HomeMy WebLinkAbout11-03-14 (2) REV-1500 EX(02-11) 1505610143
I OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania County Code Year File Number
Bureau of Individual Taxes DEPARTMENT OF REVENUE
PO BOX.280601 INHERITANCE TAX RETURN 21 14 00769
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
08 06 2014 02 24 1919
Decedent's Last Name Suffix Decedent's First Name MI
STEPHENSON JANE G
(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
C1 1. Original Return 0 2. Supplemental Return 0 3.Remainder Return(Date of Death
Prior to 12-13-82)
0 4. Limited Estate E3 4a.Future interest Compromise 0 5. Federal Estate Tax Return Required
(date of death after 12-12.82)
H 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) —
0 9. Litigation Proceeds Received 0 1 o.Spousal Poverty Credit(Date of Death 0 11.Election to tax under Sec.9113(A)
between 12-31-91 and 1-1-95) (Attach Schedule 0)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
WILLIAM R BUNT ESQ 717 582 8195,
72 --1-7.0
Ti
REGISTE OF-WILLS USEMNLF-'
First Line of Address
109 S CARLISLE STREET
Second Line of Address
PO BOX 336
ri
1309 FILED I
City or Post Office state ZIP Code
CIO
NEW BLOOMFIELD PA 17068
Correspondent's e-mail address: wrb@pa.net
Under penalties of perjury,I declare that I have amined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and complete.Declaration of parer other than the personal representative is based on all information of which preparer has any knowledge,
SIGNrOF POWN RESPO DATE
�.� 2;C6��RN -Thomas G.Stephenson )O
ADDRE6%
16 Craig Run Road, Q
SLaGannon,PA 17020
SIGNATURE OF.PREPd*K1l5T_HER THAN REPRESENTATIVE DA7E
/0 William R Bunt Esq
ADDRESS V
Law Office of William R.Bunt
109 S.Carlisle Street, New Bloomfield, PA 17068
Side I
1505610143 1505610143
1505610243
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: STEPHENSON, JANE G
RECAPITULATION
1. Real Estate(Schedule A).......... ...................................................
2. Stocks and Bonds(Schedule B)......__........................................ Z
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. 165 , 471 . 72
6. Jointly Owned Property(Schedule F) [3 Separate Billing Requested....... 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) [3 Separate Billing Requested............. 7. 103 , 712 . 04
8. Total Gross Assets(total Lines 1 through 7).......................................................... 8. 269 , 183 . 76
9. Funeral Expenses and Administrative Costs(Schedule H)..................................... 9. 35 , 450 . 37
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................. 10.
11. Total Deductions(total Lines 9 and 10).....................___.................................... 11. 35 , 450 . 37
12. Net Value of Estate(Line 8 minus Line 11)............................................................ 12. 233 , 733 . 39
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J)................................................. 13.
14. Net Value Subject to Tax(Line 12 minus Line 13)................................................. 14. 233 , 733 . 39
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 .045 233 , 733 . 39 16. 10 , 518 . 00
17. Amount of Line 14 taxable
at sibling rate X .12 17.
18. Amount of Line 14 taxable
at collateral rate X .15 18.
19. TAX DUE................................................................................................................. 19. 10 , 518 . 00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. M
Side 2
1505610243 1505610243
REV-1500 EX Page 3 File Number 21 14 00769
Decedent's Complete Address:
DECEDENT'S NAME
Stephenson, Jane G
STREET ADDRESS
1700 Market Street
CITY STATE ?p
Camp Hill PA 17011
L
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 10,518.00
2. Credits/Payments
A. Prior Payments
B. Discount 525.90
Total Credits(A +B) (2) 525.90
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 I+Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 9,992.10
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;................................................................................. F] FAI
b. retain the right to designate who shall use the property transferred or its income;...._....._..................._
c. retain a reversionary interest;or.................................................................................................................. H Nx
d. receive the promise for life of either payments,benefits or care?.............................................................. F
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?.......................................................................................................................
1 Did decedent own an"in trust for' or payable upon death bank account or security at his or her death?......... Fx� 0
4. Did decedent own an individual retirement account,annuity,or other non-probate property which ❑
contains a beneficiary designation?.............................................................................................................
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1,1994 and before Jan.1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving
spouse is 3 percent[72 P.S.§9116(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 of the surviving spouse is 0 percent
[72 P.S.§9116(a)(11) 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 retrn 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 bloohr adoption.
pennsylvania SCHEDULE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN CASH, BANK DEPOSITS AND MISC.
