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Home My WebLink About05-20-14 � 15056101�1 REV-1500 EX`°'_'°, � OFFICIAL USE ONLY PA Department of Revenue pennsylvania Bureau of Individual Taxes "aQ M " County Code Year File Number ��:,�,� PO BOX z8o6o1 INHERITANCE TAX RETURN �' ( Z � � �� Harrisburg PA 1�i28-o6oi RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELQW Sociai Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 07/11/2012 05/06/1921 Decedent's Last Name Suffix Decedent's First Name MI SCHAD ' HELEN A (If Applicable)Enter Surviving Spouse's information Below Spouse's Last Name Suffix 5pouse's First Name MI Spouse's Sociai Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE ' REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 1.Original Return O 2.Supplemental Return O 3. Remainder Return(date of death prior to 12-13-82) p 4.Limited Estate O 4a. Future Interest Compromise(date of O 5. Federal 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 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- THIS SECTION MUST BE COMPLETED.ALl CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DI�ED T0: Name daytime Tel�phone Numb�� 7 � rn THOMAS E. FLOWER (717) 24�5�3 �3 ;.-7 � � � � _,� :�.� REGISTER.,`6F,YVJLLS�ONLY; � _ ;..;, - O ,,,_ First line of address ° ` �"'' r 7 y � —Q � _.n C FLOWER LAW, LLC c� ca _.; � . � <;� c� Second line of address � � � ' r � --i �." 10WHIGHST � � � � cx� City or Post Office State ZIP Code DATE FIIED CARLISLE PA 17013-2922 Correspondent's e-mail address: TOM@FLOWER-LAW.COM Under penalties o erjury,I declare that I have e amine his return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct n compiete.Declaration of epare ther than the p sonal representative is based on all information of which preparer has any knowiedge. SIGNATURE P SON RESPONSIBLE R TURN DATE 05/21/14 ADDRESS DENNIS J. SCHAD, 310 ATTO DR., CARLISLE, PA 17013 SIG��N REPRESENTATIVE ��!J� / ADD S �— THOMAS E. FLOWER; FLOWER LAW, LLC; 10 W. HIGH ST., CARLISLE, PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056101�1 150561�1,01 J � 15�561�105 REV-1500 EX DecedenYs Social Security Number oecedenes rvame: HELEN A. SCHAD RECAPITULATION 1. Real Estate(Schedule A). .. . .. .. . .. .. . . .. . .. .. . .. . . . ...... ... . . . . .. . . 1. 2. Stocks and Bonds(Schedule B) . . ... . ... .. ... . ... .. . ..... .. .. . .. ... . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . . . . . 3. 4. Mortgages and Notes Receivable(Schedule D) .. . .. ... . . .. .. . .. . .. ... . .. . 4. ' 5. Cash,Bank Deposits and Misceilaneous Personal Property(Schedule E).. ... . . 5. 2,240.71 6. Jointly Owned Property(Schedule F) O Separate Billing Requested . . .. .. . 6. 557.70 7. Inter-Vivos Transfers&Miscelianeous Non-Probate Property (Schedule G) O Separate Biliing Requested.. ... ... 7. 8. Total Gross Assets(total Lines 1 through 7)... . .. . .. .. ... .. .. . . . .. .. ... . 8. 2,798.41 9. Funeral Expenses and Administrative Costs(Schedule H). . ..... . .. . .. .. . .. . 9. 2,940.00 10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule I). . .. . ... .. . .. . 10. 11. Total Deductions(total Lines 9 and 10). . . ... ... ... .. . .. .. . ... . .. . .. . . . . 11. 12. Net Value of Estate(Line 8 minus Line 11) . . .. . . ... .. ... .. . . . . .. . ... .. . . 12. 0.00 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been made(Schedule J) ... .. .... . . . .. . .. .. . .. . . 13. 0.00 14. Net Value Subject to Tax(Line 12 minus Line 13} .. . ... . .. .. . ... .. . .. . .. . 14. 0.00 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(1.2)X.0_ 0.00 15. 