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HomeMy WebLinkAbout02-0475 ~ Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of Helen E. Sullivan No 21-02- LIlES also known as , Deceased Social Security No. 206-24-8047 l'el,""',.oI",,,,noi.,.,.1lJyu""'age"'oIde','W'yl,...,I,,o; (COMPLETE "An OR "B" BELOW:) f\A. A. Probate and Grant of Letters and aver that Petitioner{s) is/are the executOr named III the Last Will of the ... Decedent, dated February 17,1999 and codrcills} dated - 5,.,. ,ele~..." <:Heur,...,.."c.., ..y.. ."nuncia,i,,",. ~e",h "f e~ew"'r, ole Except a follows, Decedent did not marry, was not divorced. and did not have a child born or adopted after execution of the documents offered t~; was not the victim of a killing and was never adjudicated incompetent: B. Grant of Letters of Administration 10.',".".h.'''':.I... 1"""."'0"'";'\'''''''''"'''''''''".''''''.''.''''''''''"'''' Petitioner(sl after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: I Name Relationship Residence I {COMPLETE IN ALL CASES:} Attach additional sneets IT necessar y Decedent was domiciled residence at 7 Cumberland RadM IC ur P r~", '''~"', "",,,b~, '.,d ''''''''C"pnl''yl Decedent. then ~ years of age, died March 9, 2002 at Hershey Medical Center, Dauphin County, PA fLu""""'" Decedent at death owned property with estimated values as follows: (If domiciled in PAl All personal property (If not domiciled in PAl Personal property in Pennsylvania. IIf not domiciled in PAl Personal property;n County. Value of real estate in Pennsylvania Real Estate situatedT::af1ollows: . 1 b7 Sample Bridge Road; MechanlCsburg; PA' 900,000.00 ... $ $ $ $ $ J 67.050.00 1 067 0,0 00 Wherefore. Petitioner(sl respectfully request[s) the probate of the last Will and Codicilis) presented with this Petition and the grant of letters in the appropriate form to t undersigned: / Typed or printed name and residence John C. Sullivan e Road Mechanicsbur P A 17055 RW-7 I~I- ld'l/..f Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland before me this 15th Sworn to and affirmed and subscribed day of The Petitioner{s) above-named swear(s) and correct to the best of the knowledge and belief of P Petitioner(s) will well and truly administer the est t MAY 2002, ~ :-l/1~fJ1-'1, . Y C IS c,~ Estate of Helen E. Sullivan DECREE OF REGISTER No. also known as Deceased 21-0'2.- ~15 Date of Death: March 9, 2002 Social Security No: 206-24-8047 AND NOW. MAyan ,. 2002. in consideration of the Petition on the reverse side hereon, satisfactory proof hi'ving been presented before me, [') j ~J ~ :-/) IT IS DECREED that Letters 0 Testamentary 1" of Administration "f'F.:1'1'1\1,lE1JfA:RY r:i~tvtt-' I ! IX1 ,... I.. ",." , ,.."..Ie'",- '''''. """",,.. ''''''''''''', '"''~''''' """""''''''1 I are hereby granted to John C. Sullivan . ! "ru01.. in the above estate and that the instrument(s), if any, dated February 17,2002 -..!J VV described in the Petition be admitted to probate and filed of record as the last Will of Decedent. ' FEES letters........................... $ 865.00 '---/) '.) 2j t!-t -( /,--(.4. Short Certificate(s).......... Renunciation.................. Affidavit ( )................. Extra Pages ( 9 )............ Codicil. __............__........ JCP Fee Inventory & Tax Forms... Other.... __..................... TOTAL..... RW-7a i; $ o...;;? 6. 00 $ 10.00 $ $ 27.00 $ $ 5.00 $ $ Attorney: John C. Sullivan, Esquire I.D. No: 07257 Address: P. O. Box 840 Harrisburg PAl 71 08-0840 Telephone: (717) 236-3010 DATE FilED: 5-15--2002 called Qtty on 5-16-2002 $ 943.00 RENUNCIATION '21-0'2,.- 415 IN RE: ESTATE OF HELEN E. SULLIVAN, DECEASED. TO THE REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYL VANIA. The undersigned, Michael K. Sullivan, son of the above Decedent, hereby renounces the right ..: ~ -rg to administer the Estate and respectfully asks that Letters of Administratiolbe issued to John C. Sullivan. 1'- WITNESS, my hand this 7_5 day of March, 2002. l~- rJI i <J/~ Michael K. Sullivan, Trustee under the Residuary Clause of the Will of Helen E. Sullivan RENUNCIATION 2 I - 0 '2. - 4'5 IN RE: ESTATE OF HELEN E. SULLIVAN, DECEASED. TO THE REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYL VANIA. The undersigned, Elizabeth F. Sullivan, daughter of the above Decedent, hereby renounces t / e- .-;1:2- the right to administer the Estate and respectfully asks that Letters of AdministratiOl(be issued to ~pz-t. o? John C. Sullivan. . WITNESS, my hand this;).1O day of March, 2002. ~ /I/~ Cu.mbVtR.and I<>wnah",? 17d.D :;,~~~':7:i::';"~:O' MOTHER'S NAME (f"M, Middle. Maod8f1 Su,n...-ne) LAST WILL AND TEST AMENT OF HELEN E. SULLIVAN 2 \- o-z. . 4'5 I, HELEN E. SULLIVAN, of Silver Spring Township, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament, hereby revoking all prior Wills and Codicils. ITEM !. 1 direct t.lJat my just dents, the ~xpen~e~ of my last illness, funeral and burial, shall be paid from my estate as soon as practicable after my death. GIFTS ITEM II. Tangible Personal Gifts. I give all tangible personal property owned by me at my death, and all insurance policies on such property as follows: (a) To those individuals who survive me by thirty (30) days who are designated on a list or memorandum signed by me which list refers to this Will or is found with a copy thereof, the items listed beside their names. If no such list is found within thirty (30) days of my death, it shall be presurned thz.t no such list exists. (b) The balance (including any item under subparagraph (a), the bequest of which has lapsed) to my husband, John C. Sullivan, if he survives me by thirty (30) days; and if not, in as nearly equal shares as is practicable to such of my children, Timi, Michael and Elizabeth, as survive Page 1 oflO Ii. f. S. H.E.S. me by thirty (30) days, or the issue of my aforementioned children as survive me by thirty (30) days, per stirpes. (c) In the event of disagreement among my children as to the bequest made under subparagraph (b) above, my Executor is authorized to make the division, having due regard for the personal preferences of my children, but making such division in as nearly equal shares as the Executor deems practical. (d) With respect to any item passing under subparagraph (a) or (b) to a minor, my Executor (I) may hold and deliver it to the minor at majority or earlier, or deliver it to any person to hold for the minor; or (2) may sell it, hold and invest the proceeds for the minor's benefit for any reason without considering other funds available to the minor. The receipt of any person who receives an item or payment hereunder shall be a complete discharge to my Executor. (e) My Executor shall pay, as an expense of settling my estate, all costs of delivering such tangible personal property, including the costs of packaging, delivery and insurance. RESIDUARY ESTATE ITEM III. I give IN TRUST the residue of my estate, real and personal, to the Trustee under that certain Trust Agreement signed by me on February 17, 1999, to be managed and invested under the terms of said Trust Agreement and all valid amendments thereto, to be added to the trust estate under that Trust Agreement as in effect at my death. Page 2 oflO H.ES-. H.E.S. TAX PROVISIONS ITEM IV. 1. Death Taxes. Except as otherwise may be provided in my husband's will or trust, or in any other trust, all federal, state, and other death taxes, payable because of my death, on the property forming my gross estate for tax purposes, whether or not it passes under this Will, shall be paid out of the principal of my probate estate so that the burden falls on my residuary estate, and none of those taxes shall be charged against any beneficiary. The provisions concerning payment of taxes shall not apply to generation-skipping taxes and any property over which I have a general power of appointment for federal estate tax purposes. 2. Survivorship. My husband shall be deemed to have survived me if the order of our deaths is not clear. 3. Tax Options. I hereby authorize my Executor, in my Executor's sole discretion, in whole or in part, to elect to treat in whole or in part as qualified, terminable interest property for the purpose of qualifying for the marital deduction, any property passing under my Will, said Trust Agreement, or otherwise (in which my husband has a qualified income interest for life.) My Executor shall be without liability to anyone for making or failing to make such election. 4. I hereby authorize my Executor, in my Executor's sole discretion, to make an election, in whole or in part, to cause the Pennsylvania Inheritance Tax to be payable by my estate on property passing to or for the benefit of my spouse, or to defer Pennsylvania Inheritance Taxes Page 3 of 10 1-1. ~.). H.E.S. on such property. My Executor shall be without liability to anyone for making or failing to make such election. 4. I hereby authorize my Executor and my Trustee under the Trust Agreement dated February 17, 1999, to exercise any options available in determining and paying any taxes in my estate, and to allocate my generation-skipping tax exemption. These decisions may, including income and gift taxes, be made without requiring adjustments between income and principal. The decision of my Executor or my Trustee shall be conclusive upon all persons concerned. 5. Generation-Skippin~ Tax. The primary purpose of this paragraph is to use my federal generation-skipping ("GST") tax exemption (now $1 million) more effectively if my property ultimately could be subject to that tax. I direct that: A. Division of Trusts. Any trust or addition which otherwise would be partially exempt from federal generation-skipping tax shall be divided fractionally to form separate trusts so that my federal generation-skipping tax exemption may be allocated exactly to one or more trusts. The trusts which have been divided shall have the same terms unless otherwise specified in this paragraph, but may be administered differently. Any trust or addition may be held as a separate trust if it is not possible to separate it into exempt and non-exempt trusts. Page 4 oflO J~. (:.5. H.E.S. B. Power of Appointment to Reduce Tax. The limited powers of appointment which are exercisable by a Will hereunder, shall be expanded as follows if certain taxes can be reduced: I. A child who has a power of appointment exercisable by his or her will may, by a will specifically referring to the power of appointment, appoint the trust to his or her estate to the extent the aggregate of the federal estate tax and GST tax due as a result of the child's death can be reduced. 2. Any increase in death taxes in the beneficiary's estate caused by the inclusion of the trust in it for tax purposes, shall be paid out of the unappointed principal of the trust, and a written statement by his or her personal representative may be accepted as being correct. BENEFICIARIES UNDER 23 ITEM V. Any property passing under this Will to a person under twenty-three (23) years of age, or is disabled, physically or mentally at the time an interest is distributable outright to him or her under this Will, the property shall be paid to his or her parent as custodian for that beneficiary under the Uniform Transfer to Minors Act of Pennsylvania. If his or her parent for any reason fails to qualify or ceases to act as custodian, my Executor shall appoint the custodian in his or her place. Page 5 of 10 IU~'.S. H.E.S. ITEM VI. Powers of Appointment: No provision of this Will shall exercise any power of appointment I may have. ITEM VII. Power to Disclaim: Any beneficiary under this document (or his or her personal representative, guardian or agent acting under a power of attorney) may, at any time and from time-to-time, by written instrument, release, disclaim or otherwise limit, in whole or in part, any power or interest granted to such beneficiary under this document. The disclaimer need not take effect immediately and may be contingent upon the occurrence or non-occurrence of any event. PROTECTIVE PROVISIONS ITEM VIII. To the greatest extent permitted by law, before actual payment to a beneficiary or to his or her account, no interest in income or principal shall be assignable by a beneficiary or available to anyone having a claim against a beneficiary. MANAGEMENT PROVISIONS ITEM IX. I authorize my Executor to: I. Retain/Invest: Retain and invest in any form of real or personal property anywhere which, in my Executor's opinion, is appropriate for my estate, without being required to diversify; 2. Compromise: Compromise claims and abandon any property which, in my Executor's opinion, is oflittle or no value; Page 6 oflO J-f.f.5. H.E.S. 3. Borrow: Borrow from anyone and pledge property as security for repayment of any funds borrowed; 4. Sell/Lease: Sell at public or private sale, exchange, lease or lend for any period of time any real or personal property, and give options for sales or leases; 5. Capital Changes: Join in any merger, reorganization, voting trust plan, or other concerted action of security holders and delegate discretionary duties with respect to these powers; and, 6. Disclaim: Disclaim any part or all of any property, power, or interest passing to me or for my benefit under any will, trust or otherwise; and 7. Distribute: Distribute in cash or in kind, and allocate specific assets among the beneficiary (including any custodianship) in such proportions as my Executor may think best, so long as the total market value of any beneficiary's share is not affected by such allocations. The powers, authorities and discretion given under my Will shall be in addition to those granted by law, shall continue until the distribution of the property, and shall be exercisable without court authorization. Page 7 of 10 ~. H.E.S. FIDUCIARIES ITEM X. 1. I hereby appoint my son, Michael K. Sullivan, as Executor of this Will. Ifmy son, Michael K. Sullivan, fails to qualifY or ceases to act for any reason, I appoint my daughter, Elizabeth F. Sullivan, as Successor Executrix in his place. 