RESIDENT DECEDENT PERSONAL PROPERTY
ESTATE OF Stephenson, Jane G FILE- NUMBER
-
�21 14 00769
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 VALUE AT DATE OF
NUMBER DESCRIPTION DEATH
1 -.Genworth Insurance Company-payment pursuant to policy 37,461.42
2 Asbury Bethany Village-refund 3,035.00
3 PNC Bank account no. 31200333702 21,251.59
See attached letter
4 PNC Bank account no. 31200344949 3,602.16
See attached letter
5 PNC Bank account no. 31300359881 100,008.97
See attached letter
6 Malpezzi Funeral Home-refund 112.58
TOTAL(Also enter on Line 5,Recapitulation) 166,471.72
REV-1510 EX+(08-09)
pennsylvania
DEPARTMENT OF REVENUE SCHEDULE G
INHERITANCE TAX RETURN INTER-VIVOS TRANSFERS &
RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY
ESTATE OF Stephenson, Jane G FILE NUMBER
21 - 14-00769
This schedule must be completed and filed if the answer to any of questions I through 4 on page 2 is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF EXCLUSION
Include the name of the transferee,their relationship to decadent DECD'S TAXABLE VALUE
NUMBER and the date of transfer. Attach a copy of the deed for real estate. VALUE OF ASSET INTEREST (IF APPLICABLE)
1 PNC Bank account no. 31400355042 20,370.02 20,370.02
See attached letter
2 PNC Bank account no. 31800355843 7,103.27 7,103.27
See attached letter
3 PNC Bank account no. 5113728631 38,526.39 38,526.39
See attached letter
4 New York Life Annuity No. 75606881 37,712.36 37,712.36
See attached letter
TOTAL(Also enter on line 7,Recapitulation) 103,712.04
REV-1611 EX+(10-09)
& pennsylvania SCHEDULEH
DEPARTMENT OF REVENUE FUNEPAL E)G)BMAM
INHERITANCE TAX RETURN
RESIDENT DECEDENT AMNSMTMCOM
ESTATE OF Stephenson, Jane G FILE NUMBER
21 - 14-00769
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT
A. 1 Malpezzi Funeral Home-funeral 3,544.81
2 Camp HIII United Methodist Church-funeral luncheon 500.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Thomas G. Stephenson . 13,400.00
Street Address 15 Craig Run Road
city Duncannon State PA Zip 17020
Year(s)Commission Paid 2015
2. Attorney's Fees William R. Bunt 10,767.00
I 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 William R. Bunt-reimbursement of probate fees 670.88
5. Accountant's Fees
6. Tax Return Preparers Fees
7. Other Administrative Costs
The Medicine Shoppe-pharmacy 113.91
See attached 6,453.77
TOTAL(Also enter on line 9,Recapitulation) 35,450.37
Schedule H
COMMONWEALTH OF PENNSYLVANIA Funw-A ENmsm&
INHERITANCE TAX RETURN AcWirftfta§wC4s1scor*x*d
RESIDENT DECEDENT
ESTATE OF Stephenson, Jane G FILE NUMBER
21 - 14-00769
2 Heartland Pharmacy-pharmacy 128.77
3 HCR Manor Care-nursing home 6,325.00
Page 2 of Schedule H
REV-1813 EX+(01-10)
pennsylvania SCHEDULE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF . FILE NUMBER
Stephenson, Jane G 21 - 14-00769
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON($) DECEDENT (Words) ($$$)
RECEIVING PROPERTY Do Not Ust Trustees)
TAXABLE DISTRIBUTIONS(include outright sFousal
distributions
,strIbutions and transfers
under Sec.§116(a)(1.2)]
1 Thomas G. Stephenson Son One-Half of Estate
15 Craig Run Road
Duncannon, PA 17020
2 Phillip E. Witmer Grandson One-Fourth of
132 Pointe 0 Woods Drive One-Half of
Huddleston,VA 24104 residuary estate
3 Stephanie J. Woodward Granddaughter One-Fourth of
2087 James Madison Hwy. One-Half of
Gordonsville,VA 22942 residuary estate
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate.
NON-TAXABLE DISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
S.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00
REV-1513 EX+(01-10)
pennsylvania
DEPARTMENT OF REVENUE SCHEDULEJ
INHERITANCE TAX RETURN BENEFICIARIES continued
RESIDENT DECEDENT
ESTATE OF Stephenson, Jane G I FILE NUMBER
21 - 14-00769
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$)
RECEIVING PROPERTY Do Not Ust Trustee(s)
TAXABLE DISTRIBUTIONS distributions,
outright spousal
and Fransfers
under Sec.9116(a)(1.2)]
4 Stephen E. Witmer Grandson One-Fourth of
11487 Spicers Mill Road One-Half of
Orange,VA 22960 residuary estate
5 Sarah C. Love Granddaughter One-Fourth of
6725 Parkway Drive One-Half of
Roanoke, VA 24018 residuary estate
Page 2 of Schedule J
C-)
Bill anbt ajotanunt
rT,'7 7.-
iA?
o f
C.,
JANE G. STEPHENSON
cz
I, JANE G. STEPHENSON, a resident of Pinellas County,
State of Florida, being of sound and disposing mind and
memory, do hereby -make, publish and declare this to be my
Last Will and Testament, hereby revoking and annulling all
other Wills and Codicils by me heretofore made.
I
I desire and direct that all my legal debts and funeral
expenses (including the purchase of a monument and/or head-
stonel be paid without unnecessary delay by my personal
representative hereinafter named and appointed.
II
I direct my personal representative to pay upon my
decease any and all my taxes which may then be due and owing
and/or which may be subsequently levied against my estate,
whether inheritance taxes or otherwise, and no part of my
tax shall be apportioned or prorated.
zzI
I may leave a written statement or list disposing of
certain items of my tangible personal property not otherwise
disposed of above. Any such statement or list in existence
at the time of my death shall be determinative with respect
to all items devised therein. All items not specifically
devised thereby and not specifically devised previously in
the Will I devise to my husband, THOMAS C. STEPHENSON. if
no written statement or list is found and properly identified
by my personal representative within thirty days after his
qualification it shall be presumed that there is no such
statement or list and any subsequently discovered statement
or list shall be ignored.
