HomeMy WebLinkAbout05-22-14 t 1505610105
J REV-1500 EX(oa-11)(FI) �
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania
Bureau of Individual Taxes °""�'"`"T�`p"`"" County Code Year File Number
PO BOX 28o6oi INHERITANCE TAX RETURN n] /� 1I ��
Harrisburg PAi�128-o6oi RESIDENT DECEDENT !i/ 1
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
10/29/2013 ' 01/08/1925
DecedenYs Last Name Suffix DecedenYs First Name MI
Williams ' Beatrice I M '
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
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 O 2.Supplemental Return O 3. Remainder Retum(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 Schedule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTEB��Tfl:
Name Daytime Telephd�i Number � � m
Law Office of John C OszuS+pW I GZ (717)243-7�° � a Q
�,� -c r' �
REGISTER.�F Q(�.I{S-USE�J Y ' '°� �
� .w' ��7 fU �. 1 +...--3'
�.'.� -;:;� :,;7
..
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First Line of Address va�� `-� � -q � --rl
c�a
'104 S Hanover St ' `�' `� �`' � � �
�� c :: c�
: �7 N 3� �
Second Line of Address � -i t� Q
D` -'� '+"!
W
City or Post Office State ZIP Code DATE FILED
'Carlisle PA 17013
CorrespondenYs e-mail address:
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,cortect and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SI ATU�OF--P-�ERSON R�NSIB FOR FIL�G��TURN ��� r/�
L�E�t.s'fC°�c
AD ESS
768 W South St., Carlisle, PA 17013
SIGNAT PR RER OTHER THAN REPRESENTATIVE D TE
2L /
ADDRE
104 Hanover St., Carlisle, PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 15D56101�5 1505610105 J �1
� 1505610205
REV-1500 EX(FI)
DecedenYs Social Security Number
DecedenYs Name:
RECAPITULATION
1. Real Estate(Schedule A). .... ... ...... .... ... ............ ... ... ...... 1. 159,000.00 '
2. Stocks and Bonds(Schedule B) 2. 3,032.91
...... ...... ... ...................... ..
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) ..... 3.
4. Mortgages and Notes Receivable(Schedule D) ... . .. ........ ......... ... . 4.
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E). ... ... 5. 277,871.39
6. Jointly Owned Property(Schedule F) O Separate Billing Requested .... ... 6. 36,552.41 '
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested....... . 7. 82,400.93 '
8. Total Gross Assets total Lines 1 throu h 7 s. 558,857.64 '
� 9 ).............. ...............
9. Funeral Expenses and Administrative Costs(Schedule H)... ... ....... . .. ... 9. 38,176.08 '
10. Debts of Decedent,Mortgage liabilities and Liens(Schedule I).. ... ...... ... . 10. , 4,336.03 '.
11. Total Deductions(total Lines 9 and 10)..... ... ...... ... .......... ... ... 11. 42,512.11 '
12. Net Value of Estate(Line 8 minus Line 11) .. ... ...... ............. ...... 12. ;
13. Charitable and Govemmental Bequests/Sec 9113 Trusts for which '
an election to tax has not been made(Schedule J) ................ ........ 13. '
14. Net Value Sub'ect to Tax Line 12 minus�ine 13 �a. 516,345.53 I
1 ( ) .. ... ... .... ... ... ... ...
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 A- ' 15. ,
16. Amount of Line 14 taxable _ . __
at lineal rate x.0 45 516,345.53 �g. 23,235.55 '
17. Amount of Line 14 taxable _
at sibling rate X.12 17. '
18. Amount of Line 14 taxable .
at collateral rate X.15 ' 18• ' '
19. TAX DUE ........................ ...... ... ... ............. ... ... .. 19. 23,235.55 '
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT �
Side 2
� 1505610205 1505610205 J
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Beatrice M. Williams
STREET ADDRESS
_ ___ __ _ __
34 Tunbridge Lane
___— _ _ _. __ __ - _- -
CITY _ —__ STATE --r ZIP
Carlisle PA 17015
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 23,235.55
2. CreditslPayments
A.Prior Payments 22,450.00
B.Discount 1,181.58
-
Total Credits(A+g) (2) 23,6 .5
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) 396.03
5. If Line 1+Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5)
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.............................................................................................................................. ❑ �
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?.............................................................................................................. ❑ �
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(aj(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)J.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 naturai 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(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 individuai who has at least one parent in common with the decedent,whether by blood or adoption.