16. Amount of Line 14 taxable at lineal rate X.0_ 0.00 �g, 17. Amount of Line 14 taxabie at sibling rate X.12 0.00 �� 18. Amount of Line 14 taxable at coilateral rate X.15 �.00 �$ 19. TAX DUE .. . . . ... .. ... .. . ... . . . .. . .. . . . .. . . .. ... .. . .. . . . ... . . . .. . . 19. 0.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT �j Side 2 � 15�5610105 1505610105 J REV-1500 EX Page 3 File Number Decedent's Complete Address: �'� r ��'� �� DECEDENT'S NAME HELEN A. SCHAD STREETADDRESS 1 LONGSDORF WAY SOUTH MIDDLETON TOWNSHIP CITY __ STATE ' ZIP CARUSLE ' PA 17015 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 0.00 2. CreditslPayments — A.Prior Payments 25.10 B.Discount _ . . . 126 Total Credits(A+g) (2) 26.36 3. Interest (3) 0.00 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 2Q to request a refund. (4) 26.36 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:.......................................................................................... ❑ X❑ b. retain the right to designate who shall use the property transferred or its income:............................................ ❑ 0 c. retain a reversionary interest;or.......................................................................................................................... ❑ 0 d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ x❑ 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?.............. ❑ � 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation? ....................... ❑ x❑ ................................................................................................. IF TNE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF TNE RETURN. For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposetl 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 tleath 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 decedenYs 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 defined, under Section 9102,as an indivitlual who has at least one parent in common with the decedent,whether by biood or adoption. REV-i5o8 EX+(1i-io) ��1� ;`pennsylvania SCNEDULE E � DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHER[TANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: HELEN A. SCHAD 21-12-0813 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION pF DEATH 1. M&T BANK CHECKING ACCOUNT#3740136126 2,798.41 TOTAL(Also enter on Line 5, Recapitulation) $ 2,798.41 If more space is needed,use additional sheets of paper of the same size. REV-iso9 EX+(oi-io) � � ' pennsylvania SCNEDULE F � : DEPARTMENT OFREVENUE rnHerurnruce Tnx aeruRrv ]OINTLY—OWNED PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: HELEN A. SCHAD 21-12-0813 If an asset became jointly owned within one year of the decedenYs date of death,it must be reported on Schedule G. SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A•DENNIS J. SCHAD 310 SHATTO DR SON CARLISLE, PA 17013 B. C. ]OINTLY OWNED PROPERTY: L�rrER on� DESCRIPTION OF PROPERTY �ie oF DATE OF DEATH I'fEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITlfTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATIi DECEDENT'S VALUE OF NUMBER TENANT )OINT IDENTIFYING NUMBER.ATTACH DEED FOR]OINTLY HELD REALESTATE. VALUE OF ASSEf INTEREST DECEDENT"SINTEREST 1. A. 09/15/07 MEMBERS 1st FCU ACCOUNT#313945-11 1,115.37 50 557.69 TOTAL(Also enter on Line 6, Recapitulation) $ 557.69 If more space is needed,use additional sheets of paper of the same size. REV-1511 Ex+{10-U9j �� '� pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FU N E RAL EXPE NSES AN D INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OP FILE NUMBER HELEN A. SCHAD 21-12-0813 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' AUER CREMATION SERVICES,CREMATION 1,959.00 2. AUER CREMATION SERVICES,PROFESSIONAL SERVICES 55.00 3. BURIAL URN 195.00 a. CORONER FEE 25.00 5. DEATH CERTIFICATES 60.00 