I direct that any expenses incurred in safeguarding or
delivering such property be paid from my estate as an adminis-
Y:
JANE G. STEPHENSON
tration expense thereof. Ifmysaid husband, THOMAS C.
STEPHENSON, shall not survive me, I bequeath all of the
aforesaid property which he would be entitled to receive to
be divided equally between my two (2) children, THOMAS G.
STEPHENSON and JANE S. WITMER, share and share alike, per
stirpes.
IV
All of the rest, residue and remainder of my estate of
whatsoever character and wheresoever situate I give, devise
and bequeath to my husband, THOMAS C. STEPHENSON, providing
he survive's me.
If my husband, THOMAS C. STEPHENSON, does not survive
me, then all the rest, residue and remainder of my estate,
of whatsoever character and wheresoever situate, I give and
bequeath to the then Trustee under that certain Trust Agreement
by me made as Settlor and Trustee dated the day of
June, 1980, the same to become a part and be distributed
under the terms and conditions of said Trust Agreement and
any subsequent amendments. By this reference I do not
incorporate by reference any provisions of said Trust Agreement
(which Trust has independent significance) so that property
so devised and bequeathed to said Trustee be blended with
and thereafter be administered and accounted for in all
respects as an integral part of said living trust as so
enlarged; and, accordingly, the receipt of the said Trustee
for the property passing to it by this Will shall be a
complete discharge and acquittance to my personal representa-
tive.
PROVIDED, that should for any reason that certain Trust
Agreement aforementioned be declared a nullity or be revoked
by me or through operation of law, then in that event, I
adopt the terms and provisions thereof (including subsequent
amendments, if anyl as part of this, my Last Will and Testa-
ment, as though. set forth herein, and I direct that my
estate be distributed in accordance with said terms and
provisions.
ZANE G. STEPHEpSON
-2-
NOTARY FOR PROOF OF WILL
STATE OF FLORIDA
COUNTY OF PINELLAS
We, JANE G. STEPHENSON, DONA L. BROWN
and DOROTHY H. ADMIRE the testatrix and
the witnesses respectively, whose names are signed to the
attached or foregoing instrument, being first duly sworn, do
hereby declare to the undersigned officer that the testatrix
signed the instrument as her last Will and that she signed
voluntarily (or directed another to sign for her, and did so
voluntarily) and that each of the witnesses in the presence
of the testatrix, at her request, and in the presence of
each other signed the Will as a witness and that to the best
of the knowledge of each witness the testatrix was at that
time 18 or more years of age, of sound mind and under no
constraint or undue influence.
Testatrix
Witness
Witn
Subscribed and acknowledged before me by JANE G. STEPHENSON,
the testatrix, and subscribed and sworn before me by
DONA L. BROWN and DOROTHY H. ADMIRE
the witnesses, on June 41, 1980
oe
My commission expires:
Notary rubric,State of notida at Large
4PUBLIC My Commission Expires NOV. 7, 1980
TRUST AGREEMENT
r.:
of
JANE G. STEPHENSON
Trust S.D. TRIS AGREEMENT is executed in duplicate this ,day.ti -
#59-6655502 of June, 1980, between JANE G. STEPHENSON, hereinafter -
referred to as the "Settlor", and JANE G. STEPHENSON, hereinafter
referred to as the "Trustee". The First Successor Trustee
shall be JANE S. WITMER, of Roanoke, Virginia. The Second
Successor Trustee shall be THOMAS G. STEPHENSON, of Duncannon,
Pennsylvania. A Successor Trustee shall assume the capacity
of Trustee only in the event of the incapacity, death or
voluntary resignation of the original Trustee hereof.
W I T N E S- S E T H:
That the Settlor, for and in consideration of the
covenants herein contained and for TEN {$10.00) DOLLARS and
other good and valuable considerations, hereby transfer,
assign and deliver all assets shown on Schedule "A" annexed
hereto and made a part hereof, receipt of which, IN TRUST,
is hereby acknowledged by the said Trustee to be held and
administered together with all other property that may from
time to time be added to this Trust, IN TRUST, for the uses
and purposes stated and upon the following terms and conditions:
FIRST:
SETTLOR LIFE INTEREST: The Trustee shall pay the- entire net
proceeds from the income. of the Trust Fund and capital gains
distributions from investment trusts to or for the benefit
of the Settlor, while living. In addition thereto, the
Trustee shall make payment from the principal of the Trust
Fund to or for the benefit of the Settlor, in such .sums and
at such times as the Settlor may request from time to time.
In the event the Settlor should be unable, in the sole .
opinion of the Trustee (.which. term includes any Successor
LAW OFFICES OF Trustee) to make such. request in writing, then the Trustee,
;EOR6E K KiCKUTER,
P.A, in its discretion, may pay such amounts as such Trustee
2801 FOURTH STREET N.
ST.PETERSBURG.FLORIDA deems proper to care for, maintain and support the Settlor.
