HomeMy WebLinkAbout04-15-15 � 1505610143
REV-7 500 ",°_,,, �
OFFIGIAL USE ONLY
PADepartmentofRevenue pennsypvania co�mvcoae rear Faeeumbe�
Bureau of Individual Taxes '"TM`x "`"""`
ao eox.zaasoi INHERITANCE TAX RETURN 21 14 0755
Harrisburg.PA n120-o60t RESIDENT DECEDENT
ENTER DECE�ENT INFORMATION BELOW
Social Sewrity Number Da[e of Oeath Da[e of Birth
07 18 2014 O1 10 1916
Oecetlenfs Las�Name SuBix DecetlenPs First Name MI
HOLLER KERMIT W
�It Appllcable)Ente�Surviving Spouse's Intormation Below MI
Spouse s Las�Name Suffix Spouse's First Name
Spouse's Social Sewriry Number THIS RETURN MUST BE FILE�IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW Remaintler Rewm(oa�e ot DeatM1
�x� � OriginalReWm L I 2 SupplemenUlReWm ❑ 3� ptlor�o4-13d0)
LimitetlEstale a Fw�remiere:icomv�omise 5. FeaeralEstateTaxReWmReqmretl
4 �� 4 � (eamotaeemaXerl2-@Asl '—
nereaamoieaies�e�a �. Pqe��apy�oii"�ia�uomqrrm� _ _ g_ totalrvumcerolsateoepositeoxes
XI 6� IPtlaUCopVbWlll) �. .
- e. 00eanonamceeesRecelvaa � � +o.e�"�d"rz"ii54dan�os��o.a�n I-I n.qnacn6enea°ieo{s� siiorA7
CORRESPONOENT-TNISSECTIONMUSTBECOMVLETED.ALLGONRESPONOENCEANUCONFIDENTIADaylimaTelepho eNumbe0E01REGTE�TO:
Name
MICHAEL L BANGS 717�730 73�'0 ,p m
c�
REc,�re�oF wi�usr,-�r�
�'1 S c7 � 0
� � r �-+ nm
Firs[LineofAtldress � � n � '�� �J
� Gp
429 SOUTH 18TH STREET i; c ,� 3 "'_ _
� _. �
Sewntl Line of AdAress > �— N ^ m
_,� r o
� ' DATEFIL � -r�
Ciry or Posl Office SWte ZIP Gode
C�I� HILL PA 17011
corre:ao�aoorsa-ma�iaaare�s: mikebangs@verizon.net
Unaerce^altleso�ce�lury.laedarePatlnav¢�ex�aminMinisreWm,indutlingacmmpanyinqunetlulesends�atemenis, nabinebestofmyknowleageantlbeliel.
I�rsWe,correCtantlwmplete.0eClaraGonof arerotM1er�M1an��epef50nalRpre5en�2tive1sba5eJonalllnformaYono�wM1lcM1pRparerM1OAiEyknowletlge.
$IGNAiV�ERSON RESPON516LE FOR FILING REiORN
[aA%i //— .� Oy_/3-QO/s
�R�r•••v Michael A. Homse
nooaEss
1240 East Lisburn Road Meehaniesbur PA 17055 oare
61GNPNRC�OFP�AAEpOTMER NftEPREBENTATNE u
!�n n.r / / Michael L. Bangs / '/d -ac,�
(r� a v�t Z ��
Aooaess
429 South 18th Street,Cam Hill, PA 17011
Side 1
L 1505610143 1505610143 �
�
J 1505610243
REV4500 EX DecedenPs Social Seari[y Number
oe�ae��r..,ama. Holler, Kermit W. .189 18 7327.
- . __. .__ . .-_ _.. .
.. . . _.. . - ..
RECAPITULATION
t. fiea�estate(ScheEWen)........ ..___. ...____ �. 179 � 665 . 06
2. StocksantlBonds(ScneauleB) _... . ._..__. 2. 8 , 084 . 74
3. Closely Held Corporalion.Patlnership or Sole-0ropnetorship(Schedule C)......... 3.
4. Motlgages 8 Notes ReceivaEle(Schedule D)... ��---�- ----- 4�
5. Cash,8ank0epositsBMiscellaneousPersonalProperty(SchetluleE)....___..... 5.
133, 036. 21
6. Join�ly Ownetl PmpeM(Schedule F) �,_ SeOarate BillinG Reques�etl......___ 6.
]. Inter-VivosT�anstersBMlscellaneousry�-PSpaaerB�illnqRepuestetl..__...... Z 974 , 436. 13
(ScnedulaG) --
8. ToGI Gross Asse6(total Lines 1 �hrough])... �......_.. -���- 8. 1 .29� .ZZZ . 14
. . . - - __. . . . . - _- 9. .._ � 34 ,736 . 83
4 PoneralExpensesandAtlminisVativeCosts�5chetluleH).__.... .��--
10. DeblsofDecetlenCMortgageLiabililiesantlLiens(Schedulel)_.._........_.__.....
. �o. 9 ,467 . 68
11. TOWIDeductions(rotalLines9antl10).....__ __._.... ...___ ��. 39�204 . 71
12. NetValueofEslalelLine6minusLinell)..._ ._.._... .__.... 12. 1 �251 � 017 . 43
�3. GharifableantlGovemmentalBequeslslSec9113Tmslsforwhich 13 1 , 886 . 83
an election to tax has no[been matle(Schetlule J) __._.. �-.��-
14. NelValueSubjecf[oTax(Linel2minu5Line13) ..._._. ___..... 14. 1 ,249, 130 . 60
TAX COMPUTATION�SEE INSTRUCTIONS FOR APPLICABLE RATES � � �
15. Nmount of Line 14 taxable
a�Ue spousal tax ra�e,or
[ransfers untler Sea 9176 �5 0 . ��
(a)(12)X.00
�s. AmountotL'�ne�ataxable 1 �pqg� 130 . 60 �6. 56�210 . 86
at lineal rate x .045
1]. AmountofLinel4�axable 0 . 00 iP. 0 . 00
at sibling ra�e X.12
18. AmountofLinel6taxable Q QO 18 0 . 00
at collateral rate X.15
�9 56,210 . 86
19. TAXDUE_ ._... ._...._ _........ .._..... ..___.
20. FILL IN THE OVAL IF VOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. �
Side 2
L 150561�243 150561�243 �
REV-1500 E%Page 3 File Number 27-'14-0755
Decetlent's Complete Address:
DECEDENT'SNAME
Holler, Kermit W. .. . _ . —. -- � —
STREETAODRESS �� �� �
2925 Maple Roatl .— ... . . — -� -�
__ ..—. .__ _ . . _ ._.. _ . .— — . . ._ _
CITV — ��-� � �� . . STATE �ZIP
CampHill PA �����
Tax Payments and Credits:
��� 58,210.88
1. Tax Due(Page 2.Line 19) �-- � —
2. Cretli�s/PaymenLs
A. PriorPayments _ 50,000.00
B. �Iscount � 2.671.58
� Totel CreCl[s(A +B) (Z) _ 52,631.58
(3)
3. Interes[ -� � �
q_ IfLine2isgreaterlhanLinel +Line9,entertheditterence. ThisislheOVERPAVMENL (4) ._ . _
Check box on Page 2.Line 20 to�equest a refund
5. R Line 1 +Line 3 is greater than Line 2,enlerlhe CiHerence. This is t�e TAX DUE. (5) . 3,579.30
Make Check Pa�able to. REGISTER OF WILLS, AGENT
e '-�.n ��� ai5a��a"�t�5.�''`��a.�2.'-._.. .�-:-.yi Y��SuiY'-�r_�i � _ e;.�j. ' .. .. ..
� �PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
Yes No
1. Ditl tlecetlenl make a trensfer anB. - -
a. relainUeuseorincomeoflhepropeeytransferreB,. .....- -- I I C
b. re[ain ihe�ight lo tlesignate who shall use�he pmperty lronsfe�retl or ils mwme __ .- � J
c. retainareversionaryinterest;oc... ._ ___._ . •
d. receivetltepmmiseforlifeofellhe payments,benefisorcare9....__. .-. ...__ , .x�
2. If tlea�h ocwrretl after �ec. 12, 1982, ditl decetlent [rensfer pro0erty w[hm one year of tlea�h without . X
receivingadeQuateconvtlera�on�.__.._ _. -___. ._....._. -�-���- --
l
3. Ditl tlecedent own an"in tmst for' or payable upon tlea[h bank account or security at his or he�tleath?._.._ ��x i,
4. Ditl tlecetlent own an indivitlual reliremen�accoun�,annuity,o�other non-pmba�e property which I Yl r
containsabeneficiarytlesigna�ion9....__ .... ---- -- L
..__. ......_...
IF THE ANSWERTO ANY OF THE ABOVE QUESTIONS IS VES,VOU MUST COMPLETE SCMEDULE G ANO FILE IT AS PART OF THE RETURN.
, -.: f ,<Zw '...«� Ft �s+8 .. .. :`i:a.$. st �'=i%'.' ,x._;� e,. �;:�:....�.
For dates of Eeath on or afler July 1. 1994 antl before Jan. 1 1995,Ihe tax rate imposed on ihe net value of transfers to orfor Ue use ot tM1e surviving
�ouse Is 3 percent[�2 P.6.§911fi(a)(1.1)(I)�.
Po�tlates of death on or aker January 1, 1995,lhe�ax rate imposetl on ihe net value of�rensfers�o or forthe use ot�he surviving spouse is 0 percent
[]2 P.S.§9116(a)(1.1)(ii)]. The slahle tloes not exempt a Iransfer to a surviving spouse from tax,and�he staNtory requiremen[s for tlisclosure of
assels and Flling a tax reWm are still appliwble even i(lhe surviving spouse is�he only benefciary.
Por tlates of death on or afler July 1,2000�.
. Thetaxrateimporsste�harentollNech�ildlsOpercent[]2P55§9116tla)�(j2)j ofageoryoungerattlea[hroarPoriheuseofanaWralparent.an
adoptive paren[, PP
. The tax rate imposetl on ihe ne[value of Vansiers to orfor the use of the tlecedenCs lineal benefmiaries is 4S percenq except as noted in
�I2 P.S.§9118(a)(1)1.
. The tax rate imposed on the net value of transfers to or forlhe use of ihe tlecedenCs si�lings is 12 percen�[]2 P.S.§9116(a)(1.3)�. A
sibling is tlefned untler Sedion 9102,as an intlividual who�as at least one parent in common witlt t�e tlecetlen(whether by blootl or adoption.
Aa.nsaxex.lw io�
SCHEDULE A
pennsylvania REAL ESTATE
oEana*rnErv1 ov aEVENue
INHERITANCE TA%REiURN
RESI�ENT OECEOENf
ESTATE OF FILE NUMBER
Holler Kermit W 21-14-0755
ai re:i crxaem ow»e:a.iy or...rc�.m m�ommo�m�.i o.r�pon.e m�.i.m.n.�..wa.rar mame�.ame��:anmee a:�no aa�a�wn�m prov.nv woma ea
e diangeE Eelwaen a w�1R al pNpe�ViFxlli��111ycwn�etl W�ngM1�o�eunNanY�ip mue��G Ebcl eetl an¢cM1etlula F 9e ol��a ra�avant�acb
prya[��copy ol Me feXlemen\e0w�MN�OropeM�a¢a�n aolE
.. m�ima.=any��<n.a..a.nowma ae�.a.�r.m�..sn now�ee.:a�.m m�ommo�.
VALUE AT DATE
ITEM �ESCRIPTION OF DEATH
NUMBER
� Real ESGte-2925 Maple Road,Camp Hill(Tax Parcel q01-20-1852-193). Soltl on 70128/14 174,665.06
(see HUD attached)
TOTAL IAlso enter on Line 1, Recapitulation� 174,665.Ofi
Qi more space Is neeCeO.aaaitional pages ol V�e same slze7
Copyright(c)2010 form soitware only The Lackner Gmup.Inc. Fortn PA-0500 Schedule A(Rev.014�)
R•�,'�'E'.`�90, gCNEDULE B
STOCKS & BONDS
ESTATE pFpEs�� FILE NUMBER
Holler Kermit W 21-74-0755
wi orcn�M loinny�o.,n.a wnn xene m a�niw�mn mua�ee aiwio.ea an smeam.F.
VALUE AT DATE
ITEM CUSIP DESCRIPTION UNITVALUE OFDEATH
NUMBER NUMBER
� 128.64511 shares of AXA Group 23.625 3.039.24
p 97 shares of MetLife,Inc. 55.445 5,045.50
TOTAL�Also enter on Line 2, Recapitula[ion) 8.084.74
QI more s0ace is neetle0,atltli4onal paqes oi iM1e same siee�
GopyrigM(c)2002 fortn software onty The Lackner Group,Inn Porm PA�150U Schedule B(Rev.6-98)
Rev 1500 EXr�H-00�
SCFIEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
oEraarmErvT or r+EVEH�E
,N„Ea„p,,,�E,�aE,,,a„ PERSONAL PROPERTY
aEsiocrvr oECEOErvr
ESTATE OF FILE NUMBER
Holler Kermit W 21-14-0755
mawa me orar.�aa:onineeeoo e�e me eaia ina vo�m..are rar.�i�ea oyme e:um.
Ni a,ov.M kmny-own.e wnn m.nent m.uM.annin mus�ee ei.�io.sa on:cneam.F.
ITEM VALUE AT OATE
NUMBER DESCRIPTION OF DEATH
7 Automobile-2001 Cadilla<STS;see Bill of Sale aHached 2.000.00
2 Fulton Bank 9,880.82
3 MetLife tlividend 31.85
4 Miscellaneous cash of decetlent 1.669.99
5 PA Oepartment of Revenue-2014 income tax refuntl 340.00
6 PA Employees Benefit Trust Funtl 1,26528
7 PNC Bank-Interest Checking 71.338.93
8 PNC Bank-Premium Money Market 10,756.04
9 Proceeds from sale of miscellaneous property at auction 8,763.98
�0 Proceedsfromsaleofscapmetal �.Z�2.��
71 PSECU -Savings account 16,062.72
72 Refuntl-NutritionAclionHeal[hletter 825
13 Refund for extended warrenty on appliances �39�1�
i4 RefundframAARP �9'23
75 Refund from Belvoir Media Group 74�38
i6 Refuntl(romComcast �Z�.ZZ
TotalofContinuation5thetlule Seeattachetlpage
TOTAL(Also enter on Line 5, Recapitulation� 133,03627
Qi more svace is neeaee,aotli0onal pages of iM1e same slze)
CopyrigM(c)201�Porm sollware onty The Lackner Group,Inn Fortn PA-0500 Schetlule E(Rev. 11-1�)
Rev�1508 E%��111��
SCNEDULE E
pennsylvania CASH, BANK DEPOSITS, 8 MISC.
