HomeMy WebLinkAbout09-19-14 .J REV-1500EX(02-11) 1505610143
Jy'1 OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania County Code Year Ede Number
Bureau of Individual Taxes dll.a*Mea.o.RsrEaae
Po 60x.280601 INHERITANCE TAX RETURN 21 14 0032
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
12 20 2013 10 06 1917
Decedent's Last Name Suffix Decedent's First Name MI
ENGLE HAROLD H
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
® 1. Original Return ❑ 2. Supplemental Return ❑ 9 Remainder Return(Date of Death
Prior to 12-13-82)
❑ 4. Limited Estate ❑ 4a. Future Interest compromise ❑ 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
® 6 Decedent Died Testate ® 7 Decedent maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
❑ 9. Litigation Proceeds Received ❑ 10.Spousal Poverty Credit(Date of Death ❑ 11.Election to tax under Sec.9113(A)
between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
GERALD J BRINSER 717 838 634
REGIST6 OFIWILLS tj4 ONDV
CO
First Line of Address r= ' n ~ 1
6 E MAIN STREET =•r ;., _
Second Line of Address y f ::3
PO BOX 323 r— rr f
DATE FILEDr,
City or Post Office State ZIP Code N..
PALMYRA PA 17078
Correspondent's e-mail address: gjbrin @aol.Com
Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and complete.Declaration of preparer other than the personal representative Is based on all information of which preparer has any knowledge.
SIGNATUREpi-P,CR$ON RESPONSIBLE FOR FILING RETURN DATE
U/yw Philip D. Keefer
ADDRESS
670 Kise Mill Ro Ji Haven, PA 17370
SIGNATU E F PREPARER OTHERjHAN REPRESENTATIVE DATE
ll("D/ � Gerald J Brinser
AD
Brinser, Wagner& Zimmerman
6 E. Main Street, Palmyra, PA 17078
Side 1
L 1505610143 1505610143
J 1505610243
REV-1500 EX
Decedent's Social Security Number
Decedents Name. ENGLE, HAROLD H.
RECAPITULATION
1. Real Estate(Schedule A)......................................................_............. 1.
2. Stocks and Bonds(Schedule B)................_.......................................................... 2. 24 769 . 0 0
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C).......... 3.
4. Mortgages&Notes Receivable(Schedule D).. ... ................................... 4.
5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)................ 5. 664 , 91 4 . 28
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............. 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) ❑ Separate Billing Requested............. 7. 3 , 604 818 63
8, Total Gross Assets(total Lines 1 through 7).......................................................... 8. 4 , 294 501 9 1
9. Funeral Expenses and Administrative Costs(Schedule H)..................................... 9. 44 832 0 1
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................. 10. 8 1 , 645 . 85
11. Total Deductions(total Lines 9 and 10).................................................................. 11 12 6 , 477 8 6
12. Net Value of Estate(Line 8 minus Line 11)............................................................. 12. 4 , 168 , 024 . 05
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J)................................................. 13. 4 , 117 , 024 . 05
14. Net Value Subject to Tax(Line 12 minus Line 13)................................................. 14. 51 , 000 . 00
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X .00 15.
16. Amount of Line 14 taxable
at lineal rate X .045 16.
17. Amount of Line 14 taxable
at sibling rate X 112 3 , 000 00 17. 360 00
18. Amount of Line 14 taxable
at collateral rate x .15 48 , 000 00 18. 7 , 200 . 00
19. TAX DUE.............................................................................-.................................... 19. 7 , 560 . 0 0
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑
Side 2
L 1505610243 1505610243 J
REV-1500 EX Page 3 File Number 21 - 14 - 0032
Decedent's Complete Address:
DECEDENT'S NAME
Engle, Harold H.
STREET ADDRESS
222 Messiah Circle
CITY STATE ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19)
(1) 7,560.00
1 Credits/Payments
A. Prior Payments 7,182.00
B. Discount 378.00
Total Credits(A +B) (2) 7,560.00
3. Interest
(3) 0.00
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 2,Line 20 to request a refund
5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 0.00
Make Check Payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;................................... ....... ❑ x
b. retain the right to designate who shall use the property transferred or its income:.................................... ❑
c. retain a reversionary interest;or........--...................................................................................................... ❑ x
d. receive the promise for life of either payments,benefits or care?.............................................................. ❑ ❑
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?....--........................--........................-........................................................ ❑
3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?......... ❑ ❑
4. Did decedent own an individual retirement account,annuity,or other non-probate property which
contains a beneficiary designation?.......-...................................--...........................................-......................... ❑x ❑
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1,1994 and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving
spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after January 1, 1995,the tax rate imposed on the net value of transfers to or for the use(if the surviving spouse is 0 percent
[72 P.S.§9116(a)(1.1)(ii)]. The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of
assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
•The tax rate imposed on the net value of transfers from a deceased child 21 yyears of age or younger at death to or for the use of a natural parent,an
adoptive parent, or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)].
•The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in
[72 P.S.§9116(a)(1)].
•The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.69116(a)(1.3)1. A
sibling is defined under Section 9102,as an individual who has at least one parent in common with the decedent,w9ether y blood or adoption.
REV-IS03 EX.(6-98)
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Engle, Harold H. FILE NUMBER
21 - 14 - 0032
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF
DEATH
1 (470) Shares MetLife @ $52.70 Per Share 52.70 24,769.00
TOTAL (Also enter on line 2, Recapitulation) 24,769.00
�. pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE GASH
err ,NHFR,TANGETAXRETURN , BANK DEPOSITS AND MISC.
RES0ENT OF rEDENT ( PERSONAL PROPERTY
FILE NUMBER
ESTATE OF Engle, Harold H. 21 - 14-0032
Include the proceeds of litigation and the date the proceeds were received by the estate.All property jointly-owned with the right of
survivorship must be disclosed on schedule F.
ITEM
NUMBER DESCRIPTION VALUE AT DATE OF
DEATH
1 PNC Bank-C.D. #3170032589 20,669.34
(Includes accrued interest of$2,14)
2 PNC Bank- Checking Account#500001583 121,827.67
(Includes accrued interest of$0.14
3 PNC Bank-Checking Account#5004883376 2,992.74
4 PNC Bank -Savings Account#5004884221 516,516.26
(Includes accrued interest of$11.32)
5 Highmark-Premium Refund 76.27
6 Genworth Financial - Long-Term Care Insurance 2,832.00
TOTAL(Also enter on Line 5,Recapitulation) 664,914.28
REV-1510 EX-(OM )
pennsylvania
DEPARTMENT OF REVENUE SCHEDULE G
INHERrTANCE TAX RETURN INTER-VIVOS TRANSFERS &
RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY
ESTATE OF Engle,Harold H. FILE NUMBER
21 - 14-0032
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF EXCLUSION TAXABLE VALUE
NUMBER Include the name ofthe transferee,their relationship to decedent VALUE OF ASSET DECD'S (IF APPLICABLE)
and the date of transfer. Attach a copy of the deed for real estate. INTEREST
1 Allstate-Annuity with Brethren In Christ Foundation 34,407.t9 100% 34,407.19
named as beneficiary(BIC will distribute these funds
as if they were in the Trust mentioned below.)
2 Brethren In Christ Foundation- Harold H, Engle 133,927.24 100% 133,927.24
Traditional IRA, Account#6014416
(Includes accrued interest of$3.31)
with residuary charities named as beneficiaries-
3 Brethren In Christ Foundation-Harold and Mary Engle 3,436,484,20 100% 3,436,484.20
Revocable Trust,Account#04271990,with various
charities named as beneficiaries.