_i-
SECOND:
PAYMENT OF DEBTS: Upon the death of the Settlor, the Trustee
shall pay out of the principal of the Trust fund, at the
written request of the legal representative of the Settlor's
probate estate, if any, such sums as such representative
shall state to be necessary for the payment of the expenses
of the illness, funeral, burial and any and all debts of the
Settlor, and federal estate taxes, including interest and
penalties, imposed upon or in relation to any property
required to be included in such Settlor's gross estate. for
federal estate tax purposes and any state estate, inheritance
and succession taxes, together with interest and penalties,
payable upon or resulting from the Settlor's death, whether
or not attributable to property subject to probate administra-
tion and property taxes, debts, claims, expenses of administra-
tion and other expenses that shall be payable out of the
Settlor's probate estate. In the event no representative of
such Settlor's estate is appointed by the appropriate court
of competent jurisdiction, then in such event, the Trustee
shall, in its sole and absolute discretion, determine the
sums payable for the aforesaid purpose. If the Settlor is
survived by her spouse, then all estate, inheritance, transfer,
legacy succession or death taxes which may be assessed or
imposed with respect to the deceased Settlor's gross estate
shall be paid out of the Residual Fund as hereinafter defined.
THIRD: .
MARITAL DEDUCTION TRUST: Upon the death. of the Settlor, if
survived by the Settlor's spouse., THOMAS C. STEPHENSON, the
then Trustee shall divide the corpus of this Trust into two
funds to be known as the Marital Deduction Fund and the
Residual Fund. The Marital Deduction Fund will be that
fractional part of the corpus which is the minimum necessary
to secure. thelesser of a) the maximum marital deduction
allowable for federal estate tax purposes and b)- the minimum
I W OFFICES OF
;FORGE K.KICKLITER, marital deduction which, after taking into account the
P.A,
2401 FOURTH STREET N, unified credit available to t-he Settlor's estate for federal
ST_PETERSSURG,FLORIOA
estate tax purposes, will result in no federal estate tax.
1 -2-
The Residual Fund shall consist of the remaining fractional
share of the trust corpus. In choosing which assets will be
placed in the Marital Fund and the Residual Fund, the Trustee
shall have absolute discretion, except that any assets which
do not qualify for the Marital Deduction shall be allotted
to the Residual Fund.
The Settlor's husband shall have the absolute power of
appointment over. any and all portions of said Marital Fund,
exercisable by him at any time after the Settlor's death or
by hit; Will, with no restrictions thereon whatsoever. If
the Settlor's husband fails to exercise validly, in whole or
in part, the power of appointment hereinabove granted to him,
then 'upon his death the entire remaining corpus as shall not
have been validly appointed by him shall be added to the
Residual Fund and disposed of as hereinafter provided.
The Trustee shall hold, invest and reinvest the assets
of the Residual Fund, collect the income therefrom and,
after deducting all expenses necessary to the operation of
such fund, pay the net income thereof in such installments
as may be convenient, but at least monthly, to the Settlor's
spouse, THOMAS C. STEPHENSON, while living. In case. the
entire income. and corpus of the. Marital Fund has been expended
or withdrawn by or for the Settlor's spouse, THOMAS C.
STEPHENSON, and additional funds are needed becauseL of
illness or accident or any other extraordinary need after
the exhaustion of said Marital Fund, the Trustee, in its
discretion, shall be empowered to invade the corpus of the
Residual Fund for the purpose, of paying to or for the
benefit of the Settlor's said spouse such 'sums as are considered
necessary, in the absolute discretion of the Trustee., under
the circumstances, to provide for the care., maintenance, and
support of the Settlor's said spouse, while living. The
surviving spouse shall hatye, no authority d=ing the term of
this Trust to exercise any discretion in the invasion of
LAW OFFICES Of principal or management of the. Residual Portion.
EORGE K.KICKLITER,
P.A6 FOURTH:
2401 FOURTH STREET N.
ST.PETERSBURG.FLORIDA BENEFICIAL TRUST: Should the Settlor's- said spouse fail to
-3-
withdraw or appoint the said Marital Fund portion, the said
Trustee shall pay to the Settlor's spouse all of the net
proceeds from the income of the Trust Fund and the capital
gains distributions from investment trusts and shall apply
or pay from the principal of the Trust such. amounts as the
then Trustee deems advisable to provide adequately for the
health, support and maintenance of the Settlor's spouse,
while living.
FIFTH:
RESIDUAL PORTION: Upon the death, of the Settlor's spouse,
THOMAS C. STEPHENSON, or -upon the death of the Settlor, if
Settlor's spouse predeceases Settlor, the Residual Portion
(and the remainder of the Marital Portion, if it has not
been withdrawn or appointed by Settlor's spouse) or the
remaining assets in Trust, as the case may be, including any
accumulated and undistributed net income, shall be distributed
as follows:
A. FIFTY (50%) PER CENT to the Settlor's son, THOMAS G.
STEPHENSON, or his lawful lineal issue, per stirpes.
B. FIFTY (.50%) PER CENT to the Settlor's daughter,
JANE S. WITMER, or to her lawful lineal issue, per
stirpes.
SIXTH:
DEFERRED DISTRIBUTION: In the event that any of the benefi-
ciaries under this Trust shall not have attained the age of
Twenty-One C211, years when he becomes entitled to distribution
of his share, then the Trustee shall retain such share for
the beneficiary until such beneficiary has attained the age
of Twenty-one C211 years. Provided, however, that the
Trustee, in its discretion, may make disbursements from such
interest so withheld for said beneficiary to provide such
beneficiary with proper support, maintenance, care and
education Cthrough collegel if the Trustee deems such appro-
priate.