s. ST.CHARLES BORMEO CHURCH,CORNWALL HEIGHTS,FUNERAL HONORARIA 500.00 B. ADMINISTRATIVE COSTS: 1. Personai Representative Commissions: Name(s)of Personal Representative(s) Street Address City _- - --__ _ _ 5tate ZIP _ _ _ __- Year(s)Commission Paid: Z• Attorney Fees: 375.00 3• Family Exemption: (If decedenYs address is not the same as claimant's,attach explanation.) Claimant Street Address CitY _ _ _ _ State ZIP Relationship of Claimant to Decedent 4• Probate Fees: 85.00 5. Accountant Fees: 6• Tax Return Preparer Fees: 7. TOTAL(Also enter on Line 9, Recapitulation) $ 2,940.00 If more space is needed,use additional sheets of paper of the same size. � pennsylvania BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX DEPARTMENTOFREVENUE INHERITANCE TAX DIVISION APPRAISEMENT, ALLOWANCE OR DISALLOWANCE PO BOX 280601 OF DEDUCTIONS, AND ASSESSMENT OF TAX ON REV-1548 DCAFP (12-12) HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS DATE 07-01-2013 ESTATE OF SCHAD HELEN A DATE OF DEATH 07-11-2012 FILE NUMBER 21 12-0813 COUNTY CUMBERLAND SSN/DC 507-16-9593 DENNIS J SCHAD ACN 12143552 310 SHATTO DR APPEAL BY DATE:08-30-2013 C A R L I S L E P A 17 013-213 9 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT dLONG THIS LIN� �"'� �iETAYN LOWER PORTION FOR YOUR RECORDS � ------------------------------------------------------------------------------------------- REV-1548 EX AFP C12-12� NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 07-01-2013 ESTATE OF:SCHAD HELEN A DATE OF DEATH:07-11-2012 COUNTY:CUMBERLAND FILE NO. : 21 12-0813 S.S/D.C. NO. : 507-16-9593 ACN: 12143552 TAX RETURN WAS: CX) ACCEPTED AS FILED C � CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. : 313945-11 TYPE OF ACCOUNT: C �SAVINGS CX) CHECKING C )TRUST C �TIME CERTIFICATE DATE ESTABLISHED 09-15-2007 Account Balance 1,115.37 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 557.69 UPPER PORTION OF THIS NOTICE Debts and Deductions ' •00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 557.69 REGISTER OF WILLS AT THE Tax Rate Y .045 ABOVE ADDRESS. MAKE CHECK Tax Due 25. 10 OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) pMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) 08-20-2012 CD016408 1 .26 25. 10 TOTAL TAX PAYMENT 26.36 BALANCE OF TAX DUE 1 .26CR INTEREST AND PEN. .00 TOTAL DUE 1.26CR � IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. * IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. � �� PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE N0. 21 BUREAU OF INDIVIDUAL TAXES Po eox 280601 pennsylvania AND ACN 12143552 HARRISBURG PA 17128-0601 DEPARTMENTOFREVENUE TAXPAYER RESPONSE DATE OH-O.�-LOZZ REV-1543 EX RFP (05-11) TYPE OF ACCOUNT EST. OF HELEN A SHAD ❑ SAVINGS SSN 507-16-9593 � CHECKING DATE OF DEATH o7-11-2012 � TRUST COUNTY CUMBERLAND � CERTIF. REMIT PAYMENT AND FORMS T0: DENNIS J SCHAD REGISTER OF WILLS 310 SHATTO DR 1 COURTHOUSE SQUARE CARLISLE PA 17013-2139 CARLISLE PA 17013 MEMBE RS 1 ST F CU provided the department with the information below, which was used in calculating the inheritance tax due. Records indicate that at the death of the above-named decedent, you were a joint owner/beneficiary of this account. If y0U al'E the SpoUS2 of the deceased and any amount other than zero is reflected below on the Potential Tax Due line, note no tax may be due, but you must notify the department of your relationship to the deceased by checking Box C in PART 1 below and writing "spouse" in PART 2. If you believe the information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. Please call 717-787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 313945-11 Date 09-15-2007 7o ensure nrouer credit to the account, two Established copies of this notice must accompany Account Balance 1�115.37 cayment to the Register of Wills. Make check $ payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax $ 557.69 months of the decedent's date of death, Tax Rate �( .045 deduct a 5 percent discount on the tax due. Any inheritance ta�c due will become delinquent Potential Tax Due $ 25. 