(Includes accrued interest of$63.02)
TOTAL(Also enter on tine 7, Recapitulation) 3,604,818.63
REV-1511 EX.(110-109)
A pennsylvania SCHEDULE
►� DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
�w INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT hJ 1 rW
FILE NUMBER
ESTATE OF Engle, Harold H. 21 - 14 -0032
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER FUNERAL EXPENSES:
A. 1 Cocklin Funeral Home- Funeral Services 14,858.66
2 Cocklin Funeral Home -Additional Death Certificates 30.00
3 Messiah Village - Funeral Luncheon 1,168.65
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Philip D. Keefer 12,000.00
Street Address 670 Kise Mill Road
City York Haven State PA Zip 17370
Year(s)Commission Paid 2014
2. Attorneys Fees Brinser, Wagner&Zimmerman -- Gerald J. Brinser 15,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
city State Zip
Relationship of Claimant to Decedent
4. Probate Fees Register of Wills (Ltrs. Pd. $210.00 = $75,001 - $100,000) 333.50
5. Accountant's Fees
6. Tax Return Preparer's Fees Diane M. Reed &Associates 950.00
7. Other Administrative Costs
1 Register of Wills-Additional Cost of Letters 300.00
TOTAL(Also enter on line 9, Recapitulation) 44,832.01
Schedule H
COMMONWEALTH OF PENNSYLVANIA Funeral Expenses&
INHERITANCE TAX RETURN Administlatke Costs continued
RESIDENT DECEDENT
ESTATE OF Engle, Harold H. FILE NUMBER
21 - 14 - 0032
2 The Sentinel - Legal Advertising 116.20
3 Cumberland Law Journal - Legal Advertising 75.00
Page 2 of Schedule H
A pennsylvania SCHEDULE [
DEPARTMENT OF NUN DEBTS OF DECEDENT
INHERITANCE TAX AX RETURN , MORTGAGE
RESIDENT DECEDENT LIABILITIES & LIENS
FILE
ESTATE OF Engle, Harold H. NUMBER 21 - 1a -0032
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
1 Paul D. Dalbey, DPM 30.00
2 PA Department of Revenue-2013 Estimated Payment 850.00
3 Messiah Lifeways @ Messiah Village 6,329.86
4 Verizon - Phone 8.50
5 Alert Pharmacy 138.49
6 United States Treasury- 2013 Federal Tax 60,746.00
7 PA Department of Revenue-2013 State Tax 13,543.00
TOTAL(Also enter on Line 10, Recapitulation) 81,645.85
REV-1513 EX-(0140)
A,, pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Engle, Harold H. 21 - 14-0032
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$)
RECEIVING PROPERTY Do Not List Trusteels)
]. TAXABLE DISTRIBUTIONS[include outright spousal
distributions,and transfers
under Sec.9116(a)(1,2)]
1 Alma H. Engle (Estate) Sister Specific Bequest 3,000.00
Estate Settlement Office, Fulton Bank
One Penn Square, P.O. Box 7989
Lancaster, PA 17604
2 Corrine and Roger Sharp None $3,000 Specific 4.500.00
6513 Peridot Bequest& 1/2
Alta Loma, CA 91701 mother's$3,000
Bequest
3 Duane and Becky Haas None $3,000 Specific 4,500.00
2265 Butte Falls Hwy Bequest& 1/2
Eagle Point, OR 97524 mother's$3,000
Bequest
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate.
jj. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
Note: The distributions listed below are pursuant to the terms of the Trust which is the
direct beneficiary of the Estate.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1 Brethren In Christ World Missions 30%of Schad. G,#2; 1,226,107.22
431 Grantham Road, Mechanicsburg, PA 17055-5812 30% of Residue
2 Cooperative Ministries General Conference BIC Church 20% of Schad. G,#2; 817,404.80
431 Grantham Road, Mechanicsburg, PA 17055-5812 20% of Residue
3 Messiah Village 20% of Schad. G,#2; 817,404.80
100 Mt. Allen Drive, Mechanicsburg, PA 17055 20% of Residue
4 Messiah College, Office of College Counselor 25% of Sched. G,#2; 1,021,756.02
P.O. Box 3015, Grantham, PA 17027 25% of Residue
5 Brethren In Christ Foundation 5% of Sched. G,#2; 234,351.21
431 Grantham Road, Mech., PA 17055-5812 5% of Residue
TOTAL OF PART It-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 4,117,024.05
REV-1513 EX-(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF R EVEN UE
INHERITANCE TAX RETURN BENEFICIARIES continued
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Engle, Harold H.
21 - 14-0032
NAME AND ADDRESS OF PERSON RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER (S) DECEDENT (Words) ($$$)
RECEIVING PROPERTY Do Not List Trustee(s)
I TAXABLE DISTR IBUTIO NS(include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)I
4 Kenneth and Clara Reighard None Specific Bequest 3,000.00
657 Groff Avenue
Elizabethtown, PA 17022-2826
5 Winifred and Earl Good None Specific Bequest 3,000.00
1445 Mill Road
Elizabethtown, PA 17022
6 James R. and Margaret Engle None $3,000 Specific 3,500.00
520 Rockingham Drive Bequest and 1/6
Harrisonburg,VA 22802 Portion of Parents'
$3,000 Bequest
7 John Edward and Ruth Ann Engle None $3,000 Specific 3,500.00
10 Lloyd Road Bequest and 1/6
Waterville, ME 04901 Portion of Parents'
$3,000 Bequest
8 Marilyn and J. Musser Wolgemuth None $3,000 Specific 3,500.00
1108 Centerville Road Bequest and 1/6
Lancaster, PA 17601 Portion of Parents'
$3,000 Bequest
9 Joanne and Lou Miller None $3,000 Specific 3,500.00
340 Hollyridge Drive Bequest and 1/6
Roswell, GA 30076 Portion of Parents'
$3,000 Bequest
10 Eugene and Ann Engle None $3,000 Specific 3,500.00
310 Hossler Road Bequest and 1/6
Manheim, PA 17545 Portion of Parents'
$3,000 Bequest
11 Richard Engle None $3,000 Specific 3,500.00
3 Albert Road Bequest and 1/6
Poughkeepsie, NY 12603 Portion of Parents'
$3,000 Bequest
12 Elaine and Richard Ucci None Specific Bequest 3,000.00
P. O. Box 67
Stamford, NY 12167
Page 2 of Schedule J
REV-1513 EAt(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES continued
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Engle, Harold H.
21 - 14-0032
NAME AND ADDRESS OF PERSON RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER (S) NDENWords) ($$$)
RECEIVING PROPERTY Do List Trustee(s)
I TAXABLE DISTRIBUTIONS[include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
13 Ronald and Betty Engle None Specific Bequest 3,000.00
109 Capitol Hill Road
Dillsburg, PA 17019
14 Philip and Cynthia Engle None Specific Bequest 3,000.00
115 Horseshoe Blvd.
Annville, PA 17003
15 Steve and Wanda Lehman None Specific Bequest 1,000.00
152 Horseshoe Drive
Annville, PA 17003-8848
16 David W. Hershey None 1/2 of$1,000 500.00
58 Walnut Street Specific Bequest to
Bristol, CT 06010 Mother,Teuntje
Hershey
17 Daniel L. Hershey None 1/2 of$1,000 500.00
32 Boltwood Avenue Specific Bequest to
Castleton, NY 12033 Mother, Teuntje
Hershey
18 Gulabi McCarty None Specific Bequest 1,000.00
Ninth Line, 8213, 12184
Stouffville ON L4A 31\16
Canada
19 Note: The distributions listed above are
pursuant to the terms of the Trust which is the
direct beneficiary of the Estate.
