or cr�clit, wirh
or w-ithout securit�r,
§5.2.3 To t�!;.r��w money fr�m any pers�.,M1t iriclrxding any fidu�iaiy
acting heret�nder, ar�� to rnortga�e or pledge ar��� re�: or persorial praper�y;
��.2.�T To ho�.� Shares �,� stock or athex� securities in riorr�inee
registr�ci��n 1:orr�, i.t�cluding that �f a cl�aring corpc�r�ti��n or clepository, or
in �iool� °iitry fi�rzn o;� tinre�stered ��r in stich otheT ��UT`ITl �.S Wl�� �)�.SS �?i'
�ieLV��Y>
�"�.2,.5 To eng�.ge in litigation and compron�iise, arbitrate or abandon
claims;
�5.2.� 'I'c� �t�a�.� �i?stributions in casri, oz•in kind at current values, or
partly in each, �illocatin� specific assets to part.icular distributees on a
rlori-pro rata l:�asis,ar�d far such purposes to malce reasonable detPrmin��kions
c�f curr.rnt values;
� � 4.; °i'o rr��:�k� electian�, d�ci��.o.rt��, co�:..;esSi��1S 2.Y1C1 8�2;I,ItIT1f'�tCS 1X1
���•
eanrie�c%io�� c��itf� a�1��i�ome, e�t��:�;, inf��ez�ipa�ic.•�, gift or other tax returxzs anc�
tl�e payment af s��c�7 kaxes,wir'riaur c��liga�ic�x�i �o adjust tlae distr'ik�ut�ve sY���a•e
of income �r pxirici�r�i of any ��erst�n affected t��ere�iy;
�5.�.� 'I`c�allocatc., in tY�� Executa��'s sUi���nd�bs�l��te discretion, any
pc�rtit�n vf zny �n�mption under Sectioxl 2,fi31(a) of tre Internat Reveriu!�
Pa�;a; 6 —��
Lode to any pr�perty as eo which I am the t.rar�sferor, including any property
transferreu by rriE tluring nriy iifetime a� to wnic�i I did not rzla.ke an
allocation ��rior to my death;
§7.2.9 To disclaim any interest I may ��ave in any estate if tY�e
Executar deems such disclaimer to be i:� tYie best interests of rny estate and
the beneficiaries therec�f;
§:i.2.�0 To terminate any trust created �iereir�, the principal of
�v}�ich is �r ��ecomes toa small in the T'r.ustee'� �ltsc;.eti��r r:n make t�ie
�sta�lisl�rxient or. continuar���e:�f t.��e tx•ust anvis�r�le. al��� t�rrzake xir:�meil:iaie
distribett�.rn�i of th� then remainirig t.rust �;r�>t�>Nt�j= �cr the ��neficiar•y t�jen.
erititlec, tca th� i.���carr�e c�.f t1�e trust i�rapert:y or, i.f the��E is .mor�, tha13 �,�ic.
bene�iciar�r, t�� t.Yze ��i�r:ficia�•ies thc�r ��rtt:t�ed tc, t��� .i�i,,ar��� �f t��e tr.,€si;
property in jlitfj�fl�Z1C3I1 to th�ir 4�e��;e�;tive ii�c�Y•e�'.�; r.l��:rein or, ii �9�;cli
inte.rests ar� nct tie��r�d, in equai �iiares t:7 su�:h I�c�r�c�f.icia:��es; pxo�•icic�r�,
YI�WeVt?',�.ZO`��r�ast�e s}lall participa�.e in�.n�c.?e�isi��x�to ter.riinate such tzusr
u by-reason of suc��i termination si.ich tru>>tee c:oul�i rec:eive a distributiori :��'
trust pz•operty from such trust as a�o�csai3. 'I'lie reesipts and releases of th�:
distributeE(sj will terminate absalutr�Ty the ri.ght �,f ail persons who rnignt
orherwise havc a.future interest in the trust, v�drhether v��sted or cantingent,
without notice to them and without the r�ecPSSity of fi.ling an accau.nt in a�y
court;
§52.11 To merge any trust crPated heret�nder with any othea
trust or irusts createc�by me or my spouse under will or deed, if the terms of
any such trust are then substantially similar and rseld£or t�ie primary henefit
of' th� same person or persons, ar�d if siich rrierger shall not cause any
adverse income,estate or generatio�skipping tx�ansfer t�consequence; and
§��2.12 '�,a allocate; z�� tlie 1i�xecur,ox•'�� soi� and absulz�tt�
discretior, aa�y portion or all of my exeinptior� urider Section 2631(a) of the
Ir�ternal Revenue Code ("My GST Exe�nption"), to any property as to which
I am the transferor, including any property transferre� by me durin� my
lifetir�e as to v�rkiich I did not iraake �n allocatio��t �rior to my death.