oevnarmEHrorAevEv�E PERSONAL PROPERTY
INHERITANCE iq%RETVRN
aesmeNr ueceoeur contin ued
ESTATE OF FILE NUMBER
Holler Kertnit W. 27-14-0755
ITEM VALUE AT DATE
NUMBER DESCRIPTION OFDEATH
17 Refuntl from Fagers �4'85
18 Retuntl from Harvard Health Publications 45.95
19 Refund(rom Kay, LLC 5,245.60
20 Refund from PA Employees Benefit Trust Fund 1.032.54
21 Refund fram PP&L Electric(recycling program payment) 35.U0
22 Refund from Public Citizen Fountlation 10.00
23 Refuntl from State Farm Insurance-policy on automobile �43.8�
24 Refund fram Turf Enterprises 76.95
25 Refund from Verizon-(close of account) 102.32
26 Sale of miscellaneous pereonal property to Nedra Marshall 'I,600.00
27 State Farm -insurance company refund(automobile) 43.46
28 State Farm -insuronce coverage �eTund(umbrella policy) 62.61
29 SWte Farm-insurance covera9e refuntl (homeowners) 533.'I6
30 U.S.Treasury �refund oT 2074 income tax '1100.00
TOTAL IAlso enter on Line 5.Recapitulationl 733,036.21
Copyrlght(c)2010 form soRware ony The Lackner Gmup, Ina Po�m PAd50�Schetlule E(Rav-1140)
0.ev-1510 E%�(W L91
SCNEDULE G
pennsylvania lNTER-VIVOS TRANSFERS AND
°E'"R'"E"T°`RE�`��E MISC. NON-PROBATE PROPERTY
NHEA�.AH�E,A.RE,�A�
aEsioeNroEc[oEi+r
ESTATE OF FILE NUMBER
Holler Kermit W 21-74-0755
rn�.,:meam.m�:�oe�moie�ae em maa n me a�s..er�o a�y mq�e:eo�i�mro�n a o�paye mrea a�na aev-isoo��:re�
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH °,+aF oeco's Excwsior+ TA%ABLE
INCLUOENAMEOFiRANSFEREEIHEIRRELAilONSHIGTOOECEOENTANO MTEREST �IFAPPLICA9LE) VALUE
NUMBER TMEDATEOFTMNSFER ATlACNACOPYOFTHE�EEDFORPEALESTATE. VALUEOFASSET
7 Wells Fargo-Brokerage Account 7370-9459;the 329.267.97 329,267.9'I
decedenCs three children are the trensfer on death
beneFlciaries of this accounl.
2 Wells Fargo-Brokerage Ac<ount 5509-65t0;the 6,770.40 6,710.40
tlecedent's grentichildren Jennifer R.Manlove,
Christopher Manlove,Steven 5.SehaRer,antl Lara
Homsey-Messer are the transfer oi death beneflciaries
of lhis account.
3 Wells Fargo-Brokerage Account 2347-9716; Trinity 7.886.83 1.886.83
Lutheren Church is the transfer on death beneficiary
of this account
4 Wells Fargo-Brokerage Account 4373-0643;the 636,570.99 636.570.99
deeedenCs three children are the transfer on death
beneficiaries af this account.
TOTAL IAlso enter on Line 7.Recapitulationl 974.436.73
Qt more space Is neeaed.aatlitlonal pages ot Ne same slze)
Copyright(c)2009(orm soflware only The Lackner Group, Inc Form PA-0500 Schetlule G(Rev.OB-09)
R`""'"".,�°`°, I SCHEDULE N I
pennsylvania
EPAA,ME�.oFaE�E��E FUNERAL EXPENSES AND
'""`a"""`E'""AE'°R" pDMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Holler, Kermit W. 21-14-0755
Decetlent's debts musl be reportetl on Schedule I.
ITEM DESCRIPTION AMOUNT
q, FUNERALE%PENSES:
See continualion schedule(s)attached 17,009.38
g, ADMINISTRATIVEGOSTS:
1. PersonalRepresen�ativesCommissions
Name af Personal Representative(s)
S�reetAddress
City State _ Zio
Year(s)Commission Paid
2.
Atmmev's Fees Michael L. Bangs 14,000.00
3. Famity Exemp�ion' Qf decetlenfs atldress is not Ihe same as claimanfs,attach explanalion)
Claimanl
SUeetAddress
City 5tate _ Zio
Relationshio of Claiman[�o�ecetlen�
420.50
q. Probate Fees
5. Accoun�anfsFees 7,000.00
6. Tax Re�urn Preparei s Fees
8,306.95
]. Other Atlministrative Cosls
See continuation schedule�s) atWched
TOTAL(Also enter on line 9, Recapitulation) 34.736.83
Copyright(c)2009 form so(iware only The Lackner Gmup, Inc Fortn PA-150a Schedule H(Rev. 10-09)
SCNEDULE N
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Holler, Kermit W. 21-14-0755
ITEM DESCRIPTION AMOUNT
NUMBER
F �narai xD 115 �
7 Myers Hamer Funerol Home 70.893.OU
2 TrinityLutheranChurch-funerelreception 116.38
F{_p 1'1.009.38
OtherAdm' istra£vaGoste
3 CommonwealN of Pennsylvania-tluplicate car title fee 50.00
4 Cropf Bros., Inc. -repairs to real esWte prior lo sale 227.65
5 Cumberland Law Journal-estate ativertisement 75.00
6 Gary R.Hunter-deposit for painter to do work at real esfate prior to sale 500.00
7 Gary R.Hunter-work tlone at real estate prior to sale '1,704.00
8 MV Mechanical-'10/9/74 835.00
9 HV Mechanical Services,LLC-work done to real estate prior to sale 2,022.50
10 Keystone Petroleum Equipment,Lttl. -work done at residen<e 2,672.26
17 Mabile Surtace Cleaning-powerv+ash/cleaning of mobile home in Floritla 65.00
12 Oneida5mall-reimbursementforreplacemeneofdiningroomlight $4.�6
13 Powtler Works-Work done at residence prior to sale 477'��
�q Register of Wills-short certiTicates to sell automobiles 20.00
CopyrigM(c)2002 form sottware only The Lackner Group,Ina Form PA-150U Schetlule H(ftev.6-98)
SCNEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Holler, Kermit W. 21-14-0755
NUM ER �ESCRIPTION AMOUNT
75 The Palriol News Co.-esfate advertisemenl 173.78
H_g7 8,306.95
Copyright(c)2002�orm software onty The Lackner Group.Inn Form PA-1500 Schedule H(Rev.6-98)
Rev-051R E%�fl3 09)
SCNEDULE 1
pennsylvania DEBTS OF DECEDENT,
oEPARrMEr+roraE�EH�e MORTGAGE LIABILITIES AND LIENS
INNERITANCE TA%PETURN
AtsioEHro[cEOEHr
ESTATE OF FILE NUMBER
Holler Kermit W 21-74-0755
n.pon a.ore m<��.a ey m.aK.e.m nnono a..m�m�r.m.m.e��pam.un.a.�e oi a..m,m�wams��reime�nae m.ai�.i.:w�.e..
VALUE AT DATE
ITEM DESCRIPTION OF DEATH
NUMBER
1 Andrews&Patel 30.00
2 Camp Hill Borough -sewer 165.00
3 DiscoverCartl 33t67
4 Estero Island Beach Club-maintenance antl Wxes for 2015 1.926.00
5 FloridaPowerBLight-6123/14to7/23/74 �5'�4
6 FloritlaPower&Light-7/23/t4toe/22/74 35.30
7 Florida Power 8 Light-8/22/14 to 9/23/14 37.82
8 FloritlaPowerBLighl-finalbill; 9/23/14to10/15/74 �9'�2
9 Ft. Myers Pest Control 25.00
�0 FL Myers Pest Con[rol-8/8174 ��'��
�1 Ft. MyersPestControl -71H0/74 25.00
12 Gary R.Hunter-work tlone at real estate prior ro sale 370.00
13 PAAmericanWaterCompany-6/10Hbto7/9/14 28'70
tq PAAmericanWaterCo.-7H0/14to8/8H4 26.66
15 PA American Water Company-final bill; 7019/74 to 10/23174 54.46
i6 PennWaste-1011H4to72/31H4 47.55
17 PPBL Electric-fi112/14 to 7/14/14 226.80
Total of Continuation Schedule See anached page
TOTAL(Also enter on Line 10,Recapitulation) 4,467.88
Qf mora svace la neeaea,atlaitlonal Dages o(Ine same size)
Copyrigh[(c)20061orm sokware only The Lackner Group,Inc Fortn PA-1500 Schetlule I(Rev. 12-08)
0.ev 1A2 E%��1I�08�
SCHEDULE 1
pennsylvania DEBTS OF DECEDENT,
oePaarmENroFr+ever+�e MORTGAGE LIABILITIES AND LIENS
INXlRITPNCE TAX kETUftN
aEsioEr�1 oecEOEN* continued
ESTATE OF FILE NUMBER
Holler, Kermit W. 21-14-0755
VALUE AT DATE
ITEM �ESCRIPTION OF OEATH
NUMBER 190 75
18 PPBL EleClric-7/14/74 to 8/12N4
�9 PP&LElectric-8/12H4to9/i1H4 759�37
20 PPBLEIectric-9/17/i4to10/'13/14 77.03
Z� PP&LElectric-10/7S/14to10/24/14 76.68
221.54
y2 Terminix
2015
23 UGI-6/27/74to7/29/74
18.32
24 UGI-7/29/14to8/27/14
�2.67
25 UGI-8/27/'14to9/26/74
72.67
26 UGI-9/26/t4to10/24/14
181.75
27 Verizon-8/20/14
181.75
28 Verizon-9/4/74
TOTAL IAlso enter on Line 10.Recapitulationl 4.467.88
CopyrigM1[(c)2008 form soffware only The Lackner Group, Inc.