Page 3 of Schedule J
Note:All of these amounts are included in the amount listed at#5 on Schedule J
Continuation of Schedule J;
B. Charitable and Governmental Distributions:
6. Gospel Tide Hour (Broadcasting Assoc.) $3,000.00 Specific Bequest
P. O. Box 399
Chambersburg, PA 17201-0399
7. Trans World Radio $2,000.00 Specific Bequest
P. O. Box 8700
Cary,NC 27512
8. Far East Broadcasting $2,000.00 Specific Bequest
P. O. Box 1
La Mirada, CA 90637-0001
9. Gideons International $2,000.00 Specific Bequest
2900 Lebanon Road
Nashville, TN 37214
10. Cumberland Residential Services
(n/k/a CROSS, Inc.) $2,000.00 Specific Bequest
1073 York Road
Dillsburg, PA 17019
11. World Vision $2,000.00 Specific Bequest
P. O. Box 70399
Tacoma, WA 98481-0399
12. Open Doors USA $2,000.00 Specific Bequest
P. O. Box 27001
Santa Ana, CA 92799
13. Paxton Ministries $5,000.00 Specific Bequest
2001 Paxton Street
Harrisburg, PA 17111-109'
14. Brethren in Christ Historical Society $2,000.00 Specific Bequest
P. O. Box 310
Grantham, PA 17027
15. Brethren in Christ Archives $2,000.00 Specific Bequest
(c/o Brethren in Christ Historical Society)
P. O. Box 310
Grantham, PA 17027
16. Brethren in Christ World Hunger Fund $1,000.00 Specific Bequest
c/o The General Conf. of the BIC Church)
P. O. Box A
Grantham, PA 17027
17. Bethesda Mission $1,000.00 Specific Bequest
2101 N. Front Street
Building 1 Suite 301
Harrisburg, PA 17110
18. Madhipura Hospital $1,000.00 Specific Bequest
(c/o Brethren in Christ World Missions)
431 Grantham Road
Mechanicsburg, PA 17055-5812
19. Macha Hospital $1,000.00 Specific Bequest
(c/o Brethren in Christ World Missions)
431 Grantham Road
Mechanicsburg, PA 17055-5812
20. Mtshabezi Hospital $1,000.00 Specific Bequest
(c/o Brethren in Christ World Missions)
431 Grantham Road
Mechanicsburg, PA 17055-5812
21. Greenville College $1,000.00 Specific Bequest
315 E. College Avenue
Greenville, IL 62246
Din no retamrUt
T, HAROLD H.. ENGLE, of Messiah Village, Mechanicsbura,
Cumberland County, Pennsylvania., realizing the uncertainty of
this life, but with confidence in God and trust in His Son, my
Lord and Savior, Jesus Christ, who died for my sins upon the
cross, and rose. again to justify me and give me eternal life, do
hereby make, publish and declare this to be my Last Will and
Testament, revoking any and, all previous Wills and Codicils and
hereby will and dispose of all the property which 1 own at my
death in the follo"wina manner.
1. 1 direct my executrix to pay all of my debts, funeral
and administrative expenses as soon as convenient after my
decease.
2. 1 direct my executrix to distribute my personal
belongings according to a ;list left with my substitute executor.
3. All the rest, residue ;and remainder of my property, real
and personal , 1 give, devise and bequeath to the Alternate
Trustee under my Trust Agreement of April z7.; 1990, In Trust
to treat it as an addition to the principal, .subject . to that
Agreement as it exists at my death.
I ,
4. 1 nominate and appoint Mary Elizabeth Engle to be the
executrix of this my Last Will and Testament, without the filing
of any bond. Should she die before my death, renounce or refuse
to serve for any reason, or die leaving any of my estate
unadministered, 1 nominate and appoint Philip 0. Keefer, as
ACKNOWLEDGEMENT AND AFFIDAVIT
WE , HAROLD H. ENGLE, BETZI A. MORRISON and SHARON L.
SCHWALM, the testator and witnesses respectively, whose names
are signed to the foregoing instrument, being first duly sworn,
do hereby declare to the undersigned authority that the
testator signed and executed the instrument as his Last Wi11.
and that he had signed willingly, and that he executed it as his
free and voluntary act for the purpose herein expressed, and
that each of the witnesses, in their presence and hearing of
the testator, signed the Will as a witness and that to
the best of their knowledge the testator was at that time
eighteen years of age or older, of sound mind and under no
constraint or undue influence.
HAROLD,. H.
B Z A. MORRISON
COMMONWEALTH OF PENNSYLVANIA:
SS.
COUNTY OF CUMBERLAND
Subscribed, sworn to and acknowledged before me by
HAROLD H. ENGLE, the testator, and Subscribed and sworn to
before me by BETZI A. MORRISON and SHARON L. SCHWALM,
witnesses, this '1-- day of April , 1990:
' NOThF.J,L CS PL
,ARLISLE6e6000H.CUe49ERRLA�ND COUNT
MY COMMISCIDN EXPIRES OCT,3,102.
Mem7rf.Ptnnc�?.an:e,4,rdo•'rn nl Notalnu
AGREEMENT OF TRUST
AGREEMENT OF TRUST made and entered into this Z?' day of
April , 1990, by and between HAROLD H. ENGLE and MAY ELIZABETH
ENGLE, his wife, of Mechanicsburg, Cumberland County,
Pennsylvania (hereinafter referred to as "Settlors") and HAROLD
H. ENGLE and MARY ELIZABETH ENGLE (hereinafter referred to as
"Trustees") and JACOB ENGLE FOUNDATION, of Mechanicsburg,
Cumberland County, Pennsylvania (hereinafter referred to as
Alternate Trustee)
Intending to be legally bound hereby, the parties hereto do
hereby agree as follows:
ARTICLE I
Settlors hereby transfer to Trustees, in trust, for the
purposes hereinafter set forth, the property as set forth in
Schedule "A" attached hereto and made part hereof and such other
property as from time to time is transferred by Settlors to
Trustees.
ARTICLE II
The Trustees shall collect the income from the Trust Estate
and shall pay all proper charges and expenses. The net income of
the Trust Estate after payment of all such charges and expenses
shall be held, administered and invested by the Trustees, to be
distributed, together with the net income and such accumulated
income and corpus, as provided in Schedule "B" hereto and made
part hereof. Upon the death of Settlors, the corpus and accrued
income, if any, shall be distributed as further provided in
Schedule "B", attached hereto signed and dated and as from time
to time revised and made part hereof. All dividends payable in
shares of stock in the corporations declaring dividends shall be
treated as principal without regard to the number of shares
payable.
ARTICLE III
During the lifetime of Settlors, this Trust may be revoked
by the said Settlors by giving five (5) days written notice to
the Trustees hereunder, and in such case, all property whether
principal or accrued income or any combination of the foregoing
being held in the Trust shall be distributed to Settlors.
Further, during the lifetime of Settlors, this Trust may be
altered or amended by amendment of this Trust Agreement signed by
both Settlors and Trustees.
ARTICLE IV
No part of the income or principal of the property held
under this Trust or trusts subsequently created hereunder shall
be subject to attachment, levy or seizure by any creditor,
spouse, assignee or trustee or receiver in bankruptcy of any
beneficiary prior to his or her actual receipt thereof. The
Trustees shall pay over the net income and the principal to the
parties herein designated, as their interests may appear, without
regard to any attempted anticipation, pledging or assignment by
any beneficiary of these trusts, and without regard to any claim
thereto or attempted levy, attachment, seizure or other process
against said beneficiary.