2. Except as provided in Paragraph 1 above, each individual Executor/Executrix then serving, may appoint, in writing, an individual to succeed him or her. My individual Executors then serving may unanimously appoint, in writing, an individual to serve with them. 3. My individual Executors then serving may unanimously appoint, in writing, a corporation organized under the laws of the United States or any state thereof and possessed of trust powers, which has trust assets of at least One Hundred Million Dollars ($100,000,000.00), as corporate Executor. Page 8 of 10 ({.{C's. H.E.S. IN WITNESS WHEREOF, I, HELEN E. SULLIVAN, the Testatrix to this Last Will and Testament, have hereunto set my hand and seal this \ 1 day of 1- ~ ,1999. l~f~ Helen E. Sullivan In our presence, Helen E. Sullivan, signed this and declared it to be her Last Will and Testament, and now at her request, in her presence, and in the presence of each other, we sign as witnesses: /"'l / / f 71 -' f) I' (~nN..t Witness "/ J< ('''''1'.., , -[ ") '/ /4 {t' r;,j:"J"',:"'1: I Address '1~a.~ y,fitn (/ z~. Address d ,111 Page 9 of 10 COMMONWEALTH OF PENNSYLVANIA ss: COUNTY OF DAUPHIN I, Helen E. Sullivan, having been duly qualified according to law, acknowledge that I signed the foregoing instrument as my Last Will and Testament, and that I signed it as my free and voluntary act for the purposes therein expressed. I~t ~ Helen E. Sullivan We, f?",,/ A 1\)0,,,,".. and L:\ I) , \.j1,UU2/ , having been duly qualified according'to law, depose and say that w er resent and saw Helen E. Sullivan sign the foregoing instrument as her Last Will and Testament, that she signed it as her free and voluntary act for the purposes therein expressed; that each of us, in her sight and hearing, and at her request, signed the Last Will and Testament as witnesses; and that to the best of our knowledge, she was at that time 18 or more years of age, of sound mind, and under no constraint or undue influence. /} 1/ -/~'~'-'J~_I'/ , I' Witness /7 ..4 kcr;"", \ ,) [):.'!d a ~ j Subscribed, sworn to or affirmed and acknowledged before me by the above- named Testatrix and by the witnesses whose names appear 0 posite, on this /711. day of e 't<AR ,1999. otary Public My Commission Expires: NOTARIAL SEAL JEANNETTE CHELGREN, NotaJY PublIc Coty of Harrisbt"g, Dauphin CounlV Comml.sion E 'res Feb. 15 2001 Page 10 oflO COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV~1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NAUMAN SMITH SHISSLER & HALL POBOX 840 HARRISBURG, PA 17108-0840 _nn_n fold ESTATE INFORMATION: SSN: 206-24-8043 FILE NUMBER: 2102-0475 DECEDENT NAME: SULLIVAN HELEN E DATE OF PAYMENT: 06/06/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 03/09/2002 NO. CD 001265 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $24,535.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: NAUMAN SMITH SHISSLER & HALL CHECK# 25186 SEAL INITIALS: SK RECEIVED BY: REGISTER OF WILLS $24,535.00 MARY C. LEWIS REGISTER OF WILLS J- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: HELEN E. SULLIVAN Date of Death: March 9. 2002 Will No. 0475 Admin. No. 2002 To the Register: 1 certifY that notice ofbeneficiaI interest required by Rule 5.7(a) of the Orphans' Court RuIes was served on or mailed to the following Beneficiaries of the above-captioned estate on June 5, 2002: Name: Address: John C. Sullivan 107 Sample Bridge Road, Mechanicsburg, PA 17050 2005 Ewing Road, Cochranville, PA 19330 2527 Aspen Street, Philadelphia, PA 19130 107 Sample Bridge Road, Mechanicsburg, P A 17050 107 Sample Bridge Road, Mechanicsburg, P A 17050 Elizabeth F. Sullivan Michael K. Sullivan Timi A. Sullivan John C. Sullivan, III Notice has now been given to all persons entitled thereto under Rule 5.6(a) except N/A / / " (/ ( " '!~d ~ t ~--. Date: June 5, 2002 {th Si~afure ' I Iohn C. SUllivan~ Esquire Nauman, Smith, Shissler & Hall, LLP Supreme Court J.D. No. 07257 200 N. 3'd Street, 18th Floor P. O. Box 840 Harrisburg P A 17108-0840 Capacity: Personal Representative x Counsel for Personal Representative <::. IN THE COURT OF COMMON PLEASE OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION INRE: EST ATE OF HELEN E. SULLIVAN, DECEASED NO. 21-02-0475 DISCLAIMER The undersigned, Michael K. Sullivan, being the son of Helen E. Sullivan, intending to be legally bound, makes the following disclaimer: Disclaimant hereby disclaims all right, title and interest he may have in Stein Roe Mutual Fund Account #337-98169083. This Disclaimer is irrevocable and unqualified. IN WITNESS WHEREOF, the undersigned has set his hand and seal this 27th doy 7tmbec 2002. l'I,^~, ~f$C;ld Witness Ml ael K. SUl~~an \ COMMONWEALTH OF PENNSYLVANIA COUNTYOF ?f-\It..A.~)(i:t..r'fII.A On this, the :i 7 'Day of NoveWl he y , 2002, before me, a Notary Public, the undersigned officer, personally appeared Michael K. Sullivan, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed same for the purposes therein contained. SS IN WITNESS WHEREOF, I hereunto set my hand and notarial seal. otJ-'rMU-1h. ~ Notary Pu My Commission Expires: (SEAL) Notarial Seal Donna M. EUGcimGm, Not?ry Pcbl:c M~i:*~~H[~2i!~~~~~',;J;;~~';;m~~s HEATH L. ALLEN N. DAVID RAHAL CHARLES W. RUBENDALL II ROBERT L. WELDON EUGENE E. PEPINSKY,.JR JOHN H. ENOS m GARY E. FRENCH DONNA 5. WELDON BRADFORD DORRANCE .JEFFREY S. STOKES ROBERT R. CHURCH STEPHEN L. GROSE R. SCOTT SHEARER WAYNE M. PECHT ELYSE E. ROGERS CRAIG A. LONG YEAR DONALD M. LEWIS nr. BRIDGET M. WHITLEY .JOHN A. FEICHTEL ANN McGEE CARBON ELIZABETH J. GOLDSTEIN BARBARA A. GA\..L STEPHANIE KLEINFELTER KEEFER WOOD ALLEN & RAHAL, LLP 415 F ALLOWFIELD ROAD, SUITE 301 CAMP HILL, PA 17011-4906 ESTABLISHED IN 1878 OF COUNSEL: SAMUEL C. HARRY PHONE 717-612-5800 FAX 717-612-5805 HARRISBURG OFFICE: 210 WALNUT STREET HARRISBURG, PA 17101 EIN No. 23-0716135 WoNW.keeferwood.com PHONE 717-255-8000 December 6, 2002 717-612-5801 erogers@keeferwood.com Via: Certified Mail Cumberland County Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 Re: Estate of Helen E. Sullivan File #21-02-0475 Dear SirlMadam: Enclosed herewith for filing please find the following: 1. Pennsylvania Inheritance Tax Return (filed in duplicate;) 2. Inventory; 3. Check in the amount of $25.00 in payment of your filing fee. 4. Check in the amount of $2,458.16 in payment of tax due. Kindly acknowledge receipt of these documents by time-stamping the enclosed copy ofthis letter and returning it to our office. Thank you. EER/cds 90873 Enclosure , REV-1500 EX + (6-00) I OFFICIAL USE ONLY I COMMONWEALTH OF PENNSYLVANIA REV-1500 DEPARTMENT OF REVENUE /7- ~?r N DEPT. 280601 INHERITANCE TAX RETURN FILE NUMBER HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21 2002 0475 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Sullivan, Helen E. 206-24-8043 DECE- DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD.YEAR) THIS RETURN MUST BE FILED IN DUPLICATE DENT 03/09/0il 04/13/1931 WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Sullivan, John C. 3. Remainder Return CHECK ~' Original Return ~' Supplemental Return ~ (date of death prior to 12-13-82) APPRO- 4. Limited Estate 4a. Future Interest Gompromise 5. Federal Estate Tax Return Required (date of death after 12-12,-B2) PRIATE 6. Decedent Died Testate 7. Decedent Malntamed a LIving Trust 8. Total Number of Safe Deposit Boxes (Attach copy of Will) (Attach a copy 01 Trust) BLOCKS 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date 01 death between ~ 11. Election to tax under Sec_ g, 13(A) 12-31-91 and 1.1-95) (AtlachSchO) 'fflf$!!si;\Qt\pi>jMQwrillli;PPMll'!il5iiiiti/N\.@PPlljltj$!iPi-IQtlffi;$lf.$PffPjJJgNffiIMifi9i1N$:l!lM.ilfjQNSW:ll!iiP~g.pj!lli;qttjpffiQS NAME COMPLETE MAILING ADDRESS COR- John C. sullivan 107 Sarrple Bridge Road RE- FIRM NAME (If Applicable) Mechanicsburg , PA 17050 SPON DENT TELEPHONE NUMBER 717-766-4347 None. OFFICIAL USE ONLY 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 997,261.75 3. Closely Held Corporation, Partnership or Sale-Proprietorship (3) None 4. Mortgages & Notes Receivable (Schedule D) (4) None 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 16,540.48 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested (6) None RECA- PITULA- 7. Inter-Vivos Transfers & Miscellaneous TION Non.probate Property (Schedule G or L) (7) 59,536.94 8. Total Gross Assets (total Lines 1-7) (8) 1,073,339.17 9. Funeral Expenses & Administrative Costs (Schedwle H) (9) 10,869.36 10. Debts of Decedent, Mortgage Liabilities, & liens (Schedule I) (10) 978.14 11. Total Deductions (total Lines 9 & 10) (11) 11,847.50 12. Net Value of Estate (Line 8 minus Line 11) (12) 1,061,491. 67 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax (13) 7,154.74 has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 1,054,336.93 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, ortranslersunderSec. 9116 (a)(1.2) 425,793.19 X.O 0 (15) 0.00 TAX 16. Amount 01 Line 14 taxable af lineal rate 628,543.74 X.O 4s- (16) 28,284.47 - COMPU- 17. Amount 01 Line 14 taxable at sibling ratB 0.00 x.12 (17) 0.00 TATION 18. Amount 01 Line 14 taxable at collateral rate 0.00 X .15 (18) 0.00 19. Tax Due (19) 28,284.47 20. 0 IqH"'\'*ij$!\Eif8Q1r!$$ijf;Qiji!($'Pi>jti'@fi~R'Pl!A\iliQjiEillj.ilYMI$I,jJ1 C- . . '.' ~> Be SUFlETO ANSWel'l ALL QUESTIONS 01'1 PAGE 2ANO ReCHECK MATfl<< o PA15001 NTF 29755 Copyright 2000 Greatland/Nelco LP - Forms Software Only PA REV.1500 EX (6-00) Decedent's Com lete Address: STREET ADDRESS 107 S Ie Brid e Road Page 2 CITY Mechanicsb Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount STATE PA ZIP 17050 (1) 28,284.47 24,535.00 1,291.31 Total Credits (A + B + C) (2) 25,826.31 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (0 + E) 4. It line 2 is greater than Une 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. It Line 1 + Line 3 IS greater than line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of line 5 + SA. This is the BALANCE DUE. Make Check Payable 10: REGISTER OF WILLS, AGENT (3) 0.00 (4) (5) 2,458.16 (5A) 0.00 (58) 2,458.16 · .' . PLEASE ~NsViE~THEFOLl.OWINGQUESTI()NS~~P~CIN6 ~~'. 1. "X" IN THE APPROPRIATE BLOCKS Did decedent make a transfer and: 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 December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? 3. Did decedent own an "in trust tor" 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 MU OMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Itles p jurY, I d~lar t I have examined this returnJ including accompanying schedules and statements, and to the best of my elle j is true, cor a omplete. Declaration OT preparer other than the personal representative is based on information of n knowled R 0 Yes No ~ I B ~ E3 o ( LJ"-L-- DA TE/ / "-:? ,O'lIOL- PA 17050 '" 2P.S. 89116(a)(1.1)(i}). For dates of death 0(1 or after Janual)'1, 1995, the tax rate is imposed on the net value of transfers to arforthe use of the surviving spouse is 0% [72 P,S Ii 9116 (a) (1.1) (iiJl. The statute does not exp.mnt a trans/erto a surviving spouse from tax, and the statutoI)' requirements for disclosure of assets and filin\! a tax return are sli\\ applicable Bven it fhe surviving spouse is the only henelicisl)'. For dates of death 011 or after Juiy 1. 