Fortn PA-1500 Schetlule I(Rev. 12-OB)
REV-151JE%��Ot-00� I
pennsylvania SCHEDULE J
oEvnarn�Erv.or aEveNUE BENEFICIARIES
INHERITPNCE TM REiURN
ESTATE OF FILE NUMBER
Holler, Kermit W. 21-14-0755
RELATIONSHIPTO SHAREOFESTATEAMOUNTOFESTATE
NAMEANDADDRESSOF �ECEDENT
NIIMBER PERSON(SIRECENINGPROPERTV M�abs1 �$$$1
TAXABLEDISTRIBUTIONS �includeoWrigMspousal
(. tlistribu�ions,antl transfers
untler5ec.9116a 12
Selinda J.Homsey Daughter one-third of
1240 E. Lisburn Raod residue
Mechanicsburg, PA 77055
Nedre Sue Marshall Oau9hter one-third of
7912 Columbia Avenue residue
Camp Hill, PA 77017
Oneida H.Small Daughter one-third of
4577 ManorDrive residue
Mechanicsburg, PA 17055
Total
Enter dollar amoun�s fartlis�ributions shown above on lines 15 thmu �18 on Rev 1500 cover sheet as a ro riale.
NON-TAXABLE OISTRIBUTIONS:
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH FN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE NND GOVERNMENTAL DISTRIBUTIONS �,886.83
1 Trinity Wtheran Church
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV4500 COVER SHEET
1,886.83
Copyrig��(c)2010 form soflware only T�e Lackne�Gmup.Inn Fortn PA-0500 Schedule J(Rev.0140)
� A. SettlementStatement (HUD-1) �MBA°`���a1No250�0265
,�.�
1 Q�HA 2.Q RHS 3.Q Com.Unins 6.FJe Number: ] !oan Number 8 Motlgage"nsurance Case NumOer.
� cni<a�zr< i3o5roizaa
4.Q'dn 5.�Com.ms. � I
C.Nob:Tpbk�misf�misMJlogrveyoueftabmenlofaqualsel�lemm�ws¢.AmcunispakioanEOyt�etetl�emenipyen�sa snownliem¢maM¢E
'�p.o.c�'wC20�bou�SNe��¢Gasingl�peyare[�own�arelorinlormati alpuPos anpy¢nollnGuaeEml�elotab. �
D.Nama&NGtlressolBormwec E.NameBAtltlresso(Seller F.Name@Adtlre55o1Lenoer
iFRYFAANNWONQ4�iCNEL. THEE$l4i_OFF�@MIiNY��ES Ca81lu3yFUny^.COi�9lSfi¢LMMGdSP$
WB)tle�msEnLOlirzil,hvcpnlm.M1C19G92 2925Maple2c.GamOHtl{>aPp:', Senires.PJd.:FeeERomIM429+ALami I
iRoaa,Swie Y'roa �c pGOP
G.PmpertyLoration: H.SetliemeniAgen[ i.Se�tlemeniDa�e:1W2420!a
Y925MAP�EROA�,BOROUGHOFCFlMPHILL XwnesaleSeAiemem5ervi¢s DisbwsememDa:e: 1�G2Lt<
CunPHILL,Ppt]p11 ar�LmmSU:uqo�,5uilel,�.„amsWrg.�a '✓1'�F
CamO Hill Boroug� �
'/1l5)L5d]fi
Piaceol5ememem�. Tlnecxpress
2NHSHome5ae5enicv,JalSMameiSueei,CampHili Prinletl1N23201aai3:51pm
Pp 1+p1 t Oy SH
1U0. Gma�Mmum�wM1omBermvnr ,00. GrwaAmounl0vela5ellar •
10'. Cqnlrap,Wmpxa 15teWW W1. Contra]sa'esprcz �91dp0.Op
102 Pmwnal 902. Gersmal o
f03. SetlkirmitlirgnWponwrerllire1a00) ?k981 �03.
t� �
1 W. 405
M b�lEnq uYvinWvanu qpyyp�enblotllemf iEb aelk�inativance
106. Ciynamimu io a06. f+7ncwn�azes io
1W. Canryiau 1021/A1aw11qt2Jta iY.11 ao1. Counryia`as i1Ra/mlaioilqirzote 195.0
f09. $clqdWes 1M</!pt<bOfi(JWN15 11JB.W <0& $tliwllau ID2<261<Io0fiL10.20t5 iT3963
1W. 6ewx tpR@pldlapql(1p1d 121I5 109. SeNs t0/eNN11io1213L20'a ii3i!
110. iiatr 1p(lYN1AIo1YJ12J1d 91]6 410 Ttash ipM/Atdlol}fJ4A111 3116
ffl fl1
��� 411.
ti0. GmtAmouniPrehaoBortov.e� 1W,A39.% 6t4. GrouMwuniWelnSeller 19I.189.]6
2�. 1�IIIWIIh� Uh1��0�BOfNNPI 514 XWII�{]IIEVI/NpY11I�INb$0�lf
. D�IvweelmawY 5, 00 501. E�wseEeposn(aeelrtsWNon6)
Z2. Prne�elaiwildrcwba^�sl 1iY.150,00 501. SeAk+nenimay�m.wtlerlf A00; �],%9)0
ZA"+. s uMensu ' io Sp3. Eos� s ukensu edia
�. SOC. P dfirsi bw
N5. 505. G dsamrAmM �oa^.
N5 505
fi� `A�
208. SdaAue� 5�2SS.W `.4N. SNkfAssis: S,155]C
�. �
!d' aroritrmeun e seLer qtl'�bpnenlafornamsm iEb seYer
31D. Gryh.xnla� io 51Q. CiyMmu'a b
211. Gpnry�xvp �a 511 CaNylazes la
212. SUiadta�as ro 512. SMadimes 10
PA. SU
2�a. 5u
d15. 515
Z�G 5!6
P9. 51]
P18 518
��9 St9
3�. TohlAtl Botmw� 18t,505.00 510. ioWRMucibnMwunlDueSNler 18.Bi1.10
]00. CMrtBMIMneplmoio9amrwr 6W. Cn�azSAtlementla'homSailer
301. �a��+M��bu+w.mlTmelA) ID0,839.38 �1. GrosSamounlEuetosalerlliire6lJi 193,dB9.16
��. ��^g�M'T�'�^��i^a�) '..82,SOSOp 5p1. 'ured�tims'inm�cuntauesdlttllirrt5201 t881<�0
�o�. wn Ox r� ❑ rem��, �eax.0 so�. e,en � ro ❑ r�omseu., na.ess.a
vre.�ous monsareoosdete vage� oFa nUtri
iW. iahlqwlEsp40mkerFeea EH168.�0 PaitlFrom PaiCFrom ��
xnsbnMmnmiu�wn/4re]W uidbhr. Bo��OwBr'S S¢II¢r's
�oi. u�senas �o c�wnr.r�aiys�«: ��„os ac =�oos ec ;
]02 S5.5g4.3s �o Ba'4snireHavaxayHomeSen� Settlemen[ 5ettlement !