ARTICLE V
In addition to the powers conferred by case law, by
statute, and by other provisions hereof, the Trustees and
Alternate Trustee, shall have the following discretionary
powers applicable to all property held which powers shall be
effective without order of any court and shall exist until final
distribution:
(a) To retain any property of any nature received for
whatever period the Trustees shall deem advisable;
(b) To invest and reinvest all or any part of said
property in such stocks, bonds, securities or other property,
real or personal , as the Trustees shall deem proper, without
regard to statutes limiting the property which a fiduciary may
purchase;
(c) To sell , transfer, exchange or otherwise dispose
of, any part of said property, for cash or on terms, publicly or
privately, or to lease, even for a term exceeding five (5) years
or the duration of any trust herein, without liability on the
purchasers or lessees to see to the application of the proceeds,
and to give options for these purchases without the obligation to
repudiate them in favor of a higher offer;
(d) To execute and deliver any deeds, leases,
assignments or other instruments as may be necessary to carry out
the provisions of the Trust;
(e) To borrow money, including the right to borrow
money from any bank and to mortgage or pledge any asset of the
estate as security;
(f) To assume continuance of the status of any
beneficiary with regard to death, marriage, divorce, illness,
incapacity and the like in the absence of information deemed
reliable without liability for disbursements made on such
assumption;
(g) To pay from the corpus of the Trust, or the income
therefrom, all debts, claims, taxes or similar charges;
(h) To make any distribution hereunder either in kind
or in money, or partially in kind and partially in money.
Distribution in kind shall be made at the market value of the
property distributed, and the Trustees, in their absolute
discretion, may cause the share distributed to any distributee to
be composed of property similar to or different from that
distributed to any other distributee;
(i) To exercise any subscription right in connection
with any security held hereunder, to consent to or particpate in
any recapitalization, reorganization, consolidation or merger of
any corporation, company or association, the securities of which
may be held hereunder, to delegate authority with respect
thereto, to deposit investments under agreements, to pay
assessments and generally to exercise all rights of investors;
(j) To continue any partnership, joint venture, joint
ownership or other business enterprise of which Settlors are a
part at the time of 'their deaths;
(k) To compromise claims;
(1) To continue for whatever period of time as the
Trustees shall deem necessary any ownership as a tenant in common
or as a partner, in real estate or other property and to act as
Settlors could have acted while living;
(m) To do all other acts in the judgment of the
Trustees necessary or desirable for the proper management,
investment and distribution of Settlors' Estates.
ARTICLE VI
In the event that Harold H. Engle, as one of the Trustees
named hereunder shall be unable or unwilling to continue to serve
as Trustee, then Jacob Engle Foundation, shall serve as Alternate
Trustee for Harold H. Engle for the remaining life of Mary
Elizabeth Engle and shall further continue to serve as Trustee
after the death of Settlors.
It is the intention of the Trust that Harold H. Engle shall
be a Trustee as long as he is living or is able to serve as
Trustee.
ARTICLE VII
During Settlors' lifetime, the Trustee shall be at liberty
to register property held hereunder, to the extent registerable,
usino Settlors' Social Security Number: 3ZsC- 01- q3J i for
Harold and Social Security Number: f(.Y- 3S-o for Mary
Elizabeth.
ARTICLE VIII
The Trust shall be administered and interpreted in
accordance with the laws of the Commonwealth of Pennsylvania.
IN WITNESS WHEREOF, Settlors and Trustees have hereunto set
their hands and seals the day and year aforesaid.
/WITNESS: SETTLO�RS:
(SEAL)
HARbLD H. LNUE J
MAR E IZ�H EHLE
TRUSTEES:
(SEAL)
HARULD H. ENULL
71��•`Lc.� �� �:�— tj,z t' SEAL)
YA RY E ZABEIH EN LE'
ALTERNATE TRUSTEE:
JACOB ENGLE FOUNDATION
By:LW c[ /? 41(SEAL)
SCHEDULE B
1. During the lifetime of Settlors herein, all net income from the Trust shall be paid to
or for the benefit of the Settlors in at least quarterly installments.
In addition to the net income,the Trustee shall pay to or for the benefit of the Settlors
such portion or portions of the principal as requested by the Settlors or by someone
acting legally on their behalf. Further,the Trustee may pay to or for the benefit of
the Settlors, any additional sums the Trustee deems necessary and proper for their
maintenance and support including,but not limited to,medical and housing expenses. .
2. Upon the death of either Settlor,the Trustee shall pay to the individuals set forth on
Schedule "C" attached hereto the sums set forth opposite their name(s) on said
Schedule.
3. Upon the death of the surviving Settlor,the Trustee shall again pay to the individuals
set forth on Schedule "C"the sum set forth opposite their name(s).
4. Upon the death of the last Settlor, any trust funds,both principal and undistributed
income,remaining after payment of the gifts set forth in Schedule"C"and and o_t�her
pro ep r c xges<_and,ezcpen=,including death taxes, shall be paid unto the Brethren
In Christ Foundation to be distributed for charitable purposes in accordance with
separate instructions on file with the Foundation.
Executed this /17 7'7, day of 147,42 e eq , 2002.
WITNESS: /� s
(SEAL)
Harold H. Engle, Settlor
–'` — Mary EObeth Vigle, Settlorij
By her ttomey-in-fact,Harold H. Engle
(SEAL)
Harold H. Engle,Att ey-in-fact
For Mary Elizabeth Engle
I
Harold H. Engle,Trustee
AT T: Brethren In Christ Foundation
By (SEALS
Altem Trustee
i
SCHEDULE C
Alma H. Engle
If she predeceases either of the Settlors,this bequest shall lapse. $3,000
John H. and Anna Engle,
the survivor of them, or their issue per stirpes. $3,000 (total)
Ruth H. Haas, $3,000
or her issue per stirpes.
Corrine and Roger Sharp, $3,000 (total)
or the survivor of them. If they both predecease either of the
Settlors, this bequest shall lapse.
Duane and Becky Haas, $3,000 (total)
the survivor of them, or their issue per stirpes.
Kenneth and Clara Reighard, $3,000 (total)
the survivor of them, or their issue per stirpes.
Winifred and Earl Good, $3,000(total)
the survivor of them, or their issue per stirpes.
John Edward and Ruth Ann Engle, $3,000 (total)
the survivor of them,or their issue per stirpes.
James R and Margaret(Peg)Engle, $3,000 (total)
the survivor of them,or their issue per stirpes.
Marilyn and J. Musser Wolgemuth, $3,000 (total)
the survivor of them, or their issue per stirpes.
Joanne and Lou Miller, $3,000 (total)
the survivor of them, or their issue per stirpes.
Eugene and Ann Engle, $3,000 (total)
the survivor of them, or their issue per stirpes.
w -:. ...Fe..�.;�.......:.a- _..... ..-.-,za.-z+xw.mm...w.;+,..--,+-.,N..s- a^.:-,. :ssa'r!}*.- ..a•. .w.w*=w._+.,,-::...-.+-:...r>'...=...n,_,r.
Richard Engle,- $3,000
xovFh. is<issue'per stirpes.
#r Y.e6:UiJ '#1JY. Yr'y l A ,{.U'Ll
Elaine and Richard Ucei,-,, M.? }f#F` fit:,,, g,r nt $3,000 (total)
the survivor o'f them, or their issue per stirpes.
