HomeMy WebLinkAbout09-18-14 (2) REV-1500 Ex(pi.a,)(FI) 1505610105
ennsstvania OFFICIAL USE ONLY
Bu Department d Revenue Pap _Y , County Code Year File Number
Bureau 28o6viduatTaxes INHERITANCE TAX RETURN : I / V ///3
Ha BOX 280601 0� `�'
Harrisburg PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
07/23/2014 05/19/1920
Decedent's Last Name Suffix Decedent's First Name MI
Davis Jesse E
(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
CID 1.Original Return O 2.Supplemental Return O 3. Remainder Return(Date of Death
Prior to 12-13-82)
O 4.Limited Estate O 4a.Future Interest Compromise(date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
OP 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit(Date of Death O 11. Election to Tax under Sec.9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
Thomas P Gleason, Esquire (717) 532-3270
N
REGISTER OF WILLS US ONLY
� m
C= °� curio
First Line of Address Do '0 rno co :;3 tzy
49 West Orange Street 7z; n r— t✓ m m
t— L M C)O p
Second Line of Address Jl
Q
r] r•� `O '>'7
Suite 3
City or Post Office State ZIP Code DATE FILED . - r_-; CA
Shippensburg PA 17257 c!t va
x .n
Correspondent's e-mail address:tomgleason @tomgleasonlaw.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.
SI
RE OF PERSON RES NSIBLE FOR FILING RETURN DATE
a,d ./CJL� 9�i10iy
a^—
ADD ESS
932 Balsam Street, Barefoot Bay, FL 32976
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610105 1505610105
VU
1505610205
REV-1500 EX(FI)
RECAPITULATION
1. Real Estate(Schedule A). ..... . . ..... . ... . . . ... .. . . . ... . .... . ... .._. 1. 145,000.00
2. Stocks and Bonds(Schedule B) . . . . ..... .. .. . ........ . ... ..... . ..... . . 2. 218,209.90
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) .. . . . 3. 0.00
4. Mortgages and Notes Receivable(Schedule D) . ....... ......... . ..... ... . 4. ! 0.00
5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E).... . .. 5. 1,224,818.07
6. Jointly Owned Property(Schedule F) O Separate Billing Requested . . . . ... 6. ., 0.00
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested.. ... . . . 7,
0.00
8. Total Gross Assets(total Lines 1 through 7). . ..... . .. . . .... .... ..... . ... 8. 1,688,027.97
9. Funeral Expenses and Administrative Costs(Schedule H).. . .... . .... . ... . .. 9. 23,370.75
10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule 1)............. . . 10. 3,004.55
11. Total Deductions(total Lines 9 and 10)... . .. . . .... . . .. . ..... . ... ..... . . 11. 26,375.30
12, Net Value of Estate(Line 8 minus Line 11) . .... . . .... ... . . . ... ... . . . ... . 12. 1,561,652.67
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which "
an election to tax has not been made(Schedule J) . . . .. ..... . . .. ..... . . ... 13. . 0.00
14. Net Value Subject to Tax Line 12 minus Line 13 14. 1,561,652.67
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 1,56165267
(a)(1.2)x.0 45 1,561,652.67 15. 70,274.37
16. Amount of Line 14 taxable
at lineal rate X.0_ 0.00 16. 0.00
17. Amount of Line 14 taxable
at sibling rate X.12 0.00 17. 0.00
18. Amount of Line 14 taxable
at collateral rate X.15 0.00 18 0.00
19. TAX DUE .. . ....... . . . . .. ... .. . . ... .. ... . 19. 70,274.37
.. . .... ..... . ... . .... . ...