2000: The tax rate imposed on the net value of transfers lrom a deceased child twenty-ane years 01 age or younger at dsath 10 or lor Ihe use of a natural parent, an adOPtive perent, ar a stepparent althe child is 0% \72 P.S. 1191 16(a}(1.2)]. The tax rate imposed on the net value of transfers to or lor the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72.P.S. S 9116(1.2) \72 P.S, ~9n6(a)(1)J The tax rate imposed on the net value 0\ translers 10 arlorthe use ot the decedent's siblings is 12% [72 P,S. 89116(21)(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 biood or adoption. o PA15002 NTF 29756 Copyright 2000 Greatland/Nelco lP - Forms Software Only Estate of: Helen E . Sullivan 21-2002-0475 The following person(s) are signing the return as representative(s) of the estate; John C. Sullivan 107 Sample Bridge Road Mechanicsburg, PA 17050 REV-1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Helen E. Sullivan SCHEDULE B STOCKS & BONDS FILE NUMBER 21-2002-0475 All property Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 29,306.637 shares of Vanguard Ins. Long Tenn Tax Exempt Fund at $12 A55/share 365,014.16 Accrued interest on above asset as of decedent's date of death 430.87 2 3,945.758 shares of Vanguard Tax-Managed Capital Appreciation Fund at $52.55/share 207,349.58 3 99.895 shares of Vanguard Tax-Managed Capital Appreciation Fund at $26.18/share 4 6,587.29 shares of Vanguard Explorer Fund Adm at $56.29/share 2,615.25 370,798.55 5 Steinroe Account #337-98169083 joint with decedent's son Michael K. Sullivan 51,053.34 Decedent's son, Michael K. Sullivan has disclairred his right, title and interest in this asset. See Disclairrer attached. 7 CPA31 NTF 10905 Copyright Forms Software Only, 1997 Nelco. Inc. TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 997,261. 75 Mr. John Sullivan 107 Sample Bridge Road Mechanicsburg, P A 17055-1940 Dear Mr. Sullivan: ~ itt. ~..:'"'. T... \ ,,- '.- , . 1 ,_: . TH~ROUP. March 21. 2002 RE: Estate of Helen E. Sullivan Please accept our sincere condolences on the loss of your wife, Helen E. Sullivan. I can understand this may be a difficult time for you. Please be assured that we will make the transition of the accounts as easy as possible for you. As you requested, I am sending a valuation of Mrs. Sullivan's accounts as of March 9, 2002. Since March 9,2002 was a Saturday, I have provided the share prices for Friday, March 8,2002 and Monday, March ll,2002. Helen E. Sullivan Individual Account 9896872663 Fund Name CUSIP Number Shares Owned Tax-Managed Capital Appreciation Fund Inv. CUSIP 921943205 Ins. Long-Term Tax- Exempt Fund Adm. CUSIP 922907852 Explorer Fund Adm. CUSIP 921926200 Tax-Managed Capital Appreciation Fund Adm. CUSIP 921943866 99.895 29,306.637 6,587.290 3,945.758 Helen E. Sullivan Traditional IRA. Account 9898838294 Share Accrued Principal Ralauce as of Price Interest 03/09/2002 03/08/02 I 03/11/02 $26.15 N/A $2,612.25 $2,612.25 Jj $26.20 2,0IS. ;LoS' " :/". /8# $12.46 $430.87 $365,160.70 $365,591.57 ... $12.45 -~""-~J 014 i(" Jl. I'd."'''' -~~~:f~~Cj.c~/A - "'$370,403,32T $370,403.32 I $52.34 N;A $207,704.70 $207,704.70 $52.76 -Z,S:2.s.>;: Fund Name Shares Share Price Accrued Balance as of CUSIP Number Owned 03/08/02 Interest 03/0912002 03/11/02 Selected Value Fund 739.205 $14.02 N/A $10,363.65 CUSIP 921946]09 $14.03"'" " Growth Index Fund 1,835.233 $26.79 N!A $49,165.89 CUSIP 922908504 $26.79 (3 '(',',... ~- < c ; ",,- '1' r;. !:...." 'j C!. ~,._L.t,-.;...~,-- ~I 'Vanguardr)i. Fbgship Service Pas: Office Bo); lraj, \'alley Forge, Penm:-h'<mia 1945:: (Roo) 34.5-1:\44. ww\u"J.ng:u~d.(()m _''- :'i\:. blO '1<";S :;.;",) , J,l.C-" '3---(c; 5j' <:l'-iSj -'-II :::......, i (; T11 C .~ , /, '1h IL'C'....- S'fj "- 'j 5 ?l.. cJLj .' , t'.( f;[", r1 t ti ~ r.:r;lia . fi t.1 l~ r stein roe June 5, 2002 John C Sullivan 107 Sample Bridge Rd Mechanicsburg P A 17050-1940 RE: COl1"espondcn.ce # 0'0168078 Account Numbers: 337-98166426 337-98169083 John C Sullivan & Helen E Sullivan JT\VROS Dear Mr. Sullivan: Thank you for your recent inquiry concerning the value for the referenced accounts. Due to the fact that the date referenced is a weekend I am providing the requested information as of 03/08/2002. As of 03/08/2002: Account: 337-98166426 . The share balance was 2498.093 . The net asset value (price per share) was $ 8.77 . The total value ofthis account was $ 21,908.28 Account: 337-98169083 . The share balance was 5,821.362 . The net asset value (price per share) was $ 8.77 . The total value of this account was $ 51,053.34 1f you need more information, please call a Liberty Funds Services representative at 1-800-962- 1585. We will be happy to help you in any way we can. We look forward to serving you again in the future. Sincerely, Eric Brauchler Account Representative L i '-I i I >.' I 'i';,> ;";'-i' 'I," IN THE COURT OF COMMON PLEASE OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION INRE: ESTATE OF HELEN E SULLIVAN, DECEASED NO. 21-02-0475 DISCLAIMER The undersigned, Michael K Sullivan, being the son of Helen E. Sullivan, intending to be legally bound, makes the following disclaimer: Disclaimant hereby disclaims all right, title and interest he may have in Stein Roe Mutual Fund Account #337-98169083, This Disclaimer is irrevocable and unqualified, IN WITNESS 'WHEREOF, the undersigned has set his hand and seal this 27th dav ofbhpvember, 2002. ~ Ii /) // ~/. Jw- !(L~ r itL,"-C, Ifc('r- /1 ~/!(, "-:;i! JA Mic'hael K~ Su1tivan \ Witness COMMONVlEAL TH OF PENNSYLVANIA COUThTTY OF ,.. f c). "'" I cftl,., 11"1 .; Hi L-I" \- \;. .- SS On this, the :i 7 (-Day of NovoYl b.e y , 2002, before me, a Notary Public, the undersigned officer, personally appeared Michael K Sullivan, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed same for the purposes therein contained, IN WITNESS WHEREOF, I hereunto set my hand and notarial seal, ~"M-7n. ~~ Notary PuJ~h" -I I Noj,?';is.: SSQ! r..ktrll'lf.. t,t E':\,.!(':;:2~;;'::L ;';'~\'~'::~V C';1,~:j;I;::; My Commission Expires: ['"';",;:.'C',:!:,, :','l::,!, ',:' >,.,,", (SEAL) l. i'"L.(;L'.:';.;:.'..~."", ,,' ,', . .i t~1:;;\tlr.;'::;;'1 ;' ;~~'~: ;:;,j.-.~>;';',.... L:,'~~":.::'.:..,:, REV.15GB EX + (1.97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Helen E. Sullivan SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-2002-0475 Include proceeds 01 litigation & date proceeds were received by the estate All prop, Jointly-owned with right of survlvorshlo must be disclosed on Sch. F. ITEM VALUE AT NO. DESCRIPTION DATE OF DEATH 1 M&T Bank Checking Account #3741371714 3,040.48 2 Jeep 13,500.00 7 CPA81 NTF '0908 Cooyright Forms Sol/ware Only, 1997 Nelco,lnc. TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 16,540.48 ~ M&rBank. ManlJlacturers ar:d Traaers Trust ::omD2n~.', 1100 \N~hrI€- Crlve :;lC, Eox 757. Butta!c, NY 14240.0767 September 23, 2001 RE: Estate Searo.h The Estate of: Date of Death (D.O.D.) HELL'l E SlJLLIV AN 31912002 To V;lbDm It May C_=: Identified below is we account infonnarion requested. !. M&T Bank accounts in which the decedent's name appea.",: At:.e-aunt Type A.ccou.nt Number Account Title Opening Branch D.O.D. Accrued 1mcrest Balanc::> (Inciuries Ac",-. InL) $3767.36 $.00 em:. 3740105998 HELEN E Suurv AN JOHN C SUlllV AN HEl.J::'""N E SULUVAl'l 4.342 CHK 374\371714 4342 $3040.48 S.OO 1. Loans! Mortgages, or other obligations titled in the decedent's name Account Number Amount Owed A.:count Description NO Sare Deposit Box titled in the- Decedent's name existed at our office. If you have any queslions abouI tho information provided, plosc con1aJ;t our Records Department al (716) 635-40 10 or 1-800-724- 2440 OUtside of tho Buffalo, NY calling arc.a. T=i:: you. Sincerely, M&T BANK. CORPORATION ?1tl-1~~ ~~ Authonzed SignalUre '-' BY: DATE: 1-2,..7,,-0 Z- ~ C T!; , ,) q ~i\:\\!::""'I,,!'~t: .~CaC2::- ,IN~'~ .:.;~,!,),) \\',:)US': ~ Ii (, -::- ",j'. , ,~.., , :B c, REV.1510 EX + 11.97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Helen E. Sullivan SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21-2002-0475 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes, ITEM NO. DESCRIPTION OF PROPERTY INCLUDE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECD & DATE OF TRANSFER. ATTACH COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF EXCLUSION DECO'S (IF INTEREST APPLICABLE) TAXABLE VALUE 1 1835,233 shares of Vanguard Growth Index. Fund at $26,79/ share (IRA) Beneficiaries: Timi A, Sullivan and Elizabeth F . sullivan 49,165.89 100% 49,165.89 2 739.205 shares of Vanguard Selectee Value Fund at $14.03/share Beneficiaries: Decedent's daughters, Timi A. Sullivan and Elizabeth F. Sullivan 10,371.05 100% 10,371. 05 7 CPA01 NTF 10910 TOTAL (Also enter on line 7, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 59,536.94 Copyright Forms Software Only, 1997 Nelco, Inc. -!- ~~....~.. ,I.' ", 1 .. . THl:VanguardJROUr. March 21, 2002 Mr. John Sullivan ] 07 Sample Bridge Road Mechanicsburg, PA 17055-1940 RE: Estate of Helen E. Sullivan Dear Mr. Sullivan: Please accept our sincere condolences on the loss of your wife, Helen E. Sullivan. ] can understand this may be a difficult time for you. Please be assured that we will make the transition of the accounts as easy as possible for you. As you requested, I am sending a valuation of Mrs. Sullivan's accounts as of March 9, 2002. Since March 9,2002 was a Saturday, I have provided the share prices for Friday, March 8,2002 and Monday, March 11,2002. Helen E. Sullivan Individual Account 9896872663 I Fund Name Shares Share Accrued Principal Balance as of CUSIP Number Owned Price Interest 03/09/2002 I 03/08/02 I 03/11/02 Tax-Managed Capital 99.895 $26.15 N1A $2,612.25 $2,612.25 A Appreciation Fund !nv. $26.20 :) ,I...:" oS ;l.,s' CUSIP 921943205 " :i0.186 Ins. Long-Term Tax- 29,306.637 $12.46 $430.87 .$365,160.70 $365,591.57 ... Exempt Fund Adm. $12.45 ~I..::-;'J 014 i<., CUSIP 922907852 .. .. 1:J....,t.. Explorer Fund Adm. 6,587.290 -$56.:f3:r NJA -, '$370,403.32-' $370,403.32 'I ("1~ CUSIP 921926200 'Ole "'" $56.35 s ' ).<:-j , Tax-Managed Capital 3,945.758 $52.34 N/A $207,704.70 $207,704.70 Appreciation Fund Adm. $52.76 SLCI. '3 -..{cl 5" CUSIP 921943866 .J!. sa ,5",-;: ~""I C"'-j.s . I'll Helen E. Sullivan Traditional IRA Account 9898838294 Fund Name Shares Share Price Accrued Balance as of CUSIP Number Owned 03/08/02 Interest 03/09/2002 03/11/02 Selected Value Fund 739.205 $14.02 NJA $10,363.65 . " CUSIP 921946109 $14.03 ''-I Growth Index Fund 1,835.233 $26.79 NJA $49,165.89 CUSIP 922908504 $26.79 i C I -; "11 L,-J' <: -1 it, ILo';..- S'<i -- [J '('t.... .('. (, i ,-.," ','''~ .:....,. ,y ':;.>-',.6" -?(; lil.1 CI. ~,'_\c::;-:.-~'-- ~ ~) Vanguard~' Flagship Sell'ice Posr Office Box n03. Valle)' Forg~, Pennsyk1l1ia 1l)48:! (goo} .'45-1344. WW\.u'anguard.com ,,;---C~ /:i""t.:. REV-1511EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Helen E _ Sullivan SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-2002-0475 Debts of decedent must be reported on Schedule I ITEM NO. DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1 C.S. of PA Crenation 1,145.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 0.00 Name of Personal Representative(s) Social Security Number(s)/EIN No. of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees 5,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00 Claimant Jorm C. Sullivan Street Address 107 Sample Bridge Road City Mechanicsburg State PA Zip 17050 Relationship of Claimant to Decedent Survi vinq Spouse 4. Probate Fees 943.00 5. Accountant's Fees 0.00 6. Tax Return Preparer's Fees 0.00 7 PA Departrrent of Transportation, jeep registration 36.00 8 Patriot news, ads for jeep 44.00 9 Patriot News, notice of grant of letters 126.36 10 CUmberland law Journal, notice of grant of letters 75.00 TOTAL (Also enter on fine 9, Recapitulation) $ 10,869.36 (If more space is needed, insert additional sheets of the same size) 7 CPA11 NTF 10911 Copyright Forms Sotlware Only, 1997 Nelco, Inc REV.1512 EX + (1.97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Helen E. Sullivan Include unreimbursed medical expenses ITEM NO. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21-2002-0475 DESCRIPTION AMOUNT 1 West Shore Errergency Services 444.78 2 West Shore Pathology 78.36 3 MSHMC Physicians 100.00 4 Silver Spring Ambulance 355.00 7 CPA12 NTF 10912 TOTAL (Also enter on Hne 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 978.14 Copyright Forms Sottware Only, 1997 Nelco, Inc REV.1513 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER No. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 21-2002-0475 RELATIONSHIP TO DECEDENT AMOUNT OR 00 Not List Trustee(s) SHARE OF ESTATE Helen E. Sullivan 1 John C. Sullivan 107 Sarrple Bridge Road Mechanicsburg, PA 17050 Surviving S]X)use 13,500.00 2 Timi A. sullivan 107 Sarrple Bridge Road Mechanicsburg, PA 17050 3 Elizabeth F. Sullivan 2005 Ewig Road Cochranville, PA 19330 Daughter 29,768.47 Daughter 29,768.4 7 4 Sullivan Tax Exerrpt Trust 107 sarrple Bridge Road Mechanicsburg, PA 17050 981,299.99 ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 17 AS APPROPRIATE ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1 Sullivan Marital D:=duction Trust See Attached Calculation 7,154.74 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS None TOTAL OF PART II.. ENTER TOTAl. NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 7,154.74 7 CPA13 NTF 10913 (If more space is needed, insert additional sheets of the same size) Copyright Forms Software Only, 1997 NelCQ,l(lC REV-1514 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN ESTATE OF Helen E _ Sullivan (Check Box 4 on Rev-1500 Cover Sheet) FILE NUMBER 21-2002-0475 This schedule is to be used tor all single lite, joint or successive life estate and term certain calculations. For dates of death prior to 5-1-89, actuarial tactors for single Ijfe calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death on or after 5-1-89. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. O. ,l.'{,I_lt, _ _.'_' _", _ ?8flrlterv_'vo~ _I:)e~~, ~f ~r~_~~ ',' _ _ _, '_,' _ _ _ _, ',' n... ~~e,r ...................iliIRlf;eSltAJ;EiI"fl$RESlllCAUCtlLA'IlON............. .. NEAREST AGE AT TERM OF YEARS LIFE ESTATE IS DATE OF DEATH PAYABLE NAME(S) OF LIFE TENANT(S) DATE OF BIRTH John C. Sullivan 10/23/27 74 Term of Years Term of Vears T arm of Years Term of Years $ 981,299_99 .42015 5.4 % $ 412,293.19 1. Value of fund from which life estate is payable 2. Actuarial factor per appropriate table Interest table rate n 03 1{2%, 0 6% 0 10% Wariable Rate 3. Value of life estate (LIne 1 multiplied by Line 2) NAME(S) OF ANNUITANT(S) ... .ANNOltvlI"fl$At:lSltiCALCUtAtlONt.... NEAREST AGE AT TERM OF YEARS DATE OF BIRTH DATE OF DEATH ANNUITY IS PAYABLE Term of Years Term of Years Term of Years Term of Years 1. Value of fund from which annuity is payable $ 2. Check appropriate block below and enter corresponding (number) Frequency of payout -- 0 Weekly (52) 8 Bi-weekly (26) 8 Monthly (12) o Quarterly (4) 0 Semi-annually (2) Annually (1) Other ( ) 3. Amount of payout per period $ 4. Aggregate annual payment, Line 2 multiplied by Line 3 5. Annuity Factor (see instructions) Interest table rate 0 3 112%~ 0 6<;1/0 0 10% o Variable Rate % 6. Adjustment Factor (see instructions) 7. Value of annuity -- If using 31/2%,6%, 10%, or if variable rate and period payout is at end of period, calculation is; Line 4 x Line 5 x LIne 6 If using variable rate and period payout is at beginning of period, calculation is: (LIne 4 x Line 5 x LIne 6) .... LIne 3 $ $ NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of this tax return. The resulting life or annuity interest(s) should be reported atthe appropriate tax rate on Lines 13, 15, 16 and 17. (If more space is needed, insert additional sheets of the same size) 7 PA15141 NTF 10881 Copyright Forms Software Only, 1997 Nelco, Inc REV-1649 EX + (1.97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIOENT DECEDENT ESTATE OF Helen E. SUllivan SCHEDULE 0 ELECTION UNDER SEC. 9113(A) (SPOUSAL DISTRIBUTIONS) FILE NUMBER 21-2002-0475 Do not complete this schedule unless estate Is making election to tax assets under Section 9113(A) of Inheritance & Estate Tax Act. If the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust This election applies to the Sullivan Tax Exerrption Trust Trust(marital. resitiual A, B, By-pass, Unified Credit, etc,} If a trust or similar arrangement meets the requirements of Section 9113(A), and: a. The trust or similar arrangement is listed on Schedule 0, and b. The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule 0, then the transferor's personal representative may specifically identify the trust (all or a fractional portion or percentage) to be included in the election to have such trust or similar property treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property is included as a taxable transfer on Schedule 0, the personal representative shall be considered to have made the election only as to a fraction of the trust or similar arrangement. The numerator of this fraction is equal to the amount of the trust or similar arrangement included as a taxable asset on Schedule 0, The denominator is equal to the total value of the trust or similar arrangement. PART A: Enter the description and value of aU interests, both taxable and non-taxable, regardless of location, which pass to the decedent's surviving spouse under a Section 9113 (A) trust or similar arrangement. DESCRIPTION VALUE 1 SUllivan Tax Exenption Trust 981,299.99 An election under section 9113 to tax the assets in the Tax Exenption Trust is hereby rrade. Total Value of Trust is $981,299.99 Spousal portion is $412,293.19 Rerrainder portion is $569,006.80 Part A Talal $ 981,299.99 PART B: Enter the description and value of all interests included in Part A for which the Section 9113 (A) election to tax is being made. DESCRIPTION VALUE 1 SUllivan Tax Exemption Trust 981,299.99 An election under section 9113 to tax the assets in the Tax EKenption Trust is hereby rrade. Total Value of Trust is $981,299.99 Spousal portion is $412,293.19 Rerrainder portion is $569,006.80 7 PA16491 NTF 10882 Part B Talal $ (If more space is needed, insert additional sheets of the same size) 981,299.99 Copyright Forms Software Only, 1997 Nelco. Inc. REV-1649 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Helen E. Sullivan 21-2002-0475 Do not complete this schedule unless estate Is making election to tax assets under SectIon 9113(A) of Inheritance & Estate Tax Act. If the election applies to more than one trust or similar arrangement, a separate form must be filed tor each trust. This election applies to the Sullivan Marital Deduction Trust Trust(nlarital, residual A, B, By-pass, Unitied Credit, elc.). If a trust or similar arrangement meets the requirements of Section 9113(A), and: a. The trust or similar arrangement is listed on Schedule 0, and b. The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule 0, then the transferor's personal representative may specifically identify the trust (all or a fractional portion or percentage) to be included in the election to have such trust or similar property treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property is included as a taxable transfer on Schedule 0, the personal representative shall be considered to have made the election only as to a fraction of the trust or similar arrangement. The numerator of this fraction is equal to the amount of the trust or similar arrangement included as a taxable asset on Schedule O. The denominator is equal to the total value of the trust or similar arrangement. SCHEDULE 0 ELECTION UNDER SEC. 9113(A) (SPOUSAL DISTRIBUTIONS) PART A: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, which pass to the decedent's surviving spouse under a Section 9113 (A) trust or similar arrangement. DESCRIPTION VALUE 2 Sullivan Marital Deduction Trust 7,154.74 Part A Total $ 7,154.74 PART B: Enter the description and value of all interests included in Part A tor which the Section 9113 (A) election to tax is being made. DESCRIPTION VALUE 2 0.00 7 PAl6491 NTF10882 Part B Total $ (If more space is needed, insert additional sheets of the same size) 0.00 Copyright Forms Sottware Only, 1997 NeIco, Inc ESTATE OF HELEN E. SULLIVAN CALCULATION OF THE HELEN E. SULLIVAN TAX EXEMPTION TRUST and MARITAL DEDUCTION TRUST Under Item III of the Last Will and Testament of Helen E. Sullivan, the residue of her estate is to be distributed to the Trustee under a Trust Agreement dated February 17, 1999, to be administered and distributed as provided therein. Article II of the Trust Agreement provides for the funding of a Tax Exemption Trust. The Trust is to be funded with the Tax Exemption Amount. The Tax Exemption Amount is defined as "the amount of principal exactly sufficient to use fully [Decedent's] federal estate tax unified credit, adjusted by (i) any increase necessary to give the estate the full benefit of the state death tax credit (but not increase state death taxes), and (ii) the reduction, if required, to needed to reduce federal estate tax payable to the lowest possible figure, taking into account items such as adjusted taxable gifts, property included in the gross estate which does not qualify for the marital or charitable deduction, and charges to principal that are not allowed as deductions for federal estate tax purposes. Article III of the Trust Agreement provides that the balance of the principal is to be held in a separate Marital Deduction Trust for the benefIt of Decedent's spouse, John C. Sullivan, Jr. me by thirty (30) days, or the issue of my aforementioned children as survive me by thirty (30) days, per stirpes. (c) In the event of disagreement among my children as to the bequest made under subparagraph (b) above, my Executor is authorized to make the division, having due regard for the personal preferences of my children, but making such division in as nearly equal shares as the Executor deems practical. (d) With respect to any item passing under subparagraph (a) or (b) to a minor, my Executor (I) may hold and deliver it to the minor at majority or earlier, or deliver it to any person to hold for the minor; or (2) may sell it, hold and invest the proceeds for the minor's benefit for any reason without considering other funds available to the minor. The receipt of any person who receives an item or payment hereunder shall be a complete discharge to my Executor. (e) My Executor shall pay, as an expense of settling my estate, all costs of delivering such tangible personal property, including the costs of packaging, delivery and insurance. RESIDUARY EST ATE ITEM III. I give IN TRUST the residue of my estate, real and personal, to the Trustee under that certain Trust Agreement signed by me on February 17, 1999, to be managed and invested under the terms of said Trust Agreement and all valid amendments thereto, to be added to the trust estate under that Trust Agreement as in effect at my death. Page 2 oflO 1-1 [. .' H.E.S. T AX PROVISIONS ITEM IV. 1. Death Taxes. Except as otherwise may be provided in my husband's will or trust, or in any other trust, all federal, state, and other death taxes, payable because of my death, on the property forming my gross estate for tax purposes, whether or not it passes under this Will, shall be paid out of the principal of my probate estate so that the burden falls on my residuary estate, and none of those taxes shall be charged against any beneficiary. The provisions concerning payment of taxes shall not apply to generation-skipping taxes and any property over which I have a general power of appointment for federal estate tax purposes. 2. Survivorship. My husband shall be deemed to have survived me if the order of our deaths is not clear. 3. Tax Options. I hereby authorize my Executor, in my Executor's sole discretion, in whole or in part, to elect to treat in whole or in part as qualified, tenninable interest property for the purpose of qualifying for the marital deduction, any property passing under my Will, said Trust Agreement, or otherwise (in which my husband has a qualified income interest for life.) My Executor shall be without liability to anyone for making or failing to make such election. 4. I hereby authorize my Executor, in my Executor's sole discretion, to make an election, in whole or in part, to cause the Pennsylvania Inheritance Tax to be payable by my estate on property passing to or for the benefit of my spouse, or to defer Pennsylvania Inheritance Taxes Page 3 of 10 H.E.S. B. Power of Appointment to Reduce Tax. The limited powers of appointment which are exercisable by a Will hereunder, shall be expanded as follows if certain taxes can be reduced: 1. A child who has a power of appointment exercisable by his or her will may, by a will specifically referring to the power of appointment, appoint the trust to his or her estate to the extent the aggregate of the federal estate tax and GST tax due as a result of the child's death can be reduced. 