1� nine months after the date of death. PART TAXPAYER RESPONSE � V>�� - � �V �� . � �� ,��..�� \� \��\��O��\o\��\��\�\�� ,a�� .\\�.\�� \�0 ��. ��a�.....� A. ❑ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain C H E C K a discount or avoid interest, or return this notice to the Register of Wills and C0 N E � an official assessment will be issued by the PA Department of Revenue. B L 0 C K g, � Tbe above asset has been or will be reported and tau paid with the Pennsylvania inheritance tax return 0 N L Y filed by the estate representative. C.. � The above informa ion is incorrect and/or debts and deductions were paid. Complete PART 2� and/or PART 3� below. If indicating a different tax rate, please state �� " �� °�� PART �� e � � �� ,\ � relationship to decedent: �\ � \ \ \ � \� TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS .�\ �� ; "�° LINE 1. Date Established 1 � �� 2. Account Balance 2 $ �� 3. Percent Taxable 3 X � �� '\�\ �\� � ` � '��. \\\\\\\Y\O.\\`\ 4. Amount Subject to Tax 4 $ � �� `� 5. Debts and Deductions 5 — � � \\\\\\\\\\��\\\�\\ \ ��\ 6. Amount Taxable 6 $ \\ \ �\\\�\ �� \\\\\ 7. Tax Rate 7 X � �� . �� _.. 8. Tax Due 8 s �� , ��0�\.\\� �� a0\`� � � �� o�� .��..:� ��<., � ,�.�v��o��:� PART DEBTS AND DEDUCTIDNS CLAIMED 3❑ DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) S Under penalties of perjury, I declare that the facts I reported above are true, correct and complete to the best of my knowledge and belief. HOME C ) WORK ( ) TAXPAYER SI6NATURE TELEPHONE NUMBER DATE � U ._ � _ IC ACCOUNT NQ. ACCOUNT TYP�I� STATEMENT PERIOD PAGE : 3740136126 M8T CLASSIC CFiECKTNG NJINTEREST JUL.27-AU6.24�2012 1 OF 1 00 0 04319M NM 017 000001503 FIDS1549D01708241208 OS 000000 37470 � HELEN A SCHAD � 310 SHATTO DR CARLISLE PA 17013-2139 INTEREST EARNEd FOR STATEMENT PE�IOD �.a0 MY�H STft[E7-CkRLISLE INTEREST PAID YEAR TO DATE 0.21 ACL'Oi�NT SUMh{�if�Y R�GINNxNG' DEPOSFTS 6 � OTHFR CURR�NT �NDxNG $ALANCE >07HER ADDITIONS CHECKS F�IA SUBTRACTIONS INTEREST`PD BALANCE N0. AMOUNT N0. AMOUNT N0. AHOiINT 2,240.71 2 2,2�3.96 0 0.00 1 4,514.68 0.01 0.00 ACCOUfVT ACTIVITY POSTIN6 DEPOSITS,INTEREST `GHECKS �'QTNER DAILY" � DAFE TRANSACTION DESCRIPTIQk 8 OTHER ADDITIONS SUBTRACTIONS &ALANCE' � m 07-27-12 BEGIlMlING BALANCE 52.240.71 0 e 08-01-12 US TREASURY 312 XXCIV SERV 1,149.28 � 08-01-12 US TREpSURY 312 XXCIV SEN'i 1,124.68 4,514.67 °cp 08-03-12 INTEREST PAYMENT 0.01 � 08-03-12 CLOSEOUT 4.514.68 0.00 N G LL ; ENDING BALANCE S0.00 . a . a 0 ti ANkUAL ?ERCENTAGE YIELD EARNED = 0.00 % 0 0 0 M 0 0 0 � SAVE BIG 0t3 FlACK TU S�NUOL AASICS NMEW YOD USE YQtiR M8T CNEL'K CAlfD OR N8T CREDIT CARQ AT POPULAR R�tAZLERS IN STORES, ON THE kE6 AND OiiER TIiE PHbNE. FOR FULL DETAILS ANf! YO STAit'f SAVIWt+, VISIT MTki.COM/S�iOPPIkG. FOR CUSTOMER SER4ICE QUESTIUHS, Pi.EdSE CAtL 1-800-724-2440. L008(6/12) �..�._ .. __. ,_.� � ,. .e . _ �_ . „�, ...,� _ _�.q._�.� .M �-�-�� . �� _ AuEK i:kr��IHI iUiv 5'tKVii.t 41U0 JONES70V1lN kD HARRIW�URG, FA 17109 o��ai� 11:°��5 y�TION SERVICES OF PENNSYL�ANIA� INC. MerchantID: OOOOOOOGl�b9��5 Terminai ID: ��5�87'�9 ?37Z565986 3arrisburg,PA 17109 • 1-800-720-8221 • Fax 717-541-9943 • Shawn E. Carper,Supervisor CREDIT CA�G AMEX SALE CARD# XN;�XAXXXXXX200G INUOICE 0002 6atch#'. 