SEVENTH.:
INCOMPETENCY CLAUSE: Whenever the. trust property or any
LAW OFFICES OF
EORGE K.KICKUTER, income of the trust property shall become payable, or is
P.A
2401 FOURTH STREET N. required to be paid pursuant to any of the provisions here-
ST.PETERSBURG.FLORIDA
-4-
of, payable to or used for the benefit of a person under
legal disability or incapacity or, by the demonstrated lack
of reasonable financial acumen and prudence, is, in the sole
opinion of the Trustee, unable to properly administer such
payments, then such. payments may be made:
(a) Directly to such beneficiary or to his credit:
051 To the legally appointed guardian or conservator
or other legal representative of such beneficiary;
Ccl To some near relative, friend or spouse of such
beneficiary to be applied for the benefit of such
beneficiary; or
{dl By expenditure by the Trustee for the support,
maintenance, education or medical care of such
beneficiary;
and any such payments or expenditures shall be a full acquitt-
ance to the Trustee in each instance. . When, in the judgment
of the Trustee, the beneficiary is able to manage his own
property or affairs, then the Trustee shall distribute to
said beneficiary the share to which he is entitled. However,
if the beneficiary shall die before receiving distribution,
the share to which he is entitled shall be distributed to
his estate.
EIGHTH:
NON-TRANSFERABILITY CLAUSE: The interest herein transferred
to the beneficiaries is present interest although distribution
thereof may be deferred. No disposition, charge or encumbrance
of either the income or principal, or any part thereof shall
be in anywise liable to any claim of any creditor of any
such beneficiary's interest hereunder as collateral therefor.
NINTH:
TRUSTEE APPOINTMENTS: Any individual Trustee serving without
a Co-Trustee may at any time appoint a Co-Trustee to act
with him and may remove any Co-Trustee so appointed. Such.
appointment or removal shall be in writing and executed,
witnessed and notarized in the same manner as this Trust
Agreement,
Each Trustee here-under (whether originally designated
LAW OFFICES OF
iEORGE K,KICKUTER. herein or appointed as Successor Trusteel shall have the
P.A
2401 FOURTH STREET N. right to resign at any time by giving thirty (3al days'
ST.PETERSBURG.FLORIDA
written notice to that effect to the current income bene-
-5-
ficiaries of this Trust.
In the event a Trustee shall become incapacitated, he
shall be removed. In establishing the inability of a Trustee
to act or to continue to act hereunder, the statements of
two licensed doctors of medicine shall be sufficient to
establish such incapacity and third parties are protected in
relying on such statements without any further act or notice.
In case of the death, resignation or incapacity of all
the above enumerated Trustees, or in the event there is no
Trustee or only one Trustee and such Trustee is also such a
beneficiary that a Co-Trustee is required and none has been
appointed, the then current income beneficiaries may, by a
majority action (majority in interest rather than number) ,
designate from time to time the Trustee or Co-Trustee and
remove any Trustee so designated. Such appointment or
removal shall be in writing and executed, witnessed and
notarized in the same manner as .this Trust Agreement. In
the event the beneficiaries shall fail to so appoint or so
remove, no rights shall merge and this Trust shall not fail;
however, any person having a present, future, beneficiary or
other interest herein, or title to or possession of any
trust property, may apply to a court of competent jurisdiction
for the appointment of a Successor Trustee or Co-Trustee and
the judicial settlement of the predecessor Trustee's accounts.
Upon signing a written acceptance of this Trust, any
Successor Trustee shall be vested with title to all trust
property subject to the trusts herein declared. No further
act on the part of the parties hereto or of any Court shall
be necessary to vest in a Trustee the fiduciary powers and
duties in the supervision and management of this Trust Fund.
TENTH:
TRUSTEE POWERS: In the administration of the trust created
hereunder, the Trustee shall have the power and authority,
in addition to any other powers thatmaybe conferred by
LAW OFFICES OF law:
;EORGE K.KICKLITER,
P.A.
2401 FOURTH STREET k A. To allot to any share nreated hereunder an undivided
ST.PETERSBURG,FLORIDA interest in any property constituting a portion of
the Trust Fund; to make joint investments for such
shares.
-6-
B. To sell at public or private sale, exchange, lease,
mortgage and pledge any property, real or personal,
at any time. constituting a portion of the Trust Fund,
to borrow money for any purpose connected with the
protection, preservation or improvement of the trust
estate, -upon such terms and conditions as the Trustee
shall deem proper.
C. To invest and reinvest the Trust Fund or any part
thereof, in any property, real or personal, domestic
or foreign; securities including without limiting
common andmutualfunds, investment trust certifi-
cates, bonds, debentures, preferred stocks, stock
options, margin accounts, common stocks, life insuranc
mortgages, mortgage participation certificates,
leases, royalties, working interests and other partici
pations, and rights relating to minerals, oils and
gas, limited partnerships and obligations (secured
and unsecured) whether or not any such investment
would be an appropriate trust investment apart from
this provision and even though such investment is
generally considered speculative or causes a greater
proportion of the trust estate to be invested in
investments of one type or of one company than would
be appropriate for a trust apart from this provision;
and to participate in a common trust fund, as the
Trustee shall deem wise, without being limited to
investments authorized by law for trust funds.