>0.3. CaneasimWEalxRemcnl '.1.t68]0
1W. &CMCF� l0 9eM1snlreNelnawayhome5gnya 215.W
]p5. &okwF& �, Lemm�2ti¢al',�Servims 235.W
EW Nm� •InCennectionxilM1Loui
891. Qnpigna�onqix9e �IncluGesOipiAa�imPpnlp.pJO%w80.9G�, 5955:]C I�rom,GFEM1'�
804. VarveGtacM1arBeDa^�s)faines,xcile�imerwireledwsen S �GomGFEpP��.
8�1 vwraarysietlonAmaAoncnarges (F�mG�Ea� 395.W
000. Appa�sallm 'oM1415,1nc 5500-�PAC:9"UnmGFEi3`
805. Gm�i repat io CreQa Pms �imm GFE M3; a�93
BO6. ivsenice IOGeiewa Feimin OircrsYMMm ;iranGFEk3) 35.W
BW. FbotlsNikafw^� IOLweL ICFpbSenkes 7mmGFEi31 1p.W �
8C'U
9W. MmeR u4eEb LentlxbbePWlnAtivance
9p1. pyryN�deslNayesimm 1N1d/1p1<io11N12p11@S40ASE4tlav ���omGFEM10� �6L.i5
901. Mqtgagelnw2nceD�+um lor nonNs�o tlmnGFE�3;
W3. Hwneanefsinsurnw lorl �¢arsloEnelnsuranw I�maGFEk19 '26.00
90d. monNsla I��omSFEai'
1 .R rM�Lm
1W1 i�16MGepuA�aYWrmppiaonw� S:EU91 � 1,p95<4
1W2Hdneownelzlnsurar�re IRynUs S fi05NmornA St8150 '
����9����H✓M� monUs 5 ]8951imr.N 5 ��
1001. u�es mmNs S mmN '
t0p5.Ccunryiaes 9 ��s 8 BIBLmanN 5190.J8
IOO6.S�M9imes S �Ns S R15.WImmin 51.0]9.&5
1 W).AggR)ale PilWslrtieil S�95fi.T1
HW.iNeGh a
�m�.nu���a�,aersuu�n���e n�o�cFeue•. i�em
+lazsaua,minacvylae io s
110.i.OrmNSlPoelnsurdim-WRepuOikiltN�mura�Cpnpa�y 'hanGFEiS' �'�
�,ia. ie,av:nre��su�z�aaRewoscr�u�ins�a�aco,�o�r si.saux
11p5. LwAm'sMMpoGyluri15P2,250.00 La-dehPN y
1106. Urre's Nk pafvry WM f191.dW.00 Omiefs Policy
iim.na�mr:wro++dmciou�oneiw,m�«w��m siesa.w
io Nmnaie Seulamait Sericev
t1pB. UMvrnnYspMbnd�heldaltik�insumwpwrvum E'✓�6�fi
toON - iitlelruurava
11�
i]W.�venmMNemNN mETrvuNCM n
1POtGpe'iurent�amSugdwges S (ImnGFE� '��
11P1.p¢�fg�.pp Mm 511300 Rtlra�ei
130].imtlxwss 1 pmrGFEtlB? t9ui0
1NC.Gry�Cw�7'�� ]eeiS�.91a.00 S
12[d.5uhiarls�mips JreGSt.91a.W S '.9ta:�G
11U6. �aES f
1100.AtltltlIwWSMWmWC
1 1.f�uuN se�rms tlW yw w'i stup la fl:om GFE D6)
1301 lo
f30.J. Ic
1 .iaCaOfcAm bHamsale5etlbmmi5ervlms 15.
13JS.No�xyFm �oN WEtic �Z.
13p6. 1111d1o1YJ1l1d bL Wl�quyivi 1�.
1WI. m S
i,349.82 13,569.10
'VaE a6qe Mtlmir9 M IBWiw.ar.ISk�",ILI��(�Mvesia.&o(K�r.^Gedi M'�Aa�snv.m m Ga9e I.^Gr�ii M sdis slwxr�m page'.
Pmiws on5a200501eM age 6 HVUt
COm ' alGaotlF�AM1611mebGF anEHU0.1CM n GooEPoiNESGmale NU41
C xTulGnnWMcmu HU61LIneNumber �Sx
aro�nmmcwqe a w• sasx�
YwruednaMaye(ppnbifanliespeaficlntereslralecnosen p B01 C�i� �IX
Yarz4vsb]M9�nauoncha9as a 803 34;J0 3A5W
irai9x�a�es i 1P03 JB18�0 'd'JW
CA ThtlinTahlUnnIXNtrta�eMorti��n10% GootlFeXM1ESOmate HU0.1
C,av�rvre�treo�d^9tl�� p '.N1 '�95.CC '95.W
scc.ec� �:x
nppalsa�ree " B04 ss.x� �3.�
Q4NIrepM pB�S c,�p� 95.W
Taurrire b � �9.W tOW
Motls�lialnn i BG'
i
Y
� B95.W 8&<,93
y Soo>,; s�s:ex
GooaFaiNEstimace Muo-1
C aTh�tGnLM1�n e 1'4i'C i,55Ca
InA9tlap0.dlfpYarasvcwttwuni � I�i 6021 1fiC.A5
Om1YN�ueslAa¢sfrw^ i 9C1 5ffiOSGtiEa �W.W iP6W
HmawnYs Inwra-�m ��3 t b58.-x
T2esaPimsaqle'4a'sWelnswx�m a �IOt 1.01650
sOd W 2?1 W
OMrtlaHtlBlnsWdMR�CWfleW�KT�tlelrtufMSCwnpB�Y C 11W
5
C
Loaniertns
Yw��iniYalbanxmunils :ti1250.JC
Yarbanu'mis �o r�rs
TWlirvAil iIIbPS�fdl¢i5 4'��1
Yw�NNNmonUrya*wnlmrtOMM����nle�lakanYmM9A� 19R531ir�Guda I
'mwrmca��s �X PmaD�
o����
o����,�,�
Cr�yuvintdaNrtlense'1 Q% No. ❑"es,Aca�nse�oama�+muma' % '�efirsirnai9x .
.��pea, , , aq<anoangeayv�nzvery vearsatter � Every
�n�ba�ayw�r tt�a��a�i�guarm�ionareieeiv.eorNy,. � x Ovaxgner�
ina, %
EwnHYwmakeWY�^6m4rta.W�YarloaiGtlaw�rse> Q% W. ❑vo,tl�M1seioartavmumali
Eren�YamIDta��SmVre�rnY��M'noriwatlb 0X W. QVa,MeNatiraaasecm�cem : . armt�e+wnNry .
pvqal.hWeY�ardmM988a��nwakenaei arwnlweEm�nsawf
i Ae ma.imum Aw�e+x rvu�o�is E
o�roraa�n�aav��no�yn' �rro. O��.rW���m�mcrewr�,a,ice���r,.s
�yurpvnl�eaeaENimqaY^a^�' Q� �Y��Ya'�aveaoNiomoeY^Wmofi O�ein
�q :
YW 0�MI itS9 d TTNIy WGx CaY��I�IX i1Pm5�Sufl�d5 M%�M 12a¢5
TOIaImOnWYamwntw9Eirclu6^9esaw'aiwntWY^�6 ��KK�,�ir�wra+x ramusiPaYlMuite'nsaiiacnYYarsaY.