2. Any increase in death taxes in the beneficiary's estate caused by the inclusion of the trust in it for tax purposes, shall be paid out of the unappointed principal of the trust, and a written statement by his or her personal representative may be accepted as being correct. BENEFICIARIES UNDER 23 ITEM V. Any property passing under this Will to a person under twenty-three (23) years of age, or is disabled, physically or mentally at the time an interest is distributable outright to him or her under this Will, the property shall be paid to his or her parent as custodian for that beneficiary under the Uniform Transfer to Minors Act of Pennsylvania. Ifhis or her parent for any reason fails to qualify or ceases to act as custodian, my Executor shall appoint the custodian in his or her place. Page 5 of 10 N ;. .::; H.E.S. ITEM VI. Powers of Appointment: No provision ofthis Will shall exercise any power of appointment I may have. ITEM VII. Power to Disclaim: Any beneficiary under this document (or his or her personal representative, guardian or agent acting under a power of attorney) may, at any time and from time-to-time, by written instrument, release, disclaim or otherwise limit, in whole or in part, any power or interest granted to such beneficiary under this document. The disclaimer need not take effect immediately and may be contingent upon the occurrence or nOD-occurrence of any event. PROTECTIVE PROVISIONS ITEM VIII. To the greatest extent permitted by law, before actual payment to a beneficiary or to his or her account, no interest in income or principal shall be assignable by a beneficiary or available to anyone having a claim against a beneficiary. MANAGEMENT PROVISIONS ITEM IX. I authorize my Executor to: 1. RetainlInvest: Retain and invest in any form of real or personal property anywhere which, in my Executor's opinion, is appropriate for my estate, without being required to diversifY; 2. Compromise: Compromise claims and abandon any property which, in my Executor's opinion, is oflittle or no value; Page 6 of 10 /--/ { ~.- H.E.S. 3. Borrow: Borrow from anyone and pledge property as security for repayment of any funds borrowed; 4. Sell/Lease: Sell at public or private sale, exchange, lease or lend for any period of time any real or personal property, and give options for sales or leases; 5. Capital Changes: Join in any merger, reorganization, voting trust plan, or other concerted action of security holders and delegate discretionary duties with respect to these powers; and, 6. Disclaim: . Disclaim any part or all of any property, power, or interest passing to me or for my benefit under any will, trust or otherwise; and 7. Distribute: Distribute in cash or in kind, and allocate specific assets among the beneficiary (including any custodianship) in such proportions as my Executor may think best, so long as the total market value of any beneficiary's share is not affected by such allocations. The powers, authorities and discretion given under my Will shall be in addition to those granted by law, shall continue until the distribution of the property, and shall be exercisable without court authorization. Page 7 of 10 , r-r _ :;, H.E.S. FIDUCIARIES ITEM X. 1. I hereby appoint my son, Michael K. Sullivan, as Executor of this Will. If my son, Michael K. Sullivan, fails to qualify or ceases to act for any reason, I appoint my daughter, Elizabeth F. Sullivan, as Successor Executrix in his place. 2. Except as provided in Paragraph 1 above, each individual ExecutorlExecutrix then serving, may appoint, in writing, an individual to succeed him or her. My individual Executors then serving may unanimously appoint, in writing, an individual to serve with them. 3. My individual Executors then serving may unanimously appoint, in writing, a corporation organized under the laws of the United States or any state thereof and possessed of trust powers, which has trust assets of at least One Hundred Million Dollars ($100,000,000.00), as corporate Executor. Page 8 of 10 1-/ ( :;. H.E.S. IN WITNESS WHEREOF, I, HELEN E, SULLlV AN, the Testatrix to this Last Will and Testament, have hereunto set my hand and seal this -" day of "T" ,~:.;.'), ~~ ~"',.....: , 1999, , , .';"1 (-,j-<~,.,-, t c."" '.... ,!A:,I.--L',::",o.-{;_""'" 1)( Helen E. Sullivan In our presence, Helen E, Sullivan, signed this and declared it to be her Last Will and Testament, and now at her request, in her presence, and in the presence of each other, we sign as witnesses: /, /.// 71 c'", l.-7' I A ~ ".J if'l:S <0" /,/ /) II' / if '-"0:.-_- l~'^"'ll?', " 1'1 Witness Address /I . :.J <i...-.C{.-, , , Witness :'1 /~ -:LI')~'-':--'~) /;; I , if ('T,'--, <. L, ,-f. " j"4 Address Page 9 oflO COMMONWEALTH OF PENNSYLVANIA ss: COUNTY OF DAUPHIN I, Helen E. Sullivan, having been duly qualified according to law, acknowledge that I signed the foregoing instrument as my Last Will and Testament, and that I signed it as my free and voluntary act for the purposes therein expressed. " rl ," t<"'YL r L~") ,:,-(:L~ '- /~; ! Helen E. Sullivan /) Wi" d f7. h . b dl e, /'\:'Tlrll/ A.{ "\;: '. ~/'...:, an ~/,L.-~' ,.':' .:J.rnc-.--" , aVlng een uy qualified according tolaw, depose and say that we were piesent and saw Helen E. Sullivan sign the foregoing instrument as her Last Will and Testament, that she signed it as her free and voluntary act for the purposes therein expressed; that each of us, in her sight and hearing, and at her request, signed the Last Will and Testament as witnesses; and that to the best of our knowledge, she was at that time 18 or more years of age, of sound mind, and under no constraint or undue influence. /~) / /, Y //) ,. .l:"', !~-4}r-1i: 7 I/,> " ""':"~../ ,/ // /'1 )""'>."-..-,-', --'-~/ /! [~n/l" -~/ . / v Witness . . Witness Subscribed, sworn to or affirmed and acknowledged before me by the above- named Testatrix and by the witnesses whose names appear opposite, on this --h I! day of f. ie'.ur.",,, , 1999. ,) / '-,..,--;~ -r:r '- '--, . , (~:...- F,- -,,_,.-, i . /--/ Notary Public My Commission Expires: .':.i..." 'c. "~ .' ,( I Page 10 of 10 REVOCABLE TRUST OF HELEN E. SULLIVAN ONTIDS /7/-1? dayof hbnUdi , 1999, I, HELEN E. SULLIVAN, of Silver Spring Township, Cumberland County, Pennsylvania, transfer the property listed on the annexed Schedule "A" to myself, Helen E. Sullivan, as Initial Trustee and Michael K. Sullivan, as Successor Trustee. Upon my death, my Trustee shall collect any life insurance payable to this Trust. All the property and any additions shall be held IN TRUST as follows: DURING MY LIFETIME 1. Mv Personal Trust: During my lifetime, my Trustee shall invest and manage the property as a separate Trust and make distributions as follows: A. Pavments/Control: As much, even if all, of the net income and principal as I may from time-to-time direct, in writing, shall be paid to me or as I may specify. IfI notify my Trustee in writing, I may direct and control the sale, purchase, management or retention of any investment, in which event no Trustee shall review' the investment at any time nor be subject to liability for acting in accordance with those directions. B. Disabilitv: However, ifI am, in my Trustee's opinion, disabled by illness or other cause and unable to manage funds properly, as much of the net income and principal as my Trustee from time-to-time determine to be desirable for me or my husband's welfare, comfort, support or emergency needs shall be paid to either of us or applied directly for those purposes. My Trustees shall manage any investments I had controlled. Any corporate trustee shall have no duty to exercise its powers under this paragraph, unless it is notified in writing by a family member of mine or by a physician of mine that he or she believes I am disabled. C. Balance: Any remaining net income shall from time-to-time be accumulated and added to principaL AFTER MY DEATH II. Tax Exemption Trust: After my death, my Trustee shall set aside the Tax Exemption Amount if my husband survives me, or all the principal if he does not survive me. (The Tax Exemption Amount on the date this Agreement is executed is $650,000.00 in have not used my tax exemption during my lifetime.) My Trustee shall invest and manage the amount as a separate trust and make distributions as follows: A. Trust for Husband: If my husband, John C. Sullivan, Jr., survives me: 1. During his lifetime: a. The net income shall be paid to him at least monthly; b. As much of the principal as my Trustee may think desirable from time-to-time for the welfare, comfort, health, education or other needs of my husband or any of my descendants living from time-to-time 2 shall be paid to or for the benefit of that person. My husband's approval (unless my Trustee believes he is disabled and unable to give his approval) shall be needed for any distribution to a descendant, and none of the principal of this Trust shall be paid to or applied for the benefit of my husband unless the principal of the Marital Deduction Trust has been exhausted. I intend that my husband be given primary consideration, and I hope that to the extent possible, he shall be able to maintain the standard of living to which he has been accustomed during my lifetime. 2. Upon my husband's death, the then remaining principal shall be paid to or in trust for anyone or ore persons or organizations - excepting only his estate, his creditors, and the creditors of his estate - on any terms which my husband may specify in his will specifically referring to this power of appointment; and to the extent he does not make an effective appointment, shall be held in accordance with the following paragraphs of this article. B. Trusts Primarilv for Children: After my husband's death (or mine ifI survive him), my Trustee shall hold the then remaining principal not effectively appointed by my husband as one trust. The Trustee shall divide the Trust principal into equal shares ("Trusts") to provide separate equal shares for each of my children, Timi, Elizabeth, and Michael, who shall survive me 3 by thirty (30) days, AND one (1) separate equal share, which shaIl be a Sprinkle Trust for the benefit of all my children. C. Sprinkle Trust for the Benefit of Our Children: 1. The Trustee shall distribute the income of the Sprinkle Trust for the benefit of my children in such amounts and for the benefit of such child or children, as he/she may elect in his/her absolute discretion. Such election shaIl be made after considering their health, maintenance and support, and after considering all resources available to them, including federal and state public assistance, such as Social Security Administration benefits. 2. Although all my children are intended to be the primary beneficiaries of the Sprinkle Trust, it is my desire that the Trustee consider contributing such income and principal of the Sprinkle Trust as the Trustee deems appropriate to supplement the resources available to our son, John, III, for his health, maintenance and support. Notwithstanding the hereinabove provisions, in no event is the Trustee obligated to distribute the income or principal of the Sprinkle Trust for our son, John, III, but only if the Trustee, in hislher absolute discretion, decides to do so. In no event shall the Trustee reimburse any amounts to the federal or state governments, agencies, or any subdivision of them. 3. On the death of our son, John, III, I give the principal and undistributed income of the sprinkling trust equally to our children, Timi, Michael and Elizabeth, 4 who survive this event by thirty (30) days. However, if a child does not survive to this event by thirty (30) days and leaves descendants who so survive, such descendants shall receive, per stirpes, the share the child would have received had he or she so survived the event. D. Trusts for the Benefit of Our Children. Timi. Michael and Elizabeth. With reference to the several trusts established under Paragraph II, B "Trusts Primarily for Children", during the lifetime of Timi, Michael and Elizabeth: (1) The net income from hislher trust shall be paid to him or her at least quarterly; (2) As much of the principal of hislher trust as my Trustee may from time-to- time deem desirable for the welfare, comfort, health, education, or other needs of that child, or any of his or her descendants living from time-to-time, shall be paid to or for the benefit of that person; and (3) Each child shall have the cumulative rights to withdraw up to one-third ('Is) of the principal of his or her trust at any time after reaching fifty (50) years of age, up to one-half (Yz) of the balance of the trust at any time after reaching fifty-five (55) years of age, and the entire trust balance at any time after reaching sixty (60) years of age. A reasonable number of partial withdrawals for each fraction is permitted. (The aggregate principal subject to withdrawal for each fractional drawcdown shall be determined by multiplying the 5 applicable fraction times the sum of the then principal balance of his or her trust after adding back the prior partial withdrawals.) (4) At the death of each child or at the time for the setting apart of shares in the case of a child who dies before that time, any then remaining principal of his or her trust shall be paid: (a) To or in trust