Similar�y,�:�y spouse's Execut�r m�.y a�.locate any porti;�n or a�I of my spouse's
exemptic�n ("My Spause's ipS€' Ex�mptiz�n") frorn �enera�ion skippiri�,
transfer ta.x to property helc� h��eunder of w�iich my spuusL is cleert�ed
trar�sferor. Any sz,�c.h election or a.li.�c�.t�an shall be bindix�g upon che'rruste�
and any t�en�ficiary of any trust c�:cattd l�ereunder. '�'re Trus�ee is directed
to divide any trust cr.eated uncier tl��is y`�ill into tv��cl (2) or mare separate
trusts, if necessary, to segregate the portiari or portics7is of the trust or trusts
created hereunder �ver which My GST Exemption ar My Spouse's GST
Page 7 �,�� Y._._
Exemption has beP� allocated (the "GST Exempt Trus�s") from the portion
or portions o£the tx•ust or trusts cr�ated �ereunder over wYiich n�ither My
GST Exemption nor My Spouse's GST Exemption has been allocated (the
"Nori-GST Exempt Trusts"); provided, huwever, that any such separated
trusts shall be held, administered and €iisposed of in accordance with the
terms�aereunder as i�ieritical trusts in all other i•espects, except as provided
in §:3.i.6 .
ARTiCi.E SiX
PI3i>VISIC)1�' FO�.'1'A3i1?�
§6.:1 ,�.11 e�tate rt�.xe5, inli�rita�-��•r, !:�`�('S, i.;Tr�ItS�Pt.' taYC,� azi�i c�th�;.� �a��.�,cy�
of'a sirnilar nature pay�.ble by i°ea.sox► �f my death t����r�y gov�rrfrraPr�t <�,�su��clivision thereof
�xpon or with respeci io any �:�roperty subject to a�it� such tax, �.nd a��y penalties thereori,
shall be paid by ��i�� �:x�cucor aat of the� I��ir�ci���.1 of tlzdt porcion ��i� i��y �stat� disposed of
b}%Axticle Two of tt�is yVill, and a11 i��teresi v�-ith resJ�ec� to any �uc�r� r��x�s shall be ,�aid bv
the Executor out of ttie income or �rincipa,I or partly oL�k o('t1r�e ir�come and partty out of
the principal of sucti p�rtion of my estate, in the abs�3lu�c discretion of the Executor,
without reimbursemeiit from or apportionment among tlie beneficiaries, recipients or
owners of silc:Yi propc��;:a:y for .3?ny .:�.rch taxes; ��en���ties ar u�ter�st; p.rovic�ec;. }��vwever, �he
Executor shall nc►t ���a�� a.n.y such t�ixes, penalties or int�r�st attributablP to any property
included in my�state �ale.ldy r���caiase Uf a pocver of.`app��intm�r�t �YFereovex which I po�sess
but have not F1xercis�;l z;� azry qualified �ermina�le interE�t, pr�perty; provided further,
how�ver, the Ex�cutoz, shall an:ly pay any sup��lt�ine�rtat Eedera.l estate tax, or ar�y pex�alties
or iriterest related thereto, imposed by Section 49$OA(d) of t�ie Internal Revenue Code, if
the payment o:�such t:a..k by the �,�ecutor would cause a net reduction in the amount of all
Yag� 8 _�.1L�_
estate t�es, inheritance t�es, transfer taxes and other taxes of a similar nature payable
by reason of my death to any government or subdivision thereo£ If the payment by the
F.xecutor would not cause such a net reduction, such sup�lemental federal csiate ta.�,
together with any penalties or interest related thereta, shall t;e bor,r7c �y ir�e recipients of
t�e qualified plan benefit (including my estate if it.is a recipier�c��t°axiy suc}�afinefit) gi�ui�
rise tc su�.h suppieint=r�ia1 :federa! esiat� t:�x ir� �.rc�t�zft�#i�::r, ;'� :.k,t�ir ret�T�{'�'LI�E' :[iii.i:ests
therein. � �
ARTICLN S�;V�iV
PROViSION FOR DF..B'{'S AND EXPENSES
�7.1 I direct rhat any oa m;� legally enforcea����:� debts, axxy expenses of
���y last iliriess,�uneral axld bu-rial,and an}r of the adrninistrative ex:penses of rny estate shall
be paid frc�m the principal of that portion of rriy estate c�isposed of by-tlrticle Two of this
�r11
ARTICI.I, �:I('=1IT
t_`yli�f;ELI��iE0�;5 I':�>�;C'�C{i\iS
�8.1 As usea irl i��is Will, t�if� tc::�� "[x�ter��a).�1�evei�t�e.���t:�.�:"shall r�iean
the lnternal Revenue Cade a�'1��8E�, as amendecl ii�arr time to time, or �h� r�orrespori�ing
provision of subseq��ez�x ?aw.