QX YwAavea�aEONa�NmonWYesoo.�'DaYmm'dt3"oG?9
Na12wA51naIdE�nNMmTNIyamWnlP.�NIdStI�.I'1.61 i�is��naWSJ�Wp31.in1961.a
mylgqC�nwRnw aN mY�I¢m5 tlreIXe��e1cw.
o���,�e= o����: �w,�
❑�,�,�.�,� o�� ��
❑ �
Nob: Ityau have anY 9�a0wis aDoul Ne Seltlemen�GM1ar9es an0 Loan ferms luieo on Nis form.please cu�lac�yo�r'�e�Ee�
XU61
Prtvbuz eCitlonz are oEsolNe Vaqe l o <
HUD CERTIFICAT�ON OF BUYER AN�SELLEF
I nM PnNlry 2v�qxpE��e XV�1 SeRbmenl S�a�emenl in0;o�ne CBsI ol my knowlpOge inE�eli¢(II Is a Vue ana a¢wale s:alemenl ol all ie[Cip�s and
G�Owaem�n�i me0e on my itCoun�Oi Oy ma�m l�e:nnfYdiOn I b�Mr q�ily Pal I��vp rpc¢iveE a wpY�I!he MOP1 Se10¢menl5lalemen;
iA�%N WONG MITC�E 1 •""�—
�Y�if,�f� Na�.s�, ea«.
TME ESiAiE OF NERMIi W.HOLLER
iliv HUD1 SetlYnw�SWnml vrfiicM1 I lyw q��rtE i�a hue enE am�rale eccwinl olN4 VanStRion I�ave uumE or will wux��e luntls lo Ce
pieLweeO��YLONBnm MI�Nis sd�emenl.
io/ar/�
$ERLEMEN�AG MLE
WApNINQ R ISR CIUME TO 1lNOWINGLT MV{E FTLSE STATEMENlS TO ME IINITE�STPTES ON TXIS OR ANT SIMILAF FORM GEN.4TIE5 UPON
LOM/ILTION CAN INCWCE A FlNEANO IMPRISONAENT.FOR DEfBILS SEE TITLE 1B:LL5.GOOE SELTION ICp1 hND SELiION tOtO
P2vlousMMonsare0bs0�tte G3qe4o 4 HUtrI
BILL OF SALE
I, MICHAEL A. HOMSEY, Hxecuror of the Estatc of Kermit W. Holler, do hereby sell a
a� 06 / C /i D / L L/'� C ,$7S , Vehicle Identifroation Vumber
�V�;� IG6kY5yfl�VZ9�7v3 to Gury R . f� �nte� _ forthesumof
7�c�Io �iousa�d CnG Oa�/� __($���� Dolla�s.
Date: �
9�2 3� 2C%i�-/ -�C�� �. f�'r°�nec, _
MICH.4FI. A. HOb1SLY
�PNCBANK MEMORANDUM
_-�_ _- ___
To-. Bangs �aw. Office llc
Faontr Michael Free PnoNe�. (_ _-__
Dnre�. October O8 , 2014 Fax�. ;_ j _-_
cc: Enia,�.
RE: eatate of Kermit Ho11er
Dear we�dy K Stracb
Kermit Holler had a PNC a chec:<ing with a ba:ance c_
57:, 338 . 93 and a Money hia.:cet with a ba-�.ar.ce o' S1C', 'So . '�=� a�
the date of his deaCh �uly 18 2C14 . KerR.it Ho__er �.as the only
name on each of these accoun�s. TSe c2ecRine acoon.^.c �.�a- =pe=
on 01-0:-19"78 anfl the 21o�ey '.!a_.�et or ^_9-C8-2J��5 .
Thanxs
Michael eree
PNC Bank
Hamp3e.-, Hrar.ck:
A member oi(�e PNC Financial Services Greop
Dea�
WNNLpnCbank.COC1
PSEC�
�8:�9����4
Bangs Law Office LLC
Michael L. Banes: Esquve
329 5 18'" Svee[
Camp Hill PA 1701 I
- - --- 32c-�IE�RMIF R' lIOL::LEii, Deeeased �
PSECU Refere�ce? 46957382J3629
Dear Anomey tilichael L. Banes:
The above referenced person haz an accowt wi[h PSECIi which was opened on Deczmber'. '_OC3.
The Share accounts w'ere individually held by KERMIT W' HOLLEA.
The following are[he Datz of Dea[h Balances for KERMIT 11�' HOLLER's accoun[with PSECC�.
Accouut DateofDeath Balauces Interest—Joh' I - 18
Savings (Sl) 516.062.7' S 1.19
'@e account haz been closed per Michael A. Homse�: Execu[or�reques[.
If yoo have any questions, please contac[ou�depar[mznt loll-frez at(800) 23%-�323. press 6, exte�sion
3120 or email cco is 'ces n�osecu.com .
Sincereh.
,�iGJCi-L G�-ti.l�
Llsa Carl
Member Service Represen[xice
PSECti
a. o- eoz 5�0 �� 3 �ARRise��3. '� i ' �� o5� �ct3 800337J328 >�psew.mm
INIS CAEDII UNION IS FE�EAALLY INSURED BY iHE NAl10NAl(AEDII IINION FDMINIPPAiION.EQUAI OPPOAiUkIiV LENDEP.
W 1 E ga Ad � ors,LLC
■
� � . 4de
I 6
August 27, 2014
Bangs Law Office, LLC
429 South 18`"Street
CampHiII, PA 17011
RE Date of Death Kermit W. Holler
Dear Attomey Bangs:
Listed below is the date of death values for the above mentioned estate�.
1. Brokerage account 7330-9459 the information you have been provided is corrett except
Oneida's Iast name is Beigh and the date of death value for this account is$329,26791.
2. Brokerage account 5509-6510 the information you have been provided is correct ezcept lara's
last name is Homsey and the date of death value for this a[munt is $6,710.40
3. Brokerage account 2347-9716 the information you have 6een provided is correct and the date
of death value is 51,886.83
4. Brokerage a¢ount 4313-0643 the beneficiaries are Selinda Homsey, Nedra 5 Marshall and
Oneida Holler Beigh and the date of death value is 5636,570.99.
If�can be of further assistance, please give me a call.
f
Since
� L da K.Ne
niorClient 6� te
This repoa is not the official record of your account. However. it has been prepazed to assist you
with your investment planning and is for infortnational purposes only. Your Wells Fazgo
Advisors Client Statement is the official record of your aceount. �Cherefore, if there are an}�
discrepancies between this report and cour Client Stacement, you should rel} on the Client
Statement and call }'our local B[anch Manager with any quesucros. Cost data and acquismon
dates provided by you are not verified by w'ells Fargo Advisors. Transactions requiring tax
consideration should be re�iewed carefully with your accountant or tax advisor. linless
otherwise indicated. market prices/values are the most cecent closing prices a��ailable at the time
of[6is report, and are subject to change. Prices may not reflect the value at �chich securities
could be sold. Past performance does not guarantee future results.
.>�..�..�.�.:.: ..: _ .. . ,.
�������
Memee�FlNM�SiPC
LAST «7LL ati'D TESTA,1tE�T
OF
KERMIT N�. HOLLER
I, KEILbIIT ��'. HOLLER. o�Cumberland Counn�. Penns9�'anie. deda2 diis to
be mc A'�ill and re��oke ail prior AA111z.
FIRST: Tan� ible Pe�sonal Prouertr. I �i�e all of mc ian�ible personal
propett}�, including nm� automobiles, together ���ith all insurance on such pmperty. in accordance
u�i�h a meinorandum 1 ma�� lea��e addressed io my EXecutor. ���hich memorandum reed not be
otfered for probate- Any of my taneible personal propeny [hat u no� effecti�el}� disposed ot b}�
such memorandum. m�erhar with ail insurance on such property, I �ice m m� c;iildren �vho
survlve me. to be divided among them es the�sha;l a�ree. lt there is :�o aereemen�. such
properry shnll be dn�ided amons m} children. in as nearly equal shares �s prnc�icab'.e, as m��
Esecuror. 'm mp Executor's sole discre�ion.deems appropriate- M� F xecutor shal I pag. as an
expense oPsettlin�my estate. [he costs ot packing. sioraee. shippin_ and insurance incurred in
connection «�i[h the distnbution oi[he eifls of taneible personal properry made abo��e-
SECOND: Incan ible Personal Prooenv�. 5[ocks, oonds, e�c., �ot contractually
designated in their respecti��e imestment aaowits as Transfer on Death. I �i�e to my daughrers
in equal shares. per wpi[a. Should all of my daughters predecease me. such Propen}' siiail be
distributed p�.irsuant m Para�raph FOCRTk{
THIRD: Real P�ouarr�� I direct !ha[ �as soon .�s reasorrnbl: eon�eniem after
my death, appraisals be obtained for and «��h respec[ to each propem. C'sing said appraisals as
�uidelines, all such properties shall be sold and the funds divided equall�� amone my three
dau_h�eYs per capita- Should arn�o[nn dau@h:er desire to o�+�n a 2a:ticular p.operr, sha simll
purchase the same ai no more than the appraisal pnce-
FOURTH: Residue: I give, de��ise and beyueath all of the residue of my
estate. of���hatever nature and �vhere�'er simated. [o m}' dau�hters per capita- >�I}� children, all of
«hom ell are no�� li��ing. are- SELIn'DA J. HOYISE}'. pNEIDA H. BEIGH, zmd NEDR4 5-
�L4RSHALL. Shadd none of mti� daughter surei�e me. I gi��e the residue ot my estate to [he
Trinity Ecangelical Lutheran Church. Camp Hill. Pennsyh�aniz.