�
ft:.V-1507.F�+ (]J-SZ}
� pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE
INHERITANCE TAX REfURN REAL ESTATE
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Beatrice A. Williams 21-13-1184
Ali real properry owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property
would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F.
Attach a copy of the settlement sheet if the property has been sold.
ITEM Inciude a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
1� 34 Tumbridge Lane,Carlisle,PA 17015 159,000.00
TOTAL(Also enter on Line 1, Recapitulation.) $ 159,000.00
If more space is needed,use additional sheets of paper of the same size.
REV-1503 EX+(8-12)
`��"`pennsylvania SCMEDULE B
DEPARTMENT OF REVENUE
INHERIfANCE TAX REfURN STOCKS & BON DS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Beatrice A.Williams 21-13-1184
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1' 27 shares M&T Bank common stock @$112.33 3,032.91
TOTAL(Also enter on Line 2, Recapitulation) $ 3,032.91
If more space is needed,insert additional sheets of the same size
REV-15o8 EX+(08-iz)
� \�� pennsylvania
SCHEDULE E
DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN pERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Beatrice A. Williams 21-13-1184
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 OF DEATH
�. 1992 Mercedes C240 Sedan 6,844.00
2. FSC Securities Corporation Cash Account 3MA098275 264,827.20
3 M&T Bank Dividends 37.80
4 Penn National homeowners refund 33.00
5 Centurylink phone refund 23.84
g Pershing dividends 476.22
7 Pacific Life annuity dividend 468.33
g Penn National Auto Insurance refund 161.00
g Misc Pers Property 5,000.00
TOTAL(Also enter on Line 5, Recapitulation) $ 2��,8�1.39
If more space is needed,use additional sheets of paper of the same size.
REV-15o9 EX+(oi-io)
�: � :''pennsylvania SCHEDULE F
� DEPARTMENT OF REVENUE �pINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Beatrice A.Williams 21-13-1184
If an asset became jointly owned within one year of the decedenYs date of death,it must be reported on Schedule G.
SURVIVING]OINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A•Patricia E Boldoser 768 West South Street Daughter
Carlisle, PA 17013
B.
C.
JOINTLY OWNED PROPERTY:
LEffER DATE DESCRIPTION OF PROPERTY %oF DATE OF DEATH
LfEM FOR 102NT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER.ATTACH DEED fORJOIMLY HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 03103109 M&T Bank Power Checking Acct#445118 4,264.44 50 2,132.22
2 A 03103109 M&T Bank Power Money Market Acct#15004224164662 68,840.37 50 34,420.19
TOTAL(Also enter on Line 6, Recapitulation) $ 36,552.41
If more space is needed,use additional sheets of paper of the same size.
