HomeMy WebLinkAbout01-06-15 (2) .. .a
1505610143
REV-1500 EX(02-11)
PA Department of Revenue y OFFICIAL USE ONLY
p penns Ivania County Code Year File Number
Bureau of Individual Taxes DEPARTMENT OF REVENUE
PO BOX.280601 INHERITANCE TAX RETURN 21 14 0062
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
10 19 2013 09 22 1972
Decedent's Last Name Suffix Decedent's First Name MI
.SHELLEY CORINNE M
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
0 1. Original Return1:12. Supplemental Return ❑ 3. 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)
O 6 Decedent Died Testate Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) ❑ (Attach Copy of TCrust) t p
❑ 9. Litigation Proceeds Received ❑ 10.beiweenP�1 31�1 anjtJ9ataeso f Death ❑ 11.Election to tax under Sec.9113(A)
(Attach Schedule O) o
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFQI�&IATION SHO D BE 6REQWD TO:
Name Daytime Tq&@ne Nurr@6 O
JUDITH L HOAR CPA 717 SP 290� �-t
r t7t m
REGISTER!bPPW(LLS USE ONE*
First Line of Address
1705 OREGON PIKE C�n
Second Line of Address GID
City or Post Office State ZIP Code DATE FILED
LANCASTER PA 17601
Correspondent's e-mail address:
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.
SIGNATU E OF PERSON RESP FILING RETURN DATE Q
Judith L. Hoar
ADDR
1705 Oregon Pike, Lancaster, PA 17601
SIGNATgP,E OF PREPARER OT R HAN REPRESENTATIVE DATE
L� Judith L Hoar CPA
ADD
1705 Oregon Pike, Lancaster, PA 17601
Side 1
L 1505610143 1505610143 J
T
1505610243
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: Shelley, Corinne Marie
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1.
2. Stocks and Bonds(Schedule B)............................................................................. 2.
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. 30 ,562 .25
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 92 , 834 . 16
7. Inter-Vivos Transfers&Miscellaneous NtProbate Property
(Schedule G) u Separate Billing Requested............ 7,
8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 123, 396. 41
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 19, 605 . 60
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 112 , 638 . 65
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 132 ,244 . 25
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12, -8 , 847 . 84
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. -8 , 847 . 84
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. 0 . 00
16. Amount of Line 14 taxable
at lineal rate X .045 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. 0 . 00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑
Side 2
1505610243 1505610243 J
REV-1500 EX Page 3 File Number 21-14-0062
Decedent's Complete Address:
DECEDENT'S NAME
Shelley, Corinne Marie
STREET ADDRESS
106 Old Schoolhouse Lane
CITY STATE ZIP
Mechanicsburg PA __[ 17055
Tax Payments and Credits:
1. Tax Due(Page 2, Line 19) (1) 0.00
2. Credits/Payments
A. Prior Payments
B. Discount 0.00
Total Credits(A +B) (2) 0.00
3. Interest (3)
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;.................................. ❑ ❑x
c. retain a reversionary interest;or............................................................................................................... x
d. receive the promise for life of either payments,benefits or care?............................................................ ❑ ❑x
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?....... ❑ ❑x
4. Did decedent own an individual retirement account,annuity,or other non-probate property which
contains a beneficiary designation?.................................................................................................................. ❑ 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 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)(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 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-150irEX+(11-10)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Shelley, Corinne Marie 21-14-0062
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
NUMBER DESCRIPTION OF DEATH
1 Cash 34.10
2 Goldman Sachs Roth IRA#7121785 1,416.53
3 Wells Fargo#1010008810621 9,421.04
4 Wells Fargo#2197283720 100.01
5 Wells Fargo#30364519485 501.09
6 Wells Fargo#3064519477 706.58
Accrued interest on Item 6 through date of death 0.03
7 Wells Fargo#6199722999 15,086.34
Accrued interest on Item 7 through date of death 1.02
8 2002 Saturn -Vehicle sold to third party;condition is fair to poor due to numerous accidents 1,200.00
and lack of regular maintenance
9 Bedroom fireplace 75.00
10 Comcast-refund 67.64
11 DVD collection 20.00
12 Holy Spirit Hospital -refund 32.47
13 Jewelry-gold weight and scrap value 225.00
14 Living room fireplace 115.00
l
Total of Continuation Schedule See attached page
TOTAL(Also enter on Line 5, Recapitulation) 30,562.25
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule E(Rev. 11-10)
Rev-1503 EX+(11.10)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
continued
ESTATE OF FILE NUMBER
Shelley, Corinne Marie 21-14-0062
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
15 Miscellaneous personal property of nominal value(used televisions and electronics) 250.00
16 Social Security Disability benefit 1,265.40
17 Travelers-vehicle insurance refund 45.00
TOTAL(Also enter on Line 5, Recapitulation) 30,562.25
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev. 11-10)
Rev-1509 EX+(01-10)
pennsylvania SCHEDULE F
DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Shelley, Corinne Marie 21-14-0062
If an asset was made joint within one year of the decedent's date of death,it must be reported on schedule G.
SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Nathan A. Herber 1820 Porter Street Other
Conway, PA 15027
B.
C.
JOINTLY OWNED PROPERTY:
DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM LETTER DATE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECD'SVALUE OF
NUMBER FOR JOINT MADE NUMBER OR SIMILAR IDENTIFYING NUMBER.ATTACH DEED FOR VALUE OF ASSE DECEDENT'S INTEREST
TENANT JOINT JOINTLY-HELD REAL ESTATE. INTEREST
1 106 Old Schoolhouse Lane,Mechanicsburg 185,668.31 50.000% 92,834.16
Borough, Pennsylvania-At time of death,
four properties within same development
were listed for sale with prices ranging from
$199,900 to$179,000;given location of
property(closer to main road with less
privacy),type of unit(middle),and square
footage,value of real estate can be
reasonably estimated to be within this range.
The date of death value used is equal to the
mortgage liability shown on Schedule I.