for anyone (1) or more persons or organizations - excepting only his or her estate, his or her creditors, and the creditors of his or her estate - on any terms which he or she may specify in his or her will specifically referring to this power of appointment; and to the extent he or she does not make an effective appointment; (b) To his or her then living descendants, per stirpes; or, in the default of such descendants; (c) To my then living descendants, per stirpes, excluding my son, John, III; or in default of such descendants; (d) One-half(Yz) to the person(s) and in the share(s) determined as ifmy husband had then died unmarried domiciled in Pennsylvania without a will, and the balance to the persons and in the shares determined as if I had then died unmarried domiciled in Pennsylvania without a will. 6 /\ny portion paid in trust for a descendent of mine under paragraph (b) or (c) shall be held in accordance with the provisions of the trusts under this Article II III. Marital Deduction Trust: Ifmy husband, John C. Sullivan, Jr., survives me, my Trustee shall invest and manage the balance of the principal as a separate trust, and make distributions as follows: A. Payments During Husband's Lifetime: During my husband's lifetime: 1. The net income shall be paid to him at least monthly; and 2. As much of the principal as my Trustee may from time-to-time think desirable for his welfare, comfort, support, or other needs shall be paid to him. I intend my Trustee to use principal liberally for my husband to enable him to maintain insofar as possible the standard ofliving to which he has been accustomed during my lifetime. B. Payments Upon Husband's Death: On my husband's death: 1. Except as otherwise provided by a specific reference to this trust in my husband's will, any increase in death taxes or administration expenses in his estate caused by the inclusion of this trust in it for tax purposes, shall be paid out of the unappointed principal, and a written statement by his personal representative ofthe-arnounts payable may be accepted as being correct; and 7 The balance of the then remaining income and principal shall be paid to or in trust for anyone or more of my descendants on such terms which he may speed:y in his will specifically referring to this power of appointment, except that he may also appoint the income to his estate in the same manner; and to the extent the balance is not effectively appointed, shall be added to and administered as part of the Tax Exemption Trust in the manner provided under Article II of this Trust. C. Election for Marital Deduction: If an election is made to qualify only a fraction of ') this trust for the marital deduction in my estate, my Trustee shall hold each fractional share as a separate trust under the same terms contained in this article. IV. Adopted Persons: Persons adopted during minority shall be considered as children of their adoptive parents, and they and their descendants shall be considered as descendants of their adoptive parents. v. Survivorship: deaths is not clear. TAX PROVISIONS My husband shall be deemed to have survived me if the order of our 8 , /.,;,."", VI. Intent and Funding of Trusts: I direct that: A. Intent: Every provision of this document shall be interpreted, and all powers, authorities, and discretion given under this document shall be exercised, in accordance with my primary intent that the Marital Deduction Trust shall qualifY, or eligible to qualifY, for the federal estate tax marital deduction. In particular, all payments from t.he Marital Deduction Trust during my husband's lifetime may only be to him, to his legal representative, or directly for his benefit. Also, he shall have the right to require my Trustee to make all property held by the Marital Deduction Trust productive of a reasonable amount of income. B. Funding: Property distributed in kind to the Tax Exemption Trust shall be valued at its date of distribution. If my husband survives me, to the extent possible, all property ineligible for the federal estate tax marital deduction shall be distributed to the Tax Exemption Trust. C. Change to Save Income Taxes: Calculated as of the date of my death, if any principal passing to the Tax Exemption Trust would consist of property known as income in respect of decedent (IRD), assuming all my other applicable trusts are funded first with the IRD property, I change the formula to a fractional share applied against the principal, so no capital gains are incurred. The numerator of the fractional share shall be the amount determined under the current formula stated in the Tax Exemption Trust; the denominator and "the principal" shall mean the sum of (i) the-principal held under this instrument army death, (ii) the amount of the proceeds of any 9 Pennsvlvania Inheritance Tax Return Calculation of The Helen E. Sullivan Tax Exemntion Trust The Helen E. Sullivan Marital Deduction Trust Tax Exemption Trust - Initial Calculation Maximum amount sheltered $ 1,000,000.00 by applicable credit: Less: Taxable Gifts: $ 0.00 Less: Schedule G to persons $ (59,536.94) other than spouse: Less: Federal Schedule D $ (25,000.00) property passing to persons other than spouse Subtotal: $ 915,436.06 Plus State Death Tax Shelter $ 65,836.93 Amount: For Pennsylvania Inheritance $ Tax Purposes: The Helen E. Sullivan Tax Exemption Trust 981,299.99 Balance: The Helen E. $ Sullivan Marital Deduction Trust 7,154.74 in investment and administration:. provided that any combination of trusts for this purpose shall not alter their status as separate trusts; and 1. Distribute: Distribute in cash or in kind or partly in each. The powers, authorities and discretion given under this document shall be in addition to those granted by law, shall continue until the distribution of the property, and shall be exercisable without court authorization. XII. Payments to Aid in Settlement of Estate: My Trustee shall pay the balance of any cash gifts under my will which cannot be paid from my probate estate. A written statement by my personal representative of the amount payable may be accepted as being correct. My Trustee shall have the power, but not the duty, to make payments which my Trustee may think desirable to facilitate the settlement of my estate. In the exercise of this power, my Trustee may pay directly or to my executor or administrator, any or all of (1) my debts, (2) the expenses of my funeral and burial, and (3) death taxes and administration expenses in cOlmection with my estate. These payments shall be made from fhe Tax Exemption Trust. XIII. Exercise of Discretion: Where my Trustee is given discretion under this document, I direct that: A. Shares of Beneficiaries: In the administration of a sprinkle trust, subject to a specified person being- considered as the primary beneficiary, one or more of the 14 eligible distributees may be wholly excluded from any or all periodic distributions: all distributees need not be treated equally or proportionately; the pattern followed in one distribution need not be followed in others; and income may be accumulated to whatever extent and in whatever amounts my Trustee may think appropriate. B. Other Resources: In making decisions on distributions, my Trustee may take into account funds available to the beneficiary from other sources to whatever extent my Trustee thinks appropriate. C. Conclusive Upon All Parties: Any discretion under this document - if exercised or not exercised as long as done so in good faith - shall be conclusive upon all persons concerned. My Trustee shall have no further responsibility over funds paid or applied using this standard of care. XIV. Beneficiaries Under 23 or Disabled: If any beneficiary becomes entitled to an outright distribution of income or principal and is (1) under the age of twenty-three (23), or (2) in my Trustee's opinion disabled by illness or other cause and unable to manage the funds properly: A. Payments: As much of the income or principal as my Trustee may from time-to-time think desirable for that beneficiary, shall be paid to or for the beneficiary. Payments may be made to any person or organization taking care ofthe beneficiary. B. Balance: The balance of the income and principal- and the net income from those funds -"shaUbe fuanagedaS it separate trUst for that beneficiary. FUiids shall be paid 15 to or for the beneficiary in accordance with the prOVISions of the preceding paragraph. When the beneflciary reaches twenty-three (23) years of age, or in my Trustee's opinion becomes free of disability, as the case may be, the then remaining balance shall be paid to the beneficiary. If the beneficiary dies before that time, the balance shall be paid to his or her personal representative. XV. Early Ending of Trusts: If my Trustee determines that it is desirable to do so, my Trustee may end any trust under this document in the following manner: A. Method: My Trustee may end any trust by paying the then remaining principal and income of that trust to the person then eligible to receive the income, or if there is more than one person, to them in the proportions which my Trustee thinks appropriate. Alternatively, any payment may be made to any trust which my Trustee believes will be more appropriate, even though there may be other beneficiaries B. Disabled Persons: If any person is a minor, or in my Trustee's opinion disabled by illness or other cause and unable to manage the funds properly, my Trustee may pay the funds to the person's parent, guardian, legal representative or any person or organization taking care of the person. If a person is a minor, my Trustee shall deposit the funds into a savings account in the minor's name and payable to the minor at majority, or appoint and pay the funds to a custodian for the minor under the . Uniform Gifts or Transfer to Minors Act of any state. 16 XVI. Rights to Income: If a trust is funded from a larger trust or share, it shall be entitled to proportionate amount of the income from the time the trust is to begin, until the actual fimding. During that period, income and principal may be distributed directly to the beneficiaries, subject to the terms of the trust. All income undistributed at a beneficiary's death shall be treated as if it had accrued after his or her death. XVII. Protective Provision: To the greatest extent permitted by law, before actual payment to a beneficiary or to his or her account, no interest in income or principal shall be assignable by a beneficiary or available to anyone having a claim against a beneficiary. XVIII. Insurance Policies: My Trustee shall have no duty to pay premiums on any insurance policies payable to my Trustee, and the companies issuing the policies shall have no responsibility for the application of the proceeds or the fulfillment of the trust. XIX. Situs and Governing Law: The situs of the trust shall be in Pennsylvania. All questions as to the validity, effect, or interpretation of this document or the administration of the trusts shall be governed by the law of Pennsylvania. XX. Accounting:: At least quarterly, my Trustee shall send the beneficiaries who receive income currently or their legal' representatives statements showing the transactions in their trusts:' No 17 accounting shall be required routinely by a court, but my Trustee and any beneficiary shall be entitled at any time to seek a judicial settlement of a trust account in any court of competent jurisdiction selected by my Trustee. Also: A. Out of Court Settlement: My trustee may at any time settle any account or question concerning the administration of a trust by agreement with all the then legally competent beneficiaries who are eligible to receive income - and if there are any - either (I) with all their then legally competent living descendants, or (2) with all the legally competent persons whom my Trustee determines would be entitled to receive a share of the principal if all the beneficiaries who are eligible to receive income had died immediately prior to the date of the agreement (disregarding powers of appointment). However, 1. If my Trustee determines that there is no legally competent person to make an agreement, then the agreement may be made by the legal representative, legally competent spouse, or oldest legally competent relative of the closest degree of each person specified above; and 2. If an addition is made by will or from another trust, my Trustee may accept the statement of the fiduciary that the property delivered to my trustee constitutes all the property to which my Trustee is entitled. My Trustee shall have no duty to require the fiduciary to state an accounting of his, her, or its 18 administration, or to inquire into any action of the fiduciary, and only shall be responsible for the property which my Trustee receives. B. Effect: Any settlement under the above paragraph shall bind all persons who may ever be interested in the trust, and shall effectively release and discharge my Trustee. XXI. Additions: I and my husband and, with my Trustee's approval, anyone else may add to any of the trusts. However, my Trustee shall have the right to refuse any addition which my Trustee believes would put my Trustee at risk individually, such as environmentally contaminated property. If any addition, including one from a trust to another trust under this document, does not have the same GST tax inclusion ratio as the trust to which it otherwise would be added, it shall instead be held in a separate trust with identical terms at that trust. XXII. Rights Reserved: I reserve the following rights, each of which may be exercised whenever and as often as I may wish: A. As to Insurance: All rights vested in me as the owner of any insurance policies payable to my Trustee. B. As to Revokin~ this Trust: The right by an instrument in writing - other than a will- to revoke or amend part or all of any trust. However, no alteration shall increase my Trustee's responsibilities or change my Trustee's compensation "vithout my Trustee's - written consent 19 FIDUCIARIES XXIII. 