000412 Approv�l Ccde: 173991 120758 MCR-5 Entry Nlethod; Manual Approved: Online SALE AMOUNT $215,0� Jul 12, 2012 iU5TOf�lEF �.UPr Dennis J. Schad 310 Shatto Drive Carlisle, PA 17013 Helen Artis Schad - Deceased SPECIAL CHARGES X Direct Cremation $1 ,595.00 Nationwide Guarantee Program Worldwide Travel Protection TOTAL SPECIAL CHARGES 51 ,595.00 PROFESSIONAL SERVICES X Services of Funeral Director & Staff Included Other Preparation of the Body Facilities & Staff for Memorial Service Staff & Equipment for Memorial Service Witnessing the Cremation Private Family Viewing/Witnessing Cremation X Packaging And Forwarding Cremated Remains $55 .@@ Personal Delivery of Cremated Remains Scattering of Cremated Remains Medical Documents/Courier Fee TOTAL PROFESSIONAL SERVICES $55.00 AUTOMOTIVE EQUIPMENT X Removal Vehicle Included Lead Car/Clergy Car Family Car Service Vehicle TOTAL AUTOMOTIVE EQUIPMENT 50.00 . �, �. � :.::w _..��, �. ��- _ .: 4�REMATION SER`� ��' �SP �;�,iiu� `'�N AUER CREMATION SERVICES OF PENNSYL�ANIA, INC. •O�,p ��G• 4100 Jonestown Road • Harrisburg,PA 17109 • 1-800-720-8221 • Fax 717-541-9943 • Shawn E. Carper,Supervisor EN ' DISE Register Book Memorial Cards Thank You Cards Remembrance Package Cremation Container X MacKenzie Stone-Tone $250.00 Urn Burial Vault Veterans Flag Case Grave/Memorial Marker X Discount -$55.00 TOTAL MERCHANDISE $195.00 CASH ADVANCED ITEMS Grave Opening Cemetery Equipment Newspapers Newspaper Vault Service Charge Clergy Church/Organist/Soloist Flowers X Crematory Charge Included X County Coroner Cremation Approval Fee $25.00 X 10 Certified Copies of Death Certificate $60.00 TOTAL CASH ADVANCED ITEMS $85.00 SUMMARY OF CHARGES Special Charqes $1 ,595.00 Professional Services $55.00 Automotive Equipment $0.00 Merchandise $195.00 Cash Advanced Items $85.00 SUB TOTAL $1 ,930.00 CREDITS -$750.00 AMOUNT PREPAID Date Jul 13, 2001 -$940.@0 TOTAL $240.00 AMOUNT PAID Date Jul 24 , 2012 -$240.00 BALANCE DUE $0.00 �L 15 �� C� "��-lD ��Tl-� C��r c� A-N�� `�� C��1' THIS STATEMENT MAY NOT REFLECT ALL NEW5PAPER CHARGES � a a a � z °' �' +�'�' � O c � o � � � W a a. o, 's � � p y i � N N r�r ` i � W 7r' r O ;� A 0 ~ (a .0 •� Pa �m � � �.] � +• m o o �o � r � �.ry .., .� Z U o � .� � F ..N.� a •I�M � a a� � � � o � a .°� � � ai .b' .°'o � � N `� �, z z b � ¢ z z � � V � � � � E � m � ° .°c >, S o s � � V S U Cj U Q a" � U a U coG i�1 � U � U U 1�1 � � � U � � F � F iC � d � g DC �o .w � o h � N n ~ U � � ^� o >, o � o e � � � ow °o �+ U � f�. us c°►. . � � . 4 � .. � � .. y � �•+ � .N.� F-T� E p � ^A� E A ° �p '� 'o F" z � S r. � N O Z. C � ed ,'Z � C� 3 �.., � = � p z � '� �? C Z N � d � � � � w a�i � � ° c � � � �1, T ,8� a �.'7'i � U m U `�d m w � V O �j 'd O F "4 p" '0 0. V C �V � �TF � � T � V � 4 p C ,C Z na, V 'cy F ia � C1 �{�� a a aS Q V o �S �" a� d y '� m � v� U m LAST WILL AND TESTAMENT ,^ -�, �� +�� c_.._ n-,c.� ��' QJ-�i C .�Ci t"1'l C"7 t"" C_�7�t-7 ��(�.t TV (-rtfti HELEN A. SCHAD U=�:�': � �r'`-' �� C;��J �.:�,�� _ -r, I, HELEN A. SCHAD, a resident of Bucks County, Pennsylvania do ��=,publishand �� -.-1 .. �� d � V� ~�'T7 declare this to be my last Will, hereby revoking all Wills and Codicils previously made by me`�' FIRST: IDENTITY OF TESTATOR'S FAIVIILY I declare that I am a widow. I have four(4) children, now living, whose names and birth dates are: Name Birth Date Michael 2-22-47 Dennis 8-28-50 - Stephen 12-10-54 Timothy 1-24-56 I have no deceased children. All references in the Will to "my children" are references to them. SECOND: PROPERTY BEING DISPOSED It is my intention by this Will to dispose of a11 of the property which I may own. However, I hereby elect not to exercise any power of appointment exercisable by a Will which I may now have or which may hereafter be conferred on me; no provisions of this Will shall be construed as an exercise in whole or in part of any such power. THIItD: EXPENSE OF FUNERAL AND LAST ILLNESS I direct the payment of the expenses of my last illness and funeral. 