R�V-151U EX+ (09-�9}
�' pennsylvania SCHEDULE G
DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
INHERITANCETAXRETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Beatrice A.Williams 21-13-1184
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.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH °/a OF DECD'S EXCLUSION TAXABLE
INCLUDE THE NAME OF THE TRANSFEREE,TNEIR RELATIONSHIP TO DECEDENT AN�
NUMBER THE DATE OF TRANSFER. ATfACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1. Pacific Life bond annuiry Acct:VR00005842 26,550.08 100 26,550.08
2 Pacific Life bond annuity Acct:VR03039182 55,850.85 100 55,850.85
TOTAL(Also enter on Line 7, Recapitulation) $ 82,400.93
If more space is needed,use additional sheets of paper of the same size,
REV-1511 EX+ (08-13}
� � pennsylvania SCHEDULE H
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Beatrice M. Williams 21-13-1184
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. fUNERAL EXPENSES:
1' Hoffman Roth Funeral Home-Carlisle,PA 5,571.34
2 George's Flowers-Carlisle, PA 125.08
3 JDK Caterers-memorial service food 4,988�78
a Wine and Spirits-memorial service 263.85
s David Evertt-music for memorial service 415.68
s Jack Larson-music for funeral service 50.00
� Judy McCarren-music for funeral service 50.00
B, ADMINISTRATIVE COSTS:
1. Persona)Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
City--- -----— State__-- ZIP ......... ___—- ._....--
Year(s)Commission Paid:
13,335.00
2. Attorney Fees
3. Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees: 563.50
5. Accountant Fees:
6. Tax Return Preparer Fees:
�• Legal Advertising-Cumberland County Law Journal 75.00
s Legal Advertising-The Sentinel 116.20
s Baughman Memorial Works-grave inscription 195.00
�o Deluxe Check 15.50
�� PPL-Electric Bill 75.33
From Schedule H Continued 12,335.82
TOTAL (Also enter on Line 9, Recapitulation) $ 38,176.08
If more space is needed,use additional sheets of paper of the same size.
Beatrice M.Williams Schedule H Continued File#21-13-1184
Item Description Amount
12 UGI-gas service $ 124.08
13 Vital Chek-additional death certificates $ 118.00
14 Larry Weston -snow removal $ 60.00
15 South Middleton Twp water bill $ 136.25
16 Sam Weston-leaf cleanup $ 100.00
17 Advanced Disposal -trash service $ 41.38
18 Zeiglers Moving&Storage- remove furniture from house $ 456.14
19 County Taxes paid at settlement $ 18.50
20 Steve Barrett Real Estate-sales commission pd at settlement $ 4,770.00
21 Hooke, Hooke & Eckman-sales commission pd at settlement $ 4,770.00
22 Transfer tax paid at settlement $ 1,590.00
23 Tax certification needed for settlement $ 5.00
24 Final water/sewer bill paid at settlement $ 146.47
$ 12,335.82
R=V-]5]?. F�+ (]2-12}
� pennsylvania SCHEDULE I
. DEPARTMENTOFREVENUE DEBTS OF DECEDENT,
tNHERITANCE TAX REfURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Beatrice A Wiliiams 21-13-1184
Report debts inturred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1• Sarah A Todd Memorial Home 2,722.31
2 Second Presbyterian Church-remaining pledge 450.00
3 Cumberland Goodwill Fire Rescue-ambulance 168.75
4 Millennium Pharmacy 116.47
5 Robert C Caims,Tax Collector-real estate school tax 437.13
6 United Healthcare-health insurance 197.75
7 George Blashford,DMD 173.00
8 Visa bill 56.00
9 PPL-Electric Bill 14.62
TOTAL(Also enter on Line 10, Recapitulation) $ 4,336.03
If more space is needed,insert additional sheets of the same size.
REV-1513 EX+ (01-10)
��x pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE gENEFICIARIES
INHERITANCE TAX REfURN
RESIDENT DECEDENT
FILE NUMBER:
ESTATE OF:
Beatrice A. Williams 21-13-1184
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. Patricia E Boldosser 768 W South St.,Carlisle,PA 17013 Daughter 302795.23
2 Sylvia Dallas 334 Scaife Road,Sewickley,PA 15143 Daughter 213550.30
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:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
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,
Lj Y1t1,�1 I3dIl1S
sTn��r �sxron �ic�
SBP.24-OCT.23,2013 3 OF 3
SC]n�U Le �
�—'�� BEATRICE A WILLIAMS
PATRICIA E BOLDOSSER
'.ACGO�ZkT `: BSATRICS A WILLIAMS
POWER MO Y MARKRT 'RTTLB< ?' PATRICIA S BOLDOSSBR
ACCOUNT NO. 15004224164662 STONSHSDGS
ZNTSREST SARNSD FOR STATSMENf PBRZOD 4.52
ACCOUNT SUMMARY -
`ABPOSZ�S & i���DY2Ai�A�S;d� t3��R GE7RRKZiT &PES�2iG
Ii8.GF11NF�K'i`< ' _ ° _I�EgT., `
, � p�. ` TIONS< StTB IGSNS _` , . ,:
NO. AMOUNT NO. �O�T 4.53 68 840.37
68 835.84 0 0.00 0 0.00
ACC�UNT ACTIVITY
>z�s�e�ric >t�s�z�r�,zrr��a�r :t� n�r,v� �:tx�e� <:u�y :
: o ` o : > � . . an ..�so ` s `
$b8,835.84
09-24-13 BBGINNING BALANCE 4.53 �66,840.37
10-23-13 INTSREST PAYI�NT
$68 840.37
SNDING BALANCE
ANDiUAL PSRCBNTAGS YIBLD BARNSD = 0.07 $
** BND OF STATSMENT **
Hotciin�s bY Investor _.._._
_.__--.._.. ......