1. Provisions Regarding Mv Trustee: A. I, Helen E. Sullivan, will be the initial Trustee of this Trust. If I am unable or unwilling to continue to serve, my son, Michael K. Sullivan, shall be the Successor Trustee of all trusts created hereunder, and if both I, Helen E. Sullivan, and Michael K. Sullivan, are ever both unable or unwilling to serve or to continue to serve, my daughter, Elizabeth F. Sullivan, shall be the Successor Trustee of all trusts hereunder. Any reference to the "Trustee" equally refers to the "Successor Trustee." B. Division ofDutiesfDelegation: My Trustee shall be custodian of all the securities in my estate, may hold the securities in the name of a nominee, and shall maintain the records. Any individual Trustee may delegate in writing from time-to-time to my Trustee, any or all of the individual Trustee's powers and duties. Unless any individual Trustee otherwise directs in writing, I authorize my Trustee to rely upon any oral instructions or approvals as long as my Trustee believes in good faith they are genuine. C. Resignation: Any Trustee may resign at any time without court approval by written instrument delivered to the Trustee and to the individuals who could approve an account under the "Accounting" article of this document. D. Successor Individual Trustee Appointment: Each individual Trustee shall have the power during his or her lifetime, or by Will, to appoint his or her successor for such term as he or 20 she shall specify. In default of appointment, a majority of my then living descendants who have legal capacity and who are beneficiaries of the particular trust, shall have that right. E. Removal: A majority of the then individual Trustee or Trustees of a trust shall have the power to remove the then acting corporate Trustee of that trust and appoint a successor corporate Trustee by written instrument delivered to each of them. The successor corporate Trustee appointed in this manner shall have no powers under the "Early Ending of Trusts" article, may only exercise its discretion over principal for the health, support, maintenance, or education of a beneficiary, and shall have no power to exercise its discretion for the support of someone a Trustee has an obligation to support. It is my hope that a corporate Trustee faced with removal would resign. F. Successor Trustee Liability: No Successor Trustee shall be obliged to examine the accounts, records, and acts of the previous Trustee or Trustees, nor shall such Successor Trustee in any way be responsible for any act or failure to act on the part of the previous Trustee or Trustees. The Successor Trustee shall be responsible only for the assets which have been actually delivered to him or her. G. .8.mlQ: No Trustee shall be required to give bond or security in any jurisdiction. H. Compensation: Any corporate Trustee shall receive compensation in accordance with its standard schedule offees in effect while its services are performed. No individual Trustee who is a beneficiary of any trust under this document shall receive compensation. 21 XXIV. DEFINITIONS AND MISCELLANEOUS I am married to John C. Sullivan, Jr. at the time this Trust is executed, and all A. references to my "husband" are to him. B. A Trustee is "disabled" or under a "disability" under this Trust whenever any Trustee. other than a disabled Trustee, or ifthere is no such Trustee, any person who would become successor Trustee on such determination of disability, receives written certification from two (2) physicians regularly attending me or Trustee (as the case may be), at least one (1) of whom is board-certified in the specialty most closely associated with the alleged disability, that such person has become physically or mentally incapacitated, regardless of cause and regardless of whether or not there has been any adjudication of incompetence, mental illness, or need for a committee, conservator, guardian, or other personal representative. A Trustee is recovered from his or her disability whenever the then-serving Trustee receives written certification from two (2) physicians regularly attending such disabled person, at least one (1) of whom is board-certified in the specialty most closely associated with the alleged disability, that he or she is no longer incapacitated and is again able to manage his or her own personal and financial affairs. No Trustee is liable to anyone, including me, for removing me or any other person from the Trusteeship, if the Trustee relied in good faith on the aforementioned physicians' certifications. No one else is liable to me or any other person for dealing with a Trustee other than the one removed for disability, if such removal was made upon good faith reliance on the aforementioned physicians' certifications. 22 D. No person shall be deemed to have survived me for purposes of this trust unless he or she is living on the date thirty (30) days after the date of my death, as determined by the respective legal death certificates. E. All tax-related terms mean the same things in this trust instrument as they mean in the Internal Revenue Code of 1986, as amended. F. "Personal representative" shall include any executor, ancillary executor, administrator, or ancillary administrator, whether local or foreign, and whether of all or part of the decedent's estate. Whenever this tmst requires or permits the Trustee to act on the direction or in conjunction with a personal representative, if no personal representative has been appointed, the Trustee shall (if required) or may (if permitted) take such action alone and without the consent or concurrence of a personal representative. G. "Death taxes" means all estate, inheritance, legacy, succession, transfer, and other taxes (including any tax on excess retirement accumulations) imposed with respect to my death by any state, the United States, or by any foreign country, and all interest and penalties imposed with respect to such taxes. Death taxes shall include neither generation-skipping transfer taxes for which my estate is not legally responsible, nor taxes imposed on a taxable event with respect to a qualified domestic trust, under federal estate tax law. H. Notwithstanding anything in this instrument to the contrary, all trusts created hereunder shall terminate and their funds be distributed if all interests in such trusts have not vested twenty-one (21) years after the death of the last to die-of those of my husband -andmy descendants ')" -~ who shall have been alive on the date of my death. Distribution under this article shall be made to the persons to whom the trustee must or may then pay the trust's income, in proportion to their interests in trust income or, if such interests are indefinite, equally to such beneficiaries without regard to their relationship to me. For purposes of this paragraph, any beneficiary entitled to receive support is entitled to receive income. 1. There is only one (1) signed original of this trust. Anyone may rely on a copy of said document as certified by a notary public or similar official to be a true copy of the signed original (and of the amendments or other writings, if any, endorsed on or attached thereto) to the same effect as if such copy were the signed original. Anyone may rely upon any statement of fact certified by anyone who appears from the original document or a certified copy thereof to be a Trustee hereunder. J. This trust shall be governed by and construed according to the laws of the Commonwealth of Pennsylvania. K. Whenever the context of this trust requires, the masculine gender includes the feminine and neuter, and vice versa, and the singular nunlber includes the plural, and vice versa. 24 IN WITNESS WHEREOF, I have hereunto set my hand and seal all as of the day and year first above writien. WITNESS: -5?/~~/d,~ I /// {/ S/ltL t~. ~ Helen' E. Sullivan ' WITNESS: TRUSTEE: 1}}+/i~ ~dj~v CZj~ HClen E. Sullivan WITNESSES: d(~ b1.~ W~ess /, daA0wl~ yJA Address / .-;/~Y)_.":\i il /\ "I I ,f"1 r.- - ., , r -~ Witness I '~."".'-"r'-".?;: Address 25 SCHEDULE "A" TRUST ASSETS This Schedule "A" is included only for the convenience of the Trustee and beneficiaries, and any failure to list trust assets on Schedule A shall in no way affect the trust's ownership of those assets. Established Initial Value Gross Value Cash Status Policv No. 26 COMMONWEALTH OF PENNSYLVANIA :ss COUNTY OF DAUPHIN ON THIS 12- day of hbrP-d (2 q , 1999, before me, a Notary Public within and for / the aforementioned County and State, personally appeared Helen E. Sullivan, to me known to be the person described in and who executed the foregoing instrument and acknowledged that she executed the same as her free act and deed, in her respective capacities. FURTHER, that said Helen E. Sullivan, signed in the presence of both witnesses, and that both witnesses signed at the request of the said Helen E. Sullivan in her presence and in the presence of each other. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal the day and year in this certificate first above written. :sf {Jh_~.d.2P_~ Nb~jPublic " M:jLe"omrnission Expires: hb. /,;;- c2 C <71 / Register of Wills of Cumberland County, Pennsylvania ~ INVENTORY Estate of Helen E. Sullivan No. 21-02-0475 also known as Date of Death 03/09/02 Deceased Social Security 206-24-8043 No. John C. Sullivan Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside of the Commonwealth nsylvania except that which appears in a memorandum at the end of this inventory. IlWe verify that the statements made in tnv tory are tr~nd correct. I/We understand that false statements herein are made subject to the penalties o'f 18 Pa. C.S. e~~arr- 04 relatin un orn 'falsification to authorities. Name of / It' ~ . ) Personal Representative: Attorney: John C. Sulliv vi: John C. Sullivan LD. No.: Dated: I~/Y/O J-. Address 107 Sample Bridge Road Mechanicsburg, PA 17050 717-766-4347 Telephone DESCRIPTION VALUE 1. M&T Bank Account #3741371714 $ 3,040.48 2. 29,306.637 shares of Vanguard Ins. Long Term Tax Exempt $ 365,445.03 3. 3945.758 shares of Vanguard Tax Managed Capital Appreciation $ 207,349.58 4. 99.895 shares of Vanguard Tax-Managed Capital Appreciation $ 2,615.25 5. 6587 shares of Vanguard Explorer Fund Adm $ 370,798.55 6. Steinroe Account #337-98169083 $ 51,053.34 7. Jeep $ 13,500.00 Total $1,013,802.23 (Attach Additional Sheets If Necessary) NOTE: The Memorandum ofrealestate outsidetTle Commonwealth Qfpennsylvania may, atthe election of the personal representative, indudethevalue of each item, but such figures should not be extended into the total of the Inventory. Form RW-7 lDaupl1'ln County) - Rev.1II92 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.2B0601 HARRISBURG. PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT SULLIVAN JOHN C ESQUIRE 200 N 3RD STREET 18TH FLOOR POBOX 840 HARRISBURG, PA 17108-0840 __nnn fold ESTATE INFORMATION: SSN: 206-24-8043 FILE NUMBER: 2102-0475 DECEDENT NAME: SULLIVAN HELEN E DATE OF PAYMENT: 12/09/2002 POSTMARK DATE: 12/06/2002 COUNTY: CUMBERLAND DATE OF DEATH: 03/09/2002 NO. CD 001923 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $2,458.16 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: JOHN C SULLIVAN ESQUIRE CHECK# 3434 SEAL INITIALS: CW RECEIVED BY: REGISTER OF WILLS $2,458.16 DONNA M. OTTO DEPUTY REGISTER OF WILLS ("")JooooOC')C') ~ggg ~~t>J~ t"'t;j1!l> t>J05:i21 "'=0:;0:; >~C'lC'l ... og ....."'