1 FOURTH: RESIDUE I devise and bequeath the residue of my estate of every nature and wherever situate in equal shares to such of my children as survive me by thirty (30) days; provided that if any such child fails so to survive me,but is suivived by a spouse who so survive me, such spouse shall receive the share such deceased child would have received had he so survived me; provided further that if any such child fails so to survive me and is not survived by a spouse who so survives me, but is represented by descendants who so survive me, such descendants shall receive, per stirpes, the share such deceased child would have received had he so survived me. In the event there is no one living who is entitled to receive the residue of my estate under the foregoing provisions, I give the residue of my estate to the Red Cloud Indian School, Pine Ridge, South Dakota 57770-9710. - FIFTH: CONTINGENT RESIDUARY TRUSTS Whenever pursuant to the provisions of this Will all or any part of a distributive share of my residuary estate shall be payable to any beneficiary before such beneficiary shall have reached his or her twenty-second year, or to any beneficiary when he or she may be subject to any other disability, then and in that event, I give devise and bequeath the shares to which such beneficiary may be entitled under my Will, said share to be determined as of the time of my death, unto my Trustee hereinafter named, IN TRUST NEVERTHELESS, for the following uses and purposes to wit: To hold each share which shall vest in a beneficiary during his or her minority or during a time that any beneficiary by reason of illness, age, incapacity or otherwise shall in the opinion of the Trustee be unable properly to receive and disburse the same, in trust and invest the same in property authorized by this instrument and apply income and principal as necessary for maintenance, education, comfort and support of such beneficiary, accumulate and invest as aforesaid income not needed for 2 such purposes and pay over and distribute all remaining principal and accumulated income to such beneficiary at his or her twenty-second year or at the termination of his or her incapacity or to the estate of such beneficiary at his or her death prior thereto. I direct that such payment shall be made without the intervention of a guazdian and the receipt of such person as may be selected by my Trustee to disburse the same shall be sufficient acquittance. SIXTH� ALIENATION AND ATTAC�IlVIENT OF BENEFICIARY'S INTEREST No beneficiary of an interest hereunder shall have any right to alienate, encumber, or hypothecate his or her interest in the principal or income in any manner, nor shall any interest of any beneficiary or remainderman be subject to claims of his or her creditors for liable to attachment, execution, or other process of law. - SEVENTH: GENERAL ADMINISTRATIVE POWERS OF TRUSTEE In order to carry out the purposes of any trust established by this Will, the Trustee, in addition to all other powers granted by this Will or by law, without court approval, shall have the following powers over the estate, subject to any limitations specified elsewhere in this Will. 1. To accept in kind and retain any property which I may own at my death, without regard to any principle of diversification, and to invest in or purchase any form of property, without restriction to legal investments for fiduciaries. 2. To register property in the name of a nominee or to hold property unregistered. 3. To compromise claims. 4. To manage, control, repair, and improve all trust property. 5. To sell, for cash or on terms, and to exchange any trust property. 