D. In respect to any securities, to vote upon any
proposition or election at any meeting and to
grant proxies, discretionary or otherwise; to vote
at any such meeting.
E. To make distributions in kind, i.e., either in the
form of trust assets, cash, or a combination of both.
F. To determine what is principal and what is income
hereunder, in the Trustee's discretion, without
respect to any statute or rule of law, provided
standard acceptable accounting principles are
followed; except that any capital gains distribu-
tions paid with regard to any mutual fund shares
at any time constituting a part of the principal
of the trust shall be considered income of the
trust and distributed as such.
G. To hold bonds, shares or other securities in
bearer form, or in the,name of the Trustee or
other nominee, without indication of any fiduciary
capacity; to deposit cash in checking or savings
accounts, in a bank or savings and loan institution,
and withdraw from the same without indication of
any fiduciary capacity.
H. To enter into any fixed or level payment withdrawal
plan with any mutual fund authorizing payment to
the Settlor or any other beneficiary hereunder of
a specified monthly amount payable from the income
dividends, capital gains distributions and, to the
extent necessary, from the proceeds of liquidation
of shares of such mutual fund and to deposit
shares of such mutual fund with a custodian or
other agent pursuant to any such authorization.
I. To manage, repair, improve, remodel, alter, add to
or take from any property, real, or personal, at
any time forming a part of the trust estate. With
IAw OFFICES OF respect to any trust created here-under, the Settlor
MORGE K KICKLITER, hereby waives compliance by the Trustee with
RA. provisions of Section 738.12 of the Florida Statutes,
2401 FOURTH STREET N
$T.PETERSBURG,FLORID
or as subsequently modified or ammended, relating
to under productive property.
1 -7-
J. To employ accountants, attorneys and such agents
as it may deem advisable; to pay- reasonable
compensation for their services and to charge same
to (or apportion same between) income and principal
as it may deem proper.
K. To exercise any and all powers and discretions
given to a Trustee from time to time under the
Florida Uniform Trust Administration Law and the
other laws of the State of Florida not inconsistent
with the provisions hereof.
ELEVENTH:
DUTIES OF TRUSTEE: The Trustee shall have the duty to file
any required income tax, intangible tax or other tax returns
for the Trust and to see that any taxes due are paid thereon.
The Trustee shall have the duty tomaintainrecords of
receipts and disbursements of the Trust Fund and to account
for all trust proceeds of any type.
TWELFTH:
TRUSTEE AUTHORITY: No purchaser from the Trustee or any
other person dealing with the Trustee shall be under any
obligation to see to the application of the purchase money,
or to the proper administration of this Trust. Any corporation,
its transfer agent and its dividend disbursing agent, and
any person, firm, bank or savings ngs and loan association, or
any other party with whom the Trustee shall deal, shall be
under no obligation or liability with respect to the validity
or proper administration of this Trust, and shall be entitled
to rely entirely upon written orders of the Trustee or his
nominee, and shall be entitled to assume that this Trust
Agreement as now written is in full force and effect until
receipt of the written notice of its amendment, termination
or revocation.
The Trustee shall have the power and authority to
designate the authorized signatures on accounts with banks
and savings and loan institutions whether such signatories
be a Trustee or not and all institutions relying on such
authorized signatures are exonerated from any loss, claim or
liability. Accordingly, one of two or more Trustees as well
LAW OFFICES OF as non-fiduciary parties may be authorized signatories.
iEORGE K.KICKLITER,
P.A. THIRTEENTH:
2401 FOURTH STREET N.
ST.PETERSBURG.FLORIDA EXONERATION FROM DUTY TO AUDIT: Any Successor Trustee here-
-8-
under shall not be required to audit or to determine the
accuracy or propriety ety of any disbursements contained in the
accounting theretofore rendered by the predecessor Trustee
and such Trustee is hereby exonerated from any liability or
responsibility with respect thereto. A Successor Trustee
shall not be required or be under any duty to ascertain the
correctness or validity of any prior accounting of any
predecessor Trustee and no such liability shall attach to a
Successor Trustee hereunder in respect of such accounting.
FOURTEENTH:
TERMS: Whenever convenient or desirable, the term "Trustee",
as used in this Agreement, shall include any substitute,
successor and additional Trustee or Trustees and in the
plural. The term "beneficiary" shall include every individual
and entity, named or unnamed, entitled to share under this
Agreement as herein provided. The term "child", "children",
"issue" or "descendants" shall include the Settlor's lawful
children or the issue of said children, unless otherwise
provided herein, but any share to which such afterborn
children shall be entitled shall not vest later than the
time permitted by the Rule Against Perpetuities. Unless
otherwise required, masculine personal pronouns include the
feminine and the singular and plural'may be construed inter-
changeably.