Bill Davldson Combined Account Portfolfo
Bsatrice A Williams pate: 10129I2013
341UnbtidgeLn FSCSecuritlesCorporation �reaced: ��io�i2oti3
Cartisla,PA 17013 60d 8 Linglestown Rd
Hartisbury,PA 17112
717-852-6901
8eatrice A Williams
Acct Namo:BEATRICE A WILLIAMS 34 TUNBRI�GE LN CARI.ISLE PA 1T013-7684
Acct No:VR000058A2 AcctType:IRA Individual4y EstablishQd
Rep.No:27140
Tlckor AasetTyp• Mgt.NaM¢ Quantlty ; P�1ca�:).:.: ::ValuQ(�);
�As.s�t Nama.:., : . : �. . . .
POR7 OP7 CONSERVATIVE BONDS PACIFIC LIFE 2,a37.17 10.89 26,560.08
S,�`„_ _1 U� � Account Total: S28.550.08
(:�T 1eA _......._
.. ..
Acct Name:BEATRICE A WILLIAMS 34 TUNBRIDGE LN CAR�fSLE PA 170�3-7684 Acct7ype:Generel •
Acc3 No:VR03039182
Rvp.No 2T140
` T�ck6r -Ass9��YPe 9 � �-:•,Vatu� �)1
�A�iO{Name : 80NDS , PACIFIC LIFE� :5158.89 p�10 83 � 55,850 8�r.
, , . 5
ppRT OPT CONSERVATIVE
Account Totai� 555,850.85
Sc.1r�e� 11� G --...__.... __ ...... --....__ — -—
^ACCt Nam�:BEATRICE A WILLIAMS 768 SOFJTH ST. CARLISLE PA 17013-2833 Acct7ypQ:lndividual
Acct No:3MA098275
Rep.No 75T
7lcker AssotTypo .Mgt:Ndlne
, . . ' Quanflty P,rico(i)' . � Valua.{il)i �
��sol�.Nam�,�. � . . , .
CA5H CASH 28M1,827.20 1,00 264,827.20 .
��1� � Accounl7otal: 5264.82720 ,
` InvostorTOta�: Z347,228.18 :
_ _ � �_._. .,..__.M__ " p�pe i ot2
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lorm HUD-1(3'�)nl MY�odt�.906.2
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' - q. SeLtlement S�tement us.oevartmem a Housinc a�d urban oevelopmern
B T OMB ov No.2 85
1. OFHA 2. OFmFW 3. OConv.Unins. 6.FYe Number 7.Loan Number 8.Morlgape Nsurance Case'Numher
4. VA 5. Conv.Ins. 1 � N�
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D.NAME OF BORROVVER �acna►a w.ca.swy a�a Msrt+.�.c�iay .
noor�ss:
E rwME oF s�ueR: rn.�.c.of e.a�a wa��:
qpp��: T 1701
F.NAME OF IENDER:
nDDRESS:
G.PROPERTY ADDRESS: . 34 Tunbridya Lan�,Ca�llsle,PA 17015
i Townshl
H.SETTLEMENT AGENT: Abom 3 Kutuldds ''
pI.ACE OF SETTtFMENT: I 1 1
I.SEfTLEMENT UATE:
.SUYMARY OF BORROWER'S TRANSACTION: K SUM Y OF E LER'S T SACTION:
1 0 FR
tOt. Contractsalea 159 40i. Contract 1590�,OQ
102. Personal 402. Peraonal
103. Seidement b borrower ' 1400 1 90200 403.
104. �.