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
L 1505610205 1505610205 J
REV.1500 EX(F0 Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Jesse E. Davis
STREET ADDRESS
953 Ridge Road
CITY STATE I ZIP
Shippensburg PA 17257
Tax Payments and Credits:
1, Tax Due(Page 2,Line 19) (1) 70,274.37
2. Credits/Payments
A.Prior Payments _ -___ - 0.00
B.Discount 3,513.71
Total Credits(A+B) (2) 3,513.71
3. Interest
(3) 0.00
4. If Line 2 is greater than Line 1+Line 3,enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2,Line 20 to request a refund. (4) 0.00
5. If tine 1+Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 66,760.66
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.......................................................................................... ❑ 0
b. retain the right to designate who shall use the property transferred or its income ................ ❑ ■
c. retain a reversionary interest .........................................---.............................................................................. 0 0
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?.............. ❑ a
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
contains a beneficiary designation? ..................................---..........................f...._................................_............ ❑ 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1,1994,and before Jan.1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers t0 or for the use of the surviving spouse is 0 percent
[72 P.S.§9116(a)(1.1)(it)],The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a 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.§9116(a)(1.3)].A sibling is defined,
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
REV-1502 EX+(12-12)
T pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
21-14-0735
Jesse E. Davis
All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property
would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F.
Attach a copy of the settlement sheet if the property has been sold.
VALUE E DATE
ITEM
Include a copy of the deed showing decedent's interest if owned as tenant in common. Of DEATH
NUMBER DESCRIPTION
1• Property located at 953 Ridge Road,Shippensburg,PA(Parcel No. 11-10-0610-035 145,000.00
(See attached sales agreement)
TOTAL(Also enter on Line 1, Recapitulation.) $ 145,000.00
If more space is needed,use additional sheets of paper of the same size.
REAL ESTATE
AGREEMENT OF SALE
THIS AGREEMENT OF SALE ("Agreement') is made this day of
August, 2014, by and between THE ESTATE OF JESSE E. DAVIS, late of
Cumberland County, Pennsylvania (hereinafter referred to as "Seller"), and ANDREW
(n. MARTIN AND husband and wife, of
Franklin County, Pennsylvania(hereinafter referred to as"Buyer").
WITNESSETH,that in consideration of the mutual covenants and agreements
hereinafter contained,the parties, intending to be legally bound hereby agree as follows:
1. Seller shall sell to the Buyer and Buyer shall buy from Seller certain real
estate lying and being situate in Hopewell Township, Cumberland County,
PA, to wit, known and numbered as 953 Ridge Road, Shippensburg, PA
(Parcel ID No. 11-10-0610-035), along with all improvements thereon. Said
premises are more particularly described in a deed filed in the Office of the
Recorder of Deeds for Cumberland County, Pennsylvania in Deed Book
Volume 254, Page 3444.
2. Buyer shall pay to Seller as the total purchase price for the Property pursuant
to this Agreement the sum of One Hundred Forty-Five Thousand
($145,000.00) Dollars. The Buyer did not make an earnest money down
payment at the time of signing this agreement and the full purchase price is to
be paid to the Seller at the time of settlement.
3. The property shall be conveyed by special warranty deed and title to the
Property shall be good and marketable and free from all liens and
encumbrances. Seller shall be responsible for the cost of preparation of the
deed for this conveyance.
4. Property is being sold"as is".
5. All county, municipal, and school taxes as well as rents, water rents, and
sewer rents, if any, shall be prorated as of the date of settlement.
Apportionment shall be based upon the calendar of the fiscal years of the
taxing authorities for which the subject taxes are levied.
6. The Pennsylvania realty transfer tax of two percent shall be home equally
with one percent being paid by Seller and one percent being paid by Buyer.
7. Settlement shall be held within sixty(60) days of executing this agreement, at
such time and place chosen by Parties.
8. Risk of loss for the property shall remain with the Seller until Settlement.
9. All times fixed for performance in this Agreement by any of the parties
hereto shall be of the essence.
10. The parties represent that no broker was involved in this transaction
and the parties save and hold each other harmless and indemnify each
other for any broker's commission.
11. This Agreement is the final and entire agreement between the
Buyer and the Seller and the parties shall not be bound by any terms,
conditions, statements, warranties, or representations, oral or written, express
or implied, not expressly set forth herein.