3 6. To lease any property for tenns within or beyond the duration of the Trust for any purpose which the Trustee in his discretion may deem advisable in accordance with law, with or without an option to purchase, and to make such improvements or effect such repairs or replacements to any real estate subject to this Trust, and to insure such real estate against fire or any other risks, and to charge the expense therefore to principal or income or part thereof to each as the Trustee may deem proper, and to develop such properiy,to subdivide it, dedicate it to public use, or grant easements therein as the Trustee may consider advisable; and any lease or agreement made with respect thereto shall be binding for the full term thereof even though it may extend beyond the duration of the Trust. 7. To borrow money and to mortgage or pledge or otherwise encumber or hypothecate trust assets as the Trustee may, in his discretion, deem advisable either from himself individually or from - others. 8. On any division or distribution of the trust estate, in the discretion of the Trustee, to divide and distribute property of the trust estate in money or in kind, including undivided interests, or partly in money and partly in kind, including undivided interests; to exercise such powers, herein conferred, after the ternunation of the trust estate until final distribution of the trust assets. 9. . To employ any attorney, investment advisor, accountant, broker, tax specialist, or any other agent deemed necessary by my Trustee; and to pay from my estate reasonable compensation for all services performed by all of them. 4 EIGHTH: OPERATIONAL PROVISIONS Trustee 1. I appoint my son,Dennis Schad, Trustee hereunder. In the event of his death, resignation, renunciation, or inability to act in that capacity, then I appoint my son Timothy Schad, as Trustee in his place and stead. Determination of Income and Princi�al 2. The Trustee shall determine what is income and what is principal of the Trust established under the Will, and what expenses, costs,taxes, and charges of any kind whatsoever shall be charged against income and what shall be charged against principal in accordance with the applicable law of the Commonwealth of Pennsylvania as they now exist and may from time to time be enacted, - amended, or repealed. Waiver of Trustee's Bond 3. No bond shall be req�ired of any Trustee appointed in this Will. Choice of Law 4. The validity and administration of the Trust established under this Will and all questions relating to the construction or interpretation of the Trust sha11 be governed by the laws of the Commonwealth of Pennsylvania. NINTH: EXECUTOR Appointment 1. I appoint my son, Dennis Schad, as the Executor of this Will. In the event of his death, resignation, renunciation, or inability to act in that capacity, then I appoint my son, Timothy Schad, 5 as Executor of this Will in his place and stead. My Executor, whether original, substitute, or successor, is referred to herein as my"Executor". No Bond Required 2. No bond or other security shall be required of any Executor appointed in this Will. Powers 3. My Executor shall have, in extension and not in limitation of the powers given by law or by other provisions of this Will, the following powers with respect to the settlement and administration of my estate. Same Powers as Trustee (a) To exercise with regard to the probate estate a11 of the powers and authority - conferred by this Will on the Trustee over the trust estate. Distribution of Estate (b)When paying legacies or dividing or distributing my estate, to make such payments, division, or distribution wholly or partly in kind by allotting and transferring specific securities or other personal or real properties or undivided interests therein as part of the whole of any one or more payments or shares at current values in the manner deemed advisabie by my Executor. (c)My executor shall exercise any options available in determining and paying death taxes on my estate in such a way as my executor reasonably believes may be expected to achieve the greatest overall tax savings for my family. These decisions shall be made without regard to any effect upon the size of any beneficiary's interest or the size of any trust and without requiring adjustments between income and principal. 