105. 405.
Ad' stments for i[ema ' selbr in advanco Ad' tmanb f m ler in
t08. SchodTazes 01117h4m 4 �Oe. SchoolTaxes 01N7H4b 4 S9
109. ' 409.
110. 410.
111. 411.
112 412
1 (i NT D FR 161494.52 4Z0.(i UNT D T 1
P Y B HA F WER NT TO
201. sitaeamest 501. Excess SeeinsWCtiora -
202. Prhd anaum a new bans 50z. Settlement to seMer 1400
203. Ex ban s taken su ' to 503. Eu s taken to
204. 504. olFot t e Loan
p�, 505. oif of secad ban
206. �•
207. 507.
208. 508.
209. 509•
211. 1 1H�b01117H4 1 511. Caun Iaxes 1M�b 1 7H4 1
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
" 219. 519.
301. Gross snanl due borrower 1 181�Y4.S2 601. Gross anauil due b aelx ne 4 Y
3p2, less anaur�s Ror bo,rower ine 220 2 018 602. tsss red�wibe amaunt due aeMer 520 1 7
3.CASH F 159 47 .02 803. ASH T 141
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UNiiED STATES ON TMI&qi ANY SM�IIUR fOHM.PENAITIES UPON CON V1CTqN i haro caused a rAU cau��tM NMS�o Ds 040unM�n aaaEanea wiT tnis sulertMnt.
CAN INCLUOE A FINE ANO�APRISONMENT.FOR DETAILS SEE S�TLE/8:
U.S.COOE SECTION 1001 ANO SECTION 1010.
By.
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CODI CIL �
OF
BEA TRI CE A. WILLIAMS
I, BEATRICE A. WILLIAMS, c�f 5?i S. Hanc�ver Street, Carlisle, Cumberland
County, Pennsylvania, cic� herel�v n�.�l:� ;in�l cicrl;u�e this tc► he a Cc�ciicil te� my Lttst Will and
Testament clatecl Fehru�irv 1=�, i'1���.
1. I rev��ke the �14111t11111111�'lll ��I I ,iri�i��r. �I�ru�t C'c�n���,�ny <« "l�ru�[�e c�f the Trutit
created by paragraph Sixth c�i n�v �Vill ,inei in li�u tl��rc��� .���E�c�int n�y ci��ubhters, SYLVIA
DALLAS and PATTI BOLDOSSER tc� he the Cc�-Trustees c�f the Trust established by the
provision of subparagraph Sixth c�f n�v Will.
2. I ratify and cc�nfirm n��� VVill in all c�ther respects.
IN WITNESS WHEREOF, I h<<ve hereuntc� set my hanci and seal this �7�`'
day of August, 1996.
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� i�ca,�rtiic�; a. ����i_�.ian�s
SIGNED, SEALED, PUI�I_.ISI ll:O ,in�l
DECLARED in the E�re�enr� ul�:
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COUN'TY OF CUMi3ERLANI) •
I, BEATRICE A. WILLIAMS, Testatrix, whc��e name is signed to the attached or
foregoing instrument, having heen cluly yu�ilifiecl acec�rclin�; tc� law, cic� hereby acknowledge
that I signed and executecl the instruinent �i� .i r��ciicil t�� my La�t Will; that I signed it �
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willingly; and that I signecl it a� mv free �in�l vc�luntary act fc�r the purpc�ses therein ,
expressed.