=21 0.021>; ...=~-< "'~C'l" t>Jot>J ~~ ~~ =,. "'0 t>J.,. 0:: >-< t'" t'" '" .., o .. n '" *'" 3 ...... '0 U1 :r:: ""l _.r.n~ FE. ;;- ~~~ w-. I--"o~ ~I-Io.. ...... ~ ...... 0 .j". '" ~ 0.. o O"l ." - :u en -I o r- :I> en en s: :I> - r- n ::;E ;"1'0 ~ Ui 0 r ! ~ 0 ~ r: i= ) " 0 " :i r.,J )> '1 ro :::j iTi ro Q t; 20 "C :u ",,", l' 0 )(111 <D ;,. ,l.LJ 00.....0 Ol ): :rg ):CJ r""' 0> ro> rl.LJ 10> 0> -'" CJ -'" ~'f .f Ii';, .. " , 'r' .~I ~~ I Jlr;~; ~ ';11' /111:11:,;;.." ,lltlll , I'~I[ , f:~~: ,1111111 11,',JI11 ~ :: ~' n" 1/-6..3- l'i BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG. PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN *' REV-~B3 EX iFP IDl-On JOHN C SULLIVAN 107 SAMPLE BRIDGE RD MECHANICSBURG PA 17050 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-31-2003 SULLIVAN 03-09-2002 21 02-0475 CUMBERLAND 201 HEL EN E Allaunt Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CD CDURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account7 submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES ~ RE-y=48Ji-Ex-IiFP--[oi:-ojj-----iii-NiificE--oF--DETE-RHINIiflo-N-AiiD-As-sESS-HENT----------------------------- OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN .. ESTATE OF SULLIVAN HELEN E FILE NO.21 02-0475 ESTATE TAX DETERMINATION ACN 201 DATE 03-31-2003 1. Credit For State Death Taxes as Verified 26.993.15 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) 45.546.34 3. Inheritance Tax Assessed by Other States or Territories of the United States (Excluding Discount and/or Interest) .00 4. Total Inheritance Tax Assessed 45.546.34 5. Pennsylvania Estate Tax Due .00 TAX CREDITS: PAYMENT RECEIPT DISCDUNT (+) AMDUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 -IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TDTAL DUE IS LESS THAN $1, NO PAVMENT IS REQUIRED FDR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" [CRI, YOU NAV BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.! I?.<S 3-/-'/ '\.. BuREAU OF INDIVIDUAL INHERITANCE TAX DIVISION DEPT. 260601 HARRISBURG, PA 17128-0601 TAXES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEOUCTIONS AND ASSESSMENT OF TAX JOHN C SULLIVAN 107 SAMPLE BRIDGE RD MECHANICSBURG PA 17050 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-31-2003 SULLIVAN 03-09-2002 21 02-0475 CUMBERLAND 101 '*' REY-l!i47 EIt lFP tOl~Qll HELEN E Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REv=m-j-Ex--Aiij>--fiiFiiiy-ijiiYIcE--oF-i-N"HEifIi'ANcE-YAx-APPRAIsEHEij:r-,--ALLowANCE-oi----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX HELEN E FILE NO. 21 02-0475 ACN 101 ESTATE OF SULLIVAN TAX RETURN WAS: I ) ACCEPTED AS FILED I X) CHANGED SEE DATE 03-31-2003 ATTACHED NOTICE If an assessment was issued previously, lines 14, IS and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. stocks and Bonds {Schedule BJ 3. Closely Held stock/Partnership Interest (Sehedule C) 4. Mortgages/Notes Receivable lSehedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) IS) (6) 17J .00 997,261.75 .00 .00 16.540.48 .00 59.536.94 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule HJ 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Hon-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 10,869.36 978.14 Ill) (12) (13) (14) NOTE: 13,500.00 X 1,040,836.93 X .00 X .00 X NOTE: To insure proper credit to your account} sub.it the upper portion of this for. with your tax payltent. 1,073,339.17 11 .R47 ~o 1,061,491.67 7,154.74 1,054,336.93 00 , 045, 12 , 15 , .00 46,837.66 .00 .00 46,837.66 (19)' TAX CREDITS: 'ft,n<n, ,+I AMOUNT PAID DATE NUM8ER INTEREST/PEN PAID (-) 06-06-2002 CDOO1265 1,291.32 24,535.00 12-06-2002 CDOOl9Z3 .00 2,458.16 INTEREST IS CHARGED THROUGH 04-15-2003 TOTAL TAX CREDIT 28,284.48 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 18,553.18 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 333.83 TOTAL DUE 18,887.01 . IF PAID AFTER DATE INDICATED} seE REVERSE FDR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) . . REV-1470 EX (&-88) '* INHERITANCE TAX EXPLANATION OF CHANGES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENTS NAME FILE NUMBER 2102-0475 101 Helen E. Sullivan REVIEWED BY ACN Bill Lyons SCHEDULE ITEM NO. EXPLANATION OF CHANGES Under the terms of the Tax Exemption trust, the trustee may distribute principal to issue during the lifetime of the surviving spouse. In the absence of a request for a future interest compromise, the Department has the right to assess tax at the highest rate in the chain of potential distributions. Therefore, the tax has been assessed at 4.5% on the value of the residuary trust. ROW Page 1 /'}-6.3 -F/ ..~ ~ BUREAU OF INOIVID~ TAXES IHHERll ANtE TAX 'iIV1S: ., DEPT. 280601 ' HARRISBURGJ PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 10-15-2003 SULLIVAN 03-09-2002 21 02-0475 CUMBERLAND 101 ELYSE ROGERS 415 FALLOWFIELD STE 301 CAMP HILL RDD PA nOll Allaunt Remitted * REY-l~U EX AFP [01_05) HELEN E MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account} subMit the upper portion of this form with your tax pay.ent. CUT ALONG THIS LINE __ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-Y = iS93Ti-iif'P-foFo3y-----j,-..-iiftiERYiiiNCri-TAX-RE-ciiRD--iiii:.-uS'i'MENT--....----------------------- -- - --- ESTATE OF SULLIVAN HELEN E FILE NO. 21 02-0475 ACN 101 DATE 10-15-2003 ADJUSTMENT BASED ON: VALUE OF ESTATE: PROTEST BOARD DECISION 1. Real Estate (Schedule AJ 2. stocks and Bonds {Schedule Bl 3. Closely Held stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable lSchedule DJ 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule fJ 7. Transfers (Schedule G) 8. Total Assets DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Administrative Costs/ Miscellaneous Expenses (Schedule H) Deb~s/Hortgage Liabilities/Liens (Schedule I) Total Deductions Net Value of Tax Return Charitable/Governmental Bequests; Non-elected 9113 Trusts Net Value of Estate Subject to Tax 10. II. 12. 13. 14. TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Amount of Line 14 taxable at Collateral/Class B 19. Principal Tax Due TAX CREDITS: rate (9) (10) (15) (16) (17) I1B) (1) (2) (3) (4) IS) (6) 171 .00 997,261.75 .00 .00 16,540.48 .00 59,536.94 IB) 10,869.36 978.14 (II) (12) (13) (14) (Schedule oJ) 425.793.19X 00 = 628.543. 74X 045= .OOX 12 = .OOX 15 = (19) 1,073,339.17 11,847.50 1,061,491.67 7,154.74 1,054,336.93 .00 28.284.47 .00 .00 28,284.46 RE~.rPl '+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-06-2002 CDOO1265 1,291.32 24,535.00 12-06-2002 CDOO1923 .00 2,458.16 TOTAL TAX CREDIT 28,284.48 BALANCE OF TAX DUE .02CR INTEREST AND PEN. .00 TOTAL DUE .02CR . IF PAID AFTER DATE INDICATED, SEE REVERSE I IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) BOARD OF APPEA"" , DEPT.281021" .. \ ' HARRISBURG,PA 1712jl-1021 COMMONWEALTH OF PENNSYLVANIA . DEPARTMENT OF REVENUE ELYSE E ROGERS ESQ KEEFER ET AL 415 FALLOWFIELD RD STE 301 CAMP HILL PA 17011-4906 IN RE ESTATE OF: SULLIVAN HELEN E DOCKET NO.: TAX TYPE: APPEAL TYPE FILE NUMBER: ACN: APPRAISEMENT: PETITION FILED: EXAMINER: MAILING DATE: DECISION AND ORDER 0307610 Inheritance Protest 2102-0475 101 3/31/2003 4/11/2003 DONNA E AUMENT Direct Dial: (717) 783-7894 Fax: (717) 787-7270 Email: daument@state.pa.us September 26, 2003 In its appraisement and assessment of the estate's inheritance tax return, the Department determined that, in the absence of a request for a future interest compromise, tax on the entire $981,299.99 Tax Exemption Trust is due at the 4.5% rate, the highest rate in the chain of potential distributions. Petitioner states that the trust is a sole use trust for which an election to tax in this estate has been made. Petitioner further contends that tax should be assessed on the basis of a life interest to the surviving spouse at the 0% rate and a remainder interest to the decedent's issue at the 4.5% rate. Article II of the decedent's revocable trust establishes a Tax Exemption Trust from which the trustee must pay the net income to the surviving spouse. In addition, at the trustee's discretion, he may distribute as much of the principal as desirable for the welfare, comfort, health, education or other needs of the spouse or any of the decedent's living descendants. The spouse's approval is needed for any distribution to a descendant. Upon the decedent's death, the remaining principal passes to whatever , SULLIVAN fl~LEN E BOARD DOCKET NO. 0307610 Page 2 of 3 persons or organizations the spouse designates in his will and, absent such appointment, will pass in equal shares to the decedent's three children. Section 2113 of the Inheritance and Estate Tax Act of 1991, 72 P.S. S 9113, as amended, defers the taxability of assets transferred for the sole use of the transferor's surviving spouse during the surviving spouse's entire lifetime, unless the estate elects not to defer the taxability. In the opinion of this Board, the term "sole use" means that the spouse is the only person who may receive or direct receipt of the trust income and corpus during his lifetime. The Board finds that the Tax Exemption Trust is a sole use trust and that the estate elected to pay the tax in this estate on a timely filed return. As the estate has supplemented its original future interest compromise request with the affidavit of the surviving spouse confirming that he shall not, during his lifetime, consent to the distribution of principal to any of the decedent's descendants, the Board agrees that tax on the trust shall be computed on the basis of a life estate to the spouse at the 0% rate and a remainder interest at the 4.5% rate. We confirm Petitioner's calculation based on a life estate factor of 0.42015 using the federal 5.4% table for a person aged 74 in March of 2002. Accordingly, it is hereby Ordered that the protest is sustained. The Department is directed to issue an amended appraisement and assessment reflecting that the $981,299.99 Tax Exemption Trust is taxable to the extent of $412,293.19 at the 0% rate and $569,006.80 at the 4.5% rate. FOR THE BOARD OF APPEALS GERARD J. SALLAVANTI, CHAIRMAN - , SULLIVAN I4i\LEN E BOARD DOC~ET NO. 0307610 Page 3 of 4 JOSEPH R. SLEEK, MEMBER A STATEMENT OF ACCOUNT WILL BE MAILED TO YOU BY THE BUREAU OF INDIVIDUAL TAXES. ANY APPEAL FROM THIS DECISION MUST BE FILED WITH THE ORPHANS' COURT WITHIN SIXTY (60) DAYS OF RECEIPT OF THIS DECISION. IF YOU REQUIRE THIS INFORMATION IN AN ALTERNATE FORMAT UNDER THE PROVISIONS OF AMERICANS WITH DISABILITIES ACT OF 1990, PLEASE CALL (717) 783-3664, OR FOR SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND SPEAKING NEEDS: 1-800-447-3020 (TT ONLY). v D/ STATUS REPORT UNDER RULE 6.12 Name of Decedent: Helen E. Sullivan Estate Date of Death: March 9, 2002 Will No. Admin. No. 2002-00475 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate. 1. State whether administration of the estate is complete: Yes~ No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No----X- b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes X No ,-__/-<fohn C. Sullivan, Esquire Name (Please type or print) 107 Sample Bridge Road Address Mechanicsburg, P A 17050 (717) 766-4347 Telephone Capacity: X Personal Representative _ Counsel for Personal Representative BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 2806Dl HARRISBURG I PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '04 NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN *' REV-1!'EXAFP[Ol-OZl ELYSE ROGERS 415 FALlOWFIELD STE 301 CAMP HILL fEB 20 jill :20 02-16-2004 SULLIVAN 03-09-2002 21 02-0475 CUMBERLAND 202 HELEN E RDD L':"_._;~(I Cffor,~lP,~;i,i_ ';0., PA Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account I subllit the upper portion of this for.. with your tax paYllent. CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR FILES ~ REV =736--E;(AFP--m:-ozr----.....-ii1offci;:--OF--IiEi'E-RMiNAfiiftriiifli-iis-sElilfHEiily----------------------- - ---- OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER .. ESTATE OF SULLIVAN HELEN E FILE NO.21 02-0475 ACN 202 DATE 02-16-2004 ESTATE TAX DETERMINATION 1. Credit For State Death Taxes as Verified 26,993.15 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) 26,993.14 3. Inheritance Tax Assessed by Other States or Territories of the United states (Excluding Discount and/or Interest) .00 4. Total Inheritance Tax Assessed 26.993.14 5. Pennsylvania Estate Tax Due .01 6. Amount of Pennsylvania Estate Tax Previously Assessed Based on Federal Estate Tax Return .00 7. Additional Pennsylvania Estate Tax Due .01 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .01 INTEREST AND PEN. .00 TOTAL DUE .01 -IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL OUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)