FIFTEENTH:
TRUSTEE COMPENSATION: A professional Trustee shall be en-
titled to reasonable compensation for its services in the
administration of this Trust. The term "reasonable compensa-
tion" shall be that compensation which is customarily paid
for like services in the community at the time and place the
said Trustee services are performed. A non-professional
Trustee shall not be entitled to compensation for his or her
services, however, he or she shall be entitled to reimbursement
for any expenses incurred in the administration of this
LAW OFFICES OF
EORGE K.KICKLITER, Trust when such expenses are incurred in the course of
P.X
2401 FOUATIA STREE7 N. performing as a fiduciary hereunder.
ST,PETERSBURG.FLORIDA
-9-
SIXTEENTH:
FUTURE ADDITIONS: The Settlor, or any person, may (by Will
or otherwisel, from time to time, with the consent of the
Trustee, transfer additional property, real or personal, to
the Trustee to be held under this Agreement and the Trustee
shall have authority to hold, manage and dispose of such
property subject to all of the provisions of this Agreement
which shall then and thereafter be applicable to such property.
SEVENTEENTH:
MINIMUM BALANCE: If at any time the Trustee determines that
the value of any trust under this instrument is less than
TEN THOUSAND ($10,000.0,0) DOLLARS, the Trustee, in its sole
discretion, may distribute the principal of same to the
primary beneficiary of the current income of said Trust, or
to his guardian or conservator, either in cash or in kind,
or otherwise, and the Trust shall then terminate.
EIGHTEENTH:
SEVERABILITY CLAUSE: This Trust is established under the
laws of the State of Florida and the validity, administration
and interpretation of this Trust shall be governed by the
laws of said State. However, this Trust may be administered
elsewhere within the United States and abroad, and it shall
not be necessary that the Trust or any Trustee hereunder be
qualified in the State of Florida or that court approval be
required to exercise any power, right, or discretion granted
to the Trustee. The Trustee shall further be authorized to
act without posting any bond or without any notice to or
consent from anyone. It is the. intent of this Agreement in
all things to conform to the law in the disposition of the
properties and securities herein, however, if by inadvertence
parts hereof may be held to be invalid, the. Trustee does
hereby declare that invalidity of any of the provisions
herein contained in respect or particular shall not be
deemed or held to impair any of the other provisions of this
LAW OFFICES OF Agreement for the disposktion of the properties and assets,
;EORGE k KICKLITER,
Rk real, personal or minced, of the Trust or the income derived
2401 FOURTH STREET N.
ST,PETERSBURG.FLORIDA therefrom, as herein provided.
-10-
NINETEENTH:
DISSOLUTION AND DISCHARGE: Upon the final distribution of
all assets held in trust hereunder by the Trustee to the
beneficiaries and, subsequently, upon delivery to the said
Trustee of a written receipt from the said beneficiaries,
this Trust shall thereupon be dissolved and said dissolution
shall act as a complete discharge and acquittance of the
said Trustee.
TWENTIETH:
AMEND14ENT AND REVOCATION: The undersigned Settlor, during her
lifetime, reserves the right at any time to revoke, alter or
amend this Trust Agreement in whole or in part by written
instrument signed by the Settlor and delivered to the Trustee
or Successor Trustee. Upon the death of the Settlor, this
Trust shall become irrevocable. Neither the signature nor
the consent of any Trustee shall be necessary or required to
carry out any or all of the provisions of this paragraph.
TWENTY-FIRST:
TRUSTEE ACCEPTANCE: The Trustee hereby accepts the Trust
herein created.
IN WITNESS WHEREOF, the Settlor and Trustee has hereto
set hand and seal the date first aforesaid.
WITNESSES:
z. ltll�x4c:t!.n,7(SEAL)
MANE G. STEPHENSON - Settlor &
V Trustee
>,
The foregoing instrument, of which this is the eleventh
of twelve pages, was signed, sealed, declared and published
by JANE G. STEPHENSON as her amendable, revocable, inter
vivos Trust Agreement, in the presence of us, the undersigned,
who at her special instance and request, do attest as witnesses
after the said Settlor and Trustee signed her name thereto,
in her presence and in the presence of each other the day
IAW OFFICES OF anI&,year first aforesaid.
GEORGE K KICKLITER,
P.A. of 'St. Petersburg Florida.
1401 FOURTH STREET N.
ST-PETERSBURG.FLOAIpA
of 'St. Petersburg Florida.
2014 3: 12?M PNC Sank No. 2909 P. 2
1^1 PN C
1:0 1 1 1
September 17,2014
William R Bunt Esq.
P 0 Box 336
109 S Carlisle St
New Bloomfield,PA 17068
RE: lane Stepehnson
SSN:
DOD: 08-06-2014
Dear Mr,Bunt:
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# 31400355042 Established: 11-20-2010
JANE STEPHENSON ITT
THOMAS G STEPHENSON
DOD balance: $ 20,36831 + 1.71 accrued interest
Interest paid 01-01-2014 thru 08-06-2014$ 21.61 YTD
Account# 31800355843 Established: 01-28-2011
JANE STEPHENSON ITF
THOMAS G STEPHENSON
-DOD balance: $ 7.103.00+0.27 accrued interest
Interest paid 01-01-2014 thru 08-06-2014$ 6.18 YTD
Account# 31200333702 Established: 09-23-2008
JANE STEPHENSON
DOD balance: $21,250.12+ 1.47 accrued interest
Interest paid 01-01-2014 thru 08-06-2014$ 22-20 YTD
Account# 31200344949 Established: 11-27-2009
JANE STEPHENSON
DOD balance: 13,602.01 +0.15 accrued interest
Interest paid 01-01-2014 thru 08-06-2014 $ 33,29 YTD
Account# 31300359881 Established: 08-09-2011
JANE STEPHENSON
DOD balance: $99,992.69+ 16.28 accrued interest
Interest paid 01-01-2014 thru 08-06-2014$ 171.52 YTD
Page I of 2
J 2014 3: 12PM PN(, Bank No. 2969 2. 2
Checking Account
Account# 5 113 728631 Established: 08-09-2011
SANE STEPHENSON 11T
THOMAS G ST.EPRENSON
DOD balance: $38,526.10+0.29 accrued interest
Interest paid 01-01-21014 thru 08-06-2014 $ 1.57 YTD
Please note that this office provides date of death balances for deposit accounts(TKAs,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-BANK(1-889-762-2265)or stop by your 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 exempt froth 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 note me immediately by reply or by telephone at 800-762-177.5 and
immediately destroy this faxed document.