§8.2 VVheriever a fiduci.ary is directed to distribute property to or for the
benefit of any beneficiar�r who is under (a) twenty-one (21) years of age, or (b) a legal
Page 9 _��
disability or otherwise suffers from an illness or mental or physical disability that would
make distribution di.rectly to sucli beneficiaxy inappropriate (as determined in such
fiduciary's sole discr�tion exercised in �aoc� faitri j, �he fiduciazv may distribute such
property to the per5c�ri w�io has custady of such be�eficiary, rrray ap�ly stach property for
the k�enefit of st�c�� 1��erieficiary, Anay c�istribute such propert�y to �x custodian far such
�ienei�i�iary,�vheclzer tnet�serving nx•selectcd�ira.�appointect��y t�i�;ficucia�y(includin�;the
tiriucilr}%), under any applicable i.�ni�'arni "I'ransfers t�} :Vii�ic�zs Aci �r Uniforrr� CTi.fts lo
1vlirz�rs,�lct, .�i;�.y disGr;bu�e�ucr�p�C��ez`ty tu tYt�:�iarci�an of such���ei�eficiary's esta.te, �i�.a5�
�istriY�ute suc.h property dir�ctl_y to such be��efici�.ry's estate, or may distribute sucl-i
��.r.op�rty directly to such beneficiary(�xcept if ariy o£the condit.ior�s rzereizibefore described
in (b) apply), wi:tYiout liability on the part of the :�iduciary t� see to tlie application nf suc��
pxoperty. This provision shall nat in any way operate tc� suspend �u�h benefic°iary's
absolute ownership ot such property or to prevent the absolute vesting thereo£in such
benefici.ary.
§8.3 Except as oth�rwise may be pr���ided in �his �iVill, during the
conti��t��rice of any of�tYi€� tt'i,iSt� �,;:T��u�.;r? aricp�r tiic� ��v�-;�ions ;►.i tr.t�s ��J4'il�, :si�� t��exca�'t�r
i�nt��t�'Y�j:�TQ]?�I Cy 15=�iistributec��c,arid�°ec�eivec���v ax i�����i�eficiary��erLUZ�d�:r, the pri��c�pal
suans thus heid in trust fcar any t�c�r2�fieia�°y, re5s�eetively, and the izic-orr?<� th�,�reof`sh�.lt ilot
�e subject to or li�ble �or aray contracts, debts, engagements, liabilit:es ar torts of such
beneficiary now c�r hea•ea:fter made, contracted, incurred Qr committed, but shall be
absalutely free fr�m the s��ne, ar�d such benefi�iary shal�have no power to sell, assign or
' ._._ /LU .
F'�..�'¢• ��l
encumber all o.r any paxt of. the �arincipal sums or suc:kY ben�nciazy's int�rest thereiri,
respectively, or the ir�caxne thereaf, or to anticipate the i:�come.