12. Buyer may at his option,within thirty (30)days of the date of this Agreement,
order from a reputable Pest Control Operation certified by the Pennsylvania
Department of Agriculture, a written"Wood Destroying Insect Infestation,
and Resultant Damage Report" and shall present said report to Seller before
settlement. The expense for said report shall be borne by Buyer. If the
inspection reveals evidence of active infestations,previous infestation, and/or
resultant damage which has not been corrected, Seller hereby agrees, at
Seller's expense,to have the structure treated for such infestation.
13. In the event that Buyer desires that the Property be tested for the presence of
radon, Buyer may do so at his own expense. In the event that the test results
indicate the presence of radon levels which exceed four(4)Pico curies/liter,
Seller shall have the option of taking the appropriate remedial action and
obtaining a release from Buyer thereafter or taking no remedial action. In the
event that Seller chooses not to take any remedial action upon said detection
of the above radon levels or greater,then in that event, the Buyer shall have
the option of. 1) accepting the property with the radon levels revealed by the
testing, without abatement of the purchase price and agrees to release the
Seller from any and all liability there from or, 2)requiring the return of all
monies paid by Buyer on account of this transaction,which shall include but
not be limited to escrowed funds, reasonable title examination fees and
application costs,thereby declaring this Agreement of Sale null and void.
Buyer agrees to perform such radon test within Thirty(30) days of the
execution hereof.
14. Any changes or additions to this Agreement must be made in writing and
executed by the parties hereto.
15. This Agreement is binding on the parties hereto,their heirs, personal
representatives, successors and assigns.
16. In the event any part of this Agreement is construed as unenforceable,the
remaining provisions of this Agreement shall be in full force and effect and
enforceable as though the unenforceable part or parts were not included.
17. In the event that either party waives any right or remedy contained herein or
otherwise provided by law with respect to a breach or violation by the other
party of any of the terms and conditions of this Agreement, such waiver shall
not operate as a waiver as to any future violation or breach by said other
party.
18. This Agreement shall be construed under the laws of Pennsylvania.
IN WITNESS WHEREOF,and intending to be legally bound,the parties
hereto have executed this Agreement the day and year first above written.
THE ESTATE OF JESSE E. DAVIS
(tea. P ,rkr (SEAL)
wit'hiss ck Lee Davis,Executor, Seller
(SEAL)
Witiless Andrew Martin,Buyer
(SEAL)
Witness Buyer
REV-1503 EX+(8-13)
0 pennsylvania SCHEDULE B
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN STOCKS & BONDS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Jesse E. Davis 21-14-0735
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1' U.S.Savings Bonds(see attached list) 218,209.90
TOTAL(Also enter on Line 2, Recapitulation) $ 218,209.90
If more space is needed,insert additional sheets of the same size
/06/2014 Orrstown Bank Page: 1
Branch: 2 Savings Bond List Teller : 46
Serial Number Denomination Issue Date Value Interest
X001668161I $10000 03/2003 $15,932.00 5,932.00 *
X001435639I $10000 03/2002 $17,216.00 7,216.00 *
X001435638I $10000 03/2002 $17,216.00 7,216.00 *
X001435640I $10000 03/2002 $17,216.00 7,216.00 *
X0021344441 $10000 12/2005 $13,496.00 13,496.00 *
X002134443I $10000 12/2005 $13,496.00 $3,496.00 *
X005681309EE $10000 03/1992 $15,104.00 $10,104.00 *
X005681310EE $10000 03/1992 $15,104.00 $10,104.00 *
X005681311 EE $10000 03/1992 $151104.00 $10,104.00 *
X005681312EE w $10000 02/1991 $15,716.00 $10,716.00 *
X005681313EE $10000 02/1990 $16,352.00 11,352.00 *
X005681314EE $10000 02/1990 $16,352.00 11,352.00 *
L616711415EE $50 11/1999 $38.44 $13.44 *