Ronald'and`Bett"EnglE;^"`" s°f $3,000(total)
_
�,the,su rvivor'of them, or their issue per stirpes.
Philip and $3,000 (total)
4Cynthia Engle,tom; it 94
the survivor of Them', oc their issue per stirpes.
Steve and Wanda Lehman, $1,000 (total)
41 I�w
or the`survroor of them.
Teuntje Hershey, $1,000
-or her'issue per stirpes:
Gulabi McCarty $1,000
If shepredeceases either of the'Settlors,this bequest shall lapse.
i
Dr.Harold H.Engle
925 Larch Loop
Mechanicsburg,PA 17055
CHARITABLE DISTRIBUTION FORM (page 2 of 2)
Distribute the residue of my estate as follows:
Percentage Charitable Organizations: Addresses:
30% Brethren in Christ World Missions PO Box 390
Grantham, PA 17027
20% Cooperative Ministries PO Box A
Go The General Conference of the BIC Church Grantham,PA 17027
20% Messiah Village 10 Mt Allen Drive
Mechanicsburg, PA 17055
25% Messiah College Grantham, PA 17027
5% Brethren in Christ Foundation PO Box 290
Grantham, Pa 17027
Date: g Signature: 9Y ��
Address: p� S � �6 0,6
P.1— .
es No
The charitable organizations may be notified now ❑ FRI
Sewd:XUngle,or,llal°aUCWa bla Diet Rne EnQts2
LAW OFFICES COPY
BRINSER,WAGNER&ZIMMERMAN
A Professional Corporation
6 EAST MAIN STREET-SECOND FLOOR
(EAST MAIN& SOUTH RAILROAD STREETS)
P. 0. BOX 323
PALMYRA,PA 17078
PHONE:(717)838-6348
FAX: (717)838-6912
MECHANICSBURG OFFICE
GERALD J. BRINSER MESSIAH VILLAGE
KEITH D. WAGNER 100 MT.ALLEN DRIVE
JOHN M.ZIMMERMAN MECHANICSBURG, PA 17055
CALEB J. ZIMMERMAN PHONE: (717)697-4666
March 5, 2014
Glenda Famer Strasbaugh, Register of Wills
Cumberland Co Courthouse
I Courthouse Square
Carlisle PA 17013
In Re: Harold H. Engle Estate
No. 21-14-0032
Dear Register of Wills:
Enclosed you will find a check in the amount of$7,182.00 as payment of a"deposit"towards
the inheritance taxes due on the above-captioned estate.
If you have any questions, please feel free to call.
Thank you.
Very truly yours,
r}
N
/ < /`�L 60-8224/2313 107
y ESTATE OF HAROLD H ENGLE
PHILIP D KEEFER ,, -,a �'�3.
670 USE MILL RD. �=
YORKHAVEN^ 17370 - $..-.// V2-
C E)ST�2-
P ARS
TO �J
E H�ORD
F
/j
St
ON y� JryP
MEMO IP 0 10 7
�; 231313 224i' 2L8540355ry �
MET Historical Prices I MetLife, Inc. Common Stock Stock - Yahoo! Finance Page I of 2
Fic', IT."A's Soi 33r•ce Vveal')Ll Ga..as (ti A ri 51wrt. 1 fickr ri I More
se,ch finance Carol fir
it fi
Finance Home My Portfolio Market Data Yahoo Originals Business&Finance Personal Finance i Contributors
Enter Symbol foo- T;r,Ss,lu, 014 9 13,0.1 in 1)',eal x", 1-r r, Report an ace.
vmv E+-TRADE EVERY
'E,
Man MET IS DOW& ECOND
U Anninditabil 0 IS CRfflCAL WT Ps.
MetLife,Inc.(MET) wsr *Follow
55.06 Sao 15.4 02PM EDT
Historical Prices Got Historical Prices for:
GO
Set Date Range Palmyra Do you
quality for a$350.000
C�)Daily life insurance policy for
Start Cover"DE.--I E,Jim,1,2010 QWeekly 51 3.04 a month?
End Data:LDa L26_ -112M 1 0 Monthly Seel Your Aqe.:
0 Dividends Only "i<2.1 4"L4 •.+`7.L=
Get Prices 2r.
429 -.a �-,G 1
i I P,-1iru,,Ire I Lazt y 4
4
Prices
31
Date Open H 3h L— close Volume Adj Closi
L-
4
5 1 1
Dec 20 2013 5223 '5332 5208 53 12 10,118,800 52,08 1��'4 1 4 A7
Pit a"D
_,ad be,a y can
ose
of pit adjusted far vular and spins
F,j
Dooviload to Spreadsheet 4
Currency in USD 53
51 ;r5
59 -,1
C"3 -,x F4
?i 1,r 72 -At
74 • 7S -� 7r
Cqattiake ahmy_paymcrf
initial
ABC`J,.s
ri
http://finance.yahoo.com/q/hp?s—MET&a=l I&b=20&l)&d=l I&e=20&f=2013&g=d 9/16/2014
F-e b. 27, 2014 3 ; 13PM PNC Bank No. 6854 P. 1/2
February 27, 2014
Gerald 7 Brinser Esq
Brinser, 'Wagner & Zimmerman
6 East Main St 2"a Floor
PO Box 323
Palmyra, PA 17078
RE: Name: Harold H Engle
SSN:
DOD: 12-20-2013
Dear Sir/Madam:
In response to your request for Date of Death(DOD)balances for the customer noted above, our
records show the following:
Certificate of Deposit
Account# 31700325890 Established: 05-01-2008
HAROLD H ENGLE
DOD balance: $ 20,667.20+2.14 accrued interest
Interest paid 01-01-2013 thru 12-20-2013 $ 6037 YTD
Checking Account
Account# 5000001583 Established: 07-24-1997
HAROLD H ENGLE
DOD balance: $ 121,827.53 + 0.14 accrued interest.
Interest paid 01-01-2013 thru 12-20-2013 $ 14.38 YTD
Account# 5004883376 Established: 12-26-2006
HAROLD H ENGLE
DOD balance: $ 2,992.74 non interest bearing
Savings Account
Account# 5004884221 Established: 04-20-2009
HAROLD H ENGLE
DOD balance: $ 516,504.94+ 11.32 accrued 'interest
Interest paid 01-01-2013 thin 12-20-2013 $ 443.19 YTD
Page 1 of 2
—Feb. 2/. 20TV 3 13-FM —PNC—B ank No. 6854 P. 2/2
Please note thaf this office provides date of death balances for deposit accounts(]RAs, CDs, Checking and
Savings). We do not process any financial transactions or provide statements. If you need assistance with
any of these items, please call 1-888-PNC-13ANK(1-888-762-2265)or stop byyour local PNC Bank branch
office.
Sincerely,
National Financial Services Center
PNC Bank,N.A-
Member FDIC
This message is intended for the use of the individual or entity to which it is addressed and may
contain information that is privileged, confidential and exemptfrom disclosure under applicable law.
If the reader of this message is not the intended recipient or the employee or agent responsible for
delivering this message to the intended recipient, you are hereby notified that any dissemination,
distribution or copying of this communications is strictly prohibited If you have received this
communication in error,please notify me immediately by reply or by telephone at 800-762-1775 and
immediately destroy this fazed document.
Page 2 of 2
(BIC'T
Brethren in Christ
FOUNDATION
HAROLD H. ENGLE
222 MESSIAH CIRCLE ROOM 452
MECHANICSBURG PA 17055-8619
Harold H Engle Traditional IRA
Account#6014416
Account Information On: 12/20/2013
ONLINE ACCESS is a great way to follow the activity of your HSA and/or TAP Account. Sign up today by contacting Kim
Lehman using the information below.