TOTAL(Also enter on Line 6, Recapitulation) 92,834.16
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group,,Inc. Form PA-1500 Schedule F(Rev.01-10)
REV-151'EX+(10-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX
RESIDENTDECEDENTTURN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Shelley, Corinne Marie 21-14-0062
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 3,298.61
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State ZiD
Year(s)Commission Paid
2. Attorney's Fees Brubaker Connaughton Goss & Lucarelli 1,113.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State ZiD
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees Estate administration,work with creditors, Final 1040, Rev 13,500.00
6. Tax Return Preparer's Fees
7. Other Administrative Costs 1,693.99
See•continuation schedule(s) attached
TOTAL(Also enter on line 9, Recapitulation) 19,605.60
Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev. 10-09)
s
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Shelley, Corinne Marie 21-14-0062
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Expenses
1 Auer Cremation Services 1,495.00
2 Auer Cremation Services-coroner fee 30.00
3 Auer Cremation Services-obituary 560.92
4 Cemetary 300.00
5 Daniel Frost, Minister 100.00
6 Grace United Methodist Church 225.00
7 Heritage Estate Monuments, Inc 295.00
8 Memorial cards 40.00
9 Miscellaneous funeral service expenses 252.69
H-A 3,298.61
Other Administrative Costs
10 Auer Cremation Services-death certificates 90.00
11 Cumberland County Bar Association-advertising 75.00
12 Cumberland County Register of Wills 133.50
13 Disposal costs 50.00
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Shelley, Corinne Marie 21-14-0062
ITEM
NUMBER DESCRIPTION AMOUNT
14 Franz Shelley-mileage and tolls-for household clean-up and removal of personal property 514.74
and trash/junk at decedent's residence
15 Judith Hoar-mileage and tolls-for household clean-up and removal of personal property 541.91
and trash/junk at decedent's residence
16 Patriot News-advertising 123.38
17 Postage 2.41
18 Tim Shelley-mileage and tolls-for household clean-up and removal of personal property 128.05
and trash/junk at decedent's residence
19 Wells Fargo-check order 23.00
20 Wells Fargo-return item charge 12.00
H-137 1,693.99
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
Rev-1512'EX+(12-08)
SCHEDULE 1
pennsylvania DEBTS OF DECEDENT,
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Shelley, Corinne Marie 21-14-0062
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 Capital Cardiovascular Associates 13.05
2 Century Medical Reponse 1,156.00
3 Citibank N.A.-CITI Mastercard#*6859 3,863.33
4 Discover Bank#*7861 601.26
5 Juniper Mastercard#*6659 5,575.16
6 Lewin&Nadar Cardiology Associates 4.50
7 Nationstar Mortgage acct#195194907-The decedent was listed on mortgage lien 92,834.16
associated with joint ownership with ex-spouse of the property located at 106 Old
Schoolhouse Ln., Mechanicsburg, PA and,as stated in the decedent's Marriage Settlement
Agreement,dated 1/12/2011, .....as long as Wife continues to exercise her right of sole
occupancy of the marital residence,then Wife shall be responsible for the payment of the
mortgage...". Further,the agreement called for the division of the proceeds/losses on a 50/50
basis reduced by half of the value of the mortgage.As such,decedent's liability at the time
of her death was one half of the liability of$185,668.31 as shown on Form 1098 at 12/31/13.
8 Pinnacle Health Emergency 200.50
9 Quantum Imaging and Therapeutic Associates 2.40
10 U.S.Treasury-2012 Individual Income Tax due 116.00
11 U.S.Treasury-2013 Individual Income Tax due 1,536.00
12 Verizon Wireless 567.61
13 Wells Fargo Visa#137256 6,168.68
TOTAL(Also enter on Line 10, Recapitulation) 112,638.65
(If more space is needed,additional pages of the same size)
Copyright(c)2008 form software only The Lackner Group,Inc. Form PA-1500 Schedule I(Rev. 12-08)
REV-1513EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Shelley, Corinne Marie 21-14-0062
NAME AND ADDRESS OF RELATIONSHIP TOSHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT
0 Not Last Trustee(s) (Words) ($$$)
ITAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2))
1 Gregory Allen Herber Other 100%of residue $0
4249 Cider Press Road
Slatington, PA 18080
2 Nathan A. Herber Other 0 $0
1820 Porter Street
Conway, PA 15027
(Divorced from decedent on 111712012)
Total
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet as appropriate.
NON-TAXABLE DISTRIBUTIONS:
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10)
Attachment—Rev-1500
Corinne Shelley File No. 21-14-0062
As a result of the marriage settlement dated January 12, 2011, Nathan Herber and Corinne Shelley are
joint owners of the real property located at 106 Old Schoolhouse Lane, Mechanicsburg Borough,
Cumberland County, Pennsylvania and are jointly liable for the mortgage on said property.
INDEX
FORM REV-1500/1"A INHERITANCE TAX:RETURN
CORINNE M. SHELLEY ESTATE
NO. 21-14-0062
Exhibit Schedule Description
A Copy of Will of Corinne M. Shelley (dated 11/14/2007)
B E Goldman Sachs IRA #7121785
C E Wells Fargo Account 41010008810621
D E Wells Fargo Account#2197283720
E E Wells Fargo Account##3064519477
F E Wells Fargo Account#6199722999
G E Wells Fargo Account#3036451.9485
H E Blue Book value—2002 Saturn L-Series
I F; I Marriage Settlement Agreement (dated 1/12/2011 See
Article III describing decedent's interest in the marital home
and her liability for the mortgage on said home.
Last Will and Testament
of
Corinne Marie Herber
I,CORINNE MARIE HERBER, Social Security Number 162-62-2727,of 502 June
Apple Court,Abingdon,Maryland 21009,of Harford County,Maryland, being of sound and
disposing mind,memory,and understanding,do make,publish and declare this as and for my
LAST WILL AND TESTAMENT,hereby revoking any and all Wills and Codicils heretofore
by me made.
FIRST
A. I direct my Personal Representative or Representatives,hereinafter referred to in the
singular neuter,to pay out of the principal of my residuary estate my legally enforceable
unsecured debts and funeral expenses,said expenses including,but not by way of limitation,the
cost of a burial lot,perpetual care thereof,and the cost of a marker or tombstone erected at my
grave;and I authorize it to expend for these purposes such sums as it deems proper,without any
limit prescribed by law and without obtaining the prior or subsequent order or ratification of any
Court.
B. I direct that all inheritance taxes,federal estate taxes, Maryland estate taxes and all
other similar taxes payable by reason of my death(including any such tax levied against life
insurance,property passing by operation of law and any other property which is taxable in my
estate for purposes of any such death tax,whether or not such property passes under the terns of
this,my Will)shall be paid out of the principal of my residuary estate and no person shall be
required or called upon by my Personal Representative to contribute to the payment of any
portion of such taxes.
SECOND
A. All the rest of my estate and property,whether in possession,expectancy or
remainder,including all property over which I may have any power of appointment, I give,
devise,bequeath and appoint to my husband, NATHAN ALLEN HERBER, if he survives me.
B. If my spouse and I die under circumstances that there is no sufficient evidence that we
died otherwise than simultaneously, I direct that I shall have survived my spouse.
Pagel of 3
THIRD
A. In the event my said husband, NATHAN ALLEN HERBER,shall predecease me,or
if we should meet death in a common disaster, then I give,devise, and bequeath all of my Estate,
whether real,personal or mixed,and whether the same be in possession,reversion, expectancy or
remainder or over which I may have any power of disposition or appointment, and wheresoever
to my father-in-law, GREGORY ALLEN HERBER
B. In the event that my father-in-law,GREGORY ALLEN HERBER,does not survive
me,then I give,devise,and bequeath all of my Estate, whether real, personal or mixed,and
whether the same be in possession, reversion,expectancy,or remainder or over which I may have
any power of disposition or appointment, and wheresoever situate in equal shares, share and
share alike to JENNIFER DOMVILLE,ANDREW HERBER,AND MARSHA HERBER
If any one of them does not survive me then the share that he or she would have received shall be
divided equally between the survivor or survivors of the above named individuals.