FIFTH: Trus! Pro�ision< for Certain_ B�neF'����r��s
A- Any� income or pnneipal distributable ro a bene6cizrp ��'ho. In the sole
dere�n�ination of[he Esecuror or Tnistee. is incapacitated, shall be heid in � [rus� fund by the
Ezecutur durin� [he administration of my estate and thereafier by the Trustee- The Executor or
Trusee :na�� apply such amoimts ot ihe inco:u: and principul od�ern'se disvibu:able as [he
Execu[or or Trustee. in nis sole discretion. deems proper lor the support. heal�h. educa[ion and
�relfare of such beneficiary, either b�� direct paymen[ of bills, or bp payments [o such beneficiary.
his or her dul}� appointed �uardia� ot the estate or person, or am person ��'no has the ca�e oc
control oC such beneficia�y. as said Eseaitor or Trustee selee[s,
g. The Execu�or or 'in�stee shull disvibute the balance oi.�rincipal of any
fu:�a iieiC �.n trusi hereunder �o suci� bencficiary� ��hen the beneticisr>. in :he soie detem�ina[ion
of the E�ecutor or Trus[ee. is no lon�er incapaci�ated. If sueh beneficiary dies ��hile
:ncapacitated. distribu[ion shall be made pursuant to paragraph FOURTH.
�. Whene��er. in the sola determivation of the Esecutor or Trustee. am� tund
held in tniit u�ider �his Aiticle FIFTH is or Ims become me small to ���arrant es�ablishine or
continuing such fund in mist, or ia �dministra�ion is or becomes impractieal tior any other
reasor.. tht Esecutor oi Trustee. in the Fstcutor or Ta�s[ee's sole discretion. map pay saeh Eund,
outn_h[,to the guardSan of the estate or person ot the beneficiar� ot sud� fund, ur �o any person
�cho has the care or cuntrol of such benefici��n.
p. Thz Eaecutor or Tniscee shall not be obliged m super�ise or inquire in[o
the application of anv distnbutlons oi income or prineipal made �ander this artiele and the receipt
by a payee designared hereunder shall be a compie[e release of the Executor or Trus:ee.
SIXTH: Pro�ec[i�e Pcovision- .411 pnncipal and ineome shall, until acmal
distnbu[ion to the beneticiary. be free oi the debts. contracts, alienations and an[ic!pacions of any
beneficiary, and shall no; be liable ro an� levy, a[tachme�t, execution or sequestration ���hile in
the hands of my Executor or Trustee.
SEVE.�'I�H: Tax Clause: 4i! es[ate, inheritance, succession and other dea[h
taxes. imposed or payable by reason of m}� den[h. and anp penalties thereoc. ��'i[h re�pect to all
property owned by me at [he [ime of my death and passing under this \k ill or an}� Codicil (the
�'Ta�es"). shall be paid out of the principal of my residuary� estate, as if[he Taxes «�ere
adminis[ration expenses, ��ithout apportionment or nght of reimbursement. The Taxes shall be
paid at such cime or times as my E�ecueor may dezm ad�isable.
EIGHTH: Po�vers of Exec�amr and Tniscee: In addition to the powers given
bv la���, nn� Eseeuror and Tnistee, and any successors, wlthou� an}' order of coun and in the sole
discretion ut the E�ecumr and Trustee. n:a�-
a, Ratain any real or personal proper[q. as lo.i� as deemed advisable.
b_ Invest in any real or personal propert�� in actordance wi[h the
prudent investor ntle.
c. Subscribe for stocks, bonds ur other investmencs�,join in any plan
ot lease. mongage. merser, consolidation. axchanee, reoreanization. toreclosure or
�oung vust and deposi[ securinas thereunder; and generall�� e�zrcise a!I the rights ot
security holders or employees of any corporation.
, e 3-
d- Regisrer securities in the name of�i nominee or In such manner that
[idz will pass by delivery.
e. Ab�e secr�itles in puson or b< pros�. and in s�ch connection
dele�nte discretionary powers.
E Repair. alter. improve or lease. (or am� period of time.any real or
personal propert}�. and ei��e options tor Izuses.
Sell at public or privace saie, for cush or credit. ���idi o� «�ithout
security, escha��ge or partition any real or pzrsonal propem�, and �i��e ophons for sales or
e�chan�es-
h. Bon'ow money from any person. includin� am fiduciary, and
mongage or pledge nny real or personal property.
�,. Dise4aim a�n interest ur po��er �ra�itad to me under an�� ii�stnimcnt
or by opera[ion ot la�+•.
j. Employ invesunent and le�al counsel, accountants, brokers and
� o[her specialisa, and, whenever thzre shali be no corpora[e fiduciar}� i:� oCfice, a
coryorme cusmdian, and compensate ihem xnd reimburse Iheir espenses out of income or
pnncipal or both (in addition �o tiduciary commissions). and deleeate �o im�es[ment
coimsel lineludin, an nccount eseeuu�e at a securrties 6nn) dis-creuo�� ���ith respect to the
im�estman[ and rein�as[men� o�an> or all ot[he assets held here�.in��r.
k. Pay administration expenses, includin�, �+Id1ou. limitation, interest
on death ta.aes ("administration e�penses') from prineipal or income. h�eludin@ income
othenvise payable to charity; proaided, however, that no allocation of admmistrauon
expenses to income shall be made that would precene anp assets from othern�ise
qualityfng for the federal es[aie tax chantable deducuon.
L Cse administration e�penses as deductions tor faderal estate tax
pu[poses or fiducfary income tu� pucposes or panly for each. �vithout makmg adjus[menls
ben�een pnneipal and income ln consequenee of�he e.�ere�se of such d�screuonarv
pow'er.
m, Compromise claims-
n. Dicide any trust hzreunder. «�hich division may be made on a non-
pro rata basis. into [wo or more separate and indeuenden[ vusts .and make any principal
distribu[ions otherwise authorized hereunder Gom :he wsts un a non-pio raia basis-
o. Add ro [he pnncipal ot"any trust created heab�� any property
receiG�ed Gom any person by Deed. ���'411 or in anp other manne:-
p. At any time mer�e any trust hereunder �4'ith an}' other Irust held by
my Executor and Tmstee, �vhether created by me or by any other person by Will or Deed,
_.,. ,. .. _4.
it ihe temis of the trust are then substant�ally similar and hrld for tlie pnman benefit of
the sazne person or persons.
q. Make dis[ributions �vithout the consent of am� beneficiarv. in cash
or in specific property, real or personal. or an undivided interest [hzrein, or panly in cash
and paNy in such properry and do so, zxcep[ as othencisc spzcifically� provided
elsewhere herein, withou� regard m :he income tax basis uCspeciC�c pmpe.ry allocated [o
am benefician� �includin, eiip �rusti '���d ��ithout makine pro raia disuibu�ion ol specific
assets
c Alloca�e basis pursuant to Section 1032 of�he tiiternal Revenue
Code of 1986, as amended. or successor provisions (the "Code')�. provided. ho�sevee. that
such alloca[ion shall be made in a fair and equitable maruier mnon, tht bene8ciaries of
my estare, as my Esecu[or. in my Executor's sole discretion. shall derermine.