Sworn or affirmed tc� ancl ackne�wleci�ecl hefc�re me, hy BEATRICE A. WILLIAMS,
the Testatrix, this � `7 �' clay c�f -�--�.��iu-�-��~' , 199�.
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1;(;A'TKICE A. WILLIAMS, Testatrix
,� � �
Nc�tarv Puhlic
rarnauLL sEa�
!lS6RlENE MAAHEYKA Notery Pib�ic
Ce�isle,Cumberlard Couxy,Pa
My Commi�sion E�ires 6lBnJ8
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COMMONWEALTH OF PENNSI'LVANIA .
. ss.
COUNTY OF CUMBERLANU •
we� 3AMES D. FLOG�IER t�ncl TERESA J . BURKHOLDER , the
witnesses whose names are �i�.:neci tc� th� <<tt,�rhecl c�r fe�re�c�in� in�trument, heing duly
qualified aeeordin� tc> law. cic� c1e��c�`� ,�ncl �;�v th�it ���e <<re ��re�ent cincl saw Testatrix,
BEATRICE A. WILLIA�1S, �i`,n ;u��i r.���rut�� th� in�trunicnt <« �i cc�cliril tc� her Last Will,
that she signecl willin�ly ��n�i th,it :I�� ��rrut�cl it c« h�r frce :1111I vc�lunt�iry act fc�r the
purposes therein expressecl; th.it �.�rl� ��t� u� in tl�� h�.�rin�, .u��i �i�ht c�f the Te�tatrix signed
the Codieil as witnesses; ancl that tc, thc b��t c�l c,ur knc�wle�lbt the Testatrix was at that time
18 or more years of age, of sc�uncl minci ancl under nc� ec�nstraint c�r tindue influenee.
Sworn or affirmed tc� anci �uh�crihe�i tc> hefc�re me hy J�S D. FLOWER
an TERESA J. BURKHOLDER , witnesses this c�� � 1 day of
19�)(�.
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� NOTARIAI.SEAL
MERLENE MAiiHEVKl1�efY�� _
CarCele,CumbeAtnd CounY,Pa _
My Commission Expiros 6I8i98
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��.�t �i11 �.n� C�1��t�zm�rct i
OF
BEA TR/CE A. W/LL/AMS
I, BEATRICE A. WILLIAMS, of 525 South Hanover Street, Carlisle, Cumberland
, �
County, Pennsylvania, declare this instrument to be my Last Will and Testament, in
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manner and form following: '
FIRST: i hereby expressly revoke all Wills and Codicils heretofore made by �
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me. j
SECOND: I hereby direct my Executor to pay all my just debts, funeral and �
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administrative expenses out of my estate, as soon as practicable after my death. ;
THIRD: I direct that all taxes which may be assessed in consequence of my �
death of whatever nature and by whatever jurisdiction imposed shall be paid out of my
estate as a part of the administration of my estate.
FOURTH: I give and bequeath such of my personal properry as may be listed i
on an unsigned memorandum kept with my Will to persons named thereon, provided they !
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survive my death. Should such a memorandum not be found with my Will, it shall be �
conclusively presumed that none was prepared, and all of my personal property shall be
considered a part of the remainder of my estate.
FIFTH: I give and bequeath to my husband, ROY E. WILLIAMS, JR., all the ;
rest of my tangible personal property. �
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SIXTH: I give to FARMERS TRUST COMPANY, of Carlisle, Pennsylvania,
in Trust, a sum equal to the tax credit equivalent for Federal Estate Tax purposes, which
sum is, as of the date of this Will, Six Hundred Thousand ($600,000.00) Dollars. The
Trustee shall invest and reinvest the principal and pay all of the income to my husband,
ROY E. WILLIAMS, JR., in quarterly or other convenient installments, as long as he may
live.