FOURTH
If any person entitled to receive all or a portion of any distributive share of my estate
pursuant to any provision of this Will shall not have attained the age of 21 years at the time
designated for such distribution,then such share shall be distributed to a custodian for such
beneficiary selected by my personal representative. The share shall be held by and administered
by the custodian pursuant to the Maryland Uniform Transfer to Minors Act until such descendent
attains 21 years of age or dies prior to attaining 21 years of age. The selection of a custodian as
provided hereunder shall be within the sole and absolute discretion of my personal
representative. Its exercise of discretion shall be sole and absolute and its selection of a
custodian shall be final and binding upon all persons interested in my estate and all other persons
whomsoever.
FIFTH
A. I constitute and appoint my husband,NATHAN ALLEN HERBER, to be the
Personal Representative of this my LAST WILL AND TESTAMENT. If he is unable or
unwilling to qualify,I appoint my father-in-law, GREGORY ALLEN HERBER, to be the
Personal Representative. If he is unable or unwilling to qualify,I appoint MARSHA HERBER
to be the Personal Representative. I direct that my Personal Representative be excused from the
necessity of giving bond.
B. In addition to all other powers,duties and discretions granted to or imposed upon him
by law,my Personal Representative shall have particularly the power to invest and reinvest,sell,
assign,mortgage,exchange,lease,transfer or otherwise dispose of all or any part of my estate,all
in his sole discretion without application to,the approval of,or the ratification by,the court
having jurisdiction over the administration of my estate.
Page 2 of 3
IN WITNESS WHEREOF, I have hereunto signed my name this Iy day of
IV() 2007.
IrlA4�
CORINNE MARIE HERBER
The foregoing instrument was signed,published and declared by CORINNE MARIE
tom"' HERBER,the testatrix above named,as and for her LAST WILL AND TESTAMENT(and
also each of the preceding pages was initialed by her)in the presence of both of us,and we,at
the same time,at her request, in her presence,and in the presence of each other,hereunto
subscribe our names as attesting witnesses.
Address: 1
Address:
r� 506 JU0
Page 3 of 3
16 . 79 +
16 . 71 =
Asset
Management
33 . 50
PO Box 219711
Kansas City,MO 64121-9711 May 19,2014 3 3 . 5 0 /
2 . 00 =
TROUT EBERSOLE&GROFF LLP ---------------
ATTN JUDITH L HOAR
16 . 75
1705 OREGON PIKE
LANCASTER PA 17601-4201
16 . 75 x
84 . 569 =
---------------
1, 416 . 53
REFERENCE: 12775860
Goldman Sachs Mutual Funds
State Street Bank and Trust
Corinne Shelley
Dear Ms. Hoar:
We are writing in regard to the above referenced account.
The following information is in response to the inquiry regarding the Estate of Corinne Shelley.
The account referenced above was established on December 31, 1999.
The date of death value for the Roth IRA account number ending in 1785 on October 18,2013, was$1,413.15. The
account value is calculated by multiplying the number of shares held,84.569, by the Net Asset Value(NAV)per
share, which was$16.71 on this date.
The date of death value for the Roth IRA account number ending in 1785 on October 21,2013,was$1,419.91. The
account value is calculated by multiplying the number of shares held, 84.569,by the Net Asset Value(NAV)per
share,which was$16.79 on this date.
As October 19,2013,was not a business day, the preceding and following business days' values are provided.
The account statements for the account will be sent under separate cover once available.
If you have any further questions,please contact Goldman Sachs Funds at 1-800-526-7384,Monday through Friday
between the hours of 7:OOAM and 5:30PM CT.
Sincerely,
Goldman Sachs Funds
www.GoldmanSachsFunds.com
Goldman,Sachs&Co.,member FINRA
PMA account 2197283720 ■ October 1,2013-October 31,2013 ■ Page 5 of 10
Wells Fargo° Essential Checking
Activity summary Account number: 1010008810621
Balance on 10/1 9,072.23 CORINNE M HERBER
Deposits/Additions 1,666.71 Wells Fargo Bank, N.A.(Member FDIC)
Withdrawals/Subtractions -52.50 Pennsylvania account terms and conditions apply
Balance on 10/31 $10,686.44
Questions about your account: 1-800-742-4932
Worksheet to balance your account and General
Statement Policies can be found towards the
end of this statement.
Transaction history
Deposits/ Withdrawals/ Ending Daily
Date Description Check No. Additions Subtractions Balance
Beginning balance on 10/1 9,072.23
10/1 US Treasury 312 Xxciv Sery 100113 Corinne M Shelley 401.31 9,473.54
10/11 ATM Withdrawal-10/11 Mach ID Sas201 M&T 1415 South M&T 50.00
Bank Mechanicsbur PA 1016 00463284465879596
10/11 Non-Wells Fargo ATM Transaction Fee 2.50 9,421.04
3 SSA Trees 310 Xxsoc Sec 102313 Xxxxx2727A SSA Corinne M 1,265.40 10,686.44
Shelley
Ending balance on 10/31 10,686.44
Totals $1,666.71 $52.50
147665
PMA account 2197283720 ■ October 1,2013-October 31,2013 ■ Page 4 of 10
Did you know that you can review your safe deposit box information through Wells Fargo
Online Banking?Sign on to online banking and go to your account summary page. Check it out
today.
PMA° Premier Checking Account
Activity summary Account number: 2197283720
Balance on 10/1 100.01 CORINNE M HERBER
Deposits/Additions 0.00 Wells Fargo Bank,N.A.(Member FDIC)
Withdrawals/Subtractions -0.00 Pennsylvania account terms and conditions apply
Balance on 10/31 $100.01 Questions about your account: 1-800-742-4932
Worksheet to balance your account and General
Statement Policies can be found towards the
end of this statement.
Interest you've earned
Interest paid on 10/31 $0.00
Average collected balance this month $100.01
Annual percentage yield earned 0.00%
Interest paid this year $0.01
147664
PMA account 2197283720 ■ October 1,2013-October 31,2013 ■ Page 6 of 10
Did you know that you can review your safe deposit box information through Wells Fargo
Online Banking?Sign on to online banking and go to your account summary page. Check it out
today.
Wells Fargo Money Market Savings SM
Activity summary Account number: 3064519477
Balance on 10/1 706.58 CORINNE M HERBER
Deposits/Additions 0.03 Wells Fargo Bank, N.A.(Member FDIC)
Withdrawals/Subtractions -0.00 Pennsylvania account terms and conditions apply
Balance on 10131 $706.61
Questions about your account: 1-800-742-4932
Worksheet to balance your account and General
Statement Policies can be found towards the
end of this statement.
Interest you've earned
Interest earned this month $0.03
Average collected balance this month $706.58
Annual percentage yield earned 0.05%
Interest paid this year $0.35
Transaction history
Deposits/ Withdrawals/ Ending Daily
Date Description Additions Subtractions Balance
Beginning balance on 10/1 _706.58
10/31 Interest Payment 0.03 706.61
Ending balance on 10/31 706.61
Totals $0.03 $0.00
Online and Telephone Transfers from a Savings Account May Be Declined
Beginning December 11,2013,transfers from this savings account through online banking(including mobile and
text)or by telephone may be declined for the remainder of the monthly statement period if the federal limit of six(6)
transfers is reached.We are taking this step to help customers stay within the federal limit.
As stated in your Account Agreement, most transfers from savings accounts are limited by Regulation D to six(6)per
month including transfers for overdraft protection coverage,online banking,or by telephone(automated and
banker assisted). If the limit is exceeded,an excess activity fee applies and the account may be converted to a
checking account.