L616711416EE $50 08/1997 $43.46 $18.46 *
X0018007841 $10000 07/2003 $14,912.00 $4,912.00 *
X001800785I $10000 07/2003 $14,912.00 $4,912.00 *
Pre-January 1990 Bonds: 0 $0.00 $0.00
January 1990:and Later Bonds: 16 $218209.90 $108159.90 *
Total Bonds: 16 $218209.90 $10$159.90
N/E=Not yet eligible for redemption
REV-r5oB EX+(DB-a2)
Pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS BE MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Jesse E. Davis 21-14-0735
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed an Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Orrstown Bank Checking Account No.560006 263,562.73
2. Orrstown Bank IRA Account No.4000038765 17,551.53
3, Orrstown Bank CD Account No.4000037843 28,650.88
4, Orrstown Bank CD Account No,4000037844 28,650.88
5. Orrstown Bank Money Market Account No.103200204 48,015.11
6. Citizen's Bank Checking Account No.6300744101 100.00
7. Citizen's Bank Money Market Account No.6301629195 204,83836
8, Santander Checking Account No.3531002449 86,300.19
9, Santander Money Market Account No.3534052544 59,336.39
10. Santander CD Account No.3535176014 27,44713
11, Santander CD Account No.3535176022 27,447.13
12. Trans America Annuity Account No.0201F109604 131,143.46
13, Trans America Annuity Account No.020OPM93127 5,059.84
14, Royal Bank of Canada Investment Account No,316.41006 289,052.57
15. Cash on hand at house 910.00
16, Sale of Silver Coins 1,194.00
17, 2007 Chevy Impala 3,597.00
18. Miscellaneous household items 1,545.00
19, Case 222 tractor&accessories 925.00
20. 2014 County.Twp.tax proration from sale of 953 Ridge Road,Shippensburg 87.47
TOTAL(Also enter on Line 5, Recapitulation) $ 1,224,818.07
If more space is needed, use additional sheets of paper of the same size.
REV-1511 EX+ (08-13)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Jesse E. Davis 21-14-0735
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
1. Auer Cremation Services 105.00
2. Honorarium to Hopewell U.M. Church for Memorial Service 500.00
3. Honorarium to Rev.Sheryl Houser for Memorial Service 100.00
4. Bagpiper for Memorial Service 225.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: 12,000.00
Name(s)of Personal Representative(s) Jack L. Davis
Street Address 932 Balsam Street- —
city Barefoot Bay_ state....FL ZIP 32976
Year(s)Commission Paid: 2014 - .-
4,650.00
2. Attorney Fees:
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: 393.50
5. Accountant Fees:
6. Tax Return Preparer Fees: 3,500.00
7 Cumberland Law Journal to publish estate 75.00
8. News Chronicle to publish estate 8825
9. Additional Probate 700.00
10. Delta Airlines for airfare for Executor's travel from FL to PA for estate administration purposes(3 trips) 884.00
11. Executor transport costs for travel to and from airport 150.00
TOTAL (Also enter on Line 9, Recapitulation) $ 23,370.75
If more space is needed,use additional sheets of paper of the same size.
REV-1512 EX-) (12-12)
pennsytvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Jesse E. Davis 21-14-0735
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM - VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Prorated 2014-15 School taxes on 953 Ridge Road,Shippensburg 44108
2. PA Transfer tax on 953 Ridge Road,Shippensburg 1,450.00
1 Wilbur Tosten for lawn mowing at 953 Ridge Road 100.00
4. Adams Electric Co.for electric from date of death to settlement on 953 Ridge Road 289.61
5. Onstown Bank for new checks for estate account 31.40
6. Fuel used by Executor for travel for the administration of the estate 286.69
7. Kuhn Cable for final cable service 108.09
a. Century Link for final phone service 182.81
9. Repairs to damaged mailbox 2.83
10. Chambersburg Hospital for EKG 3.22
11. Staples for supplies for the adminstration of the estate 17.96
12. Funk's Repair to repair washing machine 85.86
13. Parking at Harrisburg Airport 3.00
TOTAL(Also enter on Line 10, Recapitulation) $ 3,004.55
If more space is needed,insert additional sheets of the same size.