Account/Trust Officer
DAVID M STRAUSSER
431 GRANTHAM ROAD
MECHANICSBURG PA 17055
(717)796-4788, EXT. 5418
FAX: (717)697-7714
dstrauss@bicfoundation.org
y N r m N Q N C0 Q (O t0 (7 tm+1 N •O(1 O
} F N V Q m IO O < CO (O <O
(O N M N N
M � m
r � a
N G
N_ N N Q N [D Q N (•I [O f0 N O O M M Cl O
(p 10 Q O m W V CO O O N N Q [O m
Q N r O N r Rl N N d' M Q O) OJ
N N V (O O1 O] cJ N N O m OJ t7 m Q M t0 O1
r E
cr O) M Q Q m ry N
C W �
O C
Q
Y
O 7 O M C) N M Q N r (7 m tO O O N O tO lO m
Y N r o] N r (O r O N W O O N M N N
(p Q N M Q M N N N N O Q (O r m
N N E t0 r N
V
V
Q
N O O N O N Q N m t0 M r N O N N O O N
G o M p N N m o rn r m Q N M N
M N
N m m r O m Q O O O Q N (O O)
�p p N N N
Q O] N N N O V Q CO M
pO r r OJ (D M N m N O r N r m N 16 C5 li
N M
d O O O O O O O O O O O
•- O M U r
J 1J m N
d O lD N V N r N N O N
r m N (D O O O m O O O
R C N
O
r
`L
r
W
O
L
2 D
a e m o
e e e N O E N
O t0 N IO N N
U C U
O O O T O {C L ? a
Y N � L' N ❑ N L a r a
E
C H s W = L• Q LL C W ❑ •C• N x d N LL i O LL
C � p`p � T 'O w � O T m O m V' a C • m_ m
N@ On N D 9 S m N
- m c A E Dc m :° a@ o D m m m m
U o o m o U o D u i ii H
LL LL_ = F LL F C N O w
a A y N O O 3 N T a R J N U
to
L N i W LL O Oi V > > > D✓ U V O O y i m O U 7 C
m m a o U c `o E > > m o E E K 5 0• x y o 'r E 5 x L°
U U U 2 m w 'a ❑ 'a 'a F w 'u w > ¢ a iiU
O yo M A N N N o rn M m o Q N Q
� M N N Q r (•1 M N O M1 O •A Q N N r
N r N N m O N M t0 m O Q N <O OO
N (p O [7 M O m (O N M M r GJ N OD 0
Y
3
O
V
v
Q
Traditional IRA Designation or Brethren in Christ Foundation
431 Grantham Road
Change of Beneficiary Form P.G.Box 290
. , . _ Grantham,PA 17027
IRA O�[WNER/ INFORMATION y //
Name . /7.f1'�C'OLQ' L/ GN6LE - _ �A Account(Plan)Nuq�b_er.t �b1. y41 ......... ....e......
Address,City,Sate,and ZIP 22`� YY)ESSt�N� CtR �v ,.!1.a Z.,....._rn G 1 l' 4 114S.�Y..t�s. ..�A...,..1 7b5. .......
ty, ........
Social Security Number . 'y Gp.d
.3.... Dale of Birth.) .'7.�.:`. ...... y 1
..... ... ...Daytime Phone Number.................................
DESIGNATION OF BENEFICIARY (see Additional Information included with this form.)
At the time of my death,the primary beneficiaries named below will receive my IRA assets-If all of my primary beneficiaries die before me, the
contingent beneficiaries named below will receive my IRA assets. fnghe event a beneficiary dies before me, such beneficiary's share will be
reallocated on a pro-rata basis to the other beneficiaries that share the deceased beneficiary's classification as.a primary or contingent beneficiary.A
designation of a beneficiary's primary or contingent classification is generally made by entering a percentage in one of the two columns to the left of
the name. In the event a beneficiary is named as both a primary and contingent beneficiary, of if a beneficiary is not assigned to a beneficiary
classification, such beneficiary shall be a primary beneficiary. If no percentages are assigned to beneficiaries, or if the percentage total for any
beneficiary classification exceeds 100 percent, the beneficiaries in that beneficiary classification will share equally.If the percentage total for each
beneficiary classification is less than 100 percent,any remaining percentage will be divided equally among the beneficiaries within such class.If all
of the beneficiaries dip before Me iriy,IRA assets wl(J be paid to my_gstatg, This designation revokes antd.sppercedes.all earlier beneficiary
desigriations'which may apply to this IRA.
Primary Contingent Name of Beaefietary SSN or TIN Relationship to Date of .Address,City,State,and ZIP
Share Share p v `` IRA Owner J�...�th
........ z.. ..G... ............................L...�..,,..�.1�.::
... ...�c . arrv � .x2..... v ..c ..........
%..............% m 5s... ot,1... .1 .! G.._...
................... ............................ .................... .........................................................
.........
z ......%..............°/a Y!:?' ,nNlCy41� .C.. ........................... ............................ .................... ...................................................................
!a:......%..............�.�3_!C....Fo v.1 ..t?O .cai�............................ ............................ .................... ...............................-...................................
..............%.......I......%................................................. ............................ ............................ .................... ...................................................................
..............%..............% ................................................. ............................ ............................ .................... .......................................-...........................
..........%..............% .......................................I......... ............................ ............................ ..................I. ......................................................:............
we..............% ................................................. ............................ ............................ .................... ..........................:........................................
%..............% ............:.................................... ............................ ............................ .................... ...................................................................
Total l00% Total 100%
3 SPOUSAL CONSENT
Community or marital property state laws may require spousal consent for a nonspouse beneficiary designation. The laws of the state in which the
financial organization is domiciled,the IRA owner resides,the first is located,the spouse msidn,or this transaction is consummated should be reviewed
to detennine if such a requirement exists.Spousal consent for the beneficiary designation may also be required by financial organization policy.
.......................... I Am Married.I understand that if I designate a primary beneficiary other than my spouse,my spouse must consent by signing
(IRA Ovmer lnidals) below.
I Am Not Married.I understand that if I marry in the future,I must complete a new Designation of Beneficiary form,which
<uu Owaegnrtiafs) - includes the spousal consent,documentation-
I am the spouse of the IRA owner.Because of the significant consequences associated with giving up mj interesi;i -the IRA,the custodian/trustee
has not provided me with legal or tax advice,but has advised me to seek tax or legal advice.l acknowledge traVYhave received a fair and reasonable
disclosure of the IRA owner's assets or property and any financial obligations for a community property saqte:In-th event I have a legal interest in
the IRA assets,I hereby give to the IRA owner such interest in the assets held in this IRA and consent to the betiellf5ary designation set forth in this
form.
..................................................................................................................... ..ign--tu....,o--f-..................re.............................................................are.......
Signature of Spouse Date Signature of Witness(if required) Date
(Witness cannot be a beneficiary of this IRA) _
4 SIGNATURES
I certify that I am the IRA owner or individual legally authorized to complete this form.I certify the accuracy of the information set forth in this t
form, and I authorize this designation. I understand that the IRA agreement,disclosure statement, and amendments thereto may provide me with j
additional guidance.I assume full responsibility for any consequences associated with my naming of beneficiaries.I indemnify and agree to hold the i
- custodianitrustee harmless against any liabilities.I acknowledge that the custodian/trustee cannot provide,and has not provided,me with tax or legal _
advice.I have ppbeen
^1advised to ek�guidance of a tax or legal professional,
katurirTll <.f W..ner... ... ..... .. .p.,"I..\.,.. Date p Si ''e. ...................-..%,e
gn gn re of Custo a Date
tat Copy-Cuslodlenrrrustee Zed Copy-1 vmer
Traditional IRA Designation or Change of Beneficiary Form
Bank..Systems'^ IRA-1 U112Di 1
Wolters ia.r Financial Service.®19]5,2011 To Reorder F..0-800-552-9010 Page t of l
i
1.