There are no limits on transfers or withdrawals made in person at ATMs or Wells Fargo banking locations or on any
types of deposits.
If you have questions, please contact your local banker or call the phone number on the top of your statement.
147666
PMA account 2197283720 !m October 1,2013-October 31,2013 ■ Page 8 of 10
Wells Fargo° High Yield Savings
Activity summary Account number: 6199722999
Balance on 10/1 15,086.34 CORINNE M HERBER
Deposits/Additions 1.02 Wells Fargo Bank, N.A.(Member FDIC)
Withdrawals/Subtractions -0.00 Pennsylvania account terms and conditions apply
Balance on 10131 $15,087.36
Questions about your account: 1-800-742-4932
Worksheet to balance your account and General
Statement Policies can be found towards the
end of this statement.
Interest you've earned
Interest earned this month $1.02
Average collected balance this month $15,086.34
Annual percentage yield earned 0.08%
Interest paid this year $22.32
Transaction history
Deposits/ Withdrawals/ Ending Daily
Date Description Additions Subtractions Balance
Beginning balance on 1011 15.086.34
10131 Interest Payment 1.02 15,087.36
Ending balance on 10/31 15,087.36
Totals $1.02 $0.00
147668
PMA account 2197283720 ■ October 1,2013-October 31,2013 w Page 7 of 10
Wells Fargo Way2Save° Savings
Activity summary Account number: 3064519485
Balance on 10/1 501.09 CORINNE M HERBER
Deposits/Additions 0.00 Wells Fargo Bank,N.A.(Member FDIC)
Withdrawals/Subtractions -0.00 Pennsylvania account terms and conditions apply
Balance on 10/31 $501.09 Questions about your account: 1-800-742-4932
Worksheet to balance your account and General
Statement Policies can be found towards the
end of this statement.
Interest you've earned
Interest paid on 10/31 $0.00
Average collected balance this month $501.09
Annual percentage yield earned 0.00%
Interest paid this year $0.04
147667
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MARRIAGE SETTLEMENT AGREEMENT
-PREAMBLE-
MADE by and between, Nathan Herber (Husband)
AND Corinne Shelley-Herber (Wife).
WHEREAS, Husband and Wife were married on or about September 26, 2002, and
WHEREAS, Husband and Wife intend to separate, and wish to do so peacefully,
amicably, and
WHEREAS, Husband and Wife intend to resolve fully, finally and completely the
following issues:
N c
c)
Article 1. GENERAL TERMS OF THIS AGREEMENT am
Article Il. MARITAL STATUS rn
o
ren `V r - ,
Article 111. PROPERTY AND DEBTS ' w � Fill
Article IV. INCOMES AND EXPENSES `J
Article V. PROBATE RIGHTS
Article VI. MISCELLANEOUS RIGHTS, RESPONSIBILITIES AND CLAIMS
THEREFORE, intending to be legally bound, Husband and Wife agree to the terms
contained in this Agreement.
r,
initials initials
Page l of 25
Article I. GENERAL TERMS OF THIS AGREEMENT
Section 1.01 Effective Date of Agreement
(a) EFFECTIVE IMMEDIATELY: The terms of this Agreement take effect
immediately when Husband and Wife sign this Agreement.
Section 1.02 Termination of Agreement
(a) TERMINATION: Husband and Wife may terminate this Agreement by
subsequent written agreement expressly terminating this Agreement,
acknowledged by Husband and Wife before a Notary Public. All other forms of
purported termination of this Agreement are waived.
(b) COHABITATION / RECONCILIATION / REMARRIAGE: This Agreement shall
remain'valid and enforceable despite Husband and Wife cohabitating,
reconciling, attempting to reconcile, or the remarriage of Husband to Wife.
Section 1.03 Modifiability of Agreement
(a) FORMAL MODIFICATION ONLY: The terms of this Agreement are modifiable
only by subsequent written agreement signed and acknowledged by Husband
and Wife before a Notary Public. No other purported modification shall be
valid.
(b) NO COURT MODIFICATION: The terms of this Agreement shall not be
subject to modification by any court.
Section 1.04 Persons Obligated;Persons with Standing
(a) BINDING UPON: The terms of this Agreement are binding upon Husband and
Wife, their agents, guardians, personal representatives, heirs and estates. All
references to Husband and Wife in this Agreement shall be deemed to include
their agents, guardians, personal representatives, heirs and estates unless
otherwise noted.
,4?4-initials initials
Page 2 of 25
(b) ENFORCEABLE BY: The terms of this Agreement are enforceable by
Husband and Wife, their agents, guardians, personal representatives, heirs
and estates.
(c) NO ASSIGNMENT: Neither Husband nor Wife shall assign any rights or
obligations arising under this Agreement to any other person or organization.
Section 1.05 Performance
(a) GOOD FAITH: Husband and Wife shall exercise good faith in performance of
all terms of this Agreement.
(b) PROMPT &TIMELY: Husband and Wife shall perform all terms of this
Agreement in a reasonably prompt and timely fashion.
(c) ADDITIONAL DOCUMENTS: Husband and Wife shall sign and acknowledge
before a Notary Public any documents that may be necessary to give full force
and effect to this Agreement.
Section 1.06 Enforcement
(a) IN PENNSYLVANIA: Within the jurisdiction of the Commonwealth of
Pennsylvania, Husband and Wife may utilize any remedy or sanction set forth
in the Pennsylvania Divorce Code and Pennsylvania Rules of Civil Procedure
to enforce this Agreement to the same extent as though this Agreement had
been an order of the court.
(b) OUTSIDE OF PENNSYLVANIA: Husband and Wife intend that this
Agreement shall be enforceable to the fullest extent possible under the
contract and/or domestic relations laws of any jurisdiction where a party seeks
enforcement.
(c) ATTORNEY FEES: If a party finds it necessary or desirable to enforce any .
term of this Agreement in court, and if that party is successful in whole or in
part in that litigation, then the reasonable attorney fees and litigation costs of
the enforcing party shall be promptly reimbursed by the other party.
,C�'initials initials_
Page 3 of 25
(d) WRITTEN DEMAND: Written demand for performance is not required before
seeking enforcement through any court. Reimbursement of reasonable
attorney fees, however, shall not be granted unless reasonable advanced
written notice of intent to seek court enforcement was provided to the party in
breach.
(e) NO WAIVER OF BREACH: The failure of Husband or Wife to demand strict
and immediate performance upon every breach of this Agreement shall not
waive the right of any party to enforce any term of this Agreement.
Section 1.07 Interpretation of Terms
(a) LAW OF PENNSYLVANIA APPLIES: Husband and Wife intend that the laws
of the Commonwealth of Pennsylvania shall be applied to all interpretations of
this Agreement.
(b) COURTS: Husband and Wife irrevocably submit to the jurisdiction and venue
of the Court of Common Pleas of Cumberland County, Pennsylvania—and
waive jurisdiction and venue in all other courts—for purposes of interpretation
of this Agreement. Appellate jurisdiction shall be with the appellate courts of
the Commonwealth of Pennsylvania and the United States Supreme Court.