REV-1513 EX+(01-10)
t�ij;pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Jesse E. Davis 21-14-0735
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under
Sec.9116(a)(1.2).]
I. Jack L. Davis Lineal-Son 1/3
2. Wesley A. Davis Lineal-Son 113
3. Timothy C.Davis Lineal-Son 1/3
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
11 NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART R-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
If more space is needed,use additional sheets of paper of the same size.
LAST WILL AND TESTAMENT
OF
JESSE E. DAVIS
I,Jesse E.Davis,a resident of and domiciled in the Commonwealth of Pennsylvania,
make,publish and declare this to be my Last Will and Testament,revoking all wills and codicils at
any time heretofore made by me.
FIRST: I direct that the expenses of my last illness and funeral,the expenses of the
administration of my estate,and all estate,inheritance and similar taxes payable with respect to prop-
erty included in my estate, whether or not passing under this will, and any interest or penalties
thereon, shall be paid out of my residuary estate,without apportionment and with no right of reim-
bursement from any recipient of any such property(including reimbursement under Section 2207B
of the Internal Revenue Code). The provisions of this Article FIRST shall not apply to the extent
that contrary provisions concerning the payment or apportionment of any such taxes have been or
shall be made in any inter vivos instrument executed by me relating to any insurance,trusts,gifts or
other transfers,jointly owned property or accounts, or property subject to power of appointment.
SECOND: I give all tangible personal property owned by me at the time of my death,
including without limitation personal effects, clothing,jewelry, furniture, furnishings, household
goods, automobiles and other vehicles,together with all insurance policies relating thereto, to my
wife Elizabeth C. Davis, if she survives me,or if she does not survive me, to those of my children
(Jack Lee Davis, Wesley Arthur Davis and Timothy Clark Davis)who survive me,in substantially .
equal shares,to be divided among them as they shall agree,or if they cannot agree,as my Executor
shall determine.
THIRD: I give all the rest, residue and remainder of my property and estate, both
real and personal, of whatever kind and wherever located,that I own or to which I shall be in any .
manner entitled at the time of my death (collectively referred to as my "residuary estate"), to the
trustee under the following trust to be held and disposed of in accordance with the terms,covenants
and conditions of such trust: Jesse E.Davis and Elizabeth C. Davis Living Trust Dated:Even Date
Herewith.
In connection with the preparation of any tax return for me or my estate, I authorize
my Executor: to determine whether to elect to qualify any property as qualified terminable interest
property for Federal and/or State estate tax purposes; to make any election available under Section
2652(a)(3)of the Internal Revenue Code with respect to qualified terminable interest property as my
Executor may deem advisable; to make any election available with respect to Chapter 13 of the
Internal Revenue Code and to allocate the same to property eligible for such allocation, whether or
not such property is held hereunder,including property transferred by me during my life as to which
I did not make an allocation prior to my death,in such amounts and proportions as my Executor may
deem advisable; to determine whether to include or exclude any item of property; to determine
within permitted limits the date of valuation of my estate;to determine whether certain deductions
shall be taken as income tax deductions or estate tax deductions;and to determine whether to adjust
between principal and income.
FOURTH: If any property of my estate vests in absolute ownership in a minor or
incompetent,my Executor, at any time and without court authorization,may: distribute the whole
or any part of such property to the beneficiary;or use the whole or any part for the health,education,
maintenance and support of the beneficiary; or distribute the whole or any part to a guardian,
committee or other legal representative of the beneficiary,or to a custodian for the beneficiary under
any gifts to minors or transfers to minors act,or to the person or persons with whom the beneficiary
resides. Evidence of any such distribution or the receipt therefor executed by the person to whom
the distribution is made shall be a full discharge of my Executor from any liability with respect
thereto,even though my Executor may be such person. If such beneficiary is a minor,my Executor
may defer the distribution of the whole or any part of such property until the beneficiary attains the
age of twenty-one (2 1)years, and may hold the same as a separate fund for the beneficiary with all
of the powers described in Article SIXTH hereof. If the beneficiary dies before attaining said age,
any balance shall be paid and distributed to the estate of the beneficiary.