A. Should Federal Estate Tax laws enacted subsequent to the
date of this Will, and prior to my death, either increase or decrease the
amount of the tax credit equivalent, it is my intent that the funds constituting
the principal of the Trust be such greater or lesser amount, in lieu of the
above stated Six Hundred Thousand ($600,000.00) Dollars;
B. Should there be insufficient assets to fully fund this Trust, it
shall be funded to the maximum extent possible;
C. Should the income, when taken together with other income
that my wife may have from other sources, prove insufficient to properly
provide for his wel#are, comfort and support, then Trustee may, in its sole
discretion, pay to him whatever sums it deems necessary and appropriate
out of the principal of this Trust, as well as the income, to permit him to
' mair�tai� a standard of living similar to that enjcyed by him duriny "is
' lifetime.
D. The Trustee, on behalf of the beneficiary, may make payments
to others for his use and 'benefit, to assure his welfare, comfort and
maintenance.
2
nd the Trust shall terminate and �I
E �pon the death of my husba , �hildren,
all assets of the Trust shail be distributed in equal shares to my
SYLVIA
DALLAS and PATT� BOLDOSSER, or the issue of any deceased
child, per stirpes. estate, I give, devise and
SEVENTH: All the rest, residue and remainder of my
bequeath to my husband, ROY E. W��LIAMS, JR•, absolutely.
E1=_
Shouki my husbar►d, ROY E.Wi�MS� �R•,fail to survive me, then
I d;rect tnat my e
ntire estate be distributed among my children as set forth in Paragraph
Fifth, Sub-paragraph E above. husband, ROY E.
E��H: I hereby
nominate, constitute and appoint my
be the Executor of this my Last Will and Testament. in the event that
WILLIAMS, JR•, to reason, I then
ROY E. W�LLIAMS, JR. shail be unable to serve as Executor for any r
inate constitute and appo►nt my daughter, SYLVIA DALLAS, and my
daughte ,
nom ,
ER as Executrices. No personal representative shall be required to fi e
pqTTl BOLDOSS ,
bond in this or any other jurisdiction.
�N WITNESS WHEREOF,
I hereunto set my hand and seal this �y�
day of -���--� 1995
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Beatrice A. Williams
SiGNED, SEALED, PUBLISHED and
DEC�ED in the presence of:
_... �,1 Lt� `� � .� ,� L(.�'�� �.
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COMMONWEALTH OF PENNSYLVANIA • �
; SS.
COUNTY OF CUMBERLAND •
I, BEATRICE A. WILLIAMS, Testatrix, whose name is signed to the attached or
do hereby
foregoing instrument, having been duly qualified a asornding� �w'aWhat I signed it .
acknowledge that I signed and executed the instrumenry y Ses therein
willingly; a�d that I signed it as my free and volunta act for the purpo
expressed.
Sworn or affirmed to and acknowledged before me, by BEATRICE A. WILLIAMS,
� da of � , �LA1�-i�-u , 1995.
Testatrix, this /� Y
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Beatrice A. Williams, Testatrix
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Nota Public ,!
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7t���5�i J.8t1RiCr'ULurn,l��tary Puh;iti y
i �itlfi{�`��.p�illfl'�:.�'w��is'i�l�VNu��f���a/•�(� �
� ,k!����r�i r`I:;;:j�'kri 1;.;��.'i{�'�9��IJ. �K��.7.7� i
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COMMONWEALTH OF PENNSYLVANIA :
: SS.
COUNTY OF CUMBERLAND .
�/g� James D. Flower and Michelle L. Faust , the
witnesses whose names are signed to the attached or foregoing instrument, being duly
qualfied according to law, do depose and say that we were present and saw Testatrix,
BEATRICE A. WILLIAMS. sign and execute tne instrument as her Last wil: that she
signed willingly and that she executed it as her free and voluntary act for the purposes
therein expressed; that each of us in the hearing and 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.
Sworn or affirmed to and subscribed to before me by Ja:nes D . Flower
and Michelle L . Faust , witnesses this � day of �, �:: ��..� -�;�:,:,�,
1995.
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��,��:�;�J.Bt�RKF?C�LD�t�,Notary Public
5 C:��,s�U,uum?x�r�ansi County,Pa•
�,���,;�;rn��:�t��qt�x�itCt&F�I�. 1�,1998
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