Page 2 of 2
Winner Of the Dalbar
Service Award from
2000-2013
September 11, 2014
Thomas Stephenson
15 Craig Run Road
Duncannon,PA 17020
Policy Number: 75606881
Decedent: Jane G Stephenson
Dear Mr. Stephenson,
Thank you for your recent inquiry regarding the date of death value on the above policy.
As of August 6, 2014 the value of the above-referenced policy was approximately $37,712.36.
If you have any questions, our Client Services Representatives are available Monday through
Friday from 8:30a.m. to 5:30p.m. Eastern Time at 1-800-762-6212.
Sincerely,
Kenneth Quella
Service Associate
New York Life Annuity Service Center• P.O. Box 9859 •Providence, R1 02940 •1-800-762-6212
Annuities are Issued by New York Life Insurance and Annuity Corporation (NYLIAC) (A Delaware Corporation)
Variabte annuities are distributed by. NYLIFE Distributors LLC, Member FINRAISIPC
NYUAC and NYLIFE Distributors LLC are wholLy owned subsidiaries of New York Life Insurance Company
51 Madison Ave, New York, MY 10010)
17. 20 14 3: 12PM PN(,' Sank No. 2969 P 2
PNC
September 17, 2014
William R Bunt Esq.
P 0 Box 336
109 S Carlisle St
Neu•Bloomfield,PA 17068
RE: Jane Stepehnson
SSN:
DOD: 08-06-2014
Dear Mr. Bunt:
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# 31400355042 Established: 11-20-2010
JANE STEPHENSON ITF
THOMAS G STEPHENSON
DOD balance: $ 20,368.31. + 1.71 accrued interest
Interest paid 01-01-2014 thru 08-06-2014$21.61 YTD
Account# 31800355843 Established: 01-28-2011
JANE STEPHENSON ITF
THOMAS G STEPHENSON
DOD balance: 7.103-00+0.27 accrued interest
Interest paid 01-01-2014 thru.08-06-2014$ 6.18 YTD
Account#31200333702 Established: 09-23-2008
JANE STEPHENSON
DOD balance: $ 21,250.12+ 1.47 accrued interest
Interest paid 01-01-2014 thru.08-06-2014$ 22-210 YTD
Account# 31200344949 Established: 11-27-2009
JANE STEPHENSON
DOD balance: $ 31,602-01 +0.15 accrued interest
Interest paid 01-01-2014 thru 08-06-2014$ 33.29 YTD
Account# 31300359881 Established: 08-09-2011
JANE STEPHENSON
DOD balance: $ 99,992.69+ 16.28 accrued interest
Interest paid 01-01-21014 thru 08-06-2014 S 171.52 YTD
Page 1 of-1
i. 2614 3: 12PM PNC Bank No. 2969 2. 1
Checking Account
Account# 5113728631 Established: 08-09-2011
JANE STEPHENSON ITF-
THOMAS O STEPHENSON
4
DOD balance: $38,526.10+0.29 accrued interest
Interest paid 01-01-2014 thru 08-06-2014$ 1.57 YTD
Please note that this office provides date of death balances for deposit accounts(TRAs,CDs,Checking and
Savings). We do not process any llnancial transactions or provide statements, If you need assistance with
any of these items,please call 1-888-PNC-BAND.(1-888-762-2265)or stop by your 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 exempt from 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. lfyou have received this
communication in error,please notes me immediately by reply or by telephone at 800-762-1775 and
immediately destroy this faxed document.
Page 2 of 2
Winner of the DaLbar
Service Award from
2000.2013
September 11, 2014
Thomas Stephenson
15 Craig Run Road
Duncannon, PA 17020
Policy Number: 75606881
Decedent: Jane G Stephenson
Dear Mr. Stephenson,
Thank you for your recent inquiry regarding the date of death value on the above policy.
As of August 6, 2014 the value of the above-referenced policy was approximately $37,712.36.
If you have any questions, our Client Services Representatives are available Monday through
Friday from 8:30a.m. to 5:30p.m. Eastern Time at 1-800-762-6212.
Sincerely,
Kenneth Quella
Service Associate
New York Life Annuity Service Center P.O. Box 9859 •Providence, RI 02940 •1-800-762-6212
Annuities are issued by New York Life Insurance and Annuity Corporation jNYLIAC) (A Detaware Corporation)
Variable annuities are distributed'by, NYLIFE Distributors LLC, Member FINRAISIPC
NYUAC and NYLIFE Distributors LLC are whokLy owned subsidiaries of Now York Life.Insurance Company
51 Madison Ave, New York, NY 100101