FIFTH: I appoint my wife Elizabeth C. Davis to be my Executor. If my wife does
not survive me, or shall fail to qualify for any reason as my Executor, or having qualified shall die,
resign or cease to act for any reason as my Executor,I appoint Jack Lee Davis as my Executor. If
Jack Lee Davis shall fail to qualify for any reason as my Executor,or having qualified shall die,re-
sign or cease to act for any reason as my Executor, I appoint Timothy Clark Davis as my Executor.
I direct that no Executor shall be required to file or furnish any bond, surety or other security in any
jurisdiction.
SIXTH: I grant to my Executor all powers conferred on executors under the
Pennsylvania Probate, Estates and Fiduciaries Code, as amended, or any successor thereto, and all
powers conferred upon executors wherever my Executor may act. I also grant to my Executor power
to retain,sell at public or private sale,exchange,grant options on,invest and reinvest,and otherwise
deal with any kind of property, real or personal, for cash or on credit; to borrow money and
encumber or pledge.any property to secure loans;to pay any legacy or distribute,divide or partition
property in cash or in kind, or partly in kind, and to allocate different kinds of property, dispropor-
tionate amounts of property and undivided interests in property among any parts, funds or shares,
and to determine the fair valuation of the property so allocated,with or without regard to tax basis;
to exercise all powers of an absolute owner of property; to compromise and release claims with or
without consideration;and to employ attorneys,accountants and other persons for services or advice.
The term"Executor"wherever used herein shall mean the executors,executor,executrix or admin-
istrator in office from time to time.
2
K }
6
y
-- SEVENTH: If any beneficiary under this will and I die in a common accident or
under circumstances in which it is difficult or impractical to determine who survived the other,such
beneficiary shall be deemed to have predeceased me.
IN WITNESS WHEREOF, I, Jesse E. Davis, sign, seal, ublish and declare this
instrument as my last will and testament this /Q day of 5, Kt4 , 2001. I also
have affixed my initials on the bottom of each of the preceding pages hereof.
L.S.
sse E. Davis
The foregoing instrument was signed, sealed, published and declared by Jesse E.
Davis,the above-named Testator,to be his last will and testament in our presence,all being present
at the same time, and we, at his request and in his presence and in the presence of each other,have
subscribed our names as witnesses on the date above written.
�N �
residing at
9S'7
skQ� P� »�syr
residing at
s-� r PA- / 7 2 5`7
3
ACKNOWLEDGMENT AND AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA, COUNTY OF CUMBERLAND,ss.
We,Jesse E. Davis Az&'i{ Ai• b{[9�K t iU la l�/ +U �s /ll
, the Testator and the witnesses respectively, whose
names are signed to the attached or foregoing instrument,being first duly sworn,do hereby declare
to the undersigned authority that the Testator,Jesse E. Davis, signed and executed said instrument
as his last will and testament in the presence and hearing of the witnesses, and that he had signed
willingly, and that he executed it as his free and voluntary act and deed for the purposes therein
expressed,and that each of the witnesses at the request of the Testator,in the presence and hearing
of the Testator and each other,signed the will as witness,and that to the best of his or her knowledge
the Testator was at the time at least eighteen years of age,of sound mind and under no constraint,
duress, fraud or undue influence.
sse E. Davis
Testator
Witness
Witness
Subscribed, sworn to and ac e by the ai Jesse E. Davis,
Testator, and subscribed and sworn e ore me b e abo e this /() day of
e t '200 .
v
N Publ
My commission expires on
.. Notarial Seal
pabick J.McLaughlin,Notary Ptdrlfa
Upper Moreland T Momgomery
My commission Expires JJune 21,2004
am r,Pennsylvania ASSWOUon 01 NOW"