Section 1.08 Validity of Agreement
(a) PRESUMED VALID: This Agreement shall be presumed valid in any litigation.
(b) CLEAR AND CONVINCING STANDARD OF PROOF: As Husband and Wife
intend this Agreement to fully, finally and completely resolve all litigation
between them, only clear and convincing evidence of invalidity--not
preponderance of evidence—shall warrant invalidation of this Agreement or
any term of this Agreement.
(c) ATTORNEY FEES: If the validity of this Agreement is upheld in court
proceedings, the party who challenged the validity of this Agreement shall
promptly reimburse the reasonable attorney fees of the party who upheld the
validity of this Agreement. CS1�
initials initials_
Page 4 of 25
(d) PARTIAL INVALIDITY: If any term of this Agreement is determined by a court
to be invalid or unenforceable for any reason, the entire balance of the
Agreement shall remain valid and enforceable. The parties intend each term
of this Agreement to be independent of the others.
Section 1.09 Opportunity for Independent Legal Advice
(a) OPPORTUNITY GIVEN: Husband and Wife acknowledge they have had a full
and fair opportunity to obtain independent legal advice concerning this
Agreement, the Pennsylvania Divorce Code, and other applicable law.
(b) WIFE'S ATTORNEY: Wife has been independently advised and represented
by John F. King, Esq.
(c) HUSBAND'S ATTORNEY: Husband acknowledges that this Agreement has
been prepared by counsel selected by Wife, to wit, John F. King, Esq. who has
advised Husband that he has the absolute right to be represented by
separate and independent counsel of his/her choosing to advise him/her in the
within matter, and John F. King, Esq. has strongly recommended to Husband
that he secure said counsel. By executing the within Agreement, Husband
acknowledges that he understands his right to said counsel and has consulted
with said counsel, or is voluntarily choosing not to do so. By executing the
within Agreement, Husband waives any claim for conflict of interest which he
could otherwise assert against John F. King, Esq.
Each party fully understands the facts and his or her legal rights and
obligations, and each party acknowledges and accepts that this Agreement is,
in the circumstances, fair and equitable, and that it is being entered into freely
and voluntarily, and that the execution of this Agreement is not the result of
any duress or undue influence, and that it is not the result of any improper or
illegal agreement or agreements. In addition, each party understands the
impact of the Pennsylvania Divorce Code, whereby the court has the right and
duty to determine all marital rights of the parties, including divorce, alimony,
alimony pendente lite, equitable distribution of all marital property or property
�l
initials initials
Page 5 of 25
owned or possessed individually by the other, counsel fees and costs of
litigation, and, fully knowing the same, each party hereto still desires to
execute this Agreement, acknowledging that the terms and conditions set forth
herein are fair,just and equitable to each of the parties, and waives his or her
respective right to have the Court of Common Pleas of Cumberland County, or
any other court of competent jurisdiction, make any determination or order
affecting the respective parties' rights to alimony, alimony pendente lite,
support and maintenance, equitable distribution, counsel fees and costs of
litigation.
Section 1.10 Integration
(a) All prior negotiations, promises and agreements between Husband and Wife
are merged into and superseded by this Agreement.
Article II. MARITAL STATUS
Section 2.01 Effect of Divorce,Annulment
(a) NO DISSOLUTION REQUIRED: No action for divorce or annulment is
required for this Agreement to be valid or enforceable.
(b) AGREEMENT SURVIVES DISSOLUTION: if a decree of divorce or
annulment is entered between Husband and Wife, this Agreement shall
remain valid and enforceable.
Section 2.02 4ncorporation, Merger
(a) INCORPORATION: This Agreement may be incorporated into any decree for
divorce or annulment.
(b) NO MERGER: This Agreement shall not merge into any decree for divorce or
annulment.
(c) NO PREJUDICE TO ENFORCEMENT: Regardless of whether this
Agreement is incorporated into any decree, Husband and Wife irrevocably
consent to enforcement of this Agreement by the court(s) as if this Agreement
A114- initials initials`1 1\
Pate 6 of 25
were incorporated into the decree of divorce or annulment. A copy of this
Agreement may be attached to any petition for enforcement.
Section 2.03 Grounds for Divorce or Annulment.
(a) NO WAIVER: Husband and Wife intend to reserve any and all grounds for
divorce and annulment under applicable law. Nothing in this Agreement shall
be construed as waiver of any grounds,for divorce or annulment.
Section 2.04 Process.
(a) COMMENCEMENT OF DIVORCE ACTION: Husband anticipates the future
filing of a divorce action under Section 3301(c ) and 3301(d) of the
Pennsylvania Divorce Code, alleging that the marriage of Husband and Wife is
irretrievably broken
(b) COURT: Husband's action will be filed in the Court of Common Pleas of
Cumberland County, Pennsylvania. Neither Husband nor Wife shall file any
action for divorce or annulment in any other court of Pennsylvania or any other
jurisdiction.
(c) Husband shall not file for divorce until twenty-four (24) months after the date of
execution of this Marital Settlement Agreement, unless consented to earlier by
wife. The wife may initiate the filing for divorce at any time. .
Article III. PROPERTY AND DEBTS
Section 3.01 Real Property
(a) 106 Old Schoolhouse lane, Mechanicsburg, PA, 17055, Cumberland County,
Pennsylvania
i) OWNERSHIP: Wife and Husband owned this real property and residence
at the time this Agreement was signed. Neither Wife nor Husband shall
transfer any interest in this real property or residence pending the
distribution or alternate distribution described in this Agreement.
&/)�-initials initials S
Page 7 of 25
ii) ENCUMBRANCES: At the time this Agreement was prepared, this real
property and residence was subject to a mortgage and note with Bank of
America with an outstanding principal balance of approximately One
Hundred Eighty Five Thousand Six Hundred Seventy-four dollars
($185,674). At the time this Agreement was prepared, there were no
other mortgages or liens encumbering this real property and residence.
Neither Husband nor Wife shall permit any other mortgage or lien to
encumber this real property and residence pending the distribution or
alternate distribution mentioned below.
iii) POSSESSION AND OCCUPANCY: Wife shall have the right of
occupancy in the marital residence for a period no shorter than sixty three
(63) months following the execution of this Agreement. The parties further
agree that should any of the following scenarios take place, they will follow
the terms contained therein:
(a) Scenario 1 - Should Husband determine that it is his desire to
depart the marital residence while Wife still resides therein, and
should Wife so demand, then the,house will be immediately listed for
sale, and upon settlement of said sale, Husband and Wife will divide
the proceed/losses thereof on a 50/50 basis. In the event of Scenario
1 above, so long as Wife continues to exercise her right of sole
occupancy of the marital residence, then Wife shall be responsible for
the payment of the mortgage and escrow, homeowner's association
fee, electric, gas, phone/internet, sewer, cable, water and garbage. In
the event that something catastrophic occurs to the residence,
catastrophic meaning an event that occurs outside of the Wife's
control that is greater than $500, the Husband agrees to pay one half
(1/2) the cost of the repair. The intent of this is to cover the cost of
any major HVAC or structural repair that is no one's fault, not to
compensate for acts of negligence.