A-
�F
Brethren in Christ
FOUNDATION
HAROLD H. ENGLE
222 MESSIAH CIRCLE ROOM 452
MECHANICSBURG PA 17055-8619
Harold and Mary Engle Rvoc TR 04271990
Account#1020103
Account Information On: 12/20/2013
ONLINE ACCESS is a great way to follow the activity of your HSA and/or TAP Account. Sign up today by contacting Kim
Lehman using the information below.
Account/Trust Officer
DAVID M STRAUSSER
431 GRANTHAM ROAD
MECHANICSBURG PA 17055
(717)796-4788, EXT.5418
FAX: (717)697-7714
dstrauss@bicfoundation.org
v o e e e o 0 0 0 0 0 o v o v o 0 0 0 0 o v o o v o N
v m N m m o N M m rn o o P n o M M m rn M m Q n
(D M O
M q v
J pl.
� � a
_N Q
p a b n M Q Ir o o m P r o o m m Q N o r m P N o m m N
N b E. OD m P O O In N n In O O (p O P m O (O Ill Q CO l() N
N N O IO IO Q O N (O Ill N O r r N N P Ol M m m m m Ol
U N N t➢ Ol n M P Q Q O P P O P m m . Ill P r m
M m
0 C
Q
M
O> b O Q O I!) N O O T M r LO N r (O m 0 O] I() M Q O T
Q J O N n N P N N O Q m M IO P O O N m In [O
q O N O m N P O M n O r Q r m N m m m (O N r QI Ill m m Q
V > M m O Vl n O fp m N m (p m N Ol m m N O OI O n O m
N N m n O P P f? Ol m
V
Q
NO P n O n M N O T I[) N O O O n O N n O T O O N M m
b O N O n n O N n M P I() O O O Q W
O m Q M c0 P n O O O n n [O m O Ol r N OI m n Itl O M v1 Q
n
N
Rt b o 0 o O o 0 0 0 0 0 0 0 o a o 0 0 0 0 0 0 0
0 u o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 � o 0 0 0 0 0
o m Ill _M o m P Q Q m r m a M m to m M r N m
IU N Ill N OI N m N N
U
O
0'
d
C
W
T
i
R
C
t6
o
o n y ¢ w
¢ ¢
<
o O b a o o ¢ _ N LL LL U w v c q
a a a n w w ¢ E LL v m E l? U
O D
E` U > N C
Y W _ E G J g N W y q C N b LL a
e e e n 0 e b N W
O > C -Q Ej c m V
' b ° fn o: 3 0 W E C a J N v> =N J
O
m EP E o 0 m v 0 > E - U > C -
E J.
w m 'S m � n E c -o a > U m U Q
c q v w N av 2 w = > V o o n 'n T O r 6 ❑ E v J w
>c v o l H F q m a u N c E N a V c c c d w N N O O
a E 7 O
c n i 3: m
a a LL o
m 1-
M
=p E N >g > 0>> > - O W E E O o` LL o` g O w n q g q q n n n LLV
Z �
O p in w L w K 2 ¢ U U q U U 0 2
7 r1
G y o 0 0 o m m In P m P m m m M o m m n M m M Ol M M
b P O O O O m m m N r r m N OI N , m , m P Ill P O O O
r q Vl O O O Ul M Ol m n N O m r h N n M M P m n n
N M M O M o M P m m O Q N r n Ill M o -ll m M m M Q r
m r e _ m m In rn o e In r N In P m v o N
M
G
O
V
V
Q
y O N N O O m N r f7 N (O Cl N Cl m O
N r O O O C) N N t0 N Q N O O N O W N
M � w
m
� c a
N a
N d E O 7 r O Q C'1 N IT M Q r m n m N <n v C')
V m N
a m N n C'1 l"1 n Q m N O V O (O Q m
o Q <n m m r � m Q_ o n o Ln N N
O C
Q
Y
d d Q n n n t0 r Ol n n n ^ O � Q m N nJ OJ
Q ? m rn ? m N N cn v
V
Q
y O N Cl C') O N N T O r O tD O 7 CJ n N
U p O o N ai O O r O N N Cm i O o T O N O 1 n Q v m
� N
r
N
d o 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 u O o 0 0 0 0 0 0 0 0 0 0 0 0 0
m O n f0 n N C') m N m r N V "
m
d O N N N Cl N O r r C'1 C) OI m m
V
O
d
W
l7
C
C
t6
—
�
wf 0
,V N
U
U
w
o ¢ m
U 1-5
N U U O c d d U U C
o � _
¢ LL p � a p LL lL d
-g LL �p
p
o. 2
e LL 7 C a d U Ql N U lO N
m E ac o o c ? c m d N .E E m m m
~ E
w ¢ � > >d x
d V C O a U a LL — (Yp a k E g E T N N W
_d a a a > F
a .ai m Z m m S E E m
6 76 1
M N (9 C O' >0 O O O d LL co
9 y N O > U U U U = .p. LL O Ot d d d d C
K p 'r m m m E E E d p n w > > °n °o. — d
Z 0 0 2 (7
O
r m N r N N m m 1] O O m O M `3 O
O m Q N (O N O n 41 N N C] m m r r
N N g N O G] m m N m Q Q n N N N
f7 f0 t7 O m n r r Q (D n O ['1 Y'l m m Q N
C m
0
V
Q
RECEIPT FOR PAYMENT
LISA M. GRAYSON, ESQ. Receipt Date : 1/10/2014
Cumberland County - Register Of Wills Receipt Time : 10 :51 : 02
One Courthouse Square Receipt No . : 1076667
Carlisle, PA 17613
ENGLE HAROLD H
Estate File No. : 2014-00032
Paid By Remarks : BRINSER WAGNER & ZIMMERMAN
CJ
--- - ------- ------ --- ---- Receipt Distribution ----------- ---- ---------
Fee/Tax Description Payment Amount Payee Name
PETITION LTRS TEST 210 . 00 CUMBERLAND COUNTY GENERAL FUN
WILL 15 . 00 CUMBERLAND COUNTY GENERAL FUN
SHORT CERTIFICATE 50 . 00 CUMBERLAND COUNTY GENERAL FUN
JCS FEE 23 . 50 BUREAU OF RECEIPTS & CNTR M.D
AUTOMATION FEE 5 . 00 CUMBERLAND COUNTY GENERAL FUN
INVENTORY 15 . 00 CUMBERLAND COUNTY GENERAL FUN
INH TAX RETURN 15 . 00 CUMBERLAND COUNTY GENERAL FUN
Check# 4490 $333 . 50
Total Received. . . . . . . . . $333 . 50
The Sentinel ZIMMERMAN BRINSER,WAGNER& AD NUMBER USALESPERSON
w ww.cumberlink_com 6 E. MAIN STREET,2ND FL. 428730
P.O. BOX , P BILL DATE PALMYRA, PA 17078 Crgoar SHrvF.NSb�CC vLOe.ecuKrc 717-838-6348 03/17/14 START DATE 03/01/14
AD NUMBER AD DESCRIPTION CLASS LINES
428730 NOTICE NOTICE IS HEREBY GIVEN THAT 10 PUBLIC NOTICES 20 ' 2 cols
Publication Insertions Rate Net Amount Gross Amount
3 THE SENTINEL-LEGAL 3 LGL $106.20
TOTAL AD CHARGE
$106.20
3 PROOF OF PUBLICATION G1PRF $7.00
3 MOBILE SITE
MOB2 $3.00
`
q
f �c� J c�
Purchase Order Est.Harold En le
9 PAY THIS AMOUNT $116.20 $139.44
Lee Enterprises no longer accepts credit card payments sent via e-mail. *AFTER 04/11/14
Emails containing credit card numbers will be blocked. Please use the coupon
below to send credit card payment to our lockbox.