6 TENTH: EXERCISE OF POWERS WITHOUT COURT APPROVAL All of the powers granted herein or by law may be exercised, except as otherwise provided by law, from time to time in the discretion of my Trustee and Executor without further court order or license. ELEVENTH: TAX PRORATION All federal, state, and other death t�es payable because of my death, with respect to the property forming my gross estate for ta.�c purposes, whether or not passing under this will, and any interest or penalty imposed in connection with such tax, shall be considered a part of the expense of the administration of my estate and shall be paid out of the principal of my probate estate so that the burden thereof fa11s on my residuary estate, and none of those taxes shall be charged against any - beneficiary or any outside fund. TWELFTH: GENERAL - Effects of Inoperative, Invalid, or Illegal Provisions 1. If any provision of this Will or any Codicil thereto is held to be inoperative, invalid, or illegal, it is my intention that all of the remaining provisions thereof sha11 continue to be fully operative and effective so far as is possible and reasonable. Headin�s 2. The headings above the various provisions of this Will have been included only in order to make it easier to locate the subject covered by each provision and are not to be used in construing this Will or in ascertaining my intentions. 7 IN WITNESS W�-IEREOF, I, HELEN A. SCHAD, hereby set my hand to this last Will, which has been signed by me on this ..�� date of , 1996 at �i-�`�� "" , Pennsylvania. � / ,f`� �� 7 i��,�"�2/ -(�' �� HELEN A. S CHAD In our presence the above named Testatrix signed this and declared it to be her Will, and now at her request, in her presence and in the presence of each other, we sign as witnesses. �� _ !� . , � � � ,. _ �'� .�� ' ��%� , $ COMMONWEALTH OF PENNSYLVANIA : COUNTY OF BUCKS : I,HELEN A. SCHAD,testatrix whose name is signed to the attached instrument, having been duly qualified according to law, do hereby acknowledge that 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 e�ressed. �� HELEN A. SCHAD Sworn or affirmed to and acknowledged before me, by HELEN A. SCHAD, the testatrix, this 3 J n day of ��,,��,�" , 1996. / �__ _ . (SEAL) %'" - _ - ��♦;� , t�. � •r , �, Notary u ic � � �1 � J We, �,,.�„�-r/ ;T �� and � c� f r r �:. � « �r ,:-, �� t- c ,1 , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law do depose and say that we were present and saw testatrix sign and execute her Last Will and Testament; that she signed willingly and that she executed it as her free and volunta.ry act for the purposes herein e�ressed;that each of us in the hearing and the sight of the testatrix signed the will as witnesses; and , that to the best of our knowledge the testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. --, - /, G•,",� �,.� 1 z �C - 6,� Sworn or �rmed to and subscribed to before me by ��-f;:�/�;�' ( '��.> >!��;�'' And , , t . �''`'da of '' � �<< l� r�:r v2. ( <<,�� - t a �;� , vv�tnesses, t}us ;4 Y f7�-;`4� =r� f , 1996. . c,;� (SEAL) � _� , ,/ ;(��,:._ �,t, 'L:� �� Notary Public � UOTARIAL SEAL NANCY FcqRqR� �otary public , Southamptcn Gi_�cks �ounry ��%I�� :�im�r,i�sion c:<qrros J:�,i� J yoq_ 9 ------ ,