_&Zfinitials initials C
Page 8 of 25
(b) Scenario 2 - Should Wife depart the marital residence, a certified
real estate appraiser shall be hired to perform an appraisal of the
marital residence. The "value" of the marital residence as determined
by the appraisal shall be reduced by the balance of the mortgage at
that time, and Husband shall pay to Wife one half(1/2) of the"value"
as calculated herein, unless there is a loss. If there is a loss, the Wife
pays the Husband nothing.
(c) Scenario 3: Husband and wife continue to live as housemates:
Husband shall be responsible for all bills and expenses related to the
ownership and occupancy of the marital residence, including, but not
limited to, mortgage and escrow, homeowners association fee,
electric, gas, phone/internet, sewer, cable, water and garbage. So
long as Wife continues to reside in the marital residence, Wife shall be
responsible to pay Husband Six Hundred Fifty dollars ($650) per
month in contribution toward said expenses.
(d) Scenario 4: If scenario 1-3 have not occurred, and should both
husband and wife vacate the property at approximately the same time,
then the property will be listed for sale. While the property is listed for
sale, Husband shall be responsible for all bills and expenses related to
the ownership and occupancy of the marital residence, including, but
not limited to, mortgage and escrow, homeowner's association fee,
electric, gas, phone/internet, sewer, cable, water and garbage. All
proceeds/losses from the home sale will be split 50/50.
iv.) Wife shall be responsible for, and be the owner of, Donald the dog, and
Husband shall be responsible for, and be the owner of, Fred the dog.
v.) So long as the parties continue to reside together in the marital
residence, the parties shall maintain an automobile insurance policy covering
each of the parties' automobiles, and each party shall be responsible to pay
,ol'initials initials_
Page 9 of 25
the portion of the automobile insurance policy premium attributable to that
person's automobile insurance coverage in said insurance policy.
vi.) DEDUCTIBLE EXPENSES: In any given future tax year should
Husband and Wife file separate tax returns, then Husband may claim the
mortgage interest, real property taxes, and any other tax deductible expense
related to the real property and residence except under Scenario 1 above.
Should Husband depart the marital residence and Wife remain then Wife
may claim the mortgage interest, real property taxes, and any other tax
deductible expense related to the real property and residence which is paid
by Wife during such period of time.
Section 3.02 Motor vehicles
(a) Saturn
i) TITLE AND REGISTRATION: At the time this Agreement was prepared,
this motor vehicle was titled and registered in the name of Wife.
ii) LOAN /LIEN: At the time this Agreement was prepared, this motor vehicle
was not subject to any debt obligation.
iii) DISTRIBUTION: Wife shall receive title and registration of this motor
vehicle.
(b) Acura
i) TITLE AND REGISTRATION: At the time this Agreement was prepared,
this motor vehicle was titled and registered in the name of Husband.
ii) LOAN /LIEN: At the time this Agreement was prepared, this motor vehicle
was subject to a purchase money loan. Husband shall be solely
responsible for the payment and satisfaction of all debt underlying this
motor vehicle.
iii) DISTRIBUTION: Husband shall receive title and registration of this motor
vehicle. c
orf initials initials
Page 10 of 25
Section 3.03 Stocks, savings bonds, securities and stock options
(a) ING Direct Stocks and ETF's Account
i) OWNERSHIP AND ORIGIN: At the time this Agreement was prepared,
this account was held as joint tenants with right of survivorship.
ii) NUMBER OF SHARES: There were approximately 54 shares of RWR,
862 shares of SIRI, 125 shares of UNG, 104 of XLF, and 1,511 shares of
YRCW at time this Agreement was prepared.
iii) VALUE: The market value of this common stock varies. This account had
a value of approximately Seven Thousand Two Hundred Forty-eight
dollars ($7,248) at the time this Agreement was prepared,
iv) DISTRIBUTION: Husband shall receive ownership and control of this
stock account.
Section 3.04 Certificates of deposit
None
Section 3.05 Checking accounts and cash
(a) Wachovia Checking Account
i) OWNERSHIP AND CONTROL: At the time this Agreement was prepared,
this account was owned by Wife, and controlled by Wife.
ii) VALUE: This account had a minimal value at the time this Agreement was
prepared.
iii) DISTRIBUTION: This account will remain solely owned by Wife.
(b) M&T Bank Checking Account
i) OWNERSHIP AND CONTROL: This account was owned by Husband
and Wife, and controlled by Husband.
ii) VALUE: This account had a minimal value at the time this Agreement was
prepared.
Wd initials initials
Page 11 of 25
iii) DISTRIBUTION: This account shall be distributed to Husband and
Husband shall have sole ownership thereof. Wife shall execute any
documents required by M&T Bank in order to transfer ownership to
Husband solely.
(c) Other checking account(s) in Husband's or Wife's name
i) OWNERSHIP AND CONTROL: Husband or Wife may own and control
other checking account(s), alone or jointly with other persons.
ii) VALUE: Husband and Wife each waive disclosure and discovery of the
value of any such checking account(s).
iii) DISTRIBUTION: Husband and Wife shall each retain ownership and
control of any such checking account(s).
Section 3.06 Savings accounts, money market and savings certificates
(a) ING Direct Orange Savings Account
i) OWNERSHIP AND CONTROL: At the time this Agreement was prepared
this account was owned by Husband and controlled by Husband.
ii) VALUE: At the time this Agreement was prepared, this account had a
value of approximately Fifty-four Thousand Nine Hundred Seventeen
dollars ($54,917).
iii) DISTRIBUTION: Husband shall transfer to Wife the amount of Thirty
One Thousand Eighty-two dollars ($31,082)
Section 3.07 Contents of safe deposit boxes
None
Section 3.08 Trusts
None
Ald initials initials—
Page 12 of 25
Section 3.09 Life insurance policies
(a) Husband is the owner of a certain term life insurance policy with American
General, policy number YM00411164, with a coverage amount of One Million
Dollars ($1,000,000). Husband shall maintain said policy for the entirety of its
term and shall be responsible for payment of all premiums thereon. Husband
shall name Wife as irrevocable beneficiary of said policy. Husband shall direct
American General to mail a copy of any notice of delinquency of premium
payment directly to Wife.
(b) Husband is the owner of a certain term life insurance policy with American
General, policy number YMD01010355, with a coverage amount of Three
Hundred Thousand Dollars ($300,000). Until such time as Wife's name is
removed from the deed, Husband shall maintain said policy and shall be
responsible for payment of all premiums thereon. Until such time as Wife's
name is removed from the deed, Husband shall name Wife as sole
beneficiary of said policy. Husband shall direct American General to mail a
copy of any notice of delinquency of premium payment directly to Wife.
Section 3.10 Annuities
None.
Section 3.11 Gifts
None.
Section 3.12 Inheritances
None.
Section 3.13 Patents, copyrights, inventions, royalties
None.
Section 3.14 Personal property outside the home
None
Ile initials initials
Page 13 of 25
Section 3.15 Businesses
None
Section 3.16 Employment termination benefits--severance pay, worker's
compensation claim/award
None.
Section 3.17 Profit sharing plans
None.
Section 3.18 Pension plans
Husband is the owner of a certain traditional defined benefit pension plan known as
the "Yellow Qualified Plan". The annuity pension payment from said plan shall be
divided between Husband and Wife on a 50/50 basis. Husband agrees to the
creation and filing of a Qualified Domestic Relations Order (QDRO) or such type of
document as may be required by the Plan Administrator to effectuate such division.