�V i�'t�i'l"Ni�,SS i1�/�-�LIti�;C):F, I ha��e: ;�e1�F��.into se�. �n� harid �rid s�al �Yzfs
� ��da c��' , 20Q3.
c�.____ Y _ _ _ �
1�.k�'� C��I� E�f.�)
_______..___.______.�_------- .._._ ,
tS..t3P�I. C�?1�3r.�;.�t+.1I:�*��'-�z
�igri�r�, sealed, p��l�l:shed ax�� de�lareci by =ti��,� a:�a�-e di�.T11Pi� K�'�i�l�
t��3��RH�LSER;ts and for 1i�s I_�ast�'ill, xn thE pz�esence of us ar�c� naci�. t�k us, jf��ic�, a,t his
r��c;���st and �t� his presence anz� in the presence of each �th�r, l�avc: here�zn:to suk�scribed
o�r r�a�ies .�s ,�vitnesses thereta the day° aaid year last abovF written.
� �
� _���C��` ►� Residing ac _�����"°,'�'��i-,. �,�—_._.
`� 4-- �
�
r �j �r f � �±� � 1� f�..� �i�
��� �I�'��_°� ,���� Residin at _!������ _- –
�.e_� �
r
. • �-!,�-�"'
'� `�' ,���
� `�"-�'
, ' `� ��� ^ .
�;,%' ��..�,._.. .__.---°--------�- �lf�Stt11�1�ilt ... __.�._ Cr��YL! * F'L J�'`� �G'`�� r
�G .._�.__..__._..._.
�.:`�; . �.
COI�IMONWE.�LT�I OF PENNSYI.,VANIA :
. SS.
�;OUNT'Y OF DAUPHIN �
, -�
�Ve, KAI'�,1�J�3�'R��OL,w Lr;, C.t1C�£��.�ct���,and ����{,��� . �'_��c.�''���%'
�" $�, . -- r _
� �11C�� _ ��� ancl �- _r-� - $ � :��jr �c��- ,���E�witnes�es �,��hose
��__ -�,�=�- �_________.___ ,
�
TIaTYIGS 2l•re}s.i�tiPd io the at�ai�zect��r fore�;oingi.r�slruil�erit,�sc�it��;�i•st�i�.id���;t��ori�,do hereb�
dec�are to the unders%�ri;�d a�:thority th�t the ia.tator si�mr.��;:�n� €����cuted the 9.nstxumc��:f.t
as hi� Lask t'�'i;�; t��.at tiac tcs�«LC)(' Si},;I?�C'' tv�.fli.Yi�ty a.�zci e;.�:cc�u��ci iz ���i��, lree an�� v���:nsa.a�v
act tor the ?�urp�ses t�iereuz exX?c�es�:uc�; that eacl� s!�i�scri��in�;�it��c:s i�a i.;.��: ����arir�g a.:�ci
sight of the �estator signerl the �'Vill as a witness arid t��at ta tl��e t�est of' f3is or h��i•
kriowledge the testator was at that time ei�Y�teen (l8) years of a.ge or older, of sound mznd
and under no constraint or undue influence.
.. ,,
�,
�/�L-� l./ 4��'��n� � �,�.. ,�`� ,_
� �'l�Q-n!'-d "�'" �i ���,��_ �,�t='�7��____
KA��L OBERHOLSER WITNESS
/ .�-> .
�,�..�;.
��°I.� =���
, ::.'_
..
.. _
__� _._.__�=-_ .__ _. -•._.�._:---�_--
WITNESS °' W�T?1�:�� ^M,_
SL1�).`iC:T�hed,S4i�L+i'T4 LG a?id ac�:ri�wl.edged betoi�e i;ae�y��;.����...�rlji��.�1��.�t�:'�,>
the t�stator, dnc� si���scrit3e!.i �crzci s�v�r.ri to befare x�iE� bv _��w,� G��1x,-t�.���- _,
�71�;��;�� ./�,�����__�,arid .l� � �c;� r� . �'�•��' �,, __,�rritr�esae5,this ��'�:`=�
day rsf_ ;���s7�" ,_, 2003.
i i `t-� (��,o G`�
i�d0i: V �1��:i1C.�____._._..__.__.__. �_.�
���!:�L,�
Tlotarial Seal �blic
Joan E. Brothers, Notary
Susyuehanna't�vp., Dauphm County
iviy Commission Expires Feb. 12, 2006
Membe�,PennsyNan�aASS�cia��of Notaries
��..��.;-,-�.m„ ...