;. Exucise all po��er. authorit�� and discreuo:i enan hereby, after the
iermination of any trust creoted herein unlil tlie same Ss t�.dl� disvibuted-
[. Fund or diaide any [rust or trus� share hereunder at anp time into
[wo separa[e trus[s or shaces in order tha� lhe federal genera�iomskippin¢ transter tax
("GST") i�clusion ratio for each trusi or share shall be either 0 or t. and e�ercise ang
discretionary pow'ers over principal or income against either one ur.the other or both oi
the two trusts or shares in sudi mamier as, in the opinion of the Trustee, will lessen
fzdzraltransferta�es.
u. Gi�e am bcnzfician� otany trust ur truse share liereunder. at am
time prior to ihe death ot such benelivap�. a restamentarv generul pow�ec of appoinhnent,
as defined in Seciion '_Udl(b) of ihe Code, o�er all or eny portion of am vust or share
established hereunder for benefi; of such beneficiary i(the possession of such po«�er by
said beneficiary�, in the opinion oCthe Trustee other than such beneficiary, would lessen
federal transfer taxes and be in the best interests of the beneficiary. T'�e Trustee may
give a beneficiary such general pow�er by a wntten notificauon [o such benefidary of
such a���ard. �chich shall contain such inforniation as to the scope ol d�.e eeneral pow�er
and the mediod of its exercise as the Trustee other than such bene5ci;�n shali deem
appropriate. 'Ihe eftec[ive e�ereise ot such power. �o [he exren� oi suc:i e�ercise, shall be
dee�ned �o comrol �he dispusition o�ihe appuinted propert�.
v. To [he estent possible, satisfy any distribu[ion hereunder which
quaGfies for the special genera[ion assienment rule of Section ?65l(el of the Code from
GST non-ezempt assets and divide any tnist hereunder for multipic benefmlanes mto
separate trus[s for one or more of said beneficianes in such a manner �hat certain
dismbutions from one or more oi such trusts ��'ill [hereby be pro[ecteci from GST b�� the
special �eneraiion assigitment rule and mai:e such equit2ble adustntents in :he conm�uine
interests of thz other beneticiaries in the remainine trus[ share or sl:ares as the Trustee
shall deem appropriate.
�c. Make distribunons Cor[he benefit ot skip persons i as defined in
Saction 2613(a) of the Code) [o ���hich [heq are othen�ise entitled hereunder toc medlcal
and tui[ion ezoenses directly to [he pro�ider of cht se���ices and from assets ���hieh are not
GST exempl. if any-
x. Satisfc any transfer u h(ch wuuld odiei��ise be deemed a taxa6le
rertnination, a [axable dfstnbu[ion or a direct skip, for generaciomsklpping transfer tax
pulposes, out of[he principat of such wst share or shares crzated hereunder which are
GST eaempt, and satisf}' any distributions «hfch v:ould not be deemeA a taxable
terminarion. a tasable distnbution or a direct skip, for generavon-skippine transfer tax
purposes, out of che principal ut such wst share or shares created hereunder which are
nor GST exempt. In addi�ion. die Trustee. in the Trustee's sole discretion. may fund one
or more of such mist shares created hereunder for one or more beneficianes wich
disproponionate amoimts of GS1 zxempt or GS? non-zseinpt propertc. Such eywtable
adjustments in the continuine interests of the other beneficianes in the remaming trust
share or shares shall be made under such circumstances as the Trustee shall deem
appropriace.
y. Allocate any ot my federal exempuon from GST. as procided in
Section 2631 of the Code, available at the tlme of my death to am property as to which [
am the tcansferor under the pro�isions ot'Seetion 26�2(a) of the Code_ includfng am�
property transferzed by me duri�g my life. and m elect out ot any deemed allocation or
re�oke anc prior elecuon out.
_Viv Esecuror and Trus[ee may mahe, bu[ shall �ot be reqwred [o make, any
adjustment of the amount distributed to an}' beneficiary who ��ould have received a greatec or
lesser amount i(my Esecutor or7rustee had made a different or conrzary� dec�sion in reference to
anv uf the above inauers. 1 esonerare m}' Executor and Trustee from an�� liabilirv arisine from
¢ny acercise or failure to exercise these powers, prov�ded their actions (or mactions) are [aken in
;ood faith-
For purposes of in[erpretation oi[his docwirent, ��ith respect to a ;ifi to any
descendant of mine, any condition ot sun�ivorship shall be construed [o mean survival by 90
days. and if any such descendant of mine shall fail to surviae me by 90 days, such desee�dan[ of
mine shall be deemed �o have p2deceased me.
_ , . 6-
'.VINTH: Ap^^ltmie�t of Fiducianes�. I appuint my son-imlaw-, MICHAEL
.A- HOMSE1'. Execu�or and Trustee under Ihis ti`ill. Should m)� son-in-lan�. A-SICHAEL .A-
HOMSEY, tor any reason, fail ro qualify or cease to act as such during the administration of my
estu�e. I appoint my grandsun, Sre�'en S. SchafCec Ezecutor and Trastee �nde:[his \b'ill- ��o
Execumr or Trustee appointed herein shall be required to give bond or fumish siveties in any
iurisAiction. Each successor Esecutor and Trustzz appoin[zd as pro�'ided herein shall haae the
same duties, po��°ers and discretion as i(oii�inall}� appoinred.
N �!`IT�ESS w'HEREOF_ [ hs��c hereunto se[ m�� hand and seal this/S��day ot
'�farch. 2006.
� :�;�.—%' - - . (SEALI
h � fI --�tOLLER
SIG'.�ED. SEALED. PLBLISHED and DECLARED by the above named
KERMIT �4'. HOLLER as and for his last ti'ill and Testament. in �I':z presence of us. ��-ho. at his
request. in his przsence and in the presence ot ead�� othec ha�e hereur.:o s�ibszribed our names as
wime�s.
W� � ('°"�' �1 ��,�q
�1�IT\ESS AD—�R�
�� � ( c 7
��..�� �L �L � SIL., << � fi�
vJITSESS ADDRESS
CO?v(MONWEAL'IH OF PENNSYLVAMA �.
ss
COUNTYOF �i�-� ��-%' �
We, KERMIT W. HOLLER. the tes�ator, and ��_ ��-.� �� - '� ���` �
and � - ` �� - � , �hc ��imesses, ���hose names are si�ned [o the
foregoing instrument, beine first dul}' swom, do hereby dedare to the undersi_nzd authonry that
the testator signed and executed the instrument as his Iast Will and that he signed willingly, and
that hz zxecuted it as his free and volun[ary act for the purposes therein expressed, and that each
of the wimesses, in the presence and hearing of the testaror, signed thz �y'ill as a wimess and that
m the best of[he witnesses' kno�+�ledge the testaror �vas at tliat time o��er eiehteen years of age.
of sound mind and under no constraint or undue influence.
�g.;�__,_�- T/l
y� \�'. H6LLER
� �
W imess
�{�,
'"'/ ,C: — � .._. .�.'V
/ l,
W imess
Subscnbed, sworn to and acknowledged before me by KER'v1IT W. HOLLER,
the testato�, and subscribed and swom to before me by L. � � � — � '` i
and - e . i� _ . ' , the witnesses, this��)�ay of March, ?006.
� "�T�d . . � . -
' . � - � Notary Pubuc
� -- � coa+nnoNweur�o� :=:�����,=���N�
� Noranai Seai puaic I
. . KaNy L SPoer.Nda7
. � (ylyOfllansW�9.DauG��nCaunry �
�,�ypn�yiRs N,yr.23.2009 �
e- .nir -$-
MemDer oe n. �- - ` -� "�o�anaz
u
�
�
�� � .�����
�,�c��, �� ���