Section 3.19 Defined contribution retirement plans and Individual Retirement
Arrangements
(a) YRC Worldwide Retirement Account
i) PARTICIPANT: Husband participates in this plan incident to his
employment with Yellow Roadway Corporation.
ii) VALUE: The value of this account fluctuates with the market. This
account had a value of approximately Eighty-two Thousand Five Hundred
dollars ($82,500) at the time this Agreement was prepared. Husband
shall not cause the value of said account to diminish before distribution.
iii) DISTRIBUTION: Husband shall take the steps necessary to cause a
rollover of 50% of the holdings in the YRC retirement savings account to
Wife's qualified account, thereby resulting in a 50/50 distribution. Should it
be determined that a Qualified Domestic Relations Order (QDRO) is
required by the account administrator, the preparation cost of said QDRO
shall be borne by Husband.
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Page 14 of 25
Section 3.20 Disability payments
(a) Wife currently receives Social Security Disability payments, which shall remain
the sole property of Wife.
(b) Wife has initiated a review of her Disability Retirement benefit eligibility. Any
payments which may eventually be authorized as the result of such review shall
be the sole property of Wife.
Section 3.21 Litigation claims(matured and un-matured)
None
Section 3.22 Military/V.A. benefits
None
Section 3.23 Education benefits
None
Section 3.24 Debts owed to Wife andlor Husband
None
Section 3.25 Household contents, furnishings and personal property
(a) DISTRIBUTION TO HUSBAND: Husband shall receive ownership and
possession of his clothing, his weights, his golf clubs, and such other personal
items as Wife and Husband may agree.
(b) DISTRIBUTION TO WIFE: Wife shall receive ownership and possession of all
other household contents, furnishings and personal property.
Section 3.26 Liabilities
(a) PERMANENTLY CLOSE CERTAIN ACCOUNTS: Husband and
Wife shall cooperate to permanently close all joint credit card accounts and
authorized user rights shared by either of them.
(b) NO FURTHER CHARGES ON CERTAIN ACCOUNTS: Neither Husband nor
Wife shall make any further charge or draw on any joint credit account, or
initials initials
Page 15 of 25
credit account of the other. if a party does make a charge or draw, then that
party shall immediately reimburse the other party.
(c) ACCOUNTS TO BE PAID BY HUSBAND: Husband shall be responsible for
timely payment in full of all credit accounts in his sole name. Additionally,
Husband shall be responsible for timely payment the balance of the monies
owed on all credit accounts which had previously been held jointly.
(d) ACCOUNTS TO BE PAID BY WIFE: Wife shall be responsible for timely
payment in full of all credit accounts in her sole name.
Section 3.27 Other Property.
(a) Any other property (not already identified) including, but not limited to, lottery
winnings, that meets the definition of marital property (as that term was
defined under Pennsylvania law at the time this Agreement was signed by the
parties) not expressly divided and distributed between Wife and Husband in
this Agreement shall be equally divided and distributed between them.
Section 3.28 After-Acquired Property.
(a) Except as specifically provided to the contrary elsewhere in this Agreement,
Husband shall receive exclusive ownership, possession and control of all
property acquired by him on or after the day he signs this Agreement.
(b) Except as specifically provided to the contrary elsewhere in this Agreement,
Wife shall receive exclusive ownership, possession and control of all property
acquired by her on or after the day she signs this Agreement.
Section 3.29 Equitable Division of Marital Property Intended.
(a) The preceding terms are intended by Husband and Wife to be an equitable
division, distribution or assignment, in kind or otherwise, of all marital property
between the parties.
(b) Unless specifically designated as support, alimony pendente lite or alimony, all
transfers of property and money between Husband and Wife in this Article are
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intended to accomplish a distribution of marital property. Such transfers are
not intended to be taxable to, or deductible by, either party.
Section 3.30 Disposition of Property.
(a) Husband shall have complete freedom to mortgage, sell, grant, convey or
otherwise encumber or dispose of said real and personal property, except as
restricted in paragraph 3.01 herein.
(b) Wife shall have complete freedom to mortgage, sell, grant, convey or
otherwise encumber or dispose of said real and personal property, except as
restricted in paragraph 3.01 herein.
Section 3.31 Waivers
(a) INTENTIONAL AND CAREFULLY CONSIDERED: The intent of Husband and
Wife in making the following waivers is to accept the terms of this Agreement
in lieu of litigation. Husband and Wife acknowledge that the following waivers
are intentional, carefully considered and appropriate under the circumstances.
(b) SPECIFIC WAIVERS: Except as expressly provided elsewhere in this
Agreement, Husband and Wife forever waive:
i) DISTRIBUTION OF MARITAL /COMMUNITY PROPERTY: Husband and
Wife are satisfied with the distribution of property under this Agreement,
and therefore forever waive their respective rights to distribution and
division of their property under the laws of any jurisdiction. Husband and
Wife forever waive all claims to distribution and division of marital property
under the laws of Pennsylvania and any other jurisdiction. Husband and
Wife forever waive all claims to distribution and division of community
property under the laws of any jurisdiction. Neither Husband nor Wife
shall file or maintain any action against the other for distribution and
division of property except to enforce the terms of this Agreement.
ii) INVENTORY AND APPRAISAL: Husband and Wife are satisfied with the
disclosures and valuations of property in this Agreement, and thereforeL4��initials initials
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forever waive their respective rights to obtain further disclosure or
valuation of property under the laws of any jurisdiction. Husband and Wife
waive the right to compel filing of inventory and appraisement forms under
Pennsylvania law, and discovery of the extent and value of property under
the laws of any other jurisdiction.
iii) FORMAL DISCOVERY: Husband and Wife are satisfied with the
disclosures and information provided about property in this Agreement,
and therefore forever waive their respective rights to formal discovery
concerning property under the laws of any jurisdiction.
iv) FURTHER INFORMATION: Husband and Wife are satisfied with the
information provided about property in this Agreement, and therefore
forever waive their respective rights to obtain further information
concerning property—except as expressly provided in this Agreement.
v) INVESTIGATION: Husband and Wife each represent on their own behalf
that he or she has had a full and fair opportunity to make whatever
investigation her or she deems necessary concerning property.
Therefore, Husband and Wife forever waive their respective rights to
further investigate property.
vi) DIVISION OF ENTIRETIES PROPERTY: Husband and Wife forever
waive all claims to division of entireties property between divorced
persons.
Article IV. INCOMES AND EXPENSES
Section 4.01 Spousal Support
(a) Husband shall pay to Wife as spousal support the amount of Two Thousand
Two Hundred Fifty dollars ($2,250) per month beginning upon the date of
execution of this Agreement and ending upon the finalization of the divorce.
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Health insurance will continue to be provided, if necessary, for a period of 63
months from the signing of this agreement.. .
(b) It is anticipated that Wife shall no longer be eligible for coverage on Husband's
medical insurance policy after the parties' divorce is finalized.
Section 4.02 Health Insurance.