PERSONAL M�i,MOI;ANDUM TO L.A�T WILL AND TESTAMENT'
C3�KAE�.L OBI�sR�-iC7Is5FR
�A'TED:
PEI�SnN TO RECI:,I�J�' I�X�M I�)E�CRIPT�(�N QF ITEM
.,::, �: �
REV-1510 EX+(OS-09)
�e���` pennsylvania SCHEDULE G
DEPARTMENTOFREVENUE INTER-VIVOS TRANSFERS AND
INHERITANCETAXRETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Karl M. Oberholser 21-13-1348
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
DESCRIPTION OF PROPERTY
ITEM INCLUDE TNE NAME OFTHE TRANSFEREE,THEIR REIAT[ONSHIP TO DECEDENT AND DATE OF DEATH %OF DECD�S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER. AITACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST IF APPLICABIE) VALUE
1• TIAA CREF Contract IH3094T8 107,710.21 100 0.00 107,710.21
TOTAL(Also enter on Line 7, Recapitulation) $ 107,710.21
If more space is needed,use additional sheets of paper of the same size.
TIAA
CREF .;
FinaNCU��s��nces
February 4,2014
PST87RSR1(i5
Estate of Karl Oberholser
C/O Connie Oherholser
l I2 Sholly Dr
Mechanicsburg PA 17055
Re: Karl M Oberholser
s
TIAA Contract- IH3094T8 IH3100T0
.= Dear Connie Oberholser:
— We recently received notification of death for Karl M Oberholser and are now contacting you suice Estate
_ of Karl Oberholser is a named beneficiary for the above-listed TIAA-CREF retirement accounts. My name
is Jeannine Edmonds from TIAA-CREF's Beneficiary Relationship Team and I will be your primary
— contact to assist you throughout this process.
= The survivor benefit that Estate of Karl Oberholser is entitled to receive is listed below. Any balances in the
_ . TIAA Traditional Annuity will continue to eam interest, and balances in the variable annuity accounts
� and/or mutual funds will fluctuate based on investment performance. In addition,this value can be subject
= to change due to special spouse provisions or State Statutes.
= Account Value as of 07/25/2013
TIAA Traditional $107,710.21
Total $107,710.21
For your convenience,we have listed the materials the authorized representative,guardian,executor or
authorized power of attomey,as applicable,will need to provide to receive the benefits:
❑ Pennsylvania:Allows for elective withholding. If you wish to elect state withholding,please
indicate the amounts on your application.
❑ MARITAL STATUS Verification-If a participant of a retirement plan subject to the
Employee Retirement Income Security Act(ERISA)passes away before receiving retirement
income,his or her surviving spouse(if any)is entitled to a death benefit equal to at least
one-half of the annuity accumulatian(s),subject to the law. In addition,some Nan-ERISA
institutions govern the amount that we must pay to a surviving spouse. TIAA-CREF must
determine if any benefits are payable to a participant's surviving spouse before paying death
benefits. Therefore,we require completion of the Marital Status Verification form.
❑ SURVIVOR BENEFITS DISTRIBITTION Request Form
❑ Proceeds Plus Supplemental Contract-if payee option selected,this needs to be signed
and returned in order to complete your request.
TIAA-CREF Individual&Institutional Services,LLC Member FINRA,SIPC. BENEBUND-EE
8500 Andrew Carnegie Blvd,Charlotte,NC 28262 Tel:l (877)535-3910
REV-1511 EX+(10-09)
��� ���`� pennsylvania SCHEDULE H
�� DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN AD M I N ISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Karl M. Oberholser 21-13-1348
DecedenYs debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A• FUNERAL EXPENSES:
i.
�.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Year(s)Commission Paid:
z. Attorney Fees: 600.00
3. Family Exemption: (If decedent's address is not the same as claimanYs,attach explanation.) 0.00
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4• Probate Fees: 153.50
5• Accountant Fees:
6. Tax Return Preparer Fees:
7.
TOTAL(Also enter on Line 9, Recapitulation) $ 753.50
If more space is needed,use additional sheets of paper of the same size.
REV-1513 EX+(01-10)
�pennsylvania SCHEDULE �
DEPARTMENT OFREVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Karl M. Oberholser 21-13-1348
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under
Sec.9116(a)(1.2).]
1• Constance L.Oberhoiser, 112 Sholly Drive,Mechanicsburg, PA 17055 spouse 100%
ENTER DOLLAR AMOUNTS 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 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
L
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
L
TOTAL OF PART II— ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. #
If more space is needed,use additional sheets of paper of the same size.