You may also send the coupon to a secure fax at 319-291-4014. THE SENTINEL
c/o LEE NEWSPAPERS
Thank you for advertising with The Sentinel! Deadline for PO BOX 540
in-column legal ads is 4:00 p.m. two business days prior to WATERLOO IA 50704-0540
date of insertion. For questions, call (717)240-7130.
PROOF OF PUBLICATION
State of Pennsylvania, County of Cumberland
Patrick Doane,Production Director, of The Sentinel, of the County and State aforesaid,
being duly sworn, deposes and says that THE SENTINEL, a newspaper of general
circulation in the Borough of Carlisle, County and State aforesaid,was established
December 13th, 1881, since which date THE SENTINEL has been regularly issued in said
County, and that the printed notice or publication attached hereto is exactly the same as
was printed and published in the regular editions and issues of
THE SENTINEL on the following day(s):
March 1,8, 15, 2014.
COPY OF NOTICE OF PUBLICATION
o ce Affiant further deposes that he/she is not
Notice Is hereby given that Letters Testamentary on the Estate of HAROLD H.
ENGLE,Deceased.late of Upper Allen Township,Cumberland County, interested in the subject matter of the
Pennsylvania,have been gnmled to the undersigned Executors. aforesaid notice or advertisement, and that
All persons therefore indebted to said estate are requested to make immediate
payment,and those having just claims will please present the same.duly all allegations in the foregoing statement as
authenticated.for settlement,without delay.Philip D.Keefer.670 Kiss Mill
Road.York Haven.PA 17370,Executor;Gerald J.Brinseq Attorney. to time,place and character of publication
are tr
Sworn to and subscribed before me this
�I� d�.t ,-r �1�rch aD14
otary Public
My commission expires:
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Bethany M.HoltrY,Notary Public
Carlisle Bom,Cumberland county
MY COMMISIOn Pxplrm Sept,26,2015
MEMBER PENIISYIVAN[0.AS5 AT CX OF NOTARIES
AND
�rISSOCIP���
CUMBERLAND LAW JOURNAL
32 SOUTH BEDFORD STREET
CARLISLE, PA 17013
Tale: (717)249-3166 Fax:(717)249-2663
March 14, 2014
Cumberland Law Journal is published every Friday by the Cumberland County
Bar Association and is designated by the Court of Common Pleas as the official legal
publication for Cumberland County and the legal newspaper for publication of legal
notices.
TO: Gerald J. Brinser, Esquire
RE: Harold H. Engle Estate
Legal advertisements must be received by Friday Noon. All legal advertising
must be paid in advance. Make all checks payable to: Cumberland Law Journal.
------------------------------------------------------------------
------------------------------------------------------------------
Advertisement inserted on the following dates:
February 28, March 7, and March 14, 2014
Advertising Cost $ 75.00
Proof of Publication $ 0.00
Second Proof Request $ 0.00
Payment received $ 0 .00
Total Amount Due $ 75.00
Payment received by �
PROOF OF PUBLICATION OF NOTICE
IN CUMBERLAND LAW JOURNAL
(Under Act No. 587, approved May 16, 1929), P. L.1'784
COMMONWEALTH OF PENNSYLVANIA
ss.
COUNTY OF CUMBERLAND
Lisa Marie Coyne,Esquire, Editor of the Cumberland Law Journal, of the County and
State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law
Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid,
was established January 2,1952, and designated by the local courts as the official legal
periodical for the publication of all legal notices, and has, since.January 2, 1952, been regularly
issued weekly in the said County, and that the printed notice or publication attached hereto is
exactly the same as was printed in the regular editions and issues of the said Cumberland Law
Journal on the following dates,
viz:
February 28, March 7, and March 14, 2014
A£fiant further deposes that he is authorized to verify this statement by the Cumberland
Law Journal, a legal periodical of general circulation, and that he is not interested in the subject
matter of the aforesaid notice or advertisement, and that all allegations in the foregoing
statements as to time,place and character of publication are true. j
` J
is Marie Coyne, Editor
SWORN TO AND SUBSCRIBED before me this
14 day of March, 2014
Notary
Engle,Harold H., decd.
Late of Upper Allen Township.
Executor: Philip D. Keefer, 676
Mae Mill Road, York Haven, PA
17370. F}!lrinlAL
Attorney: Gerald J. Brinser, Es- OC:�GP.4H A COLLi�
quire. iJnkar; Fti(aliC
GkSi'_i3!E ilR�llGtl,Cl}d�B'tiiJ_Ahli'";Ol+3viY
LAW OFFICES
BRINSER,WAGNER&ZIMMERMAN
6 EAST MAIN STREET-SECOND FLOOR
(EAST MAIN&SOUTH RAILROAD STREETS)
P.O. BOX 323
PALMYRA,PA 17078
PHONE(717)838-6348
FAX:(717)838-6912 MECHANICSBURG OFFICE
MESSIAH VILLAGE
GERALD J. BRINSER 100 MT.ALLEN DRIVE
NEI LFI D. WAGNER - MECHANICSI3URG,PA17055
JOHN M.ZIMMERMAN PHONE/FAX(717)697-4666
CALEB.I.ZIMMERMAN
September 18, 2014
Glenda Farner Strasbaugh, Register of Wills
N
Cumberland County Courthouse m
1 Courthouse Square M CO n
Carlisle. PA 17013 -a n �°
0
� m C.0 ,--n rn
In Re: Harold H. Engle Estate 1> cr :J CD M o
File No. 21-14-0032 ca ti- -n -n
Dear Register of Wills, -v m
r\.) Cn (D
(=3
Enclosed you will find two (2) copies of the PA Inheritance Tax Return for the above-
captioned estate. Also enclosed is a check in the amount of$300.00 in payment of the additional
cost of letters.
If you have any questions, please feel free to contact me.
Thank you.
Very truly yours,
BRINSER, WAGNER & ZIMMERMAN
)CL-" .
Gerald J. Brinser
GJ13/wIc
Enclosures
c: file
c .o. r
oo•xn •z m
¢>r-o 0
mad NG �o T
� bb�sssB 6[�s
M
0
r_
o� 0 3,(p1t' �1Spd
II �E �31Gyn
W
N
O O
O U) N -, O
x
! W J f". F-
U v ~ O
:7 O
lL LL E O C.J r U < m
.-I .
O G Y . N � Q O
G] C C N
W Lu W .t
__j
p h r i J Q 3 O
V Q- W LL U N a
O O
C> W CJ? z O
L.i d Q 2 W
CL' O = W J I- J
n U H CcxN
03 CD
N Wes .+
W � Q
8=A W.Lot pgol
uloo-sdsn P sn llsy'
z
f
CC _0 3JIAb35lVlSOd 531415 U311Nl1
LL �IVW
o o
o L.
y a 0 0 ®Jl1:R �
N
C « K -
3Z co
ry0in0 CL
T
C