(a) At the time this Agreement was prepared, Wife did not participate in any health
insurance plan other than that provided to her through Husband's
employment, and Medicare (Part A). Husband shall be required to continue to
provide health insurance (including dental and vision) coverage for Wife for 63
months from the date of signing of this agreement, as outlined above. Upon
the finalization of the divorce, Husband will be responsible to provide
continued health insurance coverage (including dental and vision) to Wife until
the conclusion of the 63 month period that begins with the date this agreement
is signed. The health insurance coverage (including dental and vision)
provided by Husband to Wife during said period shall be at approximately the
same coverage levels as that which existed on the date of the finalization of
the divorce, and further may be provided to Wife by way of COBRA coverage
at Husband's expense. The husband will continue to pay for comparable
health insurance both in quality and cost should the wife need health
insurance beyond COBRA, until the conclusion of the 63 months from the date
the agreement was signed. Should the wife remarry and gain health
insurance from her new husband, all obligations to provide health insurance
are permanently over.
Section 4.03 Health Care Expenses.
(a) Husband shall be responsible for payment of 100% of all unreimbursed
medical bills incurred by Wife until the commencement of the payment of
spousal support as outlined in Section 4.01 herein. Wife shall be responsible
for payment of 100% of all unreimbursed medical bills incurred by Wife after
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the commencement of the payment of spousal support as outlined in Section
4.01 herein.
Section 4.04 Alimony Pendente Lite.
(a) Though Wife may otherwise be eligible to claim alimony pendente lite from
Husband due to the difference between their respective incomes, Wife is
willing to waive this claim in consideration of the other terms of this
Agreement. There shall be no alimony pendente lite for Wife. Wife shall not
pursue any claim for alimony pendente lite against Husband.
Section 4.05 Alimony
(a) Upon the finalization of the divorce, Husband shall pay over to Wife as alimony
the monthly amount of Two Thousand Two Hundred Fifty dollars ($2,250)
until the end of the 63 month period that begins the date this agreement is
signed..
Section 4.06 Attomey Fees and Expenses of Litigation
(a) WIFE'S ATTORNEY FEES AND EXPENSES RELATING TO THE MARITAL.
SETTLEMENT AGREEMENT AND OTHER DIVORCE MATTERS: Husband
shall bear all attorney fees and expenses incurred by her (except as provided
in Section 1.06 and 1.08 of this Agreement) without contribution from Wife.
(b) HUSBAND'S ATTORNEY FEES AND EXPENSES RELATING TO THE
MARITAL SETTLEMENT AGREEMENT AND OTHER DIVORCE MATTERS:
Husband shall bear all attorney fees and expenses of litigation incurred by him
(except as provided in Section 1.06 and 1.08 of this Agreement) without
contribution from Wife. Husband shall not pursue any claim for attorney fees
and expenses against Wife (except as provided in Section 1.06 and 1.08 of
this Agreement).
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Section 4.07 Waivers
(a) INTENTIONAL AND CAREFULLY CONSIDERED: The intent of Husband and
Wife in making the following waivers is to accept the terms of this Agreement
in lieu of litigation. Husband and Wife acknowledge that the following waivers
are intentional, carefully considered and appropriate under the circumstances.
(b) SPECIFIC WAIVERS: Except as expressly provided elsewhere in this
Agreement, Husband and Wife forever waive:
i) All claims for spousal support and collection of arrears.
ii) All claims for alimony pendente lite and collection of arrears.
iii) All claims for alimony.
iv) All claims for counsel fees and expenses of litigation.
v) All claims for health and hospitalization insurance.
vi) All claims for health care expenses and collection of arrears.
Section 4.08 Cohabitation
(a) Husband's obligations to Wife spousal support and/or alimony shall
immediately cease upon the event of Wife's remarriage.
Spousal support, health insurance, health care expenses, alimony, and
attorney fees and expenses, shall not terminate upon Wife's cohabitation
with a third party. The parties hereby confirm that they have negotiated their
overall agreement based upon the fact that Husband's financial obligations to
Wife as established herein are not modifiable, and it is their specific
agreement and understanding that said financial obligations shall not be
subject to downward modification by any Court, as to either duration nor
amount, except that either party shall have the right to file for a modification
of the financial obligations created herein in the event that either party suffers
a significant reduction in their earning capacity which reduction is not caused
by their own action or inaction. Additionally, the parties agree that if the Wife
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loses Social Security Disability they have the right to file for modification
concerning the spousal support/alimony amount.
Article V. PROBATE RIGHTS
Section 5.01 Family Exemption
(a) Husband irrevocably and forever waives his right to claim any family
exemption against Wife's estate. Husband shall not make such claim.
(b) Wife irrevocably and forever waives her right to claim any family exemption
against Husband's estate. Wife shall not make such claim.
Section 5.02 Intestate Share
(a) Husband irrevocably and forever waives his right to claim an intestate share of
Wife's estate. Husband shall not make such a claim.
(b) Wife irrevocably and forever waives her right to claim an intestate share of
Wife's estate. Wife shall not make such a claim.
Section 5.03 Elective Share
(a) Husband irrevocably and forever waives any claim to an elective share of
Wife's estate. Husband shall not make such a claim.
(b) Wife irrevocably and forever waives any claim to an elective share of
Husband's estate. Wife shall not make such a claim.
Section 5.04 Claims Against Estate of Other
(a) Except for enforcement of the terms of this Agreement, Husband irrevocably
and forever waives any claims against Wife's estate.
(b) Except for enforcement of the terms of this Agreement, Wife irrevocably and
forever waives any claims against Husband's estate.
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Article VI. MISCELLANEOUS RIGHTS, RESPONSIBILITIES AND CLAIMS
Section 6.01 Personal Rights
(a) Neither Husband nor Wife shall abuse, threaten, interfere with, stalk, harass,
attempt to control or disturb the other or the families of the other.
(b) Without otherwise limiting their respective remedies under applicable law,
Husband and Wife submit to injunctive relief as a remedy for breach of this
term.
Section 6.02 Income Tax filings;records
(a) REFUNDS AND LIABILITIES ARISING FROM JOINT FILINGS: Any past or
future income tax refunds or liabilities arising from joint filings shall be shared
by Husband and Wife in proration to their incomes reflected on the applicable
tax return.
Section 6.03 General Release of claims
(a) Husband quit claims and forever releases to Wife any and all other claims of
any kind he may have against her. Husband grants Wife an unconditional
release of any and all claims except as expressly provided in this Agreement.
Husband shall make no claims against Wife except to enforce the terms of this
Agreement.
(b) Wife quit claims and forever releases to Husband any and all other claims of
any kind she may have against him. Wife grants Husband an unconditional
release of any and all claims except as expressly provided in this Agreement.
Wife shall make no claims against Husband except to enforce the terms of this
Agreement.
It is the general premise of this agreement to have the wife protected and supported
both financially and with health insurance for a period not to exceed 63 months from
the date of signing of this agreement. All time frames that are in the above
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arrangement regardless of whether it is called spousal support' or 'alimonyshall
end at a maximum of 63 months from the date of signing of this agreement.
IN WITNESS WHEREOF, Husband and Wife have signed their names below:
v Date: I a - a
Corinne Shelley-Herber
